Definitions and diagnoses matter.
How we define something determines the action we take.
If we develop health symptoms, we try to identify the problem so that we can treat it. If a child develops unusual behavioural issues, we try to understand what is happening so that we can help the child. We understand that treating or masking symptoms does not resolve the underlying condition.
So how is trauma commonly defined?
Some define it as the event.
Some define it as the emotional and physical response to, and lasting effects of, an overwhelming event.
Some define it as trapped survival energy.
Each definition directs us towards a different solution strategy.
If trauma is the event, we focus on what happened.
If trauma is the lasting emotional or physiological effect of the event, we focus on those effects.
If trauma is dysregulation, we focus on regulation.
If trauma is trapped energy, we focus on releasing energy.
An incomplete definition directs us towards an incomplete solution.
We know that the same event affects people differently.
Insight does not complete a defensive response.
People can become highly skilled at regulating their nervous system and still experience the same triggers, anxiety, hypervigilance, avoidance or reactivity.
So what is sustaining the pattern?
Living systems are organised around maintaining functional integrity.
A signal identifies a requirement. Action is organised to meet that requirement. When the action succeeds, the system no longer needs to organise around it.
Thirst signals a need for water. We drink. The requirement is met.
Hunger signals a need for food. We eat. The requirement is met.
Threat follows the same biological logic.
When the nervous system detects threat, it organises defensive action intended to prevent harm, protect us or help us survive.
When that action cannot succeed or complete, the event can end while the defensive response remains unfinished.
This is the definition at the centre of the Biological Completion Model:
Trauma is the persistence of an unfinished biological defensive response.
That definition changes what we look for. The symptoms are not the trauma. They are expressions of the unfinished response.
And the central question changes from: “how do we reduce or manage these symptoms?” to “what is this nervous system trying to do?”
We have spent decades asking, “what happened?”
This definition of trauma also requires us to ask, “what didn’t get to happen?”
Because how we define trauma determines what we try to treat.