Taxonomy
Kinds of trauma
Different injuries ask for different conversation. Type I is not Type II. Combat is not childhood neglect. Collective wounds are not private incidents with extra people. Filter, then open a kind for what helps and what harms.
Single-incident trauma
Lenore Terr, MD, described Type I trauma as a single sudden blow: a crash, an assault, a disaster, a medical catastrophe. Memory is often detailed, sometimes with omens and full-sensory replay. The person may look 'fine' between flashbacks.
Complex / captivity trauma
Judith Herman, MD, argued that trauma held in captivity — abuse that lasts, with no escape — produces a different injury than a single shock: emotion dysregulation, a collapsed self, and ruined relationships. ICD-11 later named this complex PTSD. Christine Courtois, PhD, and Julian Ford, PhD, describe phase-oriented care: safety before story.
Developmental & childhood adversity
Bruce Perry, MD, PhD, maps how early terror and neglect shape a brain in the order it develops: regulation first, then relationship, then reason. Vincent Felitti, MD, and Robert Anda, MD, showed a dose-response between childhood adversity and later health. Nadine Burke Harris, MD, translated that into pediatric practice: toxic stress is medical, not a character problem.
Sexual violence
Herman's early work on father-daughter incest and later on rape placed sexual violence in a frame of domination, not misunderstanding. Roland Summit, MD, described how children accommodate abuse: secrecy, delayed disclosure, retraction. Freyd showed that when the offender is a needed caregiver, not-knowing can be survival. Details are not owed to anyone.
Intimate partner & coercive control
Herman's captivity model fits many abusive relationships: isolation, unpredictable violence, and the destruction of independent reality. Leaving is often the most dangerous period. Conversation that centers 'why don't you leave' recreates the interrogator.
Betrayal trauma
Jennifer Freyd, PhD, argued that the mind may suppress awareness of abuse by someone it depends on. Later work named institutional betrayal: churches, schools, teams, clinics that protect the institution over the person. DARVO — Deny, Attack, Reverse Victim and Offender — is a common counter-move. Conversation that sides with the institution reenacts the betrayal.
Combat, war, and moral injury
van der Kolk's early clinic was full of Vietnam veterans whose bodies still lived in-country. Jonathan Shay, MD, PhD, a VA psychiatrist, named moral injury: the wound when a leader or a war betrays 'what's right.' It is not only fear. It is grief, guilt, and a broken covenant. Civilian chatter about 'heroes' can feel like a muzzle.
Medical & birth trauma
Helplessness in a hospital — restraints, pain, loss of voice, a baby in danger, a body handled as an object — can encode as trauma even when the staff 'meant well.' van der Kolk and Levine both emphasize that the nervous system records powerlessness, not the clinician's intent. Follow-up care that ignores this creates institutional betrayal (Freyd).
Traumatic grief & sudden loss
When death is violent, sudden, or witnessed, grief and trauma braid. Bonanno, PhD, showed that resilience is common in ordinary grief — and that we still pathologize people for not performing sadness 'correctly.' Traumatic loss adds replay, search, and a shattered assumptive world. Do not merge this with a single 'stages' script.
Historical & collective trauma
Maria Yellow Horse Brave Heart, PhD (Hunkpapa/Oglala Lakota), defined historical trauma as cumulative emotional and psychological wounding across generations. Yael Danieli, PhD, documented how Holocaust-affected families transmit both silence and over-disclosure. This is not 'dwelling on the past.' It is a living climate.
Racialized & oppression-based trauma
Resmaa Menakem locates white-body and Black-body trauma in flesh, not only in attitudes. Kenneth V. Hardy, PhD, describes racial trauma as often invisible to the people causing it. Thema Bryant, PhD, insists culture is not an add-on to trauma work. Everyday conversation fails when it treats a hate crime, a stop, or a thousand micro-cuts as 'just stress.'
Displacement, torture, and refugee trauma
Torture is designed to destroy meaning and attachment, not only to cause pain (Herman's captivity frame). Displacement adds loss of language, status, grave sites, and a future. Alexander McFarlane, MD, and others in disaster psychiatry warn that interviews by officials can re-traumatize. Conversation in a new country often happens across power: you have papers; they may not.
Vicarious & occupational trauma
Charles Figley, PhD, named compassion fatigue in those who sit with pain for a living. Nurses, journalists, first responders, lawyers, clergy, and also family members can carry images that are not 'theirs' and a nervous system that is. Bloom's Sanctuary Model treats organizations as able to become traumatized too. 'Just leave work at work' is not physiology.
Early attachment & neglect
Schore, Perry, and van der Kolk all insist that what didn't happen — a face that never came, a crib that was quiet too long — sculpts the brain as surely as a blow. Neglect is often invisible in conversation because there is no incident to point to. Gabor Maté, MD, frames later addiction and illness as adaptations to an early missing of attunement.
Institutional & captivity systems
Hospitals, churches, foster systems, prisons, residential schools, and closed groups can combine betrayal trauma with captivity. Herman and Bloom both warn that 'helping' institutions recreate what they claim to treat. Conversation that defends the brand ('but they do so much good') is not neutral.
Disaster & community shock
Alexander McFarlane, MD, spent a career on bushfires, combat, and the long tail of disaster. After a shared event, people are not on the same clock: some organize, some freeze, some look 'fine' until month four. Community rituals can heal and also pressure people to perform recovery. van der Kolk noted that being with others who went through it can restore a sense of belonging — if no one is forced to testify.