There is no simple way of being sure, and even professionals can have doubts in some cases. However, in many cases the effects of trauma (physical, cognitive, emotional and behavioural – see What is trauma?) are so clear cut that there can be little doubt about the situation. None the less, it is important not to jump to conclusions – these are complex issues, and so we should be wary of oversimplifying them. Trauma produces high levels of distress, and so it can be through recognising signs that a person is distressed that we may come to suspect that a traumatic experience has befallen them. However, this can be misleading at times. I am thinking of situations where someone has experienced an event that is potentially traumatic (being the victim of a crime, for example), but where there is little or no sign of distress. Of course, the fact that distress is not visible does not mean that it is not being experienced – some people prefer to keep their feelings to themselves (perhaps to help them maintain a sense of control). The relationship between distress and trauma is not a simple one. When someone has experienced a trauma, it is likely that that their normal life patterns will be disrupted. Some people will welcome help in such circumstances, while others will not. We should be careful not to try and impose help on somebody who does not want it (or who is not yet ready to accept it), as this could make the situation worse. It is also important to note that there are dangers in accusing people of over-reacting to a trauma. Different people will react in different ways and, for some, the sense of disorientation they experience, can lead them to behave in ways that are quite out of character – sometimes quite significantly out of character. In such circumstances, it is important to make sure that we do not ‘add insult to injury’ by failing to appreciate the difficulties someone is experiencing and actually exacerbating them by not being sufficiently understanding or supportive.

Dr Neil Thompson                        

Neil’s website and blog are at

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