This is a guest post by Dr. Laura McNally, an Australian registered psychologist, author, and Ph.D. Her commentary has been featured in The ABC, The Guardian, The Australian, The Ethics Centre, and more. Guest posts reflect the views of the guest author and not necessarily my own.
I am an Australian psychologist who has watched the rise of "Instagram therapists," initially with enthusiasm and now with concern. While at first I appreciated psychoeducation becoming more accessible, it is clear that social media has rewarded one particular narrative around therapy. That narrative is a conflation of any form of distress with an etiology of trauma. (I'm also on Instagram @actualpsychology.)
The idea that everyone is traumatized by routine parenting practices is taking off online and it’s landing well with social media users. “Not being heard” is defined as a key feature of childhood trauma by American psychologist Dr. Nicole LePera who argues anything a parent does to “deny your reality … your authentic nature as children” including “unconsciously moulding or shaping you” is trauma. Her Instagram account made headlines for rapidly gathering over 2 million followers, increasingly via posts that posit trauma is universal. Thousands of commenters pour in to echo the same sentiment—all their difficult feelings suddenly make sense—it’s trauma.
The sudden popularity of Dr. LePera’s take on trauma has inspired hundreds of social media influencers to promote their stories of self-diagnosed trauma—elevating trauma as a kind of status item rather than functional impairment. A similar phenomenon has been observed on college campuses where sociologists Campbell and Manning noted that stories of suffering and victimhood are shared as a necessary component of high moral status.
However, there are valid reasons people fall into a trauma trap, particularly in times of distress. According to trauma expert, Harvard Professor of Psychology Richard McNally, the idea of repressed trauma eludes people into thinking all the puzzle pieces of their troubles now suddenly fit together. Like a lightbulb moment, someone who is “having a difficult life may remember a trauma, which may or may not have actually traumatized him, and everything makes sense.”
The idea that our parent’s less-than-stellar communication style can be explained as trauma may feel validating at first, but the high of the lightbulb moment wears off. In its wake, the individual is left with more complexities to resolve, including a new cognitive bias toward possibly benign childhood experiences. While over half the American population is likely to go through an event that may be classified as trauma exposure, less than 10% are likely to have a trauma response to that event and even fewer will go on to develop PTSD. However, a commentary in Medscape argues that “viewing more and more of modern life through the lens of trauma, we may overmedicalize normal emotional responses to stressors and undermine human resilience in the face of adversity.”
Promoting the non-scientific view that normative life experiences constitute trauma exposure raises a grab bag of ethical issues for psychologists. One of the most glaring is the fallibility of memory and the role of priming in shaping cognitive experience. The famous Lost In A Mall Technique demonstrated just how easily memory can be rewritten: If people were told they had been “lost in a mall” during their childhood, many would suddenly “remember” the experience despite it not having taken place at all. Unlikely as it is that individuals entirely fabricate false traumatic memories, the reframing of non-traumatic experience through a trauma lens is incredibly problematic for overall psychological well-being.
The most alluring aspect of the trauma trap argues that “feeling unseen or unheard” exposes us all to cumulative trauma—sometimes termed "small t trauma." This idea puts parents on edge and casts a shadow on all childhoods. Hundreds of parents regularly show up in Dr. LePera’s comment section anxiously querying how they can avoid traumatizing their child. The answer—they can’t, unless they “work on healing” their own repressed trauma. Imbuing this kind of parenting anxiety over trauma is not just misleading but dangerous—parenting anxiety has a substantial link to anxiety in children. And while LePera rightfully highlights that emotionally invalidating environments can be psychologically damaging for some, research shows emotional invalidation is not linked with trauma.
Chronic emotional invalidation in childhood is more closely linked to adult emotional dysregulation—less regulated emotional responses. To confuse symptoms of emotional dysregulation with trauma means an increased risk of misdiagnosis, overdiagnosis or inappropriate treatment methodology for an already vulnerable population. If a person suffering from dysregulation is dealt with the additional blow of misattribution bias, this means a more lengthy, costly, and difficult treatment journey. Trauma expert Richard McNally explains, “If a [non-traumatized] person takes a PTSD interpretation of their troubles ... you’re going to miss the boat … You’re going to spend your time chasing this memory down instead of dealing with the way the patient misinterprets present events.”
Indeed, the impact of childhood trauma is fundamentally different from emotional dysregulation. Studies have shown that survivors of childhood trauma have altered neurobiological epigenetic markers and different neuropathology than survivors of adulthood trauma. Severity, duration, and timing of childhood trauma exposure are linked to various PTSD related psychopathology as well as asthma, heart disease, diabetes, and stroke. Symptoms of PTSD can include insomnia, recurring nightmares, flashbacks, audio-visual processing difficulties, and hallucination-like experiences called derealization or depersonalization. Trauma survivors may find their destabilization is more akin to psychosis than any particular feeling. So while trauma may include emotional dysregulation, emotional dysregulation does not infer trauma, and psychologists have the obligation to differentiate rather than blur these two concerns.
While fans of LePera are told this approach is validating human suffering, it is distinctly invalidating for survivors of trauma to be told a neurobiological impairment is just the same as feeling emotionally invalidated. On the one hand, therapists like LePera offer free psychoeducation and self-empowerment tools, while on the other hand, the trauma trap is inculcating a deficit model into unsuspecting and hopeful followers. That is, the notion that everyone has deeply repressed traumatic experiences that they are unable to resolve, if only you dig deep enough.
It is undeniable that all individuals face adversity. However, it is suspect that our cultural narrative is so rapidly shifting toward trauma misattribution, raising the status of victimhood whilst diluting the conceptual validity of trauma. While the conceptual creep of trauma may be propagated under the guise of "help," Instagram therapists who promote a non-scientific view of trauma are tellingly the same therapists proposing treatment methods that only their paying social media fans can access. As Haslam observed in 2016, “concept creep phenomenon broadens moral concern in a way that aligns with a liberal social agenda by defining new kinds of experience as harming and new classes of people as harmed, and it identifies these people as needful of care and protection.”
The colloquial broadening of trauma may appear to offer a one-size-fits-all solution to resolving human suffering, but its adherents are likely to find themselves in a bait and switch trap. Non-traumatized people may require additional psychological support to sort through their past experiences that are now viewed through the lens of trauma, while survivors of actual trauma are expected to absorb the costs of seeing their adversity used as a marketing tool. As Professor McNally has said, “We should return to the original concept of trauma; the credibility of our field depends on it.”