What really counts as trauma? Dr. Nassir Ghaemi untangles PTSD, combat, sexual abuse and the myth of “complex trauma”.

In this live‑stream episode Dr. Ghaemi explains why the word “trauma” should be reserved for truly extreme events—historically rooted in Freud’s early work on hysteria, combat‑related shell shock, and sexual abuse—rather than everyday stressors like job loss or moving. He contrasts these severe experiences with universal negative life events that affect everyone but rarely qualify as trauma.

He highlights that only about 15 % of people exposed to severe trauma develop PTSD, while 85 % remain resilient, underscoring the role of underlying biology, personality traits such as neuroticism, and other risk factors. The rise of “complex trauma” blurs this line, stretching the trauma label to common stressors without solid scientific validation.

The discussion also revisits borderline personality disorder, noting how early DSM editions linked it to childhood sexual trauma, a connection later removed from criteria despite strong empirical associations. Dr. Ghami argues for clearer diagnostic boundaries to avoid conflating mood disorders, PTSD, and personality pathology.

Key references mentioned include:
Bodkin JA, Pope HG, Detke MJ, Hudson JI. Is PTSD caused by traumatic stress? J Anxiety Disord. 2007;21(2):176-82. doi: 10.1016/j.janxdis.2006.09.004.
Jones PJ, McNally RJ. Does broadening one’s concept of trauma undermine resilience? Psychol Trauma. 2022 Apr;14(S1):S131-S139. doi: 10.1037/tra0001063.
Sampson L, Gradus JL, Cabral HJ, et al. Stressful life events and incident depression among U.S. military personnel. Soc Psychiatry Psychiatr Epidemiol. 2023 Jul;58(7):1009-1018. doi: 10.1007/s00127-023-02445-9.

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