They Don't Know Trauma

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An Empirical Perspective

On his 2018 album Black Privilege, Ace Clark released a track entitled “They Don’t Know” which featured Beanie Siegel and Jay Future. Lyrics of the hook state, “I don’t think that they really know (that they really know). No, no, no. They don’t really know what we talkin’ ‘bout.”

Throughout each verse, undesirable, unpleasant, unfavorable, and unfortunate events are described (e.g., growing up in impoverished conditions). Presumably, people who haven’t experienced similar circumstances “don’t really know” what it’s like to endure hardship.

Even though I don’t fully agree with it, I can appreciate the argument for empiricism regarding lived experience and emic versus etic understanding expressed on the track. For context, one source states:

In philosophy, empiricism is an epistemological view which holds that true knowledge or justification comes only or primarily from sensory experience and empirical evidence. It is one of several competing views within epistemology, along with rationalism and skepticism.

Empiricists argue that empiricism is a more reliable method of finding the truth than purely using logical reasoning, because humans have cognitive biases and limitations which lead to errors of judgement. […]

Empiricism in the philosophy of science emphasizes evidence, especially as discovered in experiments. It is a fundamental part of the scientific method that all hypotheses and theories must be tested against observations of the natural world rather than resting solely on a priori reasoning, intuition, or revelation.

At the risk of oversimplifying this complex systems matter, consider the Latin phrases a priori (‘from the earlier’) and a posteriori (‘from the later’). The former is independent of experience, as the latter is dependent on empirical evidence.

From a logical and reasonable (collectively “rational”) view, using a priori knowledge in the form of a modus ponens syllogism (i.e., if p, then q; p; therefore, q), I comprehend that shocks above 2,700 volts are often fatal. I don’t have to experience that voltage to understand this.

Alternatively, using a posteriori knowledge, I could test cognitive biases and limitations of my comprehension through experimentation which is experiential (relating to, derived from, or providing experience—direct observation of or participation in events as a basis of knowledge).

Thus, the perspective expressed in “They Don’t Know” relates to empiricism, which supports an argument for a posteriori or empirical knowledge, by suggesting that unless one experiences a particular hardship, then one cannot truly know about that particular form of suffering.

Trauma

One aspect I appreciate about an empirical perspective of life is that it’s largely supported by evolving science regarding trauma. According to the American Psychological Association (APA), trauma is defined as:

[A]ny disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning.

Traumatic events include those caused by human behavior (e.g., rape, war, industrial accidents) as well as by nature (e.g., earthquakes) and often challenge an individual’s view of the world as a just, safe, and predictable place.

For the record, life is impermanent and uncertain. From both the a priori and a posteriori perspectives, the world isn’t “a just, safe, and predictable place.” To suggest otherwise is beyond irrational; it’s outright delusional. I invite you to think critically of any argument to the contrary.

Also, I appreciate that the APA definition of trauma relates to experiential stressors (i.e., rape, war, industrial accidents, earthquakes, etc.). In this way, trauma is experienced by the individual being traumatized. Given this outlook, the APA defines posttraumatic stress disorder (PTSD) as:

[I]n DSM–IV–TR, a disorder that may result when an individual lives through or witnesses an event in which they believe that there is a threat to life or physical integrity and safety and experiences fear, terror, or helplessness.

The symptoms are characterized by (a) reexperiencing the trauma in painful recollections, flashbacks, or recurrent dreams or nightmares; (b) avoidance of activities or places that recall the traumatic event, as well as diminished responsiveness (emotional anesthesia or numbing), with disinterest in significant activities and with feelings of detachment and estrangement from others; and (c) chronic physiological arousal, leading to such symptoms as an exaggerated startle response, disturbed sleep, difficulty in concentrating or remembering, and guilt about surviving the trauma when others did not.

Subtypes are chronic posttraumatic stress disorder and delayed posttraumatic stress disorder. When the symptoms do not last longer than 4 weeks, a diagnosis of acute stress disorder is given instead.

Changes in PTSD criteria from DSM–IV–TR to DSM–5 and DSM-5-TR include the following: Exposure to the traumatic event may be secondhand if the event happens to a loved one or if there is repeated exposure to aversive details (e.g., as with first responders cleaning up after a disaster); the subjective criterion requiring that the person feel fear, terror, or helplessness has been eliminated; symptom clusters have been recategorized, with additional symptoms; and separate criteria have been developed for children age 6 years or younger.

With Bayesian reasoning, a person may hold opinion X until or unless new data is received, at which time the individual then adopts opinion Y. So, too, is the matter of an ever-changing definition for PTSD. Nevertheless, I stated of trauma in a blogpost entitled Big T, Little T:

Over the past couple decades or so, I’ve heard a lot about trauma. Apparently, trauma relates to any and everything one can imagine.

Your preferred coffee shop is out of a particular ingredient? Trauma! You don’t score as high on an exam as you’d like? Trauma! The person in whom you’re romantically interested rejects you? Trauma! You have no state-issued ID with you? Trauma! […]

Nonetheless, I’m aware that the concept of trauma and treatment of PTSD are ever-evolving. For this I am in part grateful, because I remain hopeful for more effective clinical interventions in the future.

That stated I currently stand in opposition to the trend I’ve observed over the last two or so decades regarding inclusion of mildly annoying, slightly irritating, moderately disappointing, or emotionally upset events as being representative of trauma.

Despite ongoing changes to the definition of trauma, not every undesirable, unpleasant, unfavorable, and unfortunate event constitutes trauma. Likewise, not every disagreeable, unsatisfactory, negative, frustrating, annoying, or disappointing event causes PTSD.

They Don’t Know Trauma

Recently, I loosely followed a civil case against rapper Cardi B. According to one source, “Cardi B has been cleared by a Los Angeles jury in a $24 million lawsuit filed by a security guard who accused her of assault during an alleged incident in 2018.” Per a separate source:

Emani Ellis sued Cardi B for $24 million, accusing her of assault, battery and intentional infliction of emotional distress in the aftermath of a confrontation in a hallway outside of an obstetrician’s office. Ellis claimed that, during the set-to, the rapper scratched her with a long nail extension, leaving a facial scar.

Personally, there’s as much interest in Cardi B as there remains a desire to hear another person defecating in a stall adjacent to the one in which I occupy when using a public toilet. Relatively nothing about the rapper appeals to me. Nevertheless, I enjoy certain aspects of legal cases.

Therefore, I paid some attention to Cardi B’s case. What I found fascinating was that so many people who also observed the case were treated to day three testimony by Dr. James Rosenberg, MD, a psychiatrist, who stated the following:

This doesn’t constitute a trauma. Again, accepting Miss Ellis’s report of what happened, at face value, it doesn’t constitute a trauma. It would be a stressor, to some degree, on an interpersonal basis, but under the American Psychiatric Association standards for what constitutes the trauma – for example, to able to develop PTSD – this does not meet that.

It has to be something like life-threatening, accident, illness, witness to violence. So, for example, you know, physical or sexual abuse growing up, kidnapping, sexual assault, military combat. These things are traumas, and they can lead to PTSD. An argument or unpleasant interpersonal interaction isn’t a trauma, and can’t lead to PTSD.

The American Psychiatric Association standards which were referenced by Dr. Rosenberg specifically state the following:

·   directly experiences the traumatic event;

·   witnesses the traumatic event in person;

·   learns that the traumatic event occurred to a close family member or close friend (with the actual or threatened death being either violent or accidental); or

·   experiences first-hand repeated or extreme exposure to aversive details of the traumatic event (not through media, pictures, television or movies unless work-related)

Examples of traumatic events include being in a motor vehicle accident (MVA) in which a fatality results, being required to work the scene of that accident (e.g., law enforcement), working the scene and discovering that one’s spouse died in the event, and so forth and so on.

However, one doesn’t qualify for a traumatic stressor when learning of one’s ancestors having been enslaved hundreds of years ago, having one’s employment terminated, being cutoff in traffic without a MVA resulting, or having one’s face scratched by a bombastic rapper.

For people on social media platforms (e.g., TikTok) and other media sites (e.g., The New York Times online profile) who suggest otherwise, they don’t know trauma! With hope, people who are ignorant about trauma and PTSD learned something from Dr. Rosenberg’s testimony.

Fortunately, my chosen psychotherapeutic modality, Rational Emotive Behavior Therapy (REBT), values rational thinking while also considering empirical knowledge. The same isn’t necessarily true about other models within the field of mental, emotional, and behavior health.

As such, if you’re searching for a clinician who will attempt to validate your irrational claim to trauma when you’ve not experienced an actual traumatic event, I highly encourage you to look elsewhere. Truly, I’m not the sort of individual that will treat everything as a traumatic event.

If you’re looking for a provider who tries to work to help you understand how thinking impacts physical, mental, emotional, and behavioral elements of your life, I invite you to reach out today by using the contact widget on my website.

As the world’s foremost hip hop-influenced REBT psychotherapist, I’m pleased to try to help people with an assortment of issues from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.

At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply trying to help you to feel better, I want to try to help you get better!

Deric Hollings, LPC, LCSW

Photo credit (edited), fair use

References:

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