The Body Keeps Score And So Does the Mind
When I hear the word trauma, my mind still goes first to my paramedic training. A high-speed car crash. A fall from a height. A child beaten by a parent. A suicide attempt. In emergency medicine, trauma is concrete. It’s something that threatens life or limb and demands immediate intervention.
When I moved into counseling, I had to relearn the word. Trauma now meant psychological injury. Extreme stress. Experiences that overwhelm a person’s coping ability. Events that leave lasting effects on how someone feels, thinks, relates, and functions. Sets of circumstances that change a person's worldview. Definitions matter. But somewhere along the way, the word trauma has expanded so much that it has started to lose clarity.
Books like The Body Keeps the Score by Bessel van der Kolk, research on adverse childhood experiences, and foundational work by Judith Herman have helped the field take psychological trauma seriously. At the same time, the word has become nearly ubiquitous. If I search for continuing education on trauma, I find hundreds of courses. Trauma has become the dominant lens through which we explain distress.
When Trauma Becomes Everything
In a recent talk, trauma expert Janina Fisher noted that when society overuses the word trauma, it risks diluting the experience of people who are truly traumatized. That observation lands. When everything is trauma, it becomes harder to understand what trauma actually is and harder for survivors to feel accurately seen.
This doesn’t mean people aren’t suffering. They are. It means that suffering comes in many forms, and not all distress requires the same explanation or intervention. Confusion around trauma can lead to over-pathologizing normal reactions to stress or underestimating the impact of genuinely overwhelming experiences.
What Trauma-Informed Care Actually Means
In 2014, SAMHSA released its framework for trauma-informed care, followed by detailed guidance and protocols, including TIP 57. The language can sound technical, but the core ideas are surprisingly simple.
Trauma-informed care emphasizes:
- • safety
- • support
- • collaboration
- • acknowledgement
- • transparency
- • empowerment
Stripped down, trauma-informed care isn’t a specialized technique. It’s an orientation. It’s about how we show up with people when they’re vulnerable. In emergency services and health care settings, especially, this reminder is overdue.
From the Ambulance Bay to the Therapy Room
Van der Kolk’s central contribution, that trauma is stored in the body, matters. The nervous system remembers threats long after the danger has passed. Sensations, reflexes, and emotions often respond before conscious thought catches up.
But bodies don’t exist in isolation. Meaning, interpretation, memory, identity, and relationship shape how trauma is lived and understood. The mind doesn’t disappear just because the body reacts. Trauma therapy works best when both are addressed; when regulation, understanding, and agency develop together.
From my vantage point, effective trauma counseling is often far less dramatic than people expect. It isn’t about reliving memories endlessly or uncovering buried truths. It’s about pacing, safety, restoring choice, and helping people reconnect with themselves and others in tolerable ways.
So What Is Trauma Therapy?
Trauma therapy isn’t a single modality or technique defined by buzzwords and credentials. Trauma therapy is a process that helps people feel safe enough to regain control over their bodies, thoughts, emotions, and lives.
It involves respecting how trauma shaped someone without letting that experience define them forever. It means moving carefully, honoring strengths, and understanding that healing rarely follows a straight line.
Best I can tell, that’s trauma therapy.
Strategize Your Success
Trauma has become a powerful word, but power without clarity can confuse more than it helps. Understanding what trauma is and what it isn’t allows people to seek support without fear, shame, or unnecessary labels.
Tactical Counseling approaches trauma with precision, respect, and practicality. Counseling is about meeting people where they are, helping them feel safer, more grounded, and more capable in their own lives.
If you’re trying to make sense of trauma, your own or someone else’s, and want support that is thoughtful rather than performative, let’s talk. Together, we can Strategize Your Success.
Resources for Further Reading
- • van der Kolk, B. (2014). The Body Keeps the Score. Viking. https://amzn.to/4qoA94L
- • Substance Abuse and Mental Health Services Administration. (2014). TIP 57: Trauma-Informed Care in Behavioral Health Services. https://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816
- • Substance Abuse and Mental Health Services Administration. (2023). A Practical Guide for Implementing a Trauma-Informed Approach.
https://store.samhsa.gov/product/practical-guide-implementing-trauma-informed-approach/pep23-06-05-005. Document removed from the SAMHSA website amid recent federal content changes.