A Guide To Medical Trauma

What is medical trauma? 

Trauma¹ is complicated and variable. A trauma response can stem from a single event or multiple potentially long-lasting experiences. Some people who experience trauma develop post-traumatic stress disorder (PTSD), but fortunately, most do not. 

Medical trauma² is a specific form of trauma that occurs in a medical setting. This can be a doctor's clinic, hospital, surgical theater, or any other place where medical care is delivered. Medical trauma, like general trauma, is complex.

While the situation is driven by the specific medical practices and procedures undertaken, personal qualities, including the relationships between the patient, family, medical professionals, and the care delivery setting, also play a role in how or if a trauma response develops. 

Medical trauma can cause psychological distress and health problems, such as PTSD. It’s worth noting that medical trauma is subjective. A patient's interpretation of events, not the severity of the procedure or illness, determines the course of the trauma.

For example, a person who undergoes a routine, non-invasive surgery may experience a stronger trauma response than someone who undergoes a more complicated and time-consuming procedure. 

People who experience medical trauma typically respond in one of three ways:

Re-experiencing 

Re-experiencing is when a person constantly thinks about the trauma and relives the particularly traumatic components of the triggering event or experience. While some level of re-experiencing is normal, flashbacks and nightmares about the event can become significant and affect a person’s ability to function. 

Avoidance

Avoidance means completely blocking out any thoughts or flashbacks about the trauma. It can also involve giving up on certain activities to avoid triggers. Like re-experiencing, avoidance can affect a person’s life by discouraging them from engaging in normal, everyday activities. 

Hyperarousal

Hyperarousal is when a person is excessively vigilant about particular dangers. It’s when a person’s “fight-or-flight” reflex kicks in unnecessarily. 

Medical trauma is not just an individual experience or a response that one person will have to something that happened to them directly. People can experience medical trauma based on their family and community history.

For instance, there are known historical cases where minority communities in the US were subjected to unethical experimentation and forced medical procedures. These historical events may make people wary or fearful of seeking medical care. 

Research on medical trauma 

Until recently, research³ on medical trauma was limited. The void was especially significant when comparing the volume of research on medical trauma to other forms of trauma and PTSD. However, this is a growing area of interest with many exciting possibilities.

For example, examining the brain and its function in trauma has provided valuable information that may be used, in the future, to develop innovative and effective treatments for medical and other types of trauma.

A study⁴ of people who had experienced medical trauma found that disruption in specific brain pathways connecting cognitive and emotional functions is vital in the development of trauma. This information could help researchers better understand trauma for future studies on treatments. 

Some research can be applied to improve patient experiences in real-life medical settings. For example, a study⁵ on patients with medical PTSD found that the two most common triggers of the condition were intraoperative awareness and ICU stays. Intraoperative awareness is a rare event where people wake up and are conscious during surgery.

Knowing that these situations trigger trauma responses will help medical professionals focus on areas that need improvement so they can better support vulnerable patients. Likewise, research on the symptoms and experiences of medical trauma can help healthcare providers better understand the patient experience to deliver a higher quality of care. 

Finally, there are numerous articles⁶ on how medical professionals can communicate with people about their conditions without triggering medical trauma.

Symptoms of medical trauma 

Symptoms of medical trauma vary widely and differ based on people’s experiences, backgrounds, personalities, and coping skills. Symptoms may come on right away, or they may appear over time.

Initial symptoms 

Some people experience symptoms of trauma immediately after the triggering event. Initial symptoms may include: 

• Emotional responses, such as anger and sadness

• Anxiety and hyperactive behaviors, including impulsiveness, aggressiveness, and an inability to concentrate

• Confusion

• Extreme tiredness

• Dissociation (becoming disconnected from one’s environment, memory, and identity)

And less commonly,

• Prolonged dissociation

• An inability to rest or settle for an extended period

• Constant intrusive thoughts and memories 

Delayed symptoms 

Some people may not experience noticeable symptoms right away and have a delayed response to medical trauma. Delayed symptoms often include: 

• Consistently sleeping at inappropriate times 

• Repetitive dreams

• Diagnosed sleep disorders

• Avoidance symptoms

• Depression

• Re-experiencing symptoms

General symptoms 

You may experience other signs of medical trauma at any time after a traumatic event or experience. General symptoms of medical trauma include:

• Emotional responses, such as anxiety, depression, self-harm, and feelings of guilt. Issues with substance abuse and gambling are related to these emotional responses

• Physical symptoms, can be highly variable and include stomach and gut problems, sleep issues, breathing problems, skin issues, and more

• Behavioral symptoms include repeatedly reliving and reenacting the trauma, avoiding medical settings and triggering places, and self-harm

• Cognitive/mental symptoms, such as dissociation, flashbacks, and poor memory

Common causes of medical trauma 

Any medical interaction or procedure can cause medical trauma. Trauma is based on an individual’s experiences and how their mind and body respond to those experiences. What one person considers traumatic may not have the same effect on another person.

While medical trauma is subjective, some experiences and illnesses are more likely to lead to trauma:

Giving birth

Giving birth is painful for mothers and can be traumatic, especially when there are complications. Almost half of the new mothers self-reported that they had medical trauma related to their delivery. In the same study,⁷ researchers found that 4-18% of new mothers in samples representing the general population had PTSD caused by birth trauma. 

Some factors, including mental health issues and poor experiences with medical staff, increase the risks of developing medical trauma from childbirth. Birth trauma can affect the mother's ongoing experiences by causing difficulties with breastfeeding and future births. 

Cancer 

Cancer is another condition associated with trauma. People with cancer often undergo highly invasive procedures over a long time and can become fearful for their life and future. It’s no surprise that studies⁸ identify cancer as a "traumatic stressor" for between a third and half of patients.

A small number of cancer patients and their families develop medical trauma and PTSD. A person is more likely to develop PTSD if they’ve had a previous traumatic event or lacks a solid support network.

Heart attacks 

Heart attacks are generally sudden and shocking, and they demand a significant amount of medical intervention and may require relatively invasive treatment. Beyond that, heart attacks are sometimes life-threatening.

More research is needed to conclude the connections between heart attacks and medical trauma, but one small study⁹ found that nearly 25% of participants (who were all recovering from some type of major cardiovascular event, such as a heart attack) went on to develop PTSD.

Frequently asked questions about medical trauma

Can medical trauma cause PTSD? 

Trauma is an individual experience. The magnitude of a traumatic experience’s effect on a person’s life (or whether it has any effect at all) varies. Most people who experience medical trauma, or any other type of trauma, won’t go on to develop PTSD. Unfortunately, some do. In cases of PTSD, symptoms are prolonged and interfere with daily functioning. If you’re experiencing any signs of medical trauma, schedule an appointment to see your healthcare provider. If you’re in crisis, call 911 immediately. 

Who experiences medical trauma? 

Anyone can experience medical trauma. It can develop in people of any age, gender, socioeconomic class, ethnicity, and so on. That said, some people, including children, people with lower incomes, and minority groups, may be more likely to have unfavorable medical experiences that may trigger medical trauma or PTSD.

How can I cope with medical trauma? 

Fortunately, many treatment options exist for people experiencing PTSD and medical trauma. Some people may need medication, but healthcare providers recommend therapy as the first line of defense.

Different therapies can help regulate emotional responses, learn coping skills, and desensitize a person to minimize their body’s response to triggers. 

One form of therapy that can help people with medical trauma is trauma-focused cognitive behavior therapy (TF-CBT). TF-CBT helps people process their traumas and triggering factors to respond more appropriately and develop better-coping skills.

The lowdown 

The term “trauma” describes a set of responses and symptoms related to one or more traumatic events. Medical trauma refers to traumatic experiences that happen in medical settings. The major reactions to medical trauma are re-experiencing avoidance and hyperarousal. 

There’s a growing body of research on medical trauma and its connection to the mind, body, and other conditions, such as PTSD.

A highly individual condition, medical trauma may cause various symptoms, including sadness, confusion, tiredness and sleep disorders, avoidance, depression, and more.

Certain medical events, such as giving birth, being diagnosed with and treated for cancer, or having a heart attack, are more likely to trigger medical trauma. Fortunately, help is available. While therapy is typically the first line of defense, some people need medication to recover from medical trauma.