Trauma is a psychological injury, a highly stressful, frightening, or upsetting experience that exceeds our current capacity to integrate it emotionally. It can be a single event (accident, assault, disaster, etc.) or repeated and chronic experiences (neglect, violence, abuse, prolonged insecurity, etc.). 

What constitutes trauma is less “what happened,” i.e., the traumatic event itself, than its consequences on the person, notably nervous system dysregulation (hypervigilance, freezing, numbness, dissociation, etc.), as if the body remained in “survival mode.” This is why the sense of security, self-image, ability to regulate emotions, and ability to connect with others can be disrupted following trauma.

Thus, the same situation does not traumatize everyone in the same way; the context, available resources, and support received significantly alter its impact.

Trauma with a capital T or a small t: what are we talking about?

Complex trauma refers to a form of repeated, prolonged, or cumulative traumatic exposure, often experienced in contexts where the person feels trapped, powerless, or unprotected. It is frequently linked to relational trauma (e.g., neglect, psychological or physical abuse, sexual abuse, intimidation, chronic instability, family insecurity) and usually occurs in childhood or adolescence (although it can also develop in adulthood).

Complex trauma is characterized not only by the severity of the events, but by their duration and effect on a child’s development: a sense of safety, trust, attachment, self-image, and the ability to self-regulate are all impacted. When these experiences are repeated without sufficient support, they can have a lasting impact on the nervous system, emotional regulation, and relationships.

Developmental trauma refers to repeated and/or prolonged experiences of stress or trauma during childhood (often within the family), such as neglect, abuse (physical, sexual, emotional), or a climate of chronic adversity. It can include exposure to violence at home (domestic violence, abuse) or in the community (war, displacement, insecurity, trauma related to exile).

A key factor is the relational context: developmental trauma occurs when a child is exposed to overwhelming stress and the attachment figure does not help to reduce this stress or is themself the source thereof. The child is then left alone to cope with the stress, without sufficient co-regulation, which can have a lasting impact on the development of their inner sense of safety.

Because it occurs during key phases of childhood, developmental trauma can impact overall development, including attachment, emotional and behavioral regulation, cognition (attention, learning, executive functions), and self-esteem.

Bessel van der Kolk and others have also proposed the idea of a “developmental trauma disorder” to better describe the clinical presentations associated with early and chronic exposure to trauma.

ACEs or Adverse Childhood Experiences refers to stressful or traumatic events and conditions experienced during childhood that can have lasting effects on an individual’s health and development: 

• Forms of abuse (verbal/emotional, physical, sexual)
• Neglect (not feeling loved, lack of care, lack of material security: food, clean clothes, etc.)
• Family dysfunction (parent with a mental disorder, addiction, domestic violence, separation/divorce, abandonment, incarceration of a parent, etc.)

ACEs have become a major benchmark thanks to the famous “ACE Study,” launched in 1995 in California, based on a large cohort of adults (more than 15,000 people). This study showed a strong correlation between the number of ACEs and the risk, later in life, of:

• Mental health problems
• Health risk behaviors
• Serious physical illnesses
• Earlier mortality.

The higher the ACE score, the greater the risk.

Adverse childhood experiences are common, even in relatively privileged populations, which has contributed to making ACEs a central reference point for understanding the link between childhood, chronic stress, trauma, and overall health.

Today, ACEs are discussed in a broader sense, including poverty, racism, community violence, insecurity, etc., as the social context can also expose a child to chronic stress.

However, ACEs do not explain everything and do not predict an individual’s fate. Protective factors (support, secure attachment, safety, community, access to care, resources) can significantly alter the impact.

PTSD or post-traumatic stress disorder is a disorder that can develop after experiencing or witnessing a traumatic event. It is generally characterized by four main types of symptom: intrusions, avoidance, changes in thinking and mood, and hyperarousal. PTSD is diagnosed when these symptoms persist over time and cause significant distress or difficulty in daily functioning.

C-PTSD or complex post-traumatic stress disorder includes the symptoms of PTSD, but most often occurs after repeated or prolonged trauma, particularly when it is relational and/or impossible to escape: domestic violence, repeated abuse, severe neglect, exploitation, captivity, torture, war, etc. In addition to the classic symptoms of PTSD, C-PTSD involves more persistent difficulties regarding emotional regulation, self-image, and relationships.

Systemic (or structural) trauma refers to suffering and insecurity that is produced or perpetuated by social systems (laws, policies, norms, organizations) that create or perpetuate inequality, marginalization, exploitation, and oppression. This type of trauma is often chronic and cumulative: it can result, for example, from repeated exposure to discrimination, precariousness, insecurity, exclusion, or violence, with impacts on mental health and the body. 

Institutional trauma refers more specifically to injuries linked to institutions (schools, hospitals, the justice system, child protection services, the police, universities, businesses, etc.) when they become sources of danger, humiliation, lack of protection, or re-traumatization.​​

Collective trauma refers to the psychological and social impact of a traumatic event on a group, community, or entire society. It is not just the accumulation of individual suffering: it is also an attack on bonds, shared values, and the sense of belonging. 

Historical trauma, often associated with the idea of intergenerational trauma, refers to cumulative emotional and psychological wounds experienced by a group exposed to massive trauma (colonization, slavery, genocide, forced displacement, apartheid, political violence, war, etc.), the effects of which can be passed down through generations. It does not only concern the past; it also persists because certain communities continue to experience forms of oppression, precariousness, or discrimination, which can reactivate the wound and hinder healing. 

Attachment is a clinical term that refers to the lasting psychological and emotional bond between two human beings. In Bowlby’s attachment theory, it refers primarily to the bond that develops between a baby and its caregiver(s): a bond in which the child seeks closeness and feels safer in the presence of that person.

Attachment is not love in the romantic sense: it is a system of survival and regulation. When a child feels distressed, they turn to an attachment figure for reassurance, comfort, and protection. Over time, these repeated experiences form an internal base that is secure or not, based on the sense of: “Can I count on the other person? Am I important? Is the world a safe enough place for me?”

Four main attachment styles are generally described:

• Secure (confidence, emotional adjustment, more direct communication)
• Anxious (fear of losing the bond, hyperarousal)
• Avoidant (withdrawal, defensive autonomy, minimization of needs)
• Disorganized (a mixture of approach and fear, often linked to unpredictable or frightening environments).

An attachment style is not a lifelong sentence: our bonds can evolve, it is possible to repair attachment wounds, and we can even have different styles depending on our relationships and periods of our lives.

IFS (Internal Family Systems) is a therapeutic approach developed by Richard C. Schwartz PhD in the 1990s. It is based on a simple idea: our inner world is made up of different parts (sub-personalities, aspects of ourselves) and a core compassionate “Self” capable of bringing coherence and connectedness to the system.

The IFS approach see the mind as naturally multiple, and this multiplicity as healthy. As in a family, certain parts may find themselves pushed into extreme roles (controlling, avoiding, numbing, sacrificing themselves, etc.) to protect the system, especially after injuries or traumas. IFS seeks not to eliminate these parts, but to understand them and restore a more balanced relationship with them.

The heart of the work is accessing the Self, an intact inner state of presence and leadership. This Self is recognized primarily by eight qualities (the “8 Cs”): calm, clarity, curiosity, compassion, courage, creativity, confidence, and connection. From this place of Self-leadership, we can connect with the parts, help them free themselves from their burdens, and reharmonize the inner system, which also supports the quality of our relations with others.

IFS is a non-pathologizing approach used in clinical contexts and as a framework for understanding in personal development, counseling, education, mediation, and coaching. The “5 Ps” support the IFS approach: presence, perspective, patience, playfulness, persistence.

Polyvagal Theory (PVT) is a theoretical framework developed by neuroscientist Dr. Stephen Porges to better understand how the autonomic nervous system, and in particular the vagus nerve, influences our internal states, emotions, behaviors, and ability to connect with others. Deb Dana has been instrumental in making the concepts of PVT applicable in practice.

Neuroception is a key concept in PVT: our nervous system continuously scans our environment (on a subconscious level) to answer a fundamental question: “Am I safe?” and automatically adjusts our responses.

When the nervous system perceives safety, it facilitates social engagement. When it perceives danger, it activates survival responses. PVT thus helps us understand that many reactions (anxiety, agitation, freezing, dissociation, withdrawal, etc.) are primarily neurobiological adaptations. Our physiology will therefore switch between several states depending on the perceived safety or danger:

• Ventral vagal (safety): presence, connection, curiosity, ability to learn and cooperate; this is the state of social engagement.
• Sympathetic (mobilization): fight/flight, hypervigilance, agitation, anger, anxiety; the body prepares to act.
• Dorsal vagal (immobilization, freeze, shutdown): withdrawal, collapse, numbness, dissociation; the system “goes on standby” when action is not possible.

We talk about regulation when the nervous system can move smoothly from one state to another depending on the situation, without getting stuck. Dysregulation, on the other hand, occurs when the system gets stuck in survival mode, often after trauma, prolonged stress, or repeated overload: reactions become disproportionate to the present, and it becomes more difficult to be present and connected, both for oneself and in relationships.

PVT emphasizes that connection is a physiological need. Co-regulation corresponds to the (often implicit) exchange of safety signals between two nervous systems, via eye contact, voice, facial expressions, and posture. Being with a person (or animal) who makes us feel safe, and engaging with others in activities such as singing, dancing, playing together, etc. are all forms of co-regulation and powerful ways to return to a state of safety.

In relation to these states, the window of tolerance describes the activation zone in which we remain capable of thinking, feeling, choosing, and staying connected. Outside of this zone, we are either:

• In hyperactivation (sympathetic dominant): anxiety, panic, agitation, anger, rapid thoughts.
• In hypoactivation (dorsal dominant): withdrawal, fatigue, sadness, numbness, dissociation.

In therapy as in everyday life, PVT invites us to shift the question “What’s wrong with me?” to “What state is my nervous system in, and what does it need to return to a state of greater safety?” 

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapeutic tool developed in the late 1980s by Dr Francine Shapiro, initially to help treat PTSD. In EMDR therapy, the person is asked to briefly connect with a traumatic memory (images, emotions, beliefs, bodily sensations) while receiving bilateral stimulation (eye movements, alternating tapping, alternating sounds). The goal is to reduce the emotional charge associated with the memory and promote more adaptive reprocessing.

Somatic Experiencing® (SE) is a body-oriented therapeutic approach developed by Peter A. Levine PhD to help resolve the effects of trauma and stress by working with the nervous system and not just with the narrative.

The central idea is that after an overwhelming event, the body can remain stuck in survival mode. SE aims to restore the natural capacity for self-regulation by guiding the person to pay attention, very gradually, to their internal sensations and micro-signals from the body. Trauma-related patterns held in the nervous system can gradually resolve as the person is supported in completing defensive actions that were interrupted at the time of the traumatic experience.

Somatic Experiencing helps people to be and feel safely embodied, to reduce the burden of trauma, and to regain greater stability, presence, and vitality.

Sensorimotor Psychotherapy (SP) is a body-oriented approach to psychotherapy developed in the 1980s by Pat Ogden PhD. It combines talk therapy with close attention to sensations, posture, movement, and physiological arousal, as trauma and attachment wounds often leave traces in the body as well as in the narrative.

Sensorimotor Psychotherapy helps individuals observe what is happening “here and now” in their bodies (tension, impulses, numbness, agitation, etc.), regulate their arousal, and regain a sense of inner security. 

This approach also aims to gradually and safely reactivate incomplete defense responses in order to reduce dysregulation and dissociation. Sensorimotor Psychotherapy helps to connect the body, emotions, and cognitions so that healing is not only “understood” but also embodied. 

L’EFT (Emotional Freedom Techniques ou techniques de libération émotionnelle), aussi appelé tapping (tapotements) est une technique “corps-esprit” utilisée pour apaiser des émotions difficiles, des pensées envahissantes, le stress ou l’anxiété.

Concrètement, il s’agit de se concentrer sur un problème (émotion, souvenir, appréhension), puis de tapoter du bout des doigts une série de points d’acupression (main, visage, buste), tout en répétant une phrase courte liée à ce que l’on ressent. Les points utilisés correspondent à ceux de l’acupuncture (sans aiguilles).

Mindfulness refers to a form of attention and awareness: the ability to be aware of what is happening within oneself (sensations, emotions, thoughts) and around oneself, here and now.

Jon Kabat-Zinn defines it as a presence that arises from “paying attention, intentionally, to the present moment, without judgment.” It is not about “clearing your mind,” but about observing with openness and curiosity the experience as it is, being aware of our habitual patterns, and thus living less on autopilot. Kindness and compassion towards oneself and others are fundamental aspects. 

Mindfulness can be cultivated through meditation, but also in everyday life (e.g., eating, listening, walking while being fully present). It has been widely promoted in healthcare through programs such as MBSR (Mindfulness-Based Stress Reduction), created by Kabat-Zinn in 1979, to teach people how to better cope with stress and suffering. 

David Treleaven PhD has worked extensively on Trauma-Informed Mindfulness, as has Christine Forner.

Breathwork refers to a set of conscious and controlled breathing techniques used essentially for relaxation, meditation, or therapeutic purposes.

In concrete terms, these can be gentle practices (diaphragmatic breathing, slow breathing, cardiac coherence, etc.) or more intense methods, sometimes based on higher voluntary ventilation, which can induce altered states of consciousness.

The main idea is to act on the body to influence one’s internal state. By modulating the rhythm, depth, or pauses, these practices are effective in supporting nervous system and emotional regulation, calming the stress response, reducing anxiety, and improving clarity and the ability to stay present.