TIRCIA · General public
What is trauma?
Understanding what happens after an overwhelming event, and why it says nothing about weakness
By Marie-Agnès Thulliez · Author · Publishing Director7-minute read
An accident, an assault, a disaster, the sudden death of someone close, repeated violence: after an overwhelming event, it is normal to be shaken. Most of the time, this settles. Sometimes the effect lasts, and that is what we call trauma.
This article explains in simple terms what happens, how to recognise it, and what genuinely helps people recover.
An event, and the mark it leaves
Two things are often confused. First there is the event: a situation in which a person has been confronted with death, a serious threat, serious injury or sexual violence. You may experience it yourself, witness it, or learn that it happened to someone close to you (in the case of a death, if it was violent or accidental). Some professions are also exposed to such events repeatedly (emergency services, police).
Then there is the trauma: the mark the event leaves when the brain cannot "digest" it. The same event may leave a lasting mark on one person and not on another. This says nothing about anyone's strength or worth.
Such events are common. In a large survey of 68,894 adults in 24 countries, more than 70% had experienced at least one traumatic event in their lifetime (Benjet et al., 2016).
Why the brain stays on alert
When faced with danger, the brain sets off an alarm. The body prepares to flee, to fight or to freeze. This survival reflex is faster than thought: we do not choose how we react.
When an event is too intense, the memory is sometimes stored "in pieces": images, sounds, smells and sensations, without a clear story that says "it's over". An everyday detail can then set the alarm off again, as if the danger were still present. This is a simplified explanation, but it helps to understand something essential: these reactions are those of a body that was trying to protect you. They come from a protection system that has remained stuck in the "danger" position.
Signs to know about
In the days and weeks after a serious event, it is normal to have trouble sleeping, to go over what happened again and again, to feel on edge or, on the contrary, numb. For most people, these reactions gradually ease.
We speak of post-traumatic stress disorder (PTSD) when the signs last for more than a month and interfere with daily life. According to the American classification (DSM-5-TR), they fall into four groups; the World Health Organization's classification (ICD-11) retains three, leaving out the "thoughts and mood" group:
- Re-experiencing: intrusive memories, flashbacks, nightmares, very strong reactions to anything that recalls the event.
- Avoidance: of places, people, conversations or thoughts linked to what happened.
- Changes in thoughts and mood: shame, guilt, mistrust, a sense of being different or cut off from others, loss of interest.
- Staying on alert: being easily startled, disturbed sleep, irritability, difficulty concentrating, a constant sense of danger.
After repeated violence, particularly in childhood, the difficulties can be broader: trouble managing emotions, a damaged sense of self, difficult relationships. When these difficulties come on top of the signs of PTSD, the WHO classification (ICD-11) speaks of complex post-traumatic stress disorder.
Around 4% of adults worldwide develop PTSD at some point in their lives, and half of them still have symptoms years later (Koenen et al., 2017): hence the importance of seeking help. The diagnosis is made during an assessment by a trained professional: a doctor, psychiatrist or psychologist.
What genuinely helps
In the first few days, what matters most is to get to safety, to rest, to stay surrounded by others, and to talk about what happened only if you want to. It is best to avoid alcohol, and medication taken without medical advice, as a way of "keeping going": they bring relief in the moment but get in the way of recovery.
If the signs last for more than a month, or if they are very overwhelming before then, it is time to see a professional. Trauma-focused psychotherapies have a proven track record. Several major international guidelines, such as that of the US Departments of Veterans Affairs and Defense (Schnurr et al., 2024), put EMDR, prolonged exposure therapy and cognitive processing therapy first. The American Psychological Association guideline (APA, 2025) recommends trauma-focused cognitive behavioural therapies as first-line treatments, including cognitive processing therapy and prolonged exposure, and places EMDR second-line (conditional recommendation). The effect of these therapies can be pictured like this: the memory comes to be experienced as a past event, one that no longer sets off the alarm.
The US Veterans Affairs and Defense guideline advises against benzodiazepines (anti-anxiety medication) for PTSD (Schnurr et al., 2024). Certain antidepressants (sertraline, paroxetine, fluoxetine, venlafaxine), on the other hand, may be prescribed by a doctor; the APA gives them a conditional recommendation (APA, 2025). Other approaches are sometimes offered alongside, such as neurofeedback: what we know about it today.
Trauma is often accompanied by depression. If this applies to you, this article may help: Depression: understanding what is happening and what genuinely helps.
Where to find help
- Your GP or family doctor: a good first point of contact, who can refer you to a psychiatrist or psychologist trained in trauma.
- Specialist trauma services: many countries have hospital or public services dedicated to post-traumatic disorders; your doctor can tell you about those near you. In France, the regional psychotrauma centres (centres régionaux du psychotraumatisme, CRP) see children, adolescents and adults with post-traumatic disorders. Some can be contacted directly, others require a referral letter from your GP (Cn2r, 2025). According to a map updated in March 2025, 18 centres and their satellite sites cover every region; they are coordinated by the National Centre for Resources and Resilience (Psychotraumap, 2025).
- Victim support services: most countries have free, confidential support for people affected by a crime, an accident, an attack or a disaster. In France, the 116 006 victim support line is free and confidential, open 7 days a week (Justice.fr, n.d.).
- Reimbursed psychological support: ask about the schemes available where you live. In France, the Mon soutien psy scheme reimburses up to 12 sessions a year with a partner psychologist, from the age of 3 and without going through a doctor (Santé.fr, 2026).
For family and friends
- Believe the person and listen without judging or minimising.
- Let them set the pace: it is up to them to choose when, and how much, they talk about it.
- Help in practical ways: go with them to an appointment, reassure them about their safety, keep routines going.
- Be patient with irritability or withdrawal: these are often signs of trauma, rather than a rejection of you.
- Look after yourself: supporting someone close who has been traumatised can wear you out too.
Need help now?
Suicidal thoughts: contact a crisis line: 988 (US/Canada), Samaritans 116 123 (UK and Ireland), or find a local helpline at findahelpline.com. In France: 3114.
Immediate danger: call your local emergency number (999 in the UK, 911 in North America, 112 in the EU).
Victim support: contact your local victim support service. In France: 116 006, free, every day.
Violence against women: contact your local domestic abuse helpline; in the UK, the National Domestic Abuse Helpline 0808 2000 247 (free, 24/7); in the US, the National Domestic Violence Hotline 1-800-799-7233 (24/7). In France: 3919, free and anonymous, 24/7.
Children at risk: contact your local child protection services; in the UK, NSPCC 0808 800 5000. In France: 119, free, 24/7.
Key points
- Trauma is the lasting mark left by an overwhelming event, and it can be treated.
- Reactions in the first few weeks are normal and usually ease.
- Signs that last for more than a month are a reason to see a professional.
- EMDR and trauma-focused cognitive behavioural therapies are the reference treatments.
- Your doctor and local victim support services can point you in the right direction; in France, the regional psychotrauma centres and 116 006 are there to guide you.
References
- American Psychological Association (2025) Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD). Updated 2025 (first version: 2017). Available at: https://www.apa.org/ptsd-guideline/treatments (accessed 16 October 2026).
- Benjet, C. et al. (2016) 'The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium', Psychological Medicine, 46(2), pp. 327–343. Available at: https://doi.org/10.1017/S0033291715001981.
- Cn2r, Centre national de ressources et de résilience (2025) Porte d'entrée vers les soins [Gateway to care]. Available at: https://cn2r.fr/wp-content/uploads/2025/12/Fiche_QR_porte_entree_soins.pdf (accessed 16 October 2026).
- Justice.fr (n.d.) Je suis victime : le 116 006 [I am a victim: the 116 006 line]. Available at: https://www.justice.fr/je-suis-victime/116006 (accessed 16 October 2026).
- Koenen, K.C. et al. (2017) 'Posttraumatic stress disorder in the World Mental Health Surveys', Psychological Medicine, 47(13), pp. 2260–2274. Available at: https://doi.org/10.1017/S0033291717000708.
- Psychotraumap (2025) Cartographie de l'offre de soins en psychotraumatologie [Map of psychotraumatology care services]. Nouvelle-Aquitaine, updated March 2025. Available at: https://ch-laborit.fr/wp-content/uploads/1/2026/02/Psychotraumap-Cartographie-de-loffre-de-soins-en-psychotraumatologie-2025.pdf (accessed 16 October 2026).
- Santé.fr (2026) Le remboursement des séances de psychologues : Mon soutien psy [Reimbursement of psychologist sessions: Mon soutien psy]. Available at: https://www.sante.fr/node/7240885 (accessed 16 October 2026).
- Schnurr, P.P. et al. (2024) 'The management of posttraumatic stress disorder and acute stress disorder: synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline', Annals of Internal Medicine, 177(3), pp. 363–374. Available at: https://doi.org/10.7326/M23-2757.
This article offers general guidance, up to date at the date of publication. It is no substitute for the advice of a doctor, who alone can make a diagnosis, or for support from a psychologist or psychotherapist.
