UNVEILING DEPTH
CHALLENGING PERCEPTION
Trauma is not an isolated event but a force that infiltrates the momentum of a life, quietly reshaping identity, perception, and behaviour across time in ways no clinical definition can fully name or contain.
It has come to me, through observation and through the slow accrual of my own experience, that every traumatic encounter a person endures tends to infest the momentum forward through the line of events that follows it. A dark thing occurs. The life, the brain, the self, the being, the identity, all of it, in involuntary submission, adapts. We are forced to change ourselves in response to what has happened to us, and the change, once it has occurred, becomes the ground upon which everything afterwards is built.
A to Z, if you will.
Since we do not live in a straight line but can use the principle of a straight line as the medium through which we have moved through time and space, beginning at one location and experiencing one thing and arriving at another, let us position ourselves at J, where most reflection tends to happen, and let the alphabet represent youthful life at A and old age at Z. The specific agony that is said to have "made us who we are" did not begin at the moment of recognition. It began much earlier, and its entry into the life has been continuous ever since.
If one was bullied in youth, at A or B, which I am declaring as a mild form of trauma given the full catalogue of options available to us in this human condition, the young subject may be inclined toward revenge, toward a permanent withdrawal from intimacy, or toward the rejection of his own cognitive callings as they arise within his awareness. From these private responses the victim is born, or the revenge seeker is born, not from the event itself but from the stories only he is formulating in his own imagination and rational thought.
The pictorial memories are delivered and return with a torment that disturbs his current world because it is different to the one that was once lived. These images, ghostly, slightly faded in appearance, brutally humiliating in their internal soundtrack, tell him only one side of the story. Most often, we find that the storyline a person tells himself about his own wounding is complimented and reinforced by the features of his culture and by those who surround him, and the wound becomes not merely personal but communal, inherited, already half-written before he takes up the pen.
While he strives forward at his own expense, sometimes never sharing a word with anyone about such events, this storyline begins to take on the appearance of a confidence trickster, a thief, the instinct of the perfidious friend who has yet to be unveiled before him. It is a story that has been forced to reconcile itself because he had to react in the present with the aligned movement of his limbs and breath, to flee from that moment, and to seek out a form of inner shelter to be secured.
This one-sidedness is often characterised by the very version of ourselves that we abandoned during the moment we witnessed the dissimulation of morality, or, to phrase it more exactly, the infestation of a sick will exerted upon us by a stranger, if we are to stay with bullying or public humiliation in the mind of the youthful one. The self that was present before the event does not survive the event. The self that emerges afterwards is already a negotiation, already a compromise between what was felt and what could be tolerated, already, in some irreversible way, estranged.
And yet, as we age, we come to understand the bully himself to be somewhat "traumatised", a fact that often goes unexamined because it complicates the moral architecture of the memory. It is commonly the case that the youthful bully who seeks to implement his will of anger, insecurity, and the need to be liked and supported by others who are seeking the same ideals is doing so from the inheritance of his traumatised parents, who have constructed the environment of his home in such a way that the child, once outside of it, declares war on himself through the abolition of the joys and freedoms of those he perceives as weaker than himself. The aggression is not his. The aggression was given to him, and he is merely distributing it onto whatever surface is available to absorb it.
Let us look at the word "traumatised" and how it is defined by the psychiatric industry.
In the clinical register, "traumatised" refers to the psychological and physiological response to a deeply distressing or disturbing event that overwhelms an individual's capacity to cope. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the document from which the Western therapeutic apparatus draws almost all of its working vocabulary, clarifies the matter further. Trauma, it asserts, is an event that includes "actual or threatened death, serious injury, or sexual violence".
Are we to suppose, according to their claim, that our trauma is limited to threatened death, to serious injury, or to sexual violence? Do we not carry our own traumas that only we know of, that do not fit inside this narrow container? How many of us quietly bear broken souls that became broken from none of these listed psychic currencies, and yet bear them nonetheless? How many of us have been dismantled by humiliations, by abandonments, by slow and unnamed erosions that would never qualify under Criterion A and yet have shaped the whole architecture of who we now are?
Once again the psychiatric industry provides the features of a condition that is not accurately lived by us, the people, the very ones who have endured our own pain and who continue to do so, not in spite of this trauma but in the commitment to endure our suffering most of the time alone.
The manual's definition is not neutral. It is not a passive description of a phenomenon existing independently in the world, patiently awaiting its accurate catalogue. It is a decision. It is an act of authorship, conducted in committee rooms, finalized by vote, and then pressed outward into insurance policies, court rooms, clinical intake forms, military discharge categories, and the private self-understanding of millions of people who have been told whether their suffering counts. Criterion A is not a window onto pain. It is a gate. And the men and women who wrote it have decided, on our behalf, which of our wounds are admissible.
The decision is contested even inside the profession that enforces it. The psychiatrist Richard McNally has argued for years that the broader definitions of previous manuals produced what he called bracket creep, the slow expansion of the category until nearly any distressing event could qualify. The tightening of the definition in the fifth edition was, in part, a response to this. But the tightening created its own crisis, which the field has not resolved.
A growing body of research, published in reputable journals and ignored by almost no serious clinician under forty, demonstrates that individuals exposed to events outside Criterion A, chronic emotional abuse, sustained racial discrimination, the slow confrontation with a loved one's terminal illness, the psychological degradation of an unhappy marriage, report symptom profiles identical to those produced by the events the manual recognizes. The hyperarousal is the same. The intrusive imagery is the same. The avoidance, the negative cognition, the years of rearranged life, all of it presents the same. The wound is the same. The verdict is different.
A 2024 meta-analysis drawing on one hundred and twenty-four studies found that so-called non-Criterion A events produced pooled rates of posttraumatic symptomatology roughly equivalent to those produced by the events the manual allows. A study of fifteen hundred college students published the same year arrived at the same conclusion through a different door, and found additionally that a substantial proportion of students with clinically significant symptoms had no Criterion A event to report at all.
The profession is confronting, slowly and under considerable internal pressure, the fact that its own cardinal gate is leaking. What the ordinary person has known forever, that you can be broken by what does not bleed, that the soul registers violence the body never sees, is now emerging in the peer-reviewed literature as a methodological embarrassment. The industry is catching up to the living.
But the deeper provocation is not that the definition is wrong. The deeper provocation is that a definition was ever thought sufficient. To place the whole catastrophe of human suffering inside a bulleted list of qualifying events, to declare the list closed, and then to administer access to recognition, treatment, compensation, and legitimacy on the basis of that list, is a species of bureaucratic violence that the suffering person must then endure on top of his original wound.
He arrives broken, and the apparatus requires that he prove his brokenness conforms to an approved template. If it does, he is given a name and a treatment protocol. If it does not, he is told that what has happened to him, however total in his interior, does not rise to the level of the real. The industry does not heal him. The industry first adjudicates whether he is permitted to be in pain.
And who adjudicates? Here we arrive at the deeper rot, the one the profession is least willing to examine directly. The physician who wears the white coat of the clinical encounter is not a disinterested party. He is not a vessel of neutral expertise lowered from above into the wound of the patient. He is a human being, carrying his own unexamined inheritance, his own untreated grief, his own quiet catastrophes that never met Criterion A and therefore never received the recognition he is now being paid to extend to others.
The data on this, once one begins to look, is devastating. The 2023 Practitioner Pulse Survey conducted by the American Psychological Association reported that thirty-six percent of practicing psychologists were burned out, a figure that had peaked at forty-seven percent in 2021 and has not returned to pre-pandemic baseline since. The Simple Practice Therapist Well-Being Report of the same year, surveying five hundred and fifty mental health practitioners, found that fifty-two percent had experienced burnout in the previous twelve months, and twenty-nine percent were currently inside it.
A separate review of the profession, published in Perspectives on Psychological Science, reported that eighty percent of those in mental health internships or jobs disclosed a lifetime history of mental health difficulties, with forty-eight percent carrying a formal diagnosis of their own. A Veterans Affairs study found that when the clinician delivering trauma-focused psychotherapy was himself burned out, the odds that his patients experienced clinically meaningful improvement in their PTSD symptoms dropped by roughly one-third.
This is the scene we have constructed. The wounded is treated by the wounded. The evaluator is evaluating from inside the same condition he is paid to evaluate. The literature on psychologist suicide, reviewed across multiple decades, indicates elevated risk among practicing clinicians compared to the general population. The men and women we have appointed as the gatekeepers of our suffering are, in many cases, standing at the gate because they could not stand anywhere else, and they are gatekeeping a phenomenon they have not themselves learned to cross.
I am not offering this as a dismissal. The clinician who suffers and continues to work is not a fraud. He is, in some ways, the only kind of witness worth having, because he knows. The problem is not his suffering. The problem is the pretence that the clinical encounter is conducted from a position of health assessing illness, from competence assessing incapacity, from one who has made it across assessing one who has not.
The encounter is, in truth, conducted between two people standing at slightly different points on the same road, and the pretence that the road has been completed on one side of the desk is the structural lie that the whole therapeutic apparatus is built upon.
We are pledging our agony into the hands of another who is wearing the same agony. In what sense is this feasible? In what sense can we listen to an industry that does not comprehend our lives as we directly live them, whose definitions have to be retrofitted every decade to account for the suffering its last definition missed, whose practitioners are burning out in greater numbers than at any point in the profession's recorded history, and whose foundational claim to authority rests on a manual authored by a committee of human beings no less broken than the rest of us?
Modern therapy is rooted in the pretentious and volatile divide between the colorings of intelligence and stupidity, between the credentialed knower and the unlettered sufferer, between the one who has read the manual and the one whose life has written it. This divide is fictional. It has always been fictional. The credential does not confer the crossing. The manual does not contain the territory. And the practitioner who believes it does is the practitioner who will fail his patient most completely, because he will be consulting a map while the patient is dying in a country the map does not show.
By suffering, and by talking about it with momentum and movement, directly. By refusing the verdict of the manual when the manual does not recognise what has happened to us. By understanding that trauma is not an event but a force, that it infiltrates the momentum of a life, that it reshapes identity and perception and behavior across time in ways no clinical definition can fully name or contain. By recognising that the woman bent over her ironing board at fifty, who jolts when her husband closes a door too loudly, is carrying something the industry would not allow her to call by its real name, and that her knowledge of her own condition is more accurate than the book that refuses to admit her.
The wound is the authority. The one who has endured it is the authority. Anything else is a clergy, administering legitimacy from behind a desk to a population whose suffering was already legitimate before the clergy arrived, and whose only mistake, most of the time, has been to trust that someone in a clinical office understood what the long silence of the unlisted wound has been trying, for years, to communicate.
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Written by Bailey Booth