“Big T” versus “little t” Trauma | Counseling | Therapy

Trauma Therapy in Philadelphia Ocean City Mechanicsville

Alex Robboy , CAS, MSW, ACSW, LCSW — Founder & executive director

Trauma Therapy in Philadelphia, Ocean City, Mechanicsville, Santa Fe image

The Center for Growth Offers Trauma Counseling in Philadelphia, Ocean City, Mechanicsville, Santa Fe, Providence

If you’re questioning whether you might have PTSD (post-traumatic stress disorder), this tip can be helpful in identifying the type of trauma you have experienced and whether it qualifies you for being diagnosed with PTSD. Life is full of “traumas,” however there is a difference between “Big T” traumas, and “little t” traumas. Think about your trauma and based on the descriptions below determine whether your trauma is a “Big T” trauma or a “little t” trauma. Our Trauma Counselors are located in Center City Philadelphia and can help.

A “Big T” Trauma…

-Will qualify you for the possible diagnosis of PTSD because the trauma caused you to fear for your life, fear serious injury to yourself, or fear serious injury or the loss of life of someone else

-Is less common, and contributes to feelings of isolation

-Is usually more serious in nature and may produce more intense PTSD symptoms

-Includes experiences such as surviving a natural disaster, fighting in war, surviving a rape or other sexual attack, surviving sexual or physical abuse, surviving a life threatening car accident or injury or surviving a physical attack such as a robbery or beating

A “little t” trauma…

-Will not qualify you for a PTSD diagnosis because the trauma was not life threatening to yourself or to someone else involved in the trauma, however it is still scary, unsettling, traumatic and/or upsetting

-Is more common, meaning that there is a higher percentage of people who have gone through a similar situation

-Can cause PTSD like symptoms but the symptoms tend to be less severe

-Includes experiences such as being in a non-life threatening situation like a car accident , going through a divorce, finding out a partner who you never suspected was cheating you, loosing your job unexpectedly, being betrayed by a family member or close friend

To illustrate the difference between “Big T” traumas and “little t” traumas, I will give two examples. Review the categories of symptoms for PTSD and examine the differences of these symptoms between the “Big T” example and the “little t” example.

The Examples

“Big T:” Joe Joe had worked for a the Philadelphia City police department for 12 years. He had seen his fair share of both boring calls and adrenaline pumping calls. Six months ago he was called to a domestic dispute. Joe was the first to the scene, and first to enter the house and find a mother shot dead and her two small children who were shot but still breathing. Until back-up arrived and an ambulance for the children, Joe had to attempt to save the children’s lives by stopping the bleeding while also trying to make sure the house was secure. Both children were in the ICU for a period of time and only one survived. The boyfriend who committed the crime was caught a week later and Joe was now involved in the case to prosecute him.

“little t:” Tom Tom was married to his wife for 15 years when he discovered she was having an affair with a close friend of his. Prior to the discovery, Tom had no idea there were issues in the relationship, he was blindsided by the affair and felt very betrayed by both his wife and his friend. Tom felt very confused by what happened in his own marriage and was having trouble emotionally processing what happened. Tom was struggling with what his role in the relationship was and struggling with understanding what went wrong. Tom felt lost and confused by the fact his wife left him for another man also living in Center City Philadelphia when he had no idea anything was wrong.


1. To be diagnosed with PTSD a person must experience a life threatening event, or feared that they or someone else would be seriously hurt or possibly die. Remember, regardless of the type of trauma experienced both experiences at a core level are upsetting and can benefit from counseling.

“Big T:” Joe feared that the boyfriend who shot mother and children was nearby and could return to shoot him. He also experienced intense fear that the children he had found would die.

“little t:” Tom did not fear for his life, or anyone else’s life when he found out about the affair or when his wife stated she wanted a divorce.

2. People with PTSD re-experience the trauma through flashbacks (when a person feels as though they are actually reliving the trauma), intrusive memories, body memories (experiencing the same physical symptoms that one experienced during the trauma),nightmares, etc. Certain smells, types of touch, seeing certain objects of scenes, and sounds can easily trigger a flashback or remind the person of the trauma. Keep in mind, replaying a situation in ones head is a critical part of the recovery process. The act of replaying a situation over and over again is what helps a person make sense of a situation. People often seek help from others when the intensity or frequency of the instant replay in their minds get to be too much. While replay is good – there is such a thing as too much.

“Big T:” While Joe has not had a full blown flashback, months later Joe is troubled by intrusive memories that he has about the event. He could be at home, washing a dish and the memory of finding the critically injured children pops into his memory. He also notices that when he is first to arrive to a call, he now experiences intense fear, a rush of adrenaline, sweating and difficulty breathing (which is the physical response he experienced during the trauma, and especially until back up had arrived). Joe also experiences nightmares about the actual trauma or finding badly injured or dead people.

“little t:” Tom is bothered by intrusive memories about when he first discovered the affair. He also finds himself very preoccupied by replaying different memories and searching for signs about the affair. Tom also finds himself having dreams about his wife cheating on him with all sorts of people they knew.

3. PTSD is also categorized by avoidance. People with PTSD avoid people, places or things that remind them of the trauma. Regardless of the type of trauma experienced, part of healing is a combination of letting go of the past so that there is nothing to avoid. And to remember the past so that one can learn from the experience(s).

"Big T:” Joe finds has found himself distancing himself from his children because they remind him of the critically injured children he found because they are around the same age and are the same gender. Joe avoids arriving to a call first at all costs and has put in a request to transfer to a more administrative position with the DEA. Joe has not been able to eat meat since the trauma because he reminds him of some of the wounds he saw. In fact, when his wife tried to serve him his favorite meal, BBQ glazed ribs, he threw up at the sight of it.

“little t:” Tom has had to find new places to grocery shop, because he and his wife used to go together to one particular shop. He avoids the restaurants they used to dine out together. Tom is considering locating to a new town to get space from the memories that are triggered by the space he currently has to live in.

4. Hyperarousal occurs with PTSD and results in a person feeling on edge, feeling always on guard, having a more reactive startle response, experiencing difficulty sleeping, being more angry or irritable, etc. An important strategy for healing is to take oneself out of dangers way, so that the personal hyperarousal guard can be lowered.

Big T:” Joe finds that he is unable to feel rested because he constantly feels on edge. Even activities that used to help him relax like fishing, working the in yard, playing sports with the kids, are difficult to do because he feels so keyed up. The constant state of heightened adrenaline has left him snapping at his wife and kids. When he is working, he feels even more on edge and his constantly checking his surroundings and location of other cops nearby in case they get a call.

“little t:” Normally a very easy going guy, Tom now finds himself usually irritable or angry. He finds it difficult to concentrate at work and finds it hard to relax at home.

In conclusion…these two Philadelphia cases should illustrate the differences between “Big T” and “little t” traumas. While “little t” traumas can cause PTSD like symptoms, from an outside perspective they are usually not as severe even though to the individual it might feel like the worst thing that has ever happened to them. Furthermore “little t” traumas will not qualify a person for PTSD even if they have every PTSD symptom because the person did not experience an event that caused them to fear their own life or injury, or the life or injury of another person. Regardless of whether you have experienced a “Big T” or “little t” trauma, therapy / counseling can be helpful if you are experiencing PTSD symptoms. Regardless of the type of trauma you have experienced, treatment is similar. The biggest difference is that people who have experienced Big T benefit the most from working with a specialist in this area, whereas most trained therapists can handle little t.

At TCFG you can schedule directly online with a trauma therapist. If you prefer talking to a trauma therapist first, you may call (215) 922-LOVE (5683) ext 100 to be connected with our intake department. Lastly, you can call our Director, “Alex” Caroline Robboy, CAS, MSW, LCSW at (267) 324–9564 to discuss your particular situation. For your convenience, we have six physical therapy offices and can also provide counseling and therapy virtually.

    OUR GUARANTEE: you deserve the best trauma therapist possible. If you wish to try a different trauma therapist simply because, then free of charge you can try out a different therapist. Being in a group practices allows for flexibility.

    The Center for Growth has offices in multiple states. We offer Trauma Therapy inperson as well as virtual trauma therapy appointments.

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Therapy Services Offered in Philadelphia, Ocean City, Mechanicsville, Providence, Santa Fe:

Why seek out trauma therapy in Philadelphia, Ocean City, Mechanicsville, Providence, Santa Fe?

There are many reasons why someone may seek out trauma therapy. Trauma can have a significant impact on a person's emotional, psychological, and physical well-being and can cause a wide range of symptoms, such as:

  • Nightmares or flashbacks of the traumatic event
  • Avoidance behaviors, such as avoiding places or people that may trigger memories of the trauma
  • Feelings of guilt, shame, or self-blame
  • Anger, irritability, or aggression
  • Depression or anxiety
  • Difficulty sleeping or concentrating
  • Physical symptoms such as headaches, stomachaches, or muscle tension
  • Difficulty in relationships and social interactions

Trauma therapy can help individuals address and cope with these symptoms, reduce their intensity and frequency, and improve overall well-being and quality of life.

Additionally, seeking out trauma therapy can help individuals understand and make sense of the traumatic event, which can be an important step in the healing process. The therapy can also help individuals learn to cope with the emotional and psychological distress caused by the trauma, and provide them with the tools to create a more fulfilling and satisfying life after the trauma.

It's important to note that not everyone who experiences trauma needs therapy, however, for some individuals, seeking out therapy can be an important step towards healing and recovery.

Trauma Therapy Services Offered in Philadelphia, Ocean City, Mechanicsville, Providence, Santa Fe:


    InPerson Therapy & Virtual Counseling: Child, Teens, Adults, Couples, Family Therapy and Support Groups. Anxiety, OCD, Panic Attack Therapy, Depression Therapy, FND Therapy, Grief Therapy, Neurodiversity Counseling, Sex Therapy, Trauma Therapy: Therapy in Providence RI, Philadelphia PA, Ocean City NJ, Santa Fe NM, Mechanicsville VA