Rebuilding After Trauma: What Kinds of Trauma Are We Really Talking About?

The word "trauma" is everywhere. But do psychologists, everyday conversation and the media really mean the same thing by it?

In this article we clarify what psychological trauma is in the clinical sense, which kinds of events can be traumatic, how they affect the mind, and how to rebuild with the help of a professional, especially in a context of war and conflict like the one we have lived through in Israel since October 7, 2023.

What do we really mean by psychological trauma?

In psychology and psychiatry, psychological trauma does not simply mean great suffering or an "emotional shock". It means exposure to an extremely threatening or horrific event, often involving a risk of death, serious injury or sexual violence, experienced directly, witnessed, or learned about as happening to someone close (for example a terrorist attack or a serious accident).

International classifications (DSM-5, ICD-11) stress this life-threatening or terrifying nature of the event. But they also point out that the same event does not have the same psychological consequences for everyone: some people will develop post-traumatic stress disorder (PTSD), others will not.

According to the World Health Organization, about 70% of people worldwide will be exposed to at least one potentially traumatic event in their lifetime, but only a minority will develop PTSD; the lifetime prevalence of PTSD is estimated at about 3.9% of the world population (2017–2019 data, fact sheet updated in 2024).

Potentially traumatic event versus trauma-related disorder

It is essential to distinguish:

• The potentially traumatic event: assault, accident, rape, terrorist attack, combat, natural disaster, and so on.
• The psychological response: some people will have a few weeks of nightmares, anxiety or hypervigilance and then regain their balance; others will develop PTSD or other conditions (depression, anxiety, addictions…).

Talking about psychological trauma therefore means talking about an encounter between an extreme event and a person, in a given context (life history, resources, social support, culture, etc.).

The main types of trauma: seeing more clearly

To better understand what "rebuilding after trauma" means, it helps to distinguish several broad categories often used by trauma specialists.

1. Single-incident trauma: the sudden, unexpected event

This is often called type I trauma or "single-incident" trauma. It is a sudden, often unpredictable event, for example:

• a serious road accident;
• an assault or armed robbery;
• rape or attempted rape;
• a terrorist attack, explosion or shooting;
• a natural or industrial disaster.

These events can lead to intrusive images, nightmares, intense fear of going out, and difficulty returning to work or using public transport. In some cases they develop into PTSD; in others, into gradual recovery, especially if the person is well supported and receives help quickly.

2. Repeated and prolonged trauma: violence, war, captivity

Chronic or repeated trauma occurs when a person is exposed for a long time, or many times, to threat or violence:

• repeated domestic or family violence;
• persistent bullying or sexual harassment;
• prolonged exposure to war, bombing, rocket fire;
• captivity, kidnapping, torture;
• a childhood spent in a climate of terror, threats or constant belittling.

This kind of history can lead to what the ICD-11 (the WHO classification) calls complex post-traumatic stress disorder (C-PTSD), which combines the classic symptoms of PTSD with marked difficulties in regulating emotions, self-esteem and relationships. This diagnosis was formalised in the ICD-11 in 2018 and has been in effect since 2022.

3. Childhood trauma and adverse experiences (ACEs)

Violence and neglect experienced in childhood create a particularly vulnerable ground:

• sexual, physical or psychological abuse;
• serious neglect (physical or emotional);
• repeated exposure to domestic violence;
• parents dependent on alcohol or drugs, imprisoned or seriously ill;
• an unpredictable, threatening family climate.

The well-known Adverse Childhood Experiences (ACEs) studies show that most adults report at least one form of adversity in childhood, and that about 16% report four or more, which multiplies by 4 to 12 the later risk of depression, addiction or suicide attempts.

These experiences do not always take the form of a single dramatic "event", but rather of an environment that is dangerous, humiliating or unpredictable overall. Their impact can show up years later as anxiety, depression, relationship difficulties or physical symptoms.

4. Collective trauma: attacks, war, forced displacement

Collective trauma affects a large number of people at the same time: wars, terrorist attacks, pogroms, forced displacement, collective disasters. Sadly, it is familiar to many people living in Israel or with ties to Israel.

Studies conducted in France after the 2015 attacks show that 6 to 18 months after the events, about 18% of witnesses had PTSD, with rates of more than 30% among people directly threatened, and more than 50% among those taken hostage or seriously threatened during the November 13 attacks.

These figures are a reminder that a context of collective violence can leave deep marks, even on those who "weren't physically hurt" but were exposed to the images, the sirens, the stories or constant worry for their loved ones.

In this context, specialised psychological support can help put words to this collective and individual experience and prevent lasting PTSD from taking hold.

Psychological trauma related to the war since October 7, 2023

Since October 7, 2023, millions of people living in Israel, or with loved ones there, have been exposed to prolonged violence: terrorist attacks, rocket fire, bombing, constant threat, military call-ups, loss of life, violent images broadcast nonstop, and constant worry for loved ones.

Even without physical injury, this repeated exposure is a major risk factor for psychological trauma.

A chronic threat, not an isolated event

Unlike an accident or a one-off assault, war goes on over time. The danger has not passed: it comes back, sometimes unpredictably.

This context encourages:

• constant hypervigilance (watching for the slightest noise, the sirens, the news);
• a feeling of permanent insecurity, even at home;
• intense nervous fatigue, because the alarm system can never "switch off".

In many people, the body stays stuck in survival mode.

Common, normal reactions… that can become a disorder

In the weeks or months after the start of the conflict, many reactions are normal:

• sleep problems, nightmares;
• irritability, anger, nervousness;
• difficulty concentrating, reduced efficiency at work;
• anxiety for your children, partner or parents;
• a compulsive need to follow the news, or on the contrary total avoidance of it.

For some people these reactions gradually fade. For others they take hold or get worse, and can develop into:

• post-traumatic stress disorder (PTSD);
• an anxiety or depressive disorder;
• significant avoidance (no longer going out, no longer using transport, isolation);
• increased use of alcohol, medication or screens "to keep going".

Exposed without being directly attacked: real trauma

People often say: "I wasn't injured or taken hostage, I shouldn't complain."

Yet the scientific evidence is clear: repeated exposure to a threat of death, even indirectly (sirens, rockets, loved ones called up, violent news), can be enough to cause psychological trauma.

The brain does not always distinguish between a danger experienced directly and a danger perceived as imminent and uncontrollable. This is particularly true of:

• children and teenagers;
• people who have already experienced earlier trauma;
• expats and socially isolated people;
• families of soldiers, reservists or victims.

A specific situation for those with ties abroad

For people living in Tel Aviv with family or roots abroad, the experience is often twofold:

• worry for yourself and your loved ones here;
• misunderstanding, loneliness or tension with people abroad;
• a feeling of having nowhere to "set down" what you are living through, for lack of people who share the same context.

This gap can deepen the sense of isolation and make it harder to process the trauma.

In this context, specialised psychological support, in your own language, with a professional who knows the local reality, can help put words to what you are living through, come out of shock or constant high alert, and prevent lasting trauma from taking hold.

Not every shock is trauma: telling the difference without minimising

In recent years the word "trauma" has been used very broadly: a breakup, a failed exam or a conflict at work are sometimes called "traumas". This change in language can help some people dare to talk about their suffering, but it can also blur the picture.

It is important not to minimise the pain of a separation, a bereavement, a divorce, a betrayal, a dismissal or burnout. These events can cause intense distress, call for therapy and affect mental health. They simply do not always meet the strict criteria for trauma as defined by international classifications.

When do we speak of psychological trauma?

We speak of psychological trauma in the clinical sense when there is:

• Exposure to an event involving actual or threatened death, serious injury or sexual violence, experienced directly, witnessed, learned about as happening to someone close, or repeated in a professional setting (first responders, soldiers, healthcare workers…).
• Persistent symptoms (beyond one month): reliving the event, nightmares, avoidance, hypervigilance, irritability, sleep problems, difficulty concentrating, etc.
• Significant impact on daily functioning (work, studies, family life, social life).

This framework helps identify people who need specialised psychotherapy, without excluding other forms of psychological suffering.

When is it rather a life ordeal or an emotional wound?

Some painful experiences do not meet the criteria for "official" trauma, but can still:

• undermine self-esteem;
• bring anxiety, sadness, anger, shame;
• reopen old wounds;
• disturb sleep, appetite and concentration;
• damage trust in others.

Whether it is grief, separation, family conflict, or difficulty settling in Israel or a new country, individual therapy can help you get through these ordeals, understand them and strengthen your resources, even without PTSD.

How does trauma affect the body, emotions and relationships?

Trauma is not just a bad memory. It affects the body, the emotions, the way you see the world and yourself, and sometimes the very ability to feel connected to others.

Possible short- and long-term symptoms

After a potentially traumatic event, it is common to experience:

• intrusive images, flashbacks, nightmares;
• a feeling that "it's still happening";
• intense fear, hypervigilance (startling at the slightest noise, needing to check exits, etc.);
• avoidance (not going out, avoiding certain roads, people, places, conversations);
• irritability, anger, sometimes turned against yourself;
• difficulty concentrating, significant fatigue, muscle tension, physical pain.

In PTSD these symptoms last beyond a month and often come with very negative thoughts about yourself or the world ("I'm not good enough", "the world is dangerous", "I'll never get over it").

Risk factors and protective factors

Not everyone reacts the same way. Studies show that the risk of PTSD is higher when:

• the event was particularly prolonged, violent or targeted (torture, repeated sexual violence, war);
• there were serious injuries, deaths or an extreme threat to life;
• the person has already experienced other trauma, especially in childhood;
• there is a family history of mental health conditions;
• the person is isolated or does not feel supported after the event.

On the other hand, several factors appear protective:

• strong social support (family, friends, community);
• being able to talk freely about what happened, at the right pace;
• early access to appropriate psychological care;
• keeping, as far as possible, a structure to daily life (rhythms, routines, activities);
• a culture or spirituality that offers ways to make sense of the event.

Examples of potentially traumatic situations and possible reactions

Rebuilding after trauma: what concrete paths?

The good news, confirmed by international studies, is that most people exposed to a potentially traumatic event eventually get better over time, especially when they are supported and have access to appropriate care.

The role of time, the body and connection

Rebuilding does not mean "forgetting", but being able to:

• think about what happened without being overwhelmed every time;
• regain a minimum of inner and outer safety;
• gradually return to as full a life as possible (relationships, plans, pleasures).

Some important levers:

• Take care of your body: sleep, food, gentle exercise, medical care if needed.
• Stay connected: choose people you trust, who can listen without judging.
• Limit over-exposure (violent images, social media) that keeps reactivating the trauma.
• Accept help: doctor, psychologist, support groups, community.

Evidence-based psychotherapies

The WHO recommends structured psychological interventions as the first-line treatment for PTSD: trauma-focused cognitive behavioural therapy, exposure therapy, EMDR, etc., delivered individually or in groups, in person or online.

These approaches help to:

• put order into memories that are sometimes very fragmented;
• learn to regulate anxiety and intense emotions;
• work on thoughts of guilt, shame or helplessness;
• gradually reconnect with avoided situations, in a safe setting.

The support offered by a clinical psychologist in Tel Aviv

In Tel Aviv, Carinne Leibovici, a French clinical psychologist, offers therapy in English, Hebrew and French, in the office or by video. She draws in particular on:

• cognitive behavioural therapy (CBT), to work on automatic thoughts, avoidance and gradual exposure to feared memories and situations;
• the psychodynamic approach, to understand how trauma reawakens older issues (childhood, attachment, family history);
• the systemic approach, useful when trauma strongly affects the couple, the family or parenting.

Depending on needs, the work can take the form of individual therapy, couples therapy or family therapy, to involve loved ones in the rebuilding process when relevant. Sharing your experience with others in group therapy can also help break isolation.

When trauma affects work or your life plans

A traumatic event can deeply change your relationship to work, life abroad, your career or your aliyah plans. In these situations, personal and career coaching led by a clinical psychologist can help you:

• reassess your priorities after the shock;
• regain confidence in your skills;
• adjust your pace, goals and work environment;
• prevent post-traumatic burnout or dropping out of work.

What if I can't come to the office?

For people living far from Tel Aviv, travelling, or for whom getting out remains frightening after a traumatic event, it is possible to work online. Research shows that for many psychological difficulties, online therapy is comparable to in-person sessions when it is well structured and led by qualified professionals.

FAQ: trauma and rebuilding

How do I know whether what I went through is "real" trauma or a difficult ordeal?

What makes the difference is not only the intensity of the pain, but the nature of the event (threat of death, serious injury, sexual violence, war, attack, etc.) and the persistence of symptoms. If you faced a situation where your life (or a loved one's) was really in danger, and more than a month later you still have flashbacks, nightmares, major avoidance, hypervigilance or difficulty functioning day to day, it may be a trauma-related disorder. If in doubt, talking with a psychologist can clarify things without minimising what you went through.

How long does it take to recover from psychological trauma?

There is no "normal" timeframe. Many people see their symptoms gradually decrease over a few weeks or months, especially if they are well supported. Others remain stuck in reliving, fear, avoidance or great fatigue several months or even years later. Studies show that with appropriate treatment (structured, trauma-focused therapies), a large proportion of patients see their PTSD symptoms decrease significantly within a few months.

Can post-traumatic stress disorder (PTSD) be cured?

Yes, PTSD is not a life sentence. Many studies show that approaches such as trauma-focused CBT and other specialised therapies bring a clear reduction, or even disappearance, of symptoms in a large share of people treated. Some emotional traces of the trauma may remain, but they no longer take up all the space, and the person can return to a full, engaged life. Some then continue deeper work (psychodynamic, systemic) to integrate the event into their life story.

Can trauma resurface years later?

Yes, it can. Sometimes an old trauma, especially from childhood, seems "set aside" for years. A later event (a new assault, the birth of a child, a bereavement, a new war or attack, etc.) can then reactivate the memories and emotions attached to it. Trauma can also resurface during major life changes (retirement, migration, separation). This does not mean the earlier work was useless, but that new layers of meaning are emerging. Returning to therapy often makes it possible to get through these reactivations without being overwhelmed.

Is online therapy effective for working on trauma?

Recent research shows that for many anxiety and depressive disorders, including PTSD, video therapy can be as effective as face-to-face therapy, provided it is led by trained professionals in a secure setting. This can be particularly useful for expats, people who are geographically isolated, or those who find it hard to get out after a trauma. Carinne Leibovici's online sessions let you be supported in English, Hebrew or French from home.

What now?

If you recognise yourself in some of what is described here, remember that you are not alone and that there are ways to rebuild, whatever the nature of the trauma (a single event, repeated violence, childhood trauma, war or attacks, an intense life ordeal).

You can look through the therapies offered to find the most suitable framework, or simply get in touch to ask your questions or book a first session, in the office or by video.

With several psychologists, Carinne Leibovici also offers free, anonymous 24/7 support in French at 03-350 5050 for soldiers, reservists and worried relatives, to help prevent post-traumatic stress. In Hebrew and English, NATAL's helpline is available at 1-800-363-363. If you or someone close to you is affected by the security situation in Israel, don't hesitate to ask for help: talking to a professional trained in trauma, in your own language, can be a decisive first step towards rebuilding.