Type III Trauma: Toward a More Effective Conceptualization of Psychological Trauma

Abstract

Research on offenders and crime victims underscores the importance of identifying trauma-related events and treating their effects. The authors build on the work of psychiatrist Lenore Terr, who distinguished Types I and II psychological trauma, by proposing a third category, Type III trauma. Type III trauma occurs when an individual experiences multiple, pervasive, violent events beginning at an early age and continuing over a long period of time. Diagnostic criteria include alterations in memory and consciousness, frequently including dissociation; emotional numbing; major developmental deficits; poorly developed, often fragmented, sense of self; a core belief that he or she is fatally flawed and has no right to be alive; a sense of hopelessness and shame; trust issues that interfere with normal relationships; and no concept of a future. Treatment of individuals who have sustained Type III trauma is more complex and demanding relative to survivors of Types I or II trauma.