Not all trauma is met with compassion.

Some forms of trauma are immediately understood. Combat. Sexual assault. Natural disasters. Acts of terrorism. When these events occur, most people instinctively recognize that they may leave profound psychological wounds. We do not question whether survivors “should” have developed post-traumatic stress disorder. We understand that extraordinary experiences can overwhelm the mind’s capacity to cope.

Other forms of trauma are met with something very different.

They are questioned. Minimized. Explained away. Survivors are told they are overreacting, too sensitive, or dwelling on the past. Rather than asking, “What happened to you?” the question quietly becomes, “Why can’t you move on?”

Over the course of my forensic work, I have come to see that our culture does not judge trauma solely by its psychological impact. We also judge it by whether it fits our expectations of what trauma is supposed to look like—and, perhaps more importantly, where we believe it is allowed to happen.

The appeal of this way of thinking is understandable. We like clear categories. We prefer trauma to have obvious beginnings and endings. We want to believe that hospitals are places of healing, families are places of safety, and trusted professionals are there to protect us. When catastrophic events occur in settings meant to provide care, they do more than harm individuals—they challenge our assumptions about the world itself. It is often easier to question the survivor’s response than to confront the unsettling reality of what occurred.

Medical trauma illustrates this tension with particular clarity.

Patients enter hospitals expecting competence, safety, and healing. Most receive exactly that. But when a catastrophic medical event occurs—whether through an unexpected complication, a devastating error, or an experience perceived as profoundly life-threatening—the psychological consequences can be every bit as severe as those following more traditionally recognized forms of trauma. In some cases, the trauma is intensified by a painful contradiction: the very people and institutions entrusted with preserving life become associated with terror, helplessness, and loss.

Yet these survivors are often forced to fight two battles.

The first is recovering from the trauma itself. The second is convincing other people that the trauma was real.

In forensic settings, I have repeatedly seen how psychological injuries become the subject of debate rather than understanding. The focus shifts away from the person’s lived experience and toward whether they should have developed PTSD at all. Their symptoms are dissected. Their credibility is scrutinized. Their suffering becomes something to defend rather than something to heal.

This reflects a fundamental misunderstanding of trauma.

Post-traumatic stress disorder is not determined by whether an event fits society’s preferred narrative. It is determined by the interaction between an overwhelming experience and the human nervous system. Trauma does not ask whether an event occurred on a battlefield or in an operating room. It does not distinguish between violence inflicted intentionally and harm experienced in a place where safety was expected. The brain responds to terror, helplessness, and overwhelming threat—not to our cultural assumptions about what “counts.”

What makes these cases especially heartbreaking is that survivors often endure a second wound. The original trauma disrupts their sense of safety. The response of others can disrupt their sense of reality. When family members, institutions, insurers, or experts imply that their reactions are exaggerated or unwarranted, survivors frequently begin to question themselves. This kind of invalidation can deepen shame, reinforce isolation, and quietly erode the very foundation needed for recovery.

None of this means that every distressing medical experience results in PTSD. Most do not. Nor does it mean that every claim of trauma should be accepted without careful evaluation. As a forensic psychologist, careful assessment is precisely what my role requires. But careful evaluation is very different from beginning with the assumption that certain kinds of trauma are inherently less legitimate than others.

Perhaps the most important lesson forensic psychology has taught me is this: trauma is not defined by our expectations. It is defined by the lived experience of the person who endured it. The question should never be whether someone’s suffering fits our preferred narrative. The question is whether we are willing to understand what that experience meant to them.

The trauma we refuse to see does not become less real because we fail to recognize it. It simply becomes another burden survivors are forced to carry—often in silence. And sometimes, the deepest psychological injury is not only what happened, but the long, exhausting struggle to convince others that it mattered.