Psychological trauma was already recognized by the early Greeks as both a cause and a result of deep mental distress. The English word trauma comes from the ancient Greek word τραῦμα, which simply means “wound.” Even 3,000 years ago, the early pioneers of medicine understood that a traumatized person was, in a fundamental sense, wounded.
One of the first to emphasize this was Asclepiades of Bithynia, who may have been the earliest physician to highlight the need for humane treatment of people experiencing psychological distress. Although he opposed Hippocrates—whose name and ideas still shape medical ethics today—Asclepiades can be considered one of the first figures resembling a psychotherapist.
His motto, cito tuto jucunde (“swiftly, safely, sweetly”), reflected his focus on restoring mental and emotional harmony. He referred to this state as psychogenic equilibrium. His treatments included warm baths, massages, calming music, and generous servings of wine, all intended to comfort and heal the emotionally wounded.
The Shift Toward Neuropsychology in the 19th Century
The modern understanding of trauma as a neuropsychological condition began to take shape in the late 1800s. Several important figures, including Freud and Janet, contributed to this shift. However, the most significant progress came from the work of Jean-Martin Charcot, a French neurologist at the Salpêtrière hospital in Paris.
Charcot treated women diagnosed with hysteria, a condition that was believed at the time to occur only in women. Symptoms included sudden paralysis, amnesia, loss of sensation, and convulsions. The common belief was that the cause lay in the uterus.
Until Charcot, hysterectomy was the standard treatment for hysteria. He was the first to suggest that the symptoms were rooted in the nervous system, not in the womb. He also made the first accurate observations of the dissociative state that we now associate with trauma, describing it as a kind of “hypnotic state.”
Charcot seemed to understand instinctively that the distant, vacant expressions of his patients—the “thousand-yard stare”—were signs of the brain trying to cope with overwhelming experiences. He carefully recorded these symptoms, offering insight into the long-lasting effects of trauma on the mind.
War and the Changing Language of Trauma
In the 20th century, war brought trauma into the medical spotlight. During World War I, British doctors used the term “shell shock” to describe soldiers who had been exposed to relentless artillery bombardment and returned with profound psychological changes.
Some of these soldiers appeared mentally absent. This may have inspired the phrase “the lights are on but no one’s home.” Others experienced intense panic, nightmares, flashbacks, and terror. Many were said to have “never come home from the war,” and from a neuropsychological perspective, this was sadly accurate.
In later wars, the terminology changed, although the symptoms remained the same:
- World War II: “battle fatigue”
- Korean War: “operational exhaustion”
All of these terms described similar patterns of trauma that Charcot had documented decades earlier.
The Recognition of PTSD in the DSM
The Vietnam War, along with powerful social movements during the 1960s such as civil rights and women’s liberation, led to increased awareness of trauma. These efforts contributed to the formal recognition of Post-Traumatic Stress Disorder (PTSD) in the DSM-III, published in 1980.
This marked a significant turning point. For the first time, the medical community acknowledged that trauma could cause long-lasting psychological symptoms. PTSD was defined by three main categories:
- Re-experiencing – Individuals would relive the traumatic event, showing that their memory systems had been deeply affected.
- Numbing – Many survivors developed ways to avoid emotional pain and psychological distress.
- Hyperarousal – This state included high anxiety, increased physiological alertness, and symptoms associated with an overactive sympathetic nervous system.
As Christine Courtois, PhD, observed:
“The inclusion of PTSD as an official diagnosis ushered in a new era in mental health. For the first time, it was officially recognized that psychological symptoms could be due to and caused by real-life traumatic events and experiences rather than some flaw or weakness in the victim’s character, the victim’s genetic makeup, or some fantasy or wish.”
PTSD Today: The DSM-5 and Ongoing Understanding
Over the past 35 years, the criteria for PTSD have evolved. The DSM-5, released in 2013, introduced more refined symptom categories. Yet even with advances in diagnostic tools and scientific knowledge, the central issue remains the same.
At its core, trauma still affects a wounded individual. Just as Asclepiades recognized thousands of years ago, healing from psychological trauma requires compassion, understanding, and care.