Trauma and the Loss of Place: Towards a Wider Definition of Psychological Trauma

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Abstract

Current diagnostic definitions of psychological trauma start from an event. They treat the individual as the one who carries the harm and the past as the time in which it happened. Work on complex, historical and continuous trauma, alongside research on ecological grief and solastalgia, has loosened each of these assumptions, yet the strands are rarely brought together in a single working definition. Drawing on clinical practice with refugees and a selective review of the literature, this concept paper proposes that psychological trauma is lasting damage to a person’s or a community’s capacity to feel safe, to trust, to belong and to make sense of life, following the destruction of, or continuing threat to, what that life depends on, including place. It offers questions for separating trauma from grief, justified fear and adaptive survival, a first framework for assessment, and a hypothesis that damage is more likely to last where repair is out of reach.

Keywords: trauma; place; displacement; ecological grief; continuous traumatic stress; community; psychotherapy

Introduction

One of the people I worked with in Dublin, a Palestinian refugee, kept a small pouch of soil from her family’s olive grove after it was razed. In our sessions, we built grounding exercises around it. She held the soil to reconnect with her heritage while staying in the present, and the pouch became an item of safety and comfort (AlAli, 2025).

I return to that pouch often because it raises a question that the usual vocabulary of trauma answers poorly. Clinical language can describe what happens to a person after a threatening event: intrusive memories, avoidance, heightened arousal, and changes in mood and belief. It is less able to describe what was taken from her. An olive grove can hold a family’s food, work and history across generations. Destroying it destroys a setting in which a life has been built and made meaningful.

If we take that kind of loss seriously, trauma has to be understood in relation to the conditions that make a life liveable: physical safety, close relationships, belonging, and a place in which one’s life remains recognisable. The loss of land and environment through war, extraction or climate change belongs within this account. Loss does not automatically make trauma, and keeping that difference clear matters as much as widening the account.

This paper has two aims. The first is to give land and place a clear position in the definition of psychological trauma. The second is to keep the definition tight enough to be useful, so that it separates trauma from grief, justified fear and survival responses that serve a purpose. It is a concept paper. It draws on selected literature and on my clinical practice, and it is not a systematic review.

What Current Definitions Capture

The two main diagnostic systems approach trauma through exposure to threatening or horrific events. The DSM-5-TR specifies exposure to actual or threatened death, serious injury or sexual violence. Exposure may involve direct experience, witnessing an event, or learning that a traumatic event occurred to a close family member or friend, subject to the criteria specified for such exposure (American Psychiatric Association, 2022). The ICD-11 describes post-traumatic stress disorder as a condition that may develop following an extremely threatening or horrific event or series of events. It identifies three core features: re-experiencing the event in the present, avoidance, and a persistent sense of heightened current threat (World Health Organization, 2021).

These frameworks give clinicians shared criteria. Their limits show when harm is prolonged, when social and political conditions drive it, or when the loss fits no exposure category. Herman (1992) drew attention to the effects of prolonged captivity and repeated interpersonal violence, arguing for recognition of complex post-traumatic stress disorder. Bonanno (2004), meanwhile, demonstrated the importance of resilience research: many people exposed to highly adverse events maintain or regain their functioning, so exposure alone cannot establish the presence of lasting psychological injury. Saraiya et al. (2025) have asked whether DSM Criterion A excludes invisible, identity-based and systemic harms, and Engelhard et al. (2026) have reopened the wider debate over what trauma means.

Read together, the diagnostic definitions rest on three assumptions. The event is the starting point: trauma is defined by what happened. The individual is the unit: the injury sits inside one person. The past is the time: the event is over, and what follows is “post”. Each assumption describes some people’s experience well. Each describes others badly, and those it describes badly are often people living under occupation, displacement or the slow destruction of their land.

Four questions remain central to this debate:

1. Is trauma the event, the injury, the process, or the consequences?

2. Does exposure to a terrible event amount to trauma, given that people differ in what they are left with?

3. What part do power and circumstance play in determining who is exposed, who can escape, and who receives protection afterwards?

4. How do we distinguish trauma from fear that fits the danger, grief, and survival responses that serve a purpose?

Trauma Where the Danger has not Ended

The term post-traumatic can suggest that the danger belongs to the past. For many of the people I have worked with, it does not. A Syrian mother who startles at loud noises may be responding to her experiences in a war zone while also living with uncertainty about her asylum application (AlAli, 2025). Understanding her response as a symptom alone leaves out the conditions that continue to shape her sense of safety.

The concept of continuous traumatic stress, revisited by Straker (2013), addresses situations in which stress persists because the threat persists. In the occupied Palestinian territory, Giacaman et al. (2011) examine mental health in relation to social distress and political oppression. In conflict settings more widely, Miller and Rasmussen (2010) argue for connecting trauma-focused approaches with psychosocial work that attends to daily stressors alongside direct exposure to war, and Summerfield (1999) questioned assumptions underpinning psychological trauma programmes in war-affected areas. A scoping review of trauma and selfhood in the Arab region highlights the limitations of applying individualised PTSD models without adequate attention to contextual, structural and cultural factors. It included only ten studies, but it raises a question about whose assumptions about the self are built into the definitions we use (Hosny et al., 2024).

Power shapes who is exposed to harm, who can leave, who is protected afterwards, and the conditions in which recovery takes place. Work on historical trauma extends this across generations, while recognising that how harm is transmitted and experienced needs further investigation (Kirmayer et al., 2014).

Land and Place

People live their lives through places. Fullilove (1996) brought together work from geography, psychology, anthropology and psychiatry to develop a psychology of place, examining how attachment, familiarity and identity connect people to their environments. Displacement can disrupt these connections and the routines, relationships and meanings that depend on them.

Research on environmental loss has given names to some of these experiences. Albrecht et al. (2007) introduced solastalgia to describe distress associated with environmental change experienced in a place one continues to inhabit. Cunsolo and Ellis (2018) developed the concept of ecological grief for climate-related losses, and Comtesse et al. (2021) examined whether it is a mental health risk, a functional response, or both.

Evidence concerning industrial extraction is also growing, although important limitations remain. A systematic review of 29 studies found predominantly negative mental health effects among Indigenous communities affected by dams, petroleum development and mining, connected to colonial relations and threats to identity, language, spirituality and ways of life. The authors noted that much of the evidence was qualitative, only one epidemiological study met their inclusion criteria, and none of the included studies treated Indigenous communities as equal research partners (Morton Ninomiya et al., 2023). Nixon’s (2011) concept of slow violence helps explain why such harm may remain unrecognised: it accumulates gradually, in a dispersed way, and is hard to identify as violence.

The destruction of place is sometimes a by-product of other aims, as with a mine or a dam. In war and occupation, it can also be a method. International law already accepts that a group can be harmed through the conditions imposed on its life: the Genocide Convention names “deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part” (United Nations, 1948, Article II). If the law can name the destruction of a group’s conditions of life as harm, psychology can ask what that destruction does to the minds of the people who live in what remains.

A Palestinian man I worked with described himself as an uprooted tree. We did not treat his loneliness as a defect in him. We explored the relationships that had sustained him and worked on restoring connections: relearning his grandmother’s recipes, joining a group where mourning songs connected exiles, and growing mint in a pot because its smell reminded him of his morning tea at home (AlAli, 2025).

The literature reviewed here indicates that loss of place can carry profound psychological consequences. Much of it describes grief, distress and general mental health symptoms. It rarely asks when the loss of place becomes trauma, understood as lasting damage to the capacity to feel safe, to trust, to belong and to make sense of life. That is the conceptual question this paper addresses.

A Working Definition

I propose the following definition:

Psychological trauma is lasting damage to a person’s or a community’s capacity to feel safe, to trust, to belong and to make sense of life. It follows the destruction of, or continuing threat to, what that life depends on: physical security, close relationships, community, and a place in which one’s life remains recognisable.

The threat may reach a person through direct experience, witnessing, learning of serious harm to someone close, or living under conditions that wear these foundations away. In plain terms, trauma is what is left damaged in a person or a people when what their life stood on is destroyed or kept under threat.

Alongside the definition I offer one hypothesis that can be tested. Damage is more likely to last where repair is out of reach: where the threat continues, where return is denied, or where the loss goes unacknowledged. Herman (1992) placed safety at the start of recovery, and Miller and Rasmussen (2010) argued that daily stressors matter alongside war exposure. The hypothesis carries their reasoning to place. A woman whose grove is razed, who can return, replant and have the loss recognised, is in a different position from a woman whose grove is razed, who cannot return, and whose loss is denied. The definition does not say the second woman will be traumatised. The hypothesis says her risk of lasting damage is higher, and that care for her has to reach beyond the consulting room.

What it adds

The definition builds on work on exposure, complex trauma, historical trauma, continuous traumatic stress, solastalgia and ecological grief. These bodies of work have addressed aspects of safety, relationships, meaning and context, but they have rarely brought them together in a single account of psychological trauma. The definition brings four connected capacities together in one account, gives place a clear position among the foundations of psychological life, extends the question of trauma to communities as well as individuals, following the emphasis on collective experience in work on historical trauma (Kirmayer et al., 2014), and offers the repair hypothesis, which makes the definition something that can be tested. Whether it explains more than existing formulations is an empirical question.

It is also close to complex PTSD, and that overlap should be stated. The ICD-11 describes complex PTSD as PTSD symptoms together with disturbances in self-organisation, meaning problems in managing emotions, a negative sense of self and difficulties in relationships, following prolonged or repeated events from which escape is difficult or impossible (World Health Organization, 2021). Trust and belonging sit close to disturbed relationships, and meaning sits close to a damaged sense of self. Complex PTSD is a diagnosis built around a person’s symptoms. The definition here is a concept about what is damaged and what a life depended on. The two can sit side by side, and what this one adds is place and community as things that can be lost.

Each part of the Definition

Lasting damage. Trauma refers to the damage that follows an experience or set of conditions. It does not refer to the event alone. Exposure may raise the risk of trauma without resulting in lasting injury, which fits the evidence that many people maintain or regain their functioning after highly adverse experiences (Bonanno, 2004). By lasting I mean damage that continues beyond the weeks of acute crisis and shows itself in more than one part of a person’s life, or of a community’s life. This is a working marker for research and assessment. It is not a diagnostic threshold, and where danger continues it has to be read alongside the question of what is still happening.

The capacity to feel safe, to trust, to belong and to make sense of life. These are the capacities trauma may damage. In clinical work their disruption may show as broken sleep, vigilance, withdrawal, difficulty trusting others or a loss of meaning. The definition looks at the changes underneath, in a person’s relationship with themselves, others and their world.

Destruction of, or continuing threat to, what a life depends on. Trauma may follow a single episode of violence, repeated harm, or conditions that continue over time, including occupation, detention, displacement and the destruction of a home environment. The definition does not assume that danger has ended before lasting damage can be recognised. Community and place are included because the literature reviewed above shows how strongly a life may depend on them.

A person or a community. Communities may lose shared capacities, such as farming, gathering, maintaining language, or mourning together. These losses may be hard to see through individual accounts alone. I put community-level trauma forward as a research question. It should not be treated as an established diagnostic category on the basis of this definition, which is a conceptual proposal. It does not replace PTSD or complex PTSD.

Witnessing and Hearing

I include learning of serious harm to someone close as a route to trauma, in line with DSM-5-TR. At the same time, I want to acknowledge a distinction that deserves further attention: witnessing harm is not the same as hearing about it. To witness is to be present. The witness sees the harm, hears it and smells it, and stands inside the place where it happens. Often the witness cannot stop it, cannot help and cannot leave. Think of a child who watches a parent being beaten, a man who stands outside while his house is razed, or a community that watches its orchard burn. The witness carries what they perceived with their own senses, and the knowledge that they were there.

Learning or hearing about harm is a different relationship to it. A person receives an account, a phone call, a report or a story. The harm reaches them as words, at a distance in place, in time, or both. That can bring grief, fear, anger and distress, and all of these are real. They are not the same as having been present.

I keep both routes because the evidence does not yet settle where the boundary falls. A mother who learns by phone that her son has been killed is bereaved. Whether she has also been traumatised depends on the three questions in the next section, including whether she still lives under the threat that took him. Where there is no lasting damage, she is grieving, and the definition recognises that grief fully without calling it trauma. In conditions of mass harm the line blurs further, because one person may witness some losses and only hear of others. I state the distinction clearly so that research can test it and, if needed, redraw it.

Where trauma ends

A wider definition must retain meaningful distinctions between trauma and other responses to loss or danger. Three questions can help.

· What was lost or threatened? Consider whether something on which the person’s life depended was destroyed or seriously threatened. A change that causes regret or sadness, while leaving the person’s wider capacities intact, may be a significant loss without constituting trauma.

· What lasting damage followed? Consider whether there is a persistent disruption to the capacity to feel safe, to trust, to belong or to make sense of life. Painful emotion alone does not establish that such damage has occurred.

· Does the response fit the situation? Fear in the presence of real danger may be an appropriate response. It can be exhausting and have serious consequences for daily life, while still serving a protective function and not demonstrating lasting psychological damage in itself.

A fourth question guides care and does not classify. What keeps the damage in place? Consider whether the threat continues, whether return is possible, whether others acknowledge the loss, and whether the person has the material means to rebuild.

These questions are also the definition’s brake against stretching “trauma” until it means any hardship, a concern Haslam (2016) raises about psychology’s expanding concepts of harm. The definition requires damage, requires that it last, and asks whether the response fits the situation. The opposite risk is just as real. A definition that is too narrow leaves out people whose harm is invisible, identity-based or systemic, and it supports programmes that treat symptoms while the conditions producing them stay in place (Saraiya et al., 2025; Summerfield, 1999).

On this reading, grief for a loved landscape may remain grief. A person may grieve the loss of a river while retaining a sense of safety, belonging and meaning in other parts of life. Another person may lose the same river alongside their home, family connections and place in a community, and find that their capacity to feel safe or imagine a future has been profoundly damaged. The first person needs room to grieve. The second may need trauma-focused care alongside protection, material support and efforts to restore what has been lost. The definition does not assume that people without land are damaged. People rebuild places, and the resilience research applies here as it does elsewhere (Bonanno, 2004).

Survival responses require similar care. Vigilance, anger and distrust can protect people in dangerous conditions. They may also become exhausting or restrictive when circumstances change. A young woman from Ramallah who had been imprisoned for protesting told me that her pride was the one thing they could not take. Her nightmares kept her alert, and after her release we considered together which responses she might no longer need (AlAli, 2025). Understanding a response’s original function helps avoid treating a person’s survival as a personal failing.

Measuring What Matters

The strongest practical objection to a definition built on capacities is that it is easy to recognise in a therapy room and hard to measure in a survey or a camp. Standard instruments count symptoms in individuals. The International Trauma Questionnaire, for example, was developed to measure ICD-11 PTSD and complex PTSD (Cloitre et al., 2018). It was not designed to ask whether a capacity has been damaged, or to ask it of a community. I do not claim to have solved this. Table 1 offers a first qualitative framework that a clinician, researcher or community worker can use, and that others can test and correct.

Table 1. Illustrative signs of damage to each capacity. The wording is a starting point for discussion and has not been validated.

In use, the practitioner starts with the loss and whether the threat continues. For each capacity they record whether the person’s own account shows no change, some change, marked change, or is unclear, keeping the person’s words beside the mark. Damage in one area for a few days is distress. Damage in more than one area, continuing beyond the weeks of acute crisis, meets the working marker for lasting. The practitioner then tests whether the response fits any danger still present, and names what blocks repair. For communities, the same questions can be put to groups, with members shaping the wording. The framework has not been tested for reliability or across languages. Its next step is co-design with the communities it describes, then comparison with instruments such as the International Trauma Questionnaire.

What Changes in Practice

In the therapy room, assessment needs to ask what happened to the person and what is still happening. Symptoms, sleep, functioning and immediate safety remain important. The assessment also needs to consider what the person has lost: home, land, work, relationships, language, community or familiar routines. It should ask whether the threat continues, and how the person came to the harm: whether they lived it, witnessed it, learned about it, or live under conditions that continue to threaten them. Each may call for a different response.

Treatment can also engage with place when this is meaningful to the person. People I have worked with have held soil from a destroyed grove, grown herbs from their homeland on a balcony, and explored a childhood village on a screen while listening to recordings of familiar birdsong (AlAli, 2025). Such practices may help restore continuity, and they need to sit alongside safety, housing, legal security and the resources to rebuild a life.

In humanitarian work, this definition supports the case made by Miller and Rasmussen (2010) for bridging trauma-focused and psychosocial approaches, and keeps in view Summerfield’s (1999) warning that programmes addressing symptoms while the conditions producing distress remain unchanged may address only part of the problem. For communities affected by extraction or climate change, practitioners should ask who caused the loss, who holds decision-making power, and whose knowledge guides the response. Morton Ninomiya et al. (2023) stress including mental health in health impact assessments and in processes of free, prior and informed consent.

Conclusion

I have proposed that psychological trauma is lasting damage to a person’s or a community’s capacity to feel safe, to trust, to belong and to make sense of life, following the destruction of, or continuing threat to, what that life depends on, including place. The definition gives land and place a clearer position in the account of what trauma may damage, while keeping the need to distinguish trauma from grief, justified fear and adaptive survival. It offers a hypothesis about repair, a first framework for assessment, and a distinction between witnessing and hearing that deserves study.

It remains a proposal. I have not demonstrated that it improves clinical outcomes or measurement, and much of the evidence reviewed here is qualitative or cross-sectional. Four directions would help test it. Community-led qualitative research could explore whether people describe loss of place as damage to safety, trust, belonging and meaning. Longitudinal studies of displaced and resettled communities could test whether the conditions for repair predict which damage lasts. Studies within one community could compare people who witnessed harm with people who only learned of it. And research on extraction and climate change should be developed with Indigenous and other affected communities as equal partners, addressing a gap identified by Morton Ninomiya et al. (2023).

Further articles in this series take the parts of the definition one at a time.

The woman in Dublin held a piece of her family’s grove in her hand. A definition of psychological trauma should be able to account for why that mattered.

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