Listen to “#9: What is Trauma?” on Spreaker.

In this episode of PTSD Bytes, host and clinical psychologist Pearl McGee-Vincent discusses trauma with Dr. Debra Kaysen, a psychologist at Stanford University and research scientist at the National Center for PTSD.

What is trauma?

Kaysen explains the difference between “big T” and “little t” trauma. “Little t” traumas are stressful events, while “big T” traumas are more severe, for example, threats to somebody’s life or sexual assault. Most people experience “little t” trauma at some point in their life. “Big T” trauma is less common, though not as rare as people may think.

Some people may be more at risk, such as those with mental health or substance use problems. Your risk for “big T” changes based on age, gender, race, and ethnicity and sexual orientation. However, anyone can experience it.

Difference between trauma and PTSD

Trauma is an event that happens to you. Posttraumatic stress disorder (PTSD) is the set of symptoms and reactions that can occur after you experience trauma. These reactions are quite common and can include nightmares, recurring memories, trouble concentrating, trouble sleeping, feeling jumpy, feelings of guilt or shame and more.

These reactions to traumatic events are similar in people around the world and across different types of traumas.


One misconception is that all people who experience a “big T” will get PTSD symptoms. However, some people get better on their own. It does not always mean continued suffering. Another misconception is that if you have PTSD symptoms, you will have them forever. As Kaysen says, there are plenty of options that can help you recover from a traumatic event.

Even in situations where the trauma is still happening, such as for those living in a war zone, treatment has been shown to help. And while not a treatment, PTSD Coach is a free mobile app with many tools that can help you cope with any reactions you may have afterward.

Additional links:

If you are a Veteran who is experiencing a crisis or supporting a loved one who is, call 1-800-273-8255 and press 1 for immediate assistance, or chat online at

Click here for more on the PTSD Bytes series.

By Alexandra Kaiser is a writing intern for VA’s Digital Media Engagement team

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Published on May. 20, 2022

Estimated reading time is 2 min.

Views to date: 1,163


  1. JOE FUGO May 25, 2022 at 10:20 pm

    VA employees know NOTHING about PTSD !!!

  2. Robin May 24, 2022 at 1:35 pm

    Wow, @Patricia. What a powerful ordeal. I can relate. I pray you are now receiving the care you deserve. Which VA Medical Center is nearest you? Maybe I can help find answers for you.

  3. Patricia T Buskuehl May 21, 2022 at 12:42 pm

    On Tuesday, November 20, 1979, my thirteenth day at my first permanent duty station, I was intercepted on my walk to work after morning formation at Ft. Ord, our 7th Infantry Division, by SSG David “Pedro” Garcia, who introduced himself, then confirmed that I was new there, then told me he was my other boss and asked if anyone had showed me around yet, then opened his car door and told me to get in. I followed orders, obeyed command, and it got me raped. He drove past and pointed out the AG office, the loading dock, then drove through the side (unmanned) gate. I looked at my watch, and asked where he was going, to which he replied, ‘Monterey is beautiful, there’s a view I want to show you.’ He engaged me in conversation while driving farther and farther from the fort. He pulled over in a Eucalyptus grove and said there was a hike to the view. We hiked about 50 yards to the edge of land over a canyon. He raped me. Instinctively, I looked down the canyon, he killed me on the inside, I did not want to go back. I was a promising young woman, graduated with honors from a college preparatory high school, and a Finalist in the Miss Missouri National Teenager Pageant 1979, I wanted to go to University of Missouri which was one mile from my home in Ferguson, but was told by UMSL that if my family couldnt pay 3500 per year tuition, I could not go; an Army recruiter at a table next to the UMSL table called me over saying ‘how would you like to work for a high ranking officer, wear dress greens everyday, have 30 days paid vacation each year, education, travel, and retire age 38? He told me I would be 71L admin spec at E-1 rank. My ASVAB scores were in high 90’s across the board, and composite score of 114 – 4 points higher than necessary to get into officer training programs, and I was already bi-lingual, English/Spanish. An acquaintance said I would do well as a Military Attache; I asked the recruiter who said I have to be twenty five years old to be. I was told that at that time, I was one of only 40% of military personnel that had finished high school. I lost consciousness after the rape, was ambulanced to ER at Silas B Hayes hyperventilating in shock only to be told by ER nurse I must be missing home, thats why I’m so upset, then hurried out of the room as I told her No! thats not it! Im not missing home! I fell back into unconsciousness. six hours later, I was awakened out of unconsciousness by the sound of a door opening behind my head, my eyes opened to find I was lying on a cold steel gurney under bright lights in a different room. a male, enlisted private in blue scrubs entered, took hold of my left wrist and pressed on it and said, ‘you can go now’, pointing to the exit sign. I asked for the nurse to finish telling her what happened, he said, ‘everyone’s gone home’. I walked out under the exit sign, the clock on the wall said 6:00PM. When I got back to my barracks, it was dusk, it was quiet, I took my US Army uniform off to take shower, go to bed, I had been unconscious through lunch and dinner, I held my underwear up to see why they were stiff like cardboard and saw the many overlapping stains of SSG David Garcia’s semen mixed with my blood and my heart sunk even further to feel like this must be all I can expect for my life. I met my obligations the next day, though I was like a zombie. I walked past my real boss, SSG Davies’ desk to get to mine – she said nothing to me, though I had not made it to work the day before, and was ambulanced to ER at about noon. After work, I marched across street to Commanders office, requesting meeting – he sat across from me as I asked out of the US Army, which he granted, no questions asked; and added that I would not be required to fulfill my 6 year reserve duty. I was moved across the fort to HHC Command to work under Major Hotmire while awaiting discharge. A Captain William F Melanson befriended me, saying he was the recreation officer, invited me on the next ski trip, then encouraging me to rent a third bedroom in his apartment offpost while I await discharge so that I’ll be happier, that I could ride into work with him everyday; what he did not tell me was that he was SSG Garcia’s boss, and that he was offering me a room in an apt with himself (Officer) and another Officer (both male) to keep me away from the females in my barracks who were all witnesses to whoever must have removed my unconscious self from SSG Garcia’s 2-door yellow Capri and placed me standing on my barracks floor in front of the women who were huddled in the doorway, looking at me aghast as I told them what SSG Garcia did as an ambulance sped to a stop at my barracks door. SSG David Garcia went home to his wife, who was a nurse at Silas B Hayes Hospital, and his 8 year old daughter, Petra, that afternoon, while I lay on a cold steel gurney in what I now believe was the morgue with his semen spilling out of my body after he raped me while being paid my every American taxpayer. Then the ER nurse committed a medical malpractice instead of doing her job as a hospital ER Nurse. I never had a chance for a normal life after that, he killed me on the inside, but my heart kept beating. If I had had the rape acknowledged and treated, and justice done, I could have carried on scarred but functional. The Commander should have moved me to Defense Language Institute which would have utilized my language skills, or officer training since I had the aptitude and ambition, and prosecuted NCO SSG David Garcia for committing a felony crime against a US Army Soldier; instead Commander covered it up, like My Life doesn’t matter. Instead I fled because my life was in danger serving my country – I was raped and it was ok with everyone. Imagine what it would feel like to work hard in highschool, hoping you could go to college but told by college if you werent able to pay, you couldnt have a college education, so you go to serve this country even after learning your government stopped the GI Bill after the Vietnam War, still you join to make an honest worthy start for yourself, proud to serve your country, only to be raped by the very person you are taught you must follow orders of – this dishonorable SSG used the training for my job, my bread + butter against me#1, deceiving a young adult in order to rape her#2, thengaslit and left for dead after a frightful ambulance ride while in shock and semi conscious#3; it was a TKO for Patricia Tina Buskuehl who comes from a long line of service men and women going back to the Civil War – Union, fighting for Our Civil Rights. My rapist is alive in southern California, with all the benefits for himself and his family from retiring from US Army while my career was cut short even after sustaining two felony crimes against Me – Rape and Medical Malpractice. Then I was uprooted to a new job with a new boss day after day for six months while awaiting discharge, waiting for Congress’s approval of discharging a soldier with no bad marks against her. Then, May 15, 1980 I was told to report to bldg 2544 to sign my DD-214. When I did, I read Honorable, Ch 5 – Inability to maintain acceptable standards for retention. I said to the E-1 clerk, one of two present, ‘this is not accurate. I need to speak to someone about this’ She shrugged her shoulders, saying there was no one. My ride was waiting, so I left, full of trauma, full of grief, full of defeat, full of remorse for giving of my strong beautiful capable Self to serve Our Country, only to be left to believe I must be inept that I didnt see the rape coming, and less-than as to why Garcia picked me to defile. There was no outprocessing, I was not told I had any benefits. I deserve justice. I did not join the army to get raped and left for dead in the ER or morgue. I lent my talents and abilities to the US Army to make a start for myself while serving my country. Garcia took the tools out of my young adult toolbox, and not getting treatment when I almost died (4 stages of shock – 4th stage of shock is death) reinforced that I was a nobody, nothing. with that untreated trauma of heinous deed inside me, I had to replace my career and housing, which I was incapacitated from doing. An unacknowledged and untreated rape causes a slow painful death if the victim doesnt kill theirself. An unacknowledged and untreated rape is much worse than death itself. I have been chronically homeless since the rape, in counseling mostly out of pocket since age 25 with nothing resolving because the rape having threatened my life, then gaslit about it, went somewhere in my psyche, hiding, so that I could survive, but I could never thrive because I was a puppet to these new erroneous beliefs that come from experiencing such an inhumane heinous act as rape. then due to a neighbor discovering I was am a veteran around 2006, he asked me if I use my VA healthcare, I said, ‘what VA healthcare?’. he took me to VA John Cochran to get I.D. and register. I did. I was directed to Vet Center where I began counseling with Dr. Linda Housmann who ended my therapy after 8 months and would not tell me why. Three years later, I was directed to go to a Standdown event where I was given appt. to have my back looked at – I noticed Dr. Linda Housmann and two other providers looking at me with sideways glances but not approaching me. I shrugged it off and went to my appt May 6, 2011 at Women’s Clinic where, while waiting in the waiting room, a female provider came from the back around the side hastily, getting right up in my face, asking, ‘Why are you here today?’ I answered her, then she asked, ‘were you sexually assaulted in the military?’. I went to answer her, causing the rape to move from wherever it was in my psyche to my conscious mind with my face contorting, my lip twitching, water beginning to pour from my eyes as I asked her, ‘How did you know?’ and fainted on her foot. Instantly, I finally understood why I had never had the marriage I had longed for my whole adult life; I saw all the painful incidents of my life on a tikertape in my mind- the incidents that didnt seem like Me…and I wanted to die, understanding all the loss was caused my someone else diminishing me and the ugly distortion the rape caused me, knowing I could not get those 32 years back to live the Patty Buskuehl I was the first eighteen years of my life. she supported my left armpit as we walked to her office where I spewed the story for the first time in 32 years. She said she was the MST coordinator and that she would set up therapy; I said what is “MST”? She said, Military Sexual Trauma, and dismissed me. I thanked her, though I was very unstable. Three weeks went by without hearing from her to start the therapy; it was becoming unbearable holding back from killing myself, but I didnt want to do that to my daughter, so I went back in to see her. Oddly, she didnt make her name known. I asked to see her, stating I was fighting suicide – the receptionist went to get her, and handed me a sticky note with the name Joanne Bystrom social worker scribbled in pencil. I went directly, trying to save my life, I told her how the rape came to the surface at the question posed by now known Dr. Patrice Pye, MST Coordinator. She said she would send me to Palo Alto Residential Treatment Center, she asked me ‘you have a daughter putting herself through school there, right?’ the only way she couldve known this is through gossip with Dr. Linda Housmann of the Vet Center, as the Vet Center system is separate from the VA Women’s Clinic, as I had not been using the VA. Three more weeks went by without hearing from her, so I called her, after stumbling over her words, she said she had called the Florida facility, they didnt have space available. I said, Florida? you said it was in Palo Alto; she said she’d call them and get back; she never did. Six months after the rape came to the surface, with my file flagged high risk for suicide, I was assigned a VA psychologist by the name of Dr. Garcia – same name as my rapist. I asked if there was a different psychologist I could work with because of the association, VA said no, take it or leave it. Dr Garcia pretended to fill out paperwork to send me to Palo Alto Residential Treatment facility, but filled it out in such a way that it would be denied. I was homeless with newly diagnosed PTSD after being misdiagnosed with Major Depressive Disorder for 32 years of my life. I was directed to a particular VSO named Jason Blakemore who told me to gather records. I went to Vet Center and read for first time that Dr. Linda Housmann ‘stronly suspects military sexual assault, doesnt seem ready to discuss it’ ! It felt like a dagger in my heart! to know that a Doctor who was there to treat veterans would suspect a felony crime against me and did not broach the subject, and in addition, ended my therapy… I asked Jason Blakemore what do we do about that? I pointed out that if the rape couldve come out at that time, I wouldve had 3 more years of my Life to live AND my daughters college would be covered under Chapter 31 or 35. He said nothing, just lowered his eyes. I gathered much other proof of disability going back to November 20, 1979 including my lifetime record of earnings from SSA which showed I never earned near enough to support myself, and I have never been married. looking over the completed application for inservice disability, I said, “I don’t see Dr. Pye’s notes here”…Mr. Blakemore replied, ‘they’re in there”. I also said, ‘now, this claim will go back to the originating event, right?’ He said, ‘nope. only goes back to the day you file. I said, ‘that’s not right!’ – he said nothing.
    I was put through 3 C & P exams, one of which, as I told how the rape came to the surface, the female examiner put down my open file and hurried out the room. While she was gone, I saw the writing on my open file – it said ‘November 20, 1979, Pvt. Patricia Buskuehl arrived to ER by ambulance in a state of extreme emotional distress, doubled over in abdominal pain, with low blood pressure’. oh my God! there it is in black and white. Examiner came back in, I’m guessing now she left to ask Dr. Pye why there’s no documentation in my file about her getting in my face when I was there to have my back looked at, asking me if I had been sexually assaulted in the military, experiencing my response, hearing my rape story, saying she’d set up therapy, then not doing so…still the exam continued and ended. It would be ten years of my knocking on doors at three VA Hospitals trying to get comprehensive treatment to work through and salvage whats left of my life, telling the story over and over of Dr. Pye asking me the question causing rape to surface, telling her, my wondering why she didnt set up therapy, why Dr. Linda Housmann or Houssman knew and instead of helping me, ended my therapy…to providers who continued to look at me like a deer in headlights…I had seen other female veterans helped by Dr Pye who were taken care of – back in school, housed, driving black Mercedes. It took ten years during which I was homeless, suicidal, a couple of lockdowns, mastectomy, losing my relationship with my daughter to think of going back to “the drawing board” to see what Dr. Pye wrote on that day in May 6, when I went in to have my back looked at…to my horror, and broken heart discovered Dr. Pye not only didnt set up therapy and allowed me to leave in the condition I was in after spewing my rape story for the first time in 32 years, but she also did not document the encounter, period. which is why, I presume, the examiner ran out the room when I told her how the rape to the surface at Dr. Pye”s question. The way Dr. Pye knew, is because Dr. Housmann gossipped about me. I believe each of them were required to do no harm, yet they both committed medical malpractice on a victim of sexual assault, a veteran of the US Army. My claim was mishandled, also on purpose, by Mr. Blakemore for PTSD without notes from Dr. Pye of the encounter on May 6, 2011 of the rape coming to the surface. This caused me to loose housing that I finally got after only one year, and Mr. Blakemore also guided me to file unemployability even as I was trying to access educational benefits to finish my teaching credential so I could support my family (self and daughter) and have a positive purpose. He did not support my effort to press for my claim to go back to the event that caused my lifetime of incapacitation…while he went home to his wife and children. there was also no support no followup from him to understand the decision and access any additional benefits. they were all in cahoots to keep me from the justice I deserve.

    • Dept of Veteran Affairs June 1, 2022 at 9:14 am

      Thank you for your service, and we appreciate you sharing your experience in this forum. Your comments are poignant, and we are sincerely sorry to hear about the pain and difficult situation you are dealing with. We contacted your local VA facility, and someone will reach out to you (if not already) to help address your concerns.

  4. Jenny Dance May 20, 2022 at 6:22 pm

    My 1st podcast ever. Your comment how many who get over ptsd quickly or never get PTSD, as being more resilient, really stung.
    I was looking for help, not looking to feel ashamed at my lack of resilience.
    and i hope we are All SURVIVORS.
    Never again…

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