Redefining Trauma for Asian Americans
When people talk about trauma, we often think of things like violence, assault, near-death experiences, or life-threatening accidents. This is the type of trauma the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) focuses on when it defines Post-Traumatic Stress Disorder (PTSD) — what many in the clinical field refer to as "big T" trauma.
But trauma isn't limited to what the DSM captures.
As a therapist working with many Asian American clients, I’ve seen how the trauma that shapes us can often go unseen, minimized, or dismissed — both within our communities and by mental health systems. Experiences like emotional neglect, intergenerational shame, perfectionism, racial microaggressions, or feeling silenced for expressing emotional pain may not qualify as "PTSD" — but they can still cause deep suffering.
The DSM is a tool that offers a shared language for clinicians — but like all tools, it has limitations. It was never designed to capture the full complexity of our humanity, our stories, or our cultural pain.
We also know that trauma is deeply personal. What feels traumatic to one person may not be to another. There is no single threshold for what "counts" as trauma — especially when you consider culture, family dynamics, generational experiences, and the ways we’ve been conditioned to suppress or deny emotional distress.
Sometimes, people refer to "big T" trauma (catastrophic events) versus "small T" trauma (relational wounds, chronic invalidation, ongoing stress). While this distinction can help at times, it can also unintentionally minimize someone’s internal suffering or provoke shame for reacting "too strongly" to something perceived as minor.
For many Asian Americans, this shame is compounded by cultural messages: to stay quiet, endure silently, prioritize success, and avoid burdening others with emotional needs. As a result, many suffer in silence, wondering if what they experienced was "really trauma" or if they’re just being weak.
But trauma is not defined by whether others understand it. It's defined by how our bodies, minds, and relationships are affected by what we’ve been through.
So what do we do with this?
We start by naming what hurt us — even if it wasn’t dramatic, violent, or visible. We listen to the parts of ourselves that feel anxious, frozen, reactive, or deeply sad without judgment. We stop comparing our pain. We tell ourselves that our experiences deserve to be acknowledged and tended to.
Instead of dividing trauma into big or small, I invite us — especially those of us raised in Asian American families or immigrant households — to make room for the pain we carry that hasn’t been named. To honor the emotional wounds we’ve been taught to suppress. To stop minimizing, and begin healing.
Because all trauma — whether clinically recognized or not — deserves healing.
Hatty J. Lee, LMFT (she/her) is an Asian American licensed marriage and family therapist and brainspotting practitioner who has been practicing for 14 years in community mental health settings, schools, and private practice virtually across California and in-person in Los Angeles and Pasadena, California. As the founder and clinical director of a group practice called Oak and Stone Therapy in Los Angeles, CA, she trains clinicians and supports people to deepen their relationship with themselves and the most important people in their lives. She writes about mental health on her Instagram and is the co-author of The Indwell Guide that integrates visual storytelling, mental health education, and practical tools to support people to heal and thrive.
