Unaddressed trauma can result in unhealthy coping mechanisms to alleviate the pain. Anything from bingeing on unhealthy food or overeating, drug abuse, or engaging in risky sexual activities.

In the short term, trauma causes an intense, biological “alarm state” including a rush of adrenaline, cortisol and other hormones as well as intense fear. We stop thinking so that we can fight against or flee the dangerous situation.

Raised stress levels mean conditions linked to trauma exposure can include chronic lung and heart diseases, auto-immune diseases and even cancer, the latter more normally as a result of stress-induced behaviours, such as smoking, rather than the stress itself.

In the 2014 bestseller The Body Keeps the Score by Boston-based Dutch psychiatrist and pioneering PTSD researcher Bessel van der Kolk, he argues that the energy of trauma is stored in our bodies’ tissues (primarily muscles and fascia) until it can be released.

A 2020 study in the Journal of the American Heart Association found children who experienced severe adversity – such as verbal, physical or emotional abuse or living with drug or alcohol abusers – were 50 per cent more likely to develop cardiovascular disease later in life than those with low exposure to childhood trauma.

Meanwhile, a recent study by researchers at Haukeland University Hospital, Bergen, Norway suggests childhood trauma can raise the risk of multiple sclerosis, finding that women who had been sexually abused had a 65 per cent greater risk of developing the disease.

Conti defines trauma as an experience that can be acute, chronic or vicarious that overwhelms our coping skills and we think differently going forward.

Many of his patients are trapped in a cycle of denial and dysfunction. The young woman who was abused as a child now suppresses her trauma with drugs and was a “frequent flyer” at the hospital, only to then return to her cycle of homelessness and drug abuse. Or another woman who, as a young teenager, had been sexually assaulted and declined a college scholarship to stay with her abusive boyfriend.

“Whatever it was that I was trying to help with, be it alcohol dependency, depression, domestic violence, insomnia, no matter what the level of severity, the roots of the problem would often lie in trauma. This would also occur around physical health issues; limb function, heart attacks, lupus.”

Trauma doesn’t have to be caused by a one-off acute experience such as a sexual assault or the death of a close relative. Conti also sees cases of chronic trauma, caused by extended traumatic events such as a long-term serious illness, or bullying.

Acute trauma such as that occurring in Ukraine may also have consequences that will be felt for generations – a 2018 study found that the male offspring of Civil War soldiers who spent time as prisoners of war were more likely to die early than people whose fathers had not. The researchers concluded that paternal stress could affect future generations and that the impact may occur through epigenetic channels.

Yet surely trauma is the result of ordinary existence, a necessary part of the life cycle that we will all face? Conti doesn’t deny it: “A certain amount of trauma is natural and universal.”