The field of mental health has been confronted by issues of psychological trauma since its inception. Throughout its history there have been a host of oscillating and conflicting views on the reality and consequences of many types of psychological trauma. A dialectical stance provides a useful framework with which to consider and work with these contradicting views. Such a stance enables a focus on the total context in which professional narratives of trauma are formed and looks for useful elements from both sides of the debates about trauma. In this article, dialectical thought is applied to professional narratives regarding the prevalence, responsibility, consequences, and treatment of trauma.