Encountering trauma has the potential to alter an individual's perception of the world.
Whether trauma stems from a single event, such as a natural disaster, or from repeated exposure to abuse, it significantly shapes an individual's thoughts, emotions, and actions through their unique lens.
Elevating your awareness of the trauma someone has endured and its profound impact on them can be invaluable when they experience anxiety or display disruptive behavior. As you deepen your comprehension of their experiences, your connection with them will grow stronger, enabling more effective interventions.
Building trust with individuals exhibiting challenging behaviors equips you with the ability to effectively communicate with them and provide the support they need to calm down. This guide offers:
In-depth insights into key trauma-related concepts.
Enhanced understanding of how trauma influences behavior.
6 Guiding Principles for adopting a Trauma-Informed Approach.
7 tips for preventing re-traumatization.
A trauma-informed perspective seeks to understand "What happened to you?" rather than asking "What's wrong with you?"
Defining Trauma-Informed Terms
Trauma can function as a filter or lens through which individuals perceive the world. Imagine wearing sunglasses: they alter the way everything appears shaded. Similarly, trauma can significantly influence a person's perspective on their surroundings.
Trauma: An emotional reaction to a distressing event such as an accident, assault, or natural catastrophe. Following the event, shock and denial are common initial responses. Over time, individuals may experience unpredictable emotions, flashbacks, strained relationships, and physical symptoms like headaches or nausea.
Trauma-Informed Care: A framework of thinking and interventions rooted in a comprehensive understanding of the profound neurological, biological, psychological, and social impacts of trauma on individuals. It acknowledges the continuous, interdependent needs of individuals for safety, connections, and effective emotion and impulse management.
Triggers: Signals that serve as indicators of potential danger, often based on past traumatic experiences, leading to a range of emotional, physiological, and behavioral reactions aimed at ensuring survival and safety. Triggers are subjective perceptions experienced as reality. The mind-body connection triggers fight, flight, or freeze responses, causing fear, panic, upset, and agitation in individuals experiencing them.
Understanding Trauma Types
Trauma can manifest in various forms, typically categorized into three main types:
Acute Trauma: This type of trauma stems from exposure to a singular, overwhelming event. Examples include instances such as sexual assault, the sudden death of a loved one, or experiencing a natural disaster. Acute trauma is characterized by vivid and detailed memories of the event, heightened vigilance, an exaggerated startle response, and tendencies towards misperceptions or overreactions.
Chronic Trauma: Chronic trauma arises from prolonged exposure to distressing situations or environments. Examples include enduring prolonged violence or bullying, experiencing profound neglect, or undergoing multiple instances of home removals. Characteristics associated with chronic trauma include denial and psychological numbing, dissociation from one's emotions or surroundings, feelings of rage, withdrawal from social interactions, and a pervasive sense of a foreshortened future.
Traumatization can occur when individuals lack sufficient internal or external resources to cope with the challenges presented by these traumatic experiences. Understanding the distinctions between acute and chronic trauma is crucial in providing appropriate support and intervention for individuals navigating through these difficult circumstances.
Complex Trauma: Complex trauma arises from a single traumatic event that inflicts devastating and enduring effects on an individual. Examples of such events include mass casualty school shootings, car accidents resulting in fatalities, or dislocation as a refugee.
The characteristics associated with complex trauma often include perpetual mourning or depression, chronic pain, difficulties with concentration, disturbances in sleep patterns, and heightened irritability. These enduring symptoms highlight the profound impact that such traumatic experiences can have on individuals, underscoring the need for comprehensive support and intervention to address their complex needs.
Traumatization occurs when internal and external resources are inadequate for coping.
Principles for Implementing a Trauma-Informed Approach
The CDC's Office of Public Health Preparedness and Response (OPHPR), in conjunction with SAMHSA's National Center for Trauma-Informed Care (NCTIC), has formulated six guiding principles to facilitate the adoption of a trauma-informed approach.
Safety
Ensuring a physically safe environment and fostering interpersonal interactions that reinforce a sense of security.
Trustworthiness and Transparency
Making decisions and conducting operations based on trust and transparency, consistently maintaining trust with those being served.
Peer Support
Utilizing peer support as a vital mechanism for creating safety, building trust, promoting collaboration, and leveraging lived experiences for recovery and healing.
Collaboration and Mutuality
Harnessing the effectiveness of mutual decision-making and power-sharing, emphasizing the importance of every individual within the organization in delivering trauma-informed care.
Empowerment and Choice
Recognizing, empowering, and building upon the strengths and experiences of individuals impacted by trauma, emphasizing the importance of autonomy and decision-making.
Cultural, Historical, and Gender Issues
Addressing cultural stereotypes and biases, implementing policies, protocols, and processes that respond to the diverse racial, ethnic, and cultural needs of individuals
.
"Adopting a trauma-informed approach necessitates ongoing attention, compassionate awareness, sensitivity, and potentially a cultural shift at the organizational level, rather than relying on specific techniques or checklists." Source CDC
Understanding Vicarious/Secondary Trauma and Compassion Fatigue
Also referred to as compassion fatigue, vicarious/secondary trauma is a phenomenon wherein an individual's own experiences are influenced by their engagement with someone else's trauma. In other words, trauma can affect not only the individual who directly experienced it but also those around them, including staff members like yourself.
Recognizing the signs of compassion fatigue is crucial, as they may include a reduced sense of efficacy at work, difficulties with concentration and focus, feelings of apathy and emotional numbness, withdrawal and isolation, exhaustion, jaded pessimism, and engaging in secretive addictions or self-medicating behaviors.
Various risk factors contribute to the development of compassion fatigue, such as being new to the field, having a history of personal trauma or burnout, working long hours or managing large caseloads, and lacking adequate support systems.
Understanding the Effects of Trauma on Behavior
Adopting a person-centered, strength-based approach in working with clients can foster a cultural shift in staff-client interactions. For instance, consider a scenario where you invite a client to join a group icebreaker to welcome someone new, but the client reacts defensively, striking out and expressing discomfort.
Viewing this situation through a trauma-informed lens involves recognizing potential trauma triggers and responding appropriately. It's essential to consider the type of trauma the individual may have experienced and identify triggers, whether obvious or subtle. Responding in a trauma-informed manner involves maintaining empathy, respecting boundaries, and offering support without pressure or intrusion.
7 Tips for Preventing Re-Traumatization
Acquire Knowledge:
Strive to gather comprehensive information by collecting data and screening for trauma histories.
Enhance Attunement Skills:
Develop your capacity, as well as that of your staff and clients, to accurately interpret each other's cues and respond appropriately.
Explore Behavior Causes:
Delve into the underlying reasons for behaviors, aiming to understand their function and the messages they convey. Recognize that what may seem like challenging behavior could be a coping mechanism. Ensure that responses are trauma-informed to foster a sense of safety and connection.
Adopt Strength-Based Approach:
Shift from a deficit-based mindset to one that focuses on strengths. Reframe perceptions of individuals from "victims" to "survivors" and emphasize their capabilities rather than limitations.
Offer Consistency and Choice:
Provide consistency, predictability, and opportunities for choice-making, tailoring interactions to meet individuals where they are. Consistency and predictability promote feelings of safety, while choice-making empowers individuals by giving them control over their decisions.
Prioritize Least-Restrictive Interventions:
When considering physical interventions, carefully weigh the physiological, psychological, and social risks involved. Opt for the least-restrictive option possible in each situation to preserve autonomy and minimize potential harm.
Facilitate Debriefing:
Make debriefing sessions a priority following any crisis or challenging situation. These sessions help identify patterns and triggers, mitigate reoccurrences of crises, and foster resilience by developing effective coping skills.
Recognize common functions of behavior, such as seeking access, avoidance, or fulfilling sensory or emotional needs.
BOOKS The Comfort Garden: Tales From the Trauma Unit By Laurie Barkin, RN, MS. A personal account of working as a psychiatric nurse at San Francisco General Hospital.
Helping Traumatized Children Learn Volumes I and II Landmark publications from the Massachusetts Advocates for Children’s Trauma and Learning Policy Initiative.
Managing Change With Personal Resilience By Mark Kelly, Linda Hoopes, and Daryl Conner. Outlines 21 keys to being resilient in turbulent organizations. Treating Traumatic
Stress in Children and Adolescents: How to Foster Resilience Through Attachment, Self Regulation, and Competency By Margaret E. Blaustein and Kristine M. Kinniburgh. Provides a flexible framework for working with kids and their caregivers.
Conflict Resolution Strategies and Self Defense Resources
The Center for Violence Prevention and Self Defense (CVPSD) is a non profit 501(C)(3) with a mission to stop violence by educating at-risk people and empower them with the skills needed to protect themselves by providing online and live training.
Through workshops and seminars we educate participants about violence prevention and guide them on assessing risk factors while establishing boundaries in relationships. Additionally practical self defense classes equip people with hands on skills and effective strategies to prevent and intervene in cases of assault. CVPSD reaches individuals and communities through partnerships with schools and other nonprofits, community groups, as well as classes for the public.