~~~Trauma

What is Trauma?

  • “Traumatization occurs when both internal and external resources are inadequate to cope with external threat.” (Van der Kolk, 1989)
    • Internal resources – resiliency, coping skills, etc.
    • External resources – support system, access to healthcare, therapy, etc.
    • External threat – domestic violence, sexual assault, other crime, car accident, natural disaster, etc.
      • Private experiences v. widespread or public experience
      • Key to definition = there are many different things that can cause trauma which ARE NOT the same for everybody
      • A traumatic event is one in which a person experiences (witnesses or is confronted with):
        • Actual or threatened death
        • Serious injury or the threat of injury
        • Threat to the physical or emotional/mental integrity of self or another
        • Responses to a traumatic event may include:
          • Intense fear
          • Helplessness
          • Horror

Prevalence

  • The Relationship of Adverse Childhood Experiences to Adult Health Status (ACE) study 
    • Conducted by Drs. Felitti and Anda as a collaboration between Kaiser Permanente and the Centers for Disease Control
    • Examined relationship between adverse childhood experiences and later health outcomes in adults
    • 18,000 adults in San Francisco area
    • Examine two categories of adversity: abuse and household dysfunction
    • 2/3 of participants reported exposure to some level of adversity in childhood
    • OUTCOME = trauma is a universal experience
    • Other statistics
      • More than 1 in 3 women (35.6%) and more than 1 in 4 men (28.5%) in the United States have experienced rape, physical violence, and/or stalking by an intimate partner.  (CDC,2013)
      • Nearly 80% of female offenders with a mental illness report having been physically and/or sexually abused. (Marcenich, 2009)
      • The majority of clients served by public mental health and substance abuse service systems are survivors of trauma. (Mueser et al, 1998)
      • Seventy-five percent (75%) of women and men in treatment for substance abuse report trauma histories. (SAMSHA/CSAT, 2000)

 

Impact of Trauma

  • Trauma alters the functioning of the brain
    • Using a simplistic definition – trauma forces the brain into “survival mode”
    • After the trauma is over the brain returns to normal, but can be easily re-triggered into “survival mode”
    • When in “survival mode” complex thinking abilities are overshadowed by a person’s instinct to self-preserve
    • Chronic trauma can have a lasting effect on how the brain functions
      • When trauma is extreme or prolonged the brain can get “stuck” in “survival mode”
      • A constant state of “survival mode” or hyperarousal can appear like dysfunctional behavior:
        • Hypersensitivity to minor threats (reactions seem extreme or out of context)
        • Extremist thinking (which can also lead to out of context reactions)
        • Hyperarousal = brain is constantly looking for danger
        • Exposure to chronic stress means exposure to extreme emotional reactions – often too intense for the brain to handle
          • Numbing (or disassociation)
          • Acting out
          • Exposure to chronic stress also creates a sense of helplessness
            • Can’t seem to escape the trauma – stuck in “victim” role
            • Exposure to chronic stress and changes in the brain often lead to other symptoms:
              • Substance abuse
              • Self-harm
              • Aggressive or violence behavior
              • Risk taking behaviors
              • Emotional dysregulation
              • Remember – a person’s response to trauma is a NORMAL reaction to a very ABNORMAL circumstance

What Does This Mean?

  • Help individuals who experience trauma understand that it’s not “what’s wrong with them,” but rather they are impacted by “what’s happened to them.”
    • Acknowledge their experience and normalize the emotions and cognitions associated with the trauma
    • Attention to basic needs – people need to feel SAFE
      • Connection to resources
      • Safety plans
      • Self-care
      • Identification of a support system
      • Take care of YOU!
        • Inactions with those who are affected by trauma can cause secondary trauma
        • Identify resources and support and engage in self-care
“I encourage everyone to let others help. There are people everywhere that want nothing more but the best for you and will stand by your side through the entire process.”