“Trauma Informed” OR “Trauma Sensitive”
Trauma Informed Care could easily become a new buzzword. Even prior to the pandemic, school systems, healthcare systems, community organizations, and faith communities, even cities, began implementing policies, procedures, and practices to meet new requirements and guidelines for institutions to offer “trauma informed care”. Hoping to address the concerns of the findings from what is now known as the ACE Studies (Adverse Childhood Experiences). The ACE study found a significant relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The majority of adults who participated in the study, with a chronic disease, had “high” ACE scores. The Adverse Childhood Experience Study (ACE), was published in 1998, in the Journal of Preventive Medicine, with a reprint in 2019. The study was conducted on adults between 1995 and 1997.
Trauma informed care has been implemented in schools, and healthcare (pediatrics), in order to identify ACE scores in children, hoping to raise awareness and provide opportunities to intervene, potentially preventing the high number of chronic diseases found in adults, including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease - leading causes of death. Not everyone working in these systems knows what it is or what to do about it, nor do they know they themselves are included in this population.
Trauma-informed care is oriented around six principles of safety; trustworthiness and transparency; peer support; collaboration; empowerment; and cultural, historical and gender issues. (Substance Abuse and Mental Health Services Administration). Safety, trustworthiness, and transparency means, “what is going on within me as I listen to you”.
In addition to widespread population with high ACE scores and associated chronic diseases, 60% of men and 50% of women in this country have experienced a life threatening traumatic event as adults, prior to the 2020 pandemic. Life threatening events would be natural and man made. Man made would be war, domestic violence, automobile accidents, rape and assault; while natural disasters such as fires, hurricanes, tornadoes, floods, plagues and pandemics may be life threatening, for the individual or the life of a child, spouse, parent, or a comrade as in the military.
Trauma sensitive interventions are designed specifically for trauma integration, trauma recovery of an individual or community with post traumatic stress, acute traumatic stress, secondary trauma, known or unknown collective trauma that has not yet been integrated. The adults may have significant ACE’s and associated chronic diseases. A significant number have experienced a life threatening event as an adult. Yet they are unaware of the need for trauma recovery and trauma integration.
Yet they are aware that they find it difficult to be fully present with another’s dysregulated nervous system, as their own nervous system is dysregulated. Withdrawing, numbing, being easily distracted, blaming, anxiety and anger are very common. Taking leave mentally, emotionally, or physically. What is emerging in the moment is missed. The provider may be in need of trauma integration before providing trauma informed care.
Holding space is difficult. Requires presenceing, and attunement, to fully see, and hear another. We can only hold space for other people, listen and be a witness if we ourselves are inwardly present and connected to our feeling - self. That space is where healing, calm, and clarity happens. Then, “We are the medicine”, as stated by Dr. Christine Bethell, professor of Public Health, Johns Hopkins University.
Collective trauma needs a collective healing. Work places and institutions themselves have been created in a collective trauma field and may be re-traumatizing. Trauma informed care is offered without looking at the institution’s culture and the systems in place that are most likely a source of re-traumatization and institutional inertia.
“When we contribute to the healing of collective trauma, we reduce its disruptive effect and help induce a shift from trauma-inducing to trauma-informed and trauma-integrating institutions and societies”, Thomas Huebl