What is Trauma Informed Care?
Trauma-informed care (TIC) is understanding traumatic stress reactions and responses to trauma. It can affect treatment presentation, engagement, and the outcome of behavioral health services. Reactions and responses can immediately follow trauma or long after a traumatic experience. Trauma affects everyone differently, clearly displaying the criteria for posttraumatic stress disorder (PTSD), resilient responses, or brief subclinical symptoms or consequences that fall outside of diagnostic criteria. The results and impact on an individual’s life can be subtle, insidious, or destructive. Many factors vary the impact, such as characteristics of the individual, including personality or demeanor, attributes of the event or events that transpired, developmental process, the meaning behind the trauma and sociocultural factors. Differentials are multiple traumas, one-time trauma, and long-lasting repetitive events.
Understanding the Trauma Response in the Body
We have all heard the survival phrase “fight or flight.” This is a natural response in which the body perceives a threat, and stress hormones are released to aid you in survival, hence the “fight or flight.” The release of these stress hormones creates amazing responses in our bodies to reduce non-essential tasks and increase body function necessary for the body to prepare itself for the survival response. When an individual repeatedly becomes exposed to trauma, these stress hormones over long periods can cause harmful and unhealthy results to mental health, such as a lost of sense of self and safety, difficulties trusting others, emotional reactivity, intrusive or racing thoughts, avoidance, emotional numbing, and irritability. It is vital for trauma-informed care emergency response providers to be aware of these reactions and outcomes to respond with sensitivity to reduce opportunities for re-traumatizing an individual.
Cognitive Affects from Traumatic Experiences
Many factors contribute to altering cognitions before, during, and after a traumatic event. The ‘Cognitive Triad’ model by Beck and colleagues describes three main cognitive patterns: thoughts about self, the world (others/environment), and the future. Self-views can look incompetent, damaged, shameful, overwhelmed, or too much to handle. Views of the world can include feeling the world is a dangerous place, no one can be trusted, and life is unpredictable. Future views include hopelessness, things will never get better, or feeling what the point is. In turn, this perpetuates and enhances depressive and anxious symptoms.
Trauma Symptom Complexity
It is important to note that trauma responses can present with many debilitating symptoms and, in some occurrences, look like psychosis, running the chance of being misdiagnosed with a psychotic or bipolar disorder. They include but are not limited to the following:
- Emotional dysregulation
- Numbing
- Somatization – Emotional distress via physical ailment or concern
- Hyperarousal and sleep disturbances
- Feeling different
- Flashbacks
- Dissociation, or depersonalization, or derealization
- Behaviorally reenactments – repetitively reliving and recreating a past trauma
- Self-harm and self-destructive, impulsive, or risky behavior
- Substance abuse
- Avoidance
- Paranoia
6 Guiding Principles to Trauma-Informed Approach
Developed by the Center for Disease Control and Prevention’s Center for Preparedness and Response in partnership with SAMHSA’s National Center for Trauma-Informed Care, emergency preparedness and response evolved to support an individual’s social, emotional, mental, and just physical health. It highlights attention, sensitivity, cultural change, and awareness of organizations providing care. It engages constant assessment for quality improvement to support the individuals suffering and includes positive community building.
- Safety
- Trustworthiness and transparency
- Peer support
- Collaboration and mutuality
- Empowerment and choice
- Cultural, historical, and gender issues
Self-Care and Seeking Help
Trauma takes an emotional, physical, and mental toll. Taking care of your body first is very important. Regulating your physical body will aid in mental and emotional health. It’s important to eat well-balanced meals regularly, exercise, and attend to sleep hygiene, getting adequate sleep. Reduce or illuminate alcohol and refrain from mind-altering drug use and abuse. Take time outs for enjoyable activities. Ask for additional help and support from friends and family members. If symptoms increase or do not dissipate, consider the option of mental health treatment with trauma-informed care professionals. If you or a loved one are in need of support for a trauma-related condition contact First Light Recovery.
Resources:
Center for Disease Control and Prevention, Center for Preparedness and Response
SAMHSA National Center for Trauma-Informed Care
Understanding the Impact of Trauma, Justin Russotti, PhD, LCSW