Understanding Trauma

For those in the helping professions, there is a need to recognize trauma and integrate this knowledge into the work that they do with others. Trauma awareness and trauma-informed care mean being sensitive to how trauma can affect individuals and making this a consideration in how help is provided.

Lori Gill, psychotherapist and CEO of the Attachment and Trauma Treatment Centre for Healing, presents a dynamic overview of Trauma through this video presentation. Lori provides the fundamental understandings behind trauma and its effects on the body. Viewers learn how the brain responds to a traumatic event and how these reactions manifest themselves in the body. Viewers also learn how to apply appropriate regulating and calming strategies when in a helping role. Lori Gill emphasizes the importance of self-care strategies for distress/crisis call responders and demonstrates what workers can do to build resilience and to be ready to help others.

Glossary: Trauma: Trauma is an emotional response to any event that evokes a sense of terror and causes one to fearing their safety. It can include violent and nonviolent events like an accident, death by suicide, rape, separation or divorce, or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, intrusive images or sounds, strained relationships and even physical symptoms like headaches or nausea. These feelings are normal reactions to an abnormal event that can have a profound effect on safety. Validation, compassion, and education are needed to promote healing. Trauma Informed Care: Becoming “trauma-informed” means recognizing that people often have many different types of trauma in their lives and responding in a compassionate manner is key. Trauma Informed Care is an organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma. It means taking one’s experiences with trauma into consideration when providing help or care. Trauma Informed Care emphasizes physical, psychological and emotional safety for both consumers and providers, and helps survivors rebuild a sense of control and empowerment. Fight or Flight response: The fight-or-flight response, also known as the acute stress response, refers to a physiological reaction that occurs in the presence of something that is terrifying, either mentally or physically. A chain of rapidly occurring reactions inside the body help mobilize the body's resources to deal with threatening circumstances. In response to acute stress, the body's sympathetic nervous system is activated due to the sudden release of hormones. The sympathetic nervous system stimulates the adrenal glands triggering the release of catecholamines, which include adrenaline and noradrenaline. This results in an increase in heart rate, blood pressure and breathing rate. After the threat is gone, it takes between 20 to 60 minutes for the body to return to its pre-arousal levels. Essentially, the response prepares the body to either fight or flee the threat. It is also important to note that the response can be triggered due to both real and imaginary threats. Questions for Further Consideration: A distress/crisis line worker responds to a variety of calls and concerns. Knowing the importance of being sensitive to those who have experienced trauma, how does one begin to recognize something as traumatic? It is helpful to recognize the parameters that define a traumatic event. Consider the following about a traumatic event:

It was unexpected The person was unprepared There was nothing the person could do to stop it from happening Simply put, traumatic events are beyond a person’s control. It is also important to note that it is not the event that determines whether something is traumatic to someone, but the individual’s experience of the event and the meaning they make of it.

‘Trauma is when we have encountered an out of control, frightening experience that has disconnected us from all sense of resourcefulness or safety or coping or love’ Tara Brach 2011

Are there different types of trauma and do people respond differently as a result?

Three main categories of traumatic events can each lead to a different trauma response and respond to a different form of treatment:

Recent acute traumatic events (e.g., car crash, violent assault, etc.) Past single traumatic events (e.g., rape, death of spouse, accident) and events that last a period of time (e.g., a natural disaster or outbreak of political violence or war) Long-term chronic abuse (e.g., ongoing childhood sexual or other abuse, including neglect; growing up in violent environment). Callers to a helpline may describe the way they are feeling without recognizing it as a sign of trauma. Others may seek information directly about trauma and how it can affect them. A distress/crisis line worker can provide some awareness in this area.

There are some universal experiences following all forms of trauma, be they experiences of interpersonal violence (sexual, emotional, physical, or verbal abuse perpetrated by another person) or impersonal (accidents, natural disasters, difficult surgical or medical procedures, etc) or experiences of extreme loss.

Physical reactions to trauma might include: Trouble falling or staying asleep Feeling agitated and constantly on the lookout for danger Getting very startled by loud noises or something or someone coming up on you from behind when you don't expect it Feeling shaky and sweaty Palpitations Trouble breathing Cognitive reactions to trauma might include: Upsetting memories or nightmares such as images or thoughts about the trauma Trouble concentrating or thinking clearly Being unable to think about anything but the traumatic experience Difficulty accomplishing normal tasks that require concentration or focus Being reminded of the trauma by simple events or occurrences Emotional reactions to trauma might include: Feeling as if the trauma is happening again (flashbacks) Getting upset when reminded about the trauma (by something the person sees, hears, feels, smells, or tastes) Anxiety or intense fear, feeling in danger again Anger or aggressive feelings and feeling the need to defend oneself Trouble controlling emotions; sudden anxiety, anger, or upset Shutting down emotionally and/or avoiding situations or other people Feeling that one is going crazy Psychological reactions to trauma might include: Trouble trusting others after trauma Confusion about sense of self or self-esteem Relationship issues Fears or confusions about sexuality