What is traumatic stress and why is everyone talking about trauma informed care?

Maria Perez, PhD, VP of Behavioral Health at Sixteenth Street Community Health Centers, Board Vice Chair of the Milwaukee County Mental Health Board

For some time, there has been a lot of talk about trauma and its effects on the health and well-being of our communities. There has been much written about how trauma affects the brain, impacts a child’s development and learning, and how traumatic events can impair adults in their work, relationships, and ultimately their quality of life. Traumatic events can range from one single event that affects a person’s functioning, to multiple life events that have additive effects and can cause significant impairment in daily functioning. Situations such as domestic violence, physical and emotional abuse, witnessing violent acts or events where someone has been threatened, harmed or killed – have been linked to traumatic stress. Effects can be so severe that they can lead to posttraumatic stress disorder (PTSD). This disorder involves having been exposed to a traumatic event(s), and these events are re-experienced in the form of flashbacks, nightmares, emotional and physiological reactivity, avoidance of trauma-related stimuli, and negative thoughts and feelings after the event. Re-experiencing these events can take the form of irritability, hyper vigilance, startle response, and difficulty sleeping and concentrating.

Whether or not the trauma-related stress is mild, moderate, or severe – symptoms can make it very difficult for people to lead “normal lives” or have healthy relationships. These experiences can also lead one to isolate or avoid situations or people that remind them of earlier traumatic events. Imagine the loneliness of living with unresolved trauma and feeling so easily upset by situations that the mildest trigger evokes feelings of fear, anger, terror, shock, or even disconnectedness from oneself.

Many agencies who work with clients from all walks of life are now providing additional training to their staff, including healthcare fields, social services, and law enforcement. These settings deal with large numbers of individuals, many of whom are suffering from trauma-related stress. Such training in “trauma-informed care” helps those who encounter people who are highly anxious or irritable, withdrawn, tearful, upset, or behaving in ways that are disruptive. Being able to view clients through a “trauma-informed” lens allows us to step back and not react to behaviors and emotional reactions that seem disproportionate to the situation or extreme. It makes room for us to listen with compassion and most importantly not react. Only then are we able to understand the person in distress and de-escalate the situation while working towards resolution.

Caring for those in our community means trying to understand the impact that trauma has on all of us. We are surrounded by violent images, words, and events through the media or in day to day life. Being trauma-informed means understanding we are all touched by traumatic events. We can do a lot to mitigate the effects of trauma by simply being aware of ourselves and others, managing our reactions and helping others by validating them in the midst of heightened states of arousal. This approach helps others feel validated and goes a long way in releasing the grip of a person’s sense of powerlessness. We can all do a lot of good just by knowing what traumatic stress looks like, and then changing our own responses when encountering those who are suffering.

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