Trauma is defined as "singular or cumulative experiences that result in adverse effects on functioning and mental, physical, emotional, or spiritual well-being." Traumatic experiences such as exposure to violence, bullying, abuse, food insecurity, sexual assault, and life-threatening experiences like natural disasters and war, are a major contributor to an individual's mental health and ability to perform daily occupations. Trauma affects all body systems and can put an individual at higher risk for conditions like heart disease, stroke, certain cancers, and autoimmune disorders.
"Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones... Trauma produces actual physiological changes, including a recalibration of the brain's alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant."
- Bessel van der Kolk, M.D., The Body Keeps The Score
Adverse Childhood Experiences (ACEs)
ACEs, or Adverse Childhood Experiences, "have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity." ACEs are potentially traumatic events that occur during childhood (0-17 years), such as:
experiencing violence, abuse, or neglect
witnessing violence at home home or in the community
having a family member attempt or die by suicide
growing up in a home with substance misuse or mental health problems
household instability due to parental separation or household members being in jail/prison
Trauma is widespread. The ACEs study conducted by the CDC and Kaiser found that "two thirds of adults reported experiencing [at] least one ACE, and 1 in 5 reporting three or more" ACEs. "ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities" (CDC).
In light of the prevalence of trauma and the negative impacts it often incurs, implementing a trauma-informed approach is essential, not only in traditional mental health settings, but across all healthcare settings and public health efforts.
Substance Abuse and Mental Health Services Administration (SAMHSA) Traits of a Trauma-Informed Program/System:
Realizes the widespread effect of trauma and understands potential paths for recovery
Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system
Responds by fulling integrating knowledge about trauma into policies, procedures, and practices
Seeks to actively resist re-traumatization
Substance Abuse and Mental Health Services Administration (SAMHSA) six core trauma-informed principles:
Safety
Trustworthiness and transparency
Peer support and mutual self-help
Collaboration and mutuality
Empowerment, voice, and choice
Cultural, historical, and gender issues
Addressing Trauma
The following is part paraphrase, part-direct quote from Bessel van der Kolk's book The Body Keeps the Score. I highly recommend reading it if you're interested in mental health or the connection between the body and the brain as it pertains to trauma.
"We can now develop methods and experiences that utilize the brain's own neuroplasticity to help survivors feel fully alive in the present and move on with their lives. There are fundamentally three avenues:
Top Down: Talking, reconnecting with others, and allowing ourselves to know and understand what is going on with us, while processing the memories of trauma.
Medication: Taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information.
Bottom Up: By allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that results from trauma.
Which one of these is best for any particular survivor is an empirical question. Most... require a combination."
Some Helpful Charts
REFERENCES
Fette, C. (2019). Understanding and Applying Trauma-Informed Approaches Across Occupational Therapy Settings. 9.
van der Kolk, B. (2015). The body keeps the score: mind, brain and body in the transformation of trauma. London: Penguin Books.
Preventing Adverse Childhood Experiences. (n.d.). 40.
Preventing Adverse Childhood Experiences |Violence Prevention|Injury Center|CDC. (2020, April 22). https://www.cdc.gov/violenceprevention
/childabuseandneglect/aces/fastfact.html
Photo by Brunel Johnson on Unsplash
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