What is trauma and why you need a trauma informed therapist?
The CDC statistics on abuse and violence in the United States are sobering. They report that one in four children experiences some sort of maltreatment (physical, sexual, or emotional abuse). One in four women has experienced domestic violence. In addition, one in five women and one in 71 men have experienced rape at some point in their lives — 12% of these women and 30% of these men were younger than 10 years old when they were raped. This means a very large number of people have experienced serious trauma at some point in their lives.
Trauma is caused by exposure to natural or manmade disasters or to significant life stressors such as. experiencing abuse (Kaplan and Sadock, 2015. Synopsis of Psychiatry). The result of surviving traumatic situations is a neuro-chemical change in our brains, which causes certain symptoms to reappear in the presence of ‘triggers’. These triggers are circumstances that are in some way similar or reminds us of the initial trauma. A person who has suffered from trauma is now primed for perceived danger and with that, can be readily triggered by interpersonal conflict and stress. Given the high stress of daily modern life, with busy lifestyles that sometimes interfere with our self-nurturing or even a sense of balance, it is easy for people who have suffered trauma to end up living life that can feel like a cycle of pending threat and fearful avoidance (Young, Kathleen, 2010 “How trauma impacts Mental Health”).
What constitutes trauma to one person if very particular and self-defined. The reason for this is that our emotional experience of the event is a great factor in determining trauma. Past trauma imprints our brain and this imprint can surface due to triggers and can sometimes become long-lasting patterns of how we relate to ourselves and to others. A person can become to accustomed to the impact of trauma, that their whole life can be filled with pain and anxiety and this can become their “normal”.
The following list provided by Dr Kathleen Young are examples of how childhood trauma might impact you as an adult:
- Relationship Problems–difficulty with communication, trouble setting healthy boundaries, repeating unhealthy patterns in choices of partners and difficulty with intimacy.
- Social Alienation–feeling different from others, not accepted, stigmatized, social phobia.
- Low Self-Esteem–self-doubt, self-blame, shame, feeling like an imposter.
- Difficulty with Feelings–trouble in recognizing, managing and appropriately expressing feelings, depression, panic attacks, anxiety
- Body issues–disconnection/dissociation from body, distorted body image, coping mechanisms that can harm the body (self-injury, eating disorders, abuse of alcohol anddrugs), see sexual problems.
- Sexual Problems–sexual inhibition or compulsive sexual behavior, flashbacks to abusive experiences during sexual contact, inability to achieve orgasm, pain or numbing during intimacy.
- Physical problems– migraines, chronic pain, arthritis, chronic fatigue and irritable bowel syndrome
- Other Symptoms of Trauma–feelings of fear, agitation, amnesia for events or parts of your life, numbing of bodily areas, nightmares, dissociation.
Trauma can impact your physical health:
Trauma plays a role in many mental health disorders:
- Trauma and Anxiety
- Trauma and Substance Abuse
- Borderline Personality Disorder
- Dissociative Disorders
- Eating Disorders
Trauma impacts your relationships:
- Relationships after Severe Trauma: Making Healthy Choices
- Family of Choice
- Forgiveness and Trauma: Are Some Things Unforgivable?
And of course, trauma affects the development of your sense of self:
- Childhood Wounds: Understanding Yourself in Context
- Shame and Self-Blame After Trauma with histories of trauma, recognize the presence of traumasymptoms, and acknowledge the role that trauma has played intheir lives.
Because as we can see the impact of trauma is to extensive, it it important to find a trauma-informed therapist to help you in your therapeutic journey towards your life goals.
As I trauma informed therapist, I can provide a sense of safety within the counseling process, with acceptance, gentleness, kindness and healthy boundaries. I will work with you to regulate the intense feelings that arise when triggered and slowly process what happened, to normalize how you may have been impacted, and over time and through the empowering work we will do together, you will gain for the first time, or regain a sense of personal control. I can help you to gain insight into what your feelings are telling you, to recognize your needs in the moment, and to be able to assert yourself in getting those needs met.
Our work together is to help you regain your sense of control and power, learn to trust yourself and others, and to find meaning in life despite what has happened. I invite you to reach out to see if I may be a good fit for what you are hoping to achieve in your life.
I offer a free 15 min consultation for you to get to meet me via Doxy me.
– Respectfully, Emily
What does trauma-informed care look like?
The first step is to recognize how common trauma is, and to understand that every patient may have experienced serious trauma. We don’t necessarily need to question people about their experiences; rather, we should just assume that they may have this history, and act accordingly.
This can mean many things: We should explain why we’re asking sensitive questions. I might say, “I need to ask you about your sexual history, so I know what tests you may need.” We should explain why we need to perform a physical exam, especially if it involves the breasts or genitals. If someone is nervous, we can let them bring a trusted friend or family member into the room with them. I’ve had many female patients hold someone’s hand during a pelvic exam. We can tell them that if they need us to stop at any time, they can say the word. If someone refuses outright to have a certain exam or test, or if they’re upset about something (like having vaccinations), we can respond with compassion and work with them, rather than attempting to force them or becoming annoyed.
For someone who has experienced trauma, the hospital or doctor’s office can be a scary place. Dr. Lincoln explains: “Patients often do not volunteer such information about prior experiences, because of guilt or shame. Medical professionals often ask about safety in a patient’s present relationships, but few ask about past experiences. A simple question such as, “Is there anything in your history that makes seeing a practitioner or having a physical examination difficult?” or, for those with a known history of sexual abuse, “Is there anything I can do to make your visit and exam easier?” can lead to more sensitive practices geared to developing a trusting relationship. Patients can advocate for themselves by explaining to physicians their anxiety about medical visits, why this is so, and what they have found helpful or harmful in prior healthcare encounters.”
Trauma comes in many forms
It is also important to note that there are many types of trauma. A colleague of mine has a child who survived a life-threatening illness. Prior to his ICU stay, he never flinched at vaccines; since his hospitalization, any needle sticks make him extremely anxious. Another colleague describes how after years of invasive infertility treatments, and despite becoming a mother, she sobbed uncontrollably at her simple routine gynecologic exam, because it touched such a nerve of helplessness and failure. Trauma-informed care is the open-mindedness and compassion that all patients deserve, because anyone can have a history that impacts their encounter with the medical system.
We as providers need to recognize that many, many patients have a history of physical, sexual, and/or emotional abuse, as well as serious illnesses and negative experiences in the medical setting, and we need to learn to respond with empathy and understanding.
- Sexual violence facts at a glance. National Center for Injury Prevention and Control, Division of Violence Prevention.
- The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2011.
- Child maltreatment facts at a glance. National Center for Injury Prevention and Control, Division of Violence Prevention.
- Child maltreatment 2012. US Department of Health & Human Services Administration for Children and Families, Administration on Children, Youth and Families Children’s Bureau.
- Violence, Crime, and Abuse Exposure in a National Sample of Children and Youth: An Update. JAMA Pediatrics, July 2013.
- The National Intimate Partner and Sexual Violence Survey. Centers for Disease Control and Prevention.
- Bringing trauma-informed care to children in need can ease toxic stress. StatNews, December 2017.
- Understanding trauma-informed care. Mass General News, January 2014.
- Trauma-Informed Care in Behavioral Health Services. Substance Abuse and Mental Health Services Administration, 2014.