Trauma-Informed Care

Trauma-Informed Care

Just as one person might react to an a situation in an ordinary way, others may have disturbing reactions that appear abnormal. Many people say that disturbing reactions are normal as long as the situation is abnormal. The coping reactions of individuals post-trauma are weakly understood, even by most of the individuals who can offer support and necessary treatment. It’s imperative that everyone understands that trauma victims (for instance, those who have experienced human trafficking) may not always behave or react in the same manner that everyone may expect.

When a woman experiences a traumatic event, it tends to impact every single area of functioning. This includes, but is not limited to the following:

• Mental Functions
• Physical Functions
• Social Functions
• Behavioral Functions

The United States Department of Health (HHS) and Human Service Office of Women’s Health (OWH) reports that 55-99 percent of women receiving treatment for substance use as well as a 85-95 percent of women in the public mental health system have reported some kind of traumatic history. The abuse most typically occurred during childhood.

The Adverse Childhood Experiences (ACE) study examined associations between childhood trauma and maltreatment versus stress, health and well-being later in life. Nearly 66 percent of the participants, both male and female, reported that they had at minimum one childhood experience of neglect, sexual abuse, or family dysfunction. More than 20 percent of them reported that they experienced three or more of these instances. Women were statistically far more likely than men to have had and report a traumatic childhood experience.

This study found a link between the early trauma and risk behaviors, serious emotional issues, social problems, worker performance problems, high health care and other costs, adult disease and disability, and mortality. Elevated scores on given tests were also associated with heart disease, liver disease, lung cancer, autoimmune disease, chronic pulmonary obstructive disease, depression, hallucinations, attempted suicide, abuse of substances, use of antipsychotic medications, multiple sex partners and the increased probability of becoming a domestic violence or sexual assault victim.

In an effort to break the cycle of violence, all of the following are necessary:

• Public Education
• Early Detection
• Intervention
• Prevention
• Trauma Treatment

Educational efforts need to be intensified in order to expand trauma-informed care availability. Trauma-informed care refers to treating the entire person, taking a person’s past trauma and any resulting coping methods into account when trying to understand behaviors to treat the individual.

To exemplify the importance of trauma-informed care, the following is a common illustration:

Some people tend to only assume rape victims are telling the truth when they are emotional when they are retelling the details of the sexual assault. Societally, this is because an emotional reaction is perceived to be the only “normal” one relating to that type of trauma. However, it isn’t uncommon for victims to speak with little to no emotion about traumatic events. When this occurs, it does not mean that they are lying or even exaggerating. Instead, stoicism is a way for some victims to attempt to cope with the trauma they endured. This behavioral response is referred to as “detachment.”

There are numerous situations where trauma-informed care can help others to understand the behaviors of a trauma victim, but there is very little understanding regarding the trauma ramifications among the general public. This lack of understanding goes well beyond a lack of response for trauma victims or an empathy gap. In fact, it often results in condemnatory attitudes and even the re-victimization of trauma survivors.

For instance, let’s illustrate this occurrence with the following example:

When individuals say that they do not understand why a woman “chooses” to stay in an abusive relationship, they must first recognize that they aren’t saying this from a place of being a victim of trauma. Therefore, their understanding of the reasons of a woman may “choose” to stay in that relationship is very limited. Using clichéd beliefs about behaviors that should be “appropriate” for rape victims is referred to as “rape myth acceptance.” In communities and societies where there is a high rate of rape myth acceptance, it is very common for victim blaming to occur while the perpetrators often suffer very few penalties.

Let’s consider another illustration relating to a different type or abuse with the following example:

Substance abuse. Here, you have a trauma-informed, compassionate approach that begins with recognizing that individuals may use substances like alcohol or drugs as a skill of survival after a traumatic event. If this perspective is not considered, healthcare professionals may be unable to effectively offer assistance.

This very limited way of thinking can influence basic policy decisions that affect millions of people across the country. Past traumatic events, along with the psychological and physical effects, can often become deemed as “pre-existing conditions” which excludes those individuals from access to affordable health insurance.

The current proposed health bill is lacking when it comes to protection for individuals who have pre-existing conditions, including domestic abuse and rape. This lack of protection opposes efforts to more effectively address the trauma and treat the entire person. Essentially, it is punishing people for acknowledging and attempting to overcome certain forms of trauma. Further, it reinforces the societal stigma that these individuals face even more.

In order to address this, healthcare professionals as well as law enforcement need to undergo training in trauma-informed care. It can help to build capacity among all providers that offer holistic patient care, being particularly receptive to how various experiences over a person’s life may relate to their existing health behaviors and medical status. Law enforcement officials need to be familiar with various unexpected, yet potential, reactions that they could receive from victims. In the event they are called to a situation of alleged abuse, they will then be trained and, not only know what to expect, but to also understand how what appears to be a lack of emotion may be a sign of true abuse as well. Crushing this particular myth, as well as other limiting narratives, means making a huge effort to widen everyone’s understanding of what victims have been through and how these particular “pre-existing conditions” have impacted their lives and personalities. Every single person needs to practice tolerance and empathy. You never know what any given individual has gone through.