Trauma Informed Care: Notes from a Therapist

Phrases such as “I am so traumatized by this incident,” “I am trauma bonding with this person,” and “Everything is just too traumatic” are frequently encountered in these contemporary times.  However, from a clinical perspective, it is essential to recognize that not all experiences can be classified as traumatic. The term “trauma” carries significant weight and is associated with specific incidents that result in substantial negative repercussions affecting both the physical and mental well-being of an individual.

Since the commencement of my journey into the fields of psychology and mental health, I have become increasingly aware of the importance of not trivializing these subjects. Thus, it is highly important to begin by clarifying what constitutes "trauma" and what does not.

Trauma

• Trauma is defined as a significant injury to an individual caused by an external agent. In essence, it represents an external stimulus that inflicts harm upon a person.

• The effects of trauma can be enduring, leading individuals to experience sudden flashbacks that provoke acute psychological and physical pain.

• Furthermore, individuals may encounter a spectrum of negative emotions, including fear, shame, confusion, and denial.

Trivialized Trauma

• While stressful events—such as failing to meet a deadline and subsequently facing inquiries from a manager or professor—can indeed induce considerable negativity in one’s life, these occurrences do not constitute trauma. 

• Similarly, experiencing a prolonged and challenging day may be categorized as "stressful" and unequivocally impact one's physical and mental well-being; however, it does not rise to the level of trauma.

• Moreover, seemingly minor occurrences in daily life, such as experiencing a bad hair day or developing a blemish, may create temporary stressors. Nevertheless, these situations, while potentially distressing, do not qualify as trauma.

This discussion serves as a critical examination for some individuals and may elicit defensiveness in others regarding the understanding of what constitutes "actual trauma" as opposed to "trivialized trauma." As we advance through this discourse, it is also equally important to explore the underlying causes of trauma. Notable factors include:

• Witnessing a distressing negative event.

• Experiencing physical or sexual abuse (or any kind of abuse). 

• Generational trauma transmitted from parents to children.

• Military service, particularly among former armed forces personnel.

Key Considerations for Trauma-Informed Care

Trauma-informed care is a critical approach that can benefit both professionals from psychology and those from non-psychological backgrounds. It is essential to recognize the importance of expanding our knowledge in this area. The steps for the same are as follows:

1. Comprehensive Client History

Begin by gathering a detailed “case history” of the client, which includes the first step of a genogram (Check out picture for genogram template reference). This valuable tool aids therapists in understanding the client's family history intricately. Through the format of the case history, practitioners can identify significant “trigger points” that relate to the client's experiences during childhood, adolescence, or adulthood.

2. Identifying Distressing Events

Once the trigger stages are understood, it is imperative to explore these distressing experiences in greater depth. This exploration must be conducted with utmost sensitivity to ensure that the client does not experience re-traumatization. Certain ways to achieve this, are to either converse with one of their relatives, or family members (with the client’s consent)and procure more information regarding the instance. Secondly, create a level of open-ended questions, which would slowly lead them to share the main crux of the incident. 

3. Creating a Safe Environment

Establishing a safe therapeutic space is vital. The therapist should embody empathy, which involves connecting with the client’s struggles, and demonstrate unconditional positive regard, ensuring a non-judgmental and supportive atmosphere. This would indeed create a positive atmosphere for the client, as that would maybe urge them to slowly open up to the therapist, or at the very least consider doing so. 

4.  Understanding the Impact of Trauma

Understanding is often closely linked to empathy, and they can indeed be interconnected. However, it is important to assess the specific impact of the traumatic incident on the individual's social, emotional, and physical well-being. Has this experience led them to withdraw from the outside world? Furthermore, is there a potential risk for the development of comorbid psychological disorders?

5. Communicating Information to Caregivers

Upon thoroughly familiarizing oneself with the various aspects and considerations, the subsequent challenge arises: educating the caregivers. It is essential to ensure that they comprehend the entire process that occurred throughout the series of 6, 8, or 20 sessions that were conducted. If deemed necessary and preferably, after providing psychoeducation to family members, it is advisable for the therapist to guide them through the entire procedure. This guidance should include essential strategies to mitigate emotional burdens, followed by appropriate therapy sessions.

6. Collaborate and Seek Help

This is an invaluable insight for emerging professionals in the field of therapy. It is essential to recognize that legal considerations are integral to the practice of psychology. When faced with particularly challenging situations, it is advisable to establish a collaborative team that may include social workers, legal advisors, and, when appropriate, trauma survivors to facilitate group therapy. This approach not only empowers clients but also reassures them that they are not alone on their healing journey.

I don't want to conclude this blog post with typical motivational quotes about trauma survivors—it's just not my style. However, I do want to emphasize that it’s never too late to seek the help you deserve. Until the next blog, have a wonderful week ahead, you lovely human beans !