Trauma Informed Practice

Trauma has become a buzzword in recent years, but it is a very real and significant part of many people’s experiences. Understanding trauma is important, including different types of traumas and what it means to be trauma informed. Working with clients that have experienced significant trauma requires a skill set that will be introduced in this chapter, yet by no means do we suggest you will be sufficiently trained to work with complex trauma in clients. That level of care is to be undertaken by specialists such as psychologists, Indigenous Elders and knowledge keepers, medical doctors, and others who often have years of extensive training and practice. The idea here is to introduce the concept of trauma and understand how it impacts the nervous system. You will also be able to recognize some common trauma responses and how to properly provide support within your role as a community support worker.

According to the Substance Abuse and Mental Health Services Administration (2014),

Survivors’ immediate reactions in the aftermath of trauma are quite complicated and are affected by their own experiences, the accessibility of natural supports and healers, their coping and life skills and those of immediate family, and the responses of the larger community in which they live (chapter 3, para. 4).

Awareness is key to providing a safe psychological space, appropriate support and care, and not acting in ways that may aggravate the trauma response of the client.

Understanding the definition of trauma and the subjectivity of the experience is very important in order to avoid making assumptions about an individual’s experience or discounting the displays of trauma they are showing. Often, trauma occurs in childhood as a result of what have been termed adverse childhood experiences, or ACES. Alberta Family Wellness Initiative (n.d.) defined ACES as “negative, stressful, traumatizing events that occur before the age of 18 and confer health risk across the lifespan” (para. 1).

Trauma can occur at any time throughout life, but when it occurs in childhood the brain is still developing, therefore the impact can become internalized differently. According to the National Child Traumatic Stress Network (n.d., para. 2), “Early childhood trauma has been associated with reduced size of the brain cortex. This area is responsible for many complex functions including memory, attention, perceptual awareness, thinking, language, and consciousness. These changes may affect IQ and the ability to regulate emotions, and the child may become more fearful and may not feel as safe or as protected.”

Bessel van der Kolk, an expert in trauma and neurobiology, stated, “trauma is something that happens to you that makes you so upset that it overwhelms you” (Big Think, 2021). Trauma is a subjective experience one has that is perceived to threaten them in some way. The key words here are subjective and perceived.

Everyone experiences events from different perspectives. Trauma is not caused by the event itself, but the perception and subsequent processing of the event. The event is subjective; two people can experience a similar event and, depending on various factors, one may perceive it as trauma and the other may not. If the event stays stuck in the nervous system, it can cause prolonged trauma. If the event is processed, often with the support and guidance of a therapist, spiritual leader, or a support group, the event may not lead to prolonged trauma. If an event threatens a person’s physical, emotional, or psychological safety, it can be very traumatic. According to Diane Poole Heller (2020), there are different categories of trauma that can impact a person:

Developmental trauma – Developmental trauma occurs in the first three years of life. This reaction to an environment of neglect or abuse can disrupt the cognitive, neurological, and psychological development of the child, with repercussions that can impact adult relationships and mental health.

Complex trauma – Complex trauma is an experience or collection of experiences sustained by an individual that causes harm. Experiences of complex trauma have a cumulative effect. Complex trauma often happens during a certain period or within a specific relationship or series of relationships.

PTSD/PTS – Post-traumatic stress disorder, more recently called the less stigmatizing post-traumatic stress, is a response to a traumatic event or series of events that causes the individual to relive or replay the event in a terrifying cycle that causes additional suffering. PTS may cause nightmares, terror, withdrawal, insomnia, substance abuse, depression, and fear (paras. 5–7).

In recent years, there has been a new understanding of neurobiology and the limbic response to trauma. When a traumatic experience occurs, our brain immediately jumps into action to try to keep us safe. This is called the fight-flight-freeze-fawn response, or limbic response. We often don’t think about it, it just happens. This survival part of our brain operates automatically and works very well to protect us, yet cannot distinguish between real and perceived threats.

When we have experienced trauma, we may have what is called a trauma response to an event that others may perceive as nonthreatening. For example, a client may walk into your office and smell a candle that reminds their subconscious of a trauma they experienced as a young child. This is often not a conscious act that one is able to control. The body will immediately go into a trauma response: the heart may race, person may feel uncomfortable or slightly agitated and not know why, palms may sweat, and they may become very quiet or defensive. This is a trauma response that can easily be misinterpreted by a worker as the client being difficult. Below is a table of some common signs and triggers of trauma created by Poole Heller (2020, para. 14).

 If we understand trauma, we can respond to different expressions with compassion through a lens of creating psychological safety. Research is showcasing how a trauma response may occur through what is called intergenerational trauma. This is the genetic inheritance of trauma from our ancestors. This term, which comes from the study of epigenetics, was defined by Ryder (2022) as “the study of how the events that happen to you and your behaviours — such as traumatic events and trauma responses — can change the way your genes work” (para. 7). Epigenetic trauma is the process of genetically stored trauma that impacts an individual even if they did not experience the source event. For example, escaping a famine, war, torture, oppression, violence, and other extremely stressful and traumatic events is carried forward in the genes. Patterns of migration, relocation, living in a refugee camp, being separated from loved ones, and adjusting to a new culture are all stressful life experiences that impact future generations.

The above examples show that even though we did not personally experience trauma, our nervous system may have a collective traumatic memory within it. This field of study is fairly new, and there is still more research to be done on how trauma impacts future generations. The link between colonization and intergenerational trauma, also known as historical trauma, is strong, and you should be familiar with it. According to O’Neill et al. (2018), “historical trauma describes the legacy of traumatic events experienced by historically-oppressed communities over succeeding generations, a legacy that includes social and psychological responses” (para. 27). They go on to explain three characteristics of historical trauma:

1. 1. Widespread in many Indigenous communities
   2. Historic traumatic events resulting in distress and collective loss for contemporary community members
   3. The purposeful, destructive intent of outsiders who perpetuated the traumatic events

This understanding of historical and intergenerational trauma is very important when working with Indigenous clients, as the trauma continues to be felt today. Lastly, it is important to note that intergenerational trauma occurs from adverse childhood experiences and historical traumas. An understanding of family violence as well as histories of oppression will help you as a CSW to become a trauma informed practitioner.

As workers, we carry our own past and lived experiences that may have contained trauma. Workers may experience vicarious trauma or counter transference when working with clients. An example of this may be a client who reminds you of someone in your past who bullied you. This memory may be in the subconscious, but we may respond to it, outside of our awareness, by feeling annoyed by the client, or being less patient with them than we normally would. This is why self-awareness is very important; it allows us to ask ourselves “is this my trigger or is it a behaviour of the client?” Becoming a trauma informed community support worker means we are aware of the impact of trauma, and are actively learning more about how to respond effectively to underlying trauma in clients.

References

Alberta Family Wellness Initiative. (2024). ACES: Adverse childhood experiences (ACEs). https://www.albertafamilywellness.org/what-we-know/aces/

Big Think. (2021, September 17). What is trauma? The author of “The Body Keeps the Score” explains | Bessel van der Kolk | Big Think [Video]. YouTube. https://www.youtube.com/watch?v=BJfmfkDQb14&ab_channel=BigThink

National Child Traumatic Stress Network. (n.d.). How early childhood trauma is unique. https://www.nctsn.org/what-is-child-trauma/trauma-types/early-childhood-trauma/effects

O’Neill, L., Fraser, T., Kitchenham, A., & McDonald, V. (2016). Hidden burdens: A review of intergenerational, historical and complex trauma, implications for indigenous families. Journal of Child & Adolescent Trauma, 11(2), 173–186. https://doi.org/10.1007/s40653-016-0117-9

Poole Heller, D. (2020, July 29). Types of trauma and identifying the signs. Trauma Solutions. https://dianepooleheller.com/touching-on-trauma/

Ryder, G. (2022, February 18). What is genetic trauma? PsychCentral. https://psychcentral.com/health/genetic-trauma

Substance Abuse and Mental Health Services Administration. (2014). Chapter 3: Understanding the impact of trauma. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK207191/