Trauma Informed Care
Around 70% of us have experienced one or more traumatic incidents in our lives. Events such as a car accident, war, first-responder work, sexual assault or violence are perhaps more commonly understood as 'traumatic'.
Some of us possess a natural resilience helps us heal following a single traumatic event. Others are unable to process or recover from their experience, and develop symptoms of trauma. And it is our experience and reaction, rather than the nature of the event itself, that defines trauma.
Increasingly 'complex' or developmental trauma has been recognised as a leading cause of psychological and physical health problems. Complex trauma may involve 'adverse experiences' such as emotional neglect, abuse or mistreatment as a child or later in our lives. Often the negect is occurring at the hands of a caregiver or partner, a form of ‘relational trauma’. As the child / adult is unable to leave this environment, the effects are cumulative over time.
Research in the area of Attachment, Poly Vagal Theory and Developmental neuroscience has demonstrated that ‘trauma’ includes not only difficult events, but the absence of ‘good’ experiences in one’s early childhood years - such as having a kind, caring and sensitive caregiver, able to prioritise the emotional and developmental needs of their children above their own.
A child raised in an environment in which their emotions or perceptions are consistently overlooked or invalidated, or in which they are criticised, blamed, shamed or punished for simply being a child, develops strategies to help them manage what is occurring. These strategies often take the form of disconnecting from, suppressing, or minimising their emotions. Or blaming themselves for the behaviour of others.
The human nervous system is calibrated in the context of a safe, trusting relationship with one or more adults. This involves one or more caregivers (who themselves are able to offer a ‘regulated’ nervous system) who are attentive, able to notice changes in the childs emotional state, and remain present to support the child to understand and name their own emotions, and, over time, soothe themselves. When these conditions are absent, we may observe a difficulty in “emotion regulation”, often labelled as a ‘personality’ traits.
Trauma can show up as depression, anxiety, nightmares, pain, panic, migraines, somatic (bodily) issues, relationship or sexual problems, auto-immune conditions, dissociation, and addictions. For this reason trauma is often mis-diagnosed or not recognised.
Neuroscience has shown that trauma can affect our nervous system and the way we respond to stress. Trauma can also disrupt our capacity to calm ourselves, soothe our emotions, feel safe in our bodies, or to trust ourselves or others. Complex trauma can impair our ability to form nourishing relationships, and has been linked to chronic feelings of guilt, shame, hopelessness and despair, and with a range of medical or somatic problems.
Trauma can also interfere with cognitive processes, including the way memories are stored. Some or all elements of a traumatic experience are encoded in implicit neural networks that lie outside of our conscious awareness. It is possible for a traumatic memory to surface months or even years after the event(s) occurred, or for an event - such as a relationship breakdown - to trigger intense and overwhelming feelings that had lain dormant in the body across a lifetime.
Working with trauma requires respect for the complexity of the mind and body. In particular it is important to;
Create safety - it is crucial that a trusting connection exists between the client and therapist.
Go slow - ample time is required for gentle and careful reflection.
Collaborate - the client is the expert on their experience, and should guide the pace of therapy.
Be sensitive - trauma memories may be beyond our conscious awareness. Reminders (or 'triggers') may occur spontaneously or unexpectedly, can be prompted in a myriad of different ways, and can evoke surprising, strong and sometimes difficult reactions.
Listen to the body - trauma is an experience that occurs and is stored within the body. It cannot be healed by 'talking therapies' alone. There is strong evidence that somatic and body-inclusive therapies are profoundly important in the treatment of trauma and other mental and emotional problems.
Trust the process - healing from trauma is an organic process. It may not be possible to move ‘forward’ at a particular time (as much as we, or those close to us, would like that to occur). This requires us to cultivate patience and compassion for ourselves as we move through the process of healing.
Trauma-sensitive care requires us to understand and anticipate these issues, and respond with care and sensitivity.
At Botanic Psychology, these principles form the foundation of our approach.