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What is Trauma Informed-It’s Complicated

I am an interested in having a conversation about trauma informed approaches, modalities, and practices in the industries of mental health, wellness, and other adjacent fields. Being a part of the incredible international peer support community, I’ve had the immense privilege of learning, sharing, and contributing to the dialogue around Trauma-Informed approaches. It’s been a journey of education, both receiving and giving, and a chance to be part of organizations that wear the “Trauma-Informed” badge with pride—sometimes rightfully, sometimes not so much. Through my experiences, I’ve come to realize that being Trauma-Informed cannot be just a label; it’s about genuine understanding, empathy, and action. So, why this post? Well, it’s my way of shining a light on the concerns and successes contributing to the ongoing narrative about the state of research on trauma. Let’s talk about what’s working, what isn’t, and how we can continue supporting one another on this path of healing and understanding. 🌈🌻

What We Are Understanding by Studying Trauma

  1. Veterans Study: Trauma can physically alter our brains, not due to physical injury, but through a rewiring process1. These changes occur in individuals with and without psychopathologies, such as PTSD, depression, and anxiety. People exposed to trauma without psychopathologies compensate for these changes by engaging the executive control network1.
  2. Adverse Childhood Experiences (ACEs): ACEs are significant factors in depression and cognitive decline. A systematic review found that neuropsychological scores in individuals with trauma histories and any psychiatric diagnosis ranged from low to high average. Recent research suggests that ACEs negatively impact cognitive function, with depression mediating this relationship.
  3. Marginalized Communities: Systematic trauma refers to the traumatic experiences faced by marginalized groups due to systemic oppression and discrimination. Studies suggest that a history of traumatic events can lead to a proliferation of discrimination stressors and threat appraisals, which predict psychological distress. Trauma-informed approaches need to consider the unique social context of various socially marginalized groups.

4. Intergenerational Trauma: This type of trauma occurs when the traumatic effects are passed across generations without exposure to the original event2. The field is developing and often examined as part of research into historical trauma2. Preliminary studies have focused on Holocaust Survivors and their offspring, with more recent research examining the intergenerational effects of the residential school system on Indigenous people and communities across Canada2.

5. Trauma and Mental Illness: Trauma refers to events, experiences, and their effects upon individuals. It can contribute to caregivers demonstrating inconsistent affective responses to their children, leading to dissociative, mood, and behaviour symptoms in the next generation. Trauma is linked to the development and severity of mental illness across the lifespan.

Problems with Trauma Research

Most early research on trauma and PTSD focused on male samples5. The majority of these studies examined factors related to how male combat Veterans responded to war-related trauma5. Around the same time, researchers who studied women’s experiences of sexual assault identified a syndrome that was similar to that experienced by combat-exposed men5. This recognition led to an increase in research on women’s experiences of traumatic events and risk for PTSD56. However, the research that was done on adverse childhood experiences was based off of research done primarily on affluent white women56. This has led to a lack of clear evidence on the best therapies for people with complex trauma7. Further in-depth research is warranted for the most promising7. There are several emerging treatment options for people of colour experiencing racial trauma8. However, given the scarcity of literature, we need more studies to establish the validity and efficacy of available assessment and treatment options8.

The Challenges Around Diagnosing and Treating Trauma

  1. Systemic Trauma’s Effects: Systemic trauma, experienced by marginalized groups due to systemic oppression and discrimination, can have long-lasting effects on physical and mental well-being. The body’s stress response system, the hypothalamic-pituitary-adrenal (HPA) axis, becomes more reactive to stress, increasing the stress hormone cortisol.
  2. Cost of Treatment: Treating trauma can be costly. Prescription drugs are the second biggest cost to the Canadian healthcare system, at $39.8 billion in 2018, just behind hospitals. Drug prices in Canada are now the third highest among the OECD countries.
  3. Dialectical Behavioural Therapy (DBT) Costs: DBT is a therapy that helps people learn and use new skills and strategies to build lives they feel are worth living. However, the cost of DBT can be high, with the cost for advanced DBT 12 sessions at $999.00 and $1,800.00 for 24 sessions.
  4. Implications of the System: The system that causes trauma and then charges for treatment has multifaceted implications. It places a financial burden on individuals already dealing with the psychological and physiological effects of trauma. It also raises questions about the accessibility and affordability of mental health care, particularly for marginalized communities who may be disproportionately affected by systemic trauma.

Concerns in the Trauma World

  1. Lack of Oversight: There is no oversight for any trauma-informed modality. They are based in some questionable science1.
  2. Covering Up Systematic Issues: Trauma-informed approaches can cover up systematic issues and paint places where people who have experienced trauma are still not seen or treated appropriately34. Yet because people took trauma informed “fill in the blank,” the space is now being called trauma informed34.

So, that’s the scoop on trauma, mental health, and the very brief overview of trauma informed approaches, modalities, and practices in the industries of mental health, wellness, and other fields—our chat’s wrapping up, folks! Thank you for being open to explore this topic and diving into this journey with me. Let’s keep the conversation going, whether it’s over a cup of coffee or through the digital waves. Take care of yourselves, keep the vibes real, and I’ll see you in the next slide! 🌻🌟

Citations 8 Intersection of Racism and PTSD: Assessment and Treatment of Racial Stress and Trauma – Springer 5 Research on Women, Trauma and PTSD – PTSD: National Center for PTSD 6 Higher stress among minority and low-income populations can lead to health disparities – APA 7 Mental health problems in complex trauma: the most promising therapies are identified in a new review – NIHR 2 New study explores the influence of complex trauma on mental health and cognitive function – KCL 3 Adverse childhood experiences: What we know, what we don’t know, and what should happen next – EIF 1 InBrief: The Impact of Early Adversity on Children’s Development – Harvard Adverse Childhood Experiences (ACEs) – Centers for Disease Control and Prevention Adverse Childhood Experiences (ACEs) – Public Health Ontario Adverse Childhood Experiences Prevention Strategy – Centers for Disease Control and Prevention 2021 Year in Review of Trauma and PTSD Research – Psychology Today Dialectical Behavioural Therapy (DBT) Costs – DBT Systemic Trauma’s Effects – Trauma and Recovery Lack of Oversight – Oversight and Government Reform Trauma and Mental Illness – Mental Health and Trauma Cost of Treatment – Canadian Institute for Health Information