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 event2The field is developing and often examined as part of research into historical trauma2Preliminary 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 samples5The majority of these studies examined factors related to how male combat Veterans responded to war-related trauma5Around the same time, researchers who studied women’s experiences of sexual assault identified a syndrome that was similar to that experienced by combat-exposed men5This recognition led to an increase in research on women’s experiences of traumatic events and risk for PTSD56However, the research that was done on adverse childhood experiences was based off of research done primarily on affluent white women56This has led to a lack of clear evidence on the best therapies for people with complex trauma7Further in-depth research is warranted for the most promising7There are several emerging treatment options for people of colour experiencing racial trauma8However, 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 appropriately34Yet 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

Empowering Mental Health: The Journey from WRAP to APPR

Mary Ellen Copeland, an author, educator, and mental health recovery advocate, has been a driving force in transforming mental health care by emphasizing personal empowerment, self-help, prevention, and recovery through natural supports, education, training, and research. Her dedication to making mental health resources accessible led her to develop the Wellness Recovery Action Plan (WRAP) in 1997.

However, Mary Ellen’s vision of WRAP being freely available for all encountered challenges when the Copeland Center began monetizing it, requiring fees for facilitator training and materials. This departure from the initial intent of providing free access to WRAP prompted Mary Ellen to create a royalty-free alternative called Action Planning for Prevention and Recovery (APPR).

APPR emerged as a response to the COVID-19 pandemic, which highlighted the need for accessible mental health resources. Unlike WRAP, APPR is designed to be freely available for anyone to use and adapt. Mary Ellen’s commitment to democratizing mental health support shines through in APPR, ensuring that individuals facing mental health challenges have access to effective tools without financial barriers.

The Essence of APPR

APPR draws inspiration from Mary Ellen’s extensive studies of how individuals cope with life challenges daily. Her approach emphasizes empowering people to use techniques and strategies that have proven effective for others, fostering a sense of personal agency in mental health recovery.

Post-Crisis Empowerment

In the post-crisis landscape, APPR stands as a beacon of hope and resilience. Developed collaboratively with individuals who have lived experiences of serious mental health challenges, it provides a structured framework for individuals to regain control over their lives.

WRAP’s Evolution and Global Impact

While WRAP continues to be a widely adopted tool globally, Mary Ellen’s decision to create APPR has expanded the reach of her vision. Her work has touched millions of lives through books, media, and lectures, encouraging individuals to use WRAP or APPR as a personal guide to achieving the desired emotional state and creating the life they envision.

Recognition and Validation

The effectiveness of WRAP has not gone unnoticed. Extensive studies have led to its listing in the federal National Registry of Evidence-based Programs and Practices, validating its impact on mental health recovery. APPR, as an extension of this legacy, carries forward the principles of empowerment, self-help, and recovery.

In conclusion, Mary Ellen Copeland’s journey from WRAP to APPR represents a commitment to making mental health resources universally accessible. By providing a royalty-free alternative, she ensures that individuals facing mental health challenges have the support they need without financial barriers, ultimately fostering a global community focused on empowerment, prevention, and recovery.

Black Sheep Can Upgrade To Spicy Unicorn: Embracing Your Unique Journey

Most of us are a wee bit odd, we roam to the beat of our own songs, some of our beats more distinct than others.  We may have given ourselves the “Black Sheep” label, it may have been an honorary title, it may have been given without permission.   It has happened, we have found ourselves here, not knowing what to do with our rank of oddity.  There are a number of options available to us, one is complain about the situation, blame “others” about the situation, avoid the situation, conform as best as possible, or embrace it (unless you are an asshole, then this advice sucks.)  Well it is not advice anyway, it is how I use my trauma recovery to guide me forward.  Sometimes I am a battle unicorn, who is effective, but very lonely, sometimes I am a community unicorn full of fun and support.   When I am in my full self, I am happy being all of my pieces.

Our unique sense of what is me, myself and I developed in relation to our early support systems.   Some support systems are equipped with love and secure boundaries that allow us to safely mature.  These are skills that kin groups learn and teach their children, who in turn, pass it on to theirs.  A better skill tool box than others.  Many families have instead generations of abuse, neglect, poverty.  The skills that are passed down in these kin groups are survival based.  Fight or flight all of the time, even when it is no longer a need, just a frustratingly tragic inheritance.

When we are blamed for problems in the family, we are taught that we bear responsibility for other people’s happiness.  We eat sins.  We look for ways to carry the weight of our people’s happiness.  Some of us devote our lives to achieving and improving, in the hopes to deserve affection.    Some of us give up, hide, wilt away, waiting for someone to seek us.  Some of us numb ourselves with addiction or distraction.  Some of us try it all.  Regardless of what we do, it is not until we give up responsibility for other’s happiness, that we can heal.

This usually occurs when we had uncommon life experiences when we were young.  Our perspective was shaped by something that most people outside our immediate family do not get to experience.   This can leave us feeling isolated, even within our family.   When this happens we can feel like

I have been the black sheep, I have had no choice, time and tide created the “other” in me.  These forces have created this in all of us.  Most of us eagerly share our unique selves with the world.  Some of us are weighed down by the fear of reaction to our “other,” encumbered by pain and uncertainty.  We make our way in the world carrying our burdens of judgement, we are exhausted and need support.  Nurturing and understanding all that makes us beautiful and messy allows us to heal the parts of us that were neglected, abused, and ignored. We need to look at our wounded parts with all of the love and attention that you give a tiny baby.

Achieving this upgrade requires courage and stamina.  It requires us to leave blame behind and step into the realm of self-compassion. Embracing our uniqueness means acknowledging that the path to healing involves understanding our individual narratives and rewriting the script with love and acceptance.

When we carry the “Black Sheep” or any other “othering” label, it’s an opportunity to redefine what that means to us. Instead of viewing it as a burden, we can see it as a badge of resilience, a testament to our ability to navigate through challenges that others might not comprehend.

Our unique experiences may have left us feeling isolated within our own families, but it’s crucial to recognize that we are not alone in this journey. Many others share similar struggles, and through connection and empathy, we can build a community that understands and supports one another.

As we embark on the path of healing, it’s essential to let go of the blame that may have been instilled in us. Blaming ourselves for the family problems or feeling responsible for others’ happiness only perpetuates the cycle of pain. True healing begins when we release those burdens and redirect our focus inward.

The process is not easy; it requires courage to confront the wounds, strength to carry the weight of our past, and resilience to face potential judgment from the world. Yet, in doing so, we unlock the door to self-discovery and the freedom to live authentically.

So, let us cast off the shackles of blame, embrace our uniqueness, and embark on the journey of self-love and understanding. For in doing so, we not only heal ourselves but also contribute to the healing of those around us. We become the architects of our own narratives, forging a path that celebrates the beauty in our imperfections and the strength in our authenticity.

Navigating Personal Responsibility in a Judgmental WorldPersonal Responsibility

In our tight-knit community, where judgment seems to be a constant companion, discussing personal responsibility can feel like treading on thin ice. The prevalent societal expectation that individuals with mental health challenges should carry on as if everything is fine only adds to the complexity.

Embracing Personal Responsibility in a Complex Landscape

Addressing personal responsibility in this context can be daunting. People are quick to judge without truly understanding or empathizing with the unique experiences of individuals. It’s disheartening when, despite our best efforts, the world insists we should be doing more.

I firmly stand by the belief that everyone is doing their best. While it’s easy to think others could do better, it’s essential to recognize the limits of our understanding. Each person’s journey is different, and we can’t accurately gauge their struggles.

Even in my own life, finding the balance between giving my best and acknowledging my limitations is an ongoing challenge. Balancing high-intensity activities with self-care can be a struggle, leading to frustration. I’ve learned that self-punishment with shame only perpetuates a cycle that does more harm than good.

The Journey to Personal Responsibility

Navigating personal responsibility, especially in a world that often feels out of control, begins with acknowledging the chaos around us. It calls for introspection, a deep dive into the core of our values and ethics.

Understanding why we do what we do is crucial. Whether it’s fueled by passion or driven by the desire to support loved ones, knowing our motivations helps us prioritize self-care effectively.

It’s essential to remember that the world won’t change just for us. Empowerment comes from identifying problems within our capacity to solve. If it’s not our responsibility, it’s not our problem.

Building a Better World Through Personal Responsibility

I firmly believe that personal responsibility plays a pivotal role in shaping the world we want to live in. Authenticity, in this context, is built on understanding our capabilities and taking deliberate steps toward positive change.

In a judgmental world, where the pressure to conform to unrealistic expectations is ever-present, embracing personal responsibility becomes an act of self-empowerment. By focusing on the problems we can solve and taking responsibility only for what is within our capacity, we pave the way for a more compassionate and understanding community.

Let’s strive to create a world where personal responsibility is celebrated, where individuals are supported in their unique journeys, and judgment takes a backseat to empathy and understanding.

Campfires – A Modern Spin on A Human Tradition

OH&WG along with Healthy Minds Around the Loop and our community partners are working to build healthy minds, bodies and increase resilience in our community. Communities are built by sharing so we have found some things to share: gathering space, refreshments, information on low cost and no cost community resources. We are offering guided mindfulness practices along with supporting monthly community chosen activities, workshops, along with ideas generated as we go.

There is no doubt that mental health and issues surrounding mental illness have moved from a conversation had behind closed doors, to one that has gained a global voice and community awareness. Research and technology that allow us to understand the underlying physical and social contributions of mental illness and resilience have helped to remove some of the stigma from individuals.

We are trying to move from conversation to action. We are not offering solutions, merely the hope that if we create space, community may grow and together we can create wellness.

Healthy Minds Around the Loop Association is offering Campfires; a place to drop in and grab a coffee or tea, find out about free low cost and no cost wellness programs in Spryfield and surrounding areas, try out meditation, and participate in monthly workshops and events. We will be holding our campfires beginning in September at Chebucto Connections.

We will be holding events over the summer that promote community building and mental health, we are doing so in order to promote our program and engage people in our community. If you or your organization are interested in participating we have a number of ways you can do so:

by providing information or offering to speak about free and low cost resources that you provide

by providing snacks, or water and drinks;

by giving gift certificates related to your business;

by supporting your staff to volunteer;

by contributing a cash donation; or

By attending our events and bringing friends and family along with you.

We do hope you will find a way to help us in supporting resilience, positive mental health outcomes, and community building. Together we can make a difference!

Healthy Minds Around the Loop Association

Fostering people-centred, accessible, and inclusive mental health services

healthymindsaroundloop@gmail.com

Perspective

My old neighbourhood

When I was sixteen years old my mother informed me that she was taking me out of school to give me an education.  What she meant by this was that I was going to miss two weeks of my first term of grade eleven because we were going to South East Asia.   It was the 1980’s so we did not have web browsers and social media, there was no way to casually meet people from other countries. I was a kid from rural Nova Scotia my comprehension of the world was limited.  

Our itinerary was 3 days in Hong Kong, then flying to Thailand and spending 3 days (nights) in Bangkok and finally 3 days in Pattaya, a beach resort about a hundred kilometers to the south east.   It took absolutely no persuading for me to leave school, I did not actually spend that much time there while I was in the country. I am not proud of that fact but it is the truth. Flying time, not including layovers, was twenty hours or so.  This was brutal on me, my body does not like to travel, by the time we made it to Hong Kong my feet were so swollen they were bulging out of my shoes.

To this day I do not let being sick keep me from experiencing all that I can, I am not sure if I would recommend this, but again this is not about judging my day to day life choices.  We saw as much of the area around Hong Kong as we could get to within our three days. This included a tour of Guangzhou on mainland China. I remember a pretty hardcore open market and school kids singing, the way everywhere around the world gets school kids to sing even here.  There was also a temple and a zoo with a panda. I remember shopping in Macau on another day and purchasing my first black market goods, “A Salt with a Deadly Pepa” and “Tiffany”, cassettes that would travel with me for decades to come.

I remember being in Bangkok, but by then I was very sick, so I did not see as much here.  I did have the honour of seeing the royal temple and then I do not really remember much after that until we got to Pattaya.  Overwhelming poverty was everywhere, I had never experienced anything like it before. I was still too sick to leave the hotel most days, but I could lie by the pool, and by the last day I felt a bit better so that evening I ate at a bar down the street.  I have a few vague memories about this place, but they are mixed up in stories from earlier dinners that I was not there for. I do have one memory that I know is all mine. It was the conversation that gave me the education that my mother had brought me to Asia for.

My hubby and I when we were dating back in 1988

I hate to generalize about people, but the people of Thailand are overwhelmingly blessed with a youthful beauty. Many people often mistook my baby-faced sixteen year old self to be a grown woman.  I say this because it makes it difficult to guess how old our server was that evening. My gut tells me that she was under twenty-five and she could easily have been younger than me. Many young girls worked in the bars around Pattaya.  Rural families facing starvation sold their daughters to businesses in the towns and cities. We were warned about human traffickers working the beach and for me not to go there by myself.

I am going to call my friend that evening Kouru.  This is not her real name, it means lotus which describes her spirit.  She also grew through a lot of darkness and still exuded a warm beauty.  I do not remember much of what we said that evening, but I remember she asked me what I was going to do when I grew up.  I believe at the time my plan was to be a marine biologist.

It was the first time I was having a conversation with someone who was my gender, around my age, and from an entirely different culture.  We were chatting like school friends and then she asked the question. It was the first time I realized just how incredibly lucky I am to have been born a Canadian citizen with all of the advantage that comes with.  She asked my plans and the mask of vacation disappeared. I saw them emerge in my mind. The number of possible futures the 16 year old me had in front of her in that moment in time felt infinite.

My imagination showed me all of the gifts and privilege that I had been born into.  Kouru could see on my face how insecure I was sharing my reality with her. She asked me to tell her, she asked as if I was reading a her a Hugo novel.  Kouru was an adventure seeker, she wanted to see what I was seeing so I told her about being able to do anything that I wanted to do. I told her about being able to go to university, and the paths that opened for me.  This was not something that was available to most women in the world in the 1980’s. A look crossed her face, a look of such beautiful warmth, she was genuinely happy that one of us could go on this adventure. She seemed so authentically grateful that I had these gifts, it hit me like a punch.  

Pattaya

I understood that Kouru would not only never go to university, she was unlikely to have had highschool or earlier grades.  Women who were sold to the bars worked in the sex industry. Some were enslaved, some were not, and I do not know her story. People still go to Thailand for the sex trade; at that time it had many very dark corners and I am sure they are still there.  

My new friend most likely had a very difficult life ahead of her, and I had infinite possibilities.  The randomness of fate along with its cruelties seemed infinite as well. I could not bring Kouru along on my journey with me physically, but today if I need to know something whether something is possible her spirit still lends me her perspective on my options.  

I hope fate had a kinder life for Kouru than I imagined.  I know that things have changed in Thailand and that women’s roles are evolving the way that they are here.  

The education that I received on that vacation has been the most profound of my life.  I live where I have access to almost limitless resources. My access to these resources is limited by my imagination.   I had the veil of privilege removed for a moment so that I could see all of the treasure that stands before me, not just an education but a gift.

Barefoot Gift Cards

This is the story of  how we came up with the best local present you can give or receive this year.

 

Two years ago the owners of Witch Haven Farms decided to give back to their community by helping  struggling families grow food. The hope was to help with rising food costs, and increase nutritious food availability, variety, and security in their community.   They helped people start their own home lots, offering everything from seeds to support. The families had success in their new gardens, so much success that they had excess.

 

Witch Haven began buying the excess and offered the veggies at cost to seniors they know in neighbouring communities.  The income created even more household security and made a real difference for the families growing food.

 

People began eagerly joining the program, and success has brought the challenge of organizing and delivering all of the food.  This issue brought Witch Haven to the Ecology Action Centre’s Community Food Leadership Certificate Program.  

We fell in love with the idea and formed the Barefoot Farmers Association and work beside our community partners Shelter Nova Scotia, the Mulgrave Park Family Centre, and Sipekne’katik Food Pantry.

We all put our heads together and came up with the perfect local gift idea:

 

Barefoot Gift Cards

 

Each gift card provides twenty dollars worth of local, organic produce and eggs to a local shelter or community pantry.  This would be a great gift in itself, however this twenty dollars also provides economic growth to our Barefoot Farmers Collective, and increases food security in Nova Scotia.  

 

You see it is the perfect local gift.

 

Get yours in person at the Brewery Market on Saturday December 22, 2018

 

Order Online @

 

Facebook@BarefootFarmersAssociation

https://osberghealth.com/barefoot-farmers/

 

E-transfer @

 

barefootfa@gmail.com

 

Writing to meditate and heal

I read a beautiful book I once named “The Artist’s Way” by Julia Cameron.  She introduced me to the practice of morning pages.  Writing three pages each morning started as just something new to try.  It began so long ago now that I have forgotten my motivation.  It would take me hours, struggling to make the words flow out of my fingers onto the page.  Most of the time it was pages of the silliest mundane drivel, anything to reach my goal.

That drivel was probably the most important stuff that I ever wrote.  Having a learning disability that makes it difficult to spell, I have always felt a lot of shame around my writing.   These morning pages were the first time I made myself use my voice in a way that was  allowed to be, and meant to be imperfect.  The goal was not to write anything in particular, what mattered was writing three pages.  What ended up happening was my first experience of listening to myself and the inner dialogue that was creating the world I lived in.

There are lies that we tell ourselves all the time: I can’t cook, I am not prepared enough, there is not enough time.  In the background noise of my pages I write down my lies.  They usually come out as blame, creating problems and self doubt.  When I see the lies on the page in front of me a different part of my brain takes over and solves, works around or flat out dismisses them.

My journey of recovery started with those first pages.  I have learned to use meditation as my daily tool for connecting my internal chorus to my awareness, but I would not have known that was possible without those pages.  If you are looking for a place to start, and especially if you have no access to professional help, try morning pages.  Three pages written everyday (within reason, some is better than none) for at least a month, looseleaf size, single spaced.  It is tough and time consuming, and so is everything else that is worth doing.  You deserve to listen to your own story. You are worth it.