Understanding Trauma and Trauma-informed Care
What is Trauma?
The American Psychiatric Association defines trauma as “a deeply distressing or disturbing experience.”
It is essential to note that trauma is subjective, meaning that we each experience different life events in unique ways. What may be a trauma to one person may not be experienced as a trauma by another person, and vice versa.
Effects of Trauma
Trauma affects the body physically, emotionally, and socially in both acute and complex ways. Although trauma is experienced distinctly, there are trends across how trauma affects our physical and emotional wellness.
Physical:
- Somatization (physical manifestation of emotional and mental pain), Fatigue
- Loss of appetite/weight
- Unhealthy relationship with food (development of eating disorder(s))
- Hyper- or hypo-sensitivity
- Digestive problems
- Respiratory problems
- Sleep disturbances
- Nightmares
- Weakened immune system.
Mental/Emotional:
- Numbing (“emotions are detached from thoughts, behaviors and memories” in an effort to minimize pain)
- Dissociation
- Delayed response
- Lack of concentration
- Rumination
- Self-blamePossible suicidal ideation.
Social:
- Difficulty relating to or connecting with others
- Mistrusting others (including service providers)
- Difficulty expressing needs and wants
- Difficulty setting boundaries
Trauma can prompt dysregulation, which shifts us from our normal mode of functioning with a measure of resilience—what is often referred to as out “Window of Tolerance”—into modes in which our survival feels threatened in some way, such as a state of hypoarousal or hyperarousal.
Sakhi is committed to providing trauma-informed care to survivors.
We see how society attempts to quantify trauma—and subsequently, healing. A scarcity of resources and understanding impedes our ability to end gender-based violence.
That is why we believe that, at its core, the anti-violence movement must embody healing. Our activities must push culture, policy, and research to recognize the nuances of violence and to trust survivors as the experts of their own experiences.
Trauma-informed care views service provision through the lens of trauma and involves helping survivors attain access to physical safety, economic resources, and legal services while strengthening their psychological capacities to overcome trauma. These services are provided in an environment that is inclusive, destigmatizing, and non-retraumatizing. Providing trauma-informed services is a practice and a process, therefore, staff members are encouraged to be mindful and intentional.
Trauma-informed care also recognizes the impact of a survivor’s trauma on attending staff. Sakhi acknowledges the effects of vicarious trauma and actively works to mitigate its negative consequences in the provision of services.
Principles of Trauma-informed Care
- Safety
Throughout the organization, patients and staff feel physically and psychologically safe. - Trustworthiness and Transparency
Decisions are made with transparency and with the goal of building and maintaining trust - Peer Support
Individuals with shared experiences are integrated into the organization and viewed as integral to service delivery - Collaboration
Power differences, such as those that exist between staff and clients, are leveled to support shared decision making - Empowerment
Patient and staff strengths are recognized, built on, and validated. A shared belief in resilience and the ability to heal from trauma is established and maintained - Humility and Responsiveness
Biases and stereotypes (e.g., based on race, ethnicity, sexual orientation, age, geography) and historical trauma are recognized and addressed
Vicarious Trauma
Vicarious trauma (VT) describes the effects that practitioners, friends, family members, and others who bear witness to trauma experience.
It is the emotional residue of excessive exposure to trauma and can be alleviated through trauma stewardship.
VT is distinct from burnout in that it can occur in any job overtime but can also be resolved through time off, an influx in resources, or a change in one’s environment or career. Generally speaking, burnout is the result of overworking and not having access to ample resources – it is often perpetuated within nonprofits’ cultures given the mission-driven & under-deployed nature of such organizations.
Signs of Vicarious Trauma Include:
- Being in constant state of arousal
- Dreaming about client/person’s experiences
- Feeling trapped by work
- Anger or irritability
- Lack of sleep or sleeping too much
- Increased fatigue
- Blurred boundaries
- Lack of connection in personal relationships