understanding trauma and healing

TL;DR

• Trauma is subjective and can vary in intensity, affecting individuals differently based on their coping abilities and life experiences.
  
• Trauma is widespread, with studies showing high prevalence across all demographics, though marginalized groups experience it more intensely due to systemic inequalities and historical oppression.
  
• The impact of trauma can manifest in emotional, social, and behavioral difficulties, including emotional numbing, avoidance, and impaired relationships.
  
• Trauma Informed Care (TIC) provides a framework for understanding and addressing trauma empathetically and effectively.
  
  

Trauma is deeply personal. What is traumatic for one person may not be perceived the same way by another. Labeling an event as “traumatic” can sometimes lead to defensiveness or misunderstanding among those who did not experience it. In my clinical work, describing an event as traumatic comes with an unspoken rating scale that ranks only the most horrific events as real trauma, while others are minimized.  

However, trauma is better understood in terms of an individual’s ability to effectively cope with an event that is outside of their perceived norm. Whether trauma is spelled with a capital “T” (situated on the far end of the intensity continuum) or a lowercase “t” (situated on the opposing end), it is an experience that triggers both physical and psychological responses. It can alter how individuals and communities view the world. Many who seek out mental health care are not fully aware of how trauma shapes their lives and current challenges.

How Prevalent is Trauma?

According to the Substance Use and Mental Health Services Administration (SAMHSA), trauma results from a single event, series of events, or circumstances that are physically or emotionally harmful or life-threatening—like childhood neglect or community violence. These experiences can have lasting effects on day to day functioning and well-being—physically, emotionally, socially and/or spiritually.

Immediate responses may include shock and denial while long-term reactions often involve unpredictable emotional responses and relationship strain. While these reactions are typical, some individuals become impaired as a result. Impairment may include social isolation, avoidant behaviors, emotional numbing and a loss of interest in activities.

While trauma exposure is common, it can also be unexpected, and the nature of this exposure varies considerably across different demographic groups. According to SAMHSA, trauma can affect people of all backgrounds regardless of race, ethnicity, age, sexual orientation, gender, socioeconomic status or geographic location. An individual’s psychosocial background—life experiences, family dynamic, education and access to support—impacts their response to trauma. 

A person may be directly involved in a traumatic event, experience it, feel threatened by it, or even hear about it in a way that causes lasting impairment. When trauma overwhelms an individual, it can trigger survival reactions—fight, flight, freeze or fawn—and leave a lasting imprint. Communities are also affected, particularly when resources are insufficient to meet collective needs. Trauma breeds fear, vulnerability, and a sense of helplessness in the individual and the community.

The first National Comorbidity Study found that 61% of men and 51% of women reported experiencing at least one traumatic event in their lifetime. These events included natural disasters and life-threatening situations, the latter being most common. In a second study, the National Epidemiologic Survey on Alcohol and Related Conditions found that:

• 71.6%  of respondents reported witnessing trauma, 
• 30.7% experienced trauma with injury 
• 17.3% experienced psychological trauma.
  

Trauma Among Marginalized Groups

While these statistics reflect the widespread nature of trauma across the general population, certain groups, particularly those who are marginalized, face an even greater burden due to systemic inequities and historical oppression. 

Marginalized communities—including women, Black, Indigenous and People of Color (BIPOC) people, LGBTQ+ (individuals whose gender identities and sexual orientation differ from the norm), those of low socioeconomic status, the homeless, veterans, the disabled—face a higher risk of trauma. These risks arise not only from the aforementioned systemic inequalities and historical oppression but as the result of segregation, achievement and wage gaps, racial profiling and biased sentencing.

• Historical trauma refers to the cumulative psychological and emotional wounds of an individual passed through generations within a given community, typically BIPOC communities – resulting from events like colonization and slavery.

• Systemic inequalities are ingrained disparities within the framework/infrastructure of a society that have a disproportionate impact on marginalized communities such as disparities in healthcare, education and employment.

Research has found that marginalized groups experience trauma at higher rates than the U.S. population at large, often with significant impacts to their mental and physical wellbeing. Examples of trauma triggers within these marginalized communities and groups include

• Genocide and forced assimilation
• Generational trauma
• Lack of awareness and available/accessible services
• Barriers to care and low quality of care
• Overcriminalization
• Parental denial and/or rejection
• Adultification and Parentification—assuming or being given a role exceeding the maturity level of the individual 
• Community violence and adverse childhood experiences (ACES)

Principles of Trauma Informed Care

Now that we have defined trauma, explained how one is likely exposed to it and discussed its lasting impact on various individuals and communities, let us outline the approach that is used to address trauma. Over the past decade, rising national awareness has focused on the connection between trauma, psychological distress, quality of life and mental health. From this awareness, Trauma Informed Care (TIC) was developed. 

Trauma Informed Care (TIC) is a best practice used to equip treatment providers with the skills to understand and address clients’ trauma histories empathetically, working within their program guidelines. Integrating this approach benefits not only the individual but also their families, communities, and service providers. TIC aims to destigmatize thoughts regarding trauma and its impact, bring to the forefront trauma’s pervasive effects and require service providers to acquire the knowledge and skills to effectively meet the needs of their clients.

The National Institute of Health’s National Library of Medicine affirms that TIC interventions focus on how trauma may have had an impact on an individual’s life and how they engage with healthcare. TIC stresses the individuality of a person versus applying a one-size-fits-all model. The TIC intervention model allows for the establishment of a trauma informed environment -one that is safe, collaborative and compassionate. It aims to prevent re-traumatization and build resilience by using three key elements:

• Realizing trauma’s prevalence
• Recognizing trauma’s impact on individuals, communities, programs, and systems
• Responding by putting trauma knowledge into practice.
  

Which will allow for:

• Prioritizing safety
• Trustworthiness
• Collaboration
• Empowerment
• Culturally responsive approaches—cultural sensitivity, addressing historical trauma and consideration of gender identity
• Leadership support
• Staff training
• Improvement to TIC approaches
  

Traumatic events are unexpected and sometimes unavoidable. However, an individual’s response to the event in question is what determines whether it is traumatic. That, along with experience and interpretation, can have a lasting impact. However, with TIC, the question changes from, “What is wrong with me?” to “What has happened to me?”