Why is understanding trauma important for those who work in social services? Statistics tell us that nearly 95 – 100% of those served in social service settings have experienced trauma in their lives, specifically physical, sexual, and or emotional abuse. Many individuals have experienced trauma as children and may grow into adults who continue to experience traumatic events, such as domestic violence or violence within their community. Unless social service professionals recognize the role that trauma and abuse have played in the lives of those they serve, they will not be able to fully understand the symptoms and behaviors exhibited by the people they are trying to help. Often, the symptoms and behaviors seen are attributed to a mental health diagnosis or to substance use, without consideration as to how trauma and abuse may have affected the individual. Working from a trauma framework in the context of a person’s life experiences, their culture, and their community is the most helpful, respectful, and empowering model for helping adults with histories of trauma.
The definition of trauma identifies trauma as exposure to actual or threatened death, serious injury, or sexual violence. This includes threatened death or a direct serious injury, witnessing an event that involved death, injury, or threat, learning about an event experienced by a loved one, and experiencing repeated or extreme exposure to aversive details of a traumatic event. Events such as sexual abuse, assault, domestic violence, ongoing neglect and abandonment, deprivation caused by extreme poverty, emotional, physical, and psychological abuse, gang and drug-related violence, vicarious trauma, wars, natural disasters, accidents, divorce, and sudden loss are just a few of the many examples of how trauma occurs.
The impact of abuse is long-lasting and doesn’t necessarily end when the traumatic event ends. Survivors of childhood trauma may experience the impact of that abuse throughout their lives; however, the effects may be witnessed in areas of functioning seemingly unrelated to the trauma itself. For example, someone who has experienced sexual abuse as a child may have learned to dissociate during the abuse as a coping mechanism. Throughout life they may continue to dissociate when they feel anxious and find themselves disconnecting from school, work, and other situations not related to sexual activity. The behaviors that they’ve developed should be seen as a result of their courageous attempts to cope with the abuse they experienced as a child.
When working with trauma survivors it is important for social service providers to know, understand, and work with an individual’s experiences, culture, and community. For example, those who have experienced traumatic events have the choice to forgive their perpetrator or not. However, they are often told that they must forgive an abuser to move forward. Many have not been able to forgive and feel worse about themselves because they can’t. Social service providers can present the notion that forgiveness is an option and that they have the power to decide whether to forgive or not. However, if an individual tells their provider “I grew up in a strong religious tradition that tells me I must forgive or I’ll be damned” or if they say “My AA sponsor says it is part of my step work and I have to do it or I’ll relapse and I don’t want to lose my sobriety” then the provider needs to respect the individual’s experience, culture, and community and support the person with their efforts to forgive.
Every person’s response to trauma is unique. Maya Angelou, for example, reacted to her trauma by being mute for five years. Other responses may include nightmares, flashbacks, irritability or outburst of anger, trouble concentrating, or hyper-vigilance, to name a few. A trauma model looks at the symptoms of someone who has experienced trauma as adaptions, rather than as pathology. These symptoms helped the individual in the past and continue to help them, in some way, in the present. This model emphasizes resiliency in human responses to stress while reducing shame and engendering hope for persons served and providers alike. A trauma model also provides a more holistic view of individuals by helping to reinforce a framework in which everything is part of a whole. Providers can help those who have experienced trauma change their understanding of their symptoms as having developed from creative survival tactics. This reduces shame, provides hope, and assists the person who has experienced trauma in understanding important connections between the traumatic event and subsequent symptoms. This empowers the individual to make progress in managing these symptoms.
This blog entry is an excerpt from Reliance Health’s “Trauma Informed Care” training taught by Adele Cyr, CAC, and Kerry Lee, LCSW LADC, adapted from Eileen Russo’s “Working With Adult Survivors of Trauma: Key Concepts in Understanding Trauma Dynamics” Community Connections, 2010.