Working through a past trauma is a common reason many individuals seek treatment. It is so common that there has been an increased need for trauma-informed care and approaches. The more trauma is talked about and researched, the more we realize that some common language on the topic is shifting the mindset by changing the question from, “What is wrong with you?” to “What happened to you?” As someone who is potentially seeking support for their traumas, it is crucial to understand what trauma-informed care looks like and how we can ensure we are seeking professionals who are capable of supporting us with processing and healing from our past traumatic experiences. 

What is Trauma?

Before we discuss the topic of trauma-informed care, let us first define what trauma is. Trauma can be seen as a deeply disturbing or distressing experience that overwhelms an individual’s ability to cope. Often this results in long-term emotional and psychological consequences. However, sometimes trauma isn’t as tangible to label, and be difficult to see how it is impacting you on a daily basis. 

Trauma can be caused by a wide range of events, including physical injury, sexual assault, war, natural disasters, and neglect. When we hear the word trauma, most of us think of big catastrophic experiences that are often differentiated in the psychological community by giving the connotation of Big-T traumas. Big-T traumas are experiences like rape, war crimes, or physical assault. However, these are not the only types of traumas. It’s vital for us to distinguish that smaller experiences of accumulated stress over a long period can also have very similar effects to the impact of a Big T trauma. Let us get into the specifics of defining these terms of Big T trauma and little t Trauma below.

  • Big T Trauma: As previously stated above, a Big T trauma refers to a single catastrophic event that is widely recognized as traumatic. Such as car accidents, natural disasters, or violent crimes. These events are often intensely life-threatening, and as such, they have a profound impact on an individual’s mental health and physical well-being.
  • Little t Trauma: A little t trauma is a bit more complicated. These can be cumulatively overwhelming and stressful things in a person’s life that may go unnoticed at the time they happen. The repeated or prolonged exposure to those stressful circumstances is not individually life-threatening. However, the accumulation over time can have a very significant impact on an individual’s mental health. Some examples of little t traumas can be things like chronic stress at work, financial strain, and relationship problems. Constant exposure to those stressors results in similar traumatic responses in the brain and the body. 
    • Less noticeable little t traumas but potentially more impactful than daily stress or financial strain, are attachment breaks. These are moments where a point of emotional or physical connection could be made but goes unnoticed and therefore doesn’t happen. Examples would be a parent in mis-attunement with their child’s needs (e.g., thinking their child is hungry when they are tired and need to snuggle) or a partner ignoring or missing a bid for connection (e.g., one partner comes up to the other on the couch to cuddle and connect but the partner picks up the remote and turns on the television thinking they want to watch their show together). Repeated attachment breaks can change your perspective on your sense of Self, worldview, and how you trust others in the world.
  • Complex Trauma: Another important caveat of trauma to understand is the concept of complex trauma. This refers to a developmental trauma disorder where a person has had repeated exposures to multiple traumatic events. Often these occurred during childhood or adolescence. These complex trauma experiences disrupt the developmental process in attachment patterns, and they can have lifelong consequences for emotional, mental, and physical health. An example of such complex trauma could be the repeated sexual assault of a parent or the witnessing of ongoing physical violence in childhood. As the name suggests, complex traumas are significantly more complicated to heal from. Each unique event requires thoughtful attention to help a person heal and unravel the pains of those experiences.

With this fundamental understanding of the various types of traumas, let us now discuss more specifically this concept of trauma-informed care and ensure that those seeking support with healing from the various types of traumas can get the help that they need. 

Why is Trauma-Informed Care important?

Currently, trauma is pervasive. According to research, in the United States alone, an estimated 60% of adults have experienced at least one big T trauma in their lifetime. Understanding this prevalence of trauma, we can see that it’s very important that clinicians are well-prepared and specially trained to support the population seeking treatment. As such, the mental health community started to respond to trauma in different ways and break out of the previous traditional medical model approaches to treatment. 

Historically speaking, traditional approaches to mental health concerns focus on symptom and behavior management. Unfortunately, these services could unintentionally re-traumatize individuals if they don’t consider the underlying roots and impact of the traumatic experiences. This re-traumatize often resulted in an individual seizing treatment and never receiving the much-needed support. 

The psychological community as a whole recognized that traditional approaches struggled to support those with traumatic experiences. They developed new tenets and principles of practice, which we now call trauma-informed care. Since applying this new approach, we have seen improved outcomes for people experiencing traumas, such as symptom reduction, improved physical health, increased engagement, decreased risks of substance abuse, greater social connectedness, enhanced coping skills, and a greater sense of personal empowerment. Sadly, trauma-informed care as a whole is an additional training modality not offered in basic psychotherapy training and education. As such, some clinicians are not as exposed to trauma-informed practices and approaches. Therefore, it is important that we empower individuals to recognize specific characteristics and skills when choosing a clinician for trauma support.

What are the 5 Principles of Trauma-Informed Care?

So what does a Trauma-Informed Care clinician look like in session? By understanding the 5 principles of Trauma-informed care, we can empower individuals to recognize when a clinician is using the principles to establish ideal trauma support. These principles are:

  1. Safety: The physical and emotional treatment environment should feel safe to the client. This way, we can promote healing, create an ongoing awareness of respect for boundaries, and avoid re-traumatization.
  2. Trustworthiness:  Building trust and rapport with individuals by being honest, reliable, and consistent is crucial to the health and healing of trauma. Behaviors include keeping promises, respect, confidentiality, and transparency about policies and procedures. 
  3. Choice/Autonomy: A clinician should allow the client to take the lead to avoid inadvertently pushing them before they are ready.
  4. Collaboration: At times, trauma can make a person feel hopeless and unsure of how to proceed. A trauma-informed clinician will empower an individual’s choice while ensuring they feel supported. Trauma-informed care should feel like a team approach with the client as the team captain.
  5. Empowerment: In trauma, people can feel stripped of their power. It is important to help give individuals some of their power back. A trauma-informed clinician will build back power and authority through psychoeducation, understanding reactive and proactive coping strategies, and helping to develop a strong support system. 

Using the knowledge listed above, we can help recognize if a clinician is using trauma-informed principles and can best support your needs going forward into treatment. 

Final Thoughts:

In the wake of trauma, it can be daunting to begin the journey of reclaiming ourselves and creating a future unbound by our painful past. Having the right clinicians with you is crucial. When a person feels ready to take the laborious steps in healing from their trauma, having the right therapist can act as a guiding light through that harrowing experience. Using the information above to empower your choice in a clinician can be a significant first step to finding the right fit. Ultimately, remember that help is out there, and you deserve it! The Better You Institute prides itself on having specially trained clinicians who are trauma-informed in their care. If you or someone you know has experienced trauma and wants to start healing, please reach out today to make an appointment by calling 267-495-4951. 

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