What is Trauma-Informed Counseling?

What is Trauma?

Trauma can be understood as any extraordinarily stressful experience in life that has a lasting negative impact on someone, particularly to their nervous system which leaves an impact on their mental, emotional, and/or physical health. It is not necessarily the event itself that is traumatic–rather, it is the body’s response to the event that produces symptoms of trauma. This explains why two people who experience the same event have different lasting responses. One person may move on seemingly unaffected by the event, but another person may experience symptoms when faced with similar events. In general, individuals react with a fight, flight, freeze, fawn, or collapse response. Those who have experienced chronic, toxic stress react to more than just certain events–it could be impacting the way their body functions in general.

The Physiology of Trauma

As the saying goes, “Neurons that wire together fire together.” When the body learns to protect itself from threats, this process repeats itself as the body interacts with future life events. Some of the responses that manifest because of these neural wirings are:

• Emotional symptoms
• Emotional dysregulation
• Numbing
• Physical symptoms
• Somatization
• Hyperarousal
• Sleep disturbances
• Triggers or cues
• Flashbacks
• Trauma-induced hallucinations or delusions

These responses are due to the autonomic nervous system (ANS) stepping in to protect a person from threats. The ANS regulates many unconscious processes such as breathing, blinking, and digesting. It also sends messages to the brain to release stress hormones. These hormones were designed to help us focus on what is necessary for survival in a threatening situation. However, if the threats are unprocessed, the response to them and similar environmental factors can become habitual. The most notable example of this is hypervigilance in individuals with post-traumatic stress disorder (PTSD). Their ANS may be constantly activated to protect the person from potential threats.

While it may sound appealing to be constantly on guard for danger, it is damaging for the body to be repeatedly activated by non-threatening events. In addition to the symptoms listed above, individuals with hyper-ANS arousal may not be able to use their cognitive processes efficiently. By being ready to react to threats, the brain forgoes higher cognitive processes. Because of this, therapeutic interventions such as Cognitive-Behavioral Therapy (CBT) are not effective (unless they are trauma-informed versions of CBT). Some of the ways cognitive processes are affected:

• See themselves as incompetent or damaged
• See others and the world as unsafe and unpredictable
• See future as hopeless and negative
• Foreshortened future
• Disruption of core beliefs
• Cognitive errors
• Excessive or inappropriate guilt
• Repetition compulsion
• Intrusive thoughts
• Dissociation

Behaviorally, individuals may act out to try and alleviate their symptoms. This can look like alcohol or drug use, compulsive or impulsive behaviors, or self-injurious behavior. As a society, we tend to view these things as a moral problem. However, it is important to note that they are the result of a traumatized nervous system, and they must be treated as such. Utilizing trauma-informed practices could shape how we view “problem” children in school and a good number of individuals in the prison system.

Who does this Affect?

There is not one predictive factor that determines who is likely to be more affected by traumatic events than others. There is epigenetic evidence that parents can pass on stress-response genes to children, rendering them more easily triggered by stressful situations. We also know that those who do perceive threat or are exposed to chronic, toxic stress and whose nervous systems are dysregulated are at a higher risk of disease. This includes heart disease, lung cancer, diabetes, autoimmune diseases, depression, violence, and suicide. We also know that there is some evidence of genetic predisposition to nervous system dysregulation. Research on Adverse Childhood Experiences (ACE) found that 87% of individuals surveyed had more than one adverse childhood experience and that it was correlated with health problems. Interestingly, the ACE study sampled White individuals from middle-class, college-educated families with good health insurance. Despite these previously assumed “protective factors,” the majority of the participants experienced a trauma response that left impactful symptoms. The data we have suggests that trauma is very pervasive, but it implies that it is even more pervasive in marginalized populations who do not have access to the healthcare or education that the original study participants did.

Why is this Important?

Experiencing traumatic events puts individuals at a higher risk for abuse, suicide, and mental health issues. Mental health practitioners should be aware of how trauma is impacting their clients since mental health can be dramatically altered by these experiences. Rather than seeing clients as their “disorder,” clinicians can offer more effective treatment by addressing the underlying causes that produce mental health symptoms. Here are some places to start:

1. Promote Trauma Awareness and Understanding
2. Recognize that Trauma-Related Symptoms and Behaviors Originate from Adapting to Traumatic Experiences
3. View Trauma in the Context of Individuals’ Environments
4. Minimize the Risk of Retraumatization or Replicating Prior Trauma Dynamics
5. Create a Safe Environment
6. Identify Recovery from Trauma as a Primary Goal
7. Support Control, Choice, and Autonomy
8. Create Collaborative Relationships and Participation Opportunities
9. Familiarize Clients with Trauma-informed Services
10. Conduct Universal Routine Trauma Screening
11. View Trauma Through a Sociocultural Lens
12. Use a Strengths-Based Perspective to Promote Resilience
13. Foster Trauma-Resistant Skills
14. Show Organizational and Administrative Commitment to Trauma-Informed Care
15. Develop Strategies to Address Secondary Trauma and Promote Self-Care
16. Provide Hope–Recovery is Possible!

Learn more by watching our Clinical Director Paul Krauss MA LPC explain the science and studies behind understanding Trauma-Informed Counseling:

If you would like to work with a therapist that is Trauma-Informed and is able to deliver advanced trauma-specific interventions along with mind-body counseling, then Health for Life Counseling Grand Rapids and The Trauma-Informed Counseling Center of Grand Rapids are your source for these speciality types of therapy in West Michigan.

Call us today to set up your complimentary consultation at 616-200-4433.

Learn more about our Trauma-Informed Counseling here.

Learn more about our therapists here.

(Written by the staff of Health for Life Counseling Grand Rapids)

References:

Alegría, M., Fortuna, L. R., Lin, J. Y., Norris, F. H., Gao, S., Takeuchi, D. T., Jackson, J. S., Shrout, P. E., & Valentine, A. (2013). Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder Across Ethnic and Racial Minority Groups in the United States. Medical Care, 51(12), 1114–1123. https://doi.org/10.1097/mlr.0000000000000007

Adverse Childhood Experiences (ACEs) and Community Physicians: What We’ve Learned. (2020). The Permanente Journal, 1–50. https://doi.org/10.7812/tpp/19.099

Department Of Health And Human Services, U.S. (2016). A Treatment Improvement Protocol – Trauma-Informed Care in Behavioral Health Services – Tip 57.

Helms, J. E., Nicolas, G., & Green, C. E. (2012). Racism and ethnoviolence as trauma: Enhancing professional and research training. Traumatology, 18(1), 65–74. https://doi.org/10.1177/1534765610396728

King, K. R. (2003). Racism or sexism? Attributional ambiguity and simultaneous membership in multiple oppressed groups. J. Appl. Soc. Psychol. 33, 223–247.

Kolk, V. B. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Reprint ed.). Penguin Books.

Mueser, K. T., Goodman, L. B., Trumbetta, S. L., Rosenberg, S. D., Osher, F., Vidaver, R., Auciello, P., & Foy, D. W. Trauma and posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 66: 493-499. (1998).

Nixon, R. D. V., & Sloan, D. M. (2017). Treating PTSD: Innovations and Understanding Processes of Change. Behavior Therapy, 48(2), 143–146. https://doi.org/10.1016/j.beth.2016.06.003

PsyD, B. D. L., Ph D, S. M. D., Wampold, B. E., & Hubble, M. A. (2010). The Heart & Soul of Change: Delivering What Works in Therapy (2nd ed.). American Psychological Association.

Pyke, Karen D. (December 2010). “What is Internalized Racial Oppression and Why Don’t We Study It? Acknowledging Racism’s Hidden Injuries”. Sociological Perspectives. 53 (4): 551–572.

Shapiro, F. (2014). The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experience. The Permanente Journal, 71–77. https://doi.org/10.7812/tpp/13-098