TREES An Introduction to Trauma Informed Care

Hey there, everybody, and welcome to this video on trees, an introduction to trauma informed care. I'm your host, Dr. Donnelly Snipes. The trauma informed approach means creating an environment that is safe for people to grow, to explore, and to acknowledge their trauma. And you can remember the steps, steps in the trauma informed approach with the mnemonic device trees. T stands for trauma identification, R stands for recognize and validate, E stands for empower, E stands for empathize, and S stands for support. So let's talk about each one of those really quickly. The first step is trauma identification. When you are talking with somebody, recognizing, and it doesn't even just have to be a counselor or a nurse or a doctor, when you're talking to anybody, recognize that there is a likelihood, high likelihood even, that they've experienced some kind of trauma in their life. Now, not everybody who experiences trauma develops a traumatic reaction, but some people will. So the first step is trauma identification. And trauma generally falls into two basic categories. And I'm grossly overgeneralizing here, but the first category is abuse or physical or emotional harm. And this can come from a caregiver, this can come from a stranger, this can come from, you know, an act of nature. There it was something that caused the person physical or emotional harm. The second major category is abandonment, slash rejection when people feel abandoned, and that could be physical abandonment, abandonment because somebody left, because somebody died, or emotional abandonment because the person, the caregiver, the loved one, the friend, was not emotionally available or able to connect with, with the person. And rejection kind of falls in there because when we experience rejection, sometimes we can fear abandonment As a result, when these things happen and the person has a sense of unsafeness and helplessness that does not get addressed, they can develop traumatic reactions. So our stands for recognize and validate the impact of the trauma on the person's health, mental health and relationships. We're going to talk a little bit about that on the next slide. The first E stands for empower the person to make informed decisions about how to proceed to enhance or regain their sense of safety. The first step for anybody is to feel safe. Until you feel safe, it's hard to be vulnerable. It's hard to move past that trauma. So we're needing to help people figure out what can they do to help themselves feel safe in their own skin, in their house, at work, and in relationships. And that's going to differ for each person. The second E stands for empathize. This is hard work. It is terrifying work. So we want to be empathetic to People's reactions, their apprehensions, etc. And S is stands for support. We want to provide support for people when they're going through this. Their past has impacted their thoughts, their behaviors, their emotions, their reactions, their relationships, you know, all kinds of things. However, the person now has the opportunity to recognize why they react the way they do and choose how they're going to take that, those experiences that they've had and deal with them henceforth. How are they going to let those experiences continue to impact their life? And you can't undo something once it's happened, but you can choose to either let it make you stronger and use it to make you stronger, more informed, and safer, or continue to stay in a state of fear and hypervigilance. Common signs of trauma and when I work with people, I really want them to reflect on in what ways is this behavior protective? When someone does something, maybe they tend to get angry really easy, or, or they're in unstable relationships. In what ways is that protective? In what ways is it protective for them to lash out or to refuse to get vulnerable, or to be the one that always breaks off that relationship as soon as it starts to get too comfortable? So it's important to be curious. Common signs of trauma Avoidance of thought, thoughts, feelings, physical sensations, people, places or activities that bring up memories related to the trauma. Now, sometimes people don't have overt memories. They may have bodily sensations. Things that happened when you were very young, you may not have overt memories of what happened, but when something happens, you start feeling very anxious, very angry, very irritable, and, and that can be a sign that your brain's trying to tell you something they're trying to tell you. We've been in a situation like this before, and it was no good. So you need to be alert because there might be a threat. People's behaviors, people's reactions are going to be different based on what their trauma was. But it is important to step back and say, okay. In what ways is this behavior potentially protecting a person from feeling threatened again, from experiencing that pain again? The second characteristic is persistent and elevated negative evaluations about yourself, others, and the world. When you are in a situation in which you feel unsafe, it is not uncommon to overgeneralize that feeling and feel like you're never going to be safe again. And you may not, especially again, if it happens when you're very young, you may not overtly make that decision, but you may have grown up feeling that the world was not safe, that others were malevolent in their. In their intentions. So it's important to recognize that if you've experienced malevolence from someone, you may have internalized that. And persistent negative evaluations, persistent negativity and suspiciousness may be a way that you're protecting yourself from being victimized again. The third is a negative emotional state. Depression, anxiety, anger and or mood liability. So you may be happy sometimes and then all of a sudden it doesn't take much to put you in a bad mood or you may be in a bad mood or unhappy most of the time. And we want to recognize that and look at where that might be coming from. Now people get depressed for a variety of reasons. They have anxiety and anger for a variety of reasons. All of these are very healthy, quote, normal emotions. They're designed to tell you to do something. But when it, when you feel this way, most days for an extended period of time, then you want to examine what might be going on. It could be trauma, it could be something else. But recognizing depression reflects a sense of hopelessness and helplessness. Anxiety represents a sense of fear that there's a threat. And anger is another way of responding to a threat. Sometimes you run from it, sometimes you flee, sometimes you fight and you say no, not going there again. So I am going to bow up and be as, you know, threatening as possible in response to protect myself. Feeling detached from others. When people have experienced trauma, a lot of times it's hard to empathize, it's hard to be vulnerable, it's hard to develop a connection out of fear that someone else is going to hurt them. Difficulty concentrating is a common symptom that goes along often with hyper vigilance or being very attune, being overly alert to any indication that there might be harm, rejection or abandonment. When you are hypervigilant, when you are on constant, you know, scanning for any indication, any micro expression of harm, rejection or abandonment, it's going to be hard to concentrate because you've got all the stimuli coming in and you're constantly scanning. You don't feel, feel safe. Hypervigilance happens in because that's the brain's way of trying to tell the person you're not safe, you need to be on guard. A heightened startle response makes sense. If you don't feel safe when something happens, you're probably going to startle easier. Impulsive or self destructive behavior. And this could be acting out, you know, putting your hand through a wall. It could be using substances, even shopping to excess. A lot of these behaviors are designed to either protect the person or to numb the feelings that go along with memories of trauma, irritability or aggressive behavior are anger based behaviors. Their threat reactions, irritability and aggression is designed to push away anything that might be threatening and problems. Sleeping well. If you have hyper vigilance, then it's hard to relax enough to get to sleep. And when you're not sleeping well, it just intensifies all of these other things. So that is a very, very quick and somewhat superficial overview of some of the common signs of trauma and how they might reflect protective behaviors. Even though in the present moment an observer might be going that seems self destructive or that seems, you know, like it doesn't make any sense. It does make sense. Behavior is communication and behavior makes sense. It's just a matter of figuring out what is the behavior trying to communicate and how is it productive or helpful for that person in some kind of way. Thank you for being with me and I'll see you next time. Oh, and don't forget to click the subscribe button and the bell next to it to be notified when we do put out new videos.