June 16, 2025 • 48 mins
In this episode of The CultureHug Podcast, we unpack the difference between stress and trauma, dive into the ACE Study’s insights and limitations, SAMHSA's Concepts, and explore how trauma affects individuals and communities.
Learn what it means to be trauma-informed—and why, safety, trust, and cultural awareness are key to real healing. Whether you’re a caregiver, educator, or just craving deeper connection, this is your invitation to learn, unlearn, and grow.
Sources:
Learn what it means to be trauma-informed—and why, safety, trust, and cultural awareness are key to real healing. Whether you’re a caregiver, educator, or just craving deeper connection, this is your invitation to learn, unlearn, and grow.
Sources:
- Amaya-Jackson, L., Absher, L.E., Gerrity, E.T., Layne, C.M., Halladay Goldman, J. (2021). Beyond the ACE Score: Perspectives from the NCTSN on Child Trauma and Adversity Screening and Impact. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
- Available at: www.nctsn.org
- Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- Prepared by: SAMHSA’s Trauma and Justice Strategic Initiative.
- Publication Date: July 2014.
- Available at: http://store.samhsa.gov
- UNDERSTANDING Stress vs. Trauma
- Note: This document appears to be a standalone informational graphic. No specific author, publisher, or publication date is provided within the document itself.
- What is Child Traumatic Stress?
- Publication Details: This article first appeared in the fall 2003 issue of Claiming Children, the newsletter of the Federation of Families for Children’s Mental Health, and was co-produced by the Federation and the National Child Traumatic Stress Network (NCTSN).
- Available at: www.ffcmh.org and www.NCTSN.org
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
We're in the quiet place.
Speaker 2 (00:03):
We share words on foold like whispers.
Speaker 1 (00:10):
In the.
Speaker 2 (00:13):
To go Here we.
Speaker 1 (00:17):
Start to.
Speaker 2 (00:20):
Welcome to the culture Hook podcast, your space to learn
and learn and grow one hug and one episode at
a time.
Speaker 1 (00:28):
Today we're really aiming for what we like to call
a culture hug, a space where we can kind of
lean in together, learn something and hopefully, you know, connect
a bit more with ourselves and maybe understand the people
around us a little better too.
Speaker 2 (00:41):
Yeah, that connection piece is so.
Speaker 1 (00:42):
Important, absolutely, and today's topic is, well, it's a big one,
but so fundamental to navigating life. Really, we're driving into
the complex world of trauma.
Speaker 2 (00:55):
It really is complex, and you know, we're understanding more
and more just how much it touches, how its impact
can be, and learning about it, what it actually is,
how it affects people. Honestly, it can be incredibly validating
if you've been through something, and it can totally shift
how you see.
Speaker 1 (01:10):
Others, definitely. So to help us explore this, we've gathered well,
quite a few sources, some key articles, research papers. They
offer different angles, different insights into trauma and you know,
all the related ideas and our plan today.
Speaker 2 (01:23):
Our mission if you like is to unpack these sources
together with you. We want to pull out the really
crucial bits, maybe uncover some surprising details, and just boil
it down so you walk away feeling like you've got
a solid handle on it, without feeling totally overwhelmed by information.
Speaker 1 (01:40):
Exactly. It's about getting that knowledge, finding maybe those aha
moments that might click something into place for you about
your own life, or maybe just help you see things
see people with I don't know, a slightly clearer, more
compassionate lens.
Speaker 2 (01:55):
Hopefully, yeah, a more informed lens.
Speaker 1 (01:57):
Okay, so let's jump right in. One of the first
things is our sources tackle is the difference between stress
and trauma, because they can feel similar sometimes, but they're
not the same thing.
Speaker 2 (02:06):
Are they No, not at all, And that distinction is
like super important baseline knowledge. The sources explain stress as
basically the body's natural response to pressure. It's that feeling
of worry or tension that pops up when we're dealing
with difficult situations challenges.
Speaker 1 (02:23):
Okay, so like the everyday stuff, the things that push
us maybe feel hard but aren't actually like threatening our
life for safety exactly.
Speaker 2 (02:32):
That's a good way to put it. The sources give
some pretty relatable examples. For adults. You know, I think
work deadlines, difficult coworkers, maybe studying for a big exam,
the everyday chaos of parenting, oh yeah, or even big
life changes like moving to a new city. These things
create tension, right they stresses out, Yeah, but they're not
usually dangerous in a fundamental way.
Speaker 1 (02:54):
Got it? So things that might make your heart beat faster,
maybe tense your shoulders, but usually once the situation's over,
it kind of fades.
Speaker 2 (03:02):
Generally, Yes, that's the idea. And for kids, stress looks
a bit different obviously, but it's the same basic response
to pressure.
Speaker 1 (03:10):
Okay.
Speaker 2 (03:10):
So for a child, the sources mention things like the
anxiety of starting a new school, test pressure, trying to
make new friends, adjusting when a new baby, brother or
sister arrives, or even just you know, having a big
argument with a friend.
Speaker 1 (03:22):
Right. Still, challenging, still creates worry, but within a certain kind.
Speaker 2 (03:26):
Of boundary exactly manageable challenge usually.
Speaker 1 (03:29):
Okay, So that's stress. How does trauma? How is it different?
What makes it trauma?
Speaker 2 (03:35):
Trauma, according to these sources, is defined by a really
different level of threat. It involves a frightening, dangerous or
violent event, or sometimes the whole series of events. Okay,
And the key is that it poses a significant threat
to a person's life or their physical integrity, their bodily safety.
The stakes are just way higher.
Speaker 1 (03:54):
It sounds like a fundamental shattering of safety almost. What
kind of events are we talking about here? What examples
do the sources give?
Speaker 2 (04:01):
They list some really heavy experiences, things like abuse, physical, sexual, emotional,
and neglect. Big events like natural disasters or acts of terrorism,
experiencing violence in your family or community, wo a traumatic separation,
especially for a child from their main caregiver, or being
in a serious life threatening accident. These are things that
(04:22):
kick our survival systems into overdrive in a really intense way.
Speaker 1 (04:25):
And does it always have to happen to you directly
or can seeing something happen to someone else be traumatic.
Speaker 2 (04:31):
To That's a really critical point the sources bring up,
especially when we're talking about children. Witnessing a traumatic event,
one that threatens the life or physical safety of someone
you deeply depend on, like a parent. That can be
intensely traumatic in itself, particularly for young kids, because their
whole sense of safety is basically wrapped up in whether
(04:52):
their caregiver feels safe and is physically there.
Speaker 1 (04:56):
Yea.
Speaker 2 (04:56):
If that anchor feels threatened, their whole world can feel
like it's falling apart.
Speaker 1 (05:01):
That makes so much sense. It's not just the direct impact,
but the ripple effect on your core sense of security.
It really speaks to how relational safety is, doesn't it.
Speaker 2 (05:09):
It absolutely is, yes, especially when we're young and rely
on others so much. Safety is often something we regulate together.
Speaker 1 (05:15):
Okay, so we've got stress versus trauma now. One of
our main sources from sam ahside, that's the substance abuse
of Mental Health Services Administration gives a really comprehensive definition
of individual trauma that's widely used.
Speaker 2 (05:27):
Yea. And the Samwich's add definition is really helpful because
it captures a lot of nuance. They say, individual trauma
results from an event or a series of events, or
even a set of circumstances Okay, that someone experiences as
physically or emotionally harmful or life threatening. And this is key.
It has to have lasting and verse effects on their
functioning and well being lasting a sex, Yeah, affecting their mental, physical, social, emotional,
(05:51):
or even their spiritual health.
Speaker 1 (05:52):
It's broad that really emphasizes it's not just about the
thing that happened, but how it hits you, how it
lands for you, and what lingers afterwards.
Speaker 2 (06:00):
Samiches breaks this down further right using the three e's.
Speaker 1 (06:04):
It's right, the three e's events, experience, and effect. It's
a really useful framework.
Speaker 2 (06:08):
Okay, let's take the first E the event. What falls
under that?
Speaker 1 (06:11):
So the event is the actual thing that happened, or
maybe the extreme threat of harm physical or psychological, or
it could be severe neglect, which is more about the
absence of something crucial.
Speaker 2 (06:22):
And the sources stress it's not always one single dramatic
incident like a car crash. It could be ongoing like
chronic abuse or living in a constantly violent neighborhood. It
could be a series of things over time. And this
lines up with how the DSM five defines trauma for
diagnosis purposes.
Speaker 1 (06:40):
Okay, so the event is the objective reality more or
less of what happened or threatened to happen. Then the
second E is experience. This feels like where it gets
really personal.
Speaker 2 (06:50):
It absolutely is, and honestly, the sources suggests this is
maybe the most critical E to understand the experience is
all about how the individual perceives, internalized, and is affected
by the event, right.
Speaker 1 (07:02):
Which explains why I, say, two siblings and the same
difficult home might react totally differently long term.
Speaker 2 (07:07):
Exactly, or why two soldiers in the same combat situation
might have vastly different responses. Afterwards, the sources point to
a bunch of factors that shape this experience, like what well,
things like your cultural background and beliefs, how does your
culture understand adversity you're suffering, your social supports, were you
alone or did you have people around you? And crucially
(07:28):
your developmental stage. What a five year old experience is
as traumatic is very different from what a teenager or
an adult experience is, even if the event is similar.
Speaker 1 (07:37):
So it's the event filtered through who you are, where
you are in life, and what resources you have around you.
Speaker 2 (07:42):
Precisely, And another really powerful point the sources make about
the experience of trauma is the role of power dynamics. Yeah,
very often trauma involves a situation where someone or something,
a person, an institution, even nature has overwhelming power over
the individual, leaving them feel utterly powerless.
Speaker 1 (08:01):
That feeling of powerlessness, what kind of specific emotions tend
to come up with that, according to the sources they mentioned,
some right, they.
Speaker 2 (08:09):
Do, feelings like humiliation, deep guilt or shame, a profound
sense of betrayal, and feeling silence. Think about it. Abuse
often carries intense humiliation, making someone feel bad or dirty.
Survivors of disasters might feel guilty for having lived when
others didn't. If the trauma comes from someone you trusted,
like a parent or caregiver, the betrayal is immense, shattering
(08:31):
your ability to trust, and threats, which are common in abuse,
can lead to this deep fear of speaking out, a
real silencing.
Speaker 1 (08:40):
Wow, that's a really complex and painful mix of feelings.
It's so much more than just fear. It's like a
wound to your very self and how you connect to
the world.
Speaker 2 (08:50):
It absolutely is, Yeah, which leads us directly to the third.
Speaker 1 (08:53):
E The effect, right, the lasting impact exactly.
Speaker 2 (08:57):
The effect refers to those long lasting adverse impacts that
ripple outwards from the traumatic event and the person's experience
of it. And these effects aren't always obvious right away.
Speaker 1 (09:06):
They can show up later.
Speaker 2 (09:07):
Yeah. They can be delayed, sometimes months, sometimes even years later,
and they could be short term struggles or they can
persist for a very long time, sometimes lifelong, And is.
Speaker 1 (09:15):
It possible someone might be struggling with things now but
not even realize it's connected to something traumatic that happen
way back.
Speaker 2 (09:21):
That's a really important point. The sources highlight. People might
not make that conscious connection. They might have trouble coping
with everyday's stress that others seem to manage, or find
it really hard to trust people and build healthy relationships,
or struggle with things like memory, focus, clear thinking, or
maybe they have a hard time managing their emotions or
controlling impulses, and they might not link it back to
(09:42):
those past events.
Speaker 1 (09:43):
So it affects how you function day to day, how
you relate to others, even how your brain works.
Speaker 2 (09:48):
Essentially absolutely. The sources talk about the neurobiological impact too,
how trauma, especially chronic or early life trauma, can literally
change the structure and function of the brain and nervous system,
affecting long term.
Speaker 1 (10:01):
Health, and the effects they can look different in different people,
like hyper alertness versus numbness exactly.
Speaker 2 (10:07):
It's often described as a spectrum. Some people might become
hyper vigilant, constantly on edge, jumpy scanning, for danger. Others
might go towards numbing or avoidance, feeling detached, shut down,
emotionally flat, trying not to feel anything.
Speaker 1 (10:22):
It sounds like different survival strategies, almost like the system
trying to cope with being overwhelmed.
Speaker 2 (10:29):
That's a perfect way to think about it. They were
adapt to strategies in the face of threat, but when
those states become chronic, being constantly revved up or constantly
shut down, it takes a huge toll. It wears you
down physically, mentally, emotionally.
Speaker 1 (10:42):
Yeah, I can see that.
Speaker 2 (10:44):
And the sources also mentioned the impact on spirituality. It
can shake core beliefs about the world, about safety, about
meaning and purpose.
Speaker 1 (10:51):
That really paints a picture of how deeply trauma can
permeate someone's life. It's not just in your head.
Speaker 2 (10:57):
Not at all. It's a whole being experience.
Speaker 1 (11:00):
Okay, let's shift focus slightly now to trauma specifically in children.
One of our sources really digs into what is child
traumatic stress?
Speaker 2 (11:07):
Right, and this source echoes the general definition but applies
it to kids. An intense event or series of events
that threatens or causes significant harm to a child's emotional
or physical well being.
Speaker 1 (11:18):
Does it give examples particularly relevant to childhood.
Speaker 2 (11:21):
Yeah, it expands on the general list things like natural
disasters which can be terrifying for a child, war, terrorism,
witnessing or being a victim of violence, abuse, serious accidents,
but also things like frightening or painful medical procedures can
be traumatic for kids.
Speaker 1 (11:38):
Medical procedures too. Wow.
Speaker 2 (11:39):
Yeah, and it includes that sobering statistic again, something like
one in four children experience at least one potentially traumatic
event before they hit sixteen.
Speaker 1 (11:48):
One in four. That's that really brings it home how
common this is. It's not some rare occurrence. So many
young lives are touched by this. How do kids typically
react right after something scareds Well.
Speaker 2 (12:01):
The source explains that kids, just like adults, have built
in survival responses. Their heart rate might go up, they
might sweat, feel agitated, become super alert, get that, butterflies
in the stomach, feeling, or become very emotionally upset. These
are normal protective reactions to perceive danger.
Speaker 1 (12:17):
The body trying to keep them safe.
Speaker 2 (12:19):
Exactly the fight, flight or freeze response kicking in.
Speaker 1 (12:21):
But what happens when those reactions don't settle down after
the danger is over, When they linger.
Speaker 2 (12:26):
That's exactly where child traumatic stress comes in. It's when
kids who've been through trauma develop reactions that last much longer.
These reactions persist and they start to significantly interfere with
the child's everyday life, long after the traumatic event itself
has ended.
Speaker 1 (12:41):
So the trauma response gets kind of stuck on and
that disrupts their normal functioning. What does that look like
in kids? What are the symptoms?
Speaker 2 (12:49):
The source describes a range of things. Intense ongoing emotional
upset that's more than typical kid stuff, symptoms of depression
or anxiety, Noticeable changes in behadhavior, maybe acting out, maybe
becoming withdrawn, trouble paying attention or concentrating, which obviously affects school,
having nightmares or intrusive memories, and even physical symptoms like
(13:10):
trouble sleeping, changes in needing habits, or unexplained aches and pains.
Speaker 1 (13:14):
And these aren't just happening randomly. They're often linked to
reminders of the trauma.
Speaker 2 (13:18):
Yes, exactly. The source points out that these symptoms often
pop up or get worse when something reminds the child
of the traumatic event, even if it's an indirect reminder
and the real indicator that it's traumatic stress is that
these symptoms are getting in the way of their daily life, school, friendships,
family relationships, just being a kid. Okay, this brings up PTSD.
People hear that term a lot. How does child traumatic
(13:41):
stress relate to a formal PTSD diagnosis?
Speaker 1 (13:45):
The source clarifies this right, it does, and it's a
really important clarification because the terms get mixed up. PTSD
post traumatic stress disorder, is a specific clinical diagnosis defined
by the American Psychiatric Association. To get that diagnosis, a
child yold has to show a very specific cluster of symptoms.
Speaker 2 (14:02):
What are those specific symptom clusters for PTSD? According to
the source, For a PTSD diagnosis, the child needs to
be reexperiencing the event persistently for more than a month
through things like intrusive thoughts, nightmares, or flashbacks where they
feel like it's happening again. They also need to show
avoidance or numbing symptoms like trying really hard not to
(14:22):
think or talk about it, having trouble remembering parts of it,
or feeling emotionally numb. And they need to show signs
of increased arousal like being super irritable jumpy or having
significant sleep problems.
Speaker 1 (14:33):
Okay, so PTSD is a specific pattern. How does that
fit with the broader idea of child traumatic stress?
Speaker 2 (14:40):
The source makes this crystal clear. Every child who meets
the criteria for PTSD is experiencing child traumatic stress. But
and this is the key, not every child who's experiencing
child traumatic stress will meet all the specific criteria for
a PTSD diagnosis.
Speaker 1 (14:54):
Got it. So, child traumatic stress is the bigger umbrella exactly.
Speaker 2 (14:57):
It covers the range of ongoing difficulties after trauma. PTSD
is one specific diagnosable condition under that umbrella.
Speaker 1 (15:04):
That's super helpful. And it makes sense then that not
every child who goes through something traumatic develops ongoing traumatic
stress or PTSD. Why the difference in outcomes?
Speaker 2 (15:15):
Right? The source really emphasizes that it's not automatic. Whether
a child develops lasting symptoms depends on a whole mix
of factors, things like their history, have they experienced other
traumas before? Cumulative trauma really increases risk their individual makeup.
Some kids are naturally more resilient, others more vulnerable, and critically,
(15:35):
the support they get afterwards the court seems key hugely important.
Do they have safe, stable, relationships, support of adults who
listen and believe them, access to resources. All of that
makes a massive difference.
Speaker 1 (15:47):
So you really can't predict based just on the event itself.
You have to look at the child and their whole context.
Speaker 2 (15:53):
Absolutely, The source explicitly warns against making assumptions about how
any individual child will react. Every child's is unique.
Speaker 1 (16:00):
And if child traumatic stress isn't addressed, if a child
doesn't get the help they need, what are the potential
long term impacts? The source mentions.
Speaker 2 (16:09):
It paints a pretty concerning picture. Honestly, untreated traumatic stress
can actually interfere with brain development and physical health. It
makes it really hard for kids to concentrate and learn
in school, which obviously has knock on effects. It can
fundamentally change how they see the world themselves, their future.
It can lead to difficulties later in life, like problems
(16:29):
with employment or relationships. And the source adds it takes
a huge toll on the whole family.
Speaker 1 (16:36):
Wow, it really affects everything, the child's whole trajectory and
the family system around them.
Speaker 2 (16:41):
It really does. But and this is important. The source
ends this section on a note of hope.
Speaker 1 (16:47):
Okay, good, Yeah.
Speaker 2 (16:49):
It stresses that over the last decade or so, we've
learned a lot and effective treatments for child traumatic stress
have been developed. It emphasizes how important it is to
seek help from professionals who actually have experience working with
kids and trauma, and to tap into community resources. Healing
and recovery are definitely possible.
Speaker 1 (17:07):
That's so crucial to hear that effective help is out there. Okay,
let's shift gears a bit and talk about the ACE Study,
the Adverse Childhood Experiences Study. It's become really well known,
but our source also raises some really important cautions about it.
Speaker 2 (17:22):
Yes, the ACE Study was and is hugely influential, no
doubt about it. The source acknowledges its massive contribution in
really bringing public attention to the strong link between difficult
childhood experiences, trauma and adversity, and negative health outcomes much
later in life in adulthood, physical health, mental health, the works.
Speaker 1 (17:42):
So it really helped connect those dots for people. How
did the original study measure those childhood difficulties.
Speaker 2 (17:48):
It used a pretty straightforward method. Participants filled out a
ten item checklist looking back at their childhood before age eighteen.
They just counted how many of those ten specific types
of adverse experiences they had personally encountered. That number was their.
Speaker 1 (18:00):
ACE score, And what were those original ten acees they
looked at?
Speaker 2 (18:04):
The source lists them physical abuse, sexual abuse, emotional abuse,
physical neglect, emotional neglect. Then household challenges, witnessing violence against
their mother, living with someone with a substance abuse problem,
so with mental illness, or who attempted suicide, having a
household member go to prison, or losing a parent through
(18:25):
separation or divorce.
Speaker 1 (18:26):
Okay, ten specific categories. Now this is where our source
gets really interesting and I think really crucial for anyone
hearing about ACE scores. While the study itself was groundbreaking,
the source points out some major limitations in using that
simple ACE score as a tool for understanding individuals, especially
in like a doctor's office or therapy setting.
Speaker 2 (18:47):
Yes, this is such a critical point that often gets
missed in how ACES are discussed. The source is very
clear just counting those ten things is not enough to
really understand a child's exposure to adversity or what kind
of help they might actually need.
Speaker 1 (18:59):
So what does that count miss? What are the big limitations?
The source flags.
Speaker 2 (19:03):
There are several really significant ones. First, the score tells
you nothing about the frequency of the experience that had
happened once or hundreds of times, the severity, how bad
was it, the duration, did it last for weeks, for years,
or the developmental timing? Did it happen when they are
a toddler or a teenager. A score of one can
mean very different things, but the score treats them all
(19:23):
the same, right.
Speaker 1 (19:24):
That flattens out so much important detail about the actual
experience totally.
Speaker 2 (19:29):
Second, the source points out that the original ten items
leave out a lot of other common and incredibly impactful
traumas and adversities kids' face, things like experiencing the traumatic
death of a loved one, going through scary medical stuff,
living through a natural disaster, experiencing racism or community violence.
Speaker 1 (19:47):
The list goes on, So someone could have gone through
really significant trauma that's just not on that list and
end up with a low ACE score that doesn't reflect
their reality at all.
Speaker 2 (19:56):
Precisely, and the source mentions that trying to add these
other things has led to lots of different acees checklists
floating around, which causes confusion because the scores aren't comparable anymore. Plus,
the score only counts the number of different types of adversity,
not the total number of traumatic experiences.
Speaker 1 (20:14):
Ah right, So a child experiencing, say, ongoing severe neglect
and frequent physical abuse, might only get a score of two,
the same as a child who experienced one instance of
two different things exactly.
Speaker 2 (20:27):
The source highlights that chronic trauma or multiple instances of
the same type of trauma can result in a misleadingly
low score that completely fails to capture the cumulative burden
on that child. That's why the source is so adamant
an ACE score alone should never be used to determine
a child's risk for future problems or what kind of
help they need. THEE even mentioned that one of the
original ACE study authors now cautions against using the score
(20:51):
in that way for individuals.
Speaker 1 (20:52):
Wow, that is such a vital piece of context for
anyone encountering ACE scores, whether you're a parent, a patient,
a teacher, anyone. Groundbreaking research, yes, but the score itself
is in a crystal ball.
Speaker 2 (21:06):
For individuals, absolutely not. And the source drives this home
even more by saying, not all acees are created equal.
Speaker 1 (21:13):
Okay, what does that mean? Practically?
Speaker 2 (21:15):
It means a few things. First, different types of adversity
can have different levels of impact. Statistically speaking, some are
just more strongly linked to certain negative outcomes than others.
But maybe more importantly, the impact on any individual child's
varies massively depending on their age at the time, their
life circumstances, any previous trauma history, the support systems they
had or didn't have, and their own internal protective factors.
(21:37):
They're resilience.
Speaker 1 (21:38):
So context is everything again, It's not just the event,
it's the event landing in a specific life with specific
supports or lack thereof, exactly.
Speaker 2 (21:47):
And the source also points to something really interesting called
synergistic effects. This is where certain combinations of traumas or
adversities interact to produce an effect that's greater than just
adding up their individual impacts. They amplify each other.
Speaker 1 (22:01):
Can you give an example of that from the source.
Speaker 2 (22:03):
Yeah. The source notes that research shows experiencing sexual abuse
in combination with other things like physical abuse, neglect, or
witnessing domestic violence significantly ramps up the risk for serious
behavioral problems later on. That specific combination is more toxic,
more damaging than any one of those experiences happening alone.
Speaker 1 (22:23):
And the simple ACEES score just counting the number of
categories would completely miss that crucial interaction.
Speaker 2 (22:29):
It completely masks it. The source is clear, just adding
up the number of types of acees hides these vital
interactions that are really important for understanding risk and targeting
interventions effectively.
Speaker 1 (22:40):
Okay, so the big takeaway on ACEES seems to be
the study was incredibly important for raising awareness about the
population level link between childhood adversity and adult health. But
the ACE score itself is a very blunt tool for
understanding an individual's complex experience.
Speaker 2 (22:58):
That's a perfect summary. It opened to crucial conversation, but
effective care needs a much deeper, more personalized assessment.
Speaker 1 (23:04):
Which leads us nicely into thinking more about how trauma
and development are intertwined. Our sources really emphasize that these
aren't separate things happening side by side.
Speaker 2 (23:13):
Now, they're deeply interconnected. A child's developmental stage, where they
are cognitively, emotionally, socially heavily influences how they understand and
react to a traumatic event and vice versa. Experiencing trauma,
especially within the family, which is the core developmental environment,
can significantly disrupt a child's expected developmental path.
Speaker 1 (23:32):
Does the kind of trauma a child is more likely
to face change as they get older.
Speaker 2 (23:37):
Yes, the source points this out. Certain types of trauma
are statistically more common at different ages. For example, things
related to the caregiver alike neglect, caregiver mental illness or
substance abuse, domestic violence, physical or emotional abuse by a caregiver.
These are unfortunately most common for very young children, say
(23:58):
zero to five years old. Okay, Then as kids get older,
moving into adolescence, other types of trauma like sexual assault
outside the family or being a victim of criminal assault,
become more prevalent statistically.
Speaker 1 (24:09):
And even if it's the same type of trauma like
sexual abuse, the impact can be really different depending on
whether the child is say, four years old versus twelve
versus sixteen.
Speaker 2 (24:17):
Absolutely the source uses that exact example. The developmental tasks,
the understanding of self and relationships, the coping mechanisms available,
they're all vastly different at those ages, so the consequences
and the way that trauma shapes their development will vary significantly.
Understanding that interaction, the type of trauma, the timing, and
the child's developmental stage is absolutely crucial for figuring out
(24:41):
the most effective ways to help both in treatment and prevention.
Different situations need different interventions.
Speaker 1 (24:47):
Recognizing that link is key for targeted support, and the
sources offer some hope here too. Right about interrupting that
potential negative path after trauma.
Speaker 2 (24:57):
Yes, definitely, this is where the power of intervention really
comes in. The source talks about early intervention and prevention
being critical windows of opportunity to potentially stop that negative
cascade towards the long term problems highlighted by studies like ACEES.
They talk about intervening variables.
Speaker 1 (25:12):
Intervening variables. What are those?
Speaker 2 (25:14):
These are factors that come into play after the traumatic
event happens, and they can either push things in a
more negative direction risk factors or help buffer the impact
protective factors.
Speaker 1 (25:24):
Okay, so what kinds of things count as intervening variables.
Speaker 2 (25:28):
Risk factors might be things like developing really acute traumatic
stress symptoms right after the event, or showing significant new
behavior problems or becoming depressed. Protective factors, on the other hand,
are things like having supportive adults who stick by you, parents, teachers, coaches, mentors,
having predictable routines that feel safe, having positive friendships. These
(25:49):
are the leverage points for intervention.
Speaker 1 (25:51):
So if you're working with a child or family after trauma,
you're looking at these intervening factors, not just the trauma.
Speaker 2 (25:57):
Itself exactly the source, and focusing not just on the
trauma history, but also really assessing the child's strengths. They're
existing protective factors, any positive childhood experiences they've had that
can be built upon. The goal is to actively bolster
those buffers, enhance those protective factors because they can really
mitigate the trauma's impact and at the same time address
(26:20):
any immediate negative consequences like severe anxiety or behavioral issues
that could become more entrenched if left alone.
Speaker 1 (26:28):
And this focus on strengths and resilience that connects back
to the possibility of healing.
Speaker 2 (26:33):
It absolutely does. The source is really clear. Recovery is possible.
When kids and families have access to good quality, evidence
based support that is fundamentally trauma informed, they can heal.
They even point people towards resources like the National Child
Traumatic Stress Network the NCTSN website for finding out more
about these effective approaches.
Speaker 1 (26:51):
That's a great practical resource. Okay, so we've covered a
lot individual trauma, child trauma, the ACE study complexities, the
link with the development. Now let's zoom out again. Why
is adopting a trauma informed lens important beyond just treating
individuals who seek therapy. Why does it matter for systems
for society?
Speaker 2 (27:10):
Yeah, this is where the SAMHA source really broadens the picture.
It frames trauma not just as an individual problem, but
as a major public health issue. It's widespread, it causes
significant harm, and it's incredibly costly, both personally and societally.
And it's deeply linked to high risks of mental health issues,
substance use problems, and even chronic physical diseases later in
(27:31):
life if the impacts go unaddressed.
Speaker 1 (27:33):
And despite how common it is, many people who experienced
trauma don't actually get the support they need.
Speaker 2 (27:38):
Sadly, that's often the case. The source notes that while
many people find ways to cope and overcome traumatic experiences,
often through natural supports, a huge number never access formal
services that could potentially help them heal.
Speaker 1 (27:51):
And the people who do interact with services, they're not
just showing up in therapists' offices, are they?
Speaker 2 (27:56):
No? Absolutely not. This is a crucial point the source makes.
People with trauma histories are interacting with all kinds of systems.
They're involved with the justice system, child welfare, they're in
our schools, they're seeing their primary care doctors. Their trauma
history walks in the door with them wherever they go.
Speaker 1 (28:13):
And sometimes the difficulties stemming from their trauma are the
very reason they end up interacting with these systems in
the first place.
Speaker 2 (28:20):
Exactly The source gives some really clear examples. A child
dealing with chronic maltreatment might act out in school because
they're hypervigilant and struggling to regulate, leading to disciplinary issues.
An adult survivor of domestic violence might struggle to hold
down a job due to anxiety or PTSD symptoms. Right
someone exposed to community violence might engage in risky behaviors
(28:41):
as a coping mechanism, leading to legal trouble. A young
person who is sexually abused might turn to substances or
self harm, bringing them into contact with health or mental
health services. A veteran struggling with combat trauma might have
physical complaints or substance issues that bring them to their doctor.
Speaker 1 (29:00):
So understanding that trauma history can provide a totally different
perspective on why someone might be struggling or behaving in
certain ways within these.
Speaker 2 (29:07):
System It offers that essential shift from what's wrong with
this person to what happened to this person? It provides context.
Speaker 1 (29:16):
Now here's a really powerful and maybe difficult point the
source makes. It suggests that the very systems designed to
help can sometimes unintentionally end up being retraumatizing.
Speaker 2 (29:27):
Yes, this is a really profound and necessary piece of
this whole conversation. Practices that might seem like standard operating
procedure within a hospital, a school, a court, or a
social service agency can actually be incredibly triggering and harmful
for someone with a trauma history. They can inadvertently mimic
aspects of the original trauma.
Speaker 1 (29:47):
Can you give some examples the source uses, because that
sounds really important to understand.
Speaker 2 (29:51):
Sure. The source mentions things like using physical restraints or
seclusion in mental health settings for someone who's experienced being
overpowered trapped, that can be terrifyingly similar. Or think about
child welfare removing a child from an unsafe home, even
if necessary. The abruptness, the lack of control for the
child can echo the trauma of separation or powerlessness. Yeah,
(30:15):
invasive medical procedures done without careful explanation, or ensuring the
person feels some control can feel like a violation, mirroring
past experiences. Even things like harsh zero tolerance discipline in
schools or intimidating, confusing processes in the justice system can
activate those same feelings of fear, helplessness, and threat that
(30:35):
are core to trauma.
Speaker 1 (30:36):
It's like the system's response inadvertently pushes the same buttons
that the original trauma.
Speaker 2 (30:40):
Did exactly, and the source points out that this re
traumatization actually works against the goals of the system. It
damages trust, makes people less likely to engage, and can
even make their symptoms worse.
Speaker 1 (30:51):
So if trauma is so common, its effects show up everywhere,
and the systems meant to help can sometimes harm. What's
the path for? According to the source.
Speaker 2 (31:01):
The source argues really strongly that addressing trauma effectively needs
more than just individual therapy. It requires a broad public
health approach, and fundamentally, it requires creating a trauma informed context.
This means organizations and systems need to fundamentally rethink how
they operate their business as usual. Practices need to be
grounded in a real understanding of trauma's deep and wide
(31:25):
ranging impact.
Speaker 1 (31:26):
So it's about changing the whole environment, the whole culture
of these.
Speaker 2 (31:29):
Places precisely, and the source notes that thankfully, there is
a growing awareness of this. More and more systems are
starting to recognize trauma's impact and are beginning to adopt
as trauma informed approach. And importantly, this shift isn't just
coming from researchers and clinicians. It's been hugely driven by
the voices and advocacy of trauma survivors themselves.
Speaker 1 (31:49):
Their lived experience is crucial to understanding what needs to change.
Speaker 2 (31:53):
Absolutely essential. Their insights have been fundamental in shaping what
a truly trauma informed approach looks like. And this understanding,
linking current struggles back to pass trauma, offers that vital
explanatory model, helping staff in various systems move from potentially
judging behavior to understanding its roots.
Speaker 1 (32:12):
That feels like such a hopeful shift. Okay, let's get specific, then,
what exactly is a trauma informed approach? According to sam
His they have a definition they do.
Speaker 2 (32:21):
It's built around what they call the four rs. Basically,
a program, organization, or system is trauma informed when it
realizes the widespread impact of trauma and understands potential paths
for recovery, recognize the science and symptoms of trauma, and
everyone involved. Client's family's staff responds by fully integrating knowledge
about trauma into all policies, procedures, and practices, and actively
(32:43):
seeks to resist retraumatization.
Speaker 1 (32:46):
Okay, the four rs realize, recognize, respond, and resist retraumatization.
Let's break those down a bit based on the source. First,
realizes what does that actually mean? In practice?
Speaker 2 (32:56):
Realizing means there's a fundamental shared understanding throughout the entire organization.
Everyone from the receptionist to the CEO gets what trauma is,
understands how common it is, and grasps this potential impact
on individuals, families, even the community. In the organization itself.
They understand that behaviors they see might actually be coping
(33:16):
strategies developed to survive overwhelming situations.
Speaker 1 (33:19):
So that shift from what's wrong with you to what
happened to you is really embedded in the organizational DNA exactly.
Speaker 2 (33:28):
They realize trauma is a major factor in things like
mental health and substance use issues, and that addressing it
is key. They also get that it's not just that
a mental health issue. It shows up everywhere and it
can block progress in schools, healthcare, justice systems if it's
not understood.
Speaker 1 (33:42):
Got it a foundational awareness?
Speaker 2 (33:44):
Second R recognizes Recognizing means equipping staff with the skills
to actually spot the signs and symptoms of trauma. These
signs can be subtle, and they might look different depending
on someone's age, gender, culture, or the specific setting. The
source mentions things like implementing routine trauma screening, providing ongoing training,
(34:04):
having supportive employee assistance programs, and using trauma in form
supervision to help staff recognize these signs and the people
they serve in colleagues and even in themselves.
Speaker 1 (34:14):
Okay, so realizing the scope and then developing the ability
to see it.
Speaker 2 (34:19):
Third responds Responding is the action part. It's about taking
all that knowledge and awareness and weaving it into everything
the organization does. Policies, procedures, day to day interactions, the
physical environment. Everything needs to be looked at through a
trauma lens. It means acknowledging that trauma affects everyone involved,
including the staff doing the work, and shaping the environment
(34:40):
and practices to reflect that.
Speaker 1 (34:42):
So this isn't just about having a few trauma therapists
on staff. It's much bigger, Oh much bigger.
Speaker 2 (34:47):
The source stresses that staff at every single level need
to potentially adapt or language their behavior, how they apply
policies to be sensitive to trauma histories both in clients
and co workers. This needs ongoing training, real b budget allocation,
and clear leadership buy in. Yes, it includes having access
to train trauma therapists, but the response is system wide.
Speaker 1 (35:08):
What about specific policies? How do they change?
Speaker 2 (35:11):
Policies need to be reviewed and potentially rewritten, the organization's
mission statement, employee handbooks, client rights documents. They should all
reflect principles of resilience, recovery, and healing. It might mean
explicitly stating a commitment to trauma informed care, maybe creating
client advisory boards with survivors, ensuring staff have support for
their own stress secondary trauma. Even the physical space is
(35:33):
part of the response, making it feel safe, welcoming, calming, okay, and.
Speaker 1 (35:38):
The final R resists retraumatization.
Speaker 2 (35:41):
This one is so crucial. It means actively working to
prevent practices, interactions, or environments that could inadvertently trigger painful
memories or replicate the dynamics of past trauma for either
clients or staff. The source points out that systems can
without meaning to create stressful or toxic environments that get
in the way of healing.
Speaker 1 (36:02):
So being really mindful of how routine procedures might land
on someone with a history of say, powerlessness, or violation.
Speaker 2 (36:09):
Or betrayal exactly. Staff in a truly trauma informed setting
are constantly asking could this procedure, this policy, this interaction
be retraumatizing for someone. The source uses those stark examples,
using restraints on a sexual abuse survivor or putting a
severely neglected child into isolation, understanding how those actions could
retrigger the original trauma and cause further harm.
Speaker 1 (36:31):
That makes complete sense. It's about intentionally creating an environment
that feels like the opposite of trauma, predictable, safe, empowering, respectful,
instead of accidentally mirroring the harm.
Speaker 2 (36:41):
Precisely, and the source clarifies again, trauma informed care is
the overarching culture the foundation. Trauma specific services are an
essential part of that, but the approach itself is broader
beyond the four rs.
Speaker 1 (36:55):
SAMHSA also lays out six key principles that really form
the bedrock of this.
Speaker 2 (37:00):
Yes, these six principles are like the core values that
should guide everything. They're meant to be applied across all
kinds of settings, even if the specific language needs tweaking.
They're all aimed at promoting safety, hope, and healing.
Speaker 1 (37:13):
Okay, what's the first principle?
Speaker 2 (37:14):
Number one is safety? This is non negotiable, the absolute foundation.
It means ensuring both physical and psychological safety for everyone.
The staff, the clients, the families. The environment needs to
feel safe, interactions need to promote safety, and the source
needs a really important point here. Safety needs to be
prioritized as defined by those being served. It's not just
(37:36):
about the organization's rules, it's about what makes the individual
feel safe.
Speaker 1 (37:40):
That's a powerful shift focusing on their subjective experience of safety.
What's principle number two?
Speaker 2 (37:45):
Number two is trustworthiness and transparency. This means the organization
operates openly and honestly. Decisions are made transparently. The goal
is to build and maintain trust with everyone involved, being reliable,
clear about policies and expectations, admitting limitations. All that helps
build the trust that's often shattered by trauma.
Speaker 1 (38:07):
Makes sense. Openness builds trust. Third principle third is peer support.
Speaker 2 (38:11):
The sorcerally emphasizes the value of involving peers, people with
their own lived experience of trauma and recovery, as well
as mutual self help groups. They see these as vital
ways to establish safety and still hope, build trust, strengthen collaboration,
and use that powerful lived experience to guide healing.
Speaker 1 (38:29):
So people who've been there supporting others.
Speaker 2 (38:31):
On their journey, exactly peers or trauma survivors, their involvement
is seen as fundamental for kid services. This might also
include family members who have navigated the system and supported
a trial through trauma.
Speaker 1 (38:41):
Bringing that experiential wisdom right into the process. Okay.
Speaker 2 (38:45):
Fourth principle number four is collaboration and mutuality. This one
is about intentionally leveling power differences. That means real partnership
between staff and clients, but also respectful collaboration among staff
at different levels. The source has a lovely line healing
happens in relationships, and it's nurtured by meaningfully sharing power
(39:06):
and decision making. Everyone plays a part. As one expert
put it, one does not have to be a therapist
to be therapeutic.
Speaker 1 (39:13):
I love that quote too. It really democratizes the idea
of healing. Okay.
Speaker 2 (39:16):
Fifth Principle fifth is empowerment, voice, and choice. This focus
is on recognizing and building on people's strengths, fostering belief
in their resilience, their capacity to heal and grow. The
organization actively structures things to promote empowerment, not just for
clients but for staff too.
Speaker 1 (39:32):
Helping people find their voice make choices about their own care.
Speaker 2 (39:36):
Exactly, it means being really conscious of how systems can
sometimes feel disempowering or coercive. So a trauma informed approach
actively supports clients and shared decision making, offers real choices
whenever possible about their goals and treatment, and helps them
develop skills to advocate for themselves. Staff become facilitators, guides,
not controllers. And again the source stresses the parallel process.
(39:58):
Staff need to feel safe, he and empower themselves to
be able to genuinely foster empowerment in others.
Speaker 1 (40:03):
That parallel process seems so key that internal culture has
to match the external message. Okay, the last principle number six.
Speaker 2 (40:10):
Number six is cultural, historical and gender issues. This requires
actively moving past stereotypes and biases related to race, ethnicity,
sexual orientation, age, gender identity, disability, religion, geography, you name it.
It means offering services that are responsive to gender differences
in trauma experiences and healing needs. It means recognizing and
(40:32):
leveraging the potential healing value of traditional cultural practices and connections,
and incorporating policies and practices that are truly responsive to
the specific racial, ethnic, and cultural needs of the people served.
Speaker 1 (40:44):
And acknowledging historical trauma fits here too.
Speaker 2 (40:47):
Yes, absolutely, Yeah. Recognizing that entire communities can carry the
weight of historical trauma from things like colonization, slavery, genocide,
forced migration, systemic oppression, and that this impacts individuals and
families across generations. Addressing this means understanding the history and
supporting community led healing efforts.
Speaker 1 (41:04):
Wow. Okay, So those six principles safety, trustworthiness, pure support, collaboration, empowerment,
and cultural historical gender awareness really provide a comprehensive roadmap
for creating environments where people can truly heal and thrive
after trauma.
Speaker 2 (41:20):
They really do. They're the compass for how an organization
should operate and interact.
Speaker 1 (41:25):
So thinking about actually doing this, implementing these principles, it
sounds like a huge undertaking for any organization.
Speaker 2 (41:32):
It absolutely is. It's not a quick fix. The SAMHSA
source talks about implementation, needing change across multiple levels, and
a systematic effort to align everything the organization does with
these principles. It's not just sending staff to a workshop.
It's deep, ongoing organizational change. They actually outline ten specific
domains where this change needs to happen.
Speaker 1 (41:51):
Ten domains. Can we briefly touch on what those cover
just to get a sense of the scope.
Speaker 2 (41:56):
Sure, it's a comprehensive list showing how far reaching this
needs to be. Briefly, they are one Governance and leadership,
getting buy in and investment from the top, having a
designated champion, including survivor voices in leadership. Two Policy writing
the principles into actual policies, focusing on safety, confidentiality, reducing retraumatization,
staff support, survivor involvement. Three physical environment, making the actual
(42:18):
space feel safe, calm, welcoming, non triggering. Four Engagement and
involvement creating real ways for client survivors to give feedback
and be involved in decisions, Being transparent. Five Cross sector
collaboration working effectively with other agencies school, healthcare, justice to
ensure a coordinated trauma informed network. Six Screening assessment treatment
(42:39):
services integrating trauma screening using evidence based trauma specific services
involving peers, being culturally responsive. Seven Training and workforce development.
Ongoing training for all staff, addressing secondary trauma and staff
providing trauma informed supervision. Eight. Progress monitoring and quality assurance
tracking how well the organization is doing, getting feedback from
staff and clients on safety valves. Nine. Financing allocating budget
(43:03):
resources to support all these changes. Training, safe spaces, peer
roles services. Ten Evaluation using specific tools to measure progress,
including survivor perspectives beyond just satisfaction surveys.
Speaker 1 (43:15):
Wow, Okay, that really drives home that this is a
total system transformation. It touches literally every part of how
an organization functions, from the budget to the building to
the boardroom.
Speaker 2 (43:27):
It's a fundamental shift, and the source provides guiding questions
for each domain to help organizations figure out what needs
to change in their specific context, whether it's a school,
a hospital, or a courthouse and thinking about our culture
hug idea.
Speaker 1 (43:41):
It really highlights that creating truly safe understanding spaces on
a larger scale requires this kind of deep, intentional systematic work.
Speaker 2 (43:49):
Absolutely, and that brings us to one final important layer
or sources touch on. Trauma doesn't just happen to individuals
in isolation. It happens within the context of a community.
Speaker 1 (44:00):
How does the community context play into all this?
Speaker 2 (44:02):
The source talks about it in two main ways. First,
how a community responds when an individual experiences trauma makes
a huge difference. Is the community understanding, supportive, validating, or
does it tend to avoid the topic, misunderstand, maybe even
blame the victim. A supportive community can be a massive
healing force. An unsupportive or invalidating one can actually make
(44:24):
things worse, impeding healing or even being retraumatizing.
Speaker 1 (44:28):
So the community's reaction is another one of those intervening variables,
potentially exactly.
Speaker 2 (44:32):
And the second way community matters is that entire communities
can experience trauma collectively. This isn't just individuals having separate experiences.
It can be from a shared disaster like a hurricane
or earthquake, but it can also be from events inflicted
by humans, things like historical genocide, force relocations, slavery, the
ongoing effects of systemic racism, or mass incarceration targeting specific groups.
(44:55):
Or pervasive community violence. This is often called historical trauma,
community trauma, or intergenerational trauma, and.
Speaker 1 (45:02):
The effects of that collective trauma can linger even be
passed down through generations.
Speaker 2 (45:07):
Yes, the source suggests these impacts can be transmitted across generations.
Communities might react collectively in ways that resemble individual trauma responses,
maybe becoming hypervigilant, distrustful, easily triggered by reminders of past harms.
Trauma can get embedded in cultural norms, sometimes as adaptations
that were once necessary for survival but are no longer helpful.
Speaker 1 (45:29):
So part of healing for a community involves acknowledging that
shared history.
Speaker 2 (45:34):
Yes, the source highlights that making sense of the collective
trauma experience, telling the community's story in its own voice,
and using culturally relevant frameworks for healing are often crucial
steps for communities trying to recover from collective.
Speaker 1 (45:46):
Trauma, and ultimately, whether it's individual or collective trauma, the
community's overall capacity to understand and respond constructively is vital
for everyone's well being.
Speaker 2 (45:57):
It really is, especially since, as we said, people don't
access formal help. The community itself, its level of awareness,
its skills, its compassion becomes a critical resource for healing.
Speaker 1 (46:08):
Okay, that's a lot to hold. Let's try and quickly
recap the journey we've taken. We started with stress versus trauma,
got into the nitty gritty of individual trauma with Sam
mich S's three e's Event Experience Effect. We look specifically
at child trauma, the difference between traumatic stress and PTSD.
We unpack the ACE study, its value and its significant
(46:29):
limitations for individuals. We saw how trauma and development influence
each other and the hope of intervention. Then we zoomed
out to the crucial need for a system wide trauma
informed approach, exploring the four rs, the six principles, and
those ten domains of implementation, and finally we placed it
all within the vital context of community.
Speaker 2 (46:49):
It's been a really comprehensive look, digging into the layers
of a profoundly human experience and understanding all this is.
It's not just intellectual, is it? No?
Speaker 1 (46:58):
Definitely not for you listening. We hope this knowledge feels useful,
maybe even powerful. Understanding the language, the different ways trauma
shows up, how systems can impact it. It might resonate
with your own life or help you understand people you
care about. It can offer validation, maybe words for things
that felt confusing before.
Speaker 2 (47:15):
Yeah, just knowing how common these experiences are, how they
physically and emotionally affect us, how our responses are often
survival attempts. It can really chip away at any misplaced
self blame or shame that trauma often brings. It can
feel normalizing, validating.
Speaker 1 (47:32):
And it really can change how you approach the world,
how you interact with people. When you start seeing behavior
through that lens of what might have happened to this
person instead of just judging, it opens up so much
more room for compassion, for connection.
Speaker 2 (47:46):
It absolutely does. It's a tool for building understanding inside
and out.
Speaker 1 (47:49):
So as we wrap up our culture hug deep dive today,
here's maybe a final thought to sit with. Pulling from
everything we've discussed, thinking about those core principles of a
trauma informed approach, safe, trustworthiness, collaboration, empowerment, those core human needs. Really,
how could you, in your own everyday life consciously bring
those principles into your interactions with colleagues, family, friends, even strangers.
(48:13):
How might you help create tiny pockets micro environments of safety, understanding,
and potential healing for the people around you.
Speaker 2 (48:19):
And if this conversation has sparked more questions or if
you're looking for support or more information. Those resources we
mentioned the NCTSN website for child trauma, the SANDWICHISA website
for broader resources. They're really great places to continue exploring.
Speaker 1 (48:34):
Thank you so much for joining us for this deep
dive today. We truly hope it's been a meaningful part
of your child in connecting more deeply with yourself and
with others strue understanding
We're in the quiet place.
Speaker 2 (00:03):
We share words on foold like whispers.
Speaker 1 (00:10):
In the.
Speaker 2 (00:13):
To go Here we.
Speaker 1 (00:17):
Start to.
Speaker 2 (00:20):
Welcome to the culture Hook podcast, your space to learn
and learn and grow one hug and one episode at
a time.
Speaker 1 (00:28):
Today we're really aiming for what we like to call
a culture hug, a space where we can kind of
lean in together, learn something and hopefully, you know, connect
a bit more with ourselves and maybe understand the people
around us a little better too.
Speaker 2 (00:41):
Yeah, that connection piece is so.
Speaker 1 (00:42):
Important, absolutely, and today's topic is, well, it's a big one,
but so fundamental to navigating life. Really, we're driving into
the complex world of trauma.
Speaker 2 (00:55):
It really is complex, and you know, we're understanding more
and more just how much it touches, how its impact
can be, and learning about it, what it actually is,
how it affects people. Honestly, it can be incredibly validating
if you've been through something, and it can totally shift
how you see.
Speaker 1 (01:10):
Others, definitely. So to help us explore this, we've gathered well,
quite a few sources, some key articles, research papers. They
offer different angles, different insights into trauma and you know,
all the related ideas and our plan today.
Speaker 2 (01:23):
Our mission if you like is to unpack these sources
together with you. We want to pull out the really
crucial bits, maybe uncover some surprising details, and just boil
it down so you walk away feeling like you've got
a solid handle on it, without feeling totally overwhelmed by information.
Speaker 1 (01:40):
Exactly. It's about getting that knowledge, finding maybe those aha
moments that might click something into place for you about
your own life, or maybe just help you see things
see people with I don't know, a slightly clearer, more
compassionate lens.
Speaker 2 (01:55):
Hopefully, yeah, a more informed lens.
Speaker 1 (01:57):
Okay, so let's jump right in. One of the first
things is our sources tackle is the difference between stress
and trauma, because they can feel similar sometimes, but they're
not the same thing.
Speaker 2 (02:06):
Are they No, not at all, And that distinction is
like super important baseline knowledge. The sources explain stress as
basically the body's natural response to pressure. It's that feeling
of worry or tension that pops up when we're dealing
with difficult situations challenges.
Speaker 1 (02:23):
Okay, so like the everyday stuff, the things that push
us maybe feel hard but aren't actually like threatening our
life for safety exactly.
Speaker 2 (02:32):
That's a good way to put it. The sources give
some pretty relatable examples. For adults. You know, I think
work deadlines, difficult coworkers, maybe studying for a big exam,
the everyday chaos of parenting, oh yeah, or even big
life changes like moving to a new city. These things
create tension, right they stresses out, Yeah, but they're not
usually dangerous in a fundamental way.
Speaker 1 (02:54):
Got it? So things that might make your heart beat faster,
maybe tense your shoulders, but usually once the situation's over,
it kind of fades.
Speaker 2 (03:02):
Generally, Yes, that's the idea. And for kids, stress looks
a bit different obviously, but it's the same basic response
to pressure.
Speaker 1 (03:10):
Okay.
Speaker 2 (03:10):
So for a child, the sources mention things like the
anxiety of starting a new school, test pressure, trying to
make new friends, adjusting when a new baby, brother or
sister arrives, or even just you know, having a big
argument with a friend.
Speaker 1 (03:22):
Right. Still, challenging, still creates worry, but within a certain kind.
Speaker 2 (03:26):
Of boundary exactly manageable challenge usually.
Speaker 1 (03:29):
Okay, So that's stress. How does trauma? How is it different?
What makes it trauma?
Speaker 2 (03:35):
Trauma, according to these sources, is defined by a really
different level of threat. It involves a frightening, dangerous or
violent event, or sometimes the whole series of events. Okay,
And the key is that it poses a significant threat
to a person's life or their physical integrity, their bodily safety.
The stakes are just way higher.
Speaker 1 (03:54):
It sounds like a fundamental shattering of safety almost. What
kind of events are we talking about here? What examples
do the sources give?
Speaker 2 (04:01):
They list some really heavy experiences, things like abuse, physical, sexual, emotional,
and neglect. Big events like natural disasters or acts of terrorism,
experiencing violence in your family or community, wo a traumatic separation,
especially for a child from their main caregiver, or being
in a serious life threatening accident. These are things that
(04:22):
kick our survival systems into overdrive in a really intense way.
Speaker 1 (04:25):
And does it always have to happen to you directly
or can seeing something happen to someone else be traumatic.
Speaker 2 (04:31):
To That's a really critical point the sources bring up,
especially when we're talking about children. Witnessing a traumatic event,
one that threatens the life or physical safety of someone
you deeply depend on, like a parent. That can be
intensely traumatic in itself, particularly for young kids, because their
whole sense of safety is basically wrapped up in whether
(04:52):
their caregiver feels safe and is physically there.
Speaker 1 (04:56):
Yea.
Speaker 2 (04:56):
If that anchor feels threatened, their whole world can feel
like it's falling apart.
Speaker 1 (05:01):
That makes so much sense. It's not just the direct impact,
but the ripple effect on your core sense of security.
It really speaks to how relational safety is, doesn't it.
Speaker 2 (05:09):
It absolutely is, yes, especially when we're young and rely
on others so much. Safety is often something we regulate together.
Speaker 1 (05:15):
Okay, so we've got stress versus trauma now. One of
our main sources from sam ahside, that's the substance abuse
of Mental Health Services Administration gives a really comprehensive definition
of individual trauma that's widely used.
Speaker 2 (05:27):
Yea. And the Samwich's add definition is really helpful because
it captures a lot of nuance. They say, individual trauma
results from an event or a series of events, or
even a set of circumstances Okay, that someone experiences as
physically or emotionally harmful or life threatening. And this is key.
It has to have lasting and verse effects on their
functioning and well being lasting a sex, Yeah, affecting their mental, physical, social, emotional,
(05:51):
or even their spiritual health.
Speaker 1 (05:52):
It's broad that really emphasizes it's not just about the
thing that happened, but how it hits you, how it
lands for you, and what lingers afterwards.
Speaker 2 (06:00):
Samiches breaks this down further right using the three e's.
Speaker 1 (06:04):
It's right, the three e's events, experience, and effect. It's
a really useful framework.
Speaker 2 (06:08):
Okay, let's take the first E the event. What falls
under that?
Speaker 1 (06:11):
So the event is the actual thing that happened, or
maybe the extreme threat of harm physical or psychological, or
it could be severe neglect, which is more about the
absence of something crucial.
Speaker 2 (06:22):
And the sources stress it's not always one single dramatic
incident like a car crash. It could be ongoing like
chronic abuse or living in a constantly violent neighborhood. It
could be a series of things over time. And this
lines up with how the DSM five defines trauma for
diagnosis purposes.
Speaker 1 (06:40):
Okay, so the event is the objective reality more or
less of what happened or threatened to happen. Then the
second E is experience. This feels like where it gets
really personal.
Speaker 2 (06:50):
It absolutely is, and honestly, the sources suggests this is
maybe the most critical E to understand the experience is
all about how the individual perceives, internalized, and is affected
by the event, right.
Speaker 1 (07:02):
Which explains why I, say, two siblings and the same
difficult home might react totally differently long term.
Speaker 2 (07:07):
Exactly, or why two soldiers in the same combat situation
might have vastly different responses. Afterwards, the sources point to
a bunch of factors that shape this experience, like what well,
things like your cultural background and beliefs, how does your
culture understand adversity you're suffering, your social supports, were you
alone or did you have people around you? And crucially
(07:28):
your developmental stage. What a five year old experience is
as traumatic is very different from what a teenager or
an adult experience is, even if the event is similar.
Speaker 1 (07:37):
So it's the event filtered through who you are, where
you are in life, and what resources you have around you.
Speaker 2 (07:42):
Precisely, And another really powerful point the sources make about
the experience of trauma is the role of power dynamics. Yeah,
very often trauma involves a situation where someone or something,
a person, an institution, even nature has overwhelming power over
the individual, leaving them feel utterly powerless.
Speaker 1 (08:01):
That feeling of powerlessness, what kind of specific emotions tend
to come up with that, according to the sources they mentioned,
some right, they.
Speaker 2 (08:09):
Do, feelings like humiliation, deep guilt or shame, a profound
sense of betrayal, and feeling silence. Think about it. Abuse
often carries intense humiliation, making someone feel bad or dirty.
Survivors of disasters might feel guilty for having lived when
others didn't. If the trauma comes from someone you trusted,
like a parent or caregiver, the betrayal is immense, shattering
(08:31):
your ability to trust, and threats, which are common in abuse,
can lead to this deep fear of speaking out, a
real silencing.
Speaker 1 (08:40):
Wow, that's a really complex and painful mix of feelings.
It's so much more than just fear. It's like a
wound to your very self and how you connect to
the world.
Speaker 2 (08:50):
It absolutely is, Yeah, which leads us directly to the third.
Speaker 1 (08:53):
E The effect, right, the lasting impact exactly.
Speaker 2 (08:57):
The effect refers to those long lasting adverse impacts that
ripple outwards from the traumatic event and the person's experience
of it. And these effects aren't always obvious right away.
Speaker 1 (09:06):
They can show up later.
Speaker 2 (09:07):
Yeah. They can be delayed, sometimes months, sometimes even years later,
and they could be short term struggles or they can
persist for a very long time, sometimes lifelong, And is.
Speaker 1 (09:15):
It possible someone might be struggling with things now but
not even realize it's connected to something traumatic that happen
way back.
Speaker 2 (09:21):
That's a really important point. The sources highlight. People might
not make that conscious connection. They might have trouble coping
with everyday's stress that others seem to manage, or find
it really hard to trust people and build healthy relationships,
or struggle with things like memory, focus, clear thinking, or
maybe they have a hard time managing their emotions or
controlling impulses, and they might not link it back to
(09:42):
those past events.
Speaker 1 (09:43):
So it affects how you function day to day, how
you relate to others, even how your brain works.
Speaker 2 (09:48):
Essentially absolutely. The sources talk about the neurobiological impact too,
how trauma, especially chronic or early life trauma, can literally
change the structure and function of the brain and nervous system,
affecting long term.
Speaker 1 (10:01):
Health, and the effects they can look different in different people,
like hyper alertness versus numbness exactly.
Speaker 2 (10:07):
It's often described as a spectrum. Some people might become
hyper vigilant, constantly on edge, jumpy scanning, for danger. Others
might go towards numbing or avoidance, feeling detached, shut down,
emotionally flat, trying not to feel anything.
Speaker 1 (10:22):
It sounds like different survival strategies, almost like the system
trying to cope with being overwhelmed.
Speaker 2 (10:29):
That's a perfect way to think about it. They were
adapt to strategies in the face of threat, but when
those states become chronic, being constantly revved up or constantly
shut down, it takes a huge toll. It wears you
down physically, mentally, emotionally.
Speaker 1 (10:42):
Yeah, I can see that.
Speaker 2 (10:44):
And the sources also mentioned the impact on spirituality. It
can shake core beliefs about the world, about safety, about
meaning and purpose.
Speaker 1 (10:51):
That really paints a picture of how deeply trauma can
permeate someone's life. It's not just in your head.
Speaker 2 (10:57):
Not at all. It's a whole being experience.
Speaker 1 (11:00):
Okay, let's shift focus slightly now to trauma specifically in children.
One of our sources really digs into what is child
traumatic stress?
Speaker 2 (11:07):
Right, and this source echoes the general definition but applies
it to kids. An intense event or series of events
that threatens or causes significant harm to a child's emotional
or physical well being.
Speaker 1 (11:18):
Does it give examples particularly relevant to childhood.
Speaker 2 (11:21):
Yeah, it expands on the general list things like natural
disasters which can be terrifying for a child, war, terrorism,
witnessing or being a victim of violence, abuse, serious accidents,
but also things like frightening or painful medical procedures can
be traumatic for kids.
Speaker 1 (11:38):
Medical procedures too. Wow.
Speaker 2 (11:39):
Yeah, and it includes that sobering statistic again, something like
one in four children experience at least one potentially traumatic
event before they hit sixteen.
Speaker 1 (11:48):
One in four. That's that really brings it home how
common this is. It's not some rare occurrence. So many
young lives are touched by this. How do kids typically
react right after something scareds Well.
Speaker 2 (12:01):
The source explains that kids, just like adults, have built
in survival responses. Their heart rate might go up, they
might sweat, feel agitated, become super alert, get that, butterflies
in the stomach, feeling, or become very emotionally upset. These
are normal protective reactions to perceive danger.
Speaker 1 (12:17):
The body trying to keep them safe.
Speaker 2 (12:19):
Exactly the fight, flight or freeze response kicking in.
Speaker 1 (12:21):
But what happens when those reactions don't settle down after
the danger is over, When they linger.
Speaker 2 (12:26):
That's exactly where child traumatic stress comes in. It's when
kids who've been through trauma develop reactions that last much longer.
These reactions persist and they start to significantly interfere with
the child's everyday life, long after the traumatic event itself
has ended.
Speaker 1 (12:41):
So the trauma response gets kind of stuck on and
that disrupts their normal functioning. What does that look like
in kids? What are the symptoms?
Speaker 2 (12:49):
The source describes a range of things. Intense ongoing emotional
upset that's more than typical kid stuff, symptoms of depression
or anxiety, Noticeable changes in behadhavior, maybe acting out, maybe
becoming withdrawn, trouble paying attention or concentrating, which obviously affects school,
having nightmares or intrusive memories, and even physical symptoms like
(13:10):
trouble sleeping, changes in needing habits, or unexplained aches and pains.
Speaker 1 (13:14):
And these aren't just happening randomly. They're often linked to
reminders of the trauma.
Speaker 2 (13:18):
Yes, exactly. The source points out that these symptoms often
pop up or get worse when something reminds the child
of the traumatic event, even if it's an indirect reminder
and the real indicator that it's traumatic stress is that
these symptoms are getting in the way of their daily life, school, friendships,
family relationships, just being a kid. Okay, this brings up PTSD.
People hear that term a lot. How does child traumatic
(13:41):
stress relate to a formal PTSD diagnosis?
Speaker 1 (13:45):
The source clarifies this right, it does, and it's a
really important clarification because the terms get mixed up. PTSD
post traumatic stress disorder, is a specific clinical diagnosis defined
by the American Psychiatric Association. To get that diagnosis, a
child yold has to show a very specific cluster of symptoms.
Speaker 2 (14:02):
What are those specific symptom clusters for PTSD? According to
the source, For a PTSD diagnosis, the child needs to
be reexperiencing the event persistently for more than a month
through things like intrusive thoughts, nightmares, or flashbacks where they
feel like it's happening again. They also need to show
avoidance or numbing symptoms like trying really hard not to
(14:22):
think or talk about it, having trouble remembering parts of it,
or feeling emotionally numb. And they need to show signs
of increased arousal like being super irritable jumpy or having
significant sleep problems.
Speaker 1 (14:33):
Okay, so PTSD is a specific pattern. How does that
fit with the broader idea of child traumatic stress?
Speaker 2 (14:40):
The source makes this crystal clear. Every child who meets
the criteria for PTSD is experiencing child traumatic stress. But
and this is the key, not every child who's experiencing
child traumatic stress will meet all the specific criteria for
a PTSD diagnosis.
Speaker 1 (14:54):
Got it. So, child traumatic stress is the bigger umbrella exactly.
Speaker 2 (14:57):
It covers the range of ongoing difficulties after trauma. PTSD
is one specific diagnosable condition under that umbrella.
Speaker 1 (15:04):
That's super helpful. And it makes sense then that not
every child who goes through something traumatic develops ongoing traumatic
stress or PTSD. Why the difference in outcomes?
Speaker 2 (15:15):
Right? The source really emphasizes that it's not automatic. Whether
a child develops lasting symptoms depends on a whole mix
of factors, things like their history, have they experienced other
traumas before? Cumulative trauma really increases risk their individual makeup.
Some kids are naturally more resilient, others more vulnerable, and critically,
(15:35):
the support they get afterwards the court seems key hugely important.
Do they have safe, stable, relationships, support of adults who
listen and believe them, access to resources. All of that
makes a massive difference.
Speaker 1 (15:47):
So you really can't predict based just on the event itself.
You have to look at the child and their whole context.
Speaker 2 (15:53):
Absolutely, The source explicitly warns against making assumptions about how
any individual child will react. Every child's is unique.
Speaker 1 (16:00):
And if child traumatic stress isn't addressed, if a child
doesn't get the help they need, what are the potential
long term impacts? The source mentions.
Speaker 2 (16:09):
It paints a pretty concerning picture. Honestly, untreated traumatic stress
can actually interfere with brain development and physical health. It
makes it really hard for kids to concentrate and learn
in school, which obviously has knock on effects. It can
fundamentally change how they see the world themselves, their future.
It can lead to difficulties later in life, like problems
(16:29):
with employment or relationships. And the source adds it takes
a huge toll on the whole family.
Speaker 1 (16:36):
Wow, it really affects everything, the child's whole trajectory and
the family system around them.
Speaker 2 (16:41):
It really does. But and this is important. The source
ends this section on a note of hope.
Speaker 1 (16:47):
Okay, good, Yeah.
Speaker 2 (16:49):
It stresses that over the last decade or so, we've
learned a lot and effective treatments for child traumatic stress
have been developed. It emphasizes how important it is to
seek help from professionals who actually have experience working with
kids and trauma, and to tap into community resources. Healing
and recovery are definitely possible.
Speaker 1 (17:07):
That's so crucial to hear that effective help is out there. Okay,
let's shift gears a bit and talk about the ACE Study,
the Adverse Childhood Experiences Study. It's become really well known,
but our source also raises some really important cautions about it.
Speaker 2 (17:22):
Yes, the ACE Study was and is hugely influential, no
doubt about it. The source acknowledges its massive contribution in
really bringing public attention to the strong link between difficult
childhood experiences, trauma and adversity, and negative health outcomes much
later in life in adulthood, physical health, mental health, the works.
Speaker 1 (17:42):
So it really helped connect those dots for people. How
did the original study measure those childhood difficulties.
Speaker 2 (17:48):
It used a pretty straightforward method. Participants filled out a
ten item checklist looking back at their childhood before age eighteen.
They just counted how many of those ten specific types
of adverse experiences they had personally encountered. That number was their.
Speaker 1 (18:00):
ACE score, And what were those original ten acees they
looked at?
Speaker 2 (18:04):
The source lists them physical abuse, sexual abuse, emotional abuse,
physical neglect, emotional neglect. Then household challenges, witnessing violence against
their mother, living with someone with a substance abuse problem,
so with mental illness, or who attempted suicide, having a
household member go to prison, or losing a parent through
(18:25):
separation or divorce.
Speaker 1 (18:26):
Okay, ten specific categories. Now this is where our source
gets really interesting and I think really crucial for anyone
hearing about ACE scores. While the study itself was groundbreaking,
the source points out some major limitations in using that
simple ACE score as a tool for understanding individuals, especially
in like a doctor's office or therapy setting.
Speaker 2 (18:47):
Yes, this is such a critical point that often gets
missed in how ACES are discussed. The source is very
clear just counting those ten things is not enough to
really understand a child's exposure to adversity or what kind
of help they might actually need.
Speaker 1 (18:59):
So what does that count miss? What are the big limitations?
The source flags.
Speaker 2 (19:03):
There are several really significant ones. First, the score tells
you nothing about the frequency of the experience that had
happened once or hundreds of times, the severity, how bad
was it, the duration, did it last for weeks, for years,
or the developmental timing? Did it happen when they are
a toddler or a teenager. A score of one can
mean very different things, but the score treats them all
(19:23):
the same, right.
Speaker 1 (19:24):
That flattens out so much important detail about the actual
experience totally.
Speaker 2 (19:29):
Second, the source points out that the original ten items
leave out a lot of other common and incredibly impactful
traumas and adversities kids' face, things like experiencing the traumatic
death of a loved one, going through scary medical stuff,
living through a natural disaster, experiencing racism or community violence.
Speaker 1 (19:47):
The list goes on, So someone could have gone through
really significant trauma that's just not on that list and
end up with a low ACE score that doesn't reflect
their reality at all.
Speaker 2 (19:56):
Precisely, and the source mentions that trying to add these
other things has led to lots of different acees checklists
floating around, which causes confusion because the scores aren't comparable anymore. Plus,
the score only counts the number of different types of adversity,
not the total number of traumatic experiences.
Speaker 1 (20:14):
Ah right, So a child experiencing, say, ongoing severe neglect
and frequent physical abuse, might only get a score of two,
the same as a child who experienced one instance of
two different things exactly.
Speaker 2 (20:27):
The source highlights that chronic trauma or multiple instances of
the same type of trauma can result in a misleadingly
low score that completely fails to capture the cumulative burden
on that child. That's why the source is so adamant
an ACE score alone should never be used to determine
a child's risk for future problems or what kind of
help they need. THEE even mentioned that one of the
original ACE study authors now cautions against using the score
(20:51):
in that way for individuals.
Speaker 1 (20:52):
Wow, that is such a vital piece of context for
anyone encountering ACE scores, whether you're a parent, a patient,
a teacher, anyone. Groundbreaking research, yes, but the score itself
is in a crystal ball.
Speaker 2 (21:06):
For individuals, absolutely not. And the source drives this home
even more by saying, not all acees are created equal.
Speaker 1 (21:13):
Okay, what does that mean? Practically?
Speaker 2 (21:15):
It means a few things. First, different types of adversity
can have different levels of impact. Statistically speaking, some are
just more strongly linked to certain negative outcomes than others.
But maybe more importantly, the impact on any individual child's
varies massively depending on their age at the time, their
life circumstances, any previous trauma history, the support systems they
had or didn't have, and their own internal protective factors.
(21:37):
They're resilience.
Speaker 1 (21:38):
So context is everything again, It's not just the event,
it's the event landing in a specific life with specific
supports or lack thereof, exactly.
Speaker 2 (21:47):
And the source also points to something really interesting called
synergistic effects. This is where certain combinations of traumas or
adversities interact to produce an effect that's greater than just
adding up their individual impacts. They amplify each other.
Speaker 1 (22:01):
Can you give an example of that from the source.
Speaker 2 (22:03):
Yeah. The source notes that research shows experiencing sexual abuse
in combination with other things like physical abuse, neglect, or
witnessing domestic violence significantly ramps up the risk for serious
behavioral problems later on. That specific combination is more toxic,
more damaging than any one of those experiences happening alone.
Speaker 1 (22:23):
And the simple ACEES score just counting the number of
categories would completely miss that crucial interaction.
Speaker 2 (22:29):
It completely masks it. The source is clear, just adding
up the number of types of acees hides these vital
interactions that are really important for understanding risk and targeting
interventions effectively.
Speaker 1 (22:40):
Okay, so the big takeaway on ACEES seems to be
the study was incredibly important for raising awareness about the
population level link between childhood adversity and adult health. But
the ACE score itself is a very blunt tool for
understanding an individual's complex experience.
Speaker 2 (22:58):
That's a perfect summary. It opened to crucial conversation, but
effective care needs a much deeper, more personalized assessment.
Speaker 1 (23:04):
Which leads us nicely into thinking more about how trauma
and development are intertwined. Our sources really emphasize that these
aren't separate things happening side by side.
Speaker 2 (23:13):
Now, they're deeply interconnected. A child's developmental stage, where they
are cognitively, emotionally, socially heavily influences how they understand and
react to a traumatic event and vice versa. Experiencing trauma,
especially within the family, which is the core developmental environment,
can significantly disrupt a child's expected developmental path.
Speaker 1 (23:32):
Does the kind of trauma a child is more likely
to face change as they get older.
Speaker 2 (23:37):
Yes, the source points this out. Certain types of trauma
are statistically more common at different ages. For example, things
related to the caregiver alike neglect, caregiver mental illness or
substance abuse, domestic violence, physical or emotional abuse by a caregiver.
These are unfortunately most common for very young children, say
(23:58):
zero to five years old. Okay, Then as kids get older,
moving into adolescence, other types of trauma like sexual assault
outside the family or being a victim of criminal assault,
become more prevalent statistically.
Speaker 1 (24:09):
And even if it's the same type of trauma like
sexual abuse, the impact can be really different depending on
whether the child is say, four years old versus twelve
versus sixteen.
Speaker 2 (24:17):
Absolutely the source uses that exact example. The developmental tasks,
the understanding of self and relationships, the coping mechanisms available,
they're all vastly different at those ages, so the consequences
and the way that trauma shapes their development will vary significantly.
Understanding that interaction, the type of trauma, the timing, and
the child's developmental stage is absolutely crucial for figuring out
(24:41):
the most effective ways to help both in treatment and prevention.
Different situations need different interventions.
Speaker 1 (24:47):
Recognizing that link is key for targeted support, and the
sources offer some hope here too. Right about interrupting that
potential negative path after trauma.
Speaker 2 (24:57):
Yes, definitely, this is where the power of intervention really
comes in. The source talks about early intervention and prevention
being critical windows of opportunity to potentially stop that negative
cascade towards the long term problems highlighted by studies like ACEES.
They talk about intervening variables.
Speaker 1 (25:12):
Intervening variables. What are those?
Speaker 2 (25:14):
These are factors that come into play after the traumatic
event happens, and they can either push things in a
more negative direction risk factors or help buffer the impact
protective factors.
Speaker 1 (25:24):
Okay, so what kinds of things count as intervening variables.
Speaker 2 (25:28):
Risk factors might be things like developing really acute traumatic
stress symptoms right after the event, or showing significant new
behavior problems or becoming depressed. Protective factors, on the other hand,
are things like having supportive adults who stick by you, parents, teachers, coaches, mentors,
having predictable routines that feel safe, having positive friendships. These
(25:49):
are the leverage points for intervention.
Speaker 1 (25:51):
So if you're working with a child or family after trauma,
you're looking at these intervening factors, not just the trauma.
Speaker 2 (25:57):
Itself exactly the source, and focusing not just on the
trauma history, but also really assessing the child's strengths. They're
existing protective factors, any positive childhood experiences they've had that
can be built upon. The goal is to actively bolster
those buffers, enhance those protective factors because they can really
mitigate the trauma's impact and at the same time address
(26:20):
any immediate negative consequences like severe anxiety or behavioral issues
that could become more entrenched if left alone.
Speaker 1 (26:28):
And this focus on strengths and resilience that connects back
to the possibility of healing.
Speaker 2 (26:33):
It absolutely does. The source is really clear. Recovery is possible.
When kids and families have access to good quality, evidence
based support that is fundamentally trauma informed, they can heal.
They even point people towards resources like the National Child
Traumatic Stress Network the NCTSN website for finding out more
about these effective approaches.
Speaker 1 (26:51):
That's a great practical resource. Okay, so we've covered a
lot individual trauma, child trauma, the ACE study complexities, the
link with the development. Now let's zoom out again. Why
is adopting a trauma informed lens important beyond just treating
individuals who seek therapy. Why does it matter for systems
for society?
Speaker 2 (27:10):
Yeah, this is where the SAMHA source really broadens the picture.
It frames trauma not just as an individual problem, but
as a major public health issue. It's widespread, it causes
significant harm, and it's incredibly costly, both personally and societally.
And it's deeply linked to high risks of mental health issues,
substance use problems, and even chronic physical diseases later in
(27:31):
life if the impacts go unaddressed.
Speaker 1 (27:33):
And despite how common it is, many people who experienced
trauma don't actually get the support they need.
Speaker 2 (27:38):
Sadly, that's often the case. The source notes that while
many people find ways to cope and overcome traumatic experiences,
often through natural supports, a huge number never access formal
services that could potentially help them heal.
Speaker 1 (27:51):
And the people who do interact with services, they're not
just showing up in therapists' offices, are they?
Speaker 2 (27:56):
No? Absolutely not. This is a crucial point the source makes.
People with trauma histories are interacting with all kinds of systems.
They're involved with the justice system, child welfare, they're in
our schools, they're seeing their primary care doctors. Their trauma
history walks in the door with them wherever they go.
Speaker 1 (28:13):
And sometimes the difficulties stemming from their trauma are the
very reason they end up interacting with these systems in
the first place.
Speaker 2 (28:20):
Exactly The source gives some really clear examples. A child
dealing with chronic maltreatment might act out in school because
they're hypervigilant and struggling to regulate, leading to disciplinary issues.
An adult survivor of domestic violence might struggle to hold
down a job due to anxiety or PTSD symptoms. Right
someone exposed to community violence might engage in risky behaviors
(28:41):
as a coping mechanism, leading to legal trouble. A young
person who is sexually abused might turn to substances or
self harm, bringing them into contact with health or mental
health services. A veteran struggling with combat trauma might have
physical complaints or substance issues that bring them to their doctor.
Speaker 1 (29:00):
So understanding that trauma history can provide a totally different
perspective on why someone might be struggling or behaving in
certain ways within these.
Speaker 2 (29:07):
System It offers that essential shift from what's wrong with
this person to what happened to this person? It provides context.
Speaker 1 (29:16):
Now here's a really powerful and maybe difficult point the
source makes. It suggests that the very systems designed to
help can sometimes unintentionally end up being retraumatizing.
Speaker 2 (29:27):
Yes, this is a really profound and necessary piece of
this whole conversation. Practices that might seem like standard operating
procedure within a hospital, a school, a court, or a
social service agency can actually be incredibly triggering and harmful
for someone with a trauma history. They can inadvertently mimic
aspects of the original trauma.
Speaker 1 (29:47):
Can you give some examples the source uses, because that
sounds really important to understand.
Speaker 2 (29:51):
Sure. The source mentions things like using physical restraints or
seclusion in mental health settings for someone who's experienced being
overpowered trapped, that can be terrifyingly similar. Or think about
child welfare removing a child from an unsafe home, even
if necessary. The abruptness, the lack of control for the
child can echo the trauma of separation or powerlessness. Yeah,
(30:15):
invasive medical procedures done without careful explanation, or ensuring the
person feels some control can feel like a violation, mirroring
past experiences. Even things like harsh zero tolerance discipline in
schools or intimidating, confusing processes in the justice system can
activate those same feelings of fear, helplessness, and threat that
(30:35):
are core to trauma.
Speaker 1 (30:36):
It's like the system's response inadvertently pushes the same buttons
that the original trauma.
Speaker 2 (30:40):
Did exactly, and the source points out that this re
traumatization actually works against the goals of the system. It
damages trust, makes people less likely to engage, and can
even make their symptoms worse.
Speaker 1 (30:51):
So if trauma is so common, its effects show up everywhere,
and the systems meant to help can sometimes harm. What's
the path for? According to the source.
Speaker 2 (31:01):
The source argues really strongly that addressing trauma effectively needs
more than just individual therapy. It requires a broad public
health approach, and fundamentally, it requires creating a trauma informed context.
This means organizations and systems need to fundamentally rethink how
they operate their business as usual. Practices need to be
grounded in a real understanding of trauma's deep and wide
(31:25):
ranging impact.
Speaker 1 (31:26):
So it's about changing the whole environment, the whole culture
of these.
Speaker 2 (31:29):
Places precisely, and the source notes that thankfully, there is
a growing awareness of this. More and more systems are
starting to recognize trauma's impact and are beginning to adopt
as trauma informed approach. And importantly, this shift isn't just
coming from researchers and clinicians. It's been hugely driven by
the voices and advocacy of trauma survivors themselves.
Speaker 1 (31:49):
Their lived experience is crucial to understanding what needs to change.
Speaker 2 (31:53):
Absolutely essential. Their insights have been fundamental in shaping what
a truly trauma informed approach looks like. And this understanding,
linking current struggles back to pass trauma, offers that vital
explanatory model, helping staff in various systems move from potentially
judging behavior to understanding its roots.
Speaker 1 (32:12):
That feels like such a hopeful shift. Okay, let's get specific, then,
what exactly is a trauma informed approach? According to sam
His they have a definition they do.
Speaker 2 (32:21):
It's built around what they call the four rs. Basically,
a program, organization, or system is trauma informed when it
realizes the widespread impact of trauma and understands potential paths
for recovery, recognize the science and symptoms of trauma, and
everyone involved. Client's family's staff responds by fully integrating knowledge
about trauma into all policies, procedures, and practices, and actively
(32:43):
seeks to resist retraumatization.
Speaker 1 (32:46):
Okay, the four rs realize, recognize, respond, and resist retraumatization.
Let's break those down a bit based on the source. First,
realizes what does that actually mean? In practice?
Speaker 2 (32:56):
Realizing means there's a fundamental shared understanding throughout the entire organization.
Everyone from the receptionist to the CEO gets what trauma is,
understands how common it is, and grasps this potential impact
on individuals, families, even the community. In the organization itself.
They understand that behaviors they see might actually be coping
(33:16):
strategies developed to survive overwhelming situations.
Speaker 1 (33:19):
So that shift from what's wrong with you to what
happened to you is really embedded in the organizational DNA exactly.
Speaker 2 (33:28):
They realize trauma is a major factor in things like
mental health and substance use issues, and that addressing it
is key. They also get that it's not just that
a mental health issue. It shows up everywhere and it
can block progress in schools, healthcare, justice systems if it's
not understood.
Speaker 1 (33:42):
Got it a foundational awareness?
Speaker 2 (33:44):
Second R recognizes Recognizing means equipping staff with the skills
to actually spot the signs and symptoms of trauma. These
signs can be subtle, and they might look different depending
on someone's age, gender, culture, or the specific setting. The
source mentions things like implementing routine trauma screening, providing ongoing training,
(34:04):
having supportive employee assistance programs, and using trauma in form
supervision to help staff recognize these signs and the people
they serve in colleagues and even in themselves.
Speaker 1 (34:14):
Okay, so realizing the scope and then developing the ability
to see it.
Speaker 2 (34:19):
Third responds Responding is the action part. It's about taking
all that knowledge and awareness and weaving it into everything
the organization does. Policies, procedures, day to day interactions, the
physical environment. Everything needs to be looked at through a
trauma lens. It means acknowledging that trauma affects everyone involved,
including the staff doing the work, and shaping the environment
(34:40):
and practices to reflect that.
Speaker 1 (34:42):
So this isn't just about having a few trauma therapists
on staff. It's much bigger, Oh much bigger.
Speaker 2 (34:47):
The source stresses that staff at every single level need
to potentially adapt or language their behavior, how they apply
policies to be sensitive to trauma histories both in clients
and co workers. This needs ongoing training, real b budget allocation,
and clear leadership buy in. Yes, it includes having access
to train trauma therapists, but the response is system wide.
Speaker 1 (35:08):
What about specific policies? How do they change?
Speaker 2 (35:11):
Policies need to be reviewed and potentially rewritten, the organization's
mission statement, employee handbooks, client rights documents. They should all
reflect principles of resilience, recovery, and healing. It might mean
explicitly stating a commitment to trauma informed care, maybe creating
client advisory boards with survivors, ensuring staff have support for
their own stress secondary trauma. Even the physical space is
(35:33):
part of the response, making it feel safe, welcoming, calming, okay, and.
Speaker 1 (35:38):
The final R resists retraumatization.
Speaker 2 (35:41):
This one is so crucial. It means actively working to
prevent practices, interactions, or environments that could inadvertently trigger painful
memories or replicate the dynamics of past trauma for either
clients or staff. The source points out that systems can
without meaning to create stressful or toxic environments that get
in the way of healing.
Speaker 1 (36:02):
So being really mindful of how routine procedures might land
on someone with a history of say, powerlessness, or violation.
Speaker 2 (36:09):
Or betrayal exactly. Staff in a truly trauma informed setting
are constantly asking could this procedure, this policy, this interaction
be retraumatizing for someone. The source uses those stark examples,
using restraints on a sexual abuse survivor or putting a
severely neglected child into isolation, understanding how those actions could
retrigger the original trauma and cause further harm.
Speaker 1 (36:31):
That makes complete sense. It's about intentionally creating an environment
that feels like the opposite of trauma, predictable, safe, empowering, respectful,
instead of accidentally mirroring the harm.
Speaker 2 (36:41):
Precisely, and the source clarifies again, trauma informed care is
the overarching culture the foundation. Trauma specific services are an
essential part of that, but the approach itself is broader
beyond the four rs.
Speaker 1 (36:55):
SAMHSA also lays out six key principles that really form
the bedrock of this.
Speaker 2 (37:00):
Yes, these six principles are like the core values that
should guide everything. They're meant to be applied across all
kinds of settings, even if the specific language needs tweaking.
They're all aimed at promoting safety, hope, and healing.
Speaker 1 (37:13):
Okay, what's the first principle?
Speaker 2 (37:14):
Number one is safety? This is non negotiable, the absolute foundation.
It means ensuring both physical and psychological safety for everyone.
The staff, the clients, the families. The environment needs to
feel safe, interactions need to promote safety, and the source
needs a really important point here. Safety needs to be
prioritized as defined by those being served. It's not just
(37:36):
about the organization's rules, it's about what makes the individual
feel safe.
Speaker 1 (37:40):
That's a powerful shift focusing on their subjective experience of safety.
What's principle number two?
Speaker 2 (37:45):
Number two is trustworthiness and transparency. This means the organization
operates openly and honestly. Decisions are made transparently. The goal
is to build and maintain trust with everyone involved, being reliable,
clear about policies and expectations, admitting limitations. All that helps
build the trust that's often shattered by trauma.
Speaker 1 (38:07):
Makes sense. Openness builds trust. Third principle third is peer support.
Speaker 2 (38:11):
The sorcerally emphasizes the value of involving peers, people with
their own lived experience of trauma and recovery, as well
as mutual self help groups. They see these as vital
ways to establish safety and still hope, build trust, strengthen collaboration,
and use that powerful lived experience to guide healing.
Speaker 1 (38:29):
So people who've been there supporting others.
Speaker 2 (38:31):
On their journey, exactly peers or trauma survivors, their involvement
is seen as fundamental for kid services. This might also
include family members who have navigated the system and supported
a trial through trauma.
Speaker 1 (38:41):
Bringing that experiential wisdom right into the process. Okay.
Speaker 2 (38:45):
Fourth principle number four is collaboration and mutuality. This one
is about intentionally leveling power differences. That means real partnership
between staff and clients, but also respectful collaboration among staff
at different levels. The source has a lovely line healing
happens in relationships, and it's nurtured by meaningfully sharing power
(39:06):
and decision making. Everyone plays a part. As one expert
put it, one does not have to be a therapist
to be therapeutic.
Speaker 1 (39:13):
I love that quote too. It really democratizes the idea
of healing. Okay.
Speaker 2 (39:16):
Fifth Principle fifth is empowerment, voice, and choice. This focus
is on recognizing and building on people's strengths, fostering belief
in their resilience, their capacity to heal and grow. The
organization actively structures things to promote empowerment, not just for
clients but for staff too.
Speaker 1 (39:32):
Helping people find their voice make choices about their own care.
Speaker 2 (39:36):
Exactly, it means being really conscious of how systems can
sometimes feel disempowering or coercive. So a trauma informed approach
actively supports clients and shared decision making, offers real choices
whenever possible about their goals and treatment, and helps them
develop skills to advocate for themselves. Staff become facilitators, guides,
not controllers. And again the source stresses the parallel process.
(39:58):
Staff need to feel safe, he and empower themselves to
be able to genuinely foster empowerment in others.
Speaker 1 (40:03):
That parallel process seems so key that internal culture has
to match the external message. Okay, the last principle number six.
Speaker 2 (40:10):
Number six is cultural, historical and gender issues. This requires
actively moving past stereotypes and biases related to race, ethnicity,
sexual orientation, age, gender identity, disability, religion, geography, you name it.
It means offering services that are responsive to gender differences
in trauma experiences and healing needs. It means recognizing and
(40:32):
leveraging the potential healing value of traditional cultural practices and connections,
and incorporating policies and practices that are truly responsive to
the specific racial, ethnic, and cultural needs of the people served.
Speaker 1 (40:44):
And acknowledging historical trauma fits here too.
Speaker 2 (40:47):
Yes, absolutely, Yeah. Recognizing that entire communities can carry the
weight of historical trauma from things like colonization, slavery, genocide,
forced migration, systemic oppression, and that this impacts individuals and
families across generations. Addressing this means understanding the history and
supporting community led healing efforts.
Speaker 1 (41:04):
Wow. Okay, So those six principles safety, trustworthiness, pure support, collaboration, empowerment,
and cultural historical gender awareness really provide a comprehensive roadmap
for creating environments where people can truly heal and thrive
after trauma.
Speaker 2 (41:20):
They really do. They're the compass for how an organization
should operate and interact.
Speaker 1 (41:25):
So thinking about actually doing this, implementing these principles, it
sounds like a huge undertaking for any organization.
Speaker 2 (41:32):
It absolutely is. It's not a quick fix. The SAMHSA
source talks about implementation, needing change across multiple levels, and
a systematic effort to align everything the organization does with
these principles. It's not just sending staff to a workshop.
It's deep, ongoing organizational change. They actually outline ten specific
domains where this change needs to happen.
Speaker 1 (41:51):
Ten domains. Can we briefly touch on what those cover
just to get a sense of the scope.
Speaker 2 (41:56):
Sure, it's a comprehensive list showing how far reaching this
needs to be. Briefly, they are one Governance and leadership,
getting buy in and investment from the top, having a
designated champion, including survivor voices in leadership. Two Policy writing
the principles into actual policies, focusing on safety, confidentiality, reducing retraumatization,
staff support, survivor involvement. Three physical environment, making the actual
(42:18):
space feel safe, calm, welcoming, non triggering. Four Engagement and
involvement creating real ways for client survivors to give feedback
and be involved in decisions, Being transparent. Five Cross sector
collaboration working effectively with other agencies school, healthcare, justice to
ensure a coordinated trauma informed network. Six Screening assessment treatment
(42:39):
services integrating trauma screening using evidence based trauma specific services
involving peers, being culturally responsive. Seven Training and workforce development.
Ongoing training for all staff, addressing secondary trauma and staff
providing trauma informed supervision. Eight. Progress monitoring and quality assurance
tracking how well the organization is doing, getting feedback from
staff and clients on safety valves. Nine. Financing allocating budget
(43:03):
resources to support all these changes. Training, safe spaces, peer
roles services. Ten Evaluation using specific tools to measure progress,
including survivor perspectives beyond just satisfaction surveys.
Speaker 1 (43:15):
Wow, Okay, that really drives home that this is a
total system transformation. It touches literally every part of how
an organization functions, from the budget to the building to
the boardroom.
Speaker 2 (43:27):
It's a fundamental shift, and the source provides guiding questions
for each domain to help organizations figure out what needs
to change in their specific context, whether it's a school,
a hospital, or a courthouse and thinking about our culture
hug idea.
Speaker 1 (43:41):
It really highlights that creating truly safe understanding spaces on
a larger scale requires this kind of deep, intentional systematic work.
Speaker 2 (43:49):
Absolutely, and that brings us to one final important layer
or sources touch on. Trauma doesn't just happen to individuals
in isolation. It happens within the context of a community.
Speaker 1 (44:00):
How does the community context play into all this?
Speaker 2 (44:02):
The source talks about it in two main ways. First,
how a community responds when an individual experiences trauma makes
a huge difference. Is the community understanding, supportive, validating, or
does it tend to avoid the topic, misunderstand, maybe even
blame the victim. A supportive community can be a massive
healing force. An unsupportive or invalidating one can actually make
(44:24):
things worse, impeding healing or even being retraumatizing.
Speaker 1 (44:28):
So the community's reaction is another one of those intervening variables,
potentially exactly.
Speaker 2 (44:32):
And the second way community matters is that entire communities
can experience trauma collectively. This isn't just individuals having separate experiences.
It can be from a shared disaster like a hurricane
or earthquake, but it can also be from events inflicted
by humans, things like historical genocide, force relocations, slavery, the
ongoing effects of systemic racism, or mass incarceration targeting specific groups.
(44:55):
Or pervasive community violence. This is often called historical trauma,
community trauma, or intergenerational trauma, and.
Speaker 1 (45:02):
The effects of that collective trauma can linger even be
passed down through generations.
Speaker 2 (45:07):
Yes, the source suggests these impacts can be transmitted across generations.
Communities might react collectively in ways that resemble individual trauma responses,
maybe becoming hypervigilant, distrustful, easily triggered by reminders of past harms.
Trauma can get embedded in cultural norms, sometimes as adaptations
that were once necessary for survival but are no longer helpful.
Speaker 1 (45:29):
So part of healing for a community involves acknowledging that
shared history.
Speaker 2 (45:34):
Yes, the source highlights that making sense of the collective
trauma experience, telling the community's story in its own voice,
and using culturally relevant frameworks for healing are often crucial
steps for communities trying to recover from collective.
Speaker 1 (45:46):
Trauma, and ultimately, whether it's individual or collective trauma, the
community's overall capacity to understand and respond constructively is vital
for everyone's well being.
Speaker 2 (45:57):
It really is, especially since, as we said, people don't
access formal help. The community itself, its level of awareness,
its skills, its compassion becomes a critical resource for healing.
Speaker 1 (46:08):
Okay, that's a lot to hold. Let's try and quickly
recap the journey we've taken. We started with stress versus trauma,
got into the nitty gritty of individual trauma with Sam
mich S's three e's Event Experience Effect. We look specifically
at child trauma, the difference between traumatic stress and PTSD.
We unpack the ACE study, its value and its significant
(46:29):
limitations for individuals. We saw how trauma and development influence
each other and the hope of intervention. Then we zoomed
out to the crucial need for a system wide trauma
informed approach, exploring the four rs, the six principles, and
those ten domains of implementation, and finally we placed it
all within the vital context of community.
Speaker 2 (46:49):
It's been a really comprehensive look, digging into the layers
of a profoundly human experience and understanding all this is.
It's not just intellectual, is it? No?
Speaker 1 (46:58):
Definitely not for you listening. We hope this knowledge feels useful,
maybe even powerful. Understanding the language, the different ways trauma
shows up, how systems can impact it. It might resonate
with your own life or help you understand people you
care about. It can offer validation, maybe words for things
that felt confusing before.
Speaker 2 (47:15):
Yeah, just knowing how common these experiences are, how they
physically and emotionally affect us, how our responses are often
survival attempts. It can really chip away at any misplaced
self blame or shame that trauma often brings. It can
feel normalizing, validating.
Speaker 1 (47:32):
And it really can change how you approach the world,
how you interact with people. When you start seeing behavior
through that lens of what might have happened to this
person instead of just judging, it opens up so much
more room for compassion, for connection.
Speaker 2 (47:46):
It absolutely does. It's a tool for building understanding inside
and out.
Speaker 1 (47:49):
So as we wrap up our culture hug deep dive today,
here's maybe a final thought to sit with. Pulling from
everything we've discussed, thinking about those core principles of a
trauma informed approach, safe, trustworthiness, collaboration, empowerment, those core human needs. Really,
how could you, in your own everyday life consciously bring
those principles into your interactions with colleagues, family, friends, even strangers.
(48:13):
How might you help create tiny pockets micro environments of safety, understanding,
and potential healing for the people around you.
Speaker 2 (48:19):
And if this conversation has sparked more questions or if
you're looking for support or more information. Those resources we
mentioned the NCTSN website for child trauma, the SANDWICHISA website
for broader resources. They're really great places to continue exploring.
Speaker 1 (48:34):
Thank you so much for joining us for this deep
dive today. We truly hope it's been a meaningful part
of your child in connecting more deeply with yourself and
with others strue understanding
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