Ten Things Everyone Needs to Know About Trauma

Dr. Debra Ruisard, DSW, LCSW, LCADC

Trauma Informed Care Trainer, The CTARI Institute™

The CTARI Institute™ is a subsidiary of

1. What is Trauma?

An event A series of events Absence of the good

Adverse Childhood Experiences

Racial, cultural, religious and

gendered oppression

Historical trauma

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2. How many people haveexperienced trauma?

◦ Adverse Childhood ExperiencesStudy (ACEs)

◦ Abuse – Emotional, Physical,Sexual

◦ Neglect – Emotional, Physical◦ Household Challenges –

Domestic Violence, SubstanceAbuse, Mental Illness, ParentalSeparation, Incarcerated Parent

Infographic from Acestoohigh.com

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Infographic from Acestoohigh.com

Lack of Physical Activity Suicide attempts

Smoking STDs

Alcoholism Heart disease

Drug Use Cancer

Missed work Stroke

Severe obesity COPD

diabetes Broken Bones

depression

The ACEs Study found strong correlation between number of ACEs and these possible risk outcomes

3. The risks of trauma

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4. What trauma does to the brain

• The brain’s alarm system

• Chronic trauma changes the brain• Decreased cognitive ability – frontal lobes shut

down under threat

• Increased limbic system sensitivity- hyper alert to danger all the time; impulsivity; difficulty managing emotions

• Hippocampus less effective– decreased ability to interpret information from the environment to the brain; makes it difficult to differentiate between real and imagined threats

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5. What trauma does to the body

• In the moment of a traumatic event, the body goes into instinctual responsesto survive; once safe, the body naturally releases the stress and cortisolthrough shaking.

• For those who have experienced chronic trauma and could not fight back orescape, the nervous system learns to stay on high alert to survive –constantly pumping cortisol into the body

• The nervous systems of people who experience chronic trauma adjust tothese high levels of cortisol; cortisol takes it toll on the body leading tohypertension, heart disease and other chronic illnesses

• And movement that was unable to happen (fight or flight) gets stored in thenervous system as unexpressed actions

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6. Trauma Triggers

Loud angry voices Rejection by a friend Screeching car tires

• Triggers are things that happen in our current daily experiences that arereminders of past traumatic events

• The body does not have a sense of time; therefore the body reacts as if theoriginal traumatic event is actually happening

• People often are unaware of the connection between the current experienceand past traumatic events therefore feel out of control, or ‘crazy’

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7. Trauma reactions

• In the moment of trauma, the body goes into fight, flight or freeze mode. The prefrontal cortex shuts down and the limbic brain takes over.

• When triggered, the brain responds in the same way: the cognitive brain deactivates and the emotional/instinctual brain acts as if the traumatic event is happening in the present – the person become furious, terrified, enraged, ashamed or frozen.

• Sometimes the trigger is known; sometimes it can be so subtle that the person is unaware of the trigger, but the body senses it.

• This reactivity can last for many years.

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8. Managing symptoms of trauma

• Symptoms include:

depression, irritability, insomnia, nightmares, emotional overwhelm or numbing, hopelessness, shame, worthlessness, flashbacks, anxiety, panic attacks, substance abuse, eating disorders, self harm, and more

• Understanding the connection that these symptoms have to past traumatic experiences is the first step in managing them

• Because trauma is stored in the body, often the best place to start is with body-based interventions

• Emotional regulation and cognitive strategies are also useful

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9. Responding to people with trauma

• People all around us have experienced traumatic life events and we often do not know who they are or what their life experiences have been

• However, as they interact daily with others in personal, social and work environments sometimes their responses can be difficult for others to handle or understand

• Impulsivity

• Quick and overreactive frustration or anger

• Shutting down, refusing to talk

• Avoidance

• These behaviors can trigger reactions in us that are not helpful – anger, being dismissive or offended, avoidance

• If we take what we know about trauma, we can hopefully respond rather than react to difficult behaviors in others – because we don’t know what life experiences might be fueling their behaviors.

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10. Ways to heal from trauma

Body based approaches

• Breath• Movement• Touch

Emotional regulation

• Grounding• Strategies that

get us out of the emotional brain

Cognitive strategies

• Education• Challenging

cognitive distortions

• Strengthening executive functions

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Resources

• National Child Traumatic Stress Network (nctsn.org)

• The Body Keeps the Score – Bessel van der Kolk

• Coronavirus (COVID-19) Pandemic Coping Strategies for Youth with a History of Complex Trauma by Jana Pressley, Psy.D. & Joseph Spinazzola, Ph.D. The Foundation Trust (www.foundationtrust.org)

• Coping Strategies for Complex Trauma Survivors Contending with the Coronavirus (COVID-19) Pandemic by Jana Pressley, Psy.D. & Joseph Spinazzola, Ph.D. The Foundation Trust (www.foundationtrust.org)

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Thank you!

For more information about The CTARI™ Institute please visit

www.ctari-institute.org or

email Inya Chehade @ ichehade@cge-nj.org

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