Trauma-Informed Care

According to SAMHSA, “trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically and emotionally harmful or threatening, and that has lasting adverse effects on the individual’s physical, social, emotional or spiritual wellbeing.” Trauma is not always physical or sexual violence. Trauma can come from feeling a loss of safety, perceiving threats around you or having a history of one or more adverse childhood events.

In our practice, we look at trauma as big-T Trauma and little-t trauma. Big-T Traumas are the traditional ones we think of when we hear “trauma”. Surviving sexual assault or physical abuse at any age, surviving war and experiencing robbery or some other crime are all examples of big-T Traumas. Big-T Traumas can result in PTSD and other disruptions in your emotional functioning and coping. Sometimes they are one time experiences, and other times, individuals have gone through multiple big-T Traumas.

But when people think of trauma, they don’t usually think of little-t traumas. Little-t traumas are generally less obvious. They occur every day, and many people are not negatively affected by them, long term. Some little-t traumas may include experiencing conflict with your partner or peers, divorce, work conflict, moving, financial struggles or legal issues. Generally, when we see a pile up of little-t traumas in someone’s life, they can produce a big-T Trauma reaction. This is why, in our office, we assume every person who sits on our couch has gone through something difficult in their lives.

Trauma often leads to us feeling unsafe in our life. It may be feeling unsafe in certain situations (such as being alone, or being in a specific place), feeling unsafe in our bodies, or feeling unsafe in our everyday life. Feeling unsafe then often leads to us feeling hopeless with low self-esteem and a lack of trust in the people around us. From there, we act out in many different ways. Some examples include violent fits of anger, substance use and self-harm.

On a neurological level, we call this flipping our lid. In a normal state, your executive brain is fully functioning. This part of our brain allows us to be reasonable, logical and rational. In a traumatized state, our executive functions go offline. Our brain associates the current triggering event to the traumatic event and brings up all of the emotions associated with the trauma. It then connects those emotions to our survival instincts – fight, flight or freeze. If our executive functions were working, they’d tell us that this situation is different from the trauma we experienced, and that we don’t need to go into survival mode. But we flipped our lid – our executive functions are inaccessible in the moment, and we begin reacting on pure emotion and instinct.

At Transcend Therapy, we understand this biological response and don’t judge you for it. Instead, through our trauma informed care approach, we focus first on promoting safety within our office and helping you identify where you feel safe outside of the office. We focus on your strengths. You’ve gotten through some challenging life events, and you’re still here to tell the tale. How did you do it? We will collaborate with you to find strategies for management that are most effective for you. And, if you are open to it, we may suggest EMDR treatment as a way of reprocessing the trauma so that your triggers are largely deactivated. We want to promote healing in your life, rather than behavior modification.

At Transcend Therapy, we assess for trauma before we establish a clear diagnosis and we allow our trauma knowledge to guide treatment. Trauma reactions often mimic other disorders and it’s very easy to establish several different diagnoses, when the heart of the issue is really in trauma. We also view you as a whole person, rather than a diagnosis. Our trauma-informed providers understand adaptive coping and we know that behaviors are frequently used because they’ve worked in the past – it may be the only way you know how to get your needs met. We focus on harm reduction and we help you learn new, healthier coping skills to get through the difficult moments. We also view you as an active participant in your treatment and want to collaborate with you to make sure your treatment is effective. We are open to feedback if something isn’t working for you; we can always try something new!

In contrast, providers who lack a basic education on trauma will often fail to understand how trauma may impact your life and they may actually re-traumatize you through blaming and shaming, in the name of accountability and following the “rules” of treatment. These providers typically over diagnose, which leads to frequently unhelpful treatment. Providers who are not trauma informed also tend to use labeling language because they may see the various trauma-related behaviors as intentionally provocative. They may define you by your diagnosis (calling you bipolar, rather than a person struggling with bipolar, for example), or assert that you are manipulative, needy or attention-seeking.

We believe that you deserve a therapist who will approach your treatment without judgment and will partner with you, rather than direct you. We believe you deserve treatment that is tailored to your specific needs and experiences. If you agree, get in touch with us today and start your personal journey to self discovery.