What is Trauma informed care? This is something I hear quite a bit about, but until recently really didn't have a handle on what it is. Trauma informed care is about having an understanding of how trauma impacts the life of an individual who is seeking services whether they be in the mental health sector or not. Traditional approaches for delivering services may actually exasperate survivors vulnerabilities and or triggers, effectively retraumatising the survivor.
From the ASCA website:
At the core of this agenda is the need for awareness and responsiveness
to trauma across service systems. Adult survivors of child abuse carry a
number of diagnoses and present to an array of services. Yet their
trauma is often not asked about, identified or addressed. Adult
survivors often experience complex trauma - trauma which is
interpersonal, often extreme and repeated, and perpetrated during a
child's developmental years. Complex trauma needs to be differentiated
from single incident trauma or a one-off event. It is crucial for all
service systems and practitioners to be educated around trauma in
general and complex trauma in particular and for systems to be alert to
the sensitivities, vulnerabilities and coping strategies survivors
Also in line with this is the understanding that many trauma survivors, are not ill. We do not have a sickness, we are merely displaying the affects of trauma. We don't necessarily need a pill to treat us, but we do need understanding and education.
As you have heard me say previously, DID is not an illness. It is not like Schizophrenia, or bipolar, it is not a medical condition where part of the body is not working correctly. DID is the normal response, in a normal person, to very abnormal situation (trauma). In fact if we were not normal we would not have developed DID to cope with what we were going through.
There are of course secondary conditions that often accompany DID. The most common is Post Traumatic Stress Disorder. (PTSD) Approximately 80% of survivors with DID also have PTSD. Again this is a stress and trauma condition and not an illness. Depression and Anxiety are also very common amongst trauma survivors. These conditions can at times require medication to assist the survivor in day to day living, but good therapy and education on copping techniques can make a dramatic difference.
Then there are many physical conditions that can develop due to the extra stresses on the body, i.e. high blood pressure, fibromyalga, chronic fatigue, diabetes etc. When the human body lives in a constant state of allertness or being 'on edge', it releases our fight or flight chemicals by the brain. These are great for short bursts, but the body is not designed to have them there all the time. This puts the body through immense stress and over time it takes its toll. Many survivors use drugs or alcohol to numb this feeling, but that too is only stressing an already overworked nervous system.
In dealing with all these things it is vital that the survivors needs, as a whole, be taken into account. Denying the trauma in treatment of any of these conditions can be very dangerous, and retraumatising. We as survivors need to do our best to communicate our needs and concerns to all of our health care professionals, and in return their knowledge and understanding should be there to support and help us.
First do no harm.