Trauma Informed Practice

What is trauma?

Trauma Informed Practice targets developing an understanding of the emotional psychological trauma people experience as they go through life as opposed to the physical trauma of injuries to the body.

Trauma tends to fall into one of three categories:

Acute Trauma which results from a single extreme and distressing event which threatens a persons physical and emotional safety and may include an accident, an assault, a natural disaster.

Chronic Trauma describes trauma which happens repeatedly such as in war and domestic abuse or child abuse.

Complex trauma describes the experience of multiple, long term, usually varied trauma as child abuse and domestic abuse where the person is exposed to a range of traumatic experiences usually perpetrated by a caregiver or partner and includes a sense of betrayal.

Which ever category of trauma is present the person who has been traumatised will find a reduction I their ability to cope.

What is trauma informed practice?

Trauma informed practice looks at how all human beings respond to threat in their environment and how organisations, managers, practitioners and service users can work together to identify and manage threat, empowering each other towards supportive independence.

From birth our brains start to develop neural pathways which determine our values, beliefs and expectations of the world and the people in it.

These pathways are unique to us and are created through our individual experiences.

Neural pathways are then used to interpret the world around us and the experiences and people we encounter as we go through life.

Threat can be an actual physical threat of injury or an emotional threat which triggers, sometimes unconscious, memories.

When our brain perceives a higher level of threat, it takes control of our actions and behaviour.
Have you ever walked away from a stressful event and thought to yourself “why can’t keep my mouth shut?” or conversely “why do I just shut down, why can’t I speak and put my point across?”

These responses may be your brain taking control and, at an unconscious level, based on previous experience, deciding the best course of action in the moment to keep you safe.

By being trauma informed Practitioners are able to understand the reasons threat impairs service users’ ability to engage and support them to overcome those barriers.

Our perception of threat is based in our memory of previous experience which establishes our perspective of the world. This perspective becomes our filter through which we interpret current events. Where high levels of threat are perceived, the primitive, reactive, unconscious brain cuts off access to our rational, thinking brain and takes control, deciding which course of action will keep us safe in the moment.

Our primitive brain, working in conjunction with our emotional memory, has a limited choice of responses which include:

  • Fight
    In fight mode the person will experience agitation and a quickening of their senses the automatic behavioural response is to attack, verbally or physically.
  • Flight
    In flight mode the person will experience the feeling of being trapped and the behavioural response is to get out.
  • Freeze
    In freeze mode the person will feel themselves shutting down, unable to engage
  • Flop
    In flop mode the body and mind become inaccessible. The brain protects the person from extreme threat by dissociation and, or fainting.
  • Friend
    In friend mode the person feels anxious and will attempt to appease a perceived threatening person by being overly helpful, supportive and may even degrade themselves in order to please the other.

These behavioural responses are universal and unconscious. The Window of Tolerance (first identified by Dr Dan Siegel – link in resources below) explains how people move from calm and engaged, able to function and achieve, to becoming overwhelmed and disengaged.

The Window of Tolerance falls into three sections with the middle section being the optimal. We feel calm, in control and able to fully function. When our perceived threat increases, we begin to move up towards the fight flight zone feeling ourselves getting more and more agitated, or, down towards the freeze flop zone feeling ourselves slipping away. Sometimes instantly and at others gradually our unconscious primitive brain takes over and we lose conscious control of our behaviour.

As practitioners, we need to be able to recognise where our service users are in their window of tolerance and help them to come back into the middle window before we can do any meaningful work.

There are many ways we can help people to come back to the window of tolerance and remain there, which are freely available online including:

  • Fight or flight – Breath exercises
  • Freeze – get them moving
  • Expanding and empowering the service user to remain in their window of tolerance – grounding techniques
  • By being aware of a service users threat response and helping them to return to their window of tolerance we can facilitate meaningful engagement and reduce disguised compliance
  • By explaining trauma responses to service users we can reduce shame and guilt and provide options which empower and motivation change.

Resources

Below are just a few of the potential support websites available. Please do find you own.

Breath exercises
10 Breathing Exercises to Try: For Stress, Training & Lung Capacity (healthline.com)
Breathing Exercises: The 10 Best Ones for Anxiety (verywellhealth.com)

Grounding
Grounding Exercises (therapistaid.com)

Window of tolerance
The Window of Tolerance – YouTube
Window of Tolerance Reimagined – YouTube

Useful Apps
https://www.headspace.com
https://www.calm.com

Worksheets and information
Survival In School PDF (fasdnetwork.org)
Flight, Fight or Freeze Emotional Response – Bing video