Trauma-Informed Culture

Jonathan T. Jefferson

            Trauma-informed cultures are cognizant of the fact that their clients have been traumatized and will present with a host of issues that they seek to relieve without further negative impacts.  It is important to ascertain the scope of an individual’s adverse childhood experiences prior to attempting to treat them.  Areas of concern are broad and include historical trauma, toxic stress, resilience, executive functioning, and compassion fatigue (experienced by employees).

            The Black Lives Matter awareness efforts can be attributed to historical trauma.  This form of trauma spans generations and pertains to certain cultural, racial, and ethnic populations.  African Americans experienced centuries of slavery, Jim Crow era segregation, and current high rates of incarceration.  Native Americans (Trail of Tears), Jews (Holocaust), Japanese Americans (internment), and many other groups may present with symptoms of historical trauma.  “...historical trauma often involves the additional challenge of a damaged cultural identity.” (Sotero, 2006). 

            A trauma-informed culture would cultivate positive relationships, be non-judgmental, and demonstrate understanding of the negative impacts trauma has had on marginalized groups of people within society.  Focusing on a group’s fortitude and resilience can be an avenue toward healing.  Making supportive connections with key members within local minority communities (e.g. church leaders & elected officials) would be essential to addressing historical trauma.

            Toxic stress is lengthy in time, intense, or persistently recurrent, and detrimental to overall wellness.  “Toxic stress can increase health risks including heart disease, mental illnesses such as depression and anxiety disorders, substance misuse, and has long-lasting negative consequences for cognitive functioning, behavioral health, immune functioning, and physical health.” (Hamoudi, et. al, 2015).  This was evident in my late maternal grandmother who lived through The Great Depression.  Upon her passing, my family found stockpiles of canned foods stored in her apartment.  This was likely the result of an anxiety disorder triggered by experiencing long periods of hunger. 

            Health and human services organizations that are trauma-informed can disrupt patterns of toxic stress by relieving financial burdens on families and individuals, creating safe havens, and referring clients to relevant health care providers.  Removing barriers to services (e.g. cost, location, &/or transportation), and making connections with clinical mental health sources when warranted would also be evident.  Having these supports in place is necessary to avoiding retraumatization.

            “Resilience is the ability of individuals to not succumb to adverse experiences and is the typical response to adversity.” (Southwick, Bonanno, Masten, et. al, 2014).  “Resilient people have a good sense of themselves and their abilities and have the life skills to feel competent as individuals.” (Ginsburg, 2014).  “They often have strong connections to other people in their families, communities, or schools, as well as a solid understanding of right and wrong and a sense of integrity.” (Ginsburg, 2014).

            When I think of resilient people, I think of World War II veterans who experienced

unimaginable human atrocities yet managed to live long fruitful lives.  Nelson Mandela also comes to mind.  After twenty-seven years in prison, he went on to become South Africa’s first black president and lived to the age of ninety-five.  A trauma-informed culture would implement programs for youth that build social connectedness, emotional mastery, self-confidence, and self-control.

            No trauma-informed culture can succeed without having programs in place to account for the executive functions and self regulation of individuals.  Executive functions refer to brain development affecting abilities such as critical thinking, problem solving, planning, decision making, and completing tasks.  This is an extensive and critical topic that can easily encompass an essay of its own.  “Children who have experienced prolonged or pronounced stress and adversity, including poverty and trauma experiences, may struggle more than other children do to regulate their thoughts, feelings, and behaviors.” (Zelazo, et. al, 2016).  Strategies to improve working memory, along with meditation and yoga, to improve concentration are among the processes that have proven successful at improving executive functions.

            As important, a trauma-informed culture would be attentive to secondary traumatic stress/compassion fatigue.  Secondary traumatic stress disorder is a normal, but hazardous, result that can come from working with traumatized individuals.  The symptoms of this fatigue are many and impact the cognitive, emotional, behavioral, and physical domains. 

            Trauma-informed cultures openly discuss the impacts that working with traumatized clients can have on employees.  Employees should be encouraged and supported to engage in personal wellness activities (nature walks, nutritional counseling, mindfulness practices, painting, photography, etc.).  An anonymous and free employee assistance program should be available, and employers must informally and regularly check in on staff.

References

• Ginsburg, Kevin R. (2014). Building Resilience in Children and Teens: Giving Kids Roots and Wings (3rd edition).  American Academy of Pediatrics.
• Hamoudi, Amar, Murray, Desiree, W., Sorensen, L., & Fontaine, A. (2015).  Self-Regulation and Toxic Stress: A Review of Ecological, Biological, and Developmental Studies of Self-Regulation and Stress.  OPRE Report # 2015-30, Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.
• Sotero, MM (2006). A Conceptual Model of Historical Trauma: Implications for Public Health, Practice and Research.  Journal of Health Disparities Research and Practice (1)1:93-108.
• Southwick, SM, Bonanno, GA, Masten, AS, et. al (2014). Resilience definitions, theory and challenges: Interdisciplinary perspectives.  European Journal of Psychotraumatology, 5:25338.
• Zelazo et. al (2016). Executive Function: Implications for Education (http://ies.ed.gov/ncer/pubs/20172000/).