According to SAMHSA, “Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” Three components of this definition are important. First, the event can be a single or repeated occurrence and may include harm and, especially in the experience of children, neglect. Second, the experience refers to how the person experiences the event(s) and recognizes that individuals can experience the same event(s) differently. Third, the effects may occur immediately or be delayed (or both, as in the case of a current event retriggering past trauma), may be long- or short-term, and may not be recognized as connected to the original trauma.
Trauma comes from a variety of sources, including adverse childhood experiences, race-related or racial trauma, and secondary or vicarious trauma. There are other toxically stressful and traumatic experiences that can affect an individual: natural disasters, serious accidents, terrorist acts, and war and combat. Living in poverty and the constant state of deprivation is also a traumatic experience.
SAMHSA uses a four Rs rubric to describe a “traumainformed” organization, program, or system:
- Realize the widespread impact of trauma and understand potential paths for recovery;
- Recognize the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
- Respond by fully integrating knowledge about trauma into policies, procedures, and practices; and
- Actively resist re-traumatization.
SAMHSA also outlines six principles that trauma-informed organizations follow. They bear some similarity to job quality principles advanced by the National Fund:
- Safety
- Trustworthiness and transparency
- Peer support
- Collaboration and mutuality
- Empowerment, voice, and choice
- Cultural, historical, and gender inclusion
Childhood Trauma and the Brain
UK Trauma Council
How stress affects your brain
Madhumita Murgia
A concept related to trauma is toxic stress. Toxic stress is the experience of strong, frequent, and/or prolonged adversity without adequate support or resilience. Common reactions to toxic stress and trauma stem from our “fight, flight, or freeze” responses to stressful situations and can include anger, fear, anxiety, withdrawal, depression, numbness, memory loss, confusion, hypersensitivity to loud noises, and perhaps even violence toward others or oneself, among other reactions. Toxic Stress (harvard.edu)
Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. These effects can also be passed on to their own children. Some children may face further exposure to toxic stress from historical and ongoing traumas due to systemic racism or the impacts of poverty resulting from limited educational and economic opportunities. Fast Facts: Preventing Adverse Childhood Experiences |Violence Prevention|Injury Center|CDC
Adverse childhood experiences (ACEs) are “potentially traumatic events that occur in childhood (0-17 years old)” and include abuse, neglect, and household dysfunction that undermines a child’s sense of safety, stability, and bonding. Examples of ACEs include experiencing or witnessing violence in the home or community; having a family member attempt or die by suicide; growing up in a household with substance misuse, mental health problems, and instability due to parental separation or household members being in jail or prison. ACEs happen at the household, community, and environmental levels and also include things like natural disasters.
Some people are at greater risk of experiencing once or more ACEs than others. While all children are at risk of ACEs, numerous studies have shown inequities in such experiences linked to the historical, social, and economic environments in which some families live. ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work.
ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States.
Fast Facts: Preventing Adverse Childhood Experiences |Violence Prevention|Injury Center|CDC
People who work with traumatized clients can experience secondary of vicarious trauma. Sometimes called “compassion fatigue,” it is a set of observable reactions to working with people who have been traumatized and mirrors the symptoms of post-traumatic stress disorder. The symptoms of secondary trauma may include social isolation, anxiety, physical ailments, and trouble sleeping. Resource Guide to Trauma-Informed Human Services | The Administration for Children and Families (hhs.gov)
What is Trauma?
SAMHSA describes individual trauma as an event or circumstance resulting in:
- physical harm
- emotional harm
- and/or life-threatening harm
The event or circumstance has lasting adverse effects on the individual's:
- mental health
- physical health
- emotional health
- social well-being
- and/or spiritual well-being
Who is Affected by Trauma?
Trauma has no boundaries regarding age, gender, socioeconomic status, race, ethnicity, or sexual orientation. Trauma is a common experience for adults and children in American communities, and it is especially common in the lives of people with mental and substance use disorders. For this reason, the need to address trauma is increasingly seen as an important part of effective behavioral health care and an integral part of the healing and recovery process.
Effects of Trauma
The effects of traumatic events place a heavy burden on individuals, families, and communities. Although many people who experience a traumatic event will go on with their lives without lasting negative effects, others will have difficulties and experience traumatic stress reactions. How someone responds to a traumatic experience is personal. If there is a strong support system in place, little or no prior traumatic experiences, and if the individual has many resilient qualities, it may not affect his or her mental health.
Research has shown that traumatic experiences are associated with both behavioral health and chronic physical health conditions, especially those traumatic events that occur during childhood. Substance use, mental health conditions, and other risky behaviors have been linked with traumatic experiences. Because these behavioral health concerns can present challenges in relationships, careers, and other aspects of life, it is important to understand the nature and impact of trauma, and to explore healing.
Trauma and Violence - What is Trauma and the Effects? | SAMHSA