What Happened to You?

1. Trauma shapes our brain and behaviors from early childhood

"We learn that a connection with another person can be rewarding and regulating. It pulls us to engage with our teachers, coaches, classmates."

Early experiences shape us. The brain develops sequentially from the bottom up, with early experiences having a disproportionate impact on our core regulatory networks. Trauma, neglect, or inconsistent caregiving can lead to an overactive stress response system, affecting behavior, learning, and relationships throughout life.

Adaptive responses can become maladaptive. What helps a child survive in a chaotic or threatening environment often becomes problematic in other settings. For example, hypervigilance that kept a child safe at home may be misdiagnosed as ADHD in school. Understanding the impact of early experiences is crucial for proper diagnosis and treatment.

Key brain areas affected by early trauma:

• Brainstem: Regulates basic functions like heart rate and breathing
• Limbic system: Processes emotions and memories
• Cortex: Responsible for higher-level thinking and decision-making

2. Understanding "what happened to you" is crucial for healing

"We can help each other heal, but often assumptions about resilience and grit blind us to the healing that leads us down the painful path to wisdom."

Shifting perspective transforms treatment. Instead of asking "What's wrong with you?", focusing on "What happened to you?" allows for a more compassionate and effective approach to addressing trauma-related behaviors and symptoms. This shift in perspective honors the power of past experiences in shaping current functioning.

Trauma-informed care requires awareness. Recognizing the prevalence and impact of trauma is essential for creating systems that support healing rather than retraumatizing individuals. This applies to various fields, including:

• Education
• Healthcare
• Criminal justice
• Social services

3. Developmental adversity impacts stress response systems

"When we are pushed out of equilibrium—out of balance—we have a set of stress-response systems that will be activated to help us."

Stress patterns shape our responses. The pattern of stress activation during development can lead to either resilience or sensitization of the stress response system. Predictable, moderate stress builds resilience, while unpredictable, extreme, or prolonged stress can lead to an overactive and overly reactive system.

Understanding state-dependent functioning is key. Our ability to think, feel, and behave is influenced by our current state of arousal. As we move from calm to fear, different parts of the brain dominate our functioning:

• Calm: Access to higher-level thinking (cortex)
• Alert: Focused attention
• Alarm: Emotional thinking begins to dominate
• Fear: Reactive, survival-oriented thinking

4. Relationships and connectedness are key to resilience and healing

"Connectedness has the power to counterbalance adversity."

Healthy relationships buffer trauma. Strong connections to family, community, and culture can mitigate the effects of adversity and trauma. The quality and quantity of positive relationships in a person's life are often more predictive of mental health outcomes than their history of adversity.

Healing happens in community. Traditional healing practices across cultures emphasize reconnection and belonging. Modern therapeutic approaches should incorporate:

• Building a "therapeutic web" of positive relationships
• Providing opportunities for brief, controlled revisiting of traumatic memories
• Engaging in rhythmic, regulating activities (e.g., dance, music, sports)
• Fostering a sense of belonging and cultural connection

5. Dissociation is both a coping mechanism and potential disorder

"Dissociation as a coping mechanism will happen more commonly when the individual feels that a threatening situation is inescapable."

Dissociation serves a protective function. When faced with inescapable threat or distress, the brain's dissociative response helps individuals psychologically flee to their inner world. This can manifest as:

• Emotional numbing
• Feeling disconnected from one's body
• Altered sense of time or reality

Overuse can lead to problems. While dissociation can be adaptive in the moment, chronic use as a primary coping strategy can lead to difficulties in relationships, work, and daily functioning. A sensitized dissociative response may result in:

• Difficulty staying present in challenging situations
• Struggles with intimacy and connection
• Engagement in self-harming behaviors as a form of regulation

6. Implicit bias and systemic racism are forms of collective trauma

"I believe that a truly trauma-informed system is an anti-racist system."

Early experiences shape our worldview. Our brain creates associations based on our earliest interactions and experiences. These unconscious biases can persist even when they conflict with our conscious beliefs and values.

Systemic racism perpetuates trauma. Marginalization and oppression create ongoing, uncontrollable stress that sensitizes stress-response systems. This affects individuals and communities across generations, leading to:

• Disproportionate rates of mental and physical health problems
• Overrepresentation in child welfare, special education, and criminal justice systems
• Persistent economic and social disparities

Addressing implicit bias and systemic racism requires:

• Recognizing our own biases
• Creating diverse, inclusive environments
• Implementing trauma-informed, anti-racist policies and practices

7. Modern society creates relational poverty and sensory overload

"Our current challenge is that the rate of invention is now exceeding the rate at which we can problem-solve."

Human brains are not designed for modern life. Our neural systems evolved for smaller social groups and natural environments. The constant bombardment of stimuli in urban settings and through technology taxes our stress-response systems.

Relational poverty is widespread. Modern life provides fewer opportunities for deep, meaningful connections. This relational impoverishment contributes to:

• Increased rates of anxiety and depression
• Decreased empathy and social skills
• Reduced resilience in the face of adversity

To combat these issues:

• Create "techno-hygiene" practices to limit screen time and promote face-to-face interactions
• Prioritize community-building and intergenerational connections
• Design environments that support human connection and regulate sensory input

8. Post-traumatic wisdom emerges from healing and growth

"It is impossible to be truly wise without some real-life hardship."

Trauma can lead to growth. While traumatic experiences are painful, the process of healing and integrating these experiences can lead to profound personal growth and wisdom. This "post-traumatic wisdom" often includes:

• Increased empathy and compassion
• Greater appreciation for life and relationships
• Enhanced ability to navigate challenges

Resilience is built, not innate. Rather than being an inherent trait, resilience is developed through:

• Exposure to manageable challenges
• Supportive relationships
• Opportunities to practice coping skills

Fostering post-traumatic wisdom involves:

• Creating safe spaces to process and make meaning of traumatic experiences
• Encouraging connection and mutual support among survivors
• Recognizing and celebrating growth and resilience

9. Trauma-informed care requires systemic change and empathy

"Empathy is the ability to put yourself in somebody else's shoes—both in an emotional sense, to feel a bit of what they may feel, but also in a cognitive sense, to see the situation from their perspective."

Systemic change is necessary. Truly addressing trauma requires transformation across multiple systems, including:

• Education: Implementing trauma-sensitive practices in schools
• Healthcare: Integrating understanding of trauma into medical and mental health care
• Justice system: Shifting from punitive to rehabilitative approaches
• Social services: Focusing on prevention and early intervention

Empathy is the foundation. Developing trauma-informed systems requires cultivating empathy at all levels. This involves:

• Training professionals to recognize and respond to trauma
• Creating policies that prioritize healing and connection
• Fostering environments that promote safety, trust, and collaboration

Key principles of trauma-informed care:

1. Safety
2. Trustworthiness and transparency
3. Peer support
4. Collaboration and mutuality
5. Empowerment, voice, and choice
6. Cultural, historical, and gender issues

Last updated: August 8, 2024