Important Thread: What is Trauma-informed Care and Practice? What is Blue Knot’s vision for a trauma-informed world? Want to become trauma-informed? 1/28 #March4Justice #EnoughIsEnough
“Trauma-Informed Practice is a strengths-based framework grounded in an understanding of and responsiveness to the impact of trauma, that emphasises physical, psychological, and emotional safety for everyone, and that creates opportunities 2/28
for survivors to rebuild a sense of control and empowerment (Hopper et al., 2010). Trauma-informed care and practice recognises the prevalence of trauma and its impact on the emotional, psychological and social wellbeing of people and communities. 3/28
Awareness of trauma, including of complex trauma has progressed over the last 20 years. This includes the development of the framework called “Trauma-informed care and practice”. 4/28
This framework is informed by new knowledge around attachment, development, working with the body, memory and an understanding of self. 5/28
Frameworks of care and treatment are changing from purely bio-medical (medicine and psychiatry) and/or purely psychoanalytical (psychology) to include the psycho-social (trauma-informed) and a recovery focus (recovery-oriented). 6/28
What is Blue Knot’s vision for a trauma-informed world? Trauma affects us all, directly or indirectly. Many people live with the ongoing effects of past and present overwhelming stress (trauma). 7/28
Despite the large numbers of people affected, many of us often don’t think of the possibility that someone we meet, speak with or support may have experienced trauma. This makes us less likely to recognise it. 8/28
Keeping the possibility of trauma on our radar means keeping the sensitivities and vulnerabilities of people who may be trauma survivors in mind. It means being respectful, acknowledging and understanding. 9/28
Having a basic understanding of how stress can affect any of us can help this process. Knowing this will make us less likely to fuel other people’s stress levels. This means paying attention to the way we engage with other people, as well as to ‘what’ we do. 10/28
It also means thinking about what may have happened to someone, rather than judging what is ‘wrong’ with them. Our interactions with one another are always important. They are especially important for people living with the impacts of trauma. 11/28
Trauma interrupts the connections between different systems of functioning in the brain. People recover from trauma when disruptions between different levels of functioning – physical, emotional and cognitive (thinking) – become connected or ‘integrated’ again. 12/28
It is important to understand that: Positive experiences in our relationships can help us heal. Negative experiences make our emotional and psychological problems worse. We should not underestimate the capacity of positive interactions to be soothing and validating. 13/28
This applies to all of us, and especially to people with trauma histories. Support is crucial to the process of recovery. Positive experiences of relationships are central to trauma recovery. They are also important to general well-being. 14/28
By employing trauma-informed principles, we can build a ‘trauma-informed’ society. This create possibilities for psychological and physical healing on a grand scale. 15/28
What are trauma-informed services? Trauma often affects the way people approach potentially helpful relationships (Fallot and Harris, 2001). This is because many survivors feel unsafe. Many lack trust or live in fear. 16/28
Becoming trauma-informed is about supporting people to feel safe enough in their interactions with services. To build trust, and help people overcome their fear and sense of betrayal. Becoming trauma-informed is not an end state, but a process. 17/28
It requires a step-wise implementation and review over time. The journey to becoming a trauma-informed service has been conceptualised into 4 sages (Miesler and Myers, 2013): Trauma aware: Staff understand trauma, its effects and survivor adaptations. 18/28
Trauma sensitive: The workplace can operationalise some concepts of a trauma-informed approach. Trauma responsive: Individuals and the organisation recognise and respond to trauma enabling changes in behaviour and strengthening resilience and protective factors. 19/28
Trauma-informed: The culture of the whole system, including all work practices and settings reflects a trauma-informed approach.
Trauma-informed services:`are informed about, and sensitive to, trauma-related issues’ (Jennings, 2004); 20/28
are attuned to the possibility of trauma in lives; commit to and act on the core principles of safety, trustworthiness, choice, collaboration and empowerment (Fallot and Harris, 2001); have reconsidered and evaluated all elements in light of the role and impacts of trauma; 21/28
apply this understanding to design systems which accommodate the vulnerabilities of trauma survivors, and enable services which minimise the risk of re-traumatisation; emphasise physical and emotional safety for all – clients, practitioners and service providers; 22/28
recognise symptoms as adapative rather than pathological; collaborate with clients, and affirm their strengths and resources; recognise the importance of respect, information, hope and possibilities for connection. 23/28
A key feature of trauma-informed practice is the way in which a service is offered - i.e. the whole context - not just `what’ it entails. As healing from interpersonal trauma occurs in relationship, the wider relational context in which healing takes place is critical. 24/28
Want to become trauma-informed? Becoming `trauma-informed’ does not require clinical training or specialist skills. It requires basic knowledge only. When put into practice, this reduces the likelihood of stressful interactions and helps reduce the effects of prior traumas. 25/28
Relating to one another in a trauma-informed way ‘does no harm’ and focusses on the way in which we treat one another as human beings. 26/28
To access the trauma-informed guidelines in Blue Knot Foundation’s publication: Practice Guidelines for Treatment of Complex Trauma and Trauma Informed Care and Service Delivery click here: blueknot.org.au/resources/publ… 27/28
Source: National Centre of Excellence for Complex Trauma (2021). 28/28

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More from @drlouisehansen

18 Mar
How to Prevent Trauma from Becoming PTSD: “The good news is that the intensity of emotional pain always reduces with time. This is not just a trite sentiment, as there are neurological studies that have found the ways the brain works to heal emotional wounds. 1/19 #March4Justice
The brain is geared for survival and is always looking for new threats and information, which means old experiences eventually route to the back of the line to direct your attentional resources to what is new and potentially important. 2/19
My clients often respond to this concept by stating: “This can't be true, because I have been in the same emotional pain for so long, and my traumatic event was years and years ago.”  3/19
Read 19 tweets
18 Mar
“A new type of survivor guilt: The term survivor guilt is usually used to describe emotional distress some people feel after surviving a traumatic event in which others have died, such as a natural disaster or terrorist attack.
It has been identified in military veterans, 1/14
those who survived the Holocaust, 9/11 survivors, and emergency first responders. COVID-19 has certainly been a traumatic experience and has had a profound impact on mental health. Around 1,000 people have died by suicide in Australia since it began and 2/14
modelling from the University of Sydney found suicide deaths could rise by 25% annually for the next five years. During COVID-19 we have witnessed the conventional type of survivor guilt associated with surviving the coronavirus when hundreds of thousands haven’t. 3/14
Read 14 tweets
18 Mar
Disoriented-Disorganized Attachment Pattern and Increased Risk of Further Traumatization (Part 2/2): “Established insecure attachment patterns are empirically associated with a higher rate of traumatic events and subsequent trauma. 1/23
Further trauma has a disastrous impact on affective and socio-cognitive development. Sexual or aggressive exposures of abuse by a parent, for example, are particularly devastating if they are based on a previous relational context of emotional neglect. 2/23
They may promote “identification with the aggressor” and, as a result, may create intrapsychic relational representations of “perpetrators and victims” in rapid reversals. However, this dominant pattern is based on a massive obstruction of general mentalization functions. 3/23
Read 23 tweets
18 Mar
Psychobiology of Attachment and Trauma—Some General Remarks From a Clinical Perspective (Part 1/2): “Early representatives of psychoanalysis argued that the roots of human social motivation are primarily physical and sensory (hunger, sexuality) 1/31
and that satisfaction and/or frustration of these needs lead to the infant’s initial approach to the mother. John Bowlby (1907–1990) strongly opposed this theoretical approach. Based on numerous empirical observations he developed a different theory: 2/31
the infant’s hunger for its mother’s love and presence is as great as its hunger for food. Attachment is therefore a “primary motivational system” with its own workings. Rene Spitz had made similar empirical observations with orphaned children some years earlier. 3/31
Read 32 tweets
17 Mar
How to use ‘The Hand Model of the Brain’ to Explain our Reaction to Stress: Dr. Daniel Siegel’s hand model of the brain helps children imagine what’s happening inside their brain when they get upset so that they can identify and deal with the emotions more effectively. 1/10
First, let’s see what the hand model of the brain looks like: As its name suggests, you need to use your hand for this. Your wrist is the spinal cord upon which the brain sits, your palm is the inner brainstem, and your thumb is your amygdala (or guard dog). 2/10
If you place your thumb in the palm, you’ll form the limbic system. Your other fingers are your cerebral cortex, and the tips of your fingers are your prefrontal cortex (or wise owl). 3/10
Read 10 tweets
17 Mar
Don’t ostracise drugs users – empathise with them: Dr Gabor Maté was recently awarded the Order of Canada for his work on trauma and addiction. The following is adapted from his book ‘In the Realm of Hungry Ghosts: Close Encounters with Addiction’: 1/37 #March4Justice
“From Abraham to the Aztecs, ancient cultures exacted human sacrifices to appease the gods – that is, to soothe their own anxieties and to placate false beliefs. Today, we have our own version of this, as evidenced by the overdose crisis sweeping North America. 2/37
These lost lives are offered up, we might say, for the appeasement of our own false beliefs and denial. Addicted people are victimised by our society’s disinclination to come to terms with the root sources, psychology and neurobiology of addiction, 3/37
Read 37 tweets

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