TRAUMA is the direct, personal experience of harm (or threatened harm) to self or others.
TRAUMA is a major disrupter of BRAIN-BODY REGULATION.
If severe, repeated or prolonged, TRAUMA can result in major neurobiological changes and dysfunction, including Physical Disease, Emotional Suffering or premature death.
Although the many types of TRAUMA are somewhat distinct, all forms of TRAUMA are intertwined – and synergistic (the impact on the BRAIN-BODY is cumulative).
ADVERSITY is a serious or continued difficulty or misfortune, including personal or structural TRAUMA.
The relationship of TRAUMA in childhood to the occurrence of illness or suffering later in life has been recognized throughout human history.
In 1998, a landmark epidemiologic study (“The ACE’s Study”) was published jointly by the US CDC and Kaiser Permanente.
This very large study documented a DOSE-RESPONSE relationship between 10 types of childhood adversity and later illness or life difficulties.
The ACEs Study has been replicated in over 100 subsequent research studies.
Over time, the recognized types of adversity have been expanded to include STRUCTURAL and HISTORICAL TRAUMA and challenges such as poverty, food scarcity, homelessness and more.
US Center for Disease Control (CDC) Office of Violence Prevention online resource library about ACEs: Fast Facts, Statistics, Prevention Strategies,
Felitti VJ, Anda RF, et.al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Deaths in Adults. 1998. American Journal of Preventive Medicine.
ACES CONNECTION. An online community of professionals, activists, and journalists active in providing information about trauma-informed, resilience-building practices. Daily digest of news, research, and events.
DISSOCIATION is a mental process of disconnecting from one’s thoughts, feelings, memories or sense of identity.
Previously seen as a sign of mental illness, DISSOCIATION is now understood as a normal and universal part of the STRESS RESPONSE.
DISSOCIATION can be as simple as “spacing out” when tired, bored or overwhelmed – or can include DEPERSONALIZATION (feeling odd changes of one’s experience of self – feeling detached or disconnected from one’s body) or DEREALIZATION (when the world feels unreal or distant).
Lanius R, Vermetten E, Pain C. The Impact of Early Life Trauma on Health and Disease. Cambridge Press, 2010.
HISTORICAL TRAUMA is the cumulative emotional and psychological wounding, resulting from group-community traumatic experiences, transmitted across generations within a community. Examples of HISTORICAL TRAUMA include slavery, forced displacement from home, discimination based on race, ethnicity, religion, gender and more, and forcing children to leave home to be schooled at a government or religious school of the dominant culture. Other examples include war and genocide.
STRUCTURAL TRAUMA is emotional and psychological damage from inequity enforced through public policies, institutional practices, cultural images and behaviors which are built into the structure of the culture and which reinforce social inequity. Examples include discrimination in economic opportunity, employment, education, housing, healthcare, and the right to marry.
INTERGENERATIONAL TRAUMA is trauma passed unintentionally from one generation to the next. One example is a parent who grew up without secure attachment to their parents – then having difficulty providing attachment and attunement to their own child.
Many traits that were thought to be “genetic” because they were found to “run in families,” are now recognized to be the result of INTERGENERATIONAL TRAUMA.
SECONDARY TRAUMA is the emotional stress that results when an individual hears about or witnesses traumatic experiences of another.
First Responders and healthcare providers have high exposure to the traumatic experiences of others and are at risk of SECONDARY TRAUMA.
One responsibility of healthcare organizations, public service agencies, police-fire departments and more – is to recognize that SECONDARY TRAUMA is real and a genuine risk – and to help minimize staff risk by providing regular mechanisms to help front line providers debrief from witnessing others’ trauma and to support provider self-regulation.
Through training and self-awareness, we can take steps to:
– minimize SECONDARY TRAUMA
– become aware of our own personal trauma
– prevent BURNOUT while working on our own health
- National Child Traumatic Stress Network.
- TED: Beyond the Cliff by Laura van Dernoot Lipsky. A funny and profound first person narrative of cumulative trauma and resilience.