Trauma can affect anyone and comes in many forms. Approximately one out of eight adults has experienced four or more traumatic events, such as grief, exposure to violence, social isolation and sexual, physical and emotional abuse.

Unfortunately, immigrants, older adults, children of parents with substance use disorder, and people who live in challenging situations, such as those experiencing homelessness or poverty, are more likely to be exposed to repeat traumas.

How does trauma impact overall health?

Traumatic experiences can have a long-lasting impact on a person’s emotional and physical health. In 1998, the Adverse Childhood Experience (ACE) study (link to https://www.ncbi.nlm.nih.gov/pubmed/9635069 ) concluded that there is a direct link between health and trauma. The study identified several Adverse Childhood Experiences (ACEs)--such as abuse, neglect, violence at home, separation or divorce, and exposure to substance use-- to measure the effects of childhood trauma on adult health. The study discovered that the number of traumas a person was exposed to as a child was directly related to serious health issues in adulthood. The study also found that patients who experienced four or more traumas as a child were much more likely to have substance use issues and depression as adults.

People living with multiple ACEs could also be experiencing unhealthy levels of stress because their bodies are constantly in survival mode. Left untreated, high levels of stress can lead to any number of health issues, including diabetes, obesity, hypertension, anxiety disorders and chronic pain. Not only are instances of health issues higher for these individuals, they are often harder to treat because they may have adapted or changed their habits in order to live with their trauma.

“Many adults who have experienced repeat trauma are trying to get their needs met by whatever means necessary,” says Heather Barr, registered nurse and nursing supervisor for Neighborcare’s Housing and Street Outreach Programs . “A heroin user does not start off wanting to be addict; they [likely] started using because they were looking for feelings of love and comfort.”

Practicing trauma-informed care

Traumatic experiences can affect people’s ability to get the help they need, and it is important for health care providers to apply trauma-informed care in order to better serve patients. Trauma-informed care is focused on putting the person at ease. In health care, that could mean asking permission before touching the patient, asking the patient’s preference before performing an exam, and giving the patient choices about their care. It’s important to remember that anyone could react adversely to anything at any time.

“Memories can be fractured,” says Heather. “The patient may not remember what happened to them. Something as routine as drawing blood can re-traumatize the patient. When the patient experiences a trigger, they are suddenly right back in that traumatizing moment.”

Identifying people who have experienced trauma is not always easy; the first step is realizing that anyone could be living with trauma. In many cases, applying trauma-informed care can lead to the treatment of serious conditions that would have gone undiagnosed.

“Practicing trauma-informed care changed the way I approach working with patients,” says Heather. “By acknowledging that anyone could be living with trauma, I am able to ask myself why patients are behaving a certain way and can help them be more comfortable during treatment.”

Providers who integrate trauma-informed care into their practice:

  1. Realize the widespread impact of trauma and understand potential paths for recovery
  2. Recognize the signs and symptoms of trauma in clients, families, staff, and others
  3. Respond by integrating knowledge about trauma into their practice
  4. Seek to actively prevent re-traumatization.

Learn more

If you would like to learn more about trauma-informed care, here are some recommended online resources.