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Trauma isn't everything you think it is.

When you think of trauma what do you think of? Most likely your first reaction is physical abuse, being in an accident, sexual abuse, being a war veteran or first responder. Maybe you also think of repeated bullying as a child and/or discrimination. However, what is traumatic to one person may or may not be traumatic for another. The way that trauma affects the brain is complex, and is not the same for everyone. There are many factors at play here, including the amount of protective factors an individual has -- which include the environment, support system and strengths. A child who is physically abused by a parent whom is not lacking resources such as food, clothing, adequate schooling, will very likely have a different experience than a child who is physically abused but is in a home full of standard resources and a positive school experience. The brain in these two children will develop differently over time and while both children have experienced trauma, you will likely see them have different ways of coping, different symptoms and different life outcomes all together.

There are many different kinds of trauma. Some traumas are historical in context -- and while may not affect an individual on a concrete level, it can still be a part of their lives and have consequences that need to be considered in treatment. For example -- this is also known as generational trauma -- and it refers to events that affect an entire culture. Slavery, forced assimilation and relocation of American Indians, the Holocaust are all examples of historical trauma. Tons of research has been done on the effects of generational trauma on cultures. This is EXTREMELY important when you are looking to be trauma informed -- because even though even though a Jewish person living in the USA Today may not be a Holocaust survivor himself -- he still has effects from the historical trauma on his culture today. Assimilation, for example of the American Indians has shown loss of cultural identity - which can have a significant impact on well being and lead to higher risks of other traumas in their lifetimes.

Mass traumas are also known as disasters that affect large numbers of people such as earthquakes, tornadoes, nuclear bombs, and unfortunately the increased number of mass shootings that are more prevalent in the United States of America specifically. These mass traumas not only effect the victims themselves but also the first responders, friends and neighbors. It can also frequently lead to multiple other traumas within the same population. Often times those who have been in a mass trauma have an initial outpouring of support but then as the shock calms, survivors often struggle with re-establishing their lives. You see common trauma symptoms in veterans and other first responders when returning back to "normal" life. War survivors and refugees are also groups that need to be understood when it comes to the effects of the traumas they have faced including discrimination, separation, fear for life, survival, witnessing death, starvation and torture.

Interpersonal traumas are events that occur within family members or close friends and include domestic abuse, sexual abuse, physical abuse, sexual assault, and elder abuse. Substance abuse is more prevalent when interpersonal trauma is present; but it is very important to focus on the underlying issues and problems rather than amount of drugs/alcohol consumed.

Developmental traumas include specific events within a specific developmental stage that affect later in life. These are often referred to as ACEs (adverse childhood experiences) but can also result from tragedies that occur later in life such as a life threatening illness. ACEs themselves include sexual, physical and emotional abuse; as well as a substance abusing parent, an incarcerated, mentally ill, or suicidal household member; spousal abuse between parents; and divorce that meant that one parent was absent during childhood. Studies show that multiple ACEs increase an individual's risk to developing both physical and mental health issues throughout their lifetime and should always be addressed, and not ignored.

Child neglect is when a child's need(s) are not met completely. The child may be asked to be the "parent" of a younger sibling while too young. They may be a caregiver for a parent. They may not have adequate schooling, clothing, food, shelter, medical or mental health treatment. It can also mean exposing a child to an abusive relationship or substance dependence. Childhood abuse and /or neglect is highly associated with major depression, suicide, PTSD and dissociative symptoms.

This is just a brief review of some groups and types of trauma that are important to recognize but there is SO much more out there. Bullying in school, on social media, in the work place are also types of trauma. Discrimination for sexual identity or gender is also a huge source of trauma that can be grouped within historical, developmental, interpersonal or group context.

As hard as this is to talk about, trauma does NOT mean an end. There is a way to heal. Proper treatment. Empathy. Listen with intent to understand. Please reach out and find a licensed therapist whom you can speak to if you or someone you know is struggling with symptoms of any kind of trauma. Remember, just because you don't remember all the details -- doesn't mean it doesn't matter.

Source: Substance Abuse and Mental Health Services Administration. Trauma Informed Care in Behavioral Health Services. Treatment Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance abuse and Mental Health Services Administration, 2014.

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