About the author: Angela Tonsoline is a Psychology Associate at the Human Services Center. Angela earned her PhD in Psychology from the University at Buffalo.

June is Post Traumatic Stress Injury (PTSI) Awareness Month (also known as Post Traumatic Stress Disorder (PTSD) Awareness Month). According to the National Council for Mental Wellbeing, 70% of people in the United States have experienced a traumatic event. In addition, 3.6% have a diagnosis of PTSD in the past year based on diagnostic data from the National Comorbidity Survey Replication (NCS-R).

What is trauma?

Trauma is defined as an “event or circumstance resulting in physical harm, emotional harm, and/or life-threatening harm.” (Substance Abuse and Mental Health Services Administration, 2022). This can range from a single traumatic event to a series of repeated events over time. Nobody is immune from facing trauma, as it can be experienced many different ways and can be experienced by anyone regardless of race, gender, age, etc.

What are some impacts of trauma?

Trauma can negatively impact the whole person. Some of these develop as a way for the body to protect itself to help a person survive and manage from day to day. These negative impacts can include:

•  Relationships and relationship building abilities: Making it difficult to trust others and make connections;
• Thinking, Biology & the Brain: Repetitive trauma can change the brain, including brain areas responsible for attention, problem solving, learning, long-term memory, emotions, survival, sleep, and body functions. It can also leave someone in an almost-constant state of fear and panic, even if the threat is no longer present;
• Behavior: Trauma can alter someone’s behavior including increased levels of impulsivity, increased aggression/fighting, agitation, restlessness, dissociation (the “thinking” brain turns off and can look like someone is “spacing out” or dazed), and can lead to unhealthy coping strategies in an attempt to deal with the resulting pain of the traumatic experience(s);
• Emotions: Trauma can lead to stronger emotional reactions in situations, difficulty controlling ups and downs in mood, helplessness, hopelessness, and despair;
• Self-esteem: Trauma can cause individuals to experience increased negative feelings about the self, lower self-esteem, shame, guilt, and feelings of rejection;
• Physical Health: Because trauma can impact the whole body, it can lead increased health risks including lung & heart disease, liver problems, hepatitis, cancer, diabetes, strokes, weight gain, and memory difficulties;
• Mental and Emotion Health: Beyond physical health, traumatic experiences also impact mental health including PTSI, depression, anxiety, conduct disorder, attention deficit hyperactivity disorder, oppositional defiant disorder, psychotic-like experiences, hyperactivity, etc;
• Flashbacks: Trauma can cause sudden memories that dominate in the moment, to the point one feels an experience is happening again. These can be triggered by any of the 5 senses or the environment; and,
• Self-harm and suicidality: Experiencing trauma increases the risk of self-harm and thoughts of suicide.

How do we take a trauma-informed approach?

SAMHSA (2022) developed widely adopted trauma-informed principles that can be used in daily life and at work:

• Safety: Creating a safe environment and ensuring others feel safe within the environment;
• Trust & Transparency: Building trust within relationships through openness and honesty;
• Peer Supports: Talking with other people who have gone through similar experiences;
• Collaboration: Limiting the power differential and allowing the client to feel empowered within the decision-making process, when possible;
• Empowerment, Voice & Choice: Building upon someone’s strengths and experiences, encouraging their ability to overcome, heal, and recover. It is important to support and encourage someone’s voice, decisions, goals, and self-advocacy within the recovery process; and,
• Respect: Respect for someone’s culture, history, gender, religion, race, age, sexuality, etc.
  A trauma-informed approach also includes one’s ability to respectfully communicate. Some helpful communication tips include:
• Awareness of your own facial expressions and tone of voice: Using a calming, warm, and genuine tone with eye contact and appropriate head nodding to let the person know you are listening. It is important to watch for aggressive or demanding tones;
• Providing empathy and validation: attempting to understand how the person is feeling and validating their experience. It is key to not dismiss someone’s else feelings; and,
• Avoiding confrontation, shouting, and shaming: Avoid assuming you know what someone else is going through; what may be traumatic to one person, may be different for another.

For additional information on trauma please refer to SAMHSA (https://www.samhsa.gov/trauma-violence) or the National Alliance on Mental Illness (https://www.nami.org/Support-Education/Justice-Library/Trauma).

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The mission of the Human Services Center (HSC) is to provide individuals who are mentally ill or chemically dependent with effective, individualized professional treatment enabling them to achieve their highest level of personal independence in the most therapeutic environment.

To read previous editions of the Mental Health Memo visit https://dss.sd.gov/keyresources/news.aspx#mhmemo.