By Paul Mancia, M.S.
This year, more than five million children will experience trauma. Understanding how traumatic events trigger biological changes in the brain not only allows nurses to deliver more compassionate, effective care but also improves overall job satisfaction and success.
Fight or Flight
Imagine you’re taking a stroll through the forest and you cross paths with a bear. What happens next? Your heart rate increases. Your pupils dilate. Your lungs expand. And you have to make a choice - fight the bear or run.
This response is the ‘hypothalamic pituitary adrenal axis’ (HPA Axis). When we’re in an alarm state, this reaction provides our bodies with critical hormones to survive. Overexposure to adverse experiences, however, can cause the hormones that help us escape danger to become toxic. In other words, when the bear crosses our path night after night, it can wreak havoc on brain and body development. The result? Increased rates of health problems, including asthma, digestive disorders and obesity.
The Impact on Outcomes The more adverse childhood experiences you’re exposed to, the greater the likelihood that you will experience negative health outcomes. In fact, studies show children that experience four or more adverse events will see a twelve-fold increase in risks for alcoholism, drug abuse, depression and suicide attempts and a four-fold increase in smoking and poor self-rated health. But negative health outcomes are not just a product of a bad childhood. They are based in biological and developmental changes that occur throughout childhood. Further, individuals who do not participate in high-risk health choices but have experienced a number of traumatic events as children are still more likely to develop chronic conditions later in life. What's Going on in the Brain? Think of the human brain like a house requiring a strong foundation. When children experience a traumatic event, it causes a fracture to their foundation, which may lead to underdeveloped brain functioning and can affect future development. Inattention, poor memory and impulsiveness are often symptoms seen in children where these areas of the brain have been impacted by trauma. When these behaviors cause children to do poorly in school or inhibit their ability to make friends, it can lead to further separation from positive influences and cause a regression in performance. Trauma Informed Care Many children struggling with mental health problems are actively living through traumatic experiences, such as violence, abuse or neglect. These children face the “bear in the forest” on a daily basis. The hormones that are critical to survival have disrupted proper development in key areas of the brain and body. This causes some of these children to respond to stressful situations in ways that are effective for them, but are unacceptable in our society. Unfortunately, our current treatment system does not properly take into account the insidious impact trauma has from childhood to adulthood. Many interventions are reactionary and punitive. Trauma informed care, however, aims to understand and correct critical responses to stressful situations. This approach connects both individuals and organizations to take an active and thoughtful approach to treatment. By transcending the idea of “in office” counseling, trauma-informed care integrates the entire system of care to understand the underlying causes of problem behaviors and to provide a safe environment for both children and their caregivers. Tips for Success Despite the challenges trauma brings, there is hope. New research is driving improved outcomes across all treatment settings. Increased awareness and professional development can further improve the quality of care and compassion trauma survivors receive. Here are just a few of the ways you can help: Do build relationships. The number one factor in healing trauma survivors is positive, caring relationships. Do encourage routine. The brain is calmed when it encounters something familiar and routine. When dealing with trauma survivors, establish routine interactions in an intentional way. Do create a welcoming environment. A safe, holistic, positive and respectful environment has been shown to reduce “no-show” rates for treatment and produce better outcomes. Do spread the word. Educate every level of staff about how trauma affects a person’s well-being. Don’t internalize others’ struggles. Compassionately understanding “what happened” can help you perform your work and handle the difficult challenges it brings. Don’t forget the good news. There are many evidence-based practices that help treat specific types of trauma and behavioral symptoms. Do help yourself. Compassion-fatigue and burnout occur at high rates in the helping fields. Find ways to unwind. Having an escape from work is key to a healthy professional life.