Trauma is a widespread issue across the globe and in the anti-trafficking space. It is especially important to understand what trauma is and how to respond to it so that we can offer the best possible support to those who have experienced it. We will explore trauma in this course by following the four Rs of trauma-informed care: realize, recognize, respond, and resist retraumatization. This will allow us to realize what trauma is, how widespread its impact is, recognize the signs and symptoms of trauma, respond to trauma in a trauma-informed and person-centered way, and resist retraumatization with a trauma-informed person-centered approach. This course has a companion reference that you can download from the resources tab in the top right of the course window. It is recommended that you download the reference now.
Realize
The first step of realization is to recognize what trauma is and what the widespread impact of trauma is. Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as harmful or threatening and that has lasting adverse effects on the individual’s functioning and well-being. The effects of trauma are not limited only to individuals and can be seen in multiple systems such as family trauma, group trauma, community trauma, and mass trauma, with each of these levels increasing the number of individuals affected by trauma from an event or series of events.
Trauma can affect more than those who have experienced it firsthand. For those who live and work with traumatized individuals, it is possible to be affected by vicarious trauma. This form of trauma, sometimes referred to as secondary trauma, is when someone suffers trauma as a result of indirect exposure to someone else’s trauma. Even though those who experience vicarious trauma have not experienced the direct trauma, they will still experience the symptoms of trauma from the exposure. It’s important to note that not everyone who is exposed to traumatic information will experience vicarious trauma. However, if someone who is exposed to others’ trauma shows symptoms that are persistent, it’s recommended to seek professional help from a therapist or mental health professional.
To highlight how widespread trauma is, let’s take a look at the adverse childhood experiences study, also known as ACEs. Adverse childhood experiences refer to potentially traumatic events that occurred during childhood before age 18 and can have lasting effects on a person’s mental and physical health. Nearly two in three adults have at least one ACE from their childhood, highlighting how widespread trauma really is. Click on the ACEs primer button to learn more about ACEs and click the take the ACEs quiz button to see what your score is. Once you have completed both, you will be able to proceed using the next button.
With an understanding of what ACEs are and what your own personal ACEs look like, it is important to note that ACEs are a guide, not a certainty. Not accounted for in the test are protective factors—conditions or attributes that reduce the risks of trauma from ACEs. Understanding ACEs can empower individuals to recognize trauma and make positive changes in their lives, but it is just a guide. For individuals with a high count of ACEs or who are experiencing symptoms of trauma, it is recommended to seek professional support and guidance from a mental health professional to ensure an accurate diagnosis.
Recognize
To recognize trauma, it is important to know what symptoms may look like. General manifestations of trauma may be physical symptoms such as chronic pain, fatigue, or being easily startled; emotional symptoms such as feelings of guilt or shame associated with the source of the trauma, agitation, edginess, or trouble regulating emotions; and psychological symptoms such as anxiety disorders, depression, insomnia, and nightmares.
The general manifestations of trauma are the result of one of the five types of responses that individuals can manifest in response to their trauma: fight, freeze, flight, fawn, and flop. Individuals who have a fight response may become narcissistic, bully others, and be prone to fits of rage. Individuals who have a freeze response will do just that—dissociating from their environment and shutting down. Those individuals with a flight response will begin to exhibit behaviors such as constantly being distracted, being perfectionists, or struggling with addiction. Individuals who exhibit fawn responses will work to please those around them, acquiescing to the demands of others, becoming codependent on others, and repressing themselves to keep those around them happy. Finally, those individuals who have a flop response will go limp, faint, or otherwise lose physical control over themselves. These trauma responses can manifest immediately during or after a traumatic experience or over a longer period of time, and they will also persist for years if not identified and treated.
One form of the fawn trauma response of particular concern in the anti-trafficking field is that of trauma coerced attachment. Trauma coerced attachment, often referred to using the outdated term trauma bonding, is an emotional dependency on an abusive partner, often involving a shift in the victim’s perception of themselves and the world. When an individual is experiencing trauma coerced attachment, they will often hold positive feelings toward their abuser while internalizing the abuser’s negative view of them. Despite the abuse they suffer, they may find it difficult to leave their abuser, even coming to the aid of the abuser if needed. As an extension of this, the victim may be unwilling to engage in behaviors that could provide freedom, even if the opportunity for freedom arises. While this may seem strange to hear, traffickers and other types of abusers are able to create and maintain this type of response by applying a series of tactics that we can map in a chart called the power and control wheel. Starting with coercion and threats, the abuser moves clockwise around the wheel to break down their targets and bring them under control, creating a trauma-coerced attachment. The calculated nature of the process shown on this wheel is designed such that whatever the type of trauma response a target has, they are brought under the control of the trafficker.
It is crucial to recognize that individuals working with traumatized persons may experience vicarious trauma. It is important to monitor for signs of vicarious trauma which can manifest in various ways. Physical indicators may include headaches, fatigue, insomnia, or gastrointestinal issues. Emotional signs can manifest as irritability, anxiety, guilt, or depressed mood. Cognitive changes might involve difficulty concentrating, confusion, or feelings of detachment. Behavioral changes may present as overeating, social isolation, avoidance of certain individuals, or habitual lateness. If you observe these signs and symptoms in yourself or in colleagues who work with traumatized individuals, it is essential to seek assistance from a mental health professional.
Respond
Healing from trauma is a challenging journey for those who have experienced it. As lived experience expert Hannah Blair poignantly states about her personal trauma from being trafficked, “I think people underestimate what it takes to heal from trafficking. Physically getting out of the harmful situation is 2% of the journey. The other 98% is the hard long-term work of healing that follows.” For those supporting individuals through this 98%, a thoughtful approach is essential, as an inappropriate response to trauma can hinder progress or exacerbate the trauma.
To respond effectively to trauma, it is crucial to adopt a trauma-informed and person-centered approach. A trauma-informed perspective views trauma-related symptoms and behaviors as an individual’s best and most resilient attempt to manage, cope with, and rise above their experience of trauma. Being person-centered means working with people in a setting and manner that is responsive to individuals and their goals, values, and preferences in a system that supports good communication and empowers individuals. Adopting both a trauma-informed and person-centered approach is essential for effectively addressing the complex nature of trauma. This dual approach enables practitioners to understand the intricacies of trauma while engaging with individuals in a meaningful way that respects their autonomy, reinforcing the understanding that healing is not a one-size-fits-all process. Ultimately, integrating trauma-informed and person-centered approaches leads to more effective outcomes by promoting long-term recovery and shifting the narrative of care from “what’s wrong with you” to “what happened to you.”
Trauma-informed care is based on five essential principles: empowerment, choice, collaboration, safety, and trustworthiness. Empowerment encourages individuals to take control of their healing process. Choice presents clients with options, fostering autonomy in their decision-making. Collaboration involves practitioners working alongside clients and valuing their insights and expertise. Safety ensures environments are structured to support both physical and emotional well-being. Trustworthiness emphasizes consistency and transparency to build trust between clients and providers. These principles create a framework for understanding and responding to the needs of individuals who have experienced trauma and foster resilience and healing.
A trauma-informed individual, program, organization, or system acknowledges the widespread effects of trauma and understands the various pathways to recovery. It identifies the signs and symptoms of trauma in clients, families, staff, and others involved in the system, and integrates trauma knowledge into policies, procedures, and practices while actively working to prevent retraumatization.
When interacting with a traumatized individual, validate their expressed fears and coping strategies. Provide accurate and relevant information. Assist in developing problem-solving skills. Respect the survivor’s voice and decisions. Recognize the impact of trauma and prioritize the needs of the survivor. Address basic needs such as safety, clothing, shelter, and trust. Be authentic and respectful in all interactions. Offer options to empower the survivor. Avoid taking reactions personally. Do not assume the survivor’s goals or needs. These practices serve as a foundational framework for delivering trauma-informed and person-centered care.
Healing from trauma is a challenging journey that requires time and effort. There are no quick fixes or shortcuts on the path to recovery. This healing journey can be understood through DiClemente’s stages of change model. The stages begin with precontemplation, where individuals are not yet considering change. Next is contemplation, where individuals are aware of their issues but feel ambivalent about action. Preparation follows, where individuals begin planning and taking small steps toward change. Action involves actively modifying behavior and environment. Maintenance focuses on sustaining change and preventing relapse. Relapse is a common part of the process and provides opportunities for learning before the cycle begins again. While this process may feel endless, progress often resembles a spiral staircase rather than a loop, with individuals continuing to move upward as long as they persist.
A trauma-informed person-centered approach in practice may involve a survivor care advocate working with a trafficking survivor to address transportation challenges. By empowering the survivor to make choices, supporting gradual exposure, celebrating small victories, and setting achievable goals, the advocate helps the survivor build confidence, autonomy, and trust. This illustrates the transformative power of supportive trauma-informed care.
Resist retraumatization
Responding to trauma in a trauma-informed person-centered manner is an ongoing commitment. Utilize trauma-informed checklists, monitor signs of shutdown or overwhelm, manage sensory needs, ask clarifying questions, provide breaks, and support empowerment. Be aware of fragmented memory, hold conversations when survivors feel safe, break tasks into manageable steps, and focus on facts rather than emotional reactions.
At the organizational level, transitioning to a trauma-informed person-centered approach requires building awareness and buy-in, supporting staff wellness, cultivating a trauma-informed workforce, and creating safe physical, social, and emotional environments. Safe connections are fundamental to mental health and meaningful lives.
A trauma-informed and person-centered approach benefits both survivors and those assisting them by fostering compassion satisfaction and reducing the risk of vicarious trauma.
We reviewed what trauma is, how to recognize it, how to respond using trauma-informed principles, and how to resist retraumatization at individual and organizational levels. The knowledge gained in this course supports healing and makes the journey easier for those affected by trauma.
Great job. You have finished this course. While healing takes time and effort, the understanding gained here will help you support others more effectively. Thank you.
