County programs target, treat trauma
Post-traumatic stress disorder is commonly seen as the result of wartime trauma, something that occurs thousands of miles away to our men and women in the military. Many come home broken in body and spirit, sentenced to relive and try to recover from nightmarish experiences.
But PTSD isn’t confined to the effects and aftermath of war. After decades of research and evidence-based studies on trauma and traumatic experiences, the mental health community has embraced the idea that PTSD is directly linked to childhood trauma. By treating its effects early enough, many experts believe PTSD and other psychological and subsequent physical maladies can be prevented.
At its core, PTSD is an anxiety disorder, said Michael Horn, director of Imperial County Behavioral Health Services. It is the face of trauma, and experts like Horn believe it is what happens when its victims have not been able to deal with traumatic experiences earlier in life.
“Looking at trauma with soldiers. Why does one develop PTSD and not the other? Research would suggest it’s because one has a childhood trauma background and the other doesn’t,” Horn said.
So, what exactly is trauma, and where does it come from?
Natural disasters, accidents, physical abuse, verbal abuse, sexual abuse, neglect, domestic violence, threats, bullying, deaths, medical treatment, illnesses, divorce/separation, and war all can be factors, said Lillian Vera, a licensed clinician social worker with Behavioral Health Services. Any event that causes one to experience feelings of terror and helplessness can lay the groundwork for trauma, Vera said. Often those experiences lead victims to be fearful and distrustful.
Trauma is pervasive, its roots reaching deep into the fabric of society around the world.
“Trauma transcends socioeconomic status, gender, age,” said Dr. Laura Murray, an associate scientist and clinical psychologist with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health. Murray knows of what she speaks. She is no newcomer to trauma and its effects, having begun working with its victims in the aftermath of the terror attacks of Sept. 11, 2001, on U.S. soil. She is no newcomer to the Imperial Valley, either, having trained clinicians at Imperial County Behavioral Health for nearly a decade, using evidence-based practices to help children and their families heal.
“Any community has trauma,” Murray continued, and Imperial County is no exception.
Vera said of the 1,500 admissions into Imperial County Behavioral Health Services’ adult clinics for the period of July 1, 2014, to June 30, 2015, more than half — 797 — reported some type of traumatic experience. Nearly half of the 2011 children — 865 — admitted into the children’s outpatient clinic reported having experienced trauma. And those are the ones Imperial County Behavioral Health knows about. The numbers are expected to be much higher, and its impact on the community is greater than you may realize.
Trauma exposure has been linked to developmental delays and behavioral health problems in addition to PTSD, including school problems, delinquency, substance abuse and suicide, Lynne Marsenich, a consultant and licensed clinical social worker, told Imperial County Behavioral Health clinicians and practitioners late last year at a workshop on childhood trauma and trauma-informed care. That means that anyone working with children, whether in an educational forum or a recreational or spiritual one, will run across children facing a lifetime of trauma-induced repercussions.
While many people experience painful situations during childhood, those that mark a child for life go much deeper. And when trauma has been swept under the rug, or treated dismissively, or ignored, or hidden from view by victims shamed by their experiences, it can fester into a wound that doesn’t heal, paving the way for a lifetime of anguish.
Trauma heaped on children has the most far-reaching effects, traveling with them well into adulthood. If not addressed, its effects continue into the next generation and beyond.
When those children become adults, damage has been done in layers, one traumatic experience after another, becoming increasingly difficult for its victims to endure and for clinicians to treat.
Imperial County Behavioral Health for years has been combating trauma and PTSD by training its clinicians to recognize and treat various kinds of damage caused to children, adolescents and adults Treatment also impacts their families, caregivers, everyone in their circles of influence. Why such an emphasis these days on trauma and treatment?
Extensive clinical studies have linked trauma to more than mental health issues.
“The landmark Adverse Childhood Experiences Study demonstrated that childhood trauma exposure is also associated with chronic health problems across the life span, including heart disease, obesity, diabetes, emphysema and premature death,” Marsenich told the Behavioral Health Services clinicians during training.
While some of that may be due to unhealthy choices, others are a direct response to neurobiological and psychosocial adaptations made by the brain in the wake of persistent traumatic experiences, she said.
On its website, the National Child Traumatic Stress Network explains that “Repeated exposure to traumatic events can affect the child’s brain and nervous system and increase the risk of low academic performance, engagement in high-risk behaviors, and difficulties in peer and family relationships.
Traumatic stress can cause increased use of health and mental health services and increased involvement with the child welfare and juvenile justice systems.
Adult survivors of traumatic events may have difficulty in establishing fulfilling relationships, holding steady jobs, and becoming productive members of our society.”
One of the largest investigations into the link between childhood trauma and adult health, the Adverse Childhood Experiences Study, known as ACES, is having an impact on how the mental health and medical industries are looking at trauma.
The decade-long collaboration between Kaiser Health Appraisal Clinic in San Diego and the Centers for Disease Control examined the links between childhood maltreatment and trauma, and later life health, mental health and social well-being, Marsenich told the Imperial County clinicians.
ACES and dozens of studies over three decades have sent the message loud and clear that trauma and traumatic experiences are very real problems that need to be addressed.
By doing so, the groundwork can be laid for cure and prevention.
“The simple answer (to today’s emphasis on trauma treatment) is that people were not getting better, or they were only getting better temporarily,” said Vera of Behavioral Health Services. “The mental health and medical communities are now supporting more and more the idea of prevention. Since now we have a clearer understanding of trauma’s effects on the body and mind, we are moving toward treating trauma promptly, before it causes negative or irreversible effects on a person’s life.”