Don’t overlook effects of trauma on health
“Trauma” is a word that can be understood in many contexts. Historically, we have perhaps most often thought of trauma in the physical sense. We think of individuals suffering from trauma in a motor vehicle accident or sadly, as too often the case in our local community, a gunshot wound. Considering the exceptional number of gun-related deaths in Hampton Roads, including the recent mass shootings on Killam Avenue and at the Sam’s Circle Walmart, the suffering from this kind of physical trauma couldn’t be overstated.
That being said, to understand the true scope of trauma incurred by such horrific events, we must account for the shockwaves sent through the families and communities affected by such sudden and unexpected loss. Such tragic events leave the lasting imprint of psychological trauma on survivors, who may struggle to cope with a complex emotional landscape of fear, anger, guilt and often shame. Unfortunately, evidence has revealed what astute clinicians have known for some time: the lasting negative effects of unresolved trauma can have serious and even deadly consequences for mental and physical health. Children are particularly vulnerable.
The Adverse Childhood Experiences Study published in 1999 found a strong and proportional relationship between childhood trauma exposure and risk for later development of common diseases such as heart disease, cancer, lung disease and chronic liver disease. Additional research has further elucidated how toxic stress and trauma hijack the mind and body, and place victims and loved ones of all ages at increased risk for mental and physical disease. Coming to terms with the clear and present danger that unresolved trauma poses to our health will require a reworking of the enduring model of American health care delivery that compartmentalizes the mind and body into distinct silos when diagnosing and treating illness.
Community and health care advocates for “trauma informed care” seek to transform our systems to allow for more holistic care based on the biopsychosocial-spiritual model of care. Generally, this model considers the various influences on well-being that contribute to individual health, including cultural background, spirituality, education and personal history. With the awareness that trauma is more often than not part of an individual’s personal history, practitioners and organizations can create safe and engaging environments that foster resilience in the face of trauma. Such a paradigm shift will be a heavy lift for our fragmented system that has traumatized its most skilled workers with chronic understaffing and impossible productivity goals set forth by an out-of-touch administrative class. In the near term, individuals and the caregivers of minors suffering the effects of trauma will need to be proactive in seeking help.
One initial step that can be taken by those seeking care is to establish a relationship with a mental health specialist who has expertise in treating trauma. There is promising evidence that specialized techniques such as Eye Movement Desensitization and Reprocessing offered by some therapists can improve the symptoms of trauma. In the local community, those seeking help for children affected by trauma can go to the CHKD Child Advocacy Center (chkd.org). Those of all ages can visit Integrated Health Services at 211virginia.org to connect with a counselor who can provide trauma informed care.
The effect of psychological trauma on the well-being of our community is nothing short of a public health crisis. Unfortunately, trauma’s insidious nature often blinds us to it as a cause of disease and we end up grappling ineffectively with the illness that is left in its destructive wake.
Collective action by citizens, families, health practitioners and community organizations will be required if we are to raise awareness on what can be understood as an epidemic of trauma.
For more on this topic, I recommend “Trauma, the invisible epidemic: How Trauma Works and How We Can Heal From It” by Paul Conti, M.D., and “The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture” by Gabor Mate, M.D., with Daniel Mate.