Episode Transcript
Speaker 0 00:00:00 Hello everyone. Long time. No recording by podcast I guess. Ha. So, uh, this is just a quick update before the episode really starts in earnest. Um, so I did give my talks at Asha and I think they went pretty well. I went a little bit over time, but, uh, what A D H D and info dummer doesn't go a little over time, right? I mean, but it did seem like, um, some of the people who attended really found the information useful and helpful. And in relation to this, I have a little announcement to make. I am now going to offer professional training packages for groups of SLPs, um, or organizations that you work for in how to implement trauma informed care in our speech language pathology practice, or taking the stance of professional burnout and the signs of potential trauma responses that could occur due to our work and our close relationships with, uh, patients and clients.
Speaker 0 00:01:05 So, if you think it would be helpful for your organization to receive some more direct training on trauma informed practice in the treatment room, or trauma informed care in terms of how we treat ourselves and what we do to help ourselves, then please do contact me. You can go to my website and use the contact form anywhere on that website if you would like to, at the trauma-informed slp, I'm going to put a link in the show notes. Feel free to reach out or perhaps let the people, whoever's in charge of setting up trainings for your organization, um, suggest it to them and let them know they can reach out to me that way. At the moment, I'm going to craft the packages to be based off of the length of time that your organization typically needs for these kind of trainings or uses or has set aside for this type of training. So, um, the packages can be customized based off of the material or what you feel would be most beneficial to your organization. For example, if you work more with younger children or if you work more with adults, I can craft the material toward those age groups or perhaps different disorder types that you might work with. Um, so yeah, I really hope to connect more with some of you in that professional training format. All right, so let's get on with the show.
Speaker 0 00:02:24 Okay. Hello everyone, and welcome. I am Kim Neely, and this is the Trauma Informed s l p. It is a podcast where we learn how to promote safety and empowerment and to build resiliency in everybody we know, including ourselves.
Speaker 0 00:02:49 It has been a little while. I recorded this episode once already and I was a little too circular with it. So here I am re-recording. Uh, I got a little sick after Asha in November. I got kind of a bad respiratory thing going on. It wasn't covid. I took a test, not covid, so if anyone was around me, don't worry about that. But I got a really bad cough and it just lingered for like a couple weeks and my voice sounded really, really rough. So I waited to record until I basically didn't sound like I, you know, just had my vocal fold scraped over a cheese grater. So there you go. Sorry about the delay. Getting back into recording these episodes, it's been a little while. If I'm remembering correctly, I believe we've covered what happens when an individual has a trauma response in terms of their physiology, how the nervous system becomes dysregulated, how they have too much sympathetic dominance.
Speaker 0 00:03:37 When you think of the fight or flight mechanism, physiologically, um, the parasympathetic rest and digest system is a little sluggish to come back online. Um, and also the emotional memories where those are encoded in your mid-brain. The amygdala's connection to your frontal lobe, to your anterior singulate is not very strong or is fairly well disconnected when you're in survival mode. And so that creates an issue in terms of integrating conscious awareness of what's happening when someone's having a trauma trigger, which is why they kind of end up in sympathetic dominance a lot and then might not understand why they're so anxious or they feel so stressed or why that thing seemed like a big deal. The frontal lobe might not be getting the message that it actually was a, um, memory of something that was unsafe for them. And then also the anterior ST does have a feedback loop to the amygdala to indicate an error in threat detection and in trauma responses, that connection isn't really happening very well, that that seems to be the biggest issue.
Speaker 0 00:04:49 And that is because you just can't integrate the emotional experience with conscious awareness of what's going on. Okay? So that's our trauma response, that's our physiological trauma response. And that helped us to get what we need to be trauma aware in the sense of, okay, at an individual level, this is what's happening in the person's body when they're having a trauma trigger, meaning their emotional memory is triggered, and also in the moment of the actual event, the adverse event that made them feel very unsafe and un and vulnerable. And that kind of kicked off that whole physiological survival cascade. Okay. So now that we've gone through all of that, our next step to finish off trauma aware and start to bridge ourself toward becoming trauma sensitive. And remember, in the Missouri model, the trauma sensitive in my mind is where you have more of a systemic understanding, an organizational understanding, policies, procedures, societal understandings, essentially of how trauma affects us, how trauma affects a culture or a people at a broader sense, right?
Speaker 0 00:05:54 So this episode is going to start bridging us toward that knowledge, but we're also still gonna just wrap up what we need to be trauma aware so we understand trauma at the individual level. Okay? So what we're gonna go through today to wrap that up, we're gonna go through the types of trauma, the types of events essentially that potentially create trauma in people. We're gonna characterize the trauma, the way that mental health professionals characterize it. We'll discuss what's important about knowing those two things. And then I wanna talk a little bit about the Kaiser C D C ACE Study, ACE Standard. Uh, ACE stands for Adverse Childhood Experiences, and they did this huge study, which is one of the big two studies that led to the development of trauma informed care as an entire like model or paradigm of care for organizations. Okay? So we're gonna talk a little bit about that because that study helps us to understand how trauma affects a person throughout their lifespan, and then also follow ups to that study have led to better understandings of how it affects communities and groups and, um, countries and societies. Okay? If that makes sense. Okay. So let's get going with the types and characteristics of trauma.
Speaker 0 00:07:21 Okay? Now that we're gonna get into the types of trauma. So exciting, I guess I know this is always such a happy topic. Um, I wanna offer a little bit of a trigger warning because I will be at least mentioning, uh, common things that lead to traumatic responses in people. So if you hear me mention something and that triggers something in you, you start to feel a bit dysregulated. Um, you start to feel anxious or perhaps you just have this really big emotional response to that, please take your time, pause, step away from the podcast if you need to do what you need to do to take care of yourself and your body and your reaction to that. That's the beauty of a podcast. It will be here waiting for you. So you can take your time however long that is. You also can feel free to fast forward through the sections on the types and characteristics of trauma.
Speaker 0 00:08:11 But just due to the nature of the material discussed here, I think going forward in general on this podcast, it's a safe thing to say, um, that if you feel yourself being triggered, meaning suddenly you're having this big physiological response to something you're hearing, um, just be very gentle to yourself. Uh, I want you to treat yourself with a lot of grace and pause and breathe and do what you need to do to kind of relax your body and feel connected to your body and treat yourself well and treat yourself with kindness. Because I don't want this podcast to be something that strengthens trauma responses in other people, honestly. Um, and it's not the the time to push through when you feel like you're getting triggered by something. Uh, it's not the time to really push through it, especially not if you're just sitting listening to this podcast for goodness sakes. You can just stop and give yourself the time and the grace that you need to take care of yourself. Okay, with all of that said, let's go ahead and get into it.
Speaker 0 00:09:19 Types of trauma. Why do we need to talk about it? The big thing about the types of trauma is that it helps give us information about how much support someone might have received after this kind of adverse event happened. Okay? There's different ways of char of kind of categorizing the types of trauma. And of course, these are events where not everybody might develop trauma from it, but these are the common events that occur in people's lives that result in trauma responses. So you could think of trauma types in terms of individual categories or things that affect small groups like families. These could be caused by nature. So like, um, a house fire or a tree falling on something, something like that. There could be, um, accidents, but they're human caused, right? So like a car accident, um, maybe like, uh, an injury during a sporting event, like when, if somebody's playing the sport.
Speaker 0 00:10:18 And then of course there can also be the intentional human acts to intend it to harm other people, right? So on an individual level, these are things like assault or abuse, neglect, domestic violence, um, if someone breaks into someone's home, things like that. Okay? So that's the individual or perhaps small group, like a single family. You can also think of this on a wider, broader scale of groups or communities of people. So for nature, cause things that affect whole groups. It could be a large storm, like a hurricane or a tornado or a blizzard, uh, could be a wildfire. Especially since I live in Colorado, that's always a consideration. And I used to live in Northern California where wildfires are also big considerations there. So that would be a nature caused event that could be traumatic for a larger group of people, like a whole town, a whole city, a whole state, et cetera.
Speaker 0 00:11:18 Okay? There can also be accidents that are human caused. So maybe, um, there could be like a, a, a big gas leak or an explosion somewhere, um, an oil spill somewhere like on the coast of something that really affects things. Lead in the water. Hello. That's a whole other ball of wax, which we're not getting into cuz that's, um, I'm gonna try to not get on too many soap boxes while I'll talk here. Okay? Um, and then of course you can have intentional acts, um, toward whole groups of people, right? And these are the things we hear about. We definitely hear about this on the news a lot. Like, uh, terrorist attacks and, um, countries invading, other countries, declarations of war rioting, uh, things like that. So that can definitely affect a whole group, a whole country, right? A large group of people. And then there are things called mass traumas.
Speaker 0 00:12:15 Um, potentially global traumas. Even. Uh, covid 19 gets called a global trauma sometimes because things like pandemics, um, things like perhaps some sort of famine where an event occurred. I know historically you could, you know, there are times that large volcanic eruptions happened, and then there was like this mass famine throughout the world because of, um, the, all the ash in the atmosphere made the temperature much colder. So crops failed and things like that, right? So that's a mass trauma, that's something that affected way more than a even a single country. It's more of like a global thing. Um, Spanish flu pandemic would be a global trauma. Covid 19, since it affected the whole world, is considered a global trauma. Okay? So when you think about hearing these trauma types, the big takeaway is, all right, so how much support might somebody get from their family, from their community, right?
Speaker 0 00:13:12 Or even maybe societal support or something to that effect, right? So I'll use an example from Colorado. We had that horrible Marshall Fire last year, um, that burned down a lot of houses. It was just a, and that day was crazy. The wind was insane. It was like a hundred degree or a hundred degrees, sorry. Uh, it was like a hundred mile per hour winds. It was really dry. Um, I was in the state that day. Um, luckily not near the fire. And I know people who are affected by it. Um, some people lost their homes and some people did not of who I knew. So, you know, that is definitely a traumatic event to lose your home to something like that afterwards, at least on the plus side, I guess <laugh>, it's not so much that you're putting a positive spin on the trauma, but you know, people received support.
Speaker 0 00:14:05 Um, there were, you know, clothing donations and household item donations and a lot of organizations coming together to provide support to help people get sort of reestablished somewhere and plugged back in. And not that those families who were affected did not have trauma responses, but that the community still came together, right? And so that community response of coming together and helping to support each other, that helps improve someone's sense of regaining a sense of safety, okay? And that's what's so nice about that, that helps to build some resiliency and some healing around that event is when people feel like they can regain some sense of safety and support, um, and some kind of empowerment even in the, the face of something really difficult like that. So that would be an example of an event where, okay, as h as horrible it is, and I know people had trauma responses from it.
Speaker 0 00:15:01 Uh, the people I knew included who sought counseling services and things like that. It's horrible and it's awful. But it's also not typically a trauma that you, that the people internalize a sense of shame or guilt around, for example. And they don't necessarily feel that they need to hide it, right? Not necessarily maybe they feel they need to hide their own responses, but the fact that this horrible thing happened doesn't, isn't, wasn't, didn't really need to be hidden, right? This all helps a bit with resiliency and it helps with healing. Whereas for something like sexual assault or even childhood abuse or neglect, these are things where sometimes that invi individual might internalize some sense of shame or guilt around that trauma. It might feel taboo to say it. Um, they might not receive a lot of societal support, right? Um, particularly with sexual abuse and how that gets horribly misconstrued sometimes and how those victims can become so easily retraumatized by the system when they're trying to seek help.
Speaker 0 00:16:07 So that's why it's good to know about because if you hear someone who is going to share something like a sexual abuse with you, just knowing that, that's a more delicate situation in the sense of, um, they might not have received community support, familial support, friend support, they might not have received support from anyone cuz they might not have actually shared it with anybody, right? So that's what's good to know about when it comes to the types of trauma. It's not for us to treat it, it's just for us to be aware of where that person might be in terms of if they are going to be re-traumatized and re-experiencing it or if they have some level of resilience or healing around it, or if they're least in the process of healing. Okay? Helps us give information about that. So that's why it's nice to at least know of the trauma types and have a way of thinking about the type of trauma that you might hear about or that you might know of from watching the news when interacting with people who've been through trauma.
Speaker 0 00:17:10 So now let's go into the characteristics of trauma or characterizing trauma. How he characterized the type of trauma someone went to, went through and characterizing. You can think of it kinda like the dosing. It's like how much trauma did this person experience throughout their life or up to this point in their life? Were they just sitting in a s like a super saturated traumatic environment or was it something they were able to move away from, at least to regain some sense of safety in community, right? So this is what characterizing trauma is for. It's really the dose. So the way this gets characterized is, is three main categories. The first one being single event trauma. Sometimes in the literature you see this called shock trauma. Um, this is when a traumatic response occurs in a person due to one event that happens at one point of time.
Speaker 0 00:18:00 So examples of this would be like a car accident, right? It could be a single hurricane, right? Like a hurricane that came through. That would be a group, it would be a group type of trauma, but a single event. Does that make sense? So that's a single shock trauma, a repeated trauma in somebody. This is a series of traumas that occur to the same person over a period of time. This is really common in first responders. Uh, it's very common in military personnel and also people like journalists who cover war zones, right? But it also can just be anybody, right? So for example, maybe somebody was a teenager when a hurricane came through and they had to, you know, deal with the loss of their things and flooding and all of this. And then maybe in their twenties they get into a car accident and then maybe in their thirties they get an illness, a life-threatening illness that they have to fight.
Speaker 0 00:18:55 Okay? So that's a single person having repeated traumas. They're unrelated traumas, like technically the situations, the events are different and the in, you know, where they occur and what they are different, but they're still having repeated exposure to trauma. Okay? And then sustained trauma also sometimes called chronic trauma. I tend to lean toward chronic trauma myself. Uh, just cause I think it kind of, uh, gives you that sense of, yeah, this dose is really high. Essentially this dosing of a sustained trauma is very, very, very high. So this is a type of repeated trauma, but what makes it a little different is the traumatic events are chronic, it's in the environment, it's where somebody is, they're just stuck in this chronically traumatic environment, okay? And this is important to know about because this really wears down someone's ability to develop any kind of resiliency or to adapt to new situations.
Speaker 0 00:19:55 This is where people have much more difficulty trying to feel safe around anybody or anything cuz they've been saturated in this traumatic environment for so, so long. It's really worn down their ability to adapt and to be resilient toward adverse events. So examples of sustained or chronic trauma would be, um, domestic violence, children going through any level of physical, emotional or sexual abuse or neglect. Chronic poverty is a big one for sustained in chronic trauma. And there's a lot of minority groups who go through a certain level of chronic trauma just by society policies, which is a little bit of a spoiler for when we head into more systemic understandings of trauma and how it impacts groups of people. Okay? So the thing to know about characterization of trauma is how likely it is for someone's resiliency to really be worn down. Okay? So if someone is recovering from say, a house fire, for example, with the appropriate resources, with the appropriate support from the community with access to mental health and things like this, this person is likely to be able to be more resilient against that to start their healing process and to kind of recover and regain a sense of safety and security and kind of balance out that nervous system and not have so much of that dysregulation going forward.
Speaker 0 00:21:19 Okay? Whereas someone who is in a chronic traumatic situation, let's say a domestic violence victim for example, their resiliency is likely to be a lot more worn down in terms of how dysregulated their nervous system might be, how often they're in sympathetic dominance, and also just their own perception of the world and their place in the world in terms of whether they can have access to safety, whether they deserve access to safety, like those sort of things. Their whole worldview is likely much more impacted in that sense. And it's not to say that it doesn't happen in single event trauma, that is not to say that this is a competition and some people are more traumatized than other people. That's not really the case. It's just more information in terms of um, where this person might be along the path of resiliency or healing and how much, how many resources have they had access to in terms of the trip type of trauma they had and how much might they still need, right?
Speaker 0 00:22:21 In terms of characterizing their trauma and how much support they might need. Okay? This is just to give you a slightly deeper understanding so that you don't have to ask for more details from them. You can just kind of stick it into a category in your mind of the type of trauma and how that trauma is characterized and think, okay, this is the likely impact of that and it'll be really great information to share with the mental health provider that you refer them to. Cuz you definitely wanna make a referral. So now that we've learned the types and the characteristics of trauma, let's talk a little bit about the ACE study. Woohoo, the adverse childhood events study. So there have been several follow-up studies that's come out of this dataset. Uh, but this is a huge study that was put together by the CDC in the United States and Kaiser, which is a medical provider like hospital doctor's, offices, things like that.
Speaker 0 00:23:23 They sent out surveys. Essentially they made up these surveys that looked at 10 possible adverse childhood experiences for people to have. These were related to certain categories of adverse experiences such as physical, sexual and verbal abuse, physical and emotional neglect. Uh, if you grew up with a family member who were struggling with mental illness, um, maybe witnessing domestic violence as a child or losing a parent to separation or divorce or incarceration, for example. So there were 10 ACEs. If you took the survey and you got a 10 out of 10, you experienced a whole lot of adversity basically. So, uh, the higher the score, the more adversity people experienced. Okay? This study had over 8,000 people that got included in the initial data set, and I believe it's gotten higher since then, actually. So what they did is they took these surveys and then they did some regression, they did some statistics to correlate these ACEs, like their score of their ACEs, the types of ACEs they had, and correlate that with what their health status was in terms of as adults.
Speaker 0 00:24:37 Basically, what is the health potential health impact? What is related to these ACEs? Okay? So for example, they found that people who had four or more adverse childhood experiences had an increased risk of experiencing depression, anxiety, suicidal thoughts, PTs D on the mental health side, they, uh, were more likely to have a traumatic brain injury or fractures or burns due to risky behaviors using alcohol or drugs and, you know, a whole bunch of other, um, negative outcomes essentially that kind of go along those same lines. There's actually a whole website on the CDC C'S page for this study that has a lot of great figures and, uh, breaks down all of these risks and things. So I'll put a link in the show notes, but if you also just want to search C D C ACE study, you'll probably find it. And if you wanna look through more of it there yourself, you can.
Speaker 0 00:25:35 So four or more ACEs definitely showed a lot of this. They also had an increased risk of developing like cardiovascular disease, um, and diabetes and things like that too. So those sort of chronic illnesses, uh, cancer, all of that sort of stuff, the stuff that we now know are somewhat associated with chronic stress states. Um, in that sort of literature, if you, you know, there was a whole thing like for a while there I feel like there were a lot of news articles on the adverse effects of chronic stress on a person's physical health, you know, and they talked about how too much cortisol in your system can lead to the increase of visceral fat, like the fat that's between your organs essentially, um, in your gut and how that is associated with poor cardiovascular health and things like that, right? So essentially people who have ACEs and these earlier potentially traumatic experiences we're at an increased risk for the same sort of things that chronic stress creates in people or is correlated with in people long term.
Speaker 0 00:26:42 Does that make sense? Okay. So they did find that it's actually pretty common as well for people to have adverse childhood experiences. So they found that 61% of adults had at least one and 16% had four or more different types, okay? And they also found maybe not too surprising that females and a lot of the racial and ethnic minority groups were at a greater risk for experiencing four or more ACEs, okay? So females and people in minority groups were more likely to experience more adversity, essentially as children compared to cis white males. So essentially is what they found there with the demographic breakdown. Okay? So that's a little bit of a spoiler because that's how we start tying this a little bit more to systemic things when it comes to certain adverse events, okay? But the main thing about this is that this is where we started to understand that trauma has these long-term health impacts in an individual potentially, right?
Speaker 0 00:27:49 This isn't causational, right, in the sense that the statistics are all correlational. And I know especially when looking at, uh, things that are kind of temporal like this where the event happened before, the adverse outcomes, it's easy to want to make a causational assumption based off of that. So what I wanna say in terms of correlational or causational with this is that all of these outcomes are very complex, right? Whether somebody develops cancer or diabetes or they're cardiac health and things, there's genetic factors, there's all, there's environmental factors, there's all kinds of things that get mixed into people's health outcomes as adults, right? And mainly the reason I wanna remember this is really correlational because it doesn't say if you have ACEs, you will definitely 100% develop these issues, right? What it's saying is people who have these higher ACEs, they have a positive correlation with developing these other health impacts later on in life. So there's some kind of relationship there. It's likely not one-to-one causal, it's likely ACEs are part of the mix, essentially part of the complexity that might lead to this type of health outcome. Does that make sense? So that's just a little note on interpretation of the data because I want to be very responsible with, uh, correlation versus causation. Okay? So yeah, good little S L P I took research methods. That's right folks. <laugh>, thank you Edwin Moss. He was my, he was my teacher for my research methods class, shout out.
Speaker 0 00:29:30 So since this whole a study thing, um, and since the rise of epigenetics as being this really big area of interest when it comes, comes to genetic diseases and things like that, epigenetics is one area that offers a potential explanation for how ACEs relate to these health outcomes. Okay? And same with chronic stress. Chronic stress to a body is essentially the same as traumatic response as far as the physiology is concerned. Chronic stress is just putting somebody into sympathetic dominance way too often, way too frequently, and they just get flooded with those sympathetic hormones like the adrenaline and the cortisol and all those other things. And you're essentially burning through your energy stores in your body. The human body needs rest. Okay? Rest is really important. Just like how sleep is very, very important. We know that the brain does some level of cleaning and some level of memory consolidation during sleep.
Speaker 0 00:30:29 Very critical, very important. And same thing with rest, with parasympathetic rest, right? We need to be able to have those times where are, you know, our neurons are able to cleanse and repair in our brain. We need times for tissue to start to repair, for digestion to occur so that we can maximize your nutrition and get the energy stores we need and things like that. So if we're constantly burning through energy stores sympathetically, it's not going to be a very healthy situation, right? We can do it. Our body is really smart and really able to adapt. Our bodies are good at surviving. It can be pushed to the limit and continue to go for a while, but at some point it's not going to be able to stand it anymore. Essentially when it comes to sympathetic dominance and how hard it is on the body to just constantly have these stress hormones flooding it.
Speaker 0 00:31:21 Okay? So epigenetics is this area where people have this, okay? Maybe this is somewhat related to this, maybe this is sort of the biological mechanism or, or some of the understanding essentially of how these things might relate chronic stress and adverse childhood experiences and trauma and how this might relate to adverse health outcomes. Okay? Epigenetics is that field, it's super complicated. I am not an expert in it, so I cannot <laugh>, I'm going to be giving very tiny little baby explain it to me like I'm five year old kind of explanation. So I apologize if there's some inaccuracy here for anyone who is a microbiologist out there or knows one who knows about epigenetics. But epigenetics is essentially the area of study that says, okay, we have our dna, we have our genes, right? We have our DNA sequence that makes us us, okay, but our body expresses genes differently, right?
Speaker 0 00:32:19 So it's the expression of those genes that really make up the state of who you are at that moment in time and your physical like state, like health-wise, okay? So the DNA sequence, it is what it is pretty much, right? But you have that whole translation transcription thing where like the messenger RNA comes and it like makes a little copy of the gene and then I can't remember which one is translation and transcription. I apologize about that. Um, <laugh>, I guess transcription is the mRNA I think cuz it's doing a direct copy. It's like a carbon copy, it's like a direct copy. And then the translation is like how the proteins are now going to express those genes, right? It like turns it over to proteins that then travel off to wherever that code is needed to create more, um, maybe a re a replacement organelle or something like that, right?
Speaker 0 00:33:08 Like they, those guys go off to help with repair and replacing things and stuff like that. Okay? This is part of how our body is able to regenerate itself. Essentially our tissue's able to repair itself when things die off, we're able to replace it, right? We have the cell cycles and all that stuff because we have this whole, like, we can copy off the DNA from one cell and then go off and make a new cell essentially. And the little dudes who go off with the information to make off the new cell are proteins. Proteins are like essentially the text messaging service or the email service of our entire body. Okay? So they're the ones getting the message and they're the ones sending it out. They're the, did you get that memo kind of dudes? Okay. So my understanding as a field epigenetics essentially is dealing with what messages do get sent out from the DNA and the like integrity of those messages, whether or not they're degraded or, um, kind of mutated in some way.
Speaker 0 00:34:06 So I'm gonna try to break down one of the ways that messages don't get sent out essentially because this is what has been tied a bit to stress states at least, um, in animal models. And I'm not sure what the state of knowing how this exactly applies to humans or not. I don't know exactly the state of the science for that. So, um, yeah. Anyway, so DNA gets kinda, it can, it can become kind of spooled together, right? Kind of like, like thread or, or like yarn. If you happen to knit or know a knitter, you know, you get that nice little tight spool right? Of your thread or your yarn. And if it's all spooled together really tightly, okay, it's not really available for the mRNA to get in there, right? And copy it. Okay? Then some gene sequences can be opened up and unspool and then they're ready to be copied and used.
Speaker 0 00:34:57 Okay? And I think, um, there's something about how your body can kind of tag certain parts of your DNA to be translated or transcribed. Okay? So if you put a little tag on that says, Nope, nope, nope, this needs to be spooled together, or there's like a little tag that says, yep, we need access to this now. Okay? And so I think the idea what epigenetics is, those tags, that's part of it anyway, or as those tags are being affected. So which genes are able to be expressed in the body, which ones are able to be used in the body is what's changing. And what epigenetics studies have shown is that it responds to stress, okay? Like this is one area where, um, stress has a real impact physiologically on us in the body. So for example, like in rat studies, if a mother rat was very caring and loving and like did a lot of grooming and stuff with her rat babies, um, those rat babies, they didn't have as much expression of stress genes and stress like the genetics associated with like high stress responses.
Speaker 0 00:36:02 Whereas rat babies who didn't receive all that grooming and care had higher stress responses, they were more likely to go into that like fight or flight sympathetic dominance kind of thing, basically. And yeah, these are rat studies. So can we one-to-one relate them to humans? No, we cannot. However, <laugh> the converging evidence is fairly strong that essentially this might be one of the main mechanisms or maybe the main mechanism wherein if somebody grows up in a really adverse, say sustained chronic traumatic environment, then it might change how their genetics are expressed in their body. And that might explain why the sympathetic system is really active and really fast to engage in those individuals compared to parasympathetic. And we know that in A P T S D in people with, uh, primary traumatic stress, they, um, their parasympathetic is sluggish actually. It doesn't come back online very easily.
Speaker 0 00:36:59 And epigenetics is one of those areas where we might think, okay, maybe that's why maybe the gene, the gene that handles, when we turn on parasympathetic, that genetic expression of like, we gotta make sure we balance it out. Maybe that has been shifted by the traumatic environment and by the stress somebody's been under. Okay? So this is one of those areas that maybe might be it, it's not, I didn't really include it in the physiological explanation because honestly it's not my area of expertise. I don't understand it super well. Micro stuff kind of freaks me out a little, honestly. I'm gonna take a little side note here and, and do a little, um, little full disclosure. Okay. So back in my uh, graduate school days I did take a graduate level molecular neuroscience course and uh, oh man, talk about being in and over your head.
Speaker 0 00:37:49 Whew. I hadn't had biology since like ninth grade at the time, cuz you know, I did music for a while. It was just, it was a hot mess. I had to get molecular science for dummies literally in order to remember all of this like stuff that you learned in high school because I'm like, I can't remember any of this and clearly this is fundamental knowledge I need for this class. Bit of a hard class to get through. Ha. But anyway, I still have a little bit of that. Maybe it's a little trauma response, I don't know. But I hear about organelles and mitochondria and all this stuff and I'm like, oh no, not this again. Ah, so yeah, I always have to google, like, explain it to me like I'm five, I have to google like easy explanation of epigenetics. Like that's the only way I really take it.
Speaker 0 00:38:29 Basically I'm still at the molecular Science for Dummies. Like that's, that's my level. That's my level there. All right, so side note on that. But anyway, I just wanted to go through that a little bit because that is, um, the biggest thing that might tie this together. I don't know, maybe basically if it's like the nature versus der thing, epigenetics or like, it's both basically. That's pretty much where epigenetic lands. It's like, yeah, both actually. So that debate, we're not really having it as much anymore because most things are an integration of a lot of complex factors.
Speaker 0 00:39:08 So with all that said, it's time to wrap it up. What we learned today is that there are types of trauma, right? We can characterize things as happening to individuals or small groups versus large groups and societies and countries and even the world, whether things are accidental or intentional or nature caused, right? And this informs how much access to services and help and also the internalization sense of shame or guilt or some sort of shifting worldview or personal view of themself a victim might have if somebody's been through that traumatic response. We also talked a bit about characterizing trauma, which is essentially the dosing of trauma. And the more, the more saturated in it you are, the higher the dose basically the higher the likelihood of having negative impacts throughout your lifespan and negative health impacts perhaps in the future. And epigenetics and how the body responds to stress and whether your kind of your stress button's always really rare and to go or not, basically, uh, whether your parasympathetic is able to kick back in quickly, uh, might be more related to the epigenetics, you know, and how that gets changed essentially with being in an adverse environment.
Speaker 0 00:40:24 Okay? And that might offer some explanation for the fact that the higher the dose of the trauma, the more likely the person's resiliency has been worn down a lot and the more likely they'll need either more support or more long-term support to help build resiliency and heal.
Speaker 0 00:40:44 Now that we've wrapped that up, we've all pretty much learned the main stuff we need to know to be trauma aware per the Missouri model. Next up, we're gonna definitely head toward being trauma sensitive, which is recognizing trauma and its impacts that more of that societal or even global level. Um, definitely the cultural level of groups, okay, and the impact that might have. So that's what we'll be talking about next time. Um, just as a quick reminder, if, if you feel like your organization would benefit from any level of talks or training on any of these topics, um, or the topics I talked about at Asha, if you happen to attend those, then please, you know, shoot me a contact form on my website and I will leave that in these show notes. So do please check that out. So I hope, hope you all have a great week here too. Please join me again, I want us all to discover what it really means to be trauma informed SLPs. Bye.
