Episode Transcript
00:00:00 Hi, I'm Kim Neely, and this is the trauma informed SLP. This is a podcast where we learn how to promote safety and empowerment and to build resiliency in everyone we know, including ourselves.
00:00:20 All right, welcome everybody. I'm so excited. This is my first episode, my first like real episode. Um, if you happen to hear my episode zero, which is a little introduction of myself, welcome back, super excited to have you here. What I thought would be a good starting off point for this first episode was to establish three key concepts before we really get into the basic, um, scientific and physiological evidence that we need to understand trauma. So the first section of this episode is going to be going over a working definition of trauma. This is more of the academic research base definition, and then we'll get into a little bit of what that means for what trauma informed care actually is. And then we'll talk about the general stages or phases people go through to become trauma informed, cuz you don't actually start out with trauma informed. So let's go ahead with section one.
00:01:30 So the reason I really wanted to start out with a good working definition of trauma is because I think this word's been a bit co-opted, especially in social media spaces, in certain areas, it's kind of become a bit overused. Sometimes people just roll their eyes when they hear it. Right. Um, it's sort of taken on this colloquial term, especially in like social media spaces like Twitter and such where sometimes people are using it in a way to just mean like general discomfort or emotional upset, which is not what trauma actually is. So we've gotta get a good definition so that we can start understanding the evidence base behind trauma informed care. Right? So I'm gonna give you guys a definition from the substance abuse and mental health services, administrations treatment improvement protocol series 57. You hear those, uh, stated as tip 57 a lot. It was published in 2014 and it's a big compilation of a lot of the evidence, the best evidence we have for the effects of trauma on individuals and on communities and, um, the best ways of being trauma informed with how you interact with these individuals.
Um, I will be also providing a link in the show notes. This is a free PDF download, which is great. So I'll be, um, leaving a link to that. So the tip 57 states that trauma results from an event, a series of events or a set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening, and that has lasting adverse effects on the individual's functioning and physical social, emotional, or spiritual wellbeing. It goes on to say that trauma generally overwhelms an individuals or communities resources to cope, and it often ignites the fight flight or freeze reaction at the time of the event or events. It frequently produces a sense of fear, vulnerability and helplessness. So that's a pretty long definition. I will break this down a little bit into its components, um, for this definition, but I want you to remember that.
00:03:52 I think the main takeaway is to think of trauma as a physiological response because that is what it is. Okay. It is a fight flight or freeze reaction. So a survival reaction, the physiological survival mechanisms get engaged because someone's actually experiencing a real threat at the time of the initial event. And what makes it a traumatic event is when that physiological response gets triggered. You might hear that word a lot, but it gets triggered by something that reminds the person's brain of the event, the initial threat, but the initial threat, or even a threat at all is not even present. They're just having a survival response, even in the absence of a threat. That's what makes it a trauma. Sometimes I might say trauma response and that's what it means. So a lot of times when people talk about trauma, they mean the initial actual threat, but the trauma response is what you're left with when the threat is over or when you're out of that situation and your body is still having this survival response.
00:05:03 Does that make sense? Here's an example that might help to kind of drill this home in the United States. We have the 4th of July, right? It's a awesome holiday. There's usually fireworks going on. If you're not in like a drought affected area, there are also sometimes military personnel or veterans that are affected by those fireworks, right? You might even see a sign outside their house that says like, please don't put off any fireworks near my house. Thanks very much like go to the county or cities like firework show, please don't set them off on my block. Right? And what that person is saying is that they are aware that the sound of fireworks creates a trauma response because they were in a place where there was a true threat. They were in a place where explosions indicated genuine threat and they were trained how to respond to that threat.
00:06:01 But their bodies still had that rush of adrenaline of epinephrine. So their response to that initial threat was totally healthy and normal. Quite frankly, it's healthy and regular and normal for our bodies to respond in a way that allows us to survive threatening situations. That is a completely normal thing. What is more abnormal or what creates more of an adverse effect is that now when 4th of July comes up, maybe this person loved it as a kid because fireworks are beautiful. But now that they've been to the war zone, when 4th of July comes up, they have this feeling, this overwhelming feeling that there is now a threat to their safety again. And even if they consciously know these are fireworks, there's not actually a threat. Their body is still responding as if there is one. So they get this feeling like they need to do something to survive the situation.
00:07:01 And the reason this might become a real big issue is because even if they're aware that they have this trauma trigger, this person still has to plan around it, right? They still need to get ready for an increased physical and psychological toll that this holiday is gonna take on them. They might know that they're not gonna be able to sleep well that night. So the next day they're just gonna be completely exhausted or maybe they need to take a day off work because they're so tired or they might know that they're not gonna be able to focus enough to like cook dinner safely. So they need to have leftovers planned, right? So that's how trauma can become kind of debilitating. So this military personnel's survival mode was natural, normal, and healthy when under an actual threat, but in the absence of the actual threat, it has a long lasting adverse effect. All right now, welcome to section two.
00:08:01 So now that we have that nice working definition of trauma, and we know that it is an actual physiological response, then what is trauma informed care? Like, what's the big deal? Why do we need to do this? Right? So the tip 57 does actually offer a definition for what trauma informed care is. It states that trauma informed care is a strength based service delivery approach that is grounded in an understanding of, and responsiveness to the impact of trauma. It emphasizes physical, psychological, and emotional safety for both providers and survivors. And it creates opportunities for survivors to rebuild a sense of control and empowerment. And their Intech citation was from hopper, Basu. I'm assuming and vey 2010 page 82. Um, I hope I didn't just completely butcher those names. Never heard them pronounced out loud, so, Hmm. All right. So the main keys to that is that trauma informed care is gonna emphasize safety.
Speaker 0 00:09:14 So physical, psychological, emotional safety is paramount to any sort of treatment space that claims to use trauma informed care. It's also critical that people use the trauma informed care throughout the organization. That it's something that's used for both providers and survivors. And that whole part that says creating opportunities for survivors to rebuild a sense of control and empowerment. That's about helping to build resiliency. So what is resiliency? We have now run into another term that we need to define, of course, resiliency. According to the tip, 57 is the ability to rise above adversity as an individual family, community or provider. And it includes the process of using available resources to negotiate the consequences of adverse events or an adverse event. Okay. So what's the big key takeaway of resiliency. The main thing about resiliency is, well, one, I think very important thing for people in the United States and our society to remember is that resiliency is not the process of just pushing through.
00:10:31 It's not the process of, you know, grin and bear it hunker down, push through things will be fine, just ignore it and just keep moving forward. That is not resiliency. My friends resiliency is when somebody has a feeling like they can overcome this adversity because they know how to access resources that they need. They know how to empower themselves when they feel that they're struggling, they know where to go and who to go to and where to get the support. They need to not struggle quite as much. That is what a resilient person really is able to do. The funny thing about resiliency is it's actually a fairly big area of research and probably is going to be quite booming in our post COVID world. We we're living in. Sorry. That totally made me think of material girl there for a second.
00:11:24 Cause we are living in our post COVID world. na na na.
00:11:29 Okay. Brain. Nope. We're gonna move on. Stay on track. All right. So the reason a lot of these researchers are very interested in resiliency is because people who are resilient tend to be a little bit of they're, they're basically statistical outliers. So if you're studying like a natural disaster, that happens to a big group of people, there will be some percentage of those people who show resiliency, who will not develop a trauma response from the natural disaster. So the idea of building resiliency is if there's a chance you're in interacting with someone who's never had a trauma, the process of building resiliency is teaching them how to empower themselves, teaching them how to access safe spaces, what safe spaces look like, um, and essentially teaching them these tools that they might need if they ever encounter event that would otherwise be traumatic. The other side of it, for people who have already had trauma responses is that being trauma informed means you're going to be promoting a healing emotional cycle.
00:12:35 So the same things that promote resiliency are the things that promote healing. So it's the same thing in terms of emotionally, physically, psychologically safe spaces, safe people, just people who are really helping to rebuild some sense of control in life and empowerment to cultivate the life you want. Right? And the tools you use in trauma-informed care are not the same thing as actually directly treating trauma, actually directly healing the trauma with direct trauma treatment. That is the scope of mental health providers. And it is a different thing, you know, directly treating. It involves changing people's perception of themselves and their sense of self and their perception of others and all this other really complicated stuff. That is the domain of the mental health people for us. That's not what we're about. So taking a trauma informed approach is not treating trauma. It is developing a habit of asking yourself what happened to that person rather than thinking what is wrong with them.
00:13:41 So thinking what's wrong with them. When you see someone behaving in a way that you don't understand or saying something you don't understand, that just is more of that pathogenic. Like clearly there's something that's diagnosable here. That's somebody out there can fix. And it's probably not my problem. Clearly something's just fundamentally wrong. So moving away from that, that idea that you're gonna fix it to the idea of what happened to this person, meaning this person's behavior is a combination of so many things. It's the events currently happening at the moment? It's the environment they're in, it's their sensory sensitivities, it's their genetics, their family history, their place in society, what minority groups they belong to, um, all the past events that they've gone through, that all culminates in why someone is behaving the way they are or saying what they are. And I have found when I start thinking, okay, what happened to this person to make them this way?
00:14:38 I can hold a lot more space and compassion for that person. And it allows me to be a lot more trauma informed. And it also is really helpful if I wanna be trauma informed to myself of thinking what happened to me that made me react that way. It's just really empowering. So that's the big piece. We wanna start developing that habit of what happened to that person. What are all those potential factors that led to that particular behavior or statement or whatever it is that you would otherwise not really be able to understand very well. And the other nice thing about being trauma informed is that once you start to understand the complexities that give rise to certain behaviors or certain perspectives, you don't really have to know a lot about that. Person's personal history with trauma. You just can react to them in a way that is empowering.
00:15:26 And that creates a sense of safety for them. You don't have to ask them about their trauma history. You don't have to hear about it unless they're sharing it with you, but you, you don't have to dig deep into that at all. You just know how to treat people and how to talk to people and how to listen to people such that they feel very safe and that you are helping to empower them by plugging them into resources that may be helpful for them, or that would likely be helpful for them. Okay. Hope that makes sense. Okay. So in wrapping up section two here, the main thing is we wanna develop that habit of asking what happened to that person, not what's wrong with them. And we wanna develop the knowledge that allows us to focus on all the different factors that contribute to that person's health and wellbeing or lack thereof, rather than just looking at that person as the central problem. So the person's behavior starts to inform you of the complexity of what has occurred in that person's life. And you start to understand all the factors that go into whether that person is living a healthy life and they have good mental health, or if a person is behaving in healthy ways or living a healthy life or making healthy choices for themselves. All right. So now we've made it to section 3, 3, 3, 3...
00:16:58 All right. So now that we have that working definition of trauma, we know that it's a physiological response that we're gonna have to learn a bit about, right? And now that we understand what it means to build resiliency, we understand that part of the fundamental tenant of trauma informed care is to start thinking what happened to people now that we know that I would imagine, you're probably thinking, gosh, there seems like there's a lot of things to learn in order to become trauma informed and you are not wrong. There is a fair amount of information that you have to get in order to truly call yourself trauma informed. So it's a process. It doesn't necessarily have to be a long process, but it is definitely a process. And there's definitely a learning curve along this process to become trauma informed. So I'm going to go ahead and start explaining the Missouri model of this process to becoming trauma informed.
00:17:53 I will also be of course, including a link to resources for the Missouri model in the show notes. So please do check that as well. So the Missouri model states that a trauma informed approach is not a program model that's just implemented and then monitored and you keep it a little checklist and you say, yep, we're doing it. It's actually a really profound paradigm shift in the knowledge, the perspective, the attitudes and the skills that then continues to deepen and unfold over time. And this model is really geared more toward organizational structures as a whole. So like the educational system, a school, maybe your private practice, it's it's any place where there's multiple people working essentially is what they're talking about with this Missouri model. But it also, I think, applies at the individual level as well. So in this model, becoming trauma informed, occurs on a continuum.
00:18:52 So you're gonna start with becoming trauma aware. This is where you understand the term trauma, you know, how it changes people and the way you view and interact with others start to shift. So you're starting to understand trauma at that individual level, and you're starting to understand how it impacts people. And this is the level too, where when you first start learning about it, you'll start to see it everywhere. Like it's in your favorite TV shows, you'll be like other people online will be like, why did that character do that? And you'll be like, oh, that is totally related to their trauma from season three. You know what I mean? So that's, uh, <laugh>, that's the stage of being trauma aware. You start to notice it everywhere you really do. Um, and it might seem kind of weird. I mean, a part of it is that, um, what does that effect, that effect where you, uh, because you just learned about something or because something is really on the forefront of your mind, you start to notice it everywhere.
00:19:47 So part of it is that the other part of it from my perspective is that, you know, humans, we've had a pretty long history of being pretty terrible to each other. And we also have a long history of natural disasters and lots of other things happening on this planet, right? So just existing as humans on this planet can be fairly traumatic for groups of people, for individuals, all of that stuff. So I think that might be also part of why you start to notice it everywhere because yeah, we have millennium of dealing with some pretty rough stuff historically, right? So that's the trauma wear stage. Then the next stage, you start to become trauma sensitive. This is where you start to identify organizational policies that might be traumatic. And you also start to recognize organizational policies that help build resilience. So you start to see things at a broader, more systemic level.
00:20:43 You start to notice that there are certain things, there are certain ways of doing things in the world that some of those things can help heal us and really helps to promote resiliency in people. And some of those things can really just perpetuate that traumatic cycle that people go through. Okay. So on the continuum level, I think of this, like trauma aware means you're more individually aware of the individual impact of trauma on people. And then trauma sensitive is where you start to become more aware of that systemic level, that broader level impact of trauma on like communities of people and societies and organizations at large. And then the next stage in this continuum is you become trauma responsive. This is where you start to apply your knowledge of trauma and how to build resilience. And you start to use language that supports safety and choice and collaboration and empowerment across anyone you meet.
00:21:43 Ideally. I mean, nobody can do those a hundred percent of the time. There's no way because we're all humans and we're all flawed, but which is also why it's nice because you want to be trauma-informed toward yourself, which means being compassionate with yourself, which is a pretty key tenant. I think for speech language pathologists, we, we need to hear that a lot, right? Like be compassionate toward yourself. You guys, you really are doing your best truly. So yeah. You start to use that language that supports my speech language office is a safe space or my sessions with my patients is a safe space for them to vent. Or if they're having any sort of emotional upset, like they are safe to have that. Right. So that's the idea and you're working toward empowering people. And it includes like how you work with office staff, front desk, staff admins.
00:22:30 Like it includes all of that at an organizational level. Ideally it includes everybody essentially. Okay. And then in the final stage you become trauma informed. So basically what this means is it's become habitual for you at this point. So you went through trauma where now, you know, stuff about it, you are trauma sensitive, you understand the effects, the impacts trauma has had on wider, broader, uh, systemic structures. And then you also are trauma responsive. You have the tools, you have a few tools in your toolbox that helps you to promote that safety and that empowerment and choice and collaboration with people. And when this has become a bit of a habit, when you've made that paradigm shift, that's where you start to say, I've become trauma informed. Does that make sense? So trauma informed means it's habitual for you to see and interact with others in a trauma informed paradigm.
Speaker 0 00:23:32 And it also continues to deepen and broaden over time, which honestly is why I thought I wanna make a podcast because I wanna continue to deepen and broaden my understanding of trauma informed care. And I wanna bring other people in on this journey. I wanna like interview people and, you know, find out what it means to them and think of other ways that trauma informed can really help us strengthen our practices or even just strengthen our own resiliency as SLPs, because we do need that we have fairly tough, busy jobs, right along all of this, on this, on this paradigm shift, along this whole continuum. Um, I just wanna encourage you all to be as emotionally and cognitively flexible as you can come to it with a open mind, um, with a willingness to learn some new things and just allow mental shifts to occur, cuz your perception of people, organizations, society, and things like that will likely shift.
00:24:33 But what I have personally found is that this shift is actually a really awesome one. It, it, it shifts you into a place of a lot more compassion, um, and a lot more understanding, not necessarily excusing. We don't wanna just excuse bad behavior all the time. That's not cool, but we can understand it a little more. You know, so it is a process. And the biggest part of the process I think, is to remember that also applies to yourself and how you talk to yourself. So as you're learning things, as I was learning things, there were things that I thought back on what I was doing like two or three years ago before I had this sort of training and thought, ah, geez, if I had known, then what I'd known now I could have handled that situation so much better. Right. But it, instead of beating yourself up over that.
00:25:20 And, and for me, definitely instead of just beating myself up over thinking that I had to realize that, wait, I need to be trauma informed toward myself. The fact is I didn't have that training back then. I don't have access to a time machine. I can't change that. And I did my best. I did the best I could. And also holding onto the fact that resiliency is a thing. If you feel like maybe, oh, that might mean I hurt somebody in the past, or I didn't give the best care to that client or whatever like that. Client's gonna interact with a lot of other people. And the idea is the more, the more often more of us become trauma aware and then eventually trauma informed the more people along this journey, the better because the more chances that that person will encounter someone who can help build that resiliency and it doesn't always have to just be on you.
00:26:15 You know what I mean? That it, it, yeah, it takes a whole group. It takes a community of people to really help with that. Does that make sense? Hopefully. So <laugh> basically, you don't have to carry this like ethical, emotional weight on only your shoulders. You are not the only one who is gonna influence someone's life. And as long as you learn to influence that life in a positive way and help with the healing cycle and help empower them, anytime you start, that is a perfect time to start that, you know what I mean? So, and any tools that help help with that, any broader knowledge that helps with that is a good thing to acquire, right? So that's the journey we're on here. So I just wanted to remind you all of that, cuz I know we're all fairly stressed out there, but ultimately yes, please, SLP friends be kind to yourselves. You really are doing the best that you can and sure, as you go on this journey, perceptions might shift, you'll get some new tools in your tool belt and you'll feel even more capable to continue doing your best. Does that make sense?
00:27:26 So that's it guys episode one wrapped up. Boom. So, uh, we went through three key takeaways on this episode cuz I know I did a lot of talking. So if you hung in there with me the whole time, thank you so much. And even if not, if you happen to zone out a few times, I definitely understand that. So let's wrap things up of what we went over. So we went through the first thing, which was the, uh, working definition of trauma. So the key takeaway about trauma is it is a physiological response. It's triggered by an emotional memory of a previous true threat that a person experienced and that they're still experiencing that survival mode, that fight flight fight flight or freeze mode, even if the threat's not around. The second thing we covered is that being trauma informed means you're going to be building resiliency and promoting a healing cycle among people and yourself, of course, including yourself.
Speaker 0 00:28:24 And that really means a big paradigm shift from thinking sort of pathogenically of something's wrong with this person toward more of a salutogenic or supportive model that says what happened to them. Okay. And then the third big takeaway here is that being trauma-informed is a process. It's gonna start with becoming trauma aware, which is where I'm gonna start you guys along that journey for the next few episodes. And then we're gonna build into that, um, being trauma sensitive and eventually we'll end up at that trauma responsive and deepening our habitual sense of trauma informed and what that means and opening up a broader discussion amongst all of us. That is my ultimate goal for this. So I hope you enjoyed it. I hope you got something from this. I hope I didn't go off track too many times. Hey, but please join me again next time. Um, I'm gonna talk about the physiology and we're gonna get into survival mechanisms, possibly one episode after that. So please join me back for that. I hope you all have a really great week or two and do join me again. As we all discover what it means to be a trauma informed SLP.
