Trauma impacts lives on the individual, familial, community and societal level. Historically, we have addressed the resulting symptoms of trauma with treatments of therapy, education, and all too often imprisonment. However, putting preventative factors in place can avert the symptoms, outcome and resulting negative impacts. Prevention begins with understanding how trauma impacts lives and why it impacts our brains and bodies before we can fully understand what we can do to mitigate its impact.
Our preventative measures should include the following three levels of awareness and education across systems and families. The first level encompasses the many forms and prevalence of trauma (including the Adverse Childhood Experiences study) and the research explaining how trauma impacts physical and brain health. The second level incorporates why trauma impacts our brain and body systems. This education should include knowledge of the triune brain, why our instinctual reactions override our thoughtful responses, how triggers are created, and why repeated trigger reactions can impede the development of executive functions.
The prevalence of trauma and the related brain science seem to paint a bleak picture if processed without also learning about the researched practices that prevent the long-term negative impact of trauma. All three levels of education are necessary to fully understand the scope and sequence of how to raise resilience in our communities and families. To quote Dr. Carl Bell, “Risk factors are not predictive factors because of protective factors.” Research has identified what protective factors are most effective in building trauma integration and resilience.
Trusting relationships in safe environments and building regulation and competency skills are the pillars to strengthen resilience. The ARC Framework (Attachment, Regulation, Competency) by Blaustein and Kinniburgh details these pillars and offers supporting practices and tools. Bruce Perry’s three R’s, (Regulate, Relate, Reason) encompass these practices and support a tiered process: We need to be able to foster Regulation of ourselves and others to build positive Relationships before we can begin to teach and use Reason to solve problems. Trust Based Relational Interventions (TBRI) emphasizes that must we create a safe environment with connections, prepare the body physiologically and mindfully, and increase attunement, awareness and flexible responding.
These researched practices are graphically displayed by the Trauma Integration Tree (see attached). Helping others integrate trauma is a process that takes time and follows a path of growth. Just like the growth of a tree, it begins with roots, progresses with a trunk that strengthens, and ends with multiplying branches.
Growth begins by creating a fertile environment where Creating Connected Communities roots can thrive. Just like a good root system in a tree, if these root concepts are well established, the rest of the tree will strengthen and promote resilience. The goal is to create a safe environment and trusting connections. The researched Raising Healthy Children curriculum emphasizes that healthy relationships are the base, along with structured, caring environments. Bruce Perry said, “The more healthy relationships a child has, the more likely he will be to recover from trauma and thrive.”
The root system begins with the tap root; on the Trauma Integration tree, this root is Caregiver Reflection and Regulation. As caregivers, we must reflect on our own thoughts and body reactions and regulate our emotions and energy before we can respond to others in a trauma informed way. If we cut off this tap root and do not have self-care or time to reflect on our interactions, the rest of the tree will not reach its full potential. The Center on the Developing Child at Harvard University states: In order to provide a well-regulated caregiving environment, adults must be able to set and meet goals, manage their own behavior and emotions, and establish daily routines. Bruce Perry agrees that we first must foster regulation of ourselves.
The other roots- Attunement, Responses, Routines/Rituals- create strong connections in a safe environment. When caregivers attune with others using brain science to drive their responses, needs are met and relationships are fortified. All research leads to this explanation: “Beneath every behavior there is a feeling. And beneath each feeling is a need. And when we meet that need rather than focus on the behavior, we begin to deal with the cause, not the symptom.”
To sustain a well-developed root system, routines and rituals are used to create a predictable environment that fosters belonging. Bruce Perry advises to “provide a consistent, predictable pattern for the day” because brain imaging shows that familiar patterns are calming to a child. He also reinforces that a history of connectedness is a better predictor of health than a history of adversity.
Just like a tree with shallow roots, if we have shallow understanding of these root concepts and do not daily integrate them into the environment, the entire tree is at risk of falling with a strong, traumatic wind. The Center on the Developing Child at Harvard University substantiates this framework: A child who is living in an environment with supportive relationships and consistent routines is more likely to develop well-functioning biological systems, including brain circuits, that promote positive development and lifelong health.
The trunk of the Trauma Integration Tree creates Calming and Communication. Skill building includes Emotional Identification, Modulation of energy and emotions, and ends with Emotional Expression. The trunk is similar to our physical body; to overcome the impact of trauma, we must address how emotion manifests itself in our bodies. If these skills are strong, then, like a tree, the trunk of our being will have strength and will flourish. Bruce Perry’s sequential engagement and processing supports how the outside and inside world of the child need regulation in order to relate to others and have our emotions expressed in a way that gets needs met. Harvard University and TBRI express that caregivers should facilitate social-emotional development and skill-building and co-regulation before expecting others to self-regulate.
Finally, The Trauma Integration Tree produces the upper Competency branches: Executive Functions and Self-Identity. These two concepts are fostered and developed only after the roots and trunk (a safe environment and regulation skills) have begun to develop. Bruce Perry stated: We must regulate people before we can possibly persuade them with a cognitive argument. Brain research has shown that people with a history of trauma have decreased neural connections in the pre-frontal cortex. The Center for the Developing Child at Harvard explains: When children have opportunities to develop executive function and self-regulation skills, individuals and society experience lifelong benefits.
If an agency, school, business or community spends the first few years developing a substantial root system and creates a safe environment with trusting relationships, then the trunk and branches (regulation and competency skills) will be supported and more sustainable.
Transforming lives by increasing protective factors begins with education that includes:
- knowledge about the prevalence of trauma and how it impacts lives
- understanding why the human brain reacts and responds to the environment
- what practices foster attachment in safe environments, assist others to learn regulation and expression of emotions, and create stronger competency skills.
Most importantly, we must all remember:
The power of one strong adult relationship is the key ingredient to overcoming adversity.
People, not programs, change people. -Bruce Perry
Written by: Cheryl Step, MS, LPC, NCC, NCSC Creatingresilience.org