What is Trauma?

This resource page, originally adapted from the Athens Area Community Foundation’s original trauma resources guide, is intended to provide an introduction to trauma, Adverse Childhood Experiences (ACEs), and resiliency, which are three of the key concepts at the center of Resilient Northeast Georgia’s strategic plan for the region.

Below you will find an overview of topics discussed on this page. To navigate the guide, see the hyperlinked table of contents below.

What is Trauma?
- Types of Trauma
- The 3 E’s of Trauma
- The 4 R’s of Trauma-Informed Care
Resiliency
Adverse Childhood Experiences
- The ACEs Tree
- The ACEs Quiz
Addressing Trauma and Building Resiliency: The Community Resiliency Model
Who Does Trauma Impact?
Why Does Trauma-Informed Care Matter?
What Can I Do If I Have Experienced Trauma?
- Practicing Mindfulness as a Way to Recover from a Traumatic Event
What Can I Do If Someone I Care About Has Experienced Trauma?
- The Feelings Wheel
PSA Video: Building a Trauma-Informed Region
References

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines trauma as an event, series of events, or set of circumstances that an individual experiences as physically or emotionally harmful or life-threatening and that have lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual wellbeing.

There are three types of trauma

Acute trauma: These are one-time traumatic events with short-term effects and typically have the quickest recovery period. This could include surviving a natural disaster (hurricane, flood, fire), experiencing a car accident, or being the victim of a crime.
Chronic trauma: These are multiple or repetitive traumatic events that produce a cumulative effect. For example, experiencing long-term neglect or abuse as a child, living in a domestically violent environment, experiencing war or combat situations, or even sustaining a series of acute traumas can result in a chronic traumatic experience.
Complex trauma: These events typically happen early in life and affect a child’s development and ability to form secure attachments. These traumatic events are invasive and occur in the formative years, affecting an individual’s ability to cope and function normally as they get older. Emotional, physical, and sexual abuse, pervasive neglect, and experiences of interpersonal violence are examples of complex traumas.

Although trauma is a universal experience, the way that individuals experience and process trauma varies from person to person. Whereas one person may experience a traumatic event and have no long-lasting effects, another person may experience their traumatic circumstances more intensely through chronic physical, emotional, and behavioral reactions that impact their daily functioning capabilities.

Because of this, addressing all traumas from the same perspective of care can be limiting. Approaching trauma from a singular or generic frame of care can leave traumatized individuals feeling that their needs have not been fully met or that their experiences were not given due diligence in the thoughtful and trauma-informed manner necessary for recovery.

Click here for more information about the signs and symptoms of trauma

The Three E’s of Trauma

When discussing trauma, there are three key components, known as the 3 E’s of trauma, that can be helpful in better understanding how traumatic events impact people. They are the event, the experience, and the effects. The event is the traumatic situation, the experience is the way that someone emotionally responds to the event, and the effects are the long-term and short-term outcomes associated with experiencing a traumatic event.

Breaking down trauma into these three components focuses on the long-term effects of traumatic experiences by tying an individual’s coping and processing methods to observable impacts of trauma. Using a framework that incorporates the traumatic event with the individual’s reaction helps more clearly explain the effects of trauma.

Sometimes, it is easy to notice when someone is exhibiting signs of trauma like hypervigilance, sleep disturbances, and lack of emotional control, but difficult to attribute those changes in behavior to a specific event. Building awareness around these three E’s of trauma can improve the way that individuals who have experienced trauma are being treated within the existing and emerging systems of care by promoting increased awareness of possible symptoms of having experienced a trauma.

The Four R’s of Trauma-Informed Care

The goal of trauma-informed care systems is to support individuals who have been impacted by trauma and resolve trauma-related outcomes without retraumatizing people. By advocating for a system of trauma-informed care practices, proponents of trauma-informed care are seeking to shift the perspective of trauma from “what’s wrong with you?” to “what’s happened to you?”. This practice centers on the individual’s reactions to an external traumatizing event rather than implying a moral or personal shortcoming and is, therefore, more affirming and supportive to those who have experienced trauma.

There are four components, known as the four R’s of trauma-informed care, which guide community efforts to bring trauma-informed care principles to the community. First, realize that trauma is a widespread concern in the community and recognize the signs and symptoms. Then, respond to the trauma in a way that reflects your awareness that the event may affect individuals who are directly and indirectly involved in the situation. This could look like talking about the experiences of the other people outside of the epicenter of the traumatic event. Finally, all of your efforts to be supportive should resist retraumatization of individuals who have experienced trauma and are in the process of healing by avoiding triggers.

Resiliency

The American Psychological Association defines resiliency as “the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress.” Resiliency involves ‘bouncing back from traumatic experiences and can also involve profound personal growth in the process. In this context, resiliency is the ability to adapt and recover following a trauma.

As a result of personal and environmental factors, individuals have different capacities for resiliency. Following the experience of a traumatic event, a person at a higher personal capacity for resiliency can return to normal more quickly and reliably than someone at a lower capacity. This is why individuals respond to traumas in such different ways: their baseline for resiliency is different based on the systems of support available in their daily lives.

That’s not to say that someone with fewer resources or services available to them is predisposed to being less resilient than others. Resiliency is not a static state or an inborn personality trait. Rather, it can be built through experiences, behaviors, thoughts, and actions over time and with intentionality.

Having a capacity for resiliency does not mean that a person is immune from trauma or its effects. Instead, they are better equipped to process and manage the impact of traumatic experiences. Resiliency can be fostered through the presence of many internal and external factors such as belonging to a close-knit group or community. One of the most significant predictors for a child’s development of resiliency is whether they have at least one reliable and responsive adult present in their life.

Adverse Childhood Experiences (ACEs)

Adverse childhood experiences, or ACEs, refer to potentially traumatic experiences in childhood (between the ages of 0-17) that can have long-lasting impacts on feelings of wellbeing, safety, stability, and bonding in adulthood. ACEs can result from things like witnessing or experiencing violence, neglect, abuse, housing insecurity, food insecurity, and discrimination at home or in the community at a young age.

ACEs have also been shown to occur with higher prevalence in households with instances of substance abuse or misuse, mental health problems, or familial instability from divorce, separation, or incarceration.

In the United States, 61% of adults have experienced at least one ACE and 16.7% have experienced at least 4 ACEs in their lifetime. It is essential to address these traumas because ACEs have been linked to a higher risk of chronic disease, substance abuse disorders, and mental illness in adulthood, leading to costly but ultimately preventable health expenditures.

The ACEs Tree

Early exposures to adversity have been linked to chronic illness, depression, obesity, cardiovascular disease, and substance abuse later in life, manifesting as long-term symptoms of ACEs. These symptoms, like dying leaves on a tree, indicate that the wellbeing of the individual is being compromised and that overall health and quality of life are diminishing.

Using this analogy, the ACEs Tree is a resource used to illustrate the impacts of adversity in the household and in the community on an individual’s health and wellbeing. In the same way that the leaves on a tree can be used to learn about the tree’s health, an individual’s health indicators are observably influenced by the health of their environment. Factors above the surface (causes of trauma that can be easily observed and identified in households) and deep within the soil (systemic inequities that exist in the environment of a community) can impact the overall health of the tree (the individual) over time.

The tree’s leaves represent the observable impacts of adversity, which are caused by instances of abuse, neglect, violence in the household and in the community. When exposed to adverse childhood experiences, the risk for maladaptive coping strategies, mental illness, physical disease, and toxic stress (repeated exposure to adversity and trauma that results in abnormal or unhealthy stress response) increases over the lifespan.

The soil the tree is planted in represents the community an individual grows up in. A tree that is planted in poor soil (a community with pervasive systemic inequities) will lack vital nutrients that are important for growth (early childhood development). If grown in toxic soil (adverse community environments), even trees with the healthiest individual environments (household factors) can struggle to thrive.

Adverse childhood experiences and adverse community environments interact to diminish the health and wellbeing of individuals and systems over time. The health of the household can shape the health of the community as a whole. Over time, a high enough level of sustained cyclical adversity can cause both malignancy of the soil and deeper damage to the tree itself if no intervention occurs to improve the environment.

Adapted from Ellis, W., Dietz, W. (2017) A New Framework for Addressing Adverse Childhood and Community Experiences: The Building Community Resilience (BCR) Model. Academic Pediatrics. 17 (2017) pp. S86-S93. DOI 10.1016/j.acap.2016.12.011

The ACEs Quiz

The ACEs Quiz is a diagnostic tool used to bring awareness to the ways that adverse experiences within the household can impact individuals as they mature to adulthood. Composed of 10 questions, it is intended to help bring awareness to ACEs but does not serve as an indicator for future success or sensitivity to adversity. Because there are no questions about protective factors, like support systems, this assessment is an incomplete but important tool for predicting who could be at risk based on their experiences. To provide a more complete view of risk and protective factors, an assessment of stressors outside of the household, stable and supportive relationships with adults, and individual differences in social skills, genetic predisposition, and resiliency.

Take the ACE’s Quiz here!

Addressing Trauma and Building Resiliency: The Community Resiliency Model

The Community Resiliency Model, or CRM is a skills-based wellness and prevention training program that strives to create “trauma-informed” and “resiliency-focused” communities by promoting the understanding of the impact of traumatic events and chronic stress. CRM training focuses on techniques to achieve regulation in the nervous system and a better balance between the body, mind, and spirit. This model is taught so that it is easy to teach and pass on to others, therefore allowing it to permeate throughout the community.

The Community Resiliency Model was created as a non-judgmental approach to the impacts of trauma and combines clinical perspectives on the nervous system’s response to stress with the emotion-driven perspective on people’s reactions to trauma. The goal of CRM is to reinforce that it is normal to have strong reactions following a traumatic event and works from that standpoint to provide people with the tools they need to reregulate their nervous system and begin recovering from the traumatic event.

This training is one of the core trainings utilized across Resilient Northeast Georgia as part of this grant opportunity. For more information about the training, please visit the Trauma Resource Institute.

Who Does Trauma Impact?

Trauma is a universal experience and has impacted an estimated 70% of adults in the United States. Traumatic experiences are not limited in scope by age, gender, race, ethnicity, sexual orientation, socioeconomic status, or geography, although some marginalized groups are more likely to experience trauma.

Understanding how a community responds to individual trauma can give insight into an individual’s response to a traumatic event. After all, trauma doesn’t exist in a vacuum and is often a direct result of external, community-driven factors. On an individual level, trauma can occur in the context of geographic communities, identity-based communities, and within everyday organizations like school, work, or peer groups.

Considering individual reactions to trauma against the backdrop of community response models brings focus to the interconnectedness of individuals and communities. Individuals may process and respond to their traumas in more private settings, but within their communities, they cope, adapt, and hopefully overcome the impact of their experiences. Because it is often within a community safe-space that individuals cope with their trauma, understanding the levels of support a community provides or overlooks informs an individual’s healing process.

Trauma can also occur in a community as a whole. Communities share a collection of experiences that are passed down generationally and can have far-reaching adverse effects on the individuals in the community. Addressing traumatic experiences like violence, discrimination, racism, and inequity at an individual level can alleviate some of a community’s traumas. Still, it’s often necessary to reckon with traumas on a holistic community level to achieve systemic change.

Why Does Trauma-Informed Care Matter?

The goal of discussing and promoting trauma-informed practices centers on crafting a better understanding of trauma and creating a common language to discuss traumatic events. This framework highlights that while we all experience traumas, the way we process and react to those events varies. The event or experience that one person has may leave them relatively unaffected by their experience. In contrast, the same event may invoke chronic physical, emotional, and behavioral reactions in another person as a result of their personal history and experiences. Creating a trauma-informed system that acknowledges that the impacts of traumatic events present differently on an individual and community level allows empathetic and considerate responses that reduce retraumatization and provide support for individuals in recovery.

What Can I Do If I Have Experienced Trauma?

The following infographics compile tips and suggestions surrounding personal healing from a traumatic experience. These tips are not intended to be used in place of professional guidance but instead seek to present a list of the information suggested by the top qualified individuals in the field. If you or someone you care about has experienced a traumatic event, it is recommended that you seek help from a professional trained in trauma-informed care.

Practicing Mindfulness as a Way to Recover from a Traumatic Event

In the aftermath of an emotional or traumatic event, it can be helpful to have a way to check in with yourself and assess how the experience is affecting you beyond the initial event. The R.A.I.N. technique can be valuable assets that help you to pause, take inventory of your emotional status, and then articulate and identify your feelings to yourself and to others. Coming off of a traumatic event, this is an important step in the healing process. Mindfulness fosters introspection, which can alter your perception of your emotions and allow you to more clearly ascertain your emotional state and discern the next steps that will bring you back towards equilibrium.

What Can I Do If Someone I Care About Has Experienced Trauma?

The following infographics compile tips and suggestions for supporting someone who is healing from a traumatic experience. These tips are not intended to be used in place of professional guidance but instead seek to present a list of the information suggested by the top qualified individuals in the field. If you or someone you care about has experienced a traumatic event, it is recommended that you seek help from a professional trained in trauma-informed care.

The Feelings Wheel

Using this feelings wheel to promote more effective communication of emotions can be useful for better understanding the experiences and reactions of other people. Moving outward from the inner sections, the feelings wheel is a communications device used to help individuals identify the base-level emotions they may be feeling and move outward on the wheel to the more specific and nuanced range of emotional reactions and feelings. This fosters improved understanding and a system of dialogue for expressing and communicating emotions effectively when trying to support someone who has experienced a traumatic event.

Trauma-Informed Care PSA Video

This PSA, which can be viewed below, represents the collaboration of the grant partners and key members of the community to create a tool for discussing trauma in the community. Drawing on information and testimonials from individuals in the community who work with people who have experienced trauma or have themselves experienced trauma in their lifetime, this PSA is the culmination of our work in trauma and seeks to enforce the idea that trauma is a universal experience. While most of the people you see in the video live or work in Athens, this video is designed to reach well beyond our 6-county region and is intended to be relatable and informational to people all over the state of Georgia.

Filmed and edited by Motion House Media’s Matt Hanner and Patrick Stafford, this short PSA is intended to be used from the boardroom to the classroom and everywhere in between to provide information about trauma by answering five questions: