Trauma and Mental Health - An Introduction

I have been reflecting recently on the topic of trauma and mental health, having engaged with some top up training with YoungMinds. I have also been reflecting personally in light of the recent and tragic death of Caroline Flack, on the way in which different adverse experiences can present, influence and impact different people in different ways.

I wanted to share some key learning points and reflections online, starting with an introduction to childhood adversity and trauma. This will be followed by a further article to address some of the practical responses, suggestions and strategies to supporting young people who might have experienced trauma.

• Adverse Childhood Experiences (ACES) are defined as highly stressful, and potentially traumatic, events or situations that occur during childhood or adolescence. It is our role to always be mindful that trauma means different things to different people, and one persons experience of trauma may be very different to another. I have certainly had experiences working with siblings who have responded entirely differently to the same traumatic event. This is due to a range of other factors (see below) that contribute to how each person interprets and responds to a traumatic event. Each different response must be accepted and responded to with empathy and kindness, and not disputed or compared to another.

• Trauma can be viewed through a bio-psycho social model, that meaning that trauma can occur due to an individual or combination of the following three factors;

1. Nature (What we are born with)

2. Nurture (What we grow up with) 

3. Events (What life events happen to us)

• The bio-psycho social model can be used to explain why different people respond differently to the same traumatic event. Whilst two people might encounter a similar traumatic situation, they will likely have different life experiences prior to the event taking place. They will have experienced differing experiences in relation to their nature and nurture and therefore their interpretation and response to the situation will not be the same.

• Trauma can present in a multitude of different ways. Some young people will present with clear signs of trauma and will command our attention through their day to day presentation (hyper-vigilant, highly anxious, aggressive, out of control). However there are other presentations that may be less noticeable but are equally important to address. It is important to consider as professionals, those children and young people who perhaps do not demonstrate such obvious signs of trauma, but who may have experienced such. Whilst some individuals respond through hyper-arousal (fight/flight), others may demonstrate a state of hypo-arousal (freeze). This might present as spaced out, numb, shut down and disconnected. Please see attached “window of tolerance” diagram for more insight into this.

• Protective factors can buffer the negative impact of trauma. This can explain why not all young people who face childhood trauma or adversity will go on to develop mental health problems. Protective factors can build resilience and help young people respond and bounce back from challenging life events. This is yet again a further explanation as to why different individuals may respond differently to the same traumatic event, if they have had different experiences of protective factors. Protective factors can very often come in the form of key figures and inspirational individuals in a young persons life, both in the form of friends and family, or often teachers, support workers, mentors etc. For anyone who hasn't heard footballer Ian Wright speak about his school teacher and first male role model, do take a read to hear him talk of the man who "literally turned my life around"; https://www.the42.ie/ian-wright-mr-pigden-interview-arsenal-england-sydney-pigden-teacher-pilot-world-war-ii-4297909-Oct2018/. This leads me to proudly reflect on the amazing professionals who work so compassionately with young people that they themselves become a protective factor to a young person in the face of adversity. Any state provided service for young people is not an easy one to work in right now, but despite a gross lack of resources and an ever challenging external environment, there are still so many inspirational people who continue to inspire, encourage and support young people across the country - keep up the amazing work, we would be lost without you!

If you are interested in learning more, I have attached a link to a YoungMinds poster which is free to download and which contains more details on childhood adversity and trauma; https://youngminds.org.uk/media/2141/ym-addressing-adversity-infographic-poster-web.pdf. I will also be sharing some more reflections and strategies in the coming weeks.