“Trauma-informed” practice is not just for mental health practitioners.

If you work in a client-facing role or industry, the way you interact with the people you provide services to has the potential to completely change their day — either positively or negatively 

Trauma-informed practice is a type of client-focused practice that’s gaining momentum. It has the potential to change the way medical professionals, carers, social workers, government employees, etc., provide services to people in a more positive, supportive way. 

Have you ever heard a song or smelt a fragrance that instantly transported you back to another time and place? As we all know, our senses recall memories. It is a very personal, involuntary experience which can happen very unexpectedly. We feel good when it’s a happy or fun memory, but feel sad, angry or embarrassed if the memory is of a negative experience. 

So, imagine when the memory that’s recalled is a very distressing and traumatic one. This commonly activates a “trigger”. “Triggers” occur when a memory causes a neurological and physical response, as though the person is experiencing that initial traumatic event right then and there, even years or decades after it took place. The neurological and physical response is generally associated with a “fight, flight or freeze” reaction.  

The ever-present threat of “triggers” in our everyday lives

Triggers can happen pretty much anywhere, but certain environments are more likely to be triggering for trauma survivors.  

The intimate nature of the interactions in a doctor’s surgery, for instance, presents many potential triggers. The feeling of powerlessness experienced when dealing with a government department can be particularly triggering, as can the vulnerability older people can face in aged care settings. 

Is your workplace an environment with lots of potential triggers for the people you work with?  

How to spot trauma responses in individuals

The fight, flight or freeze responses can take many forms Many of us have witnessed someone reacting in a seemingly disproportionately angry, fearful or stubborn way in a particular situation.   

But it may not have occurred to us at the time that this may have been a trauma response. 

The good news is, almost all of us can learn how to expand our thinking, look beneath the surface of people’s outward reactions, and interpret what may be triggering them. We can first aim to ease their distress, rather than contributing to it.  

Things to look out for that may indicate a trauma response can include:  

  • Distress or agitation. This can sometimes escalate to a panic attack where the person feels that they can’t breathe, they have chest pains, or they need to leave immediately 
  • Confusion or inability to focus on what is happening around them. They may seem “absent”, like they are not aware that you are there or are not registering what you are saying  
  • Anger, abuse or aggression.

What one inspirational dentist can teach us   

Melbourne dentist, Dr Sharonne Zaks, provides a brilliant example of how each of us, not just mental health practitioners, has the power to make a difference in the lives of people with an experience of trauma.   

Dr Zaks has done some remarkable work on treating dental patients living with trauma. In an interview with SBS in May 2019, Dr Zaks explains that “… it’s all about reconfiguring the power balance of the relationship, and us as dentists thinking about how to be less dominant and giving power and control back in all ways.”   

The “relationship” she is referring to is between the dentist and their patients — specifically, patients with a history of trauma. Dr Zaks has developed strategies to minimise triggers and reduce the anxiety and stress of patients who have been sexually or physically abused and are living with the ongoing impacts.   

These triggers are often based around a perceived loss of control and a sense of powerlessness. Her strategies include discussing everything with her patients, listening to what they want and need, and using their input to guide all actions. She aims to give them control over their visits and their treatments, which equalises the balance of power.  

Where previously, these patients had found a visit to the dentist too traumatic,  they are now able to get the treatments they need to maintain good dental health, which is essential for overall wellbeing.   

In this TEDx Sydney talk, Dr Zaks tells the story of one patient who, over time, was able to increasingly tolerate the dental work she needed, thanks to Dr Zaks “trauma-led care”. The patient’s confidence greatly improved because of the dental work she was able to have done, so much so that she’s since been able to get a job and make significant improvements to her life.  

How can you be more trauma-informed in your interactions with others?

You don’t have to be a dentist to learn from Dr Zaks and implement some of her techniques in your own interactions  

As Dr Zaks says, “this sort of approach should be integrated into the teaching of not just dentists, but other health professionals and teachers and police and hospitals and across all human services.”  

Many aspects of her approach can be universally applied to almost any service industry to minimise potential re-traumatisation of those impacted by trauma.  

Developing trust is a key element of her approach, through incorporating more empathy, more listening, more understanding, more patience, more kindness and more respect. It’s about learning to better understand what it’s like to “walk in the shoes” of someone living with trauma.    

Small changes can make a big difference  

The following may be some of the ways you might start to incorporate trauma-informed practice into your workplace:  

  • Look at the layout of your rooms. Does the layout of furniture highlight perceived power imbalances between you and your client? Rather than sitting behind a desk, for instance, position similar chairs around a small coffee table and let them choose their chair. Asking the person if they would like the door left open or closed can be very important.
  • Do you ask questions of people in ways that feel respectful, not invasive?  Begin questions with “are you comfortable telling me…?” or “what do you think about…?”
  • Do you explain process and procedures in a way that the person can understand?Try not to use jargon or acronyms, be accurate, explain each step and why it is necessary, before it happens if possible.  
  • Do you know how to effectively “de-escalate” a person who is experiencing the fight, flight or freeze response? 

Even if you have no other training in “trauma-informed practice”, a good first step is to ask the person something like, “I can see this is difficult, what can I do to help you?” They might need some time, they might ask you to call someone, they might want a drink of water, or they might just need you to listen to what they say. Giving them some control over the situation is likely to help. 

The more places and situations we can make “safe” for trauma sufferers, the less stress they’ll experience in their daily lives, increasing their self-esteem and improving their overall wellbeing and opportunities.  

It may just be a shift in mindset, a small change in your actions or the formal implementation of trauma-informed practices, but it could be enough to change someone’s life.