Many of us are exposed to disturbing or frightening experiences in our lifetimes. But when the frequency or the impact of those experiences prevents us from moving past them, the result can be devastating. Further, more vulnerable populations such as women, Indigenous Peoples, and the 2SLGBTQ+ community tend to be disproportionately affected.
In this post, Homewood Health Centre’s trauma treatment director describes why trauma can be so damaging, who is most likely to need trauma treatment, and how people with acute trauma and PTSD can heal their wounds and overcome their fears.
What is trauma?
As unpleasant as they are, feelings of fear are a normal, human response to a real or perceived threat. When we think we are in danger, our minds and bodies shift into a heightened state of alertness, sharpening our senses and accelerating our heartbeats to improve our chances of survival. We tense up, we sweat, our hands tremble, and time may feel like it’s racing ahead or stopping entirely.
Normally, those feelings subside once the danger is past, but for a person with trauma, they never really go away, leaving them to relive the experience and manage the emotional and physiological effects on an endless loop.
The people at higher risk of trauma
Trauma takes a tremendous toll on people in Canada. People who experience trauma are at higher risk for PTSD, anxiety disorders, substance use disorders, and other health-related conditions. About 8% of Canadians who experience a traumatic event will develop PTSD, and approximately 50% of individuals with PTSD will also suffer from depression.
Kerry Manthenga has worked closely with populations at high risk of trauma for more than 20 years. She began her career as a sexual abuse therapist working in a women’s prison, and today, she is the Director, Clinical Operations and Programs – Addiction and Trauma Services at Homewood Health Centre, one of the largest mental health and addiction treatment centres in Canada.
She explained that each person’s response to a potentially traumatic situation is different. “Two people can go through the same distressing event, yet only one will experience lingering trauma,” she said. “After a few months, some people will integrate those distressing emotions and memories into how they function in the world and the experience won’t intrude on their wellbeing. But for others, the distressing event exceeds their brain’s natural capacity to integrate the experience, and it continues to reappear in their life in different ways. Months later, they still experience fearfulness, avoidance, and flashbacks.”
This can be for many reasons, including a history of prior stressful and /or traumatic experiences. Additionally, some populations have much higher rates of trauma than the average. These groups include first responders and military personnel, whose work can place them in distressing and dangerous situations on a daily basis. But it also includes women, Indigenous Peoples, and people who are 2SLGBTQ+.
“These populations are more likely to experience multiple distressing events that compound on one another, and there’s a greater likelihood of difficulty resolving trauma and experiencing trauma-related disorders,” Manthenga explained. “That may be as a result of their immediate personal circumstances, but also because of the experience they have of systemic oppression and marginalization, which also impacts their ability to seek help.”
Indigenous Peoples and trauma
Canada’s colonial history is the cause of deep, intergenerational trauma in its Indigenous communities. The impact of residential schools alone, which forcibly separated an estimated 150,000 Indigenous children from their families, caused massive group trauma.
- Almost 4 in 10 Indigenous Peoples (38%) experienced childhood victimization.
- The rate of violent victimization of Indigenous Peoples was more than double that of non-Indigenous people.
- Indigenous Peoples have nearly four times the risk of experiencing severe trauma than the non-Indigenous population.
Women and trauma
Women in Canada and around the world are exposed to sexual violence, sexual degradation, and everyday sexism, all of which correlate with trauma and the development of PTSD. As a result, women are more likely to experience trauma and develop PTSD than men.
- Canadian women are three times more likely than men to have been sexually abused by an adult during childhood.
- Globally, 1 in 3 women experienced physical or sexual violence by a partner or sexual violence by a non-partner.
- Twice as many women as men meet the criteria for PTSD.
2SLGBTQ+ and trauma
The 2SLGBTQ+ community experiences numerous social and health inequities, including higher rates of violence and victimization. Frequent exposure to these traumatizing events is one of the reasons why they face higher rates of anxiety and double the risk of PTSD compared to heterosexual people.
- The violent victimization rate among bisexual Canadians was 9 times higher than that of heterosexual Canadians.
- Gay, lesbian, and bisexual Canadians were more than twice as likely to be discriminated against or treated unfairly than heterosexual Canadians.
- Approximately 4 in 10 lesbian, gay or bisexual Canadians experienced childhood victimization.
- Transgender Canadians are 1.5 times as likely as cisgender Canadians to experience violent victimization, more than twice as likely to experience unwanted sexual behaviour in public places, and 2.5 times as likely to experience unwanted sexual behaviour online.
Trauma signs and symptoms
While it’s not uncommon for people who experience a distressing event to have memories and flashbacks, problems start when these reactions persist and, in some cases, intensify over time.
According to Manthenga, people with trauma will experience:
- Flashbacks that force them to relive the traumatic event in the present moment.
- Sleep disruption and nightmares related to the traumatic event
- Aversion to places, people, things, or sensory experiences that remind them of the event
“When people start to structure their life around managing the trauma experiences they’re having, that’s definitely a sign that they need clinical support and care,” said Manthenga.
Trauma treatment: Healing the pain
For people living with the effects of trauma, it can feel like an inescapable condition. But it can be treated and overcome. For Manthenga, who manages the Homewood Health Centre programs that treat addiction and traumatic stress, the most effective treatments are holistic, evidence-based, and community-driven.
People living with trauma often turn to alcohol and drugs to cope with their mental health issues, which is why effective treatment of trauma and PTSD often needs to integrate addiction treatment as well.
“It’s not uncommon for people to seek relief from some of the most distressing symptoms of trauma through addictive behaviours,” said Manthenga. “Recovering from trauma in these circumstances also requires treatment for other unhealthy or unsafe behaviours they may be using to manage that trauma, including substance use disorder.”
When someone has the courage to ask for help with trauma-related disorders, they deserve a treatment journey based on proven tools and methods. An evidence-based approach uses scientific evidence and high-quality research to identify the most effective treatment modalities and ensure the most successful outcomes.
For example, the traumatic stress programs at Homewood Health Centre use Cognitive Processing Therapy, a type of cognitive behavioural therapy that helps patients learn how to modify and challenge destructive beliefs about themselves, the traumatic event, and the world around them.
This evidence-based approach has a measurable, positive impact on the mental health of program participants. For the Cornerstone Program, which treats adults with PTSD, trauma-related challenges, and co-occurring disorders, and for the Guardians Program, which specifically treats first responders, military personnel, and veterans who are living with trauma, PTSD, and other mental health and substance-use issues, 92% of program participants said the program met their needs and the proportion of participants who scored above the PTSD threshold was reduced by 49%.
Trauma can create deep feelings of isolation and shame that even well-meaning friends and family can’t fix. Going through treatment with others who have gone through the same experiences can help people living with trauma to rebuild human connections and feel less alone.
The inpatient trauma treatment setting at Homewood Health Centre is designed to create a community where people can learn to interact with and gain strength from others, including peers and supportive staff.
“Being able to share the experience of trauma and the recovery journey with people who face the same struggles and the same feelings of shame, guilt, or fear can be profoundly powerful,” Manthenga explained. “It’s both a way to generate forward motion for healing and sustain that healing when people leave the treatment program.”
Trauma recovery: A role for everyone
Manthenga pointed out that the social experiences of marginalization and oppression often exacerbate or create trauma for people, which means that simply by being more aware of the impact of trauma, and more inclusive and accepting of people who suffer it, we can play a vital role in supporting recovery.
Here are three ways we can all make a difference in the lives of people who are living with trauma.
Advocate. The secrecy and shame around the causes and effects of trauma compound its power over the people who experience it. “As a society, we can educate ourselves, become allies, and use our voices to disrupt the things that are traumatic for other members of our society,” Manthenga said.
Accept. Manthenga pointed out that the idea that you just should just ‘get over’ a traumatic experience is still prevalent. “It’s so important to recognize and to validate the experience of trauma rather than judging people for it,” she said. “Chances are good that they’re already judging themselves—usually very unfairly.”
Reach out. Manthenga urged people to “step into the conversation” when they see someone who is impacted by trauma. Ask how they’re doing and listen without judgment, send them an informative article or a first-hand account of recovery by someone who experienced trauma or the number for a support group or treatment centre. “If we’re able to just put out a hand and offer a scaffold towards some knowledge or some support, it can make a really big difference.”
Finding the way through
As for those who are struggling with the effects of trauma, Manthenga urged them to seek out a like-minded community that can understand and support them.
“When people are in the middle of living through a trauma related disorder, it can feel so overwhelming and hopeless—for them and the people around them. But as hard as it is to believe during the darkest and scariest parts of it, there are pathways through it. Find the people who are sharing those stories, listen to the voices that create the sense of possibility and hope, because healing and recovery from trauma really is possible. Never lose sight of that.”
If you or someone you love is struggling with the impact of trauma, please know that help is available. Call (866) 984-7419 to explore options.