Let’s Get Real:

• Humanity has a Traumatic Past/History with the 20^th Century in particular being one of the most violent and traumatic.
• The vast majority (over 90%) of individuals accessing community/social/disability services, youth services, mental health services, AOD services, family/domestic violence services and supported housing services have a complex trauma history. As do many of the staff & volunteers of these services.
• Up to 68% of primary & secondary students experience at least one potential traumatic experience and between 20-40% of students have complex trauma histories (3 or more traumatic stress incidents). These percentages of students makes up the vast majority of remedial/behavioural/special needs programs.
• Some of the most challenging problems in human/social services and education result from un/misdiagnosed & unresolved trauma.
• Trauma, especially when experienced in childhood, has an adverse neurophysiological impact on the brain and brain development, resulting in dysfunction in the hippocampus, amygdala, medial prefrontal cortex, and other limbic structures.
• This brain & brain development dysfunction provides a lifetime predisposition to a survival-oriented, reactive “alarm-state” of hyper/hypo-arousal. In this state individuals experience extreme cortisol/adrenaline rushes & spikes, constant states & feelings of fear/isolation; information processing breakdowns where nothing seems to make sense and often accompanied with a shutdown of cognitive capacities combined with feelings of confusion, defeat, helplessness & hopelessness.

Consequently, there are many neurophysiological, health risk behaviours, social problems and disease & disability impacts including;

Health Risk Behaviours Smoking Severe obesity Physical inactivity Suicide attempts Alcoholism Drug abuse 50+ sex partners Repetition of original trauma Self- Injury & Self-Harming Eating disorders Perpetrate interpersonal violence   Neurophysiological Effects of Trauma Disrupted neuro-development Difficulty controlling anger-rage Hallucinations Depression Panic reactions Anxiety Multiple (6+) somatic problems Sleep problems Impaired memory Flashbacks Dissociation

Disease & Disability Ischemic heart disease Cancer Chronic lung disease Chronic emphysema Asthma Liver disease Skeletal fractures Poor self-rated health Sexually transmitted disease HIV/AIDS   Serious Social Problems Homelessness Prostitution Delinquency, violence, criminal behaviour Inability to sustain employment Re-victimization: rape, DV Compromised ability to maintain intimate/familial relationships Compromised ability to parent Intergenerational transmission of abuse Long-term use of health,   behavioural health, correctional & social services

(Australian Childhood Foundation, 2010, 2013; Blanch & Jennings, 2005, 2012; Centres for Disease Control & Prevention, 2010; Felitti & Anda, 2009; International Society for Traumatic Stress Studies, 2015; Jennings, 2008; Porges, 2011; Rossen & Cowan, 2013; Trauma Informed Schools Australia, [TISA] 2015; Waite, Gerrity & Arango, 2010).

When children live in environments where exposure to, and or witnessing, violence, abuse, neglect and trauma occurs the negative and accumulative effects on their developmental, psychological, neurophysiological, psychosocial, emotional and behavioural outcomes and consequences can be extreme. Children and young people experience a range of complex emotions and feelings due to this trauma from anger, sadness, anxiety, shame, guilt, confusion, helplessness, hopelessness to despair. The consequences of this abuse and unresolved trauma impacts an individual's throughout their lifespan and can also have detrimental intergenerational effects (Australian Bureau of Statistics [ABS], 2012, 2013; Australian Institute of Family Studies, 2012, 2015; Department of Social Services, 2015; Porges, 2011; Siegel, 2009, 2012, 2013).

From the Adverse Childhood Experiences Study there are 10 factors that contribute to the development of complex trauma from early childhood onwards (Centres for Disease Control & Prevention, 2010; Felitti & Anda, 2009).

1. Physical Abuse
2. Psychological/Emotional Abuse
3. Sexual Abuse
4. Physical Neglect
5. Emotional Neglect
6. The presence in the family home of someone with a Mental Illness (diagnosed or undiagnosed)
7. The presence in the family home of someone with Alcohol and or Substance Abuse Issues
8. Witnessing Domestic/Family Violence
9. Loss of a Parent to Death, Abandonment including abandonment by Parental Divorce/Family Breakdown
10. Incarceration of any Family Member

Additional factors contributing to the development of complex trauma (Jennings, 2008; Waite, Gerrity & Arango, 2010).

• Historical Inter/Trans Generational Trauma (e.g. Vietnam Veterans, Holocaust Survivors, Dispossession of Indigenous People)
• Combat Trauma (both troops & civilians)
• Living or raised on or below the Poverty Line
• Community/Street Violence
• Forced Removal/Relocation Practices
• Institutional or Systemic Abuse
• Persecution of Language, Religious/Spiritual, Political, Cultural & Sexual Orientation Beliefs, Practices or Behaviours
• Racism, Sexism, Ageism etc. Policies/Practices
• Minority Status within a Dominant Culture/Society
• Natural & Man-Made Disasters
• Acts of Terrorism

Research has clearly established that Complex Trauma, also termed Developmental Trauma, adversely impacts on the psychosocial, emotional, mental, developmental, neurobiological, physiological, familial, relational, scholastic, vocational and legal aspects of an individual’s life throughout their lifespan (The National Child Traumatic Stress Network, 2007, 2013; van der Kolk, 2005).

As Dr Dan Siegel often states "Naming is Taming": By naming the problem correctly, solutions emerge.

Therefore, Trauma needs to be viewed as, & declared, a Public Health Issue!

References

ABS (2013). Defining the data challenge for family, domestic and sexual violence, Australia 2013. Retrieved from

ABS. (2012). Personal safety, Australia, 2005 (Reissue), cat no. 4906.0, ABS, Canberra, 2005. cat no 4906.0, ABS, Canberra. Retrieved from

Australian Childhood Foundation (2010). Making space for learning: Trauma-informed practices in schools. Retrieved from

Australian Childhood Foundation (2013). Safe & secure: A trauma-informed practice guide for understanding and responding to children and young people affected by family violence. Retrieved from

Australian Institute of Family Studies (2012). What is child abuse and neglect? CFCA Resource Sheet. Retrieved from

Australian Institute of Family Studies (2015). Child Abuse & Neglect Stats, CFCA Resource Sheet.  Retrieved from

Centres for Disease Control & Prevention, (2010). Adverse childhood experiences reported by adults – five states 2009. Morbidity and Mortality Weekly Report, 59(49), 1609-1635. U.S. Department of Health and Human Services. Retrieved from

Blanch, A., & Jennings, A. (2005). The science of trauma: A briefing paper. The Anna Institute Retrieved from

Blanch, A., & Jennings, A. (2012). The integration of trauma-informed care in the family partner program: Issue brief. The Western Massachusetts Training Consortium and the Massachusetts Department of Mental Health’s Children’s Behavioural Health Research and Training Centre.

Department of Social Services. (2015). Protecting Children is everyone’s business: A national framework for protecting Australia’s children 2009-2020. Retrieved from 

Felitti, V. J., & Anda, R. F. (2009). Threlationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behaviour: Implications for healthcare. In R. Lanius & E. Vermetten(Eds.), The hidden epidemic: The impact of early life trauma on health and disease (pp. 2-35).

International Society for Traumatic Stress Studies (2015). Research resources and links. Retrieved from

 Jennings, A. (2008). The damaging consequences of trauma and violence. Substance Abuse and Mental Health Administration Centre for Mental Health Services (SAMHSA), U.S. Department of Health and Human Services.

Rossen, E,. & Cowan, K. (2013). The role of schools in supporting traumatised students. Principal’s Research Review, 8(6), 1-7.

Siegel, D. J. (2009). Mindsight: Change your brain and your life. Victoria, Australia: Scribe Publications Pty Ltd.

Siegel, D. J. (2012). A pocket guide to interpersonal neurobiology: An integrative handbook of the mind. New York, NY: W.W. Norton & Company Inc.

Siegel, D. J. (2013). Brainstorm: The power and purpose of the teenage brain. Victoria, Australia: Scribe Publications Pty Ltd.

The National Child Traumatic Stress Network, (2007). The 12 core concepts: Concepts for understanding traumatic stress responses in children and families. Retrieved from

The National Child Traumatic Stress Network, (2013). What is Complex Trauma? Retrieved from

TICA, (2015). What's the problem? Retrieved from

van der Kolk, B. A. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401-408.

Waite, R., Gerrity, P., & Arango, R. (2010). Response to adverse childhood experiences. Journal of Psychological Nursing, 48(12), 51-61.