But the truth is… Beyond all the pain past and present, we are still here, We have within us a spirit so powerful– It enables us not only to endure but also to overcome. Come home to the truth of who we are.
-Author Unknown
The path of choice must become a healing journey, which is now being awakened in the hearts of many, as trauma-informed care is coming to the forefront of what has always played a role in the lives of those who have suffered from traumatic life events. Heal the trauma and you will heal many of the causes of the mental and physical illnesses. Integrated health care programs are designed to increase the availability of behavioral health services within primary care settings. The Behavioral Health Consultant (BHC) can assist patients without the stigma of “mental health” promoting a healing journey. The desired outcome is to reduce the impact of traumatic life events and therefore, reduce the abuse of substances, reduce abuse and neglect, reduce retraumatization, and reduce mental and physical illnesses.
Patients with traumatic stress disorder will many times end up going to their primary care provider and share an emotion-filled story of trauma exposure. When this happens, it is important for all providers to have training in the area of trauma-informed care. Not all trauma-exposed patients are involved with social services, churches, or other community services, so the patient will commonly go to a primary care provider and report a physical or mental illness. The patient may not have an understanding that these illnesses may be the result of complex trauma exposure.
I am certain that most of us have had the philosophy if we are sick, then we go to the doctor. When we get to the doctor’s office, and he asks us, “What brings you to us today?” Most patients will not say, “I have been traumatized.” With a trauma-informed healthcare system, there are mechanisms in place to assess trauma stressors. The trauma-exposed patient’s psyche has a built-in defense system with dissociative activities, yet holds on to fragmented pieces to attempt to cope a traumatic life event. With more than one traumatic event leading to complex trauma, the fragmented pieces simply continue to fragment. This ability becomes a way of coping with daily life events and at times dissociation is a hidden gift by the psychological self. When the resulting dream effect occurs, the dream is pushed aside and expressed as just another nightmare or dream. As a clinician, many times we get so focused on the presenting issues and behaviors that we become like the trauma-exposed patient’s “psychological self” and take for granted that the patient is doing well overall. The trauma- informed BHC must ask the question; “Do you have any recurring dreams or nightmares?”
These dreams and nightmares will not typically go away and may form a pattern for the patient’s inner voice, and no one is listening. Furthermore, not everyone is aware of the impact of trauma. In a trauma-informed primary care office, the BHC on staff can address the underlying cause of the reported physical and mental illness and symptoms. The structure of integration of the mind/body as described by Norbert Weiner, the founder of cybernetics: “We are not the stuff that abides but patterns that perpetuate themselves.” For the patient to get well, they need to be empowered to discover those patterns and themes in their life so that they can heal.
Applying HeartPath techniques, as described in HeartPath Practitioner in a brief format can be utilized as an intervention for the trauma-exposed patient. The BHC will give feedback to the patient with a clear creation of ideas that support the essence of each patient’s unique lived experience. The trauma-exposed patient will share lived experiences embracing present events and past events, declaring the patient’s future hopes.
A good healing intervention for trauma treatment will begin with a valid trauma-informed assessment, which includes physical body, mental, emotions and spiritual (energy). The clinician will conduct active listening allowing the narrative process to emanate with “meaning making.” Also, connecting all necessary resources to support the patient’s treatment plan, which is patient-centered and is a part of the patient’s overall health management plan. In our new book, Integrated Health, we discuss in detail how integration and narrative treatment work together to promote transformation for healing.
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