‘After trauma the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their lives. These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases. This explains why it is critical for trauma treatment to engage the entire organism, body, mind, and brain.’
(Bessel van der Kolk)1
Early life adversity and trauma can have a huge impact on our long-term health. What can healthcare institutions and staff do to combat this? Healthcare institutions can improve community health including cross-sector working via integrated care systems (ICSs), but this can take time. However, in general practice, people consulting with primary care staff may have already encountered challenges in life that can negatively impact physical and mental health. This analysis looks at what can be practically done and the role of trauma- informed care (TIC) within general practice.
TRAUMA AND ADVERSE CHILDHOOD EXPERIENCES
Seeing the world through a trauma- informed lens could explain how early life challenges result in negative health and social consequences. Trauma is defined as an event (or series of events) that has long-lasting negative impacts on a person’s physical, mental, or emotional/social wellbeing2 after the event has ended. Structural, historical, and oppressive factors can all collectively contribute to trauma. One criticism is that the definition of trauma is broad, and some may use it as a catch-all term for any stressful experience. Trauma occurs after the experience whereas stress is confined to the experience alone.
Another way of seeing such challenges is through ‘adversity’: adverse childhood experiences (ACEs). This refers to child abuse and neglect; parental separation or death; household violence; mental illness; substance misuse; or criminality. Other examples include living in foster care; experiencing bullying; …
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