What is Trauma? 

Trauma refers to the way that our internal systems perceive outside events that are distressing, overwhelming or threaten us in some way. Our response to events is unique and built upon our resources for coping and our inbuilt fragility. Trauma is not always life threatening. It is not always a single event. Trauma does not always leave us fearing for our lives. Trauma can be repetitive events that overwhelm us and upset us. Trauma can be built over time and can include events that may or may not elicit the same or similar response from others, including those who have witnessed the same events. Trauma is a very individual experience to very individual circumstances. 

Traumatic events can often feel out of our control. This could be a single incident, such as a road traffic accident, or it can be ongoing events, like abuse (online or in person) or fights in the family home. Bullying, racism, and weight-related abuse are also traumatic events that can result in a trauma response. Children and young people can be affected by events that happen to them directly or to those around them. Witnessing events, abuse or conflict can also evoke a trauma response in young people. Trauma responses are personal. It is never our job to judge that which is, or is not, traumatic for any young person.

The Three Es of Trauma: Events, Experience and Effects

Trauma is not necessarily what happens ‘to us’, but our internal response to external events. Trauma and the perception of traumatic events are unique to each of us. Traumatic events can be single events; maybe an accident, medical trauma, birth trauma, rape or other violent crime. Trauma can take place over days, months and years in multiple events. Ongoing traumatic events maybe living within a high conflict family, parental divorce or separation, parental incarceration, bulling, sexual abuse, abuse of all types, living in a family with substance abuse, financial hardship or mental health issues. These are often referred to as Adverse Childhood Experiences.

The traumatic experience can have lasting effects on a young person’s wellbeing. Trauma can negatively impact a young person’s emotional, social and physical development. 

Mental Illness, and eating disorders in particular, can be seen as ongoing trauma events for some people, perpetuating the cycle. 

Trauma is generally defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. The experience overwhelms the internal system that is in place to deal with external stimuli. This can happen to anyone and at anytime. 

Trauma affects not only the way the we see ourselves but also colours and changes our view of others and our beliefs about the world. Trauma influences our perception of safety, trust, collaboration, choice and personal agency. 

Early Childhood Trauma 

Early Childhood Trauma generally refers to traumatic events and experiences that occur from birth through to six years of age and may include pre-verbal trauma. During this period young children rely exclusively on the care of grown ups for safety, protection and nurturing. Children are reliant on adults for physical and emotional security. 

Trauma that happens during the early years can be challenging for children to process as they may have not had the developmental skills to verbalise their fear or sadness or express their reactions to threatening or dangerous events effectively to caregivers or appropriate adults. 

During this period children may be adversely affected by incidents and events that affect the safety and security their caregivers/parents or significant grown ups. This includes interpersonal violence, arguments, drug and alcohol abuse, mental health crisis, secrets, abusive or volatile relationships, physical and sexually abusive or inappropriate situations. 

Early Childhood Trauma also applies to singular events, natural disasters, accidents, fire, war and other any other event or situation that feel threatening to the small child.

Treatment of Early Childhood Trauma

Early Childhood Trauma increases the risks of developmental problems and behavioural concerns in childhood. There is also a significantly increased risk of adverse mental health experiences across the lifespan. 

Children who experience early traumatic events have an increased risk of both physical and psychological ill health. From high blood pressure, to migraines, early pregnancy, eating disorders and substance use disorder – the lifetime effects of early traumatic experiences can be seen to affect every system in the body. Young people and adults who present in residential treatment often have a history of early childhood trauma. 

Clinicians and researchers are rapidly learning more about the impact of Early Childhood Trauma and age-appropriate treatment interventions have been developed for children. 

Trauma and Addiction 

The link between trauma and substance use has been well researched. Unfortunately, for the teenagers and young people affected, trauma exposure and addiction often form an uncomfortable ‘merry-go-round’.  Trauma increases the risk of developing substance abuse and, in turn, substance abuse increases the risk of being involved in (or subjected to) trauma. 

Researchers have indicated that approximately 75% of young people exposed to trauma – or diagnosed with PTSD – use substances following the exposure. 66% of young people reporting trauma exposure have previously misused substances. The roundabout not only increases the likelihood of further traumatic experiences, it also makes stopping using very much more difficult for young people. 

Teenagers and young adults may initially use substances to alleviate some of the distress and unpleasant emotional and psychological experiences following a series of traumatic events or singular trauma exposure. Drugs and alcohol may ‘numb’ feelings, may increase pleasurable feelings or may help young people to avoid the intense emotions that can follow stressful or traumatic experiences. 

Adolescents and young people who experience addiction and trauma as a co-occurring diagnosis may be reluctant to enter treatment, may have difficulty in completing treatment episodes or may have had several previous treatment episodes where they relapse through substance use, soon after leaving treatment. 

The Wave team and Wave Programs are trauma-focused and designed specifically to reach adolescents who have not responded to traditional addiction treatment. In our experience, addiction is a trauma response and to not treat the trauma invariably leads to a return to the patterns of high-risk behaviours and addiction.

The Cycle of Addiction and Trauma in Families

Growing up in a family with an addiction or substance use disorder present significantly increases the risk of mental health issues, addiction, being subject to violent sexual and physical assault and many other adverse life experiences in teenagers and young people. Addiction and substance use also increase the risk of high conflict situations in the home and the breakdown of marriages leading to separation and divorce. 

Teens and adolescents who engage in problematic substance use are statistically more likely to experience further traumatic events and to be involved in crime either as a victim of crime or a perpetrator of crime. 

Addiction in teens is also linked to PTSD, depression, violent behaviours, mood disorders and suicidal thoughts. 

Early intervention, in trauma-focused treatment programs is an essential tool for recovery.

Trauma and Eating Disorders 

Children and young people with diagnosed eating disorders – and those who present disordered eating behaviours – often report having significant trauma exposure in childhood. There is a well-documented association between the development of eating disorders and exposure to one or more traumatic experiences. A diagnosis of PTSD, trauma and eating disorder are often intertwined. 

Eating disorders are severe psychiatric disorders, which in turn alter judgments, cognitive function, emotional stability and severely impact the quality of life and daily functioning of sufferers. Young people who develop eating disorders may have increased difficulty in managing emotional states, this is also seen in young people who have been exposed to traumatic events. 

Living with an eating disorder can in itself be traumatising. The cycle of purging, restricting and binge eating evokes a feeling of ‘disgust’ with the body for many young people. Living in a perpetually heightened state furthers the need to soothe, ‘numb out’ or distract from distressing experiences; which is described by so many young people affected by EDs. Dissociation and eating disorders are often seen in young people who attempt to escape high levels of internal distress, shame and self-criticism.

Trauma, PTSD and C-PTSD must be expressly and clinically addressed in order to achieve full recovery in both the eating disorder and any co-occurring mental health concerns.  It is important that young people diagnosed with eating disorders receive trauma-focused care. 

What is Trauma-focused Treatment? 

Trauma-focused care begins from the moment that a young person or family contacts The Wave. From the very first phone call, you will notice that we are interested in more than a list of symptoms or problems. Every member of our team is trauma trained. 

Trauma-focused care is the most important development in modern psychiatry and psychotherapy. It is an essential element in the care and treatment of children, teenagers and families. 

In the most recent update of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders DSM-5, the most significant addition to the manual (that is used by mental health professionals worldwide) is the inclusion of a specialist chapter on Trauma. 

Excellent trauma-focused treatments significantly improve the healing for children, teens and young adults and, in turn, can reduce serious mental illness in adulthood. 

Trauma-focused Treatment at The Wave

Trauma treatment for children and adolescents is a specialised area of psychotherapy and psychiatry. The Wave Programs have been designed around this specialist knowledge, regardless of the primary reason for admission. Trauma treatment begins with stabilisation and orientation and is accessible to all young people who join our programs. 

The Wave Programs use evidence-based trauma treatment approaches, housed in a nurturing and family-focused environment; where intuitive and creative approaches are also encouraged. Trauma is treated in relationships and healing begins in connection – in our community, in our peer groups and in our team-based therapeutic relationships.

The Wave trauma treatment programs build resilience in teenagers and young adults by incorporating our nine Cs into the Seven Elements of The Wave Programs:

• Connection
• Confidence
• Competence 
• Character 
• Contribution 
• Coping Skills 
• Compassion
• Care
• Creativity.