Recently I was speaking to trauma-experts from Oregon. We were discussing the struggles of conducting research around trauma.
Perhaps the most famous research centers around the studies that gave us ACEs, Adverse Childhood Experiences. The evidence from the ACEs research seems irrefutable: adverse childhood experiences can profoundly influence the architecture of the brain and the mental, emotional and physical outcomes for a person.
But there are many other things people would like solid research on concerning specific approaches that have impact on these outcomes. We understand and acknowledge that childhood adversity has a significant health issue—that has been proven.
What is exceptionally hard to measure is what helps.
Why is this? My colleagues and I discussed this for well over an hour. We decided there are many factors that need to be considered. The bottom line was that the complexity of the brain and the impact of trauma make such measurements virtually impossible.
Recently Lakeside participated in a major research study on the effectiveness of our Enhancing Trauma Awareness course. This was conducted on teachers and staff in several Head Start programs to uncover some of the ways engaging in this six-session course, held over 12 weeks, changed attitudes, beliefs and behaviors in the staff.
The results of the study were published in JAMA last April. Using some of the standard measurement tools accepted by the scientific community, it was not evident that there had been much change in the participants in the ETA training as compared with the control group. What was measurable and showed very significant impact were the qualitative studies using focus groups where participants were able to verbalize their observations about their own changes. They were enthusiastic because they could now see children who may have experienced adverse childhood experiences very differently. As a result of the training, they felt empowered and equipped to manage difficult behaviors with greater clarity and compassion. Due to the outstanding abilities of the lead researcher, Dr Robert Whitaker, these results became evident.
So, in order to research impactful approaches we need to understand that, like the brain, trauma is complex and unique in its impact within the brain and mind of each person who has suffered significant trauma. The brain literally has hundreds of thousands of moving parts, parts that are always learning, growing and changing. The brain has its own neurochemical system that alters thoughts, feelings and moods based on which cocktail of neurochemicals are being released in any given moment. The ways the brain operates, how it doses itself with neurochemicals, its vast memory banks, and how it can create triggers and flashbacks giving a propensity for reenactment, makes doing research on what is impacting the brain virtually impossible.
Some researchers have given their attention the how the impact of trauma affects the immune system. There is a whole body of science called psychoneuroimmunology that attempts to measure just that. Maybe in the future we will be able to measure the impact of different types of interactions with a trauma-impacted person to see how their immune system is soothed.
The critical bottom line about researching or considering what impacts someone with unresolved trauma is in the quality of the relationships that trauma-impacted person experiences. Relationships in which a person is cared for by a trauma-sensitive person is what positively impacts recovery and makes healing is possible. Most of us in the field conclude that relationships make all the difference in how someone handles their trauma-symptoms and how their brains eventually find pathways that allow healing from the effects of trauma.
As hard as it is to measure the impact of adverse childhood experiences and other forms of trauma, finding ways to measure the specifics of relationships that contribute to recovery and healing is as complex as the mind and the brain of a trauma-impacted person. If someone says they have the definitive research tool for this kind of measurement, I suggest you be very skeptical. At the same time, we can take great comfort in knowing that we have a power within us to promote recovery and healing if we learn trauma-sensitive ways of interacting with a trauma-impacted person. The power is in the relationships!
Invitation to Reflect
- Why do you think it’s so hard for research to come up with definitive explanations of what works to promote healing and recovery from trauma?
- Why should all of us be skeptical if we are told that someone has definitive research proving that a certain technique is the answer to the problems caused by trauma?
Diane Wagenhals, Director, Lakeside Global Institute