Understanding Trauma and Trauma-Informed Care
Why It Matters, What It Means, and How It Helps
Why Trauma-Informed Care Matters
A trauma-informed approach begins with a subtle but powerful shift:
“What’s wrong with you?”
“What happened to you?”
Trauma is far more common than many people realize, and its effects extend well beyond the original event. Research consistently demonstrates ways that trauma can shape how the brain and nervous system function, how emotions are experienced, and how people relate to others (Herman, 1992; van der Kolk, 2014). Trauma-informed care understands that many symptoms are not signs of dysfunction, but adaptive responses to overwhelming experiences.
At Clear Water Wellness, we view trauma not solely as a psychological injury, but as a mind–body experience that influences thoughts, behaviors, emotions, and relationships.
What Is Trauma Really?
Let’s start by clearing something up: stress itself is not the villain.
Short-term stress can be helpful. A little anxiety before a presentation? Motivating. Jumping out of the way of a speeding car? Excellent nervous system performance.
The problem arises when the nervous system doesn’t get the memo that the danger has passed.
Our nervous systems are designed with a built-in alarm system that activates when danger is present and deactivates once safety is restored. For individuals who have experienced trauma, that alarm system does not always shut off or may be easily activated (McEwen, 2007).
Instead, the nervous system may remain stuck in states of:
Overactivation (hypervigilance, anxiety, reactivity), or
Underactivation (numbness, shutdown, disconnection)
This response reflects neurobiological adaptation rather than weakness. Trauma can alter neural pathways involved in threat detection, memory, and emotional regulation (Perry & Pollard, 1998; Teicher et al., 2016). In other words, this is not a personal failing because trauma can alter how the brain processes threat and safety. This is especially relevant when it occurs early in life or repeatedly over time.
When Stress Becomes Traumatic
Trauma is often defined as a response to events that are experienced as intensely threatening or overwhelming. These may include, but are not limited to:
Physical, emotional, or sexual abuse
Neglect or chronic relational harm
Accidents or serious medical events
Natural or human-made disasters
Sudden loss or death of a loved one
Witnessing harm
Combat or war
Responses to trauma doesn’t only emerge from clearly define and catastrophic events! Traumatic responses can also develop through repeated, chronic, or relational experiences. This can include emotional neglect, chronic instability, persistent invalidation, or ongoing stress without adequate support can also overwhelm the nervous system over time. These experiences may not appear dramatic from the outside, but their cumulative impact on the nervous system can be profound.
Importantly, trauma is defined less by what happened and more by how the experience was processed internally. Whether we felt powerless, unsafe, unseen, or unsupported can matter for how we were affected by hardships. Two people can live through similar events and be affected very differently. Some notice symptoms immediately, others years later. Some recover without formal intervention, while others benefit from additional support. All responses are valid and healing remains possible at every stage (Courtois & Ford, 2013).
Common Responses to Trauma (APA, 2022)
Trauma can show up in physical, emotional, cognitive, and relational ways, including:
· Avoiding reminders for places, people, emotions, conversations
· Feeling constantly on edge or easily startled
· Emotional numbing, irritability, or sudden mood shifts
· Intrusive memories, nightmares, or body-based flashbacks
· Difficulty sleeping, concentrating, or eating
· Chronic pain, fatigue, or unexplained health issues
· Shame, guilt, or harsh self-criticism
· Difficulty trusting others or feeling connected
· Suicidal thoughts or hopelessness
Many trauma responses overlap with diagnoses such as anxiety, depression, ADHD, bipolar disorder, or personality disorders. Trauma-informed care helps clinicians understand symptoms in context, which helps reduce misdiagnosis and understand behaviors as survival strategies rather than innate deficits (van der Kolk, 2014; SAMHSA, 2014).
Trauma’s Impact on the Brain and Body (Aka: Why Your Body Reacts Before You Think)
Our brains are designed to be incredibly adept at it’s primary job: Keeping us alive.
Since trauma is processed and experienced through the senses, even when an event is not consciously remembered, the nervous system may still hold it through implicit memory. Implicit memory is outside of our conscious awareness and is activated by sights, sounds, smells, or bodily sensations (LeDoux, 1996).
As a result, a person may react intensely to situations that appear neutral to others. In these moments, the brain is doing its job: protecting. The challenge is that the nervous system may respond to a critical email or tense conversation with the same urgency it would a life-threatening situation (Porges, 2011).
Trauma-informed therapy helps recalibrate this system by restoring the ability to distinguish between past danger and present safety. We’re able to learn that now is different from then (Porges, 2011).
Making Sense of Trauma: Helpful Analogies
The Bus Analogy (Schwartz & Sweezy, 2020).
Imagine your mind as a bus. You—the grounded, present version of yourself—are meant to be the driver. Along for the ride are different “parts” shaped by life experiences, including trauma. At times, reactive or protective parts may rush forward and grab the wheel, steering from fear, shame, or urgency. Trauma-informed therapy helps you understand these parts, appreciate their protective intentions, and strengthen your ability to remain in the driver’s seat, even during emotional turbulence.
The Backpack Analogy
Everyone carries a backpack filled with memories, emotions, beliefs, and coping strategies. Trauma can add heavy rocks to that pack, some of which were once necessary for survival. Therapy does not demand that you dump everything out. Instead, it helps you examine what you’re carrying, keep what still serves you, gently set down what no longer does, or temporarily removing it from the backpack and storing it just in case you feel you need it later.
The Infection Analogy
A deep cut has potential to heal on it’s own. However, other times it can be slower, incomplete, or complicated. Especially if the wound is deep and didn’t receive the proper care. On the outside, the wound may seem healed, but on the inside there may be a pocket of puss and infection forming. In medicine, treating a serious cut isn’t just about waiting and hoping for the best. Depending on the injury, healing might involve cleaning the wound, closing it with stitches, using antibiotics to prevent infection, and protecting it while the body does its work. Each step supports the body’s natural ability to heal rather than replacing it. Trauma treatment works much the same way. Therapy doesn’t force the wound open or rush the process. Instead, it helps identify what the nervous system still needs to heal properly. Regulation skills can be like cleaning the wound that reduces ongoing irritation and inflammation. Therapeutic structure and boundaries function like stitches, providing stability so healing can occur. Trauma-specific interventions can act like antibiotics, addressing what’s keeping the system stuck in survival mode. And ongoing support helps protect the healing process while new patterns take root.
The Broken Bone Analogy
When a bone breaks, the body is remarkably good at letting us know something is wrong. Pain, swelling, and limited movement are signals from our bodies communicating that an injury needs attention. Sometimes a broken bone can heal on its own. But without proper assessment and care, it may heal incorrectly, continue to cause pain, or lead to problems later on and often in ways that seem disconnected from the original injury. Trauma works in much the same way. Emotional distress, physical symptoms, or changes in behavior are often the body’s way of signaling that something is wrong. These responses can show up immediately or years later, and they can affect anyone, regardless of age, race, identity, or background. With the right support, the system can heal. Trauma-informed care doesn’t ignore the pain signals or rush the process. It listens to what the body and nervous system are communicating and helps guide healing so it’s not just possible, but sustainable.
Why Trauma-Informed Care Is Essential
Trauma-informed care does not focus solely on symptom reduction. It asks why symptoms exist and what function they once served.
Rather than forcing individuals to relive traumatic experiences, trauma-informed care emphasizes:
Understanding how trauma affects the nervous system
Preventing re-traumatization
Creating emotional and physical safety
Supporting regulation before exploration
Healing happens best when people feel safe, empowered, and respected.
What Trauma-Informed Care Really Means
Trauma-informed care is an approach to treatment, not a single intervention. It recognizes that many symptoms represent adaptive responses to unsafe or overwhelming environments.
Core principles include (SAMHSA, 2014):
Safety: physical and emotional
Choice: respect for autonomy and pacing
Collaboration: shared decision-making
Trustworthiness: transparency and consistency
Cultural humility: honoring identity and lived experience
Most importantly, trauma-informed care does not require premature disclosure or re-exposure to traumatic material. The focus is on regulation, stabilization, and meaning-making.
Treatment may involve:
Psychoeducation about trauma and the nervous system
Development of grounding and regulation skills
Exploration of beliefs and emotional patterns with curiosity
Somatic (body-based) interventions
Careful reprocessing of traumatic experiences when appropriate
Strengthening resilience, connection, and self-trust
Healing is often nonlinear. While the work can be challenging, it is also associated with increased self-understanding, emotional flexibility, and improved quality of life (Herman, 1992).
When More Support Is Needed: Boosting Trauma-Informed Care with Trauma-Focused Options
In this article we’ve identified how trauma-informed care is essential! It’s like assessing a wound, cleaning it, and giving the body the conditions it needs to heal. But sometimes, the “wound” runs deeper than what stabilization and general support can fully address. That’s where trauma-focused treatment modalities come in.
Think of it like this: trauma-informed care is setting the scene for healing. And the rest, the hands-on repair, can involve specialized interventions tailored to the injury. In trauma therapy, trauma-focused modalities are those targeted “antibiotics” that address the underlying memories, neural pathways, and learned protective patterns that may keep the nervous system on high alert or stuck in old survival modes.
Some of the most well-supported trauma-focused approaches include:
Eye Movement Desensitization and Reprocessing (EMDR): Helps the nervous system process and integrate traumatic memories safely.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): Combines cognitive strategies with exposure in a structured way to reduce trauma-related distress.
Cognitive Processing Therapy (CPT): Focuses on modifying unhelpful trauma-related beliefs while processing memories.
Prolonged Exposure Therapy (PE): Gradually addresses avoidance and fear responses tied to trauma.
Internal Family Systems (IFS): Explores protective and reactive parts of the self, fostering internal harmony and agency.
These approaches don’t replace trauma-informed care. They build on it. Trauma-informed care stabilizes the system, creates safety, and nurtures understanding. Trauma-focused treatment then targets the specific patterns and memories that may be keeping someone “stuck” in survival mode. Each model offers different tools and pathways
Please note: this is not an exhaustive list, and availability of specific modalities may vary.
You Don’t Have to Carry This Alone
Trauma can affect every area of life, but healing is possible. Whether you are navigating recent experiences or long-standing patterns, support can help restore balance, connection, and a sense of agency.
At Clear Water Wellness, our trauma-informed clinicians are here to walk alongside you and at your pace, with care.
References
American Psychiatric Association. (2022). DSM-5-TR: Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Courtois, C. A., & Ford, J. D. (2013). Treatment of complex trauma: A sequenced, relationship-based approach. Guilford Press.
Herman, J. L. (1992). Trauma and recovery. Basic Books.
LeDoux, J. E. (1996). The emotional brain. Simon & Schuster.
McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation. Physiological Reviews, 87(3), 873–904.
Perry, B. D., & Pollard, R. (1998). Homeostasis, stress, trauma, and adaptation. Child and Adolescent Psychiatric Clinics of North America, 7(1), 33–51.
Porges, S. W. (2011). The polyvagal theory. Norton.
SAMHSA. (2014). Trauma-informed care in behavioral health services (Treatment Improvement Protocol 57).
Schwartz, R. C., & Sweezy, M. (2020). Internal Family Systems therapy (2nd ed.). Guilford Press.
van der Kolk, B. A. (2014). The body keeps the score. Viking.