Have you ever wondered why you do the things you do? Why you feel the things you feel? Why those feelings sometimes turn to uncontrollable anger?

Or sadness?

Or fear?

In scenarios like that, it’s easy to ask the “wrong” question – as in, “What’s wrong with me?”

But experts say that attitude doesn’t lead to the root cause of many behavioral and mental health problems. There isn’t something wrong with you. The answer, instead, lies in the past.

The better question is: “What has happened to me?”

This, according to the literature and the experts, is the basis of trauma-informed care, an understanding of which is driving a relatively new approach in behavioral health that is being put into practice, not just in therapy settings, but in workplaces.

So, what is trauma-informed care?

It is a process that has been adopted by health care providers, business and government entities, among others, to better serve clients – and their own employees – who have experienced trauma.

In practice, it is a set of guidelines to make workplaces and care settings more understanding of trauma and its effects.

Here’s what it isn’t.

It isn’t a means to give up or give in to your past traumas, as in, “This is just the way I am.” It is a way of understanding what has shaped you and your behaviors and, if change is important to you, changing that.

“It about building the resiliency within and trusting yourself to make the right decision,” said Brandon Currie, CEO of STRYV365, a youth development organization in the city that focuses on a trauma-informed approach.

Traumatic events, high-stress situations a person experiences, can occur at any stage of life.

Some common traumatic events occur in childhood. These are called ACEs – Adverse Childhood Experiences. ACEs can involve child neglect, abuse and the presence of substance abuse in the home, to name a few.

One in six adults have experienced four or more ACEs in their life, according to the Centers for Disease Control and Prevention.

Emily Mazzulla, chief trauma and resilience psychologist for Scaling Wellness in Milwaukee, or SWIM, an organization that advocates for trauma treatment in the city, said a person’s response to trauma will differ depending on the event. Some people may experience a sustained change in mood and behavior while others might avoid things that remind them of the event.

Mazzulla said that people might be able to tell if they have trauma if they find themselves reliving the event or feeling as they did when the event occurred. Or they might find themselves thinking about an event when they don’t want to. Trauma can also disrupt thinking and is associated often with strong negative feelings such as anger, fear or sadness.

Mazzulla defined trauma-informed care this way:

“Trauma-informed care recognizes the role of trauma and responds in a way that supports and encourages engagement of people who have had traumatic experiences,” Mazzulla said.

Mazzulla based much of her definition on the “Four R’s approach,” which details how trauma can be noticed and addressed. 

The four R’s of trauma, as defined by the Substance Abuse and Mental Health Services Administration, include:

• Realizing that trauma exists: Knowing the widespread effects of trauma and how it can affect people in your own life.
• Recognizing signs of trauma: Being able to identify when someone is experiencing symptoms of trauma, which can vary.
• Having a system to Respond to trauma: Implementing policies that ensure a safe environment for those who have experienced trauma.
• Resisting re-traumatization: Avoiding any behaviors or actions that might cause someone to relive a traumatic event.

Lia Knox, a behavioral health consultant and psychologist in Milwaukee and contributor to Black Space, a mental health space for people of color, works specifically with workplaces to ensure trauma-informed policies are implemented. In her work, she relies heavily on six guiding principles.

The Centers for Disease Control and Prevention lays out these six guiding principles for trauma-informed care:

• Safety: Creating a safe space for people who have experienced traumatic events. This includes a non-judgmental atmosphere if someone is acting out as a result of trauma.
• Trustworthiness and transparency: Being a reliable source for support while also being honest about the shortcomings you might have in doing it. Knox offered an example: “I might not be able to help you, but I can help you find someone who can.”
• Peer support: Being available for someone and working in tandem to ensure that they are not dealing with the issue alone.
• Collaboration and mutuality: Working together to find solutions.
• Empowerment and choice: Enabling someone to advocate for themselves and choose the right decisions after a traumatic event.
• Cultural, historical and gender issues: Recognizing the different backgrounds people may come from and accepting, with humility, that you might not know everything about them. Being able to adapt and adjust to someone’s culture and life experience.

Currie said traumatic situations can often become normalized, even part of the daily routine. An integral part of his organization’s approach is introducing kids to insights on how to manage their body’s reactions to stress by finding outlets to overcome it.

Knox said it’s important to destigmatize talking about traumatic events.

“It’s OK to talk about past and current trauma,” Knox said. "Whenever we talk about something that may have happened to us that we feel is shameful, embarrassing or hurtful, we tend to shut it down ... without realizing the person sitting next to us or across from us may have experienced the same thing or something similar, and that person could be our lifeline.”

Some resources to know

Mental health professionals can help individuals deal with trauma. If you’re looking for mental health resources, check out our previous NNS reporting.

Wellpoint Care Network, previously SaintA, offers trauma-informed care services for kids at locations around the city. Its main campus is located at 8901 W. Capitol Drive. Call (414) 463-1880.

The Wisconsin Department of Health Services offers ways to reduce toxic stress and address trauma through its Resilient Wisconsin program.