Trauma Informed Care

Weekly Teaching Tip – Oct. 31, 2018
by Dr. Steven Sims

In my practice, I usually examine the neck for any tension or elevation of the larynx. Years ago, I approached a female patient to perform circumlaryngeal massage and she immediately pulled away and became very upset. Based on either intuition or divine intervention, I decided to ask, “Has anyone ever hurt you or hurt our neck?” She broke down and told me about how a family member had grabbed her neck, and held her down as he raped her.

I now make it practice to ask permission to touch someone’s neck first (even though most patients look at me in dismay as if to say, “why would you even ask?”) Much of the work with voice professionals is hands on. Most people feel a sense of intimacy when speaking about their voices because voice is so personal and individual.

Because of the nature of what we do, I think it is important to know that sometimes our actions and even our questions can trigger traumatic events.

Trauma-Informed Care
Facts:
• One in four children experiences some form of maltreatment (physical, sexual, or emotional) in the US
• One in four women have experienced domestic violence
• One in five women have experienced rape
• One in seventy-one men have experienced rape (reported—the number may be higher)
• Nearly 50% of children report either being violently assaulted or witnessing assault

Intersection:
People who have been traumatized sometimes create a defense in creative outlets
o Singing
o Acting
o Rapping
o Comedy
These may be people who come to you for help with their voices.

What does Trauma-Informed Care Look Like?
It begins with recognizing the statistics quoted above.
Emotional trauma occurs commonly even in the US and the numbers are often much higher for immigrants.

Definition: practices that promote a culture of safety, empowerment, and healing.

Principles:
1. Safety
2. Trustworthiness and Transparency
3. Peer Support
4. Collaboration and Mutuality
5. Empowerment, Voice and Choice
6. Cultural, Historical, and Gender Issues

These are just some guidelines and reminders that many people who appear totally put together have devoted considerable effort to wrangling emotions to become functional beings. Our interactions has rapidly dismantle the protections established by our patients/clients and we have to be mindful of how we engage.