Helping people link past trauma to current pain can be a catalyst for change says Warren Larkin, as DDN reports.
At the recent RCGP/AP conference in Manchester, consultant clinical psychologist Dr Warren Larkin presented on trauma and resilience-informed practice.
Relating to developmental trauma – trauma that happened during childhood – he highlighted the following Adverse Childhood Experiences (ACEs): physical, sexual and emotional abuse; living with someone who was experiencing problematic drug and/or alcohol use, had serious mental illness or who had been incarcerated; exposure to domestic violence; parental loss through divorce, death or abandonment; and neglect.
The more childhood trauma people were exposed to, the worse their health, mental health, and social outcomes were likely to be. ‘So it’s very strange that we still don’t ask people about childhood trauma as a routine part of our assessment,’ he said.
A 1998 study found people with four ACEs – compared to those with none – were five times more likely to use illicit drugs, seven times more likely to self-identify as being addicted to alcohol, and 12 times more likely to attempt suicide. A 2015 study of the English population also found ‘this association between adversity exposure and health harming behaviours’ – people with four ACEs were twice as likely to be binge drinkers, three times more likely to be smokers, and 11 times more likely to have used heroin or crack cocaine. A recent study found that those with exposure to one of the ACEs on the list were 4.3 times more likely to develop a substance addiction.
‘If we can help people link their past trauma to their current pain, and the way they’re attempting to cope with that pain, maybe that’s a catalyst for change,’ said Larkin. ‘We need to ask people what’s happened to them, because if you don’t ask people, they don’t tell you, and if they don’t tell you, they’re going to get the wrong help.’ He referred to a 1998 study in which 82 per cent of psychiatric inpatients disclosed trauma when they were asked, compared to 8 per cent volunteering their disclosure without being asked. ‘Eighty-two per cent versus 8 per cent, it’s pretty obvious what we need to do – but professionals worry about asking these questions because we worry about making it worse,’ he said.
Larkin stressed the importance of trauma-informed care, and said it was important to normalise routine and targeted enquiry – just as with domestic abuse and suicide intent enquiry – to offer the right help sooner, ‘because treating the symptoms while ignoring the cause isn’t working.’ He concluded by quoting Desmond Tutu: ‘There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.’