Trauma-informed care

What is trauma-informed care?

Trauma-informed care is an approach that assumes anyone may be carrying something. Instead of asking what’s wrong with someone, you look at what happened to them. Safety, choice, predictability and respect are the standard here, not the exception. The goal is to keep from accidentally hurting someone all over again.

The shift: from “what’s wrong with you” to “what happened to you”

It starts with a different way of looking. The Center for Health Care Strategies sums up the core as a shift from “what’s wrong with you” to “what happened to you.” Behavior that looks strange or difficult then becomes understandable: it’s often an old survival response that was once needed. Concordia University St. Paul describes trauma-informed care as an approach that assumes people may carry a trauma history and that accounts for re-traumatization in every interaction.

The six principles

Trauma-informed care rests on six principles, laid out by the U.S. health agency SAMHSA. They are:

• Safety: people feel physically and emotionally safe.
• Trustworthiness and transparency: being clear and honest so trust can grow.
• Peer support: room for contact with others who know something similar.
• Collaboration: deciding together instead of over someone’s head.
• Empowerment, voice and choice: building on someone’s strengths and handing control back.
• Attention to culture, history and gender: taking into account who someone is and where they come from.

Why it matters

For you, this means you don’t have to be afraid that something will blindside you. When predictability and choice are the norm, you stay inside your window of tolerance more easily, the zone where you can handle tension without tipping over the edge. That’s exactly what you need to relax and enjoy yourself. Trauma-informed care promises no cure, and it isn’t therapy. It’s an attitude that keeps the chance of harm as small as possible and leaves room for recovery.

What it looks like in practice

Small and concrete. You say beforehand what’s going to happen, so there are no surprises. You ask for consent and mean it when someone says no. The pace stays one the body can handle, in small steps as with titration. When someone hits a trigger, you notice it and slow down instead of pushing on. And the choice keeps coming back: do you want to go on, do you want to pause, do you want to stop. Nothing is required, everything is open to talk about.

Where it’s used

The approach started in health care and mental health care, and it stretched wider long ago. Schools, youth services, shelters, the police and even companies apply the principles, because everywhere you go there are people carrying something. The idea is simple: if you can’t know who has a history, you’re better off working in a way that’s safe for everyone. That doesn’t make trauma-informed care a separate treatment. It makes it a baseline attitude you can take anywhere, outside care work too, right down to the way you build a date with someone.

What trauma-informed care is not

“So you treat everyone like a fragile victim.” No. It’s about handing control back, not about coddling. You assume people are strong and know best what they need.

“You have to know someone’s trauma to do it.” Also untrue. You don’t need to hear any stories. The whole point is that you work safely and predictably without knowing what someone is carrying, because you can never see it from the outside.

What I make of it

Real trauma recovery is work for a therapist, and that isn’t me. But the attitude behind it is exactly how I work as a gigolo. I tell you beforehand what to expect, I ask and I check, and I never go faster than you can handle. If I notice you going quieter or your breath climbing, I hold back, even when you say nothing yourself. Changing your mind is always allowed. I don’t need to know what you’ve been through to make you feel safe. That feeling is often exactly what makes the rest possible.

Further reading

• Window of tolerance describes the zone trauma-informed care tries to protect.
• Fight-or-flight response explains what happens when someone shoots past that edge.
• What is trauma-informed care from the Center for Health Care Strategies gives a clear introduction.

Sources

• What is trauma-informed care. Center for Health Care Strategies. Provides that trauma-informed care shifts the view from “what’s wrong with you” to “what happened to you”, along with the six core principles.
• Principles of trauma-informed care. Concordia University St. Paul. Provides that the approach assumes people may have a trauma history and tries to avoid re-traumatization in every interaction.

Related terms

• Window of tolerance. The zone trauma-informed care protects.
• Fight-or-flight response. The survival response this attitude takes into account.
• Titration. The small steps that fit a trauma-informed approach.
• Trigger. What you watch for to make slowing down possible.