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Overcoming Barriers to Trauma: Rural Women Facing Domestic Violence

Riley A. Thomas

Considerations surrounding rural and sparsely populated America and its criminogenic nature are overlooked. Therefore, much needed attention on rural centric crime considers factors not applicable to the urban. This fact may be related to issues that make society as a whole precieve rural criminology less important than metropolitan areas (Ceccato, 2018), where a majority of the American population lives. Therefore, a much greater emphasis and attention is needed for victims of traumatic crimes in rural areas due to the spatial differences than percieved mainstream criminology.

Aspects such as limited access to services, isolation, poverty, and rural cultural values make rural women more vulnerable to domestic violence than women living in urban areas (Ceccato, 2015). This post will mainly focus on rural women who suffer from intimate partner violence (IPV), and the geographic challenges of recieving treatment or support outside of the immediate area.

Examining intimate partner violence in this case is significant because it can be evaluated as one of the most underreported figures of crime. For example, Ceccato (2018) identifies that physical isolation may also lead to a disproportionately high declared fear of crime
because of individuals’ relative vulnerability. For a variety of reasons, women and victims of IPV may fall silent due to public perceptions, shame, guilt, or embarassment to name a few (van der Kolk, 2014). Reagrding trauma related to IPV, rates for violence against women vary geographically, making it difficult to untangle underreported cases between rural and areas (Ceccato, 2015). Additionally, the cohesive nature of rural areas adds another dimension of trauma support avoidance.

This consideration of a cohesive system stems from smaller communities being well versed with eachother, and the events that take place within the community. In other words, everyone knows everyone, and collective efficacy is rarely thrown off balance. Knowing this, woman may avoid support for their trauma with the fear of being ostracized by speaking out on violence, which may have the unintended effect of enabling domestic violence, and the inability to seek help for IPV trauma (Ceccato, 2015).

Knowing this the geographical difficulties of seeking help in rural IPV and trauma cases still remain prevalent. For example, rural communities and towns are in far geographical areas from metropolitan areas with greater support systems. In other words, long distances create isolation to a greater degree than urban areas (Ceccato, 2015). With these outlets out of reach, rural communities may lack the resources and support systems and highly populated areas have. This can lead to victims of trauma and IPV staying silent, since breaking the efficacy and cohesion of their community can have drastic effects on the abuser and the victim. The lack of support systems for women in rural areas can contribute for women to stay in their traumatic situations. Victims of traumatic domestic violence often cover up their abusers (van der Kolk, 2014) for a variety of reasons. Here, I can assume because of the limited access to getting treatment, and the unwillingness to face public embarrasmenterassment. Since the cohesive nature of small communities may put these victims of trauma in the shadows.

This post considers the challenges rural women may face when dealing with IPV and seeking treatment for their trauma. Knowing the spatial differences between the rural and the urban seek out potential barriers for women to attain the help that they need, due to factors such as isolation and reliance on their domestic partner. An attention on rural centric crime considers factors not applicable to the urban, and must be researched further to understand the hidden figures and perception of rural life.

Ceccato, V. (2015b). Rural crime and community safety. https://doi.org/10.4324/9780203725689

M.D., B.V.D. K. (2014). The Body Keeps the Score. Penguin US. https://bookshelf.vitalsource.com/books/9781101608302

Approaches to Childhood Trauma

I have always found the psychology of children a fascinating topic because much of our habits, actions, and language developments occur during our childhood years. So, I was excited to learn more about childhood trauma; more specifically, how children are impacted by trauma. Unlike adults, children experience, express, and cope with trauma differently compared to adults. Because of this, psychologists and psychiatrists have had a hard time recognizing and managing children who experience trauma. Although there are many tests to help guide these professional workers in diagnosing these children. In the documentary “PTSD In Children: Move in the Rhythm of the Child” directed and produced by Joyce Boaz, she highlighted the idea that there are children who are experiencing trauma who seek interventions, but there are children do not seek interventions. Children are vulnerable to their surroundings and their environment due to their sensitive nature. Trauma does not only change their perceptions of the world but also changes their neurobiological development (Rousseau, 2023). 

A biology approach to childhood trauma: 
Kolk’s chapter on “Developmental Trauma: The Hidden Epidemic” discusses the idea that trauma and stress may be involved in a more-than-just environmental impact, but rather could be a transfer of genetic makeup to progeny generations (Volk, 170). This idea is not a new idea, with understanding if our genes give rise to certain behaviors and traits. However, strong research has also found the importance of epigenetics which can certainly change behaviors (Kolk 2015). 

Currently, I am taking a course in Animal Behavior, and one of the case studies we looked at is the idea that genetics influences an individual's primary response, however, epigenetics (aka the impact of the environment on our DNA) can change this primary response. Similar to Szyf’s words, “major changes to our bodies can be made not just by chemicals and toxins, but also in the way the social world talks to the hard-wired world.” (Kolk, 2015) 

A social approach to childhood trauma: 
Now that we discovered the idea that trauma may impact a child differently depending on their innate genetic information, different children will respond and react to trauma differently. The “hard” part of this is how researchers can determine this. In Boaz’s documentary, she introduced us to multiple psychiatrists who specialize in treating children who have experienced trauma, and a consensus that all the psychiatrists agreed on is that children are hard to read. Sometimes they are unable to identify and express their feelings, and for this, therapeutic tools as well as diagnostic tools have been implemented to assist psychologists and psychiatrists to help with diagnosis and treatments. In our course, we looked at multiple different therapeutic tools including the art of yoga project, Sand Tray Therapy, and Trauma-Informed Behavioral Therapy (Rousseau, 2023). 

These tools and approaches are important for early interventions of children who experienced trauma, but I do want to recognize children who are unable to find interventions. The ACE study (Adverse childhood experiences) found with a sample size of 50,000 patients that: 
* One out of ten adults responded that he/she was a victim of some form of emotional abuse.
* More than one-quarter of respondents were victims of some form of physical abuse.
* Twenty-eight percent of the adult women and sixteen percent of the adult men responded that they were victims of some form of sexual abuse.
* One in eight of the adults responded that he/she witnessed his/her mother being a victim of abuse. 
(Taken from Rousseau 2023) 

In simple terms, trauma impacts a lot of children, and it continues to impact millions of children through different routes such as domestic abuse or school bullying. From 2021-2022, a total of 327 documented school shootings have occurred in US elementary to high school (National Center for educational statistics, 2023). This speaks words to not only the individuals who are causing the school violence but also individuals who experience the school violence. Domestic abuse has also been coined as a public health issue. Intervention is only provided when an individual seeks it, so I find it extremely disheartening for those who cannot seek it or don’t know how to seek it. Although there are many techniques and therapies involved, at the end of the day, only certain types of individuals can receive it. 


References:
National Center for Education Statistics (2023). Violent Deaths at School and Away From School, School Shootings, and Active Shooter Inceidents. Retrieved December 9, 2023, National Center for Education Statistics. https://nces.ed.gov/programs/coe/indicator/a01/violent-deaths-and-shootings
Boaz, J. (Director + Producer). (1995). PTSD In Children: Move in the Rhythm of the Child.
[Video/DVD] Gift from Within. https://video-alexanderstreet-com.ezproxy.bu.edu/watch/ptsd-in- children-move-in-the-rhythm-of-the-child/details?context=channel:counseling-therapy
Rousseau, D. (2023). Trauma and Crisis Intervention Module 1. Retrieved November 20, 2023,
from Blackboard.
Van der Kolk, B. (2015). The Body Keeps the Score: Brain, Mind, And Body in the Healing of
Trauma. Penguin Books.

childhood trauma

Childhood trauma, which includes experiences such as abuse and neglect, casts a long shadow on one's life, leaving indelible marks on one's mental health and relationships. Based on my personal experiences with difficulties, I've realized the profound impact it has on emotional well-being. Addressing childhood trauma is critical for healing, requiring compassion for oneself and a commitment to breaking the cycle of pain.

Childhood trauma is frequently manifested in mental health issues ranging from anxiety to depression. My journey has taught me the value of acknowledging the impact, encouraging open dialogue, and breaking the silence surrounding these experiences. By sharing our stories, we not only de-stigmatize the conversation about trauma, but also create a safe space for healing and resilience. Seeking professional help, participating in therapies, and developing a trusting network are all important steps in the ongoing journey toward recovery and self-discovery.

Yoga and Mindfulness: An Effective Approach for Trauma Recovery

The synergy between Yoga and Mindfulness has emerged as an invaluable approach to healing from trauma, encompassing physical and mental well-being. Yoga, a practice revered for centuries, has evolved into "trauma-informed yoga," tailored to aid trauma survivors by prioritizing safety, breath awareness, and embodiment over traditional correction-based methods. This approach emphasizes modified movements, steering away from complexity towards fostering an environment conducive to healing through safety, predictability, and repetitive patterns. (Emerson et al., 2009)

David Emerson's advocacy for trauma-sensitive yoga highlights the need to understand the scientific basis behind this approach as it reduces “autonomic sympathetic activation, muscle tension, and blood pressure, improves neuroendocrine and hormonal activity, decreases physical symptoms and emotional distress, and increases the quality of life” (Emerson et al., 2009) The Yoga Service Council's guidelines further underscore the importance of creating safe environments and employing invitational language, refraining from assumptions while focusing on strengths-based teaching models for post-traumatic growth. (Rousseau, 2023) Depending on the individual’s needs, Spence, the author of “ Trauma-informed yoga: A toolbox for therapists: 47 practices to calm,  balance, and restore the nervous system”, divided yoga practices into four categories: Calming practices, balancing practices, energizing practices, visualizations, and meditations. (Spence, 2021). It is also essential to understand that yoga is not one-size-fits-all, as mentioned in the book by Spence. The practice looks different for everyone every day, depending on one’s needs at that time. Complementing yoga's effectiveness, mindfulness has surfaced as a potent tool in trauma recovery. Originating from the work of Dr. Jon Kabat-Zinn, mindfulness involves non-judgmental observation of physical and emotional experiences to foster clarity and diminish self-criticism. (Rousseau, 2023) This practice aids in reducing negative thinking patterns and reconstructing neural structures affected by trauma.

Mindfulness, adaptable to diverse practices such as focused breathing and guided meditation, accommodates individuals at different proficiency levels, fostering gradual integration. Resources available on platforms like Mindful offer comprehensive support, catering to individuals' varied needs during their mindfulness journey. (Rousseau, 2023)

The transformative potential of mindfulness in trauma recovery lies in its cultivation of non-judgmental awareness. By encouraging individuals to observe sensations and emotions without criticism, mindfulness facilitates mental reformation, empowering individuals to acknowledge experiences without letting them define their present state.

Scientifically, mindfulness profoundly impacts brain restructuring, facilitating rewiring of thought patterns disrupted by trauma. This cognitive restructuring aids in symptom alleviation while contributing to long-term healing and resilience-building.

The combination of trauma-informed yoga and mindfulness presents an empowering avenue for trauma survivors, fostering healing, resilience, and the rediscovery of autonomy in life. This cohesive practice offers a transformative journey toward holistic recovery from past adversities. However, relying solely on yoga as a therapeutic intervention may have limitations due to the diversity of individual needs and varying levels of trauma experienced. While this approach is an effective treatment, its efficacy might be enhanced by integrating complementary methods tailored to individual requirements.

References

Emerson, David, et al. “Trauma-Sensitive Yoga: Principles, Practice, and Research.” International Journal of Yoga Therapy, vol. 19, no. 1, 1 Oct. 2009, pp. 123–128, https://doi.org/10.17761/ijyt.19.1.h6476p8084l22160.

Rousseau, D. 2023. Module 4. Boston University. 

Spence, J. (2021). Trauma-informed yoga: A toolbox for therapists: 47 practices to calm,  balance, and restore the nervous system. PESI.

Building Resilience for Posttraumatic Growth

Gayle Demarest -Blog Post- METCJ720 -Trauma and Crisis Intervention

We often hear about people who experience adverse and traumatic experiences and who become eventually diagnosed with posttraumatic stress disorder, PTSD, from either acute short-term trauma or chronic trauma, which lasts over a long period and can cause significant physical and mental illness (Rousseau, 2023). We hear less about people who resiliently recover from their experiences and thrive into posttraumatic growth.

Resilience is a buffer to becoming diagnosed with PTSD and allows us to adapt successfully in the face of adversity and stress (Horn et al., 2016). One can innately have resiliency or build resiliency to protect oneself from traumatic events. Resilience can also be taught to PTSD patients, potentially moving them into posttraumatic growth.  Several advances in the study of trauma and resilience have shown a greater understanding of how individual strengths, protective factors, and the adaptational responses of human beings can build our resilience to overcome adversity (Horn et al., 2016).  An essential step for all trauma survivors, according to Van der Kolk, is the importance of treatment provided early on,  preferably right after the trauma. If too much time passes, the traumatized person or group can become emotionally numb and only able to relate to their traumatic memories. This delay creates a setback to treatment and could steer someone toward a diagnosis of PTSD rather than posttraumatic growth (van der Kolk, 2014).

Certain protective factors have been identified in recent studies of children exposed to the extreme traumas of war (forced displacement, bombings, and rapes), including solid social support systems, religious beliefs that show meaning in suffering, and positive bonding with a caregiver. (Horn et al., 2016).  Individuals who can overcome a moderate stressor, like the death of a family member, may be able to be resilient to later stressors (Horn et al., 2016). This phenomenon is known as stress inoculation. Additionally, if an individual has control and agency over a stressor, it is less likely to become unmanageable (Horn et al., 2016).  Cognitive reappraisal is an emotion-regulating strategy often used by resilient individuals; this skill allows one to monitor negative thoughts and replace them with positive ones (Horn et al., 2016).

Rousseau states that the outcome of exposure to a traumatic event is more dependent on the inner workings of the person who experienced it than the event itself (Rousseau, 2023).  In the TED talk by Jane McGonigal, she shares that some individuals use traumatic events as a springboard to live a better life than before and that we do not have to suffer. Strengths that can lead to posttraumatic growth include mental, physical, social, and emotional resilience. If an individual can work on these areas within themselves, they are likely to experience healing from their trauma and regain a meaningful life (Rousseau, 2023). Judith Herman, author of Trauma and Recovery, points out that only through connection with others can survivors leave behind their vulnerabilities and regain their sense of self (Rousseau, 2023). In B.U. student Brogan Gerhart’s film review of “Boys and Men Healing: From Child Sexual Abuse” (2023), she writes about the widely unspoken issue of sexual abuse against men and boys and the lack of resources they have available to them for healing. She states that most of the survivors in the film found healing and resilience in connecting with other male survivors of child sexual abuse (Gerhart, B. film review, 2023).

Resiliency comes in many forms, all essential to the healing process, and if we commit to working on ourselves to improve those skills and characteristics within, we can all move toward healing and posttraumatic growth, redefining our lives and making new memories, leaving behind the traumatic ones. Building resilience is there for all of us, and there are multiple roads to get there.

References

Gerhart, B. (2023). Review: Boys and Men Healing: From Child Sexual Abuse [Film] directed by Barbini, 2011. Boston University, MET CJ720 Trauma and Crisis Intervention. Accessed December 5, 2023. https://video.alexanderstreet.com/watch/boys-and-men-healing-from-child-sexual-abuse-2.

Horn, S. R., Charney, D. S., & Feder, A. (2016). Understanding resilience: New approaches for preventing and treating PTSD. Experimental neurology, 284, 119-132.

Rousseau, D. (2023). Trauma and Crisis Intervention. Module 1. MET CJ720. Boston University.

Van der Kolk, B.A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking Penguin.

Exercise as a Form of Therapy

We all know exercise is an important part of our daily routine. While many use it as a way to stay fit and healthy, some also use it as an outlet for trauma, specifically PTSD. Our nervous systems are incredibly delicate, so when we experience trauma, it can throw off the whole body. This triggers anxiety, depression, panic, sleep disorders and many more symptoms. The Trauma Institute and Child Trauma Institute explain how different movement techniques help people gain confidence and overcome their trauma (Lederman & Greenwald, 2023). In addition to different movement techniques overcoming trauma barriers, running and walking even 30 minutes a day can lower stress levels and improve quality of life (Lederman & Greenwald, 2023). Other types of healing exercise include yoga, where not only is the person exercising but they are also practicing mindfulness and self-control (Rousseau, 2023). Group exercise can also help people overcome trauma. Van der Kolk’s The Body Keeps the Score explores this citing “...the third group engaged in a routine exercise program…after three months the participants reported that they felt happier and healthier” (2014). 

Of course, there is a line that needs to be drawn in order for the exercise to not become an addiction. This can often happen to victims of trauma, where they supplement feeling depressed or anxious for exercise (Van der Kolk, 2014). Numbing, as it is often referred to, can have a negative impact on mental health just as much as suffering from trauma. Victims have reported emotional restrictions after a traumatic event, thus needing to supplement with the sort of happiness that exercise can give (Litz & Gray, 2002). Being able to identify when the exercise addiction is causing the victim to become emotionally numb is key to overcoming PTSD. This is why regulation and speaking with a mental health professional is important for the patient. 

Many forms of exercise have helped victims work through trauma. It is a great self-care technique and when done in groups, can lead to an emotional release and/or relationship building. 

References: 

Lederman, I., Greenwald, R. 2023. Exercise to support trauma healing. Trauma Institute & Child Trauma Institute. https://www.ticti.org/exercise/

Litz, B. T., & Gray, M. J. (2002). Emotional numbing in posttraumatic stress disorder: current and future research directions. The Australian and New Zealand journal of psychiatry, 36(2), 198–204. https://doi.org/10.1046/j.1440-1614.2002.01002.x

M.D., B.V.D. K. (2014). The Body Keeps the Score. Penguin US. https://bookshelf.vitalsource.com/books/9781101608302

Rousseau, D. 2023. Module 2– Childhood trauma. Boston University. https://learn.bu.edu/bbcswebdav/pid-12438218-dt-content-rid-91015208_1/courses/23fallmetcj720_o2/course/module2/allpages.htm

Parent Centered Treatment Impacting Children’s Trauma

During the semester, we have studied many interesting facets about trauma and specifically methods aimed towards treating trauma in children and adults. For example, in trauma-focused cognitive behavioral therapy, exposure therapy, and EMDR, a therapist works directly with the victim-survivor to help reduce their symptoms and triggers that may be affecting their behaviors and day-to-day living. For the most part, these treatments targeted the afflicted individual and did not explore treatments with a wider scope that included family members and, perhaps, members of the community. A few of the materials we looked at did suggest a wider-scope approach.

As part of the documentary film review assignment, I watched a documentary titled “Trauma & Dissociation in Children I: Behavioral Impacts” by Fran Waters. This film touched on the difficulties trauma-survivors face and suggested an even better form of treatment for young victim-survivors is to work with their parents. I learned how treating parents and other guardians may be a more effective approach than working with children directly to reduce their symptoms. What was not explored in the materials we looked at, however, was the willingness of parents and other guardians as well as others who are trying to help them, such as social workers, to actually undergo these forms of treatment. One of the interesting questions raised surrounding this topic is how practical these solutions are. Would the majority of parents be willing to undergo this treatment for the sake of their children’s well-being? Alternatively, if such treatment was imposed upon them by either the court system or some other administrator, could this form of therapy still be as beneficial given the resistance it would likely face? It would be interesting to further explore these more practical aspects of the treatment.

Waters, F. (n.d.). Trauma & Dissociation in Children I: Behavioral Impacts. Kanopy. Retrieved from https://www.kanopy.com/en/product/trauma-dissociation-children-i-behavioral-impacts?vp=bu.