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"Trauma-informed care" is a semi-new buzzword that is heard all over right now but trauma-informed care gets a lot wrong when it comes to bipolar disorder (and other serious mental illnesses). I don't say this because I don't think trauma-informed care works -- I think it probably does. But like anything, it only works for a certain population; and, like with anything fashionable, right now (look, it has its own conference) they are trying to shoehorn it onto every population. And when it comes to bipolar disorder, trauma-informed care gets a lot wrong.
It is the case that some people with bipolar disorder have experienced trauma -- maybe even most, I don't know. What I do know is that trauma does not cause bipolar disorder. Bipolar disorder is a psychological, biological, and environmental disorder. (Technically referred to as a bio-psycho-social disorder.) And while the environment and a person's psychology can contribute to bipolar disorder, bipolar disorder needs biological component -- mostly a genetic component -- to manifest. One needs the predisposition for bipolar disorder. Trauma can't create a predisposition. Trauma doesn't cause bipolar disorder and addressing trauma doesn't cure bipolar disorder, either.
Well, nothing -- sort of. If you have been through a trauma, I highly recommend you deal with that trauma by seeing a psychologist. And in dealing with that trauma, it is possible that bipolar disorder will be easier to manage. That makes sense. Untreated trauma is like a boulder on your back -- remove the boulder and doing anything gets easier.
That said, the issue is with mental health professionals who think that if they deal with anyone's trauma, anyone's bipolar disorder will be helped. This is the shoehorning. This is the suggestion that if you have bipolar, trauma-informed care is the cure.
This issue tends to come up with psychologists. Some psychologists dig and dig and dig for the trauma you supposedly have experienced that you supposedly haven't dealt with and that supposedly will unlock the key to your bipolar disorder.
Well, that is bullshit.
Like I said, if you have trauma, it's important to deal with it. But if you have dealt with it or if it isn't there in the first place, that's okay too. You can have bipolar disorder without trauma. Really.
So, if you're looking at your life in its totality, and part of the puzzle is trauma -- you might be a candidate for trauma-informed care. That said, if your practitioner is insisting that trauma must be part of your bipolar disorder, then that is more trauma-insistent care, and that is problematic, to say the least.
Look, I've been through trauma. I can admit that. It's not a secret.
I've also put in lots of hard work to get over that trauma. If you've been one of my therapists, you know that too.
So in the puzzle of my life, while trauma has occurred, it's not part of my bipolar disorder experience today and, quite frankly, I find it really insulting that someone would insist that it is. It's insulting because that person is suggesting that I don't know myself. That person is suggesting that I don't understand my own history. That person is suggesting that I'm not my own expert.
Now some people do need a nudge (or seven) to deal with their own traumas. I'm sure this is true. So maybe psychologists have your best interest at heart when nudging you about trauma. But everyone is the expert in their own experience and, seriously, if a patient says they are over their trauma or that they haven't experienced a bad childhood or sexual assault, for god's sake, believe them.
So, in the end, trauma-informed care might be good for some, but it can also be insulting to those with bipolar disorder or another serious mental illness when it causes professionals to not listen to our real experiences. The fashionability of trauma-informed care overrides individuals. And that is not okay.
Banner image by Flickr user Dallas.
Natasha Tracy is an award-winning writer, speaker, advocate, and consultant from the Pacific Northwest. She has been living with bipolar disorder for 26 years and has written more than 2000 articles on the subject.
Find more of Natasha’s work in her acclaimed book: "Lost Marbles: Insights into My Life with Depression & Bipolar" on Amazon.
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“And while the environment and a person’s psychology can contribute to bipolar disorder, bipolar disorder needs biological component — mostly a genetic component — to manifest.”
Then there are those of us who don’t have a family history of bipolar disorder. I don’t know how science accounts for that. Perhaps you could write about that subject sometime.
I came up out of trauma cptsd almost to suffer biopolar and I escape it took notes and filmed it all. I was lucky so some punks and people who are biopolar sick people found a way to induce a serious trauma on me to induce bipolar on me don’t tel me the expert nothing cause ei saw it go on. I went fro sane balance tested and keep healthy to a very evil plot to remove my means todefend from damage to my brain trauma and abuse and was insult sexual insult rape and abus eand not treat and kept to induce all worst on me. I had been sexual insult and assaulted while strong and prayed to not become effected and held it got rid of asshole and came up. and then next asshole tested me. this time th3ey pulled a trick because ei remain healthy and I saw myself left as if I child who was raped traumatized and abuse and damage would be who could not tell anyone but I did. I ws not treat and the effects are deadly and now I’m fuck up to god after having 24 perfect years and escape the fate. maybe in womb , you don’t recall trauma to brain , or something.
Thank you for this, Natasha. I’ve been trying to figure this out.
I agree with Sera. Please review trauma informed care vs trauma specific care.
You seem to have confused ‘trauma-informed care’ with ‘trauma-specific care.’ Although there are certainly some providers out there that share your confusion, trauma-informed care actually has absolutely nothing to do with assessing someone for trauma, and/or recommending trauma-specific treatment (EMDR, neurofeedback, etc.). Pretty much everything you’re talking about above is about *trauma-specific care.* On top of that, the vast majority of providers who even make an attempt at practicing ‘trauma-informed’ care are still also deeply wedded to a medical, disease-oriented model.
I’ve done so much work on myself over the past 30 some years with psychologists, psychiatrists, therapists, 12 step groups and over all these years there is very little I don’t know about myself either, I was never sexually abused, or came from an abusive home. I lived a very excited life I had a high intensity with touch with men and couldn’t help myself wanting to be with them and took crazy risks with my life to be there, I wasn’t diagnosed until almost 50, from a breakdown but after getting diagnosed and on the right meds I can look back and see when it really started and why I did the things I did and it wasn’t caused by drama. Thanks for sharing your article and for letting me share too.
In my 3 decades of various treatments for mental illness, I have seen the clinical view of trauma swing from one end to the other. In my early treatment, if I spoke of how trauma, culture or my environment affected me, this was dismissed as irrelevant or delusional.
Now, the opposite ideology infuses treatment, where too many clinicians describe everything as traumatic.
Although I agree with the need for trauma specific care when required, I am greatly concerned with how crippling it is to conflate all struggles as traumatic. Additionally, it troubles me that clinicians who advocate for trauma specific care disregard how expensive and inaccessible this type of treatment is for many, as often mental illness occurs with poverty.
What helps most is when I have worked with clinicians who I feel genuinely care about me.