The intersection of autism and trauma is not an uncommon one in the greater autism community, and navigating trauma-informed care often requires a different and more delicate approach than conventional therapy.
Milestones’ Director of Education, Bradley Wyner, NADD-DDS, combines best practices regarding mental health, trauma, and autism for an approach that is positive and person-centered, with an extensive background in the intersection of autism and trauma.
We sat down with Bradley for a Q&A on the careful approach of Trauma-Informed Care (TIC).
Milestones: How did you come to value TIC?
Bradley: I had been working as a case manager for a residential provider, and had just gotten promoted to be the Behavior Specialist. The agency was sending me to all sorts of training for professional development, which was good because there was a hearty group of people we support for whom “nothing worked” – the sorts of approaches and therapies that helped most people with similar behavioral challenges were not leading to meaningful progress. I went to a training about Trauma Responsive Care (a training led by Lara Palay, who would eventually become a friend and mentor), and everything she was talking about clicked with the people I was struggling to support. She talked about safety, connection, and control as the foundational needs for agencies like mine, and all of a sudden it made sense. It was the lack of control that explained the “problem behaviors.” I went to the boss and said “we need to bring this lady in to teach us.” That was eight years ago. The things I learned that day have become the foundation to my professional practice, as well as in my personal life.
Milestones: Why is trauma significant in the autism world?
Bradley: Challenges with social communication are a key factor in autism – neurotypical people often struggle to use language and communication approaches that connect with an autistic person’s neurology – and right from the beginning, that can impact a person’s sense of reciprocal connection with the people around them. It contributes to a high likelihood of “little t” trauma for autistic people from very early on - small events that aren’t as likely to be traumatizing by themselves, but can amount to a traumatic effect over time.
Hyperlink for little t:
https://www.newportinstitute.com/resources/mental-health/big-t-little-t-trauma/
Hyperlink for “challenges with social communication”:
https://www.spectrumnews.org/news/double-empathy-explained/
Milestones: Is talk therapy inherent, or are there other aspects of healing?
Bradley: One of the most common misconceptions around “trauma-informed care” is that it means talking with someone about past traumatic events. Being trauma-informed means working in a way that promotes healing and reduces the likelihood of retraumatization, and talk therapy is only one potential way of doing so. Relationship-based approaches are one of the most effective ways to promote healing in people who have experienced trauma. Understanding of sensory integration - which is something so many of us in the autism world are able to navigate skillfully - is also tremendously helpful in addressing trauma, because it directly impacts a person’s felt safety in their body. While direct trauma therapy is often an important component of healing when someone has a significant lived experience of trauma, it is just as important – maybe even more important – to surround that person with supports that promote safety, connection, and control.
Milestones: What are challenges we see when people are trying to be trauma-informed?
Bradley: Trauma-informed care is not a service you can provide for someone in a single direction; it’s not simply “the professional does trauma informed care for the client.” So much of it relies on safe emotional regulation for the professionals or other people trying to support someone with a trauma history. Any meaningful journey into the world of trauma-informed care brings a realization that much of the work has to be done internally by the professional or the person seeking to be a helper or support.
Think of it this way: if I’m nervous, or agitated, or anxious, and I’m trying to help you calm down, it’s not going to work. You’re going to sense my dysregulation. The first thing I need to do is to ground myself in a sense of calm. Then I can reach out to you to try to help you find a feeling of safety.
That’s not what most of us signed up for, in the helping professions. But it is such a powerful discovery: so much of what we do to help other people is to help ourselves first.
Milestones: Do you have to know someone’s story to support their trauma recovery?
Bradley: That’s an excellent question. No, you don’t. As long as you are supporting someone to feel safe, to feel connected to the people around them, and to feel in control of themselves, you are supporting their trauma recovery – and reducing the risk of retraumatization.
For more information on trauma-informed care, here are some additional resources:
Department of Developmental Disabilities (DODD) Trauma Informed Care Guide
