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Trauma significantly impacts diverse Canadian populations, including immigrants, refugees, and Aboriginal peoples. Immigrants and refugees face unique challenges pre- and post-migration, from persecution to integration difficulties and systemic racism. Aboriginal peoples experience profound, intergenerational historic trauma from colonization and residential schools, resulting in widespread individual, family, and community struggles. Trauma manifests physically, emotionally, and cognitively, affecting health and relationships. Service providers must be trauma-informed and culturally competent, understanding various cultural interpretations of trauma and respecting Indigenous healing practices and the role of Elders. This approach fosters trust, essential for addressing the pervasive effects of trauma in society.

The Experience of Immigrants
and Refugees
Immigrants and refugees are a significant and growing part of
our Canadian population. Therefore, it is crucial that service
providers and service systems acknowledge trauma in these
groups by being knowledgeable about their experiences in
their home country and their experience of migration and
settling in Canada.
An immigrant is a person who has been granted the right
to live in Canada permanently by Canadian immigration
authorities. There are many different classes of immigrants,
depending on the circumstances under which the immigrant
has come to Canada.
Citizenship and Immigration Canada’s definition of a
Convention Refugee is based on the United Nation’s definition:
A person who, by reason of a well-founded fear of persecution
for reasons of race, religion, nationality, membership in a
particular social group, or political opinion, is (a) outside their
country of nationality and unable, or by reason of that fear,
unwilling to avail themselves of the protection of that country;
or (b) not having a country of nationality, is outside the country
of their former habitual residence and unable, or by reason of
that fear, unwilling to return to that country.
Immigrants and refugees may share similar experiences in
their home countries and in the process of settling in the new
country. However, because refugees are fleeing extremely
traumatic conditions, almost all of them have experienced
losses and may have suffered multiple traumatic experiences,
including torture. Their vulnerability to isolation is exacerbated
by poverty, grief, and the lack of education, literacy and skills in
the language of the receiving country (Robertson et al., 2006).
Immigrants (non-refugee status) may have faced the same
issues as refugees, and the two groups sh THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
40
experience of having to settle in a foreign country. Issues
related to trauma that they have already experienced can be
compounded by the following circumstances and challenges
faced in the integration process:
● Not understanding Canadian cultural norms
● Feeling that the host country doesn’t understand their
culture, or make any efforts to do so
● Facing constant racism that is deeply rooted in
Canadian society
● Feeling unwelcome in Canada
● Finding adequate employment
● Learning English or French
● Lack of recognition of education
● Finding adequate housing
● Few family supports
● Dealing with bureaucracy
● Feeling isolated
● Inadequate childcare
● Difficulties enrolling children in school
● Grief of missing family in their home country and not
seeing family for years at a time
● Finding themselves living in lower living standards due
to low income
● Lack of societal acceptance of religious beliefs and
practices
● Facing continued family violence
● Dealing with negative comments by politicians, the
media, or in private conversations that reflect negative
public opinions about immigrants and refugees 41
For those who faced discrimination, punishment and
torture in their home country, some additional issues
may include:
● Continued discrimination in Canada
● Distrust of the Canadian government because it
could have been responsible for their maltreatment
in the home country
● Feelings of shame
● Feeling guilty for having survived when other family
and community members may have been killed
● Feeling they need to prove how bad the situation was at
home to stay in Canada and the associated fear of
deportation
● Living with the physical, psychological and emotional
consequences of trauma, while trying to negotiate
settlement and integration (Canadian Council for Refugees,
2002)
● Living with little or no information about the welfare of
family members in life-threatening situations
● Constantly wondering when they will be reunited with
their families
● Being stuck for years without permanent status in Canada
All of these issues may contribute to a difficult transition
into Canadian society. The process of transitioning into a
new culture may trigger past and/or unresolved trauma.
Additionally, people who have survived trauma may not feel
comfortable asking for help due to the lack of understanding
of their culture by service providers and/or the image of
weakness that this may invoke in their own culture.
As service providers, we can be helpful even though we do
not understand the specifics of every culture represented in
Manitoba. If we understand people who have experienced
trauma and their challenges from their perspective, and make a
concerted effort to understand their cultural interpretations of
TYPES OF TRAUMA THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
42
the traumatic events, then that will guide our work with them. It
is how they interpret the trauma that is important and helps us
understand the impact of the trauma now and how we can be
helpful.
In summary, service providers working with individuals who
have experienced trauma have a responsibility to be aware of
the many challenges that immigrant and refugees face as they
try to integrate into Canadian society. In addition, it is important
to be aware of the cultural practices that may be important to
their recovery. Displaying this knowledge and willingness to
learn will help form a solid helping relationship that is essential
to trauma recovery. HISTORIC TRAUMA: THE LEGACY OF COLONIZATION AND RESIDENTIAL SCHOOLS 43
“Our dignity was taken away …
and a lot of people don’t realize
that. They don’t really understand
about how our dignity was taken
away from us, how we were
taught to be ashamed to be
Natives. Then our self-respect
was gone. Once you lose your
self-respect, how can you respect
someone else? Then you take
your frustrations out on other
people.”
(Elder)
The purpose of residential schooling
was to assimilate Aboriginal children
into mainstream Canadian society
by disconnecting them from their
families and communities and
severing all ties with languages,
customs and beliefs. To this end,
children in residential schools were
taught shame and rejection for
everything about their heritage,
including their ancestors, their
families and, especially, their spiritual
traditions.
Deborah Chansonneuve, 2005. THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
44
Historic Trauma: The Legacy of
Colonization and Residential
Schools
Historical trauma has been defined as “The cumulative
emotional and psychological wounding across generations,
including the lifespan, which emanates from massive group
trauma” (Yellow Horse Brave Heart, 2003).
The experience of many Aboriginal people in Canada due
to colonization and forced attendance at residential schools
encompasses all types of develop mental trauma.
Residential School:
● The last federally run residential school closed in 1996.
● There are 80,000 people alive today who attended
residential schools (First Nations and Inuit Health, 2013).
● The average age of claimants for compensation is 57
years old (Assembly of First Nations).
The term “Aboriginal” includes First Nations, Inuit and Métis,
regardless of where they live in Canada, and regardless of
whether they are “registered” under the Indian Act of Canada.
Given the high population of Aboriginal people living in
Manitoba, it is crucial that service providers have an
understanding of the profound effects colonization has had
on Aboriginal people. Colonization itself is a collectively
experienced trauma. There are important historical factors that
surround the experience of being Aboriginal in Canada.
Many thousands of Aboriginal children were taken from their
families and enrolled in the residential school system during
its existence. While the majority of these children were status
Indians, attendance also included many Inuit, Métis and
non-status Indians.
Historic Trauma: The
Legacy of Colonization
and Residential Schools 45
Regardless of the precise number of people involved,
Aboriginal people across the country have paid a high price,
both individually and collectively, for the government’s
misguided experiment in cultural assimilation (Aboriginal Healing
Foundation, 2003).
In 1867, Canada instituted a policy of Aboriginal assimilation
designed to transform communities from “savage” to
“civilized.” Canadian law forced Aboriginal parents under
threat of prosecution to send their children to the schools. The
residential schools prohibited the use of Aboriginal languages
and the observance of their traditions, teachings, practices and
customs. Children did not see their family members for months
and even years at a time.
From the mid-19th to mid-20th centuries, residential school
was the norm for Aboriginal people. They were operated by
religious orders in the earlier years and then moved to total
governmental control in later years.
Abuses that occurred in schools are numerous, including
physical abuse, neglect, torture, and sexual abuse at the
hands of the staff. Despite the fact that abuses were directed
toward specific individuals, they were part of a larger project
to suppress Aboriginal culture and identity in its entirety.
Aboriginal communities continue to feel the impact of what
some call attempted “cultural genocide.”
Impacts
The impacts of the residential school experience are
intergenerational – passed on from generation to generation.
Parents who were forced to send their children to the schools
had to deal with the devastating effects of separation, as well as
the total lack of input in the care and welfare of their children.
Many of the children suffered abuse atrocities from the staff
that were compounded by a curriculum that stripped them
of their native languages and culture. This caused additional
feelings of alienation, shame and anger that were passed down
to their children and grandchildren.
The Archbishop of St.
Boniface wrote in 1912
of the need to place
Aboriginal children in
residential schools at
the age of six, since
they had to be “caught
young to be saved
from what is on the
whole the degenerating
influence of their home
environment.”
(This was a common
sentiment from the
dominant culture
of that time.).
HISTORIC TRAUMA: THE LEGACY OF COLONIZATION AND RESIDENTIAL SCHOOLS THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
46
The effects of trauma tend to ripple outward from those
affected by trauma to those who surround them. Among
residential school survivors, the consequences of emotional,
physical and sexual abuse continue to be felt in each
subsequent generation. Deep, traumatic wounds exist in
the lives of many Aboriginal people who were taught to be
ashamed just because they were Aboriginal.
What has also been a significant factor in the healing process
of this trauma is that because of colonization, the Elders and
Healers of the communities who would have played a vital role
in the healing process were not replaced or were undermined
by the missionaries. So those who experienced the trauma
of the residential schools were essentially denied access to
resources that would have provided them with significant
assistance. “Each generation of returning children had fewer
and fewer resources upon which to draw” (Truth and Reconciliation
Commission, 2012).
A significant factor to consider is how the attachment
relationship between the children, their parents, their natural
community and their cultural supports was violated. The
experience of being taken away from their caregivers would
have been traumatic and significantly impacted the children’s
development. Attachment to a responsive, nurturing, consistent
caregiver is essential for healthy growth and development.
Many children of the residential school system did not have
this experience after they were taken from their families, and
subsequently they struggle today because of the trauma of
being taken away from attachment figures.
The impact of these disrupted attachments is felt at individual,
family, and community and culture levels:
Individual:
● Isolation/alienation
● Shame
● Anger toward school and parents 47
● Self-hatred
● Internalized racism
● Fear of authority
● Low self-esteem
● Self-destructive behaviours (substance abuse, gambling,
alcoholism, suicidal behaviours)
● Acting aggressively
Family:
● Unresolved grief
● Difficulty with parenting effectively
● Family violence
● Loss of stories
● Loss of traditions
● Loss of identity
Community and Culture:
● Loss of connectedness with languages, traditions and
cultural history
● Loss of togetherness and collective support
● Loss of support from Elders
● Lack of control over land and resources
● Increased suicide rate
● Lack of communal raising of children
● Lack of initiative
● Dependency on others
● Communal violence
Because the impacts of residential schools are
intergenerational, many Aboriginal people were born
into families and communities that had been struggling
with the effects of trauma for many years. The impact of
intergenerational trauma is reinforced by racist attitudes that
continue to permeate Canadian society.
HISTORIC TRAUMA: THE LEGACY OF COLONIZATION AND RESIDENTIAL SCHOOLS THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
48
“The legacy of the
schools became
joblessness, poverty,
family violence,
drug and alcohol
abuse, family
breakdown, sexual
abuse, prostitution,
homelessness, high
rates of imprisonment,
and early death.”
(They Came for the
Children, 2012)
“There are a large number of First Nations and Inuit
communities and individuals who have the capacity to cope
effectively with crisis and to minimize the negative effects
of trauma. These are the communities and people that we
must learn from when attempting to understand trauma in
indigenous communities. Without doing so we create the
impression that the capacity to cope with trauma does not exist
within indigenous communities and we fail to learn what we so
desperately need to know….” (Connors, 2013).
We know the building of relationships is important for healing
trauma. As service providers, our focus and responsibility is to
develop genuine and authentic relationships with those who
have experienced trauma.
This includes safety, compassion, respect, kindness,
hopefulness and trust. And that trust must be earned. As
the Truth and Reconciliation report identifies, “reconciliation
implies relationship. The residential schools badly damaged
relationships within Aboriginal families and communities,
between Aboriginal peoples and churches, between
Aboriginal peoples and the government, and between
Aboriginal and non-Aboriginal peoples within Canadian
society” (They Came for the Children, 2012).
As service providers, we need to be aware of the impact of the
residential school system on the clients we work with, and to
consider how it has played a role in the current difficulties and
challenges with which they may be struggling. Indeed, non-
Aboriginal service providers working with Aboriginal clients
who have experienced trauma are responsible for educating
themselves and being open to considering and hearing how
the residential school system has been an impact.
By understanding intergenerational trauma, service providers
can enhance their capacity to be compassionate and
collaborative, view behaviour within a larger context, challenge
belief systems and attitudes that can have adverse effects in
terms of establishing positive and healthy relationships, and to
create safer helping environments. 49
Despite the legacy of residential schools, there are many
reasons to be hopeful. For some Aboriginal people, the
experience of residential schools has strengthened their
identity and caused communities to come together. Healing
initiatives have been implemented that address aspects of
the residential school legacy. Resilience is evident in the
steps Aboriginal people have taken to counteract negative
outcomes. Many former students have found support in Elders
and healing circles. They have also opted to share memories
and stories with other former students, pursue further
education, relearn Aboriginal languages, and follow spiritual
paths to reinforce Aboriginal identity (Aboriginal Healing Foundation,
2003).
The cycle of trauma is being broken as the stories of trauma are
being told and as the many strengths of Aboriginal cultures are
being used to heal.
HISTORIC TRAUMA: THE LEGACY OF COLONIZATION AND RESIDENTIAL SCHOOLS THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
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Hope and Resilience
“It will take time and commitment
to reverse this legacy. The schools
operated in Canada for well over a
century. In the same way, the
reconciliation process will have to
span generations. It will take time
to re-establish respect. Effective
reconciliation will see Aboriginal
people regaining their sense of self
respect, and the development of
relations of mutual respect
between Aboriginal and
non-Aboriginal people.”
Truth and Reconciliation Commission, 2012 51
Cultural Teachings and
Healing Practices
Being trauma-informed involves having cultural competence
regarding the traditions and practices of any specific culture.
When working with First Nations, an understanding of their
cultural practices is essential in promoting and understanding
the healing process. Traditional healing practices are localized
and culturally specific.
“There are 617 First Nations and 53 Inuit communities in
Canada. As of the 2006 census, over one million Canadians
identified themselves as Aboriginal. Within the First Nations
there are more than 50 Aboriginal languages. Among the
Inuit population there are differences in language, beliefs and
cultural practices across the northern territories. The Métis
populations across Canada demonstrate similar diversity.
Although there is a common perspective or holistic worldview
that binds Indigenous populations together, there is also great
diversity in languages, beliefs and cultural practices throughout
the country” (Connors, 2013).
Therefore, it is necessary for all service providers to participate
in cultural competence and understanding as it relates to the
Indigenous populations they serve.
It is very important to not make any assumptions when
considering the individual’s experience and practices with
respect to cultural teachings and practices. It is also the
responsibility of service providers to become culturally aware
and competent when working with First Nations, Inuit and
Métis clients. For agencies working with these populations, it
is essential that program planning and policies be culturally
informed and competent. The following information may not
be specifically relevant to the clients you are working with, but
it is important to be curious about cultural beliefs and practices
when working with clients.
CULTURAL TEACHINGS AND HEALING PRACTICES
Cultural Teachings
and Healing Practices THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
52
First Nation traditional concepts of respect and sharing are
the foundation for their way of life and are built around the
seven natural laws, or Seven Sacred Teachings. These teachings
honour the basic qualities for a full and healthy life (Saint Elizabeth
website, Elder Care curriculum, 2013).
The Seven Sacred Teachings are represented by animals that
represent the embodiment of that particular teaching. The
animal world teaches everyone how to live connected to the
earth and how to respect all life (thesharingcircle.com; website
accessed, 2013). 53
The Seven Sacred Teachings
LOVE (Eagle)
The Eagle is able to reach the highest point of all creatures.
This teaching recognizes that true love is connected to the
Creator. Love that is given to the Creator is expressed through
love of self because without the love of self, it is impossible to
love others.
RESPECT (Buffalo)
The Buffalo is highly respected by First Nations because it gives
its life to and shares every part of its being with the people.
It is a reciprocal relationship of respect. It provides the gifts
of shelter, clothing and utensils. Native peoples developed
a sustainable relationship with the Buffalo, resulting in a
relationship that was rooted in utmost respect.
COURAGE (Bear)
The Bear is both gentle and ferocious and teaches us the
importance of having the mental and moral strength to
overcome fears that may prevent us from living our true spirit
as human beings.
HONESTY (Sabé)
Long ago there was a giant called Sabé who walked among
the people to remind them of the importance of being honest
to both the laws of the Creator and to one another. Honesty is
when we are able to keep the promises made to the Creator,
self and others.
WISDOM (Beaver)
The Beaver uses its gifts as a way to survive. If the Beaver did
not use his teeth to build his home, they would grow until
they were no longer useful to him. The Beaver teaches us that
communities are built upon the gifts of each of its members.
These gifts, which are given by the Creator, are important and
necessary to use when creating communities of health and
peace.
CULTURAL TEACHINGS AND HEALING PRACTICES THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
54
HUMILITY (Wolf)
To recognize and acknowledge the higher power of the
Creator is considered to be truly humble. By expressing
deference and/or submission to the Creator, we recognize
and accept that all beings are equal. This captures the essence
of the spirit of humility. The consideration of others before
ourselves is also an expression of humility. The Wolf teaches
us all these lessons. He bows his head out of deference in the
presence of others and will not take food until it can be shared
with the other members of his pack. The Wolf lacks arrogance
and has respect for his community, which is the Aboriginal way.
TRUTH (Turtle)
To know the truth is to know and understand and be faithful to
all of the original laws as given by the Creator. Grandmother
Turtle was present when the Creator made man and gave him
the seven sacred laws. It was Grandmother Turtle who ensured
that the laws would not be lost or forgotten.
THE MEDICINE WHEEL
First Nations across the country use various forms of the
Medicine Wheel (also referred to as Sacred Hoops or Circles) in
their ceremonies and teachings (Saint Elizabeth website, 2013).
Variations of the Medicine Wheel are dependent upon the
culture and/or the teacher. It is important when working with
clients to be curious about which Medicine Wheel teachings
they connect with, so as not to make assumptions about their
beliefs and values.
For information about other Medicine Wheel teachings, see the
following links:
www.dancingtoeaglespiritsociety.org/medwheel.php
www.fourdirectionsteachings.com/main.html 55
Role of the Elder
It is an essential consideration to involve the Elder of specific
communities when developing programming related to
First Nations, Inuit and Métis populations. It is also important
to work collaboratively with the Elder in understanding the
specific teachings and beliefs for that community as it relates to
trauma recovery and healing.
There are various definitions of an Elder, including:
● “Elders” are those people who are recognized by their
community to be first and foremost “healthy” - spiritually,
psychologically and mentally. These are often highly
“ethical” people. They may be very “spiritual” people,
but this does not seem to be a requirement of
recognition. An “Elder” in this sense can refer to
respected people in the community, regardless of age.
● “Elders” are those people in a community who have lived
a long time, and as a result have much cultural wisdom.
● “Elders” are culturally regarded as teachers, mediators,
advisors, medicine people, stewards of their lands,
and the keepers of their culture and way of life.
● “Elders” used to be known as “the Old Ones” – a term of
respect that means those people in a community who
have lived a long time and, as a result, have much
cultural wisdom, experience and guidance to share (BC
Association of Aboriginal Friendship Centres, 2010).
The role an Elder plays in a community can include:
● Cultural advisor
● Historian
● Social activist (Saint Elizabeth website, 2013)
As a service provider, there may be situations or circumstances
that may require you to access the support of an Elder. It is
important to consider the community and the cultural beliefs
and practices when approaching an Elder for assistance. The
CULTURAL TEACHINGS AND HEALING PRACTICES THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
56
following are a list of general protocols to consider when
approaching an Elder:
● Be respectful
● Ask permission
● Seek clarification if there is something you don’t
understand
● Display a sense of humility – many Elders believe humility
needs to be reflected through the way individuals
present and interact
● Wear appropriate attire based on community practices
and situation
● Being loud, interrupting and rushing the conversation
can be considered rude (Saint Elizabeth website, 2013)
If an Elder has a “helper,” ask the helper what would be
appropriate for the specific Elder. The Elder’s helper will also
provide direction with respect to offering the Elder a gift of
tobacco (National Aboriginal Health Organization, 2009).
Tobacco is considered a sacred plant. The gift of tobacco
offered to an Elder recognizes the wisdom the Elder has to
offer. Tobacco can be given as “cigarettes, pouch tobacco, or
tobacco ties (loose tobacco wrapped in a small square cloth)”
(National Aboriginal Health Organization, 2009).
In the Inuit culture, the Elders do not expect tobacco because
it is not used in their ceremonies. Instead, a small gift may be
given as an offering for the Elder’s time, support and guidance
(National Aboriginal Health Organization, 2009).
Ceremonies
First Nations Elders prefer that no photos or recordings
be taken or made during spiritual ceremonies. It is also
inappropriate to touch any of the sacred items an Elder may
use during a ceremony, including pipes or medicine pouches, 57
unless the Elder gives permission. It is also essential that
permission be asked of the Elder to photograph any of these
items.
Elders request that everyone participate in the ceremonies in
the same way.
Honour songs are performed to honour a person for various
reasons. It is expected that everyone stand and remove any
headwear during an honour song.
Smudging is a prayer ceremony where specific medicines
(plants) are burned as an offering to the Creator and the Earth.
(Saint Elizabeth website, 2013)
Teachings
Historically traditional teachings were shared by the Elders
to the community for the development of spiritual, social and
educational reasons. It is important to know that First Nations
teachings provided at a public event, such as a conference or
workshop, are not considered public information. Therefore,
it is necessary to ask permission of the Elder or the organizers
to use this information (Saint Elizabeth website, 2013). For further
information in working with Elders, see Jonathan H. Ellerby’s
work “Working with Indigenous Elders” (2005).
CULTURAL TEACHINGS AND HEALING PRACTICES THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
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The Far-Reaching Effects of
Trauma: Prevalence
Many statistics are available in Canada and the U.S. on sources
and the prevalence of trauma, such as war and family violence.
Incidences of violence and abuse are generally underreported,
especially in the areas of sexual abuse and sexual assault. It
has been well established that, because of the stigma and
shame associated with trauma, current statistics only reflect
reported data and not necessarily the actual number of cases.
The following statistics are primarily drawn from national and
provincial sources, and are only intended to provide a general
understanding of trends.
PTSD:
● According to the Canadian Mental Health Association,
about 1 in 10 people in Canada have been diagnosed
with PTSD.
● Most people can experience symptoms without
developing PTSD.
● Canadian research also identifies combat veterans,
peacekeepers, terrorist attack survivors, and
Aboriginal populations as being at a higher risk to
develop PTSD (Sareen et al., 2007).
Canadian Forces:
● As of July 2011, 30,000 Canadian service personnel
have been deployed to Afghanistan.
● Symptoms of PTSD often appear many months or
years after the event(s) that preceded them. Accordingly,
it is estimated that over the next five years, 2,750 service
personnel will suffer from severe PTSD, and 6,000
will suffer from other mental illnesses diagnosed by a
professional.
A Canadian study
identifies women as
twice as likely as men to
develop PTSD
(Van Ameringen
et al., 2008) The Far-Reaching Effects of Trauma: Prevalence 59
● 90% of people with PTSD have a co-occurring diagnosis
of depression, anxiety, substance abuse or suicidal
ideation.
● Given the present lifetime occurrence of operational
stress injuries (OSI), it is expected that 30% of
soldiers who see combat will present with PTSD or
clinical depression.
● “At the moment three quarters of veterans taking part in
Veterans Affairs Canada rehabilitation programs
following their release for medical reasons are
suffering from mental health problems” (Rodrique-Pare,
2011).
Correctional System:
● 80% of women in prison and jails have been victims of
sexual and physical abuse.
● Many adults convicted of violent adult criminals were
physically or sexually abused as children.
● The majority of those convicted of homicide and sexually
related offences have a history of child maltreatment
(Jennings, 2004).
● At the time of admission, 62% of Correctional Services of
Canada inmates were identified as requiring follow-up
mental health services (Annual Report of the Office of
Correctional Investigator, 2011-2012).
● In the past 10 years, the number of Aboriginal inmates
has increased by 37.3%, while the non-Aboriginal
prison population increased 2.4% (Annual Report of the
Correctional Investigator, 2011-2012).
Refugees:
● For the fifth consecutive year, the number of forcibly
displaced people worldwide exceeded 42 million,
a result of persistent and new conflicts in different
parts of the world. By the end of 2011, the figure stood
at 42.5 million (UN Refugee Agency, 2012).
THE FAR-REACHING EFFECTS OF TRAUMA: PREVALENCE THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
60
● In 2011, there were 24,981 applicants for refugee status
in Canada. More than 15,000 of these applications were
finalized (Immigration and Refugee Board of Canada, 2012).
● Refugees come to Canada primarily from war-affected
countries such as Africa, the Middle East and
South America. Between 2000 and 2010, Manitoba
accepted 11,215 refugees at a rate of about 1,100 a year
(Province of Manitoba, 2010).
Immigrants:
● Manitoba marked the arrival of almost 16,000 immigrants
(permanent and/or temporary residents) in 2011
(Citizenship and Immigration, 2012).
● Manitoba’s top immigrant source countries were Asia,
Africa and the Middle East, Europe and UK, and South
and Central Americas (Province of Manitoba, 2012).
● Newly arrived immigrants and refugees often
experienced trauma in their home countries. As a
result, 9% are estimated to have PTSD, and 5% suffer
from clinical depression.
● Of those who present with depression, 71% also have
PTSD.
● Physicians are encouraged to look for sleep disorders,
social isolation, and other signs of underlying trauma,
rather than probing for details which could be
retraumatizing.
● Before referring to direct services targeting trauma, focus
on practical help with regard to settlement and building
up relationships of safety (Rousseau et al., 2011).
Sexual assault:
● There were 22,000 reported sexual assaults in Canada
in 2010 (Statistics Canada, 2011).
● According to General Social Survey, nine out of ten
sexual assaults are not reported (Statistics Canada, 2011)
● One in four women will be sexually assaulted
in their lifetime (Sexual Assault Canada, 2012). 61
Family Violence
All data in this section is taken from Statistics Canada 2011 for data collected
in 2009.
Partner Violence:
● Six percent of Canadians with a current or former spouse
reported being physically or sexually victimized by that
spouse.
● Similar proportion of males and females reported having
experienced spousal violence in the previous five years.
● Many victims of spousal violence reported recurring
incidents. Slightly less than one-half of victims who
had experienced an incident of spousal violence in the
previous five years stated that the violence had occurred
on more than one occasion. Females were more likely
than males to report multiple victimizations, at 57% and
40%, respectively.
● Younger Canadians were more likely to report being
a victim of spousal violence than were older Canadians.
Those aged 25 to 34 years old were three times more
likely than those aged 45 and older to state that they
had been physically or sexually assaulted by their
spouse.
● Those who self-identified as gay or lesbian were more
than twice as likely as heterosexuals to report having
experienced spousal violence, while those who
self-identified as bisexual were four times more
likely than heterosexuals to self-report spousal violence.
● Victims of spousal violence were less likely to report the
incident to police than in 2004.
● Aboriginal women (First Nations, Inuit and Métis) are
more than eight times more likely to be killed by their
intimate partner than non-Aboriginal women (Status of
Women Canada, 2012).
● Close to one in five Canadians aged 15 years and older
(17%) reported that their current or ex-partner had been
emotionally or financially abusive at some point during
their relationship, a proportion similar to 2004.
57% of Aboriginal
women have been
sexually abused
(Sexual Assault
Canada, 2012).
THE FAR-REACHING EFFECTS OF TRAUMA: PREVALENCE THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
62
● Emotional abuse and/or controlling behaviour are often
pre-cursors to violence in a relationship.
● Emotional or financial abuse was 2.5 times more common
between partners than physical violence. Both women
and men reported emotional and financial abuse.
● Being called names or being put down is one of the
strongest predictors of family violence.
Child Abuse:
● Police-reported data indicate that children and youth
under the age of 18 were most likely to be sexually
victimized or physically assaulted by someone they
knew (85% of incidents).
● Nearly 55,000 children and youth were the victims of a
sexual offence or physical assault, about three in ten of
which were perpetrated by a family member.
● Six in ten children and youth victims of family violence
were assaulted by their parents. The youngest child
victims (under the age of three years) were most
vulnerable to violence by a parent.
● The rate of family-related sexual offences was more than
four times higher for girls than for boys. The rate of
physical assault was similar for girls and boys.
● According to the Canadian Incidence Study of Reported
Child Abuse and Neglect 2008, which consisted of
reports from Child Welfare workers, substantiated cases
of child abuse broke down in the following percentages:
◆neglect: 34%
◆exposure to intimate partner violence: 34%
◆physical abuse: 20%
◆emotional maltreatment: 9%
◆sexual abuse: 3% 63
Older Adults:
● 2,400 reported violent crimes against seniors (ages 65
and over) were committed by a family member.
● The only violent offence for which senior females
experienced higher rates than males was for
sexual assault.
● Senior women experience higher rates of family
inflicted abuse.
● Most senior victims know the person behaving violently.
● An adult child and/or spouse commit most family
violence against seniors.
THE FAR-REACHING EFFECTS OF TRAUMA: PREVALENCE THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
64
The Effects of Trauma
The effects of being traumatized are very individual, and
people who have experienced trauma are impacted
physically, emotionally, behaviourally, cognitively, spiritually,
neurobiologically and relationally.
Trauma can result in:
● Changes to the brain
● Compromised immune systems
● Increased physical and mental stress
● Decreased trust
● Attachment difficulties and conflictual relationships
● Hyperarousal and hypervigilance
● Rigid or chaotic behaviour
Service providers most often see hyperarousal and
hypervigilance, but it may not relate back to trauma and could
be misinterpreted. This misinterpretation or misunderstanding
of behaviour, and failing to recognize fight, flight and freeze
responses, can contribute to judgmental behaviour on the part
of a service provider, and lead to the development of conflict
or adversarial relationships. It is important to remember that
trauma impacts the manner in which a person does or does
not approach helping relationships and their interactions with
service providers. The effects of trauma are felt across the life
span.
According to a Canadian study, PTSD is “associated with
several physical health problems including cardiovascular
diseases, respiratory diseases, chronic pain conditions,
gastrointestinal illness and cancer” (2007). It is important to
recognize that experiences of trauma can have negative effects
on a person’s health, regardless of a diagnosis of PTSD.
This further supports the ACE (Adverse Childhood
Experiences) study that identified the direct connection
between adverse childhood experiences and the increase in
serious physical and mental health problems (1998).
The Effects of Trauma 65
The ACE study identified that the more adverse the experience,
the greater the increase in risk for the following:
● Alcoholism and alcohol abuse
● Chronic obstructive pulmonary disease (COPD)
● Depression
● Fetal death
● Health-related quality of life
● Illicit drug use
● Ischemic heart disease (IHD)
● Liver disease
● Risk for intimate partner violence
● Multiple sexual partners
● Sexually transmitted diseases (STDs)
● Smoking
● Suicide attempts
● Unintended pregnancies
● Early initiation of smoking
● Early initiation of sexual activity
● Adolescent pregnancy
Emotional:
● Depression
● Feelings of despair, hopelessness and helplessness
● Guilt
● Shame
● Self-blame
● Self-hatred
● Feeling damaged
● Feeling like a “bad” person
● Anxiety
● Extreme vulnerability
THE EFFECTS OF TRAUMA THE TRAUMA-INFORMED TOOLKIT, SECOND EDITION
66
● Panic attacks
● Fearfulness
● Compulsive and obsessive behaviours
● Feeling out of control
● Irritability, anger and resentment
● Emotional numbness
● Frightening thoughts
● Difficulties in relationships
Behavioural:
● Self-harm such as cutting
● Substance abuse
● Alcohol abuse
● Gambling
● Self-destructive behaviours
● Isolation
● Choosing friends that may be unhealthy
● Suicidal behaviour
● Violence and aggression toward others
Cognitive:
● Memory lapses, especially about the trauma
● Loss of time
● Being flooded by and overwhelmed with recollections of
the trauma
● Difficulty making decisions
● Decreased ability to concentrate
● Feeling distracted
● Withdrawal from normal routine
● Thoughts of suicide 67
Spiritual:
● Feeling that life has little purpose and meaning
● Questioning the presence of a power greater
than ourselves
● Questioning one’s purpose
● Questioning “Who am I,” “Where am I going,”
“Do I really matter”
● Thoughts of being evil, especially when abuse is
perpetrated by clergy
● Feeling disconnected from the world around us
● Feeling that as well as themselves, the whole race or
culture is bad
Neurobiological:
● An overproduction of stress hormones that do not return
to normal after being activated, and can endure for hours
or days in ways identified below:
◆Jittery, trembling,
◆Exaggerated startle response
● Alarm system in the brain remains “on,” creating difficulty
in reading faces and social cues, misinterpreting
other people’s behaviour or events as threatening,
difficulty sleeping, avoiding situations that are perceived
as frightening
● Part of the brain systems change by becoming smaller or
bigger than they are supposed to be
● Fight, flight, freeze response (which may look different
from person to person)
● Responses are involuntary
Relational:
● Difficulty feeling love, trusting in relationships
● Decreased interest in sexual activity
THE EFFECTS OF TRAUMA ● Emotional distancing from others
● Relationships may be characterized by anger
and mistrust
● Unable to maintain relationships
● Parenting difficulties
It should also be noted that there are overlaps between the categories.