“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.
Bipolar Disorder Is Not About Trauma
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.
What’s Wrong with Trauma-Informed Care in Bipolar?
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.
My Experience with Bipolar and Trauma-Informed Care
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.