Through Rose-Colored Glasses: How Protective Behaviors Impact Trauma-Informed Decision Making

Trauma-informed decision-makers realize that the drive to survive can shape how a person thinks, feels, and acts. Rather than pathologizing survival strategies, trauma-informed caregivers recognize the signs and symptoms of unhealed trauma and seek to respond appropriately (SAMHSA, SAMHSA’s concept of trauma and guidance for a trauma-informed approach: Vol. HHS Publication No. (SMA) 14-4884. Substance Abuse and Mental Health Services Administration, 2014a; SAMHSA, Concept of trauma and guidance for a trauma-informed approach: HHS Publication No. (SMA) 14-4884. Department of Health and Human Services, pp 1–20, 2014b). However, assessing for the presence of traumatic events can be complicated by some survivors’ adaptive tendencies to minimize and/or deny their adverse experiences from childhood onward. This chapter approaches protective behaviors from a balanced perspective. The reader is invited to appreciate how a “rosy view” (Mitchell et al., J Exp Soc Psychol 33(4), 421–448. https://doi.org/10.1006/jesp.1997.1333 , 1997), and related positive attributional and social desirability biases, may protect against the development of psychopathology (e.g., posttraumatic stress disorder, depression, anxiety, and attention-deficit/hyperactivity disorder). Studies contrasting the protective behaviors of people with severe mental disorders against control groups of psychologically healthy individuals (e.g., Church et al., Front Psychol 8:1–7. https://doi.org/10.3389/fpsyg.2017.01276 , 2017) will be examined. At the same time, the reader is encouraged to consider how minimization, denial, and avoidance of reminders may confound the results of self-report instruments designed to assess childhood trauma. Strategies for addressing this potential problem include (but are not limited to) the use of the three-item Minimization/Denial scale embedded within the Childhood Trauma Questionnaire (CTQ; Bernstein and Fink, Childhood Trauma Questionnaire: a retrospective self-report. The Psychological Corporation. https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Personality-%26-Biopsychosocial/Childhood-Trauma-Questionnaire%3A-A-Retrospective-Self-Report/p/100000446.html , 1997). The provided case study will illustrate how protective factors may be identified to improve trauma-informed decision-making and treatment planning. Ultimately, the reader will be tasked to answer the question, “are people who engage in protective behaviors obscuring a trauma narrative that is destined to remain untreated, or is the use of minimization and denial actually beneficial?” (MacDonald et al., J Interpers Violence 30(6):988–1009. https://doi.org/10.1177/0886260514539761 , 2015). The answer may prove to be a bit of both.