It all adds up.

Remember when you were three years old and you were scared of the neighbour's dog, the old man around the corner, or the loud clown at your friend's birthday party? One way or another, it is probably safe to say that everyone has lived through some kind of trauma or other in their life. Now, consider an 80 year-old woman and the kind of trauma that she could have experienced in all her decades of life, with all the implications for treatment and practice that follows.

As an example, my husband's great-grandmother passed away some years ago at the age of 100. Some of the stories that she told my husband from her life really make me realize how easy our lives have become compared to that. For example, when she went into labour with her second child, her husband was extremely sick with a disease that would eventually become fatal. She had to walk over a mile through a blizzard in rural Ontario to a main road where she was able to hitchhike into town and to the hospital. Compared to this, the birth of our own child, with an epidural and a short ride to the comfortable hospital room in Health Sciences Center, almost seems like luxury.

She also told stories of living through both world wars - including seeing German bombers fly over their home in England - with brothers and a son serving in foreign theaters of war, having two husbands who died before her, and seeing their financial position ruined afterward by dishonest creditors.

For sure, these are events I could never relate to. Although I was born in a country that could be said to have been in a "permanent" war for many years, I have never even seen gunfire! In contrast, at my practicum, I have heard women share with us years of physical, sexual, emotional abuse by their partners and close family members. One of the practical issues that always strikes me when I think of these things is how hard it can be, as social workers, to build credibility with people who have lived through these hardships. Compared to their lives, we are little more than children - or even grandchildren - who have lived a pampered existence in a world incredibly different to their own. Even aside from the huge changes in the world since they were young, simply adding up so many more years of pain, stress, and sadness has left them with a higher "total" sum of trauma. Krause (2004) found exactly this kind of cumulative effect of lifetime trauma in a study on older adults.

Since my practicum deals mostly with seniors with substance misuse issues, the treatment for this trauma can sometimes lead to a double threat. Early trauma or stressful events can result in anxiety attacks, depression, and moderate to severe stress disorders later on. Those who seek help from their family doctor are often given a prescription medication to help minimize their suffering. Benzodiazepine such as valium, lorazepam or xanax are the most commonly used drugs to treat anxiety, or panic attacks, however, they are highly addictive and withdrawal effects could become very challenging to handle (Recovery Connection, 2011).

Many seniors struggle with medication dependencies and interactions with alcohol or on going life situations tend to intensify their health problems, family relationships and emotional well-being. Therefore, when we try to give them advice or convince them to make different choices, it is often difficult to understand what they have been through.


One thing in my practicum that I have found to be successful in helping to deal with this disconnect is to find some way - even if it is only a partial way - to find something in common with these seniors, and feelings that we can relate to. For example, even though I have not yet lost a husband or close family member, I have had older relatives pass away and can find a common ground to discuss feelings in this regard with our seniors. Another successful method that I have been able to use is to ask open-ended questions which encourage the client to talk and share their feelings and to listen to their responses with empathy and respect. Not only does this help me understand them better, but just having the chance to talk about these experiences with an interested listener can be therapeutic, as well.

I find that in general, establishing a rapport and mutual respect with these clients can help us get around the massive differences in our lives and get to a point where they are much more willing to listen to us as social workers because they see that we really care about them and have their best interests at heart. In the end, though, it is always extremely important to be aware that we do not let ourselves become condescending or pushy, since this can undo a lot of hard work in building the relationship.

Lastly, one thing that we have to bear in mind is that trauma can have some very unexpected and unpredictable consequences in terms of people's actions. Research has shown, for example, that people and animals who have been subjected to trauma which they are helpless to escape acquire learned helplessness and become incapable of responding in logical ways to even simple problems (Badhwar, 2009). As social workers, we may sometimes become astonished at the decisions that people make that seem to defy all rational explanation. I think it is very important for us to remember that in some cases, trauma can result in people behaving this way, and that trying to deal with the problem using conventional rational means is not likely to succeed.

Badhwar, N.K. (2009). The Milgram experiments, learned helplessness, and character traits. Journal of Ethics, 13, 257-289.

Krause, N. (2004). Lifetime trauma, emotional support, and life satisfaction among older adults. The Gerontologist, 44(5), 615-623.

Recover Connection. (2011). Benzodiazepine. Retrieved from http://www.recoveryconnection.org/drug_index/benzodiazepine.php