Bills Week 18 opponent preview: Trauma

The surprising ways re-exposure to trauma might appear for the Bills, Bengals, the NFL, and its fans

It’s Week 18 of the regular season, and the Buffalo Bills are set to take on the New England Patriots. There’s an incredibly good chance the outcome of this game will help determine the seeding in the AFC playoffs. With a victory and a little help from the Las Vegas Raiders, the Bills can still claim the No. 1 seed. A loss, coupled with a win by the Cincinnati Bengals, and Buffalo can fall to the No. 3 seed.

It sounds like we should be scouting the Patriots to prepare for such a monumental game, right? Nah. The last time the two teams faced off, the Bills demoralized the Patriots to the point that Bill Belichick pocketed three timeouts with 1:53 on the clock.

The bigger foe on Sunday is going to be the memory of Monday night. For some of Bills Mafia, that might be the case, too. So let’s talk about that instead.

Defining trauma

Let’s get one thing out of the way first. Though my full-time job is one that requires a lot of time and energy spent on behavior support and mental health, we’re having a more casual conversation on the topic here. I’m not going to discuss diagnoses or disorders in any depth.

From a clinical standpoint, trauma must include “actual or threatened death, serious injury, or sexual violence.” It does not have to happen to you to be considered trauma. Seeing or learning of an event as described above regarding someone else qualifies.

For reasons that will become clear in a moment, I’m going to avoid discussing the specifics of what happened, under the assumption we all know what I’m talking about. I’ll only state that the experience we’re discussing absolutely fits that criteria.

While the clinical definition can be semi-rigid, the clinical world generally accepts that trauma can be experienced in a number of ways and degrees. It’s not a one-size-fits-all deal. For a quick primer on severity, it’s generally accepted that repeated exposure, and closeness of the relationship to the party, both tend to increase the level of experienced trauma.

Prevalence of trauma

I promise this will lead to a football point, but first we’re going to sound like an OSHA training video for a second. Probably just about everyone reading this has heard the term “universal precautions,” and it’s also a near-certainty it was OSHA-compliant materials on bloodborne pathogens that taught it to you.

The idea is nothing more than a technical version of “better safe than sorry.” It’s not that every icky substance that can come out of a person is contaminated and will harm you. It’s more that the chance is high enough that you should put the gloves on anyway, rather than gamble.

If you can believe it, I’m not going to give you statistics on how prevalent it is for people to have lived through a traumatic event. Instead, I’ll appeal to common sense. Go look at the definition above, and reflect for a moment on a few people close to you. How many of them have either lived through an experience as described above, or witnessed an event that meets the criteria? I’m willing to bet that the list you went through was a bit lopsided, and skewed toward, “Yeah, most people I know have lived through a traumatic event.”

Hold on to that thought for a moment.

Trauma responses

[Checks pseudonym.] Yeah, this section might be one I’m qualified to discuss.

A person who has experienced trauma in their past may end up wired to react to later trauma. A short version is, simply, that people adapt to their experiences. And by “adapt,” I mean changes in cognition, emotions, and even physiological changes are all possible. Even more simply put, trauma changes the person.

Two of the most common phrases used parallel to “trauma response” are “fear response” and “survival response.“ The trauma-impacted person experiencing trauma at a later point can be placed in a position where they go into survival mode. Most of you will recognize the first two response types immediately, with the third being added recently. They are:

• Fight
• Flight
• Freeze

Yes, I still swear this is a football article. I have one more point to make, and then we’re there. Promise.

It’s not just another traumatic event that can trigger those responses. It can be things that bring back the memory of the trauma. Have you ever hesitated to greet someone who reminds you of your ex? That’s a mini-freeze response. Ever snapped at someone who didn’t deserve it because something startled or upset you a minute before? That’s a mini-fight response. What about pretending you didn’t see someone to avoid a conversation? Mini-flight response.

None of those examples contain re-exposure to trauma, and yet they still trigger a response as if it did. Now imagine what might happen with more direct triggers. Like stepping out of a locker room and seeing a field again. Or attempting to make a routine tackle.

Trauma-informed care

One of the movements I’ve been most proud of in my career is helping to advance a trauma-informed care approach. There are codified tenets to do it full bore, but as I noted above, we’re going to be fairly casual with this.

The foundation that sets the stage for these rules are simply recognizing the prevalence and possible responses to trauma. After we’ve done that, the rule that stands at the top of the list is actively working to avoid re-traumatizing people when you know their history.

In the immediate aftermath, the NFL did the exact right thing. While there was some hesitation, they told Buffalo and Cincinnati, “You don’t have to go home, but you can’t stay here,” and ended the game. They continued to avoid re-traumatizing those involved by declaring the game a no-contest. But the gears of the entire 2022-2023 season can’t be halted.

This weekend, that primary rule is going to be broken. The Bills, Bengals, and every other team and fan involved in football are going to be exposed to circumstances closely matching the traumatic events that were experienced on Monday night.

Putting it all together

Let’s focus on the Bills. As the group most closely tied to Damar Hamlin, it stands to reason they’ll be the ones most likely to be re-traumatized this weekend. When they take the field, there’s nothing we can do to avoid that from happening. There is something we can do for them, though, when it comes to trauma-informed care: Know what we’re seeing.

If there’s a player either unexpectedly inactive, or who has fewer snap counts than expected, ask yourself the following question: Am I seeing a flight response?

If a player takes a bad angle or hesitates on a play, ask yourself this one: Did I just see a freeze response?

If we see a player lose his cool, there’s this question: Was that a fight response?

Trauma-informed care can even help us make sense of what we want to see happen. If the Bills absolutely dominate the game on Sunday, like we hope, we should be excited like always. We should also see this, too, as a possible fight response.

In the aftermath of this game, fans and analysts are going to have to make sense of what we watched. While that does include the X’s and O’s we’re used to, we should also expect this extra layer. Understanding what we’re looking at will help guide us, and perhaps be a bit kinder if the need arises.

Don’t forget to apply this in all walks of life. Plenty of your fellow fans might need a little extra understanding this weekend (or other times, too; there’s no time limit on any of this). I hinted at something above that I hope has been kicking around the ol’ noggin this whole time.

Universal precautions. Not everyone you meet is at risk of being re-traumatized at any given moment. But a lot of people are. Trauma-informed care isn’t much more than kindness, courtesy, and affording the person in front of you a little grace when they’re less than perfect.

When the cost is nothing more than kindness, it’s better to be safe than sorry.

Go Bills!

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Best wishes to Damar Hamlin, his family, friends, teammates, the greater NFL brotherhood, and to each and every one of you.