Objective Safety versus Implicit Safety in Patient Care
As a trauma-informed educator, I occasionally hear students ask, “If this is a trauma-informed class, why don’t I feel safe? Doesn’t trauma-informed mean creating a space where everyone feels safe?” This question perfectly encapsulates some common misconceptions about safety and what it means to take a trauma-informed approach.
It’s crucial to clarify from the outset that a trauma-informed space does not refer to a place where everyone feels safe. This misconception arises partly because the term "safety" is often used to describe two distinct concepts that are mistakenly treated as one.
Two Types of Safety
The first type of safety pertains to the actual, objective circumstances of a situation. I’ll refer to this as objective safety, or its opposite, objective threat. Threats can take many forms. The most obvious are physical threats, such as dangerous animals, violent individuals, or structurally unsound buildings. There are also relational threats, like those posed by others who intend to shame or humiliate us. Additionally, structural threats arise from laws, rules, or cultural norms that increase the likelihood of unfair or degrading treatment.
The second type of safety is implicit safety, which refers to the organism’s assessment of threat based on a complex integration of numerous inputs and previous experiences. Neurologically, an implicit safety response involves a network that includes the amygdala, the brain’s center for aversive responses; the insula, which maps our feelings; and the entire motor system.
Implicit safety is often equated to how safe one feels. The feeling component is the most relevant aspect here, though motor responses also occur, even if the individual is not consciously feeling unsafe. For example, a person might unconsciously pull away, experience increased muscle tension, sweat more, or show a mix of facial expressions, all while feeling “fine.”
Objective safety and implicit safety are not mutually exclusive, and it is adaptive for us to reduce risk by generating implicit threat responses even in the absence of objective threats. This risk reduction bias is further amplified with trauma, whether physical, relational, or structural.
Influences on Implicit Safety
Many factors can impact implicit safety, and since we are often unaware of our implicit responses, we are usually also unaware of what has influenced them. Even when we do feel unsafe, we might not consciously understand why.
Sometimes implicit safety is affected by a stimulus such as a sound or smell. These stimuli might consciously remind us of a negative memory, or they might unconsciously trigger a conditioned response if they have been paired with a negative experience in the past. For example, being in a classroom as an adult might bring up memories of negative school experiences from childhood, or being in a car could evoke an aversive response due to a recent car accident. In both cases, a person might acknowledge that the situation is objectively safe yet still struggle to influence their compelling implicit response,
Implicit safety can also be affected by the lingering effects of past event. For instance, if I watch a scary movie, my threat level might rise and remain elevated even after the movie ends. I could tell myself, “It’s just a movie. There’s no monster in the closet” but the amygdala is slow to be convinced of that. Similarly, if someone is removed from my classroom after threatening physical violence there, students might still feel an implicit threat simply by being in that space, even though the objective threat is gone. The classroom can take on a “bad feeling” that persists for a long time.
Implicit safety can also be influenced by relational contexts. If someone does or says something that echos a previous unhealthy relational dynamic, this could affect my relational implicit safety, even if I’m not consciously aware of the similarity between the current situation and the earlier one.
Ultimately, implicit safety is the nervous system’s way of keeping us safe. It generates feelings that are compelling, which is different from simply reading statistics about the odds of being harmed. I can read that it’s extremely unlikely that I’ll be attacked by a shark, but if I watch a scary shark movie or hear about a shark attack on the news, my sense of implicit safety might decrease, causing me to hesitate before getting in the water. I can tell myself that the hesitation is illogical, but that might not change the feeling, even if logic guides my final decision to swim or not.
Sometimes I bring donuts to the first day of class because sweet foods, generosity, and the act of being fed often promote implicit safety. I could leave well enough alone, but since implicit safety is a topic I typically cover in my classes, I intentionally disrupt this delicious moment by saying, “Just so you know… no glass particles have been reported in these donuts this year, so I imagine they’re glass-free.” The effects of this comment vary. Most students still go for the donuts, but the experience is undeniably altered as implicit safety mechanisms dampen their initial enthusiasm and heighten awareness of every bite. For some, this effect can linger for weeks or months, despite the absence of any objective threat. Manipulating implicit safety is Politics 101.
In all these examples, the key takeaway is that implicit safety doesn’t need to be logical or have a consciously-known cause. Expecting otherwise is unrealistic. Each person is continuously responding to numerous factors shaped by their history, and virtually anything could influence implicit safety for someone.
Safe Spaces
Being trauma-informed means understanding how trauma impacts people, which includes understanding implicit safety. It also means caring about implicit safety, recognizing changes in it, and responding in ways that avoid re-traumatization. This involves implementing policies and practices that establish objective safety in physical, relational, and structural domains. While these measures can enhance implicit safety for everyone, they cannot guarantee it. Each person brings their own nervous system to the setting, and every group environment presents opportunities for relational threats to emerge, whether due to innocuous similarities to past negative experiences or to a reasonable response to someone else’s protective behaviors. For individuals with trauma, baseline implicit threat levels are generally higher regardless of the context, so a trauma-informed space strives to minimize re-traumatization and accept protective behaviors.
Consider what would happen if we promised that trauma-informed spaces would guarantee that everyone feels safe. This quickly leads to a scenario where topics are banned, books are censored, and events are canceled. Social interactions would become so sterilized that meaningful engagement might become impossible. The premise collapses under its own absurdity.
Conclusion
A trauma-informed space should indeed be an objectively safe environment. However, while we can’t eliminate implicit threats entirely, we must still care about implicit safety. By offering acceptance and understanding of what impedes implicit safety, we can help it grow. Implicit safety issues will inevitably arise in various contexts—whether in patients undergoing procedures, students facing assignments, parents navigating bureaucratic processes, or partners dealing with relational dynamics. Our ability to prevent, mitigate, and respond with compassion to these implicit threat responses enhances the quality of what we offer and makes us more effective professionals and empathetic individuals.
Author
Dr. Mark Olson holds an M.A. in Education and a Ph.D. in Neuroscience from the University of Illinois, specializing in Cognitive and Behavioral Neuropsychology and Neuroanatomy. His research focused on memory, attention, eye movements, and aesthetic preferences. Dr. Olson is also a NARM® practitioner, aquatic therapist, and published author on chronic pain and trauma-informed care. He offers a variety of courses at Dr-Olson.com that provide neuroscientific insights into the human experience and relational skill training for professionals and curious laypersons.