Broadening Our Understanding of Trauma: Why Context Matters

Broadening Understanding Trauma Context Matters

Traumatic stress may be altered in each generation as members continue to witness the effects of trauma on previous generations. As a result, each successive generation may begin to exhibit unique symptoms of trauma.

Racial Trauma

In 2001, the U.S. Surgeon General identified racial trauma as the attributing factor to ethnic and racial disparities. This type of trauma considers the symptoms that may result when a person experiences racism. Some forms of race-based trauma include:

Trauma-related symptoms may result when someone feels threatened or experiences physical harm or injury, either directly or indirectly. But experiences of social exclusion or rejection are likely to result in the same symptoms.

  • Experiencing and/or witnessing racial harassment
  • Ethnoviolence
  • Microaggressions
  • Institutional racism
  • The constant threat of racial or ethnic discrimination

Research indicates that the more subtle forms of racism lead to constant vigilance, or a kind of “cultural paranoia,” which may serve as a defense mechanism. Experiences of racism may be subtle, but the culmination of these types of race-based trauma often result in traumatization.

Read Can We Inherit Trauma Genetically?

Systemic Trauma

In spite of the above knowledge of the many contexts of traumatic experiences, many socially relevant forms of trauma are not always considered traumatic, even by mental health care providers. This shows the relevance of systemic, or institutional, trauma.

Also known as institutional trauma or betrayal, this type of trauma is defined as the institutional action and inaction that can worsen the impact of traumatic experience. Systemic trauma regards the contextual features that give rise to, maintain, and impact trauma-related responses. There are parallels between the interpersonal and institutional trauma. These include factors of trust and dependency, as well as a lack of sustained awareness across contexts.

trauma affects memory
Broadening Our Understanding of Trauma: Why Context Matters

How can we impove trauma treatment?

As trauma professionals, it is necessary to acknowledge the above and incorporate systemic approaches in order to better assess, diagnose, and treat trauma. For instance, I ask you to consider an African-American whose current lived experience includes transgenerational trauma, historical trauma, racial trauma, and systemic trauma. Their trauma-related symptoms, such as anger or distrust, may then be interpreted by others—including those in power—as character flaws. This only heightens the trauma response, on every level.

It can be challenging to expand our paradigms of trauma. A broadened conceptual framework is necessary, both scientifically and ethically. This perspective extends the conceptualizations of trauma to consider the influence of environments beyond the person themselves.

These might include the following:

  • Schools and universities
  • Churches and other religious institutions
  • The military
  • Workplace settings
  • Hospitals, jails, and prisons
  • Agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media
  • Conflicts involving war, torture, terrorism, and refugees
  • Dynamics of racism, sexism, discrimination, bullying, and homophobia
  • Issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention.

When we have a good understanding of trauma and consider all these factors, we can provide more specialized treatment to people seeking trauma treatment. Above all, we must remember that context matters.


References:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. Carter, R. T. (2006, December 1). Race-based traumatic stress. Psychiatric Times, 23(14)Retrieved from http://www.psychiatrictimes.com/cultural-psychiatry/race-based-traumatic-stress
  3. Goldsmith, R. E., Martin, C. G., & Smith, C. P. (2014, March 11). Systemic trauma. Journal of Trauma & Dissociation, 15(2)117-132.
  4. MacDonald, G., & Leary, M. R. (2005). Why does social exclusion hurt? The relationship between social and physical pain. Psychological Bulletin, 131(2), 202-223.
  5. Phipps, R. M., & Degges-White, S. (2014, July 1). A new look at transgenerational trauma transmission: Second-generation Latino immigrant youth. Journal of Multicultural Counseling & Development, 42(3), 174-187.
  6. Smith, C. P., & Freyd, J. J. (2014). Institutional betrayal. American Psychologist, 69(6), 575-587.
  7. Williams, M. T., & Leins, C. (2016). Race-based trauma: The challenge and promise of MDMA-Assisted psychotherapy. Multidisciplinary Association for Psychedelic Studies (MAPS) Bulletin, 26, 32-37.

Written by: Tahmi Perzichilli
Originally appeared on: Good Therapy
Republished with permission. 
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Tahmi Perzichilli, MS, LPCC, LADC

Pulling from both personal and professional experience, I strive to create an environment that enhances and encourages personal growth through providing support and practical feedback. My approach is holistic, person-centered, strength-based, and trauma-informed. With compassion and understanding, I work with each individual to help build upon unique strengths and to achieve the goals that one is committed to accomplishing..View Author posts