The Critical Care series is intended to provoke, promote and invite colleagues from a range of situations and positions, to think through and engage in debate about the ways we lead, follow, invest and deliver our own individual and institutional authority.
This is the first of several related pieces that explore how commercial pressures and populist tendencies undermine efforts to respond to the complex issues of trauma in individuals, communities and wider society. In this piece, we explore whether traumatic experiences are always destined to be traumatic and how it appears helpful to suggest they are.
Just this week so far, fresh calls for trauma responsive services have been made from both the halls of government and the non-profit sector, highlighting the current drive to embed consideration of trauma into services. Justice Minister Robert Buckland outlined his plans for the future of criminal justice, which emphasised the need to re-design services to take trauma into account. One Small Thing also announced the 'Working with Trauma Quality Mark', offering organisations the opportunity to evidence their trauma-informed practice.
Early days of trauma
In the 1970s, medical and care professionals working with Vietnam veterans in the US began to understand and prioritise the nature, impact, and significance of traumatic events. As a result, acknowledging the legacies of military service in psychological, physical, emotional, and mental functioning became an essential feature of the healing process. This acknowledgement marked a timely shift away from the 'shell shock' and 'stiff upper lip' treatments of earlier wars, towards a more holistic and integrated approach to people's responses to trauma.
Since that early move towards understanding the effects of traumatic experiences in people's lives, an entire industry and focus of practice have emerged. The growth and expansion of trauma-informed work may well be a needed and valuable development. However, it also brings some complex and potentially challenging dynamics.
The ‘benefits’ of trauma
Not everyone experiences trauma due to exposure to traumatic events. There is also more to the experience of trauma than what the Jungian therapist and global trauma practitioner, Renos K. Papadopolous, describes as ‘learned helplessness’. Trauma, Papadopoulos argues, often leads people to develop new perspectives, skills and identities and can be a vehicle through which people can learn, grow, and expand. Trauma-informed approaches tend to focus on the negative impacts of trauma, supporting its victims on the healing journey, and avoiding retraumatisation. Papadopoulos argues that without very clear visions of people able to learn, develop and gain despite their traumas, this can lead to pathologizing people and keeping them stuck in paralysing states of dependency.
Clarity of purpose
The phrase "what happened to you, not what's wrong with you" is used as a guiding principle in much of the UK's trauma-informed practice. An internet search for trauma-informed practice will variously identify the three types of trauma:
- The four concepts of trauma-informed practice,
- The four R's of trauma-informed care;
- The five principles; the six principles
- The 10 Adverse Childhood Experiences (about which there is a separate critique)
This range of practices is not unusual, nor specific to work in the field of trauma. Youth violence, family relationships, drug abuse, anorexia, HIV have all had their moments in the sun before being relegated to government departments, public health or simply feeding headlines and policy reactions.
An individual's response to trauma is unique and based on many factors, including perception, context, history, and biological makeup. However, not every experience is traumatic, and not every traumatic experience leads to a harmful internalisation. The tendency towards viewing everything and anything as potentially traumatic, and almost any and everything as susceptible to a 'trauma informed' approach, is a backwards step.
Safe and containing relationships are key in helping a person to heal from trauma. Professionals working in this field require support to facilitate these relationships, and to avoid the perpetuation of harm and the projection that everyone who experiences trauma will live with.