The traumatizing experience of systemic discrimination
I’ve always thought it strange that we have the “day of” or the “month of” in our calendars. I think it often ends up as a perfunctory exercise on performative involvement, or as a marketing strategy at worst. Despite this, today I’d like to choose a less cynical, more hopeful outlook, and focus on thinking about what is being acknowledged this month.
June is National Indigenous History Month and Pride month. Black Lives Matter is justly being centred right now (although the rhythm seems to be slowing down). It’s also Post-Traumatic Stress Disorder (PTSD) awareness month. While I could think about all these in silos, I’m going to consider them as interacting experiences. At the end of the day, it’s all interconnected.
Trauma vs PTSD
Following the above, how do we articulate PTSD with the lived experiences of the Indigenous people, LGBTQQIAA2S+ folks, and BIPOC communities? I’d like to start by defining trauma. Let’s see what these two sources say:
Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical, social, emotional, or spiritual well-being. Trauma can affect people of every race, ethnicity, age, sexual orientation, gender, psychosocial background, and geographic region. A traumatic experience can be a single event, a series of events, and/or a chronic condition (e.g., childhood neglect, domestic violence). Traumas can affect individuals, families, groups, communities, specific cultures, and generations. It generally overwhelms an individual’s or community’s resources to cope, and it often ignites the “fight, flight, or freeze” reaction at the time of the event(s). It frequently produces a sense of fear, vulnerability, and helplessness (1).
Trauma occurs when people experience an overwhelmingly negative event or series of events, including violence. Violence can take many different forms and can be experienced once or many times. Violence is often the result of intentional actions to control or abuse someone, but can also have unintended consequences, such as when children are exposed to intimate partner violence. Experiences of violence can also be systemic and less visible. For many marginalized populations, discrimination and systemic violence are everyday experiences (2).
So, trauma is one thing. We may try to cope with it in many different ways, and we may have ways in which we are resilient. Sometimes, the impacts of having experienced trauma develop into a particular collection of experiences. That’s what we call PTSD. That is, you can have trauma without PTSD, but having PTSD requires the experience of trauma (3).
Trauma and PTSD
I think that not developing the particular diagnosis of PTSD does not take away from the many impacts of having experienced trauma. After all, trauma itself is losing the ability to cope. Now, what if the context you live in is continuously making you afraid for your safety and integrity as a person? What if the messages you receive are a constant drip of “you’re not welcome”, “you’re less than”, “we reject you”, “you deserve to be mistreated”? This is what the second definition centres around; violence. In many ways, the systems we live in perpetuate violent structures against the very people we’re trying to honour this month.
Living in a world that is telling you you’re wrong, that your identity is wrong, that your culture is wrong, that you shouldn’t love who you love, that the colour of your skin defines you… that is violent. Injustice has the potential to be traumatizing; ongoing inequity and microaggressions have that power too. Living in such a world is easily construed as violent because it is. Having no way out of that lived reality (because of the very lack of justice and equity) is traumatizing and re-traumatizing. It’s like never having respite from the battle grounds.
PTSD and the world
In other words, we need to think of PTSD in light of systemic problems. The same is true for other trauma-related mental health impacts. Yet, working in the field of trauma therapy, I’ve often heard that to successfully treat the impacts of trauma, the source of trauma must be over. That it must be in the past. The problem with this perspective is that, for many marginalized folks, trauma is never done. There are many ways in which society allows for trauma and violence to happen consistently around us.
Living in such an environment continuously challenges our understanding of who we are and what we can do to affect our surroundings. That is, the structures we live in impact both the lived experience and the narrative of our power. Powerlessness/disempowerment is at the core of trauma, and should be at the core of trauma therapy. Therefore, my effort in working with marginalized peoples focuses on empowerment. Where may we find someone’s power? How do we articulate that with the very real challenges of living in a world that is not affirming of someone’s identities, experiences, and power itself?
The answer to that is going to be very much specific to each individual. In my opinion, the work has to start by healing internalized messages of self-blame, while learning more about the natural interconnectedness of the world. That way, we can help that person connect with their right to exist as they are, and to externalize the problem of disempowerment. This process can (and perhaps should) coexist with that person learning new skills for inner regulation and contemplation. I see this as a way to feel empowered. How magical can it be for someone to feel free of their past, of messages that produce pain and fractures of their sense of self? What if, through that work, they could gain a sense of agency for their inner world?
The next step is to find ways of exerting their power in the world. One person can’t change the world, but they can definitely help. If we could help everyone get to this point, those who’ve been put in a disempowered sphere can reclaim their areas of power, and with that be a part of changing the world. We could all come together to create a new society. Holding that image as possible gives me hope. That’s my vision for what we could do, if we all healed together.
(1) Center for Substance Abuse Treatment (US) (2014). Chapter 1, Trauma-Informed Care: A Sociocultural Perspective. Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). Treatment Improvement Protocol (TIP) Series, No. 57. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207195/
(2) Government of Canada. Trauma and violence-informed approaches to policy and practice. Last updated: 2018-02-02. Available from: https://www.canada.ca/en/public-health/services/publications/health-risks-safety/trauma-violence-informed-approaches-policy-practice.html
(3) Pai, A., Suris, A. M., & North, C. S. (2017). Posttraumatic Stress Disorder in the DSM-5: Controversy, Change, and Conceptual Considerations. Behavioral sciences (Basel, Switzerland), 7(1), 7. Available from: https://doi.org/10.3390/bs7010007
I grew up speaking Spanish. English is my second language. When I communicate in English, I make mistakes. I've chosen to let my writing reflect the kind of mistakes I make when speaking, so that you have an idea of what it might feel like to talk to me. I trust the message is still clear but, if it's not, please don't hesitate to ask me for clarification.
The information provided on my blog is a mix of my personal thoughts, professional approach, and articles related to mental health. The purpose of sharing all of this is to communicate the models at the core of my practice, as well as to provide education. I hope this will help to minimize some of the power imbalances related to my profession. The articles on this blog should not be considered as professional advice for any one person or group of people. If you have any questions about the appropriateness of this content for you, please contact a qualified mental health professional.