Friday, August 20, 2010

Cultural Influences and Response to Trauma

“A broad understanding of culture leads us to realize that ethnicity, gender identity and expression, spirituality, race, immigration status, and a host of other factors affect not just the experience of trauma but help-seeking behavior, treatment, and recovery.”
- National Child Traumatic Stress Network


As we broaden our service response to immigrants and refugees, victims of human trafficking, and children and grandchildren of persons who have experienced trauma in this country and others, it becomes apparent that the need for more information on how to respond to trauma survivors from a cultural perspective is crucial. Not only is it necessary to understand the trauma that has occurred within cultures, but it is also important to have an understanding that how cultures respond to trauma can impact the ability of a survivor to recover from complex trauma.

Culture is not limited to one’s ethnicity or birthplace, but also relates to age, disability, religion and spirituality, social class, sexual orientation, indigenous heritage, immigration or refugee status, and gender and sex.

Laura S. Brown, author of Cultural Competence in Trauma Therapy, states that being culturally competent involves being aware of our own personal relationship to each of the above identities and to be attentive to the phenomenon of dominant group privilege.

“Privilege lends power to one’s biases; if I am a lesbian biased against heterosexual people, I may suffer from being prejudiced but I lack the social power to declare all marriage between other-sexed persons illegal. The heterosexual person, biased against me has the privilege and power to legislate against me. Acknowledging one’s privilege can be a trust-engendering and relationship-building action in therapy (advocacy). Ignoring it or pretending that it does not matter will eventually undermine trust and endanger the working alliance of therapy (advocacy). Pg. 41

The ability of a person to recover from trauma is dependent on a number of factors. How culture views the traumatic event is one of the factors. A young woman raped on a college campus in this country faces many obstacles in her recovery but also has access to sexual assault crisis services and medical care. If she chooses to let her parents know of the event, she may or may not receive support. However, if she is living in a Middle Eastern or African country, there may be a possibility that the rape occurred as an act of war resulting in the loss of status for herself and her family and possibly her death at the hands of a family member.

In some Central American countries (and others) families have had sons and daughters “disappear” or killed by the government or people posing as authority. When they immigrate to this country they are often suspicious or frightened of anyone in a government agency or in authority because of this. If a social worker or advocate is unaware of this, they may see the fear as resistance or noncompliance.

One mistake that is made by advocates/therapist/case managers is assuming the cultural identity of another person. Persons of mixed racial heritage are often identified with a group with whom they may not choose to belong or proudly identify as a member of a group that others may not recognize as a possibility. Gender identity is often confused with sex when gender identity pertains to gender roles and sex is the biological makeup. Sexual orientation is a biological response. Assumptions in regards to race, ethnicity, gender, sex and sexual orientation can lead to re-victimization of a trauma survivor.

The effects of trauma can be transmitted across generations. Children of holocaust and/or genocide survivors have grown up in a family that recognizes that their ethnicity/religion/tribal affiliations have made them the target of extremists. This can lead to either a denial of their family roots or an increase in affiliation in order to maintain the cultural identity of the victimized group.

The group’s experience in the greater world can also determine how they respond to help. If the predominant and privileged culture is descendant from the same culture that perpetuated the abuses, it may be difficult for a family to seek help outside of their own affiliation. One example of this is the American Native. Their desire to maintain services and affiliation within the tribe is a result of trying to preserve their culture and their distrust of the predominant (conquering) culture. Keeping in mind a group’s history as an oppressed people can help us understand their reluctance to seek services. This phenomenon is also reflected in populations of immigrants living together within communities. It is very important to them to maintain their cultural affiliation and maintain a sense of safety within their own communities.

Within seemingly homogeneous cultures can be a number of identities that respond to trauma differently. In New England, the Yankee culture has a strong identity with a belief in the idea of “pulling one’s self up by the boot straps” and moving on without a lot of discussion of the event. Rural populations respond differently than urban and within each of those, there may be subsets of identities that respond differently. It becomes increasing important to learn as much about a person’s identity and affiliations as possible in order to be aware of any implications due to racism, classism, poverty, sexism, ageism, homophobia, et.al. and, as said before, be aware of any privilege or oppression that exists because of your own identity.

As it is very difficult to discuss all of the implications in regards to cultural trauma and competencies I highly recommend Laura S. Brown’s book, Cultural Competence in Trauma Therapy, Beyond the Flashback (APA Publishing, 2008). Even if you are not a therapist, this book is an excellent resource for expanding your understanding of the influence of identity on a person or a group’s experience of trauma.

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