Insidious Traumatization – How Recent Events are a Call to Self Care

Over the past months we have been exposed to a large amount of hate speech.  We have also seen a number of reports of poor to dismal responses to sexual assault and domestic violence.  I won’t go into those in detail.  They fill our inboxes, Facebook feeds, newspapers, and news channels.  The images fill our brains or we create our own images based on the details we are given.  We become angry at the way people do not seem to take the allegations seriously and how systems and persons continue to find ways to re-victimize.  We lose hope in our ability to make and sustain change.  We are reminded of our own victimization(s) and we start to feel helpless and hopeless.

Our response to the ongoing exposure to the victimization of others is the result of insidious trauma, often called “micro-aggressions.”  According to Laura S. Brown in her book, Cultural Competence in Trauma Therapy, “in the lives of many individuals who are members of target groups, daily existence is replete with reminders of the potential for traumatization and the absence of safety.”  These micro-aggressions can often seem fairly benign such as when a group is ridiculed in a public way or when one’s group is betrayed in a stereotypical way.  However, when a person is targeted in a violent way through hate speech, threats, invalidation of or disbelief in their experience and this is made public the impact on other members of the group can be significant. 

Laura Brown goes on to quote Root (1992) as arguing that “when a person is subjected to insidious traumatization, that individual experiences a gradual and often imperceptible erosion of the psyche.  A useful metaphor is that of very small drops of acid falling on a stone.  Each drop by itself does little damage and may in fact etch the stone in such a way as to make it more beautiful.  Thus, in some ways the experience of daily micro-aggression may evoke resilient coping responses (as when we find positive strategies to address the ongoing violence against the groups of which we are members).  Yet each drop of emotional acid creates just enough damage to render the next drop more damaging.  Over time a fissure develops in the form of an emotional vulnerability that is invisible so long as certain aspects of the biopsychosocial and spiritual environment remain steady or supportive.” (italics mine)

This insidious trauma can create conditions in us similar to those to whom the significant aggressions are directly applied.  When it is combined with the effects of previous trauma that we have experienced and are now re-living it damages the psyche and makes us weary. 

Our only hope is to surround ourselves with others who understand what this type of trauma can do to a person and find ways to care and nurture each other as we continue to face the onslaught of further violence against groups to which we belong or have a strong affinity.  We may, at times, need to take a break in order to be able to come back in support of victims, but it is by filling our cup that we are able to have enough to help others. 

Insidious Trauma – Why Anti-Oppression and Social Justice Work are Critical for Trauma-Informed Programs

While many of us working in the field of domestic violence and sexual assault address the needs of survivors of interpersonal violence and recognize the impact of oppression on the lives of victims, we may, at times, fail to realize the overlapping impact of the insidious trauma that is experienced by many groups, including women, LGBT, disabled persons, and the elderly.  Psychologist Maria Root (in a number of articles) describes insidious trauma as the impact of living in societies where stigma, discrimination, and violence against women are still very much part of the fabric of their everyday lives.  We can expand this definition to include other marginalized populations and imagine the impact on a survivor with whom we may be working.

Those of us who work in ending violence against women are well versed in understanding oppression and social injustice in regards to women.  Let’s take that same construct and move on to recognize the impact that a person’s race and/or ethnic background has on their life experience and how it sets a person up for insidious trauma.  A person of color or a different ethnicity experiencing interpersonal violence is most likely also experiencing insidious trauma that occurs from the awareness that their race/ethnicity makes them a target just by their being present in the world.  This is increased when the person is isolated in the community, separated from family and cultural supports, and recognizes their own vulnerability.  Given the messages they may be receiving from the media regarding hate crimes or how they are being treated in public, they may be experiencing some traumatic effects due to insidious trauma. 

This also applies to people with different abilities or the elderly.  In a chapter in Laura S. Brown’s book Cultural Competence in Trauma Therapy – Beyond the Flashback, Dr. Brown tells the story of a young woman with a congenital disorder that had required increased amounts of assistance from others.  This young woman developed the belief that most people who were disabled wished they were dead.  She had developed this from hearing stories of people with disabilities who were seeking physician assistant suicide and finding that there was a pervasive attitude among the non-disabled population that people with disabilities were brave to continue living and felt it was understandable that someone would want to commit suicide.  It is easy to imagine that this attitude by mainstream society could affect a person’s image of his/her self as a valuable member of society. This woman was eventually able to find a movement that protests against this attitude and supports the dignity and affirms the lives of those livings with physical challenges. 

In addition, insidious trauma occurs within the LGBT community as they hear ministers, politicians, and social network trolls make comments about hate crimes or blaming them for natural or manmade disasters such as in Hurricane Sandy or the Sandy Hook school shooting. 

Laura Brown also states that in order to be culturally competent in providing trauma-informed services we should also consider how insidious trauma may be present even if the particular person has not identified having had an experience of overt trauma.  “Everyday racism, sexism, heterosexism, ableism, and other forms of institutionalized oppression may seem so familiar to people as the background noise of their lives that they have no cognitive construct into which to place these encounters; they simply have the post trauma distress and dysfunction arising from doing battle every day against an army of small toxic agents.” Often the historical violence that has been done to a group of people such as Native Americans, Black Americans, Jews, and a large number of immigrant populations has an impact that lasts beyond the generation during which the greatest violation occurred. 

Understanding what we do about complex trauma’s impact on a survivor’s ability to trust and feel safe in the world, we now need to add the understanding that the person we are working with may also be experiencing the effects of insidious trauma.  A person may come into shelter or for other services with lack of trust and an increased sensitivity due to oppression and stigma she may have experienced or seen others of her particular group experiencing.  In the past I have heard people refer to the person as having a chip on her shoulder.  By understanding the effects of insidious trauma, we can now understand that this distrust, hypervigilance, and protective stance are a part of the effects of the trauma experienced by their particular group and should be addressed in the same way we do with other trauma survivors. 

Knowing this, it also calls us to action in regards to addressing oppression and social injustices in society.  We can do this on individual, agency, community, and national levels.  If we are to call ourselves “trauma-informed” we need to also be aware of and address those institutions, attitudes, laws, and beliefs that contribute to insidious trauma.

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.