Don’t Ask What is Wrong – Ask How You Can Help: Becoming Trauma Informed By Patty Black




I have alway preferred to blend into the background of my social environment.  I like to stay in the back and absorb information – this is part of my personality, a way I have always preferred to be.  I planned on doing this as I excitedly traveled to my first NYAPRS Conference in Kerhonkson, NY the week of September 9th.

The  NYAPRS 31st annual  conference  almost immediately  held up to its long standing reputation as an outstanding wealth of information and resources for New Yorkers interested in the current mental health agenda. While featuring many information packed workshops, it also had great entertainment with award winning blues guitarist Rhett Tyler, Mental Health Comedian David Grenier, and the legendary “mothers” of the mental health wellness movement all coming together on stage one afternoon to speak of the rugged terrain they crossed in the beginnings of the movement for mental health rights.      I could feel this energy buzzing throughout the conference and inside the workshops on Stigma and “Trauma Informed Environments” and again when I heard how the national Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) National Center for Trauma-Informed Care (NCTIC) is currently working to build awareness of trauma-informed care and promoting the implementation of trauma-informed practices in health programs and services.

SAMHSA included the following in defining traumatic experiences: “dehumanizing, shocking or terrifying, singular or multiple compounding events over time, and often include betrayal of a trusted person or institution and a loss of safety. Trauma can result from experiences of violence.  Healing is possible.  Although exact prevalence estimates vary, there is a consensus in the field that most consumers of mental health services are trauma survivors and that their trauma experiences help shape their responses to outreach and services.”  With that being a truth, it just makes sense that someone who had been through a horrible or terrifying experinence would react or respond accordingly to the way a health care system or setting is defined. Therefore, it would make perfect sense to be sensitive to what a person may have encountered that would drastically alter their perceptions.

Trauma-informed care attempts to engage those people with histories of trauma in ways that recognize that people will have trauma symptoms and acknowledges the role  their trauma has played in their lives. NCTIC facilitates the adoption of trauma-informed environments in the delivery of a broad range of services including mental health, substance use, housing, vocational or employment support, domestic violence and victim assistance, and peer support. In all of these environments, NCTIC seeks to change the paradigm from one that asks, “What’s wrong with you?” to one that asks, “What has happened to you?”

Many brave people offered their stories and told of ways they had found hope, faith and strength again – we heard from survivors, peers, professionals, and professionals who were also survivors – others who were living lives as parents, workers, daughters, teachers, friends, etc.  There was a wonderful workshop on ending SELF-stigma and that is something that can be controlled.  After all, we can’t control how others feel about us or treat us, but we can and should work on thinking well of ourselves.  But as SAMSHA so eloquently stated above, having a trauma-informed system of support around you can be incredibly helpful and healing and the one thing to put an extremely traumatized person back on the road to recovery.

Sadly, I cannot explain away all the recent events that have made headlines or made the issues of stigma in the mental health community that much worse.  I feel horribly for the myriad tragedies in our world, from what is happening  in Syria,  to the Boston Marathon Bombers, to so many innocent lives lost for no reason.  It is horrifying when the news informs us again of more tragic mass murders and horrifying again to hear so much commentary about mental illness being the main root cause.   Yes, while there may be some people out there with mental illness who are violent, it is far more likely for many vulnerable people to become victims themselves!  Also, the term “mental illness” has never been my favorite – however, I know it is not going to go away.  There are so many nuances and variables and countless other ways to define a person.  Often, when  one gets that label, that can become their “master identity” and people have a hard time seeing beyond it to all the other good qualities and traits that define a person.  Actually, this is where ending SELF-stigma can come in handy.

In our world, there are countless murders, rapes, and atrocities that are committed by people who do NOT have a particular mental illness.   It is a cold, hard fact that many people who are crime victims and who are hurt and wounded often go on to develop “mental illness” – such as trauma survivors – and become members of this community  and it becomes a vicious cycle.  While I don’t see this cycle ending in my lifetime, I do see glimmers of hope in a better, more informed and open minded future.  I truly heard some amazing ideas at this conference and I saw hope in them, particularly in having systems become more open-minded and better informed.   The Guidebook I was introduced to at one of the sessions is a wonderful beginning resource for female survivors and those who may want to help become better informed and more aware.   Engaging Women in Trauma-Informed Peer Support:  A Guidebook – by Andrea Blanch, Beth Filson and Darby Penney (with contributions by Cathy Cave)