When it’s not just paranoia…

In the last couple of weeks I’ve spoken and written a lot about the neurological and physiological impacts of trauma. Although that’s undoubtedly important to understand, it feels like I’ve moved away from my main focus.

When I was applying for PhD candidature I knew I wanted to focus on mental health and I had the option of doing a PhD in psychology or public health. For me there was no hesitation, I wanted my PhD to be in public health because my aim is to promote good mental health, prevent the development of mental illness where possible, and create environments where people don’t need to be resilient to survive. I believe that I can have a much larger impact working at a population rather than individual level. I had three PhD supervisors – an epidemiologist, an expert in the social, cultural, and economic determinants of health, and a psychology professor who specialised in mental wellbeing. Together they helped me to develop a deep understanding of the determinants of mental health and mental illness that built upon the knowledge I had already gained from 15 years spent in clinical and mental health promotion work.

My writing is aimed at people who make decisions on behalf of others. 

In the workplace those decisions impact the day-to-day lives of their teams in significant ways, as well as their mental health, livelihood, and opportunities for promotion. Leaders have a responsibility to educate themselves, be reflexive, authentically listen, and avoid harm. 

I believe that trauma, at its core, is socially and culturally constructed. I find it infuriating that so much of the trauma discourse is about coping strategies and resilience. Although it seems like an easy explanation for why one person experiences long-term trauma responses and another does not, focusing on coping strategies is often unhelpful. It allows people with “good coping strategies” to congratulate themselves, and places shame and blame on people who experience long-term trauma impacts for not being strong enough. For not coping well enough. For not being resilient enough.

Frankly, that’s garbage. Exposure to traumatic incidents compounds over time, and eventually when there have been enough traumatic incidents or triggers there is no such thing as “good enough” coping strategies that will avoid a person experiencing a trauma response. 

As I wrote in my article “Changing the way we think about trauma” a few weeks ago:

“People who have experienced trauma are often skilled at identifying potential threats. If we’re not careful we run the risk of over-focusing on returning to a state of calm, and pathologising threat prediction altogether. Sometimes the threat is real, and people with a history of trauma can see what others may not. It is particularly important that we do not dismiss the perspectives of those who experience frequent micro-aggressions and discrimination that may not be noticed by others. Sometimes a person’s threat level remains high because they truly are not safe.”

This was the most shared quote from my recent articles. It touches at the heart of what I do.

We don’t get to blame people for having trauma responses such as heightened threat prediction if the world around them continually presents them with threats.

Sometimes the threat is real

Read the full article at The Trauma-informed Leader on Substack