July 30, 2021

From Mandy Davis, LCSW, PhD, Director, Trauma Informed Oregon

We have been focusing each newsletter on one of Substance Abuse Mental Health Service Administration’s (SAMHSA’s) principles of trauma informed care. This newsletter is focused on the principle titled: Cultural, Historical, and Gender Issues. It has been my practice, when teaching and talking about SAMHSA’s principles, to stop when we get to this one to emphasize that Cultural, Historical, and Gender Issues is clearly not a principle similar to safety or transparency.

These critical elements of who we are must be understood on their own, not lumped together. I have wondered how this principle came to be included in this way. Was it an afterthought or was it the work of tireless advocates who knew this was incomplete and insufficient but wanted a beginning?

I went back to the concept paper and spent time reading about the principles and how they were developed. Returning to this original work was grounding. Though still needing improvements, as all things do, I felt more connected to the definition than the title:

“The organization actively moves past* cultural stereotypes and biases (e.g. based on race, ethnicity, sexual orientation, age, religion, gender); offers access to gender responsive services; leverages the healing value of traditional cultural connections; incorporates policies, protocols, and processes that are responsive to the racial, ethnic and cultural needs of individuals served; and recognizes and addresses historical trauma.”
*I want to change “move past” to words that represent that we can not move past until we uncover, repair, transform..”

I believe “Culture and Culturally Sustaining Practices” is not one of the principles, but the overarching principle for which all other principles must be seen through. For example, safety can not be fully understood and addressed without anti-racist and justice-focused practices. See Charlies’ blog for more on this

What would it look like if your organization recognizes and addresses historical trauma, values traditional cultural connections, and incorporates this into policies and procedures? Maybe:

Your intake forms ask different questions; staff can pick what days they take off for celebrations and ceremonies; you hear multiple languages …..what else?

There is so much in these words: Cultural, Historical, Gender – what I want to focus on are the words traditional cultural connections. Culture is made up of many experiences and identities and our experiences with these.

As I continue to explore the intersections of anti-racist, inclusive, and trauma informed approaches, what I hear often is that trauma informed care does not elevate and value cultural strengths and healing. That it can feel like a deficiency-based model – focused more on the harm than on the healing.

I could not do this work if I didn’t believe and regularly witness people’s amazing ability to recover, heal, thrive, and inspire. I got into the work of trauma informed care because I kept seeing systemic and organizational barriers to the healing journey (e.g., minimal sessions; only some interventions covered; re-traumatizing practices, policies, people).

TIC work, for me, is focusing on harm caused by and/or made worse by organizations and systems. Taking a “Do No Harm” approach in the early days.

I appreciate that we are now pondering if spaces can do more than just Not Harm – can they promote healing? I hope so – and I am not sure. I suspect it will depend on several variables such as: which systems, and for whom and by whom, the healing is offered. This discussion is making me think and rethink the differences in trauma specific services and trauma informed care.

I am noticing some resistance in my body as I ask these questions about wellness/healing focused spaces and the role of trauma specific services in our trauma informed work. This comes from a worry that we will fall back into old patterns of focusing solely on the individual instead of on the organization and systems. Individuals need support – often in and by their community – and we also need to acknowledge the role of systems in the harm caused (possibly in the healing that can happen??). The need, of course, is to attend to both. We work to transform systems to support the flourishing of individuals who will transform systems.

I was in a meeting with Representative Pressley recently and she talked about how we have legislated harm and now we need to legislate healing. How we promote healing and wellness in our personal, work, and community spaces must consider issues of power, position, identity, anti-racism, justice, and the 5 principles of trauma informed care. I look forward to your interest in these intersections and hope you will help me do better to elevate the strengths of communities while staying focused on system change.

Also, Keep an Eye Out for…

To Do / Reminders: