We’re living through extreme times, so many of the things we used to take for granted have been upended while at the same time other truths have remained firmly in place. Like a storm uncovering a shipwreck, COVID-19 has shown the inequalities in our society even more starkly than before. So much so that you can use the impact of the pandemic as a guide to where the true priorities lie in British society.
Similarly, today when you look at trauma and its impact you can see the reality of our society’s values exposed. It’s something so ingrained it can be difficult to even identify, but once you start to see you understand how it permeates almost everything and how much harm it does.
You can see it in the profile given to certain types of trauma. The PTSD suffered by men who go to war is well established in the public’s consciousness. They’re given priority access to specialist services, and academic literature is full of well-funded research into the trauma experienced by veterans. Contrast that with the treatment of victims of multiple abuses in childhood. The diagnosis that best describes the result of those experiences – ‘complex trauma‘, was only recognised by the World Health Organization in 2019; the American Psychiatric Association still doesn’t recognise it. In the UK there have been official guidelines for the treatment of PTSD for many years but there are still none for the treatment of complex trauma. This means services are more difficult to access, funding and research are hampered; stigma is amplified. It isn’t difficult to see that to those in power, soldiers are more valuable than the types of trauma survivors who often struggle with things like education and employment.
You can see it in our language. The freeze response has been erased from the phrase ‘fight-or-flight’; meaning victims of sexual assault (mainly women) who do not run or fight back (mainly women) very often don’t know their reaction was an entirely normal biological response. Instead, they’re left with feelings of responsibility for the actions of perpetrators (mainly men).
You can see it in the narrative that trauma only results from a single event. There’s almost no public awareness that trauma can be caused by the slow burn of dysfunctional relationships and social alienation. Meaning the true impact of poverty, racism, homophobia, transphobia, ableism, and misogyny is hidden.
You can see it in the criminalising of traumatised people injecting unprofitable drugs to cope, while the same legal system allows the forced injection of profitable drugs. For adults who were traumatised as children, drugs like heroin can provide the feelings of safety and security that all of us depend on but most of us get without needing to resort to substances. The illegality of those drugs forces people into a spiral of more trauma, more stigma and less social support. At the same time, traumatised people in mental health units are restrained and forcibly injected with other drugs entirely legally. There’s a clear distinction between street drugs and prescribed medication, but the world of difference between the laws that govern them makes it obvious they’re far more rooted in political ideology than objective decision making.
You can see injustice everywhere. Trauma intersects with all forms of oppression from the structural to the personal. When you look at trauma and how society responds to it, you see our culture’s values, beliefs and judgements laid bare. People receive help and support based not on how much they’re suffering, but on how useful they are to the agendas of powerful people.
Trauma is not just political because it affects marginalised people, but because to be traumatised is in itself to be marginalised. The guilt and shame that belongs to privileged perpetrators are instead stored in the minds and bodies of people who have already experienced indescribable pain. It’s not enough to have celebrities speak out about their anxiety and we don’t need more campaigns to reduce the stigma of depression.
We need a structural change in the mental health and criminal justice systems. We need a sea change in the public’s understanding of mental distress. It’s not an overstatement to say the fight to recognise trauma survivors’ suffering is essential to the fight against oppression.
Dan Lewis has worked in mental health services for around 15 years. He runs his own blog, Amygdala & Co.
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