"If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together." - Lilla Watson

Over the last few decades, we have seen trauma informed practice shift from radical and indigenous spaces, run by and for marginalised communities, into mainstream health services. Increasingly, trauma informed practice is cited in policy and put into practice when supporting health outcomes, both for physical and mental health (Emsley et al., 2022). Broadly speaking, using a trauma informed approach means we recognise that trauma often underpins poor health behaviours (use of alcohol, nicotine, drug use etc) and/or poorer health outcomes (cPTSD, autoimmune disease, cardiovascular issues etc), often experienced by the most vulnerable.
We also know that those who experience trauma tend to face more barriers to healthcare, be that in social care, mental health support or clinicians. Trauma informed principles that centre the needs of vulnerable people and communities at their heart have the potential to break down many of these barriers.
Despite the adoption of trauma informed engagement within mainstream services, I hold concerns that traumatised individuals and communities are still viewed as a homogenous groups, resulting in further oppression from these services. This results in the eraser and denial of individual needs that often sit alongside trauma, such as economic, political, cultural, subjective, and experiential needs. In their 2017 research Shimmin et al. shows that trauma informed practice that does “not consider the simultaneous interactions between different social categories (e.g. race, ethnicity, Indigeneity, gender, class, sexuality, geography, age, ability, immigration status, religion) that make up social identity, as well as the impact of systems and processes of oppression and domination (e.g. racism, colonialism, classism, sexism, ableism, homophobia) exclude the involvement of individuals who often carry the greatest burden of illness — the very voices traditionally less heard in health research”. In other words, by ignoring issues of identity and oppression, and how they intersect within trauma informed practice, we are further marginalising those who hold the most trauma and silence those who need the most support.
In short, to be trauma informed without an awareness of intersectionality is not truly trauma informed. To ignore systems of power and oppression in healthcare, and how one’s individual identity is impacted by these systems of power and oppression is neglectful and risks further marginalisation and compounding of trauma. This is one of the issues I hope to address in my forthcoming book for Routledge, An Intersectional Guide for Male Survivors of Sexual Abuse and those who support them. That for men of different identities and circumstance, societies attitudes toward them will provide contextual protective factors (like easy access to therapy) that can aid healing, or exacerbating factors (like racism or transphobia) that will prevent healing and even compound trauma.
I believe that all those who hope to support traumatised individuals and communities proactively need to recognise the cultural and political impacts of intersectionality. Trauma isn’t just held by the body and mind, but its also held by the inequalities in society an individual faces. Starting to dismantle this and ally ourselves to those traumatised and marginalised is to allow our communities the space to heal.
If all this sounds good but you’re not sure where to start, here are examples of trauma informed approaches that centre intersectionality into their principles:
· Substance Abuse and Mental Health Services Administration (SAMHSA) six principles method. Read more here.
· Ubuntu principles. These can be implemented in engagement. It’s a means by which to shift the focus away from Western hegemonic norms towards community-based interventions and relationship building. Read more here.
· PACE is an acronym for ‘Playfulness Acceptance Curiosity and Empathy’ and is often used in therapeutic settings with Children and Young People. Read more here.
Jeremy Sachs is an integrative psychotherapist and Narrative Exposure Therapist
living in Glasgow, Scotland. In the past he has run groups for men and their families
in Brixton Prison, young homeless people and refugee teenagers. He also ran the
UK’s only HIV aware youth group for 10-12 year olds either living with or affected by
HIV, as well as a 13-19 year old HIV youth group for over 300 young people. For six
years he ran groups for men, boys and trans people who survived sexual abuse and
rape. He is currently writing a book for Routledge, Taylor & Francis Group on the
topic of intersectionality and male survivors of sexual abuse. It will be based on his
experience working in the field of sexual abuse and include survivor testimonies,
coping strategies and explore the prevalent issues that affect male survivors. It will
look at how identity and intersectionality may affect a survivor’s ability to access
support or be believed. The book is aimed at early career counsellors,
psychotherapists, social workers and, importantly, survivors themselves. Due out late
2024 / early 2025.
His work, podcasts, and articles can be accessed from his website or twitter, and to
keep up-to-date with the book, release dates and the press tour, join his bi-monthly
mailing list via the website.
@JeremySachs_
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