Medium Psychology: The Future of Healing: Shifting From Trauma Informed Care to Healing Centered Engagement

TraumaShawn Ginwright Ph.D.

From time to time, researchers, policy makers, philanthropy and practitioners all join together in a coordinated response to address the most pressing issues facing America’s youth. I’ve been involved with this process for long enough to have participated in each of these roles. I recall during the early 1990s experts promoted the term “resiliency,” which is the capacity to adapt, navigate and bounce back from adverse and challenging life experiences. Researchers and practitioners alike clamored over strategies to build more resilient youth.

In the early 2000’s the term “youth development” gained currency and had a significant influence on youth development programs, and probably more importantly how we viewed young people. Youth development offered an important shift in focus from viewing youth as problems to be solved to community assets who simply required supports and opportunities for healthy development. Since that time, a range of approaches have influenced how we think about young people, and consequently our programmatic strategies. I have, for the most part, attempted to nudge and cajole each of these approaches to consider the unique ways in which race, identity and social marginalization influence the development of youth of color.

More recently, practitioners and policy stakeholders have recognized the impact of trauma on learning, and healthy development. In efforts to support young people who experience trauma, the term “trauma-informed care” has gained traction among schools, juvenile justice departments, mental health programs and youth development agencies around the country. Trauma informed care broadly refers to a set of principles that guide and direct how we view the impact of severe harm on young people’s mental, physical, and emotional health. Trauma informed care encourages support and treatment to the whole person, rather than focusing on only treating individual symptoms or specific behaviors.

Trauma-informed care has become an important approach in schools and agencies that serve young people who have been exposed to trauma, and here’s why. Some school leaders believe that the best way to address disruptive classroom behavior is through harsh discipline. These schools believe that discipline alone is sufficient to modify undesired classroom behavior, but research shows that school suspensions may further harm students who have been exposed to a traumatic event or experience (Bottiani et al., 2017). Rather than using discipline, a school that uses a trauma informed approach might offer therapy, or counseling to support the restoration of that student’s well-being. The assumption is that the disruptive behavior is the symptom of a deeper harm, rather than willful defiance, or disrespect.

While trauma-informed care offers an important lens to support young people who have been harmed and emotionally injured, it also has its limitations. I first became aware of the limitations of the term “trauma-informed care” during a healing circle I was leading with a group of African American young men. All of them had experienced some form of trauma ranging from sexual abuse, violence, homelessness, abandonment or all of the above. During one of our sessions, I explained the impact of stress and trauma on brain development and how trauma can influence emotional health. As I was explaining, one of the young men in the group named Marcus abruptly stopped me and said, “I am more than what happened to me, I’m not just my trauma”. I was puzzled at first, but it didn’t take me long to really contemplate what he was saying.

The term “trauma informed care” didn’t encompass the totality of his experience and focused only on his harm, injury and trauma. For Marcus, the term “trauma informed care” was akin to saying, you are the worst thing that ever happened to you. For me, I realized the term slipped into the murky water of deficit based, rather than asset driven strategies to support young people who have been harmed. Without careful consideration of the terms we use, we can create blind spots in our efforts to support young people.

While the term trauma informed care is important, it is incomplete. First, trauma informed care correctly highlights the specific needs for individual young people who have exposure to trauma. However, current formulations of trauma informed care presumes that the trauma is an individual experience, rather than a collective one. To illustrate this point, researchers have shown that children in high violence neighborhoods all display behavioral and psychological elements of trauma (Sinha & Rosenberg 2013). Similarly, populations that disproportionately suffer from disasters like Hurricane Katrina share a common experience that if viewed individually simply fails to capture how collective harm requires a different approach than an individual one.

Second, trauma-informed care requires that we treat trauma in people but provides very little insight into how we might address the root causes of trauma in neighborhoods, families, and schools. If trauma is collectively experienced, this means that we also have to consider the environmental context that caused the harm in the first place. By only treating the individual we only address part of the equation leaving the toxic systems, policies and practices neatly intact.

Third, the term trauma-informed care runs the risk of focusing on the treatment of pathology (trauma), rather than fostering the possibility (well-being). This is not an indictment on well-meaning therapists and social workers many of whom may have been trained in theories and techniques designed to simply reduce negative emotions and behavior (Seligman 2011). However, just like the absence of disease doesn’t constitute health, nor the absence of violence constitute peace, the reduction pathology (anxiety, anger, fear, sadness, distrust, triggers) doesn’t constitute well-being (hope, happiness, imagination, aspirations, trust). Everyone wants to be happy, not just have less misery. The emerging field of positive psychology offers insight into the limits of only “treating” symptoms and focuses on enhancing the conditions that contribute to well-being. Without more careful consideration, trauma informed approaches sometimes slip into rigid medical models of care that are steeped in treating the symptoms, rather than strengthening the roots of well-being.

What is needed is an approach that allows practitioners to approach trauma with a fresh lens that promotes a holistic view of healing from traumatic experiences and environments. One approach is called healing-centered, as opposed to trauma-informed. A healing centered approach is holistic involving culture, spirituality, civic action and collective healing. A healing-centered approach views trauma not simply as an individual isolated experience, but rather highlights the ways in which trauma and healing are experienced collectively. The term healing-centered engagement expands how we think about responses to trauma and offers more holistic approach to fostering well-being.

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