How to talk about trauma safely

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Trigger warning: this article talks about trauma

Trauma is something that is uncomfortable to talk about, partially because there’s a stigma around it, but also because it’s an often misunderstood word. In this context when talking about trauma, it means the psychological impact that someone has suffered as a result of harm.

The field of traumatology is a relatively new one, having only really started to develop in the later half of the twentieth century. Before we can talk about trauma safely we first need to understand what trauma is. Trauma is how we refer to events that are so overwhelming that they have a lasting negative impact on a person’s ability to cope psychologically. In this instance, we will define trauma as a painful emotional experience, or shock, often producing a lasting psychic effect and, sometimes, a neurosis [1].

A person who has experienced a traumatising event often has little to no control over the situation, compounding a feeling of helplessness.

There are many triggers for trauma including:

An often unspoken source of trauma is racism and discrimination. Research found that racism affects a wide range of developmental factors, from educational outcomes to mental health.[2] The same can be said for other forms of discrimination, such as sexism, disability and religious beliefs.

Medical procedures can be a significant source of trauma. Most of us will have had to visit our family doctor at some point, and I imagine that many of us will have had to visit a hospital. For example, in the event of an operation. If this is a planned routine operation that the person is expecting with a standard recovery, there is very little chance of the person developing a traumatic response.

Trauma is a very subjective experience. What is traumatic for one person may not be for another. We can also experience secondary trauma. This is when we experience trauma as a result of learning about someone else’s experience.

How do we discuss trauma safely and appropriately?

Over the last 6 months, myself and two other members of the UK civil service have come together to set up a trauma informed design community, with over 100 members across various departments. The thing that we all have in common is that we’re not experts in the field of trauma.

This community has a mix of professions and backgrounds, with varying levels of maturity within their departments. We learnt from our very first session that there is no common way of applying trauma informed practices in our work.

Steps for engaging with vulnerable users

Traditionally design has usually been a fast paced process with a mentality of ‘move fast and break things’. But what happens when you do that with a traumatised population? There’s an inherent risk that you could risk causing harm, triggering or even re-traumatising a person by using this approach.

Acknowledging that trauma exists has been the first step in understanding how it has an impact on design. Understanding that we’re likely all affected by trauma, at various degrees of severity.

As designers we’re also morally responsible to ensure that our work doesn’t cause harm to users, through direct or indirect trauma. There is also an argument for us having a legal obligation as PTSD can be classed as a disability and could therefore be covered by the Equality Act 2010. As designers in the public sector, it is our responsibility to ensure that we design in an accessible way, begging the question, should trauma be considered under accessibility regulations?

In order to remain ethical, we must design services that support our users, keeping in mind the risk of re-traumatising them where possible removing or reducing that risk. We must also remember that trauma informed design is not there to fix the root cause of harm, but to acknowledge and recognise that trauma is in the room with us.

What areas do we need to consider?

Knowing what we do so far, and having considered our responsibilities to our users, we must also consider key topics before we engage with our vulnerable users. Here are some some areas and very basic questions:

Getting buy in from Senior Management

Although anyone can take steps to improve trauma-informed practices within a workplace, it is often much easier if we have buy-in from our senior management teams. Unfortunately getting the buy-in is often easier said than done.

If you are in the initial stages you may want to think about how trauma informed design can help users have a smoother and easier experience with your services.

If you have an established trauma informed design community, you may want to consider things such as how to get training to as many people within your organisation as possible. You may also want to think about what systems are in place to encourage innovation in the workplace in relation to trauma informed practice.

Looking at language

Language is a very powerful tool and when used correctly has many benefits. However to my knowledge there are no established terms that have been researched for the field of trauma informed practices.

Traumatic situations often have inherent power differentials. Part of our role is looking for ways to reduce those differentials. We often refer to someone who has experienced trauma as a victim without considering if this is something they want. In some cases we do the opposite and try to empower the person, calling them a survivor. This is not always a better option. Key to all of this is the empowerment of the user, and the language that they want to use.

We also need to ensure that we involve policy makers in all this work. We can make all the positive changes we want, but if policies are still referring to people in terms they can’t identify with, our users may not engage with us.

Working with others

Working in this area, there are often times where we will have to work in multidisciplinary teams to achieve the best outcomes for our users. These teams may seek the expertise of folks working both internally and externally from their own department. However it is often difficult to if a collaborative partner is trauma informed, therefore we must ask that question.

We need to know how user needs are going to be communicated between departments and third parties. We must make it very clear to the user what to expect from us in this situation, as we can risk putting them at harm if we do not do so.

It is also worth considering if we are defining emotional safety by our own standards or those of the user. This will be different depending on the service being accessed and the resources available.

Funding and finances

With the ever tightening of public spending, getting departments to understand the need for investment in this area has the potential to become more difficult. Where the opportunity rises we need to make use of learning and development budgets.

We need to see what is available in terms of peer to peer training, and developing specialist knowledge in house.

Finally, if we are expecting users to participate in trauma-informed design and research, we need to ensure that they have a warm and inviting space to do so. It is not always possible to do this at our own workplaces for various reasons, however we can question if there is a budget to provision a safe space for our users.

How to look after yourself when working in within trauma related practices

Working in the area of trauma informed design is hard, and it can have an impact on your mental wellbeing. As people working in this area we want to make the world a better place. With this mentality often comes selfless behaviour and a willingness to put others before ourselves, however in order to ensure our own wellbeing we must ensure that we do not do that.

We are not practitioners, and therefore must be incredibly careful not to accidentally establish relationships with users that could become therapeutic or parasocial. We must also learn when to let go, step back or take a break from this topic, even if it is engaging or has a special place in our lives.

Many people who work in this area do so because they or someone they know has experienced trauma. It’s not an unusual occurrence, but we must be careful to make sure that we are not using this work as a form of therapy or ‘justice’ either, as that is not the role we should be undertaking.

Vicarious trauma

Vicarious trauma, also known as secondary trauma, happens when a person is exposed to someone else’s trauma. It can have significant mental health impacts and, if not mitigated against or treated effectively, can be a pathway to post-traumatic stress disorder.

It is normal to feel sadness, frustration and even anger at the situation when we learn of another’s trauma. However when these emotions last more than a few days, and those feelings may start to interfere with work, disrupt relationships or cause distress it’s time to seek help.

As people working in this field, we are at risk of experiencing vicarious trauma, so we must make sure that we are both aware of what it is and how we can reduce our risks of experiencing it.

How can we do that?

It can be easy to brush off the depressing things that we are subjected to in this field, however this can come back to haunt us. In my role as a mental health first aider I was taught that we can only help others if we first look after ourselves. This is also true of those working in trauma informed design.

Here are some of the ways we can mitigate vicarious trauma and its effects:

Self care

The first two letters of mental health start with ‘me’. It’s at odds with the mentality of many people who work within this area, who will put themselves last. By doing so you put yourself at risk of poor mental health, increased stress and even burn out.

Some basic self care ideas include:

Ways of working

Having a proactive way of working can be incredibly beneficial, though I am aware that some folks may not have these in place, at an organisational level. On a personal level, I can recommend actively scheduling breaks away from the content you're working on. Take the time to go have a comfort break and think about something else entirely.

Make sure that you know the brief, and stick to it. I have in the past wanted to fix all the problems that a user will face whilst working on a project that allowed me to explore trauma informed design. Unfortunately this is not a sustainable way of working. It led to me feeling stressed and miserable, and meant that I was often concerned with problems outside my ability to change.

Finally, if you are working from home, try to keep a specific place for viewing work material. Where possible try to create a buffer between work and home lives. It’s not always easy, as many of us have had to share family spaces as our workspace.

Supporting colleagues

Whilst we need to look after our own mental health, we also need to be mindful of the mental health of our colleagues. When considering sharing material, first ask yourself if it needs to be shared. If it does need to be shared, warn people in advance what they are going to be exposed to.

Be aware of the signs and signals that someone might be struggling. If they act out of character, it’s often a warning sign they might be finding things tough. For example an introverted person suddenly becoming the life of the party, it would be something you might want to keep an eye on. Similarly if someone becomes withdrawn and quiet, you may want to find them someone they trust to talk to.

Most importantly, have regular check-ins – particularly when working from home. Working in this area can be unintentionally isolating. You can find yourself becoming depressed without even realising that it’s happening. So arrange check-in sessions with your colleagues. These don’t have to be to talk about the work, instead they can be to talk about anything and everything. They’re also a really good way of being able to look out for those signs and signals.

References:

  1. Webster’s New World College Dictionary, 4th Edition. Copyright © 2010 by Houghton Mifflin Harcourt

  2. Gaylord-Harden, N. K., Barbarin, O., Tolan, P. H., & Murry, V. M. (2018). Understanding development of African American boys and young men: Moving from risks to positive youth development. American Psychologist, 73(6), 753–767


Tags: trauma informed design, international design in government

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