The Little Book of Trauma Healing: When Violence Strikes and Community Is Threatened

By Carolyn Yoder
Published by Good Books
January 2006;$4.95US; 1-56148-507-1

Trauma -- Conflict Resolution

Following the staggering events of September 11, 2001, the Center for Justice and Peacebuilding at Eastern Mennonite University was asked to help, along with Church World Service, to equip religious and civil leaders for dealing with traumatized communities.

The staff and faculty proposed Strategies for Trauma Awareness and Resilience (STAR) programs in response. In the years since then, those ideas have been put into practice, re-tooled, and used successfully again and again.

Now, STAR director, Carolyn Yoder, has shaped the strategies and learnings from those experiences into a book for all who have known threatened security.

This Little Book addresses communities and societies caught in cycles of victimhood and/or violence . . . in other words, those of us who have been traumatized by terrorists or tsunamis, by unsafe and ongoing occupation or oppression.

Says Yoder, "The primary premise and challenge of this Little Book is that traumatic events and times have the potential to awaken the human spirit and, indeed, the global family. But this requires acknowledging our own history and that of the enemy, honestly searching for root causes, and shifting our emphasis from national security to human security."

A startlingly helpful approach. 

Excerpt
The following is an excerpt from the book The Little Book of Trauma Healing

Defining Trauma: The Causes and Types

The tranquility of Lam Cosmas' growing-up years in Northern Uganda was shattered in 1986 when rebels began raiding cattle and attacking unarmed civilians. Over the next years villages were sacked, crops burned, and men and women killed. Nighttime raids took boys as young as seven to be child soldiers and the girls to be "wives" to the rebels. Terrified, the villagers moved to the urban centers in droves where they continue to live crowded in camps for internally displaced persons, lacking in basic amenities.

* * *

On September 11, 2001, Marie Mitchell was at work in her California office when a neighbor called and told her to turn on the TV. As she watched the World Trade Towers go up in flames and then collapse, Marie slumped from her chair to the floor. Her 46-year-old brother was a firefighter in southern Manhattan. She knew Paul would be there.

* * *

Jinnah works long days to support his family as a rickshaw driver in the crowded streets of Dhaka, Bangladesh. He pedals his passengers in the heat of the dry season and through the warm monsoon rains that flood the streets. He works when he feels well and when has a fever, when he has eaten or when he is hungry. Two of his six children have died of diarrhea-related causes. He has given up hope of sending the surviving children to school: he cannot afford the fees for books and uniforms. Jinnah has stopped thinking about tomorrow.

* * *

A.L.M. Thaseem lost his wife and his two children in the 2004 tsunami in Southeast Asia, which also destroyed his business and heavily damaged his house. New rules by the Sri Lankan government to discourage people from living near the sea mean he cannot rebuild his guest house business or repair his home, leaving him in limbo.

The four vignettes above are quite different. But all result in some degree of trauma reaction for the individuals and the societies in which they occur.

In casual conversation, the word trauma is used to describe reactions to anything from a stressful day to a brutal murder. Indeed, both stress and trauma do affect individuals and groups physically, emotionally, cognitively, behaviorally, and spiritually. But traumatic events differ from ordinary stress in intensity and/or duration.

Traumatic events:  

-- Involve threats to lives or bodies.   

-- Produce terror and feelings of helplessness.   

-- Overwhelm an individual's or group's ability to cope or respond to the threat.   

-- Lead to a sense of loss of control.   

-- Challenge a person's or group's sense that life is meaningful and orderly.

Whether or not a situation is overwhelming cannot be determined by looking only at the events. What is merely stressful for one individual or group of people may be traumatic for another, depending on a combination of factors. These include age, previous history, degree of preparation, the meaning given to the event, how long it lasts, the quality of social support available, knowledge about how to deal with trauma, genetic makeup, and spiritual centeredness. Consequently, a traumatic reaction needs to be treated as valid, regardless of how the event that induced it appears to anyone else.

Traumas occur in a context, a social setting, with dynamic interactions between the individual and the surrounding society. The social conditions and meanings of an individual experience often cause or contribute to trauma.

For example, Kadzu has AIDS which she contracted from her husband, who had died a year earlier. She and her two sons live with her elderly widowed mother and are financially dependent on their extended family. Kadzu's situation is impacted by the attitude of her family, community, and nation toward AIDS; by the resources available for prevention and treatment; and by the intellectual property rights, drug prices, and patents of multinational pharmaceutical companies. The latter, in turn, are affected by international trade agreements. Similarly, Lam's and Jinnah's trauma is induced by the social environment in which they live.

Ongoing and structurally-induced trauma
Not all trauma is induced by single dramatic events that are outside the normal range of human experience, such as a tornado or an accident or even the death of Marie's brother in the World Trade Center. Trauma can be caused by living under abusive or unsafe conditions that are long-term and continuous. This is the case with the ongoing civil war in Lam's story or the struggle to survive in Jinnah's. Conditions that at one time were rare, such as muggings, rape, and gang activities, are now ordinary in many parts of the world. The constant possibility of death or injury in conflict zones, or where populations live under occupation and in fear of terrorism, are no less traumatic because they are routine. The ongoing violence of poverty and systems that make people unable to meet basic needs such as health care is called structural violence and is a cause of trauma. Often these structural-induced traumas go unnoticed until an event such as Hurricane Katrina graphically exposes what has existed all along.

There is no standard term in trauma literature for this experience of living with ongoing trauma. It has been called cumulative trauma; continuous trauma; chronic trauma; sequential, multiple, or plural traumas. Perhaps Martha Cabrera, who works on trauma recovery programs in Nicaragua, describes it best when she refers to her society as multiply wounded, multiply traumatized, and multiply grieving after experiencing several decades of conflict. The psychological, spiritual, social, economic, and political effects of these ongoing difficult conditions can be profound, not only for individuals but for entire societies.

Societal or collective trauma
When a traumatic event or series of events affects large numbers of people, we speak of societal or collective trauma. Trauma may be directly experienced, but it can also occur when witnessing (e.g. on television) or merely hearing about horrific events. Whether direct or indirect, a group experience of trauma can set off widespread fear, horror, helplessness, or anger. Such events are not merely private experiences but have impact at national and regional levels, resulting in societal trauma.

Some of these are specific to the culture or society. For example, "September 11" instantly evokes images of the attacks on New York City and Washington, D.C., in 2001 for U.S. citizens as well as many others. In Chile, however, "September 11" evokes the trauma of the September 11, 1973 U.S.-backed overthrow of the democratically-elected government of Salvador Allende. Many in Central America remember the September 11, 1990 stabbing of Guatemalan anthropologist Myrna Mack who was documenting human rights abuses.

Within a single society, cultural subgroups may experience events differently, depending on their proximity to the threat or their identity with the victims of the events.

Historical trauma transferred through generations
Historical trauma is the "cumulative emotional and psychological wounding over the lifespan and across generations emanating from massive group trauma." Slavery, colonialism, and persecution or genocide of one faction or religious group are examples. The "event" or institution is in the past, but the effects are cumulative and are seen in individual and group attitudes and behaviors in succeeding generations. The trans-generational transmission of these traumas can occur even when the next generation is not told the trauma story, or knows it only in broad outline. A "conspiracy of silence" surrounds events for which grieving and mourning have never taken place.

Cultural traumas are created when attempts are made to eradicate part or all of a culture or people. This has happened for many native and indigenous groups worldwide.

Secondary trauma
Secondary or vicarious trauma refers to the effects experienced by rescue workers, caregivers, and others who respond to catastrophes and attend to direct victims firsthand. Many journalists who covered victims' testimonies in South Africa's Truth and Reconciliation Commission reported post-traumatic stress reactions, even though they were briefed beforehand on how to avoid becoming personally traumatized. The effects of secondary trauma are similar to those experienced by victims and survivors themselves.

Participation-induced trauma
Another cause of trauma is rarely discussed: being an active participant in causing harm or trauma to others, whether in the line of duty or outside of the law, such as in criminal activity. Psychologist Rachael MacNair's research suggests that the traumatic effects of harming others, intentionally or unintentionally, can be as severe as or more severe than what victims and survivors experience.

The issues MacNair raises likely have significance for communities, groups, and nations. What are the emotional and spiritual implications for groups or nations that bear responsibility for events such as the holocaust, genocide, suicide bombings, state-supported assassinations, or preemptive wars?

In summary
Traumatic events and situations overwhelm our usual ability to cope with and respond to threat. The following are common traumatic events or stressors:  

-- Abuse or assault: physical, emotional, sexual (including rape)   

-- Accidents   

-- Causing harm to others deliberately: criminals; torturers; abusers; terrorists including state-sponsored or -sanctioned terrorism; abuse of power   

-- Causing harm to others in the line of duty: law enforcement, executioners, military personnel   

-- Economic policies, poverty   

-- Homelessness, being a refugee   

-- Human-caused disasters: chemical spills, dams or levees that break   

-- Living under occupation or in conditions of servitude or slavery   

-- Mass violence: assaults, massacres, genocide, wars   

-- Natural disasters: hurricanes, earthquakes, tornados, tsunamis   

-- Neglect of those who cannot care for themselves   

-- Serious illnesses, pandemics and epidemics such as AIDS, bioterrorism   

-- Structural violence: social structures and institutions that deprive people of their rights and ability to meet basic needs   

-- Sudden loss of loved ones, status, identity, possessions, home, territory   

-- Sudden changing of the rules, expectations, or norms; social revolutions   

-- Surgical, dental, and medical procedures, including difficult births   

-- Torture   

-- Witnessing death or injury

Reprinted from The Little Book of Trauma Healing: When Violence Strikes and Community Is Threatened. Copyright by Good Books (www.goodbks.com). Used by permission. All rights reserved.

Author:
Carolyn Yoder directs the Strategies for Trauma Awareness and Resilience (STAR) a joint program of Eastern Mennonite University's Center for Justice and Peacebuilding (CJP) and Church World Service. She and her family have lived and worked in the Middle East, East and Southern Africa, Asia, the Caribbean, and the U.S. Her experience includes a wide range of trauma work including secondary stress and compassion fatigue in caregivers and survivors of war and torture, both domestically and overseas.

She is a licensed marriage and family counselor, a licensed professional counselor, and a national certified counselor. She holds an M.A. in linguistics from the University of Pittsburgh and an M.A. in counseling psychology from the U.S. International University of San Diego. She and her husband, Rick, are the parents of Katherine, Jessica, and Sara.

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