Do you:
•persistently feel that there’s something wrong with you, that you’re ugly, stupid, or out of the loop?
•often feel distant or cut off from other people?
•prefer to stay home, curled up in the fetal position?
•have trouble sustaining relationships?
•experience frequent mood swings?
•have persistent sadness and depression?
•feel easily overwhelmed?
•trigger easily, experience explosive anger?
•feel hypervigilant, super alert or watchful, on guard?
•experience a sense of dread?
•feel numb or disconnected from your body?
•frequently have bad dreams or nightmares?
•startle easily?
•have trouble sleeping?
•have trouble concentrating or getting things done?
•have physical reactions when you get anxious (heart pounding, trouble breathing, or sweating)?
•suffer from disturbing memories or thoughts of a stressful experience from the past?
•get lost in rumination that you just can’t shake?
•engage in addictive behaviors (drugs, alcohol, food, shopping, etc.) to stave off feeling overwhelmed?
These are all common symptoms experienced by traumatized people. While most of us can check off “hell, yeah” to a number of these questions, not all of us would qualify for an official trauma diagnosis. Regardless of whether we meet the criteria for a trauma diagnosis, we can all benefit from trauma-informed care.
Trauma-informed care recognizes that mean, harmful, or antisocial behavior usually arises from a person’s harsh experiences rather than from malicious intent. In other words, a trauma or a trauma-like experience triggers your survival system and sets your current behaviors in motion.
Consider the above behaviors from a survival perspective. If your life is threatened, you’re going to want strategies in place to protect yourself and survive. This means you want to be hypervigilant, you want to avoid situations where you’re not in control, you want to react quickly to events or unfamiliar noises, you want to sleep lightly and be awakened easily, you want to have intense memories of specific painful events in your life so you can watch for them again. Distrusting others is extremely helpful. After all, people have let you down and you’re not going to allow that to happen again. Being angry at times helps you protect yourself. Being depressed at times stops you from being too active—and putting yourself out there spells more danger. You’re going to avoid making yourself vulnerable. Substance abuse? That, too, is adaptive, allowing you to temporarily escape your circumstances when you don’t have other coping skills.
Understood in this way, those behaviors are brilliant responses intended to help you take care of yourself. They are good skills to cultivate in dangerous times. Yet these adaptive behaviors become maladaptive over time and contribute to difficulties with regulating emotions and connecting with others.
Even those of us who don’t think of ourselves as traumatized go through times where our brain pattern mimics a trauma response: our prefrontal cortex goes offline and we get caught in the grip of reactivity. Fortunately, you don’t have to stay stuck in these conditioned responses. You can rewire your brain to have more beneficial “default” functioning. But before we talk about rewiring, let’s unpack what trauma is.
Sometimes we experience something that so violates our sense of safety and rightness that we feel overwhelmed. We feel shattered. The mind freezes in that moment and can’t let go, can’t just integrate it and carry on. The jolt could have come from an event, such as a natural disaster, terrorist attack, sexual assault, being in a war zone or car accident, seeing someone murdered, even a messy divorce. Even if it doesn’t involve physical harm, any situation that leaves us feeling overwhelmed and isolated can result in trauma.
Trauma can also stem from not just a singular event but an accumulation of ongoing stressors, such as growing up in a crime-ridden neighborhood or an environment that was unpredictable or dangerous, being bullied, or suffering partner abuse or childhood neglect.
It’s also traumatizing to grow up surrounded by cultural messages that say you are worthless because of who you are. This is the trauma of oppression, and it’s the experience of most people with marginalized identities. Having a supportive and loving family or community may not be enough to protect you from internalizing toxic cultural messages.
Most of us carry trauma in our bodies to varying degrees. For example, we’ve all experienced gender-based trauma, but the difference is in the degree. The trauma experienced by cisgender folks, if not often labeled trauma, is real. Consider men who lack full access to their emotions (because they were taught that “real men” shouldn’t cry) or women caught up in the pursuit of beauty ideals (because they were taught that beauty is currency). We can all remember being shamed for stepping outside those gender boxes or silently fearing that others will see our gendered shortcomings.
When you feel ashamed of or feel the need to conceal aspects of yourself in order to survive or find belonging, then what you’re experiencing isn’t true belonging. Instead, you constantly hustle for your worthiness (to use shame researcher Brené Brown’s language). That’s traumatic.
Although we talk about the catalyst as the trauma, in fact trauma is about an individual’s response—it’s one’s subjective experience that defines whether an event is traumatic, not the nature of the event itself. Then it extends beyond the story of what happened to become the imprint of how your past lives on inside you today.
The invisible nature of some traumas can leave us confused. To an outside observer, an emotionally deprived child might appear fine, since their basic physical needs such as clothing and schooling are fulfilled. The lack of external recognition makes the invisible scars more damaging. The child feels unloved and unworthy, all the while hearing from society that they are well taken care of. This disconnect can create confusion, guilt, and shame.
Unfortunately, too many traumatic encounters go unrecognized by typical diagnostic criteria. This is unfortunate because people may then feel ashamed that what they experienced isn’t really trauma and thus is unworthy of attention.
As you can see, there’s a lot more that causes trauma than the usual stories. Consider this humiliating story from my life. It may not contain a “classic” traumatic event—there was no rape, bomb explosion, or earthquake—but, the impact was traumatizing.
A few months after my bat mitzvah, when I was about to enter high school, my mom was pressuring me even harder to act like my assigned gender. Enchanted by the Barbizon Modeling School advertising slogan—“Be a model, or just look like one”—she’d convinced herself that I could be taught to be a girl. I protested as she signed me up for the program. But the truth was, I wanted it. I wanted to learn how to pass. I was willing to endure modeling school if it let me escape the misery of feeling inadequate and wrong.
Predictably, modeling school only reinforced my feeling of wrongness and inadequacy. Applying mascara meant poking myself in the eyes. Walking in heels was painful and awkward no matter how much I practiced. I left each day more ashamed, brandishing smudged makeup and limping from twisted ankles, reminded in the most demoralizing of ways that I was not the “girl” my parents hoped I’d be. Indeed, I was more certain than ever that I would never be that girl.
Ever the problem solver, I made a deal with the program director behind my mother’s back. After she dropped me off each day, I would hang out in a back room reading. Just before pickup, the Barbizoners would hastily apply my makeup to convince my parents I’d been in class all day. Everyone was happy. I could lose myself in books, the Barbizon people could dispense with struggling to train me, and my mother believed I was getting closer to becoming the girl she had always wanted me to be.
That is, until graduation day, when I had to parade my newly taught femininity down a catwalk. The program instructor dressed me and applied my makeup, but as I walked down the lighted catwalk, my (unpracticed) heels were markedly unsteady. When I stumbled, my heel caught in the string of lights attached to the painted backdrop. It came crashing down, managing to hit every model in training. One girl was taken to the hospital with a broken arm. The wreckage ruined the evening for all the hopeful young models and their proud families.
My attempt at passing had failed—and failed big-time. My parents were heartbroken. Even the professionals couldn’t make me a real woman. The air was thick with our mutual shame.
Of course, these classes were not an adequate or even accurate description of “girl,” but they focused on what was, then and still now, expected of women: to be thin, elegant, and beautiful and to walk constrained. In the car riding home that evening with my parents, I knew that I was supposed to want these things for myself. I also knew, as clearly as ever, that I didn’t.
The event stands out for me as a day on which my life was forever and dramatically changed. Much deeper than the awareness that I could not succeed at this particular construct of femininity was a nagging feeling that threatened the integrity of my understanding of self. It would, however, take decades for this awareness—that I wasn’t a girl—to fully surface.
While I can laugh as I tell the story today, I can also remember what it was like to be that awkward teen, feeling the shame of not being a Real Girl—and having it so publicly revealed. To feel my parents’ disappointment in who I was. To know my parents felt ashamed, believing they were negatively judged because of who I was. I mark that day, as with the bat mitzvah, as one of the turning points that pushed me into an outright war on my body—an eating disorder and later drug addiction were just two of the many ways I found ways to comfort myself from the shame.
For many of us, showing our authentic selves at some point proved unsafe. The inauthentic self we learned to show the world as armor kept us protected. “Passing” as a girl allowed me to survive my childhood, but it also contributed to my feeling isolated and alone. And it strengthened my conviction that something was wrong with me, which only magnified my shame. Healing required that I recognize that the problem wasn’t in me, but in the environment that didn’t treat me well. I did what was necessary to survive a toxic environment. That was smart, a sign of remarkable resilience at the time.
As an adult, I have more agency and I can make different choices that allow me to heal. I can find and create safe environments where I can shed my armor, where I can be seen, and where I can feel love and belonging. This last point is key: It’s belonging rather than self-love that helps me live as my authentic self. This is not a solo journey.
The diagnosis of post-traumatic stress disorder (PTSD) applies when the response to trauma takes over our lives, causing our brains to live in the past in a way we can’t control. When someone has PTSD, the nerve connections between the amygdala, hippocampus, and prefrontal cortex are weakened. The hippocampus becomes hypoactive and can’t store the memory, while the amygdala becomes hyperactive, keeping you in a fearful state. The prefrontal cortex isn’t able to override the hippocampus and soothe the amygdala when there is no danger. It’s as if you’re stuck in the traumatic experience.
This closely resembles what happens in chronic stress, except that in traumatic stress, memories of the traumatic event dominate your thoughts, sending you into fight-or-flight mode at the slightest provocation. Therapists describe this as being “reactivated.” In the short term, people may avoid the pain provoked by the memories through disassociating—that is, they cut off from their bodies, so much so that they often cannot describe their own physical sensations and may have difficulty recognizing normal sensations like cold or hunger.
About 20 percent of people who experience a traumatic event go on to develop PTSD, which is defined by the following diagnostic criteria:
•Reliving the event through intrusive thoughts and/or recurring nightmares
•Avoiding things that remind one of the traumatizing experience, such as people, places, thoughts, or other activities related to the trauma
•Having negative thoughts or feelings that began or worsened after the exposure to trauma
•Being hypervigilant or hyper-aroused, which may include feeling irritable or quick to anger, having difficulty sleeping or concentrating, and/or being overly alert or easily startled
Other criteria include that the symptoms last for more than a month, create distress or functional impairment, and are not due to medication, substance use, or other illness.
Proper diagnosis can be powerful. Those four little letters mean that symptoms are more likely to get taken seriously and not dismissed as someone being “too sensitive.” People who don’t fit the stereotype, like people with marginalized identities whose trauma comes from oppression, are less likely to get the diagnosis—and therefore less likely to get help and accommodations. They are also vulnerable to thinking their trauma responses mean there’s “something wrong with them.”
What happens when we see ourselves through a trauma-informed lens? The National Center for Trauma-Informed Care articulates this paradigm shift as moving from asking “What’s wrong with you?” to “What happened to you?” It means reexamining the stories you’ve told about yourself in a more compassionate light.
For example, maybe you lack the energy to clean your house or go grocery shopping, but that doesn’t mean you’re lazy. Few people are. More likely, if you consider yourself lazy, you just don’t have energy reserves to draw on because you’re so busy surviving, or you’ve devoted all your energy to hypervigilance. Perhaps you have such fears of inadequacy in front of others that you are frozen and can’t get anything done.
Don’t like exercise? Maybe there’s a reason. For example, the emotional trauma of being known as the fat, clumsy kid in gym class may prevent you from becoming interested in sports. As burlesque performer Fancy Feast describes, “I wasn’t bullied, but I didn’t have to be. Being last to finish the mile run, being chosen last for dodgeball, not fitting into child sizes for my school uniform—all made it easy for me to absorb the message coming in: none of this was designed for me, exercise was a form of punishment, and I would be less of an inconvenience if I would just shrink myself.”1
When viewed through a trauma-informed lens, the behaviors we think of as counterproductive or destructive instead get understood as survival. For example, adolescents are often perceived as being purposefully hostile, rude, or disrespectful when, in reality, they may be unconsciously trying to protect themselves from additional trauma. In other words, they are emotionally traumatized and have a deep sense of shame, and antisocial or unkind behavior is a way of pushing people away and protecting themselves. They may become emotionally shut down to the point where they are no longer sensitive to their own needs, and carry this into adulthood.
A trauma-informed lens requires ongoing openness to reexamining what you think of as your own bad behavior, and others’ behavior as well. It asks us to consider that everyone is doing their best given the circumstances, and that our behavior is usually an attempt to regulate ourselves so that we feel safe and comfortable. Consider this example. A former colleague and friend altered some of our joint work without informing me or seeking my collaboration. When I discovered that she had done this, I initially experienced it as a profound violation of trust. However, lightening up on my judgment enough to ask why helped me to learn that she was reeling from the hurt brought on by the ending of our personal relationship, and those feelings resurfaced more viscerally every time we did business together. (That was my experience too.) She altered our work because she thought it needed updating and that I would be in support of the update; she did so without collaboration to protect herself from the pain our interactions surfaced. This understanding was a game changer for us. We realized that we were continuing to hurt one another in our efforts to avoid more hurt—which motivated us to realize that we needed to either repair the relationship or set better boundaries. There’s a lot to be learned when you open to looking behind “bad behavior.”
These days, healers are putting less attention on diagnostic criteria and instead recognizing the value of offering trauma-informed care to everyone. We’re all at least a bit traumatized living in a world with so much injustice, whether we are on the receiving end or bear witness to it. Of course, this is not to say that all trauma is the same or has the same impact.
If you experienced a traumatizing incident, it’s helpful to remind yourself that you didn’t have control of the situation—it happened to you. Whatever you did or didn’t do in the moment was in large part mediated by your reactive reptilian brain, with little input from your rational “thinking” brain. Your response—to fight back or not—was derived from a history embedded in your body, recorded from your own life experiences and that of your ancestors.
Too often, traumatized people blame themselves or think that if only they had reacted differently, they could have controlled the outcome of the situation. Neglected kids often believe that if they were more lovable, their parents would have paid more attention to them. Part of healing is letting go of that, recognizing the limited power you had, and acknowledging that you did the best you could at the time. Trauma is not a personal failing. Trauma happens to someone, whether it is the result of a singular traumatic event or ongoing microaggressions.
Self-blame is particularly poignant in the example of rape. Most people who have been raped blame themselves in some way. Perhaps you offered a friend of a friend a ride home and blamed yourself when that person forced themselves on you in the car. However, giving a friend’s friend a ride home is a perfectly reasonable, kind thing to do. The ending to the evening was not your fault.
Or, perhaps you “submitted” to sex, not fighting back or saying no, even though you didn’t want it. Maybe you were drunk or unconscious. There are so many reasons that explain why you acted the way you did, some of which have to do with your own belief in your power or worthiness. These are definitely traits worth exploring, but the bottom line is: No one has the right to your body without your affirmative consent. What you were wearing, how drunk you were, whether you were on a date, whether you are a sex worker, and what your gender is are irrelevant to the boundaries of what constitutes rape. But they may contribute to self-blame and to whether you experience the violation as trauma.
People become more vulnerable to abuse, assault, and discrimination when they are dependent upon others who hold individual or collective power over them. Kids, for example, are dependent on their adult caregivers and may not have the resources to escape their situation. Adults may depend on others for employment or basic needs, such as food, shelter, and clothing. Or, they may believe they are dependent as a result of social conditioning. This is why many people stay in abusive relationships: they lack the resources, power, or confidence to make choices to protect themselves or to pursue their own self-interest or protection. But their dependence makes them more vulnerable to inequity and exclusion, and to many other forms of violence.
Childhood is a particularly critical time for brain development. When the process of development is disrupted by trauma, the results can be profoundly damaging. Our brains develop over time to enhance our ability to survive. When you are raised in a traumatizing environment, your brain develops in a way to ensure your survival in that setting. The neural pathways that optimize your ability to survive in that dysfunctional environment become overdeveloped, while development of other pathways may be stunted.
Adverse childhood experiences (ACEs) can include things like physical and emotional abuse, neglect, caregiver mental illness, and household violence. A survey called the Adverse Child Experiences Study2 asked people if they had experienced any of three categories of childhood abuse before the age of eighteen: psychological (being frequently put down or sworn at, or living in fear of physical harm), physical (being beaten, slapped, burned, cut, etc.), or sexual (being forced into various acts). The survey also asked about four types of household dysfunction: if someone they lived with was a problem drinker or user of street drugs, if mental illness was pervasive in their household, if a household member had attempted suicide, if there was violence or criminal behavior in the household.
The findings were dramatic: The more forms of adversity a child experienced, the more prone they were to depression and attempting suicide as adults (when compared to those who reported no adverse experience). People with four or more different types of ACEs were five times likelier, in the previous year, to have been in a depressed mood for two or more weeks, and twelve times likelier to have attempted suicide. Experiencing more types of adversity in childhood was strongly associated with alcohol and drug abuse. It was also associated with higher incidence of diabetes, chronic obstructive pulmonary disease, stroke, and heart disease.
This study wasn’t a fluke. A meta-analysis of 124 studies verified many of these links.3
Scientists use the term “toxic stress” to explain how ACEs trigger biological reactions that lead to those outcomes. If a child is subjected to multiple ACEs over time, particularly if they lack supportive relationships with other adults which can buffer them, a long-lasting stress response ensues which increases allostatic load and results in excessive “wear and tear” on the body.
Another disturbing finding in the ACEs research is that fully half of the adult perpetrators of intimate partner violence had been abused as children. In other words, victims of childhood abuse are highly vulnerable to passing their traumas onto others. Also chilling is that half of the victims had also been abused as children.4 Being victimized as a kid makes us vulnerable to continued victimization as an adult.
The National Scientific Council on the Developing Child made the important decision to expand its definition of ACEs beyond the categories covered in the initial study to account for community and systemic factors, including violence in the child’s community and experiences with racism and poverty. The body experiences the same stress response regardless of the type of adversity.
Oppression lives in our bodies. It is an ideological system and its effect is deeply physical.
This oppressive culture tells us that some bodies are better than others, that some bodies are more worthy of respect than others, and that those of us in marginalized bodies should strive to achieve normative oppressive ideals as a prerequisite to being treated well. Health professionals, who fall prey to the cultural myths just as others do, are (often unconsciously) complicit in imposing and enforcing this oppressive ideology.
Doctors are tasked with curing or helping us manage disease, not causing disease, right? Yet, this mandate goes by the wayside when considering fat people and bariatric surgery. The surgery’s intent is to intentionally damage healthy, functioning organs and have patients voluntarily assume the risk of death and “complications.” (Bariatric surgery refers to operations that help promote weight loss. It’s among the highest-paying surgical specialties, which perhaps partially explains why accuracy and integrity in research and reporting are suspended.)
People are misled about the health risks associated with being fat and told that bariatric surgery is a solution to all that ails them, from sickness to singleness and even diseases they do not have. As speaker, author, and “real-life fat person” Ragen Chastain recounts, “I’ve been told by doctors that I should have the surgery to cure my Type 2 Diabetes (which I do not have), my high blood pressure (which I do not have), my mobility problems (which I do not have), and just to make things easier ‘dating-wise’—which is not an issue since I’m in a long-term relationship with someone who loves me as I am, and not based on how my body could look after surgical manipulation.”5
Bariatric surgery is more appropriately labeled high-risk, disease-inducing cosmetic surgery than a health-enhancing procedure. Its goal is to intentionally induce malnutrition, and post-surgical nutrition deficiencies are the norm. A critical mind is essential in evaluating the research, as you have to parse the data rather than trust the bias-laden conclusions. Consider, for example, what’s not being named, tallied, or reported. Why is there so little long-term follow up? Why are so many patients left out of follow-up analysis and how does this skew reported results? Why aren’t potential harms being sufficiently investigated, like disordered eating, body-image distress, suicide, bone loss, falls, substance abuse, and heart failure, to name but a few?
We’re not getting the full story. People who have had poor results from surgery may not return for follow-up evaluation, admit the painful side effects publicly, or acknowledge that the quality of their lives is far worse after surgery. As one post-surgery client explained to me: “We’re ashamed to talk about the negatives. After all, we’ve failed all our lives and now we’ve failed again. So we pretend that it’s all rosy. We accept the compliments and quietly soil our pants, quietly tolerate the hours of excruciating pain that results from one poorly chewed piece of food, the ongoing hospital visits to treat our nutritional deficiencies. But what scares me most is the denial. Scratch a ‘success story’ and you find someone having numerous complications, but they are so brainwashed to believe they were going to die from fat, and so desperate for social approval, that they actually believe they are healthier and better off for having the surgery.”6
The health care mandate “Do No Harm” also goes by the wayside when considering short people. The idea that height is important for all things, from finding love to earning higher paychecks,7 to succeeding in life and being taken seriously, is well documented in the scientific literature. It didn’t surprise me to learn that to become a fashion model, a woman must be at minimum 5’8”, though the average American woman is closer to 5’4”. But I do admit to being surprised that even sperm banks discriminate; many have a 5’10” height requirement for donors, despite an average male height in the US of 5’9”. Short kids who are healthy and not low in growth hormone but might wind up shorter than their peers can now receive an official diagnosis—idiopathic short stature—and qualify for synthetic growth hormone shots. These shots don’t confer any health advantages, but they do come with a long list of potential contraindications. The psychological distress associated with being very short (in other words, distress resulting from being victim to stigma and discrimination) is used to justify treatment.
I have compassion for why fat people and short kids (and their parents) consider or choose to undertake medical intervention. The idea of escaping a stigmatized and discriminated against class, however false or health-damaging the method, provides hope, while managing or ending the stigma or discrimination can seem out of reach. Consideration of these ideas really drives home the message of this book: We must work to end the stigma and discrimination at their root, support one another, and develop our individual resilience to manage the stigma and discrimination while it persists.
We humans are a resilient species. If we are around people who love us, take care of us, dive deep into compassion for us when things are particularly hard, we can do well despite horrible things happening. If someone with a marginalized identity, for example, was raised in a loving family and belongs to a strong supportive community, they may be less scarred by systemic trauma.
Various protective experiences can mitigate the harms of ACEs and make us more resilient. These include having access to adequate food, living in a safe and clean home, and attending a high-quality and well-resourced school. We can also gain protection from unconditional love from adults, whether a parent, caregiver, teacher, or other ally, or even from mere contact with an adult we trust. Having a close friend to confide in likewise bolsters us. Other sources of support include involvement in civic organizations such as service clubs, religious organizations, or social groups; participating in an organized sport; doing charitable work; or having an artistic or intellectual passion. What each of these experiences have in common is that they remind you that others value you, which helps you learn to value yourself. Humans are remarkably adaptable, and compensatory factors that we accrue later in life can often help us transcend a traumatic childhood. Each protective experience makes us better equipped to compensate for a high ACEs score and improve our health and well-being.
This means that a bad start in life doesn’t seal a negative fate. We can even grow stronger for our pain. As an example, there is some research that supports the idea that people with a history of child abuse develop enhanced abilities to sense threats in the environment and learn new things, which are excellent traits to hone.8
My parents did the best they could, given the resources they had and what they knew. Their efforts to make me gender-conform came from good intentions. They wanted the best for me. What they didn’t understand was that conformity wouldn’t make me happier. It was a short-term plan to avoid the pain of stigmatization, with long-term consequences. It sent a message that I was the problem and failed to call out the real problem, which is our discriminatory culture.
Life is painful. We can’t protect our kids from every insult and injury, nor should we try to. What we can do is sit with them as they experience it, help them to know they aren’t alone, and model that we can handle suffering as a part of being human.
The best you can do is love your child, as they are. The template for healthy brain growth for a kid and for healthy emotional development is a nurturing relationship with caring, responsive adults. Children can’t handle an attachment void. Without loving support at home, kids may rely more on peers and need more outside validation. They may also become more vulnerable to absorbing cultural messages of how they are supposed to be.
Rethink common parenting practices. If your kid throws a temper tantrum, the last thing you want to do is impose a punitive “time out.” Time to cool down may be valuable, but not when it is perceived as punishment or withdrawal. That sends a message to the kid that when they’re in pain, you’re withdrawing from the relationship. You are teaching them that the relationship is unreliable and conditional, that they are acceptable only if they please you.
My kid is at the brink of adulthood now, and I think of the ways I’ve failed him. I didn’t know how to act around a young child. I was waiting for him to grow older so I could engage with him intellectually.
I used the excuse that because my partner was the primary caregiver and was competent and loving in that role—she was the one with so-called maternal instincts—it took me off the hook. It didn’t. All the loving attachment our kid got from her didn’t cancel out the messages he received from my distraction and detachment, although it did help him develop the skills to offset it.
Now, I understand that intellectual engagement, words, activities, or common interests aren’t the basis of a true relationship; real closeness is about being with. “I welcome you to exist in my presence. Being with you brings me joy.” Presence. It can’t be cerebrally understood, but you can feel it. What was it like for my kid when he was aware I was not really present with him? For kids, that detachment gets translated into “I’m not important enough.” They read it as their inadequacy. It’s traumatic.
I had to work on that, to learn not to let my mind wander off into work. To just be there. My active presence could give him the security he needed to feel independent enough to play on his own, to give him space.
Many parents worry that they failed their kids, especially parents who are traumatized or engage in addictive behaviors. We are all imperfect. We all make mistakes. Please show yourself some compassion for your inadequacies. You’re just being human.
Incidentally, upon reviewing this self-criticism, my partner (and co-parent) commented that I’m being too hard on myself, exaggerating my disengagement. I suspect she may be right; perhaps my writing reflects a skewed reality influenced by my harsh inner critic. Are you tough on yourself, too?
Gender-nonconforming kids are at a higher risk than the general population for being teased, bullied, and shamed. Caring parents, of course, don’t want their kids victimized in this way. My parents knew that if I wore my brother’s suit to my bat mitzvah, I’d be met with negative judgment and ridicule. Shaming me for gender nonconformity was their misguided way of trying to protect me (and themselves). But of course, it didn’t work. I fantasize about what they could have said that would have made my life a whole lot easier:
We know that femininity isn’t your thing and that you prefer to express yourself in a suit. We love you for that. We support you in all that you are. But we also want to help you understand that the world you are growing up in has judgments about gender and is going to be hostile toward you when you express your gender. So we want to help you decide how to handle that. Do you want to wear your brother’s suit to your bat mitzvah and face potentially hurtful reactions? Or would you rather wear a more socially acceptable dress? Or, perhaps we could work together to find some compromise. We love you and support you whatever you choose.
It’s too late to make that happen for me. But hey, we can make our parenting fantasies happen for the next generation, right?
These strategies are important not just for parents, but also for teachers and other caregivers and influencers. All of us can cultivate space in a child’s life where they can walk in and hang up their armor. Don’t underestimate how valuable that is for a kid. You may not be able to change the conditions of their life, but it is still hugely important that kids feel seen and valued. One person can make a difference. I honor all teachers and caregivers who use their considerable power to positively influence the next generation and inspire a more just future, where all kids are valued and supported.
In a society organized around inequality and systemic oppression, it is inevitable that people will experience the powerlessness, violation, and suffering associated with trauma. Institutionalized trauma, also known as systemic trauma, refers to the ways people are harmed by systems such as the criminal justice system, educational system, health care system, etc. In the United States and many other countries, these systems better serve people with dominant identities, at the expense of those with marginalized identities. Consider the “school to prison pipeline”: A low-income Black boy suffers from trauma in his home and community, which results in little time or support for studying or completing assignments and a short fuse. He then gets labeled as a troublemaker in school and is pushed on a trajectory that will most likely lead to juvenile detention center, jail, and prison.
Or consider a non-neurotypical person who gets labeled as not bright at school, though the issue is really that they are processing information in a way that is not recognized by the school. The label gets internalized and they come to believe that there is something wrong with them.
Or consider the People of Color who have experienced trauma resulting from abusive police practices or know others who have.
Or consider the fat people who are denied routine health care, like access to life-saving transplants or gender-affirming surgeries; are subject to contemptuous, patronizing, and disrespectful treatment by health professionals; denied care for their symptoms because their health issues (like sinus infections!) are attributed to excess weight; or prescribed damaging weight-loss treatments.9 It’s not surprising that the majority of fat people report avoiding or delaying medical care as a result of a history of traumatic interactions with health care providers.10
Or consider the communities that face higher risk of cancer because their water, soil, and air are toxic, victims of polluting factories that tend to be located in low-wealth neighborhoods rather than affluent ones.
Systemic injustice is traumatizing and runs deeper than any of us can imagine. Many people who are more privileged under these systems may be insulated from the reality that what they take for granted isn’t accessible to a lot of people. For example, as an able-bodied person, I never have to think about whether I can access the toilet paper in a bathroom. (I use this example because it surprised me when a colleague I had invited to guest-lecture in my class informed me of the indignity of not being able to wipe her butt in my workplace bathroom because she couldn’t reach the toilet paper dispenser.) Another example is when I hosted a workshop in a venue that billed itself as accessible for people with disabilities, though it didn’t have a bathroom stall wide enough for all of our participants. I didn’t learn that until it was discovered by a fat person who wasn’t able to use the facilities. Structures were designed for people like me and I have been able to take that for granted.
Identifying systemic trauma can help to relieve the shame and self-blame of the victims of these systems and can also help those who benefit from the systems to become aware of their privilege and leverage it to advance social justice rather than their own self-interest.
Trauma isn’t isolated to an individual. It also blows through one generation and on into the next.
My dad could be a nice guy—generous (always) and kind (often). He was also an alcoholic with an explosive temper. A functional alcoholic, he was sober and productive during the day, with the martinis and meanness surfacing at night. I stayed out of his way in the evening and grew practiced in the art of stealth living, learning how to be in a room without anyone noticing my presence. My mom and sister absorbed the brunt of his rages. My mom tried to placate him and avoid his temper, but simple things, like clinking dishes while unloading the dishwasher, were enough to trigger an outburst. If he had had a bad day at work—as was often the case during my adolescence—she could do nothing to fend off his rage. My sister, on the other hand, pointedly provoked him. My brother must have been good at stealth living, too, because I don’t even remember where he was during these moments.
Trauma spreads between people. My dad had his own stories of a painful childhood, including having a distant mother and an absent father. He received little warmth or nurturing. I have compassion for why his mom may have shown so little warmth. She was trying hard to make it as a single parent. Ironically, the time she spent away from him was in effort to create a better life for him. In the absence of a nurturing mom, though, my father never developed emotional skills for coping with discomfort or anxiety or sadness. His rage ran on pure instinct. His reptilian brain leaped into action without progressing through the logical thought process of the cortex, which might have been able to suppress the minor irritation of hearing rattling dishes.
Sometimes, he’d apologize afterward, in his awkwardly ineffective way. “I told her to empty it before I came home,” he’d say, as if that justified his abusive tirade. He was as disappointed in his temper as we were. What he did not see was that they were signs of his unresolved trauma.
That was his legacy, and now it’s mine. Part of my trauma was feeling helpless to protect my mom and sister. I stayed “safe” behind my books, clinging to Tiggy, my stuffed tiger and confidante. The trauma made me vulnerable to “reptile brain” activity, too—leaving me, like him, with a short fuse.
I managed to avoid following my dad in taking my anger out on others, but unfortunately, I took it out on myself instead. Rather than rages, my vulnerabilities had me using substances—like food and drugs—to stave off negative feelings. I also learned to fear human connection and to be vigilant, suspicious, and mistrustful of bonding, always alert for signs of betrayal.
These are some of the legacies of trauma.
Tiggy was an important component for me surviving childhood, a point I’ll return to later. Having an outlet is one of many effective ways to help manage hard times.
So often in history we hear about a dominant culture perpetrating mass trauma in the form of colonialism, slavery, war, or genocide. What we hear less about is that the affected group, tribe, or nation passes on their physical and psychological symptoms to later generations, who inherit those pathologies.
The Cherokee Indian tribe’s experience provides a potent illustration. When the Europeans colonized Mexico, they brought germs that wiped out over half the Cherokee population. The Cherokees who were still alive were forced to leave their homes and to walk more than a thousand miles, to “Indian Territory” in what is now Oklahoma. More than four thousand people died on the way and were buried in unmarked graves along the “Trail of Tears.” Their children were kidnapped, sent to assimilation boarding camps, and forbidden to use their own languages and names or practice their religion or culture. They were assigned Anglo-American names, pressured to alter their clothes and haircuts, and forced to abandon their way of life because it was supposedly inferior to white people’s. Many were beaten and sexually abused.
Not surprisingly, the Cherokees now live with high levels of fear, grief, anger, and a persistent feeling of powerlessness. With that as legacy, is there any wonder why they experience such a high incidence of substance abuse and disease? The Cherokee Nation is typical of Native American* populations in rates of diabetes running 35 to 40 percent. Trauma, not just genes, drives that painful statistic (more on this in chapter 4), and trauma explains why mental health challenges and substance abuse run high among Native Americans and why they are the racial or ethnic group most likely to commit suicide. Health inequities are especially severe in the Dakotas, where Native Americans’ average life expectancy is twenty years less than that of white Americans.
Native Americans are still subject to racism and lack of opportunity, and that trauma is passed on from one generation to the next. This is a classic case of historical trauma, a term that links people together based on a group identity, like race. Historical trauma can be seen as a subset of intergenerational trauma, which, as we saw, is characterized by family transference of trauma through generations.
The transference of trauma manifests not just in how we treat one another; its effects are also physical. A common misperception says that the genes you get from your parents came from your grandparents and nothing your parents did or do can change them. Yet research in epigenetics shows something quite different. Epigenetics studies show trauma passes down through generations through more than just learned behaviors (the “nurture” part of the old “nature versus nurture” debate). Parents do indeed pass on their chromosomes, but the condition these chromosomes are in when a child receives them—and how they are then activated or suppressed—can be improved or diminished by events and experiences in the parents’ lives. And not just traumas—even mundane matters, like where you live, who you interact with, how you sleep and age can all eventually cause chemical modifications that will alter those genes over time. These modifications can be passed from parent to child.
Historical trauma gets triggered without our knowing. The legacy of slavery is in North Americans’ blood. Time and again it’s been shown that North Americans of all races and genders tend to go on higher alert when they see a Black person, even if they may not consciously consider Black people dangerous. This is what literary scholar and cultural historian Saidiya Hartman calls the “afterlife of slavery,”11 which is characterized by the continued presence of slavery’s racialized violence within modern society.
This is why police brutality and the state-sanctioned murder of Black people is so enduring and prevalent to our modern reality in the United States. If you think someone is dangerous—even if that perception is below the level of conscious thought—you’re going to be quicker on the trigger.
I remember watching a Black man pop a car door lock with a file and assuming he was breaking in. If he had white skin and wore a suit, I expect I would have guessed the truth, that he had locked his keys in his car. I’m glad a friend stopped me from calling the police. She reminded me that while police may make me feel safe, they probably have the opposite effect on the People of Color who predominated in the neighborhood.
First reactions like these, based on instinct, don’t express who I want to be, but they do reveal primal traits and anti-Black legacies at work. Education and intellectual awareness alone can’t purge racism from your system, because trauma doesn’t just live in our thinking brains. Our rational brain can’t entirely stop it from occurring, and it can’t talk our body out of it. That makes it deadly for Black people, as their mere existence becomes a setup for victimization in our racist culture.
Trauma has a dual nature, living inside of us individually and collectively. Individual healing and social justice are intertwined, because what oppresses us externally has also made us suffer internal trauma and its accompanying fallout. We cannot separate the paths when talking about individual healing and social justice work because our well-being depends on the interconnectedness of all communities. Likewise, we can’t truly see the collective picture without thinking about the individual impact.
To stop the cycle of trauma passing through generations, we need to change the conditions. We must be committed to active decolonization from systems of oppression. Consider Jewish survivors of genocide. When my family escaped pogroms in Poland by emigrating to the United States, they did much better economically and socially (more on that later), largely supported by opportunities provided only to white people. While some trauma was passed from my grandmother to my father, the trauma was lessened in my generation. (Anti-Semitism, of course, still abounds. “Better” doesn’t mean “problem solved.”)
That’s quite different from the African American experience. Many African Americans are descendants of those who were enslaved and have been harshly victimized since: stripped of resources; lacking access to education, employment, and housing; subject to discrimination, incarceration, violence, or death. The trauma persists because the ideology of white supremacy, used to justify slavery, persists. The damage to African Americans continued long after the abolition of slavery in 1865. Efforts to subordinate and economically exploit Black people have extended through sharecropping, Jim Crow laws, redlined Black ghettos, and mass incarceration.*
Long before many of us were born, Black scholars began writing, archiving, and creating work around the legacy of slavery, the intergenerational trauma from slavery, and the blueprints for building a world without those cages. In our modern age, scholars continue to shape and influence this work by viewing body liberation through the lens of anti-Blackness, striving to stop the cyclical machine of anti-Black death. Rachel Cargle, Tressie McMillan Cottom, Brienne Colston, Da’Shaun Harrison, Samantha Irby, Myles E. Johnson, Kiese Laymon, Ijeoma Oluo, Ilya Parker, Hunter Ashleigh Shackelford, Sabrina Strings, Sonya Renee Taylor, Melissa Toler, and thousands more are doing this work to deepen the possibility of a future without white supremacist imperialism and a world that affirms the abundance within us all.
One of the greatest casualties of trauma is our weakened ability to trust people and allow ourselves to be vulnerable. The trauma of social injustice requires us to face the world with our armor on and carry that through the day, no matter how heavy it is, because we do not feel safe in the world. Later on we’ll look more at shame and vulnerability, and the importance of connection, as well as tools for coping.
We can acknowledge and even honor the past, but we don’t have to stay stuck there. We don’t have to live our lives forever defined by damaging things that happened to us and a culture that invisibilizes or tries to confiscate our personhood.
I don’t like to talk about “recovery,” as the term implies coming back to something you were before. In that sense, you never recover—you are changed forever by your experiences—but your trauma can be transformed into strength. Neuroplasticity and trauma go hand in hand. Just as traumatic events can forge neural pathways, so can positive and constructive experiences help you cope and heal, establishing new neural pathways. Many people experience positive transformation after trauma, like a fresh appreciation for life, a newfound sense of personal strength, or greater empathy, so much so that psychologists coined the term “post-traumatic growth.” I am a better person because of—not in spite of—the trauma I’ve endured. Now, for example, when I tell that Barbizon Modeling School story, I no longer feel the pain. I can even laugh at the absurdity. When others laugh, too, it’s an avenue of connection. Not only do people see and empathize with me, but it also allows them to view their own traumatic histories in a more hopeful light.
If all we ever do is focus on the pain of oppression, we lose sight of our individual and collective agency. Broadening our lens to view not just the pain, but the stories of resistance and transformation, allows us to see that a very different future is possible—and that we can call it into being.
Healing starts by acknowledging trauma’s effects on our lives. Deep and enduring pain arises from the knowledge that your childhood and past experiences have damaged you in significant ways. It doesn’t have to stop us from growing and developing, having fulfilling relationships, find a career that we’re passionate about, and living a meaningful and satisfying life. To the contrary, feeling pain can be a good thing. It can remind us of the critical importance of creating love and connection in our lives and make us more empathetic to others, thereby deepening relationships.
To start, forgive yourself. Forgive yourself for survival behaviors you picked up to manage or endure your trauma. Forgive yourself for being who you needed to be. Show compassion for your own wounds. The traumatic stress reactions you experience—the behaviors and emotions you don’t like—are responses to surviving trauma. They are normal reactions to abnormal situations, and reflect your strength, your determination, and your will to self-preservation. You are a resourceful, resilient survivor.
Recognize your trauma and how it fuels the behaviors that disappoint you. Acknowledge that it’s not your fault. Your emotions (housed in the limbic system) are in charge of your body, causing the instinctive fight-or-flight response behind those behaviors. The trauma has hijacked your brain, blocking your prefrontal cortex (rational brain) from regulating your emotions and helping you make good choices. That prefrontal cortex also takes the lead on sensing what’s going on with other people and their feelings—empathy, in other words. So, if your trauma has impaired your empathy, it’s because it makes you distrust and disconnect from others.
Since trauma robs you of your sense of safety and trust, a crucial part of healing consists of learning who to trust and reestablishing safety in connection with others. In order to relax, you need to believe that you can rely on others, to know that no one will hurt you in a certain space or relationship, and to feel protected. But connection is elusive for traumatized people. We are cut off from the very thing that can help, and this alienation invariably leads to shame. We blame ourselves for our relationship problems, for the ways we self-soothe or avoid.
Shame surrounds trauma. The emotions you experience and the behaviors you’ve adopted—anxiety, depression, dissociation, reactivity, intrusive thoughts, avoidant behaviors, substance abuse—are all ways of coping with your pain, and yet you may feel shame for “choosing” them. And a hallmark of shame, what allows it to fester, is secrecy. This is why speaking your truth and connecting with others can be such an important part of healing. To stop the self-defeating loop you are stuck in, you need compassion and love—from yourself and others. Name your pain to friends so they can bolster you, find support groups, get professional help. Help yourself by letting others help you. You are not alone. Know, too, that overcoming shame is hard; in chapter 10 we will look at some tools to amp up your resiliency and help you break out of this shell.
Healing doesn’t mean that you escape your pain but rather that you expand your window of tolerance for emotion. Healing means that you’re not always focused on soothing your pain (by means of drugs or sex or gambling or whatever your pattern is), nor are you running away from yourself (by cozying up to the internet, for example). You’re not trying to please people just so they’ll like you. Instead, you are considering what you want, what you need, what you feel—not in a selfish way of ignoring others, but in a way that is true to you and consistent with your values. Ironically, accepting your discomfort is the best way to make it go away. It gets easier over time—and with community.
Remember, too, that trauma is lodged in your body. As a protective response to trauma, people often learn to turn off the parts of the brain that produce unpleasant feelings. Yet those exact brain areas are also instrumental in enabling the entire spectrum of feelings and sensations that mold the very core of our identity and our conception of our place in the world. This leads to the ultimate tragedy of trauma: we become disconnected from ourselves.
Trauma is rarely something we can think ourselves out of. Much of it has to do with unconscious parts of the brain that keep interpreting the world as being dangerous, frightening, and unsafe. When you tell a traumatized person “You’re not a bad person” or “It wasn’t your fault,” it’s common to be met with: “I know that, but I feel that it is.” Traumatized people know we “shouldn’t” feel that way, but we do. Our brains go on autopilot to try to manage the difficult feelings, fueling behaviors that may be maladaptive today.
Reconnecting to our bodies is a critical aspect of healing. Almost anything that can help you reconnect to your physicality is valuable—running, dancing, karate, to name just a few. A wide range of physically-oriented therapies, such as EMDR, neurofeedback, yoga, and somatic therapy, have shown well-documented success in helping us push beyond our cognitive limitations to heal trauma.
Trauma forces us to see that people are vulnerable to their environment, providing a conceptual framework for understanding how oppressive social and political conditions get inside us and cause personal suffering and dysfunction.
In a society organized around domination, it is inevitable that trauma will be pervasive, both because the systemic oppression itself is traumatizing and because the power differential that is an aspect of oppression supports individual acts of domination. Calling out structural injustice shifts the blame off individuals, similar to how a trauma-informed approach shifts the question from “what is wrong with you?” to “what happened to you?” This shift acknowledges and destigmatizes the challenges we face and empowers us to engage in personal and community healing.
Unresolved trauma doesn’t just harm individuals—and drive self-harm—but also drives a cycle wherein victims become perpetrators, harming and traumatizing others. Among those who have committed serious crime, the vast majority have also suffered trauma. Few death row inmates have not suffered lives that read like a case study of extreme abuse, and it is the rare juvenile incarcerated for rape or murder who has not endured a cruel childhood. Abusers are humans with stories, just like us. Absorbing our culture, we all become perpetrators—perhaps not as explicit abusers, but in the unconscious bias that lodges in our mind and bodies, fueling the microaggressions that slowly and cumulatively traumatize, a topic of considerable discussion later in the book. Understanding this helps us generate compassion for ourselves and others, even as our actions do harm, and instills us with the responsibility to unlearn the lies we have been taught.
Trauma lives in the body and sets our behaviors in motion, but we can heal, and even come out stronger. All trauma can disconnect us from our bodies, and the cultural body hierarchy can have the impact of disconnecting some of us even further, deepening our body shame and making us believe our bodies do not belong to us. It takes active work to reclaim your body—to stay with it, trust it, and care for it. But it can be done.
To begin, we must recognize that our traumas are not our fault, and that we are not alone in our woundedness. We are all suffering from the individual and collective traumas of injustice and finding our way in a world that doesn’t give equal access, opportunity, or respect.
What connects us to one another is our human vulnerability—our need for belonging, for feeling valued and connected to others—and the distress we feel without it. This realization of our shared humanity can move us to seek connection with empathetic and understanding others. Connection with others, in turn, can help us feel safe enough to wade into our pain and vulnerability, rather than trying to escape it through disconnection or other coping behaviors. Stay tuned for deeper discussion of connection and vulnerability in chapters of their own.
We can also cultivate our self-compassion and learn to give ourselves a break when we engage in behaviors that we’re not so proud of—like the ones described in the next chapter.
Healing from trauma helps us to claim our bodies as our own and experience what it means to live in them, themes also explored in future chapters. We can’t fully move our way out of trauma because oppression and other structures of domination are ongoing, but we can learn to treat bodies—our own and others—with the respect and caring they are due.
I wish for all of us safety and the opportunity to fully inhabit our bodies. I wish for a future where body sovereignty is a birthright.
*There is no consensus on the terminology most respectfully applied to people with ancestry indigenous to the Americas. Some people suggest that because the term Native American includes the word American, it describes people within the frame of their colonizers and should be avoided. Others appreciate that using the word American affirms that they are also Americans. The term American Indian is favored by some, although criticized by others for its misinformed origins, which date back to the 1490s, when Christopher Columbus and other Europeans referred to all of Asia as “India.” Assuming they had reached Asia, they referred to the inhabitants they encountered as “Indians.” I chose to use Native Americans as it appears to be the term most commonly accepted among Indigenous people, though I recognize that it is not uniformly accepted.
*Sharecropping refers to a system where a landlord allows a tenant to use the land in exchange for a share of the crop, which resulted in trapping many people who were formerly enslaved in a new system of economic exploitation. Jim Crow laws were laws that enforced racial segregation, denying Black people the right to vote, hold jobs, get an education, or other opportunities. Redlining refers to the denial of services to residents of specific, often racially associated, neighborhoods—for example, banks denying mortgages, mostly to People of Color in urban areas, preventing them from buying a home in certain neighborhoods.