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    Changing the Conversation

    Calling for a Public Health Approach to Trauma Awareness

    Why a Public Health Approach? There are many reasons to learn about the impact of trauma and untreated trauma on individuals, families, and communities. Trauma and untreated trauma are common in all socioeconomic groups and are often misunderstood. For example, people experiencing opioid addiction, other substance use conditions, mental illness, and homelessness may shy away from treatment because of stigma in communities and treatment settings.

    The symptoms of trauma and its under-treatment are evident more and more everyday. Early childhood and adult trauma are implicated in the onset of addictions and the comorbidity of post-traumatic stress disorders and mood-related psychopathology.

    Hidden Hurt: When Domestic Violence Isn't Physical

    Many forms of domestic violence have obvious physical manifestations. Emotional abuse is subtle and often goes unseen. The victim may not even recognize that they are being abused. Emotional abuse does not leave black eyes or broken bones, but it seriously damages self-esteem and leaves scars on your soul. It took me almost ten years to realize I was in this kind of abusive relationship, and even then, I was still taking responsibility for my abuser’s actions. It took another five years before I was willing to call it domestic violence.

    My closest friends have often asked, “How could you, a strong independent woman, let that happen?” I don’t have an answer. It happened so gradually that I didn’t recognize it as abuse. To outsiders looking in, we had the perfect life. Slowly, however, I became isolated from my friends. I had little self-esteem and felt worthless. The only person I thought I could depend on was the person who was causing me to feel this way.

    Gaslighting: A Story of Trauma and Resiliency

    Gaslighting typically happens very gradually. In the beginning, the gaslighter’s actions seem harmless, if a little bizarre. Over time, however, abusive behaviors escalate. Subtly dismissive language and loving platitudes give way to mockery and blaming. “I didn’t say anything. You must be hearing things," gives way to “You never take responsibility for your actions,” to “Clearly, I can’t trust your account of things.” You start to doubt your own memories, experiences, and feelings. Friendships frost over. You become quiet, but your mind never stops buzzing.

    Gaslighting is an abusive tactic defined by the “systematic attempt by one person to erode another's reality by telling them that what they are experiencing isn't so, and the gradual giving up on the part of the other person.

    ACEs on the Brain: Learning about My Trauma

    After learning about the Adverse Childhood Experiences (ACE) Study while in graduate school, I experienced an epiphany. As a public health student, not only was it a revelation to learn about such a revolutionary study in the field of trauma, but also a personal moment of clarity. Finally, for the first time in my life, I felt as if all the previous adverse experiences I had endured were universal, normalized, categorized, understood—and I wasn’t alone.

    Understanding Trauma through the Eyes of a Watertown Resident

    This week is the anniversary of the Boston Marathon bombing and the gunfight and manhunt in Watertown that followed a few days later. When I remember this time 3 year ago, I think of the people at the finish line—those who were lost, others who survived the traumas, and the people who risked their lives to help strangers—and most importantly the resiliency shown by so many.

    As a Watertown resident, I also think of my experience being on “lock down” in my home. I live close enough to the location of the gunfight that my husband heard the sounds as they occurred. I was awakened by helicopters flying low over my house in the middle of the night.

    Stories of Youth Homelessness & Resiliency: M

     When I go to a shelter, I don’t get any sleep. Sometimes it's because people wake up at 4:30 am and scream at the top of their lungs. Sometimes it’s because people are up watching TV and walking around. 

    But mostly, it's because the shelter is not a safe place. The first time I went to a shelter, I was 18 years old. I thought my life was over, and that I would have no social life. As a gay male, I was immediately harassed. I went to sleep every night just wishing that it would be over and wondering why I didn’t have my own place or at least some privacy.

    Stories of Youth Homelessness & Resiliency: Max


    That’s the sign I used to fly when I was homeless.

    It served a double meaning for me. One meaning was to get the attention of anyone who just walked past without even looking at me or acknowledging me – like I was a piece of trash. You could see people thinking that every homeless person is the same, thinking that we all have the same story, that we all wind up on the street for the same reason. They couldn’t be more wrong.

    Stories of Youth Homelessness & Resiliency: Kay

    In January 2014, I was 19 and in a hospital. When the staff decided I was ready to leave, I met with a social worker who gave me the phone numbers of shelters. She did her best.

    I walked out of the hospital and onto the street. Soon after I left, I went to a pay phone and called some of the numbers. I was hoping someone would help me figure out where I could sleep that night. But, no one answered the phone. I stood at the pay phone feeling embarrassed and hopeless. I’m not the type to ask for money or other necessities. I wandered around Cambridge, hoping that something would happen.

    Stories of Youth Homelessness & Resiliency: Lauren

    During the holiday season last year, my son and I were staying in a small church-run shelter. From 8:30 am to 5 pm, I had to leave to sit in an old church basement adjacent to the shelter’s office

    It was a big room with some tables and chairs scattered around and a corner with some kids toys and a couch. The room was cold and dusty, and there was mouse poop behind the radiators. It smelled the way you would imagine an old church basement would smell. My son was just learning to walk and would often crawl across the floor, leaving his hands and knees dirty. 

    Honoring Diversity in Our Ranks: Language Use

    The choice of words we use to identify people with experiences of mental illness, trauma, substance use, and homelessness frames our thinking and guides our actions. Our language reflects how we view other people and honor their diversity. Those served in mental health or substance use services and those who are homeless represent a heterogeneous group. The use of non-discriminating and non-stigmatizing language respects the unique strengths of people using services as well as their diversity of choices, preferences, and rights (Learn more about the importance of language in human service settings.)

    The commitment to “getting it right” and arriving at a consensus on language that is accurate, non-stigmatizing, and unifying is a heartfelt goal of providers and many people participating in programs. Sometimes vigorous discussions erupt and can become contentious leading to conflicts that divide rather than unify. These controversies can lead individuals, even those with good intentions, to get so angry that they use language that results in opposition to others and start cycles of the blame game. Finding the right language is important so that we avoid unnecessary divisions and strife. We have more in common than our differences. 

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