Changing the Conversation

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.

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 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.”

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.