Trauma and Culture

Trauma and Culture

The purpose of this article is to highlight key considerations when working with psychological trauma from a cultural perspective.  Culture is a broad concept and can be difficult to pin down.  Often culture is understood as ethnicity or race, however it can involve many other facets of identity (or social locations) including and not limited to, religion, disability, and age (Brown, 2008).  Broadly, culture is considered as a system of values, norms, behaviors, language and history that is passed from on generation to the next (Carter, 2007).  When it comes to psychological trauma, culture plays a significant role in transmitting, buffering, and healing trauma (Danieli, 2007).  There is inherently an intersection between culture and trauma because culture shapes thoughts and behaviors, just as it is with trauma (Drozdek, 2012).  In reviewing the literature, there are some key points to take into consideration when working from a cultural and trauma-informed perspective.

1. The biopsychological responses to stressors, being the “fight-flight-freeze” responses are universal (Marsella & Wilson, 2008).
2. Culture acts as a template for interpreting and responding to traumatic stressors (Marsella & Wilson, 2008).
3. Culture shapes individual, family, and communal coping in response to trauma (Drozdek, 2012).
4. There are culturally-specific strategies (i.e., rituals, treatments, ceremonies) that are embedded within some cultures that have been developed to alleviate suffering or trauma (Wilson, 2007).
5. Individual reactions to trauma is a combination of universal aspects of trauma (i.e., the fight-flight-freeze response), with culture-bound reactions, and the unique life history of an individual (Drozdek, 2012).
6. Concepts such as Post-Traumatic Stress Disorder is based on a postmodern Western worldview and imposing these concepts can be a form of scientific colonialism (Drozdek, 2012).

How does this translate into practice for clinicians?

As a model, CCI assesses the biopsychological responses to trauma, that is the universal aspects of trauma, while acknowledging the unique ways in which trauma manifests given an individual’s cultural backdrop. Taking a cultural lens recognizes that experiences are idiographic (unique and contextual) even if there are commonalities in the traumatic symptoms.  CCI maps out biopsychological trauma symptoms using the Functional Developmental Assessment (FDA), while the narrative summary integrated within the FDA offers a way for caregivers and/or care teams to understand how unique behaviors can be a culturally-based manifestation of psychological trauma.

When working from a cultural perspective it is valuable to be aware of how one’s own cultural bias, which also includes one’s therapeutic culture, can shape how problems are interpreted and how interventions are developed.  The cultural perspective that a clinician comes from can afford certain privileges that may not necessarily be the case for some clients (Brown, 2008).  It is therefore valuable for clinicians ask themselves how their cultural biases contribute to the help they are providing and whether it is indeed helpful or unhelpful for the client.  A client’s culture may already have culturally embedded strategies for healing psychological suffering of trauma.  In these circumstances, there can be a synergy between trauma-based interventions and accessing the inherently valuable strategies that are found within a client’s culture.  Utilizing a collaborative approach ensure that interventions that are developed and implemented in a culturally-respectful manner.  Where it can be problematic is when trauma interventions are imposed upon a client or done in a non-collaborative manner.  This is where not being aware of one’s own cultural bias can result in strategies that can be unhelpful or undermining.

The intersection between culture and trauma is a fascinating topic and this article is merely a teaser that touches on some of its complexities.  If you are interested in learning more about culture and trauma I highly recommend reviewing some of the resources below.

Resources

Brown, L. S. (2008). Cultural competence in trauma therapy: beyond the flashback. Washington, DC: American Psychological Association.

The National Child Traumatic Stress Network. (2009). NCCTS leadership: Culture and trauma. Retrieved from http://www.nctsnet.org/nctsn_assets/pdfs/Culture_Trauma_InfoBrief_FINAL.pdf

Wilson, P. & Tang, P. (2007). Cross-cultural assessment of psychological trauma and PTSD. New York, NY: Springer.

References

Brown, L. S. (2008). Cultural competence in trauma therapy: beyond the flashback. Washington, DC: American Psychological Association.

Drozdek, B. (2012). Culture and trauma. In C. Figley (Ed.), Encyclopedia of trauma: An interdisciplinary guide (pp. 184–186). Thousand Oaks: SAGE Publications.

Carter, R. T. (2007). Racism and psychological and emotional injury: Recognizing and assessing Race-Based Traumatic Stress. The Counseling Psychologist, 35(1), 13–105. http://doi.org/10.1177/0011000006292033

Danieli, Y. (2007). Assessing trauma across cultures from a multigenerational perspective. In P. J. P. Wilson & P. C. S. Tang (Eds.), Cross-cultural assessment of psychological trauma and PTSD (pp. 65–89). New York, NY: Springer-Verlag.

Marsella, A. & Wilson, J. (2008). Culture and trauma. In G. Reyes, J. D. Elhai, and J. D. Ford (Eds.), The encyclopedia of psychological trauma (pp. 190-194). Hoboken, NJ: John Wiley & Sons.