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Restorative Design Conference | October 2020
Trauma-Informed Design
Panel with Rachael Dietkus, Sarah Fathallah, and Sara Cantor Aye

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What is
TRAUMA?

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“Trauma is a spontaneous protective mechanism used
by the body to stop or thwart further (or future)
damage. Trauma is not a flaw or a weakness.
It is a highly effective tool of safety and survival.”
- Resmaa Menakem, LICSW, SEP

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“Trauma is what happens inside of you as a result of a
traumatic event. It is a loss of connection to oneself
and to the present moment. In my work, trauma is just
always there in the background.”
- Dr. Gabor Maté

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There are several definitions of trauma.

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One definition
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According to the DSM*, trauma is defined as...
“exposure to death or threatened death, serious injury or threatened
injury, or sexual violence or threatened sexual violence by either:
(a) direct exposure,
(b) witnessing (in person),
(c) indirectly, by learning that a close relative or friend was exposed to
trauma (if the trauma was death, it must have been violent or
accidental),
(d) repeated or extreme indirect exposure to aversive details of the
event, usually in the course of professional duties.”
*Diagnostic and Statistical Manual of Mental Disorders.

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According to SAMHSA*, individual trauma is defined as...
“resulting from an event, series of events, or set of circumstances that is
experienced by an individual as:
1) physically or emotionally harmful or life threatening and
2) has lasting adverse effects on the individual’s functioning and
mental, physical, social, emotional, and/or spiritual well-being.”
*Substance Abuse & Mental Health Services Administration, branch of the U.S. Department of Health & Human Services.
Another definition

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Acute trauma
single incident
Chronic trauma
repeated and prolonged
Complex trauma
varied and multiple traumatic events
Relational trauma
consistent disruption of a child’s sense of being safe and loved within a family system
Collective trauma
affects social groups long subjected to interpersonal violence, structural violence, and historical harms
Racialized trauma
effects of racism on one’s mental & physical health
And several other forms and related terms:
developmental trauma, secondary/vicarious trauma, traumatic stress, grief, PTSD, Complex-PTSD, re-traumatization, etc.
Additional types of trauma

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“There are pitfalls in the singular application of
Western categories in diagnostic psychiatric disorders.”
- Maurice Eisenbruch, clinical psychiatrist in Australia

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Historical trauma
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Also known as intergenerational trauma, and defined as...
The cumulative emotional and psychological wounding over the lifespan
and across generations, emanating from massive group trauma.
Observed among Lakota and other Native populations, Jewish Holocaust
survivors and descendants, African American slave descendants,
descendants of Mexican and Latin American immigrants, and Japanese
American internment camp survivors and descendants.
Maria Yellow Horse Brave Heart’s definition of Historical Trauma.

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White supremacy as trauma
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Our bodies have a form of knowledge that is different from our cognitive brains.
This knowledge is typically experienced as a felt sense of constriction or
expansion, pain or ease, energy or numbness. Often this knowledge is stored in
our bodies as wordless stories about what is safe and what is dangerous.
White supremacy–and all the claims, accusations, excuses, and dodges around it–
are a trauma response:
This response lives not inside psyches, but deeply within bodies. The attitudes, convictions, and
beliefs of white-body supremacy are reflexive cognitive side effects, like the belief that a
claustrophobe that the walls are closing in. These ideas have been reinforced through
institutions as practices, procedures, and standards.
Resmaa Menakem explaining white supremacy as a trauma response and the trauma of white-body supremacy.

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“Trauma decontextualized in a person looks like
personality. Trauma decontextualized in a family looks
like family traits. Trauma in a people looks like culture.”
- Resmaa Menakem, LICSW, SEP

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What triggers past trauma?

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Trauma fundamentally alters how the brain processes what’s going on.
Memory is encoded as intense sensory fragments, which then form the
basis of subsequent flashbacks. This also means trouble remembering
the experience as a sequential, fully contextualized experience.
“When you ask somebody who’s been traumatized to recall and
communicate their trauma, they have very accurate information if you ask
them about those sensory fragments. But if questions are about sequencing
and context, you run the risk of getting information that may be inaccurate.”
David Lisak, Neurobiology of Trauma.
Trauma and the nervous system

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Trauma and the nervous system
After a traumatic event, one’s central nervous system reacts poorly to
subsequent experiences of stress, especially when being triggered.
Survivors either have:
• Intensified anxiety in reaction to stress (including acts of aggression
against the self or others), or
• Social and emotional withdrawal.
Survivors are often unable to modulate their affect.
Rick Nizzardini, “Exploring Trauma Histories in the Clinical Setting” lecture.

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Common triggers
• Unpredictability
• Sudden changes or transitions
• Sensory overload
• Feeling vulnerable
• Rejection
• Loneliness or isolation
• Confrontation
• Loss of control
• Feeling disrespected
• Intimacy
• Praise or positive attention
Stephanie (Witt) Guinosso, ETR internal presentation.

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How to create
SAFETY?

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Safety in the self
Safety in the environment
Safety in the clinical frame
Rick Nizzardini, “Overview of Trauma-Informed Assessment and Intervention” course.

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Safety in the self
Safety in the environment
Safety in the clinical frame
Safety in the facilitation relationship

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Safety in the self

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2323YLabs, “How to explore taboo topics with young people during design research.”

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Safety in the environment

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Safety in the facilitation relationship

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But, SAFETY is
only one piece of
the puzzle.

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Trauma-informed systems
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1. Understanding trauma and stress
2. Safety and stability
3. Cultural humility and equity
4. Compassion and dependability
5. Collaboration and empowerment
6. Resilience and recovery
San Francisco Department of Public Health’s Trauma Informed Systems (TIS).

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Trauma-informed systems
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1. Understanding trauma and stress
2. Safety and stability
3. Cultural humility and equity
4. Compassion and dependability
5. Collaboration and empowerment
6. Resilience and recovery
San Francisco Department of Public Health’s Trauma Informed Systems (TIS).