The Journal of Trauma and Dissociation recently published an article presenting a new Integrated Historical Trauma and Post-Traumatic Growth (HT-PTG) Framework. This framework aims at addressing the harms of ongoing systemic violence and discrimination and the strengths of racial and ethnic groups who experience said violence. The article detailing the framework was authored by Anna Ortega-Williams and a team of social work scholars.
“The strength of the HT-PTG framework is its focus on impacts of sociostructural-historical targeting and persistent inequities, without sacrificing engaging personal and mass group-level growth,” the authors write. “It also supports the cultural interpretation of collective violence through disrupting the binary of personal or mass group-level approaches to wellness; the divide is artificial in racial and ethnic groups that share an ethos of collectivity and resistance to oppression.”
In recent years and with the diversification of the mental health field, there has been a proliferation of frameworks developed to tackle socio-cultural, economic, and political factors that influence suffering. For example, in an interview with MIA, the psychotherapist Lillian Comas-Díaz has shared how she addresses racial trauma by using anti-colonial and sociohistorical lenses in research and practice.
Other popularized frameworks have been those of Historical Trauma (HT) and Post-Traumatic Growth (PTG). Noticing how traumas lived by oppressed and colonized groups are experienced continually, and across generational lines, Lakota scholar Brave Heart conceptualized HT. HT refers to the collective and cumulative trauma experienced by groups of people who have lived through intentional genocide, exploitation, and cultural disruptions that have led to soul wounds, unresolved grief, and the compounded loss of its people. Professionals who recognize the impact of violent trauma have also identified the growth and transformation that occurs after traumatic events, also known as PTG.
Engaging in a critical dialogue with both concepts of HT and PTG, the authors identified the strengths and weaknesses of each framework. Then, they combined them to develop the HT-PTG framework. The HT-PTG framework seeks to address the historical and contemporary forms of oppression that affect oppressed racial and ethnic groups’ wellbeing while also fostering their growth, building on their strengths, and supporting transformational actions.
One of the key insights offered by HT that is missing from other trauma-informed frameworks is that trauma is experienced collectively and is accumulated intergenerationally for oppressed and colonized groups. Moreover, this trauma is not simply psychological as it is transmitted biologically (e.g., physiology and genetics), environmentally, and socially (e.g., political systems).
As a social determinant of health, this framework positions dominant groups’ historical and recurring disruption and violence against targeted groups’ lives and culture as partially responsible for many health disparities and outcomes. Some of the impacts of HT are mediated by group actions such as “reclaiming cultural tools, values, traditions, and priorities to heal and stabilized wellness.” HT shares many features of the multigenerational, transgenerational, and collective trauma frameworks but is distinguished for being rooted in the cultural survival of groups since the colonization of these groups continues into the present.
HT has been criticized for some limitations. These limitations include a focus on historical rather than current, ongoing forms of the suffering of contemporary structural violence, a lack of specificity of the kind of experiences that have occurred intergenerationally by different groups, and how these impact health outcomes. Others are concerned that HT’s focus on negative outcomes may be pathologizing “rather than contextualizing.”
Moreover, while HT accounts for factors that ameliorate the effects of historical trauma, it hasn’t provided detailed descriptions of how these communities have survived and thrived despite their vicissitudes and has failed to conceptualize strategies on how to change systemic forms of oppression.
To this last point, the PTG framework could address this limitation as it focuses on the cognitive and personality changes that occur after experiencing traumatic events that can lead to healing. For PTG theorists, individual functioning depends on five domains: relating to others, new possibilities, personal strength, spiritual change, and appreciation for life. In addition, PTG theory suggests that the positive changes of trauma survivors depend on changes in beliefs about oneself, others, and society.
Additionally, to develop PTG, people must engage in deliberative rumination, create redemptive narratives, and discover meaning in life. Although this framework was originally designed to understand individual levels of functioning, it has been applied more recently to the growth and flourishing of communities and societies. Strong leaders and the continuous sharing of the stories and histories of trauma are necessary processes of change and transformation.
According to the authors, seven categories of transformative actions associated with PTG were identified: “transformation through education and prevention; mutual self-help; rescuing; witnessing and seeking justice; political action; humor; and artistic creation.”
Like HT, the PTG framework also has its limitations. While PTG has been used to understand collective growth after societal and communal trauma, it has a dominant emphasis on cognitive and emotional forms of coping that are difficult to maintain without action or change. Research has demonstrated that PTSD symptoms are more likely to decrease when engaging in collective action. PTG has also focused on single traumatic events rather than continuous, complex trauma experienced by oppressed racial and ethnic groups.
The Historical Trauma and Post-Traumatic Growth Framework
Because of the complementary strengths and weaknesses of HT and PTG, Ortega-Williams and colleagues developed an integrated framework, or the Historical Trauma-Post-Traumatic Growth Framework (HTPTG). This framework aims to attend to personal and group-level healing and growth in the contexts of persistent racialized violence.
HTPTG understands that there is an artificial distinction between the individual and the collective. Personal and group suffering and healing are understood as dynamically interconnected, always understood as socio-politically and culturally contextual, and stretching historically and over an individual’s lifespan.
The authors combined HT’s collective focus and PTG’s mechanisms of growth and healing to include: “(a) collective strength, (b) collective spiritual change, (c) relating to ancestors and culture, (d) new possibilities for collective destiny, and (e) appreciation for our lives.”
Collective strength refers to the individual and group’s power that depends on social cohesion and mutual aid. This allows the group to survive, flourish, and resist oppression and domination. Collective spiritual change refers to the communal cultural practices used in the healing process (e.g., ceremonies, rituals, songs) that often provide purpose and hope to communities.
New possibilities and collective destiny refer to how people and their group can challenge the narratives and material, social conditions that are imposed upon them by their oppressors and to which they are expected to adapt and assimilate. This includes the creation of counternarratives and becoming active in the process of decolonization through protesting, organizing, and working together to build a different future.
Relating to Our Ancestors and Culture refers to how traditional and emerging cultural practices connect with ancestors, family history, and culture. This creates sociohistorical and group-level cohesion that facilitates the identification of the source of collective wounds and the actions that must be taken to act and to heal.
Finally, appreciation for our lives is a modification of PTG’s appreciation for life, which focused on individual appreciation. Since groups have been collectively and systematically devalued, it is important to appreciate not just individual life but the life of the group and understand that individual and group level appreciation has reciprocal effects. Additionally, this appreciation leads to the collective desire to preserve and fight for their lives, moving them towards action. The personal and collective dynamic interplay of these mechanisms aims to develop PTG in groups who experience HT through healing, growth, creativity, and transformation.
The HTPTG framework has implications for research and clinical practice. Firstly, it shifts the focus from individual pathology and seeks to change social disorders that produce suffering. Second, it integrates the individual into the collective and erases the line between self and others in the processes of hurting, healing, and transforming. In clinical practice, therapists can use this approach to address their patients’ connection, relationship, and identification (or lack thereof) with their group, assess their experiences of personal, familial, and historical trauma, and integrate personal healing with deeper collective forms of healing.
Researchers, adopting this framework, can adopt the group’s worldview rather than imposing their own when designing research and use methods that take into account their lived experiences.
This novel framework can aid in the development of new forms of healing beyond those of traditional clinical psychology and psychiatry, opening up new ways of understanding that challenge traditional positivist science. This framework may better serve in the healing of the wounds of individuals and groups who have been systemically oppressed and facilitate the process of larger social change.
Ortega-Williams, A., Beltrán, A., Schultz, K., Ru-Glo Henderson, Z., Colón, L. & Teyra, C. (2021): An Integrated Historical Trauma and Posttraumatic Growth Framework: a Cross-Cultural Exploration. Journal of Trauma & Dissociation. DOI: 10.1080/15299732.2020.1869106 (Link)