From Psychiatry Is Driving Me Mad: “Trauma-informed care is a popular term in mental health services these days. Despite its popularity, it’s very difficult to pin down exactly what mental health professionals think the term means and what genuine trauma-informed care looks like in practice. I have lots of thoughts on the co-option of the term; its use as a smokescreen for covert personality disorder pathways; and the vague, virtue-signalling manner it is announced as being in use by mental health Trusts. Rather than discuss those topics in this particular blog, I thought I would instead share my personal experience of ‘trauma-informed care’, and how deeply traumatising it was for me.
. . . Slapping labels on people, over-medicating, enacting restrictive practices, ignoring trauma… these all have the ability to dehumanise, to obliterate the individual beneath, to erase our personhood, our stories, our experiences. But doing the exact opposite – blanket removing diagnoses, refusing medication, withholding care, and seeing nothing but trauma – is not the panacea. Trauma-informed care isn’t as simple as traveling in the opposite direction of old practices. It is not just changing the question from ‘what is wrong with you’ to ‘what happened to you’ while keeping the same clinical structure. Trauma-informed care should be about pulling down the old structure and starting afresh, with the individual sat in front of you at the centre. Seeing them, really seeing them, as an individual. It is not one way of working. It should be dynamic, constantly evolving and shifting around each person, acknowledging that we are all individuals who have different needs, and not only that but those needs also continuously change. Trauma-informed care should not be static. Mirroring our individuality, it should look different for each person.
My version of trauma-informed care involves being able to have a diagnosis [PTSD], so that I can maintain confidentiality and dignity when I share it with organisations like the DWP and my university. My version of trauma-informed care means being able to access medication and hospitalisation when I need it, without feeling either coerced or dismissed. It involves being completely and equally involved in every aspect of my care – no secret meetings, formulations, or decisions without me. It means being in control of my information. Someone else’s version of trauma-informed care might include not feeling pathologised by a clinical diagnosis, but only working with a formulation. It might include never wanting to be in hospital and never wanting to use medication. It might mean wanting to work on practical issues without being sent to therapy, and not wanting to be involved in meetings.
In my mind, associating trauma-informed care with any one method of practicing automatically disqualifies it from being trauma-informed, because it forgets to centre the one thing which is important: the person being cared for.
I experienced years of intense ‘trauma-informed care’ which dictated to me my wants and needs, rewrote my life experiences, destroyed my sense of self, erased my personhood, violated my boundaries, replicated my childhood abuse, and ultimately (and ironically) left me more traumatised than before. It all could have been avoided if someone had just listened to me, and seen the person behind the trauma.”
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