The Trouble with Lived Experience: When Peer Support Compounds Trauma by Denying Abuse

A few years ago, before I became a therapist, I entered therapy for the first time. I had never taken psychiatric medication, never been diagnosed, and had never seen myself through a clinical lens. Although I had experienced a difficult and abusive childhood in Somalia, I came to understand that in my culture, trauma and childhood are not spoken about in the same psychological terms used in the West. Through lived experience and years of making better decisions, I began to make sense of what had happened to me. I did not see it as a mental health disorder, but rather as something I had survived and carried.

By the time I decided to train as a therapist, I was in a more stable and grounded place, and I wanted to experience therapy myself. I did not believe I was mentally unwell, but I wanted to better understand the therapeutic process, both personally and professionally.

One of the ways I had navigated trauma throughout my life, long before therapy, was through the expressive range of my mother tongue. In my first language, emotions like shame, hate, and envy are spoken directly and metaphorically. These feelings are not pathologized but voiced aloud in ways that are communal and symbolic. Where Western psychology often sees such emotions as internal wounds or traits of the self, my cultural language allows for projection and dialogue, making the emotional world a shared one.

In addition to this, I had the immense support of siblings and friends throughout the years. These relationships helped me reflect and understand myself more fully as I adapted to life in a new country.

Over time, I became conscious of how deeply my nervous system had been shaped not only by trauma and abuse but also by culture. These layers were often invisible or misunderstood in clinical settings. Because of these differences—and the way my embodied experience consistently diverged from clinical expectations—I have come to identify as neurodivergent. This identification did not come from diagnosis or disorder, but from recognizing that the system was not built to understand the way I think, feel, or process experience. It became a way for me to reclaim my way of being as valid, rather than as something needing to be corrected.

That cultural misreading, and the systemic pressure to conform to Western psychological language, would later reveal to me a subtler but very real form of systemic abuse, which I explore further below.

My first therapist was a psychiatrist who advertised herself as someone who worked with women with traumatic childhoods. I reached out, believing she might offer support that resonated with my experiences. During the intake, she asked about my life. I had no health issues, was in a stable marriage, had no children, and was in the midst of a career change after a recent job loss. I shared openly that my childhood had involved serious harm. Without much further inquiry, she told me I had PTSD.

I was surprised. I had never considered myself to have PTSD. In fact, I asked her, “Wouldn’t I know if I had that?” She replied that while my life looked good on the outside, I was carrying unacknowledged trauma underneath. After researching the diagnosis, I returned to therapy and asked if she might consider complex trauma instead. She firmly disagreed, explaining that complex PTSD was not recognized in the DSM and reiterated that my diagnosis was PTSD. The conversation was over. Her words were final. Her stance was immovable. I quickly realized that my own understanding, and even my language, had no place in the therapeutic room.

What followed was not healing. It was a quiet erasure. I was not explicitly forbidden from naming what happened to me as abuse, but I was expected to speak in the language of trauma. The expectation was clear. I should reframe, reinterpret, and empathize. The physical and sexual abuse I had survived, actions that would be considered morally and legally wrong in most cultures, were treated as internalized wounds to be processed. There was no room for moral clarity. No space for naming, witnessing, or telling the truth. That denial of language, of clarity, and of the right to name my own experience became its own form of harm.

That experience left a lasting impression. It showed me how therapy, when forced into rigid frameworks, can censor and silence the very people it claims to support. It can flatten the truth, reduce abuse to trauma, and treat resistance as pathology. It helped me understand how institutional systems, even when well-meaning, can enact a subtler form of systemic abuse. This is the kind that calls for healing but denies recognition.

When my clients speak, I listen differently. I do not assume that pain always needs reinterpretation. Some things are not misunderstandings. Some things are not trauma. Some things are abuse, and they deserve to be named, witnessed, and held as truth.

That experience, of being told what I was allowed to feel and how I was allowed to describe it, is what moved me to write this piece.

In recent years, mental health systems have increasingly embraced the language of lived experience and peer support. The idea sounds promising: that those who have been through distress, crisis, or marginalization can offer support, insight, and advocacy from the ground up. But something unsettling has happened in this process. Peer support has often become another extension of the system it was meant to challenge. Instead of centering embodied knowledge, it is frequently asked to conform to institutional expectations, clinical language, and flattened narratives. In doing so, it collapses vital distinctions, especially between trauma and abuse.

The collapse begins here: not everything painful is abuse, and not everything disorienting or wounding is trauma. These are different experiences, and they require different forms of support, accountability, and healing.

Trauma, as defined by Judith Herman in Trauma and Recovery, is a subjective experience. It overwhelms the nervous system, fragments the sense of self, and disrupts meaning. But, crucially, trauma can be re-integrated over time through supportive, boundaried, therapeutic relationships that allow for reflection, safety, and reframing. In many cases, what is initially felt as trauma may shift with perspective. The parent who felt neglectful may be understood as emotionally limited. The internal chaos may gradually soften through meaning-making and nervous system repair. The hallmark of trauma is that healing often comes from within, with the right conditions, including the freedom to make new meaning.

Abuse, however, is not about how it felt. It is about what happened. Abuse is a breach of boundaries, a violation of power, a morally wrong act. Whether personal or institutional, abuse is objective. It does not ask to be reframed. It demands to be witnessed. It requires truth, recognition, and justice, not reinterpretation. A person who was sexually assaulted or financially exploited does not need perspective-taking. They need their reality named, respected, and repaired. This is not therapeutic nuance. It is moral clarity.

Judith Herman’s more recent work, Truth and Repair, extends her framework. While her early writing focused on trauma and personal abuse, she later emphasized how healing is incomplete without public recognition. Yet even then, the full separation between systemic abuse and personal abuse remained blurry.

I want to go further. Systemic abuse is not just a broader form of personal harm. It blends trauma and abuse in a way that intentionally obscures reality. It gaslights. It blurs categories. It calls power imbalance a miscommunication. It redefines a survivor’s moral clarity as overreaction. In this way, institutional systems, including medical, psychiatric, and legal systems, often compound trauma by denying abuse. They confuse integration with silence and recovery with compliance.

This brings us to peer support, and why its promise has often become muted.

Many lived experience practitioners have endured both trauma and abuse, not just personally but also systematically. Yet when they enter the professional world, they are often encouraged to speak only in subjective terms. They are asked to process, not protest. To integrate, not indict.

The lived experience that challenges the system, the person who says, “I was traumatized and abused, and the system enabled it,” becomes inconvenient. Their embodied knowledge of harm, including moral injury, is pushed aside for professionalized storytelling. Safe trauma becomes the currency. Abuse, especially institutional abuse, is quietly erased.

This creates a false binary. The system elevates academic knowledge, which is abstracted, standardized, and disembodied, and devalues embodied knowledge that refuses to flatten or forget. The peer worker who remembers clearly and still holds outrage becomes too raw, too activated, or not integrated enough.

But in reality, this clarity is not a clinical risk. It is a form of authority.

To restore integrity to lived experience work, we must begin by reclaiming the distinctions:

• Trauma is subjective. It can shift with support, insight, and reframing. Its healing lies in meaning-making.
• Personal abuse is objective. It involves wrongdoing, moral breach, and requires truth-telling and repair.
• Systemic abuse blends the two. It distorts trauma to hide abuse and uses institutional power to deny both.

Each requires a different response. Trauma needs therapeutic holding. Personal abuse needs recognition and justice. Systemic abuse needs structural accountability, not just peer support that soothes, but social movements that demand.

The core question remains: Who gets to define reality? When peer workers speak from lived experience but are told that their experiences are merely subjective, they are being repositioned in the same hierarchy that harmed them. Systems continue to define what counts, not only as trauma but as truth.

We must flip that. Authority does not only belong to those with degrees or diagnostic frameworks. It belongs to those whose bodies remember, whose truths are inconvenient, and whose clarity is not ready to be softened. Lived experience should not mean scripted testimony. It should mean epistemic freedom, the freedom to define what happened, how it felt, and what healing requires.

And sometimes, healing does not begin with reframing. It begins with witnessing.