by Marcos J. Martinez, Ph.D., MSW, and Elisa Kawam, MSW, Ph.D.
Historical Trauma
To be effective in the work that we do as social workers at all levels, it is important to understand ecological and social context. One such context in particular, the historical realm, can provide further depth in appreciating antecedents to social and behavioral problems that have an impact on our communities and clients. Our previous article on trauma-informed care highlighted the fact that social workers often work with individuals who may have complex histories of abuse and violence alongside their biopsychosocialspiritual needs (Kawam & Martinez, 2016). Individual trauma histories are encapsulated within a larger trauma narrative; over time, this narrative may accumulate into a multigenerational shared account of events that have harmful effects on functioning and quality of life.
The notion of a shared story over time is deemed historical trauma (Mohatt, Thompson, Thai, & Tebes, 2014). Important to illustrating sources of risk and markers of reduced health/mental health, historical trauma places importance not just on the individual, but in the communities’ experience of a negative event or events (Sotero, 2006).
Historical Trauma
Those with individual histories of trauma may be more likely to experience negative behavioral health outcomes, as well as decreases in daily functioning and quality of life. Compounding individual trauma is historical trauma, defined as the “cumulative psychological and emotional wounding across generations... [emanating] from massive group trauma” (Brave Heart, Chase, Elkins, & Altschul, 2011, p. 283). Starting in the 1960s, knowledge of historical trauma emerged from the stories of those who endured the Holocaust and its impact on subsequent generations, as well as the experiences of Japanese Americans placed in internment camps after World War II (Evans-Campbell, 2008; Sotero, 2006). Finding that these two groups had endured persistent mass trauma and that their children’s mental health was affected was groundbreaking at that time and built the foundation for historical trauma research today.
In a study on Lakota elders, it was found that both individual and family-wide mental health was affected by trauma. Elders reported experiencing depression, difficulty showing emotion, shame, over-dependence, isolation, anxiety, sadness, avoidance of culturally significant places, loss of concentration, and constant thinking about historical loss (i.e., language, indigenous land, and so forth) and how alcoholism was affecting the community (Whitbeck, Adams, Hoyt, & Chen, 2004). This research provided rich qualitative evidence of the long-term impact that historical trauma had on the psychological and emotional well-being of the population affected.
Populations that have historically experienced mass trauma tend to have a higher prevalence of chronic disease several generations later (Sotero, 2006). Generally, historical trauma consists of three elements: 1) a traumatic event, 2) the shared experience of the trauma by a group of people, and 3) the multigenerational impact of such trauma (Mohatt et al., 2014). Historical trauma is described as collective trauma that is inflicted on a group of people based on their identity or affiliation related to ethnicity, religious background, and nationality (Evans-Campbell, 2008). Some examples of collective/mass trauma include the experience of indigenous boarding schools, forced relocation of people, enslavement, biological warfare, ethnic cleansing, incarceration, and genocide (Evans-Campbell, 2008; Mohatt et al., 2014; Sotero, 2006). These experiences can be damaging on a physical and/or emotional level for the group/community, and the trauma can then be transmitted epigenetically to future generations, especially if descendants strongly identify with their family culture/heritage (Evans-Campbell, 2008).
Historical Response and Loss
Although many conceptualizations of trauma in general have focused on the individual effects, namely the micro and mezzo levels, historical trauma originates as a macro-level concept for investigating how a population exposed to long-term mass trauma is affected over time and generations (Sotero, 2006). Historical Trauma Response (HTR) refers to the reactions that individuals and communities experience as a result of such long-term oppressive events. Some HTRs include survivor’s guilt, depression, intrusive thinking about past events/loved ones, emotional numbing, dissociation, and unpleasant thoughts/nightmares (Evans-Campbell, 2008).
Most historical trauma research/prevention work over the past two decades has focused on Native populations, although the concept has been applied to groups of people who have been oppressed historically, including Armenian refugees, African Americans, and Palestinian youth, as a few examples (Mohatt et al., 2014). In the Native American context, historical trauma is usually associated with the experience of mass genocide/forced relocation inflicted by white colonists (Brave Heart et al., 2011). Historical loss in this regard is one way in which historical trauma is measured/assessed, specifically the loss of life and culture/language. A previously mentioned study by Whitbeck and colleagues (2004) found that individuals who were many generations removed from the mass trauma still showed intense emotional suffering.
Recent research has been helpful in assisting with the conceptualization, measurement, prevention, and treatment of historical trauma in profound and culturally specific ways. As an example, recent research has found that the presence of historical trauma and HTR is linked to a greater lifetime experience of interpersonal traumatic events. In this sense, interpersonal trauma can be thought of as an HTR. Often co-occurring with alcohol and substance use, the presence of past and current trauma can mean worsened mental health, most notably in the areas of PTSD, depression, unresolved and/or prolonged grief, chronic disease, and premature and/or violent death (Brave Heart et al., 2011).
Individual, Family, and Community Effects
Historical trauma occurs at all levels—individual, family, and community. Although each level is distinct, they are all interrelated. Individual responses to historical trauma are influenced by the experiences/responses of family members; individual and familial experiences coalesce to make up the collective community response. Thus, actions at the individual and familial levels reinforce the way the community responds (Evans-Campbell, 2008). The multidirectional impacts of historical trauma at the familial level include reduced family functioning and increased parenting stress. Likewise, community level responses can include the cessation/loss of traditional culture including loss of cultural values, and traditional rites of passage, high rates of chronic disease, and high rates of alcoholism (Evans-Campbell, 2008).
Although empirical evidence is not yet available, it is thought that community level responses to historical trauma include the weakening of social structures, alcoholism, and suicide. Historical trauma has a pervasive impact on individuals, families, and communities, underscoring the need for trauma informed work with populations at risk. In the 1990s, Brave Heart and colleagues (2011) developed interventions to address historical trauma in Native populations through the processing of unresolved grief via the reincorporation of traditional practices/customs, traditional healing approaches, and peer group support (Whitbeck et al., 2004).
In addition to group work, working with individuals and families is also critical in addressing past trauma and its impact on a community. Protective factors that have been identified in helping individuals, families, and communities process and heal from historical trauma include having a strong connection to family/community, integration of spirituality/traditional healing practices, and strengthening individual/cultural identity (Walters, Simoni, & Evans-Campbell, 2002).
Conclusion
Historical trauma has emerged as a critical area of study in understanding and addressing long-term health problems in communities. It can be thought of as a macro level factor that has direct implications for micro and mezzo level processes. Although most trauma intervention models are deficit based, current efforts explore how communities maintain wellness after experiencing trauma. These efforts focus specifically on how communities have been resilient despite the experience of mass trauma (Evans-Campbell, 2008; Walters et al., 2002).
Specific to Native communities, there is a renewed focus on the positive aspects of recapturing lost culture in addressing historical trauma. A goal of these efforts is to promote psychological well-being and the ability to process and share accounts of past trauma. Through this process, individuals become more attuned to their past, present, and future, thereby developing a sense of self and cultural continuity as a result (Mohatt et al., 2014). Similarly, a prominent protective factor is the engagement of those in the community in rebuilding and helping others heal. The impact of the collective in this sense cannot be emphasized enough (Mohatt et al., 2014).
References
Brave Heart, M. Y. H., Chase, J., Elkins, J., & Altschul, D. B. (2011). Historical trauma among indigenous peoples of the Americas: concepts, research, and clinical considerations. Journal of Psychoactive Drugs, 43 (4), 282-290.
Evans-Campbell, T. (2008). Historical trauma in American Indian/Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities. Journal of Interpersonal Violence, 23 (3), 316-338.
Kawam, E., & Martinez, M. J. (2016, Summer). Trauma informed care in social work. The New Social Worker, 23 (3), 18-20. Retrieved from http://www.socialworker.com/feature-articles/practice/trauma-informed-care-in-social-work/
Mohatt, N. V., Thompson, A. B., Thai, N. D., & Tebes, J. K. (2014). Historical trauma as public narrative: A conceptual review of how history impacts present day health. Social Science Medicine, 106, 128-136.
Sotero, M. M. (2006). A conceptual model of historical trauma: implications for public health practice and research. Journal of Health Disparities Research and Practice, 1 (1), 93-108.
Walters, K. L., Simoni, J. M., & Evans-Campbell, T. (2002) Substance use among American Indians and Alaska Natives: Incorporating culture in an “indigenist” stress coping paradigm. Public Health Reports, 117, S104-S117.
Whitbeck, L. B., Adams, G. W., Hoyt, D. R., & Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology, 33 (3/4), 119-130.
Marcos J. Martinez, MSW, Ph.D., is a social work graduate of Arizona State University and a research scientist in the Prevention Research Center at the University of New Mexico. His work focuses on culturally sensitive drug use and risky sexual behavior prevention programming that targets Hispanic and American Indian families.
Elisa Kawam, BSW, MSW, Ph.D., is Executive Director of NASW, New Mexico chapter, and teaches at Western New Mexico University and Arizona State University Schools of Social Work.