Photo by Joanna Nix-Walkup via Unsplash

Trauma and Design

written by Rachael Dietkus, LCSW

Content warning: This article and list of resources mention trauma and a variety of traumatic experiences that can occur in a work environment. This warning applies to anything that may be hyperlinked from this as well.

“Trauma is perhaps the most avoided, ignored, belittled, denied, untreated, and misunderstood cause of human suffering.” — Peter Levine

Opening reflections: I am a licensed clinical social worker and design researcher who studies trauma in the context of design. The following resources are in response to the Surviving IDEO letter, published on May 24, 2021, by my friend and colleague George Aye.

At the time of this publishing, we’re sitting at the painful one-year traumaversary of the murder of George Floyd with a full year of organizational grand gestures, public statements, and diversity pledges of how Black Lives Matter. What do we have to show for the impact of this traumatic loss, for this recurrence that has echoed throughout the past year and will continue to reverberate for decades to come? In many design spaces, what we have seen and felt instead is the familiar and confusing productivity facade in front of complete and total inaction by distraction.

Much of what follows below is centered on the experience of working in a design setting, although you will quickly see that what I suggest as resources are not exclusive to only one discipline or organization. Workplace trauma — no matter where you are and regardless of its frequency or size — is unsettling and can leave a lasting imprint.

The silence and complicit nature of a toxic and abusive culture in one organization can lead to an insidious family tree of abuse in others. If you have experienced workplace trauma, my hope is that this offers validation and reassurance. If you are at a different stage and are unsure if your experience qualifies as being ‘traumatic enough,’ I encourage you to also read on.

“Once you start spending enough time with enough toxic people, you run the risk of losing some of your own empathy, simply because you aren’t ever being given any.” — Ramani Durvasula

1.Validating your experience. It’s important to know that workplace trauma can be destabilizing, demoralizing, and dehumanizing. And when it happens in a design-centric organization where there are sometimes shallowly professed values of human-centeredness, empathy, and the myth of bringing your full, authentic self to work, it can leave you spinning in a dizzying state of cognitive dissonance and moral injury.

A common side effect of workplace abuse is invalidation, which is defined as “the rejection or dismissal of your thoughts, feelings, emotions, and behaviors as being valid and understandable.” Invalidation can cause significant damage or upset to your psychological health and well-being. What’s worse, the ripple effects of these layers of dismissal are traumatic, often happen in isolation, and may lead to passive or more overt forms of workplace and institutional betrayal. If this is (or has been) your experience, it’s important to know that (1) you are not alone and (2) your experience is valid and real.

“In the wake of trauma, the hardest thing to understand is that nothing and no one can take away the pain. … We take our focus off the tragedy, move on with our lives, telling ourselves that ‘they’ will be okay. But … the impact of trauma doesn’t simply fade away.” — Bruce Perry

2. Seeking safety. Workplace-induced emotional trauma is very real and, unfortunately, on the rise. The research is also clear: continuous exposure to trauma can hurt our bodies and lead to debilitating levels of burnout, anxiety, depression, traumatic stress, and a host of other health issues. Episodic and patterned experiences like micro- and macro-aggressions, bullying, gaslighting, betrayal, manipulation, and other forms of organizational abuse can have both immediate and lasting psychological and physiological effects. So, what can we do?

• To go to HR and management or not? There is a natural inclination to document and report workplace abuse and to then work within the HR structures that are in place where we work. But many profit- and productivity-driven workplaces are remarkably inept at putting employees (the primary human resource) first. The nauseating effects of this can lead to deeply entrenched incompetent or avoidant behaviors by the very people who we expect to listen to and support us (read: HR). Even with this said, there is value in documenting events as they occur so that you can remember the details and not forget the context later. You may also have a situation so egregious or blatantly illegal that documentation will be necessary.
• Do you need accommodations? Employees need to be cared for in ways that our leaders don’t always recognize, nor value. Workplace trauma, as well as current and past trauma, can get exacerbated resulting in impairing symptoms or a legally protected disability accommodation. Sometimes seeking out accommodations as part of the process can hold your immediate supervisor accountable (as well as their respective leadership chain) to meet your needs. The Job Accommodation Network (JAN) is a source of free, expert, and confidential guidance on job accommodations and disability employment issues. JAN provides free one-on-one practical guidance and technical assistance on job accommodation solutions, Title I of the Americans with Disabilities Act (ADA) and related legislation, and self-employment and entrepreneurship options for people with disabilities.
• Do not “manage up.” Many of the avenues that HR systems afford us can lead to empty promises and give us a sense of helplessness and hopelessness. As a result, the harm done can lead to a retraumatization of what you’ve already been enduring. Additionally, as a social worker, it would be disingenuous and unethical for me to suggest that you find ways to “manage up” or gray rock so that you can temporarily minimize the effects. Managing up is a popular narrative that, I believe, just perpetuates how we deal with cycles and patterns of abuse — be it in the workplace or elsewhere. And gray rocking, which can be quite effective to get through in the interim, is not a healthy, long-term solution to what you are enduring.
• Where should I turn? Let me be honest: many HR programs are ill-equipped, lack the knowledge, or are simply unwilling to hold perpetrators of workplace abuse accountable. If this is not the case where you work, congratulations! But if the aforementioned is familiar, it is crucial to practice self-compassion and self-trust and to seek reassurance and psychological and cultural safety with trusted friends or colleagues. Let them know that you may not want or need their advice, but rather their trust and confidence in listening to and witnessing your story. Can this friend or colleague help you assess the risks of staying? You may find it empowering to think this through with them and to also write about it. Writing into the wound, as Roxane Gay has said, may also be a helpful, therapeutic exercise with a licensed professional or in community with others who witness, trust, and respect you. Please remember: your friends and colleagues are just that — friends and colleagues. Sometimes situations are more serious and complex and should be referred to someone who has the cultural and clinical training to help you address the layers of complexity. There may be times when your unresolved trauma, prolonged grief, or more serious and long-lasting symptoms of mental health concerns need to be processed with a licensed professional (more on working with a clinician below).
• Creating your freedom map. There are times when you have exhausted your options; you’ve played by the rules set forth and are caught in a neverending wait and see. Your current reality might be that leaving is simply not an option. You might be the only paid worker in your family or perhaps you need the insurance or the job market might be too volatile. These are all valid reasons for choosing to not leave — or to not leave just yet. However, if leaving feels scary for other reasons (fear of failing, worried about what people will think, concerned about damage to your professional reputation), consider this: are you willing and able to test the limits of what your body can endure? Sometimes leaving — a radical act in and of itself — is the best option for your health, well-being, and future work. If you’re at this stage, I strongly suggest devising a plan of action for leaving and map out your escape plan. Some of the questions to consider might be: When will I leave? What do I need in order to leave? What do I want to do next? How can I take care of myself now and in the future? Who can I rely on as part of my support system? Spelling this out and naming what you need in your freedom map will give you power.

A sycamore tree — a sign of strength, protection, reliability, and clarity — getting ready to bloom.

“We are walking wounds, but I am not sure any of us know quite how to talk about it.” — Roxane Gay

3. Healing in community and finding and talking to a mental health professional. There are enormous benefits to healing with others and working with a licensed clinical mental health professional (i.e., clinician, therapist, psychotherapist, counselor, etc). Therapy can provide a safe space to share and understand the interconnected dots of what you’re going through. Sometimes trauma in the workplace can trigger unresolved childhood traumas and other struggles that we, as a society, have been conditioned to either just deal with or suppress. Have grit! Be resilient! It’s not that bad! These are white supremacy and productivity narratives that infuriate me. If it were that easy, you wouldn’t still be reading. What’s more, the power of community healing is found in the validation, empowerment, and organizing to challenge fear-based work culture — not to just learn to cope with dysfunction.

If you are new to therapy or revisiting it after having a break from it, consider this part of the overall commitment to yourself for lifelong healing and recovery. There is a growing amount of culturally responsive therapy options — many of which did not exist even a few years ago. Below are just a few resources for finding an inclusive, culturally responsive therapist:

• Inclusive Therapists is a great resource that offers a safe, simpler way to find a culturally responsive, social justice-oriented therapist. They center the needs of BIPOC and the LGBTQIA2S+ community. They also honor the full neurodiversity spectrum and advocate for mental health care accessibility for people with disabilities. You can browse by location and a number of categories. Therapists listed here commit to a culturally affirming and responsive practice. Their list of resources is also one of the most comprehensive I have seen.
• National Queer and Trans Therapists of Color Network (NQTTCN) is a healing justice organization committed to transforming mental health for queer and trans people of color. They work hard to envision a world where all people have access to healing resources rooted in social justice and liberation to recover from trauma, violence, and systemic oppression. They have 145+ psychotherapists in the directory and continue to outreach to increase the number of practitioners in under-resourced regions in the U.S.
• Therapy for Black Girls is an online space dedicated to encouraging mental wellness for Black women and girls. You can find a therapist by location and then narrow your search through a few filters.
• The Asian Mental Health Project project, founded by Carrie Zhang, works to increase dialogue via storytelling and helping to spread support resources with mental health professionals, they make it easier for Asians to be open to the idea of mental health support and treatment.
• The Decolonizing Therapy (and the Linktr.ee site here) & Dr. Jennifer Mullan sites are full of radical, affirming resources related to therapy and the growing awareness of work that sits at the intersections of psychology, somatics, spirit work, and activism through therapeutic containment.
• The Loveland Foundation was established in 2018 by Rachel Cargle in response to her widely successful birthday wish fundraiser, Therapy for Black Women and Girls. TLF is the official continuation of this effort to bring opportunity and healing to communities of color, and especially to Black women and girls. Through fellowships, residency programs, listening tours, and more, they hope to contribute to both the empowerment and the liberation of the communities they serve.
• Psychology Today is the most popular resource for finding a therapist. A majority of licensed professionals are listed there and you can narrow your search by location, insurance, issues you’d like to address, types of therapy used, and a range of other very specific criteria. For the types of workplace abuse that George mentions in his letter, I would suggest looking for someone who has specialties with the following: anti-racism, racial trauma, trauma and traumatic stress, anxiety, depression, workplace abuse, narcissism and narcissistic abuse, grief, and/or institutional betrayal.
• Low-cost or sliding scale options: these can be difficult to find and I want to provide a few tips. One thing that I have discovered is that many mental health therapists often carry a small caseload either no fee or for a sliding scale fee. This is not something you will ever typically see advertised, so I encourage you to inquire directly. If therapy is not an option or a route you want to take (for any reason), the National Alliance on Mental Illness (NAMI) has a national warmline directory. A warmline is a peer-run hotline that offers callers emotional support and is staffed by volunteers who are in recovery themselves.
• All things virtual or app-based: There are also a number of popular mindfulness and calming apps out there. Another option is signing up for a virtual mental health platform like AbleTo, BetterUp, or Talkspace. With the pandemic, there has been a significant increase in these platforms, with some with mixed reviews. (Full disclosure: I’m somewhat skeptical of these based on what I know about them at the time of this writing.) The immediate benefit is that it makes talking to someone much more accessible than before. Additionally, if you’re looking at some mental health app options or wearable technology, I’d suggest the following: Shine, Liberate, AYANA Therapy, and Apollo Neuro.

4. National and international mental health helplines. Trauma and its side effects are sometimes associated with a greater risk of suicidal ideation and self-harm. If you or someone you know is in need of services or is in immediate danger, please call your local emergency number (911). The following is a list of important resources if you or someone you know is having thoughts of self-harm or suicide.

• National Suicide Prevention Lifeline: 1–800–273–8255; available 24/7 for support, prevention, and resources.
• Crisis Text Line: Text HOME to 741741; available 24/7 for crisis counseling.
• National Alliance on Mental Illness (NAMI) HelpLine: 1–800–950-NAMI (6264) or info@nami.org; available Monday through Friday, 10 a.m. to 6 p.m. ET for information, resource referrals, and emotional support.
• Open Counseling: lists the suicide hotlines from all over the world.

“Telling thoughtful truths should not be a revolutionary act. Speaking truths to power should not be sacrificial, but they are. But I think if more of us chose to do this for the greater good, we’d be in better spaces than we are right now.” — Luvvie Jones

5. Learn and understand the language of trauma and what it means to be trauma-informed — especially in the context of design. There is a literacy around trauma that is missing in our organizations, in ourselves, and in our design work. Now more than ever, we need to be at least trauma-informed so that we can lead and work within trauma-responsive teams and organizations. Responding to this need is one of the reasons why I started Social Workers Who Design. My own practice and research are committed to being trauma-informed and becoming trauma-responsive in design.

To learn more about trauma-informed principles and trauma-informed design, here are some great places to start:

• Watch the Trauma-Informed Design session at the Restorative Design Conference hosted by Greater Good Studio in October 2020. In this session, friends, and colleagues Sarah Fathallah, Sara Cantor, and I talk about what trauma is and how it impacts and influences the ways in which we do design.
• Kelly Ann McKercher’s Trauma-Informed Practice and Design page is a growing collection of books and resources, as well as observations from their participatory design practice about where designers can ‘stumble’ into unnecessarily triggering people or undermining their recovery.
• You can also learn about the six trauma-informed care principles, originally created by the Centers for Disease Control (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA). These are a great foundation for thinking about how we might adapt these principles in a design setting, but we must dig in on these further and integrate with design.
• I owe a lot of my current work and approach to design educator Tad Hirsch, a professor of art & design at Northeastern University in Boston, Massachusetts. His April 2020 article Practicing Without a License: Design Research as Psychotherapy should be required reading for every designer, design educator, and design researcher. I am thankful for his scholarship and generosity of time in meeting with me last year to discuss his and our work in this space.
• As the interest in trauma-informed design training and practice grows, I encourage you to review or attend one of these talks or workshops here, here, and here. But I want to issue a word of caution: we must be careful to not default to a checklist or the quick fix in any of this work. I have been a social worker for eleven years and, unknowingly, have been working on these intersections for the past 20+ years and I continue to be humbled by what I learn and integrate. Be genuine in your curiosity to learn more and commit to this new way of doing in your practice. Bring social workers (and other licensed professionals) in on the design projects.
• Becoming trauma-informed is a radical act and an evolutionary practice. This is a commitment and means a shift in your training, new ways of doing and being, and embodying a deeper sense of purpose that ethically and responsibly works to understand the whole person you are designing with, for, and from. It’s relational work — not transactional and extractive.

Closing thoughts: If you found this even remotely helpful — or if there are other resources that should be included, please let me know. And remember: pay attention to the green flags and don’t doubt yourself or your reality.

“DON’T DOUBT YO’SELF” taken in 2018.

Rachael Dietkus is a Licensed Clinical Social Worker and Certified Clinical Trauma Professional. She is a design researcher, consultant, and advisor who practices from a trauma-responsive social work framework. She is the founder of Social Workers Who Design and is pursuing her MFA with a focus on trauma and design.