CHAPTER

INTRODUCTION TO TRAUMA AND TRAUMA-INFORMED PRACTICES 1

As a peer supporter, many of the women you work Sources of Trauma

SECTION I. FUNDAMENTALS
with will have experienced some form of violence or Trauma can result from a wide variety of events:
trauma in their lives. Perhaps you have experienced
• Emotional, physical, or sexual abuse in
trauma in your own life. Whether you work in a mental
childhood
health or substance abuse program, a homeless shelter,
a correctional institute, a domestic violence shelter, an • Abandonment or neglect (especially for
independent peer-run program, or any other setting, small children)
your relationships with the people you support may be • Sexual assault
profoundly affected by trauma. In this chapter, we will • Domestic violence
provide basic information on sources and impacts of
• Experiencing or witnessing violent crime
trauma and will describe how behavioral health, human
services, and other systems are becoming “trauma- • Institutional abuse
informed.” This chapter will introduce some of the • Cultural dislocation or sudden loss
concepts that will be explored in more depth later in • Terrorism, war
the guide. • Historical violence against a specific group
(as in slavery or genocide)
WHAT IS TRAUMA? • Natural disasters
Trauma occurs when an external threat overwhelms • Grief
a person’s coping resources. It can result in specific
• Chronic stressors like racism and poverty
signs of psychological or emotional distress, or it can
affect many aspects of the person’s life over a period • Accidents
of time. Sometimes people aren’t even aware that the • Medical procedures
challenges they face are related to trauma that occurred • Any situation where one person misuses
earlier in life. Trauma is unique to each individual—the power over another
most violent events are not always the events that have
the deepest impact. Trauma can happen to anyone, but Interpersonal violence is a major source of trauma in
some groups are particularly vulnerable due to their the United States, particularly for women. While men
circumstances, including women and children, people are most likely to experience violence from strangers,
with disabilities, and people who are homeless or women and girls are most likely to be hurt by people
living in institutions. they know. For women in the military, the greatest risk
of harm is from fellow soldiers; for adolescent girls, it
is from the people they love.

INTERPERSONAL VIOLENCE IN THE UNITED STATES

More than 3 million children witness domestic violence every year.

Every 35 seconds, a child is abused or neglected.

One in three girls and one in five boys are sexually abused by age 18.

One child dies from violence every three hours.

1.5 million women and 835,000 men are raped or physically

assaulted by an intimate partner every year.

www.witnessjustice.org

CHAPTER 1. INTRODUCTION TO TRAUMA AND TRAUMA-INFORMED PRACTICES / PAGE 3

 What to Look For a woman who has been put in restraints many times
Some common signs of trauma include: during her multiple hospitalizations and, upon further
exploration, she reveals that she is an incest survivor
• Flashbacks or frequent nightmares
and that she was raped by a fellow soldier when she
• Being very sensitive to noise or to being touched enlisted to get away from home. Remembering the
• Always expecting something bad to happen long road that each woman has already walked can
• Not remembering periods of your life help you focus on the strength and courage it has taken
her to survive.
• Feeling numb
• Finding yourself in situations where others
abuse or take advantage of you WHAT IMPACT DOES TRAUMA HAVE?
• Lack of concentration, irritability, sleep Scientific findings confirm that trauma affects the
problems mind and body and can have a lasting impact. One
study looked at the “adverse childhood experiences”
• Excessive watchfulness, anxiety, anger, shame,
(ACEs) of about 17,000 people enrolled in an HMO,
or sadness
correlating their “ACE score” with a range of medical
Some people don’t openly display signs of emotional and social problems.1 The relationships are staggering.
distress. People cope using whatever coping skills People with high ACE scores are much more likely
and resources they have available to them. Some may to develop mental health problems, abuse substances,
keep to themselves, some focus intently on work, while have chronic physical illnesses, and die early. Women
others may use substances or take risks. Every person are significantly more likely than men to have high
expresses their pain differently, so it’s important to ACE scores.
always stay open to the possibility that the women you
support have experienced trauma.
THE IMPACT OF ADVERSE
All forms of violence can be traumatizing, but the
earlier in life the trauma occurs, the more severe the CHILDHOOD EVENTS (ACES)
long-term consequences may be. Deliberate violence is ON WOMEN
particularly damaging, especially when it is inflicted by Women are 50% more likely than men to
trusted caregivers. Examples of such “betrayal trauma” have an ACE score of 5 or more.
include incest, child sexual abuse by clergy, and abuse
54% of depression in women can be
by professional caregivers. Secrecy also intensifies
attributed to childhood abuse.
trauma. Often perpetrators will threaten victims in
order to keep them from revealing what happened. In Women with an ACE score of 4 or more are
other cases, victims will remain silent due to self-blame almost nine times more likely to become
and shame. When violence is compounded by betrayal, victims of rape and five times more likely
silence, blame, or shame, it can have lasting effects to become victims of domestic violence
on the ability to trust others and to form intimate than women with a score of zero.
relationships—and can directly affect your work as Two-thirds of all suicide attempts are
a peer supporter. Helping women to regain their own attributable to ACEs; women are three
voice is often the first step in establishing a trusting times more likely to attempt suicide than
relationship. men across the lifespan.

It is important to remember that many of the women http://www.acestudy.org/

you work with may have experienced multiple forms
of violence over their lifetime, even though they might
not talk about it. For example, you might work with a
woman who experienced poverty and racism as a child;  1  Felitti,
V.J. & Anda, R.F. (2010). The relationship of adverse childhood
grew up in foster homes; lost family, friends, home and experiences to adult medical disease, psychiatric disorders, and sexual
behavior: Implications for healthcare. In R. Lanius & E. Vermetten
job during Hurricane Katrina; and became involved (Eds.), The Hidden Epidemic: The Impact of Early Life Trauma on
with an abusive partner. Or perhaps you work with Health and Disease. Cambridge University Press.

PAGE 4 / CHAPTER 1. INTRODUCTION TO TRAUMA AND TRAUMA-INFORMED PRACTICES

Adverse events can impact people in two ways. First, use disorders among women,
trauma affects the developing brain and body and provided recommendations
alters the body’s natural stress response mechanisms. for trauma-integrated services
Second, trauma increases health risk behaviors such as for these women, and sparked the
smoking, drinking, over-eating, and engaging in risky development of guiding principles for
sex—things that trauma survivors sometimes do to positive change.
cope. Recognizing these behaviors as coping responses
rather than “bad choices” is essential to an effective These efforts emphasized peer support, the
peer support relationship. re-traumatization that too often happens within
service systems, and the importance of focusing on
Over time, trauma can alter everything about a person’s gender. The women survivors who participated in
life and behavior. Because it shatters trust and safety the conferences and the research study demonstrated
and leaves people feeling powerless, trauma can lead clearly the power of finding and using one’s voice,
to profound disconnection from others. Survivors may especially when the experience of trauma has been
always be on guard or feel overwhelming despair. wrapped in secrecy and silence.4 Their participation has
Coping mechanisms can become habits that are hard to helped the trauma field to understand how important
quit. Trauma can lead to problems at home, at school, it is for people who have experienced trauma to
or at work. People may unknowingly re-enact their determine the course of their own lives. It is also
trauma in different ways. As a peer supporter, your job vital that they participate in every aspect of service
is to help people connect to their own strengths, to talk planning, delivery, and evaluation and that they have
about trauma and its impact in ways that acknowledge the opportunity to develop peer-run services.5
and respect the person’s coping strategies, and to
support people in naming their own experience. It
Recovery, Resilience,
is also critical to understand trauma so that you can
and Post-Traumatic Growth
help ensure that the people you work with are not
unintentionally “re-traumatized.” Re-traumatization The most important message you can convey as a peer
happens when something in the environment recreates supporter is that healing is possible. The women you
an aspect of a previous traumatic situation and triggers support have faced great challenges and survived.
a trauma response. Groups, organizations, and even It’s a tribute to their strength that they’ve made the
societies can also be traumatized, so it is also important courageous choices to get to where they are today.
to apply these concepts to the larger settings in which Research shows that people are extremely resilient.
you work. They can recover from even severe and repeated
trauma, and can grow stronger in unexpected ways.
WHAT HELPS? FACTORS THAT Just like a broken bone, a person can become
FOSTER TRAUMA HEALING “stronger at the broken places.” Often people move
Over the past twenty years, the field has learned a through predictable stages of safety, remembrance and
great deal about healing from violence and trauma. A mourning, and reconnection with others.6 Grieving is
national dialogue about women, violence and trauma often a major component of healing. This guide
was stimulated by a series of national conferences 2 includes personal stories and suggestions for healing
and the Women Co-Occurring Disorders and Violence techniques that the women you support may want to
Study (WCDVS), a five-year Substance Abuse and try, but it is critical to remember that each woman’s
Mental Health Services Administration (SAMHSA)- journey is different.
funded research study co-sponsored by all three
SAMHSA Centers (the Center for Mental Health
Services, the Center for Substance Abuse Prevention,
and the Center for Substance Abuse Treatment).3
The study explored the interrelation among violence,
 4  Mockus, S., Mars, L.C., et al (2005). Developing consumer/survivor/
trauma, and co-occurring mental health and substance recovering voice and its impact on services and research: Our experience
with the SAMHSA Women, Co-Occurring Disorders and Violence Study.
Journal of Community Psychology, 33(4), 515-525.
 2  Dare to Vision (1995), Dare to Act (2004), and Dare to Transform  5  Prescott, L. et al. (1998). Women Emerging in the Wake of Violence.

(2008). Culver City, CA: Prototypes Systems Change Center.

 3  The Women, Co-Occurring Disorders, and Violence Study (1998-2003).  6  Herman, J. (1992). Trauma and Recovery. New York, NY: Basic Books.

CHAPTER 1. INTRODUCTION TO TRAUMA AND TRAUMA-INFORMED PRACTICES / PAGE 5

 There are many resources available that describe consequences, and about the importance of women’s
trauma recovery and that outline strategies to promote voices and choices in the services and supports they
healing and post-traumatic growth. A few are listed in receive. People are alert for ways to make their
the resource section. As a peer supporter, one of the environment more healing and less re-traumatizing
most important things you can do is to remind people for both clients and staff. They understand that
that healing from trauma, like healing from a physical when you have been traumatized, regaining control
injury, is a natural human process.7 After violence over the environment is the number one priority,
occurs, a self-healing process is activated. The will so they emphasize safety, choice, trustworthiness,
to survive is triggered, and often the individual tries collaboration, and empowerment.10 Trauma-informed
to make meaning of the experience. It is critical for services support resilience, self-care, and self-healing.
helpers to support the self-healing process rather than Violence and healing both occur in a cultural context,
undermine it. Skills for supporting self-healing from so trauma-informed programs also respect and include
trauma will be described in later chapters. culturally specific healing modalities.

Because violence and trauma are so common, peer

Trauma-Specific Services and supporters should assume that every woman they see
Trauma-Informed Practices may have experienced some form of trauma. How you
One important distinction is between “trauma-specific” engage people, how you empower them to tell their
interventions and “trauma-informed” practices, stories in their own words, and how you work with
services, and supports.8 Trauma-specific interventions their existing strengths and coping strategies are critical
are designed to treat the specific signs of trauma. skills of trauma-informed peer support, and will be
Many have demonstrated positive outcomes.9 Trauma- discussed in detail later.
specific services include integrated models for trauma
and substance abuse treatment, manualized group
counseling models, cognitive behavioral therapies,
prolonged exposure therapy, body-based interventions,
Trauma-informed services don’t
eye movement desensitization and reprocessing
(EMDR), and many others. ask, “What’s wrong with you?”
In contrast, trauma-informed practices provide a They ask, “What happened to you?”
new paradigm for organizing services and supports
that recognizes the central role that trauma plays in
– Sandra Bloom
people’s lives and shifts the focus from “what is wrong
with you?” to “what happened to you?” Trauma-
informed practices can be implemented anywhere—
in educational settings, in job programs, in housing,
in justice systems, and, of course, in peer support.
Trauma-informed services seek to understand what
happened to an individual and the meaning she makes
of those experiences. In a trauma-informed program,
everyone is educated about trauma and its

 7  Mollica, R.F. (2006). Healing Invisible Wounds. New York, NY:
Harcourt Press.
 8  Distinction first made by Roger Fallot and Maxine Harris.

 9  Jennings, A. (2008). Models for Developing Trauma-Informed Be-

havioral Health Systems and Trauma-Specific Services. The Substance  10  Fallot,
R.D. & Harris, M. (2008). Trauma-informed services. In Reyes,
Abuse and Mental Health Services Administration’s National Center on G., Elhai, J.D., & Ford, J.D. (Eds.), The Encyclopedia of Psychological
Trauma-Informed Care. Trauma (pp. 660-662). Hoboken, NJ: John Wiley.

PAGE 6 / CHAPTER 1. INTRODUCTION TO TRAUMA AND TRAUMA-INFORMED PRACTICES

 CHAPTER SUMMARY: KEY POINTS
•  Trauma occurs when external events overwhelm a person’s coping responses.
•  Trauma is widespread. You can assume that many of the people you support have
trauma histories, and that many have experienced multiple sources of trauma.
•  The earlier in life trauma occurs, the more damaging the consequences are likely to be.
•  Being betrayed by trusted caregivers, being silenced, or feeling blame or shame may intensify the
impact of the trauma.
•  Trauma can affect every aspect of a person’s life over time.
•  Trauma-informed practices shift the focus from “what is wrong with you?” to “what happened to you?”
•  Trauma-informed practices emphasize voice, choice, safety, trustworthiness, collaboration, and
empowerment.
•  Healing is possible.
•  It is essential for peer supporters to understand trauma in order to support healing and to avoid
re-traumatization.

RESOURCES
Bloom, S.L. & Reichert, M. (1998). Bearing Witness: Violence and Collective Responsibility. New York, NY:
Haworth Press.
Harris, M. & Fallot, R. (Eds.) (2001). Using Trauma Theory to Design Service Systems. San Francisco, CA: Jossey Bass.
Jennings, A. (1998). On being invisible in the mental health system. In B. L. Levin, A. K. Blanch, and A. Jennings
(Eds.), Women’s Mental Health Services. Thousand Oaks, CA: Sage.
Joseph, S. & Linley, P.A. (Eds.) (2008). Trauma, Recovery and Growth. New York, NY: John Wiley & Sons.
Levine, P.A. & Frederick, A. (1997). Waking the Tiger: Healing Trauma: The Innate Capacity to Transform
Overwhelming Experiences. Berkeley, CA: North Atlantic Books.
Mockus, S., Mars, L.C., et al (2005). Developing consumer/survivor/recovering voice and its impact on services
and research: Our experience with the SAMHSA Women, Co-Occurring Disorders and Violence Study. Journal
of Community Psychology, 33(4), 515-525.
Mollica, R.F. (2006). Healing Invisible Wounds. New York, NY: Harcourt Press.
Prescott, L. et al. (1998). Women Emerging in the Wake of Violence. Culver City, CA: Prototypes Systems
Change Center.
Substance Abuse and Mental Health Services Administration. (2003). Helping Yourself Heal: A Recovering
Woman’s Guide to Coping with Childhood Abuse Issues. U.S. Department of Health and Human Services
Publication # (SMA) 03-3789.
Vesey, B. & Heckman, J., with Mazelis, R., Markoff, L., & Russell, L. (2006). It’s My Time to Live: Journeys to Healing
and Recovery. Substance Abuse and Mental Health Services Administration/Center for Mental Health Services.
The Anna Institute, http://annafoundation.org/
The Adverse Childhood Experience (ACE) Study, http://www.acestudy.org/
The National Center on Trauma Informed Care, http://www.samhsa.gov/nctic/
The Salasin Project, http://wmtcinfo.org/~wmtc/typolight/index.php/salasin-project.html
The Transformation Center, http://transformation-center.org/resources/education/trauma/info.shtml

CHAPTER 1. INTRODUCTION TO TRAUMA AND TRAUMA-INFORMED PRACTICES / PAGE 7

CHAPTER

2 AM I A TRAUMA SURVIVOR?

This manual is designed to help you provide trauma-

SECTION I. FUNDAMENTALS
informed peer support. But what if the women you
work with don’t identify or even recognize themselves CHOOSING STRENGTH
as “trauma survivors?” In this chapter, you will have Someone from the Women’s Building
a chance to think about how people come to recognize came around asking if we wanted to go to
the impact of trauma on themselves and others. By a meeting, just for women, to talk about
examining potential sources of trauma in your own violence in our neighborhood. The first
life, you will become aware of the ways in which the night seven women came. The group
women you work with might have been affected by leader talked a lot about violence and how
something that happened way back when I
trauma, whether or not they talk about it.
was little can still bother me. I guess I was
surprised. Where I live somebody gets beat
IDENTIFYING AS A TRAUMA SURVIVOR up almost every day. I didn’t say much.
Everyone experiences pain and suffering, so how They asked if we would come back again. I
do you know if you have been traumatized? Often, guess so. But like K. said: “If coming here
makes me feel better and stronger when
when a person is experiencing violence—especially
I leave, then I will come back. I can’t have
as a child—they have no way of knowing that it isn’t
pity. No feeling sorry for me. Don’t even
normal. An abused child may grow up believing that look at me with sad eyes. I have to go back
the world is a hurtful place, that they are unworthy and out there and be a strong woman. Take
deserve whatever they get. They may feel uncertain care of my kids and be strong.”
of themselves and look to others to define what is
“normal.” It may take a long time for them to realize – P
 articipant in Sister to Sister peer
that they have a right to be safe and happy, and even support group, quoted by Cathy Cave
longer to develop the skills of self-care.

Even adults can have a hard time recognizing abuse

and trauma. Many women who experience date speaking out. There may be cultural differences in
rape, for example, are unsure how to categorize their how violence is defined and talked about. It is
experience. They might think because it wasn’t a important to pay attention to how the women you
stranger and he didn’t hold a gun to their heads, that support describe themselves, and to respect the
somehow it didn’t “count” as rape. Or they might language they use. There are different views and
blame themselves for accepting the date. Women core values about self-identity, and some of these are
who experience violence at the hands of an intimate culturally based. For example, one woman who has
partner may see such events as an expected part of experienced violence may describe herself as an Asian
their relationship. Others may see certain types of woman, a parent, a daughter, and an advocate. When
violence as an unavoidable part of life in their family she shares her journey of healing from violence and
or neighborhood, something to be endured and not emotional distress, she may not use terms like “trauma
discussed. Sometimes women only begin to see survivor,” not out of shame, but because these terms
themselves as abuse survivors when they get a chance do not hold meaning for her. As peer supporters, we
to share their stories with other women. need to be clear about how we self-identify, so that
we can be aware of when our views and experiences
Even when women recognize that the violence they may be influencing how we understand the women we
experienced was wrong and was not their fault, they support. Specific strategies for holding a conversation
may find it very hard to talk about—especially if they about trauma will be discussed in later chapters, but
have been silenced, blamed, or shamed in the past for it is important to remember that defining one’s own
experience in one’s own terms is essential to healing.

PAGE 8 / CHAPTER 2. AM I A TRAUMA SURVIVOR?

Words do matter, and words that describe our identity significance, giving a sense of
matter a great deal. Many of the women you work with meaning and purpose to their
have received a psychiatric diagnosis at one time or experience. Often, simply using
another. For some, that diagnosis may be helpful, even the term “survivor” rather than
comforting. For others, it is harmful and disturbing. “victim” can make a difference
The same thing holds true for people who have in the way people think and feel
experienced violence and trauma in their lives. How about what happened to them and how they envision
they choose to talk about it—or if they choose to talk the future. On the other hand, sometimes a woman
at all—is a very personal matter. It is important that chooses to use the term “victim”—for example, to
peer supporters make it safe for women to share their emphasize that she was both powerless and blameless.
experiences.
As a peer supporter, you play an important role in
“Coming out” as a trauma survivor may have a ensuring that people can choose the words they want
profound effect on a woman’s identity. For example, to use to define and describe their experience and their
women refugees coming to the U. S. after the war in identity and helping other people in the system respect
Kosovo often defined themselves as “freedom fighters” those choices. But it is also your responsibility to give
injured in the struggle for liberation rather than as people space to look at what has happened to them
“rape survivors,” although most had been brutally throughout their lives and to begin to think about how
raped and beaten by their captors. This had cultural those events might have impacted them.
significance for them as Muslim women and personal

TRACING TRAUMA IN YOUR LIFE AND THE LIVES OF YOUR PEERS

Take a few minutes to review the possible sources of trauma in your own life. Notice if there are
potential sources of trauma that you have never considered before.

Historical trauma. We usually think of historical trauma as resulting from mass acts of violence against
an entire group: slavery, or the genocide of Native Americans, or the Holocaust, or the internment of
Japanese Americans during World War II. But it can also occur in more individual ways. If your parents
or grandparents were immigrants, belonged to a religious group that was persecuted, or came from
households that used extremely harsh physical discipline, you may feel the impact of the violence and
trauma they faced even though you never directly experienced it. Think about your own family tree. Do
you think you might have patterns of historical trauma in your family? Have you ever discussed it with
anyone?

Social violence. Social violence such as ongoing poverty, racism, dislocation, or living in severely
polluted or degraded environments can also have a traumatic impact over time. Have you ever
experienced the impact of social violence? If so, do you think that it might have affected the way you
think, feel, or act?

Childhood trauma. Children may be traumatized through emotional, physical, or sexual abuse;
witnessing domestic violence; incarceration of a family member; family separation; physical or
emotional neglect; gang violence; bullying (including cyber-bullying or “sexting”); or witnessing
violence in the streets. Think about your own childhood. How many different types of childhood trauma
did you experience? At the time, what did you think or feel about these events? Have you ever thought
about the impact that these experiences might have had on you as an adult?

Continued on page 10

CHAPTER 2. AM I A TRAUMA SURVIVOR? / PAGE 9

 Continued from page 10

Interpersonal violence. Adults, especially women, experience interpersonal violence in many forms,
including domestic violence, rape and sexual assault, sexual harassment, workplace bullying, and
experiencing or witnessing violent crime. Have you ever experienced interpersonal violence? Have you
had an experience where you felt shamed or fearful or coerced into doing something you didn’t want to
do, but weren’t quite sure if it “counted” as abuse?

Institutional trauma. Institutional procedures such as forced medication, involuntary commitment,

transportation by law enforcement, and seclusion and restraint are often traumatizing. Medical
interventions and certain aspects of routine institutional care, such as inflexible rules, authoritarian
staff, and even the use of certain words or labels may be traumatic in less obvious ways. Think about
your experience with institutions. Did anything ever happen that felt abusive? At the time, did you
consider yourself as surviving a traumatic experience? Did the staff? Would you consider them
traumatic now?

Other traumatic events. Natural disasters like Hurricanes Katrina and Rita, acts of terrorism like 9/11,
and wars can affect us—even if we are not immediately present. Groups and organizations can also be
traumatized by events such as a death or staff injury or even an unexpected layoff or reorganization. Have
you ever experienced trauma from a natural disaster or war, either directly or indirectly? Has a group or
organization you were a part of ever experienced a severe shock that affected you deeply? Have you ever
thought about how these events affect your life?

Do you consider yourself a “trauma survivor?” Why or why not? What about the people you work
with? Do you think they consider themselves trauma survivors? Why or why not?

THE POWER OF LABELS

In the following excerpt by Pat Deegan, she refers to herself, or is referred to by others, as “a
schizophrenic,” “multiple personality disorder,” “an abuse survivor,” and “chronically mentally ill.”
Consider the implications of each of these labels for Pat and for staff working in the system.

Before We Dare to Vision, We Must be Willing to See

by Patricia E. Deegan, PhD

. . . Stay with me. See with me. It is breakfast time. The same 6-year old girl is in the kitchen. Her mother
is in a quiet but dangerous fury at this early hour. There is cereal on the table, some bowls and spoons
strewn about. The other kids, dad, and grandma are in and out of the kitchen in the morning hustle to
get off to work and school. The mother takes a bottle out of the cabinet. The 6-year–old child knows
the bottle well. The mother removes a large pink pill from the bottle. The girl begins to feel ice cold in
terror. A nausea grips her innards. The pink pills are amphetamines. Adult dosages of amphetamines. The
mother places one pink pill on the table. It seems so big. The mother is afraid that someday the child may
become fat. The mother is obsessed with this fear. She turns to the 6-year-old girl. “Here, take this.” The
child’s eyes fill with tears. A hushed, whispered plea—“Please, not today. Please mommy, not today.” The
words fall on deaf ears. No one hears. No one helps.

“Take the pill. It’s for your own good. I love you. You don’t want to get fat, do you. I love you. Take the pill.
Here, try this . . . “ She takes a spoon and shows the 6-year-old how she will crush up the pill and make
the big pill “go away” by mixing the powdered amphetamine in a small glass of milk. But the 6-year-old
child already knows this trick—the milk is scary. “Drink it,” comes the command. Every fiber in her body

Continued on page 11

PAGE 10 / CHAPTER 2. AM I A TRAUMA SURVIVOR?

Continued from page 10

screams against the order but she obeys. There is no choice. The liquid amphetamine
slides down her throat and enters her stomach. Mommy is happy.

Everyone sits down and eats some cereal. Except for me, the 6-year-old girl. I go into an alcove in the
living room. It’s small place with walls that are close enough to hold me in. And soon I begin to feel the
rushes of adrenaline inside my body. I begin to whine quietly to myself. I pace around and around in a
small circle. My heart begins pounding. I shake my hands in some spastic rhythm to somehow get the
terror out. The drug is roaring through my body now. I feel like I am dying and I don’t know if it will ever
end. But I remain quiet, too afraid of what will happen if I make a noise, going around and around,
shaking and heart pounding until my body quakes. And then I feel my body get so huge and it feels
just like my skin has disappeared and nothing is there to hold me together and my skin just evaporates
so that I no longer have an inside or an outside and I just come apart. I just disintegrate. I’m gone . . .

I was forcibly drugged with adult doses of amphetamines between the ages of 6 and 16. The “breakfast
scene” as I described it happened more times than I can count. I was scared and no one soothed me.
I was a child and no one protected me. I was visible but no one around me was willing to see or to say
what was happening . . . And then I broke. When I was 17 and a senior in high school, I just broke—
snapped into a thousand pieces that did not come back together again . . .

Come, dare to see with me: a female nurse approaching me with two cups of liquid. In one cup was clear
liquid Thorazine and in the other orange juice. She poured the clear liquid into the cup with the orange
juice. She told me to drink it. She said it was medicine and that it was good for me and that the orange
juice would make it taste better. And I stiffened, and felt the cold chill and the nausea grip my bowels.

But I did not resist. I knew all about this. I drank the “orange juice.” The nurse was very happy that I drank
it. That was on a Friday afternoon. I did not return to consciousness until Sunday evening when they
roused me from my drug-induced coma. And when I woke up I found I was gone. I was gone again.
I drooled and choked and walked like a zombie and passed out and I could feel nothing and think nothing
and say nothing . . .

There seems to be a two-tiered caste system and service delivery system developing in the mental health
arena. One set of services is for people we once called the “chronically mentally ill” and who we now
refer to as the “the severely and persistently mentally ill.” The second tier in this emerging caste system is
the proliferation of specialized service, often in private hospitals, for survivors of abuse.

I have experienced this emerging trend on a firsthand basis. Between the ages of 17 and 39 I was
labeled and treated as “a schizophrenic.” When they said I was “a schizophrenic,” the first thing I always
got offered was drugs . . . But then after 16 years of being labeled “a schizophrenic” I got a new diagnosis
during a hospitalization in 1988. Now I am labeled as having multiple personality disorder. And the change
in how I am perceived by mental health professionals is extraordinary! Now everyone wants to know what
my voices are saying! Now there are no particular drugs people think I should take. Now all the clinicians
agree the treatment of choice for me is insight-oriented, long-term psychotherapy. . . . Of course the irony
is that I have been the same person all along, no matter what diagnosis I carried.

Excerpted from keynote address, Dare to Vision Conference, July 14-16, 1994, Arlington, VA. Reprinted
with the author’s permission. For more by Pat Deegan, see:

http://www.patdeegan.com/

CHAPTER 2. AM I A TRAUMA SURVIVOR? / PAGE 11

 CHAPTER SUMMARY: KEY POINTS
•  Children who are abused may grow up believing the world is a hurtful place. It may take time for them
to realize they have a right to be safe and happy, and to identify the impact of trauma on their lives.
•  Adults may also blame themselves for the things that happen to them or minimize the impact of
violence they have experienced.
•  Even women who recognize the impact of trauma on their lives may find it difficult to talk about.
•  Defining one’s own experience in one’s own terms is essential to healing. Women from different
cultures may use different words and frameworks for talking about violence.
•  Peer supporters play an important role in ensuring that people can choose the words they want to use
to describe their experience and help other people respect those choices.

RESOURCES
Cape, A.L. and Clay, S. (2003). Triad Peer Specialist Training Manual. Tampa, FL: University of South Florida.

Deegan, P. (1994). Before we dare to vision, we must be willing to see. Keynote presentation at Dare to Vision
Conference, July 14-16, 1994, Arlington, VA.

Wilkerson, J.L. (2002). The Essence of Being Real: Relational Peer Support for Men and Women Who Have
Experienced Trauma. Baltimore, MD: Sidran Press.

Pat Deegan, http://www.patdeegan.com/

PAGE 12 / CHAPTER 2. AM I A TRAUMA SURVIVOR?

 CHAPTER

PEER SUPPORT FUNDAMENTALS 3

Peer support does not adhere to any one “program

SECTION I. FUNDAMENTALS
model.” Rather, it is a dynamic and flexible approach A NATURAL HUMAN RESPONSE
to connection and mutual understanding based on a set TO SHARED ADVERSITY
of core values and principles. This chapter will present
Most people who’ve been through hard
information on the fundamentals of peer support that
times empathize with and have an urge
have been developed over the years by people who to reach out to others who struggle with
have worked in peer support roles, conducted research problems that feel similar to their own. For
on the topic, and have reflected upon and written about example, an older woman with children
it.1,2,3,4 These ideas can be applied to any setting or shares her experiences with an over-
activity. Understanding the fundamentals will help whelmed new mother. A widow offers tea
you use the strategies presented in later chapters to and words of comfort to a woman whose
apply these principles to peer support relationships husband has recently died. The desire for
with women who are trauma survivors. The chapter peer support relationships can be seen
also suggests books, articles, and websites that provide as a natural human response to shared
additional information. struggles.

What is Peer Support?

Peer support is a way for people from diverse A “peer” is an equal, someone who has faced similar
backgrounds who share experiences in common to circumstances, such as people who have survived
come together to build relationships in which they cancer, widows, or women who parent adolescents. In
share their strengths and support each other’s healing peer support, the people involved have had some sort
and growth. It does not focus on diagnoses or deficits, of similar experience, such as being given a psychiatric
but is rooted in compassion for oneself and others. diagnosis and receiving behavioral health services.
Through peer support, we can challenge ourselves and
That is one of the key differences between peer support
each other to grow beyond our current circumstances
and professional services and treatment. “Support” is
and build the lives we want and deserve. Peer support
another way of expressing the kind of understanding
promotes healing through taking action and by building
and encouragement toward growth that people who
relationships among a community of equals. It is not
struggle with similar issues can offer one another.
about “helping” others in a hierarchical way, but about
learning from one another and building connections. Peer support can take many forms. In the 1930s,
the twelve-step model emerged to provide mutual
emotional, social, and informational support for people
struggling with alcohol dependency. Today, twelve-
step programs are the most widely available mutual
support groups for people in addiction and substance
 1  Campbell, J. & Leaver, J. (2003). Emerging New Practices in Organized abuse recovery, although other models for peer support
Peer Support. Report to the National Technical Assistance Center for
have emerged, including Women for Sobriety (WFS),
State Mental Health Planning (NTAC), National Association of State
Mental Health Program Directors (NASMHPD). Alexandria, VA. SMART Recovery (Self-Management and Recovery
 2  Campbell, J. (2005). Historical and Philosophical Development of Peer Training), and Secular Organizations for Sobriety/Save
Run Programs. In Clay, S. (Ed.), On Our Own Together: Peer Programs Our Selves (SOS).5
for People with Mental Illness (17-64). Nashville, TN: Vanderbilt
University Press.
 3  Solomon, P. (2004). Peer support/peer provided services:

Underlying process, benefits and critical ingredients. Psychiatric

Rehabilitation Journal 27, 392-401.  5 
Substance Abuse Fact Sheet in Brief, Spring 2008, 5:1. “An
 4  Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical Introduction to Mutual Support Groups for Alcohol and Drug Abuse”
perspective. Psychiatric Rehabilitation Journal 25, 134-141. http://kap.samhsa.gov/products/brochures/pdfs/saib_spring08_v5i1.pdf

CHAPTER 3. PEER SUPPORT FUNDAMENTALS / PAGE 13

 ROOTS OF PEER SUPPORT: THE FEMINIST PRACTICE
OF CONSCIOUSNESS-RAISING
Consciousness-raising is a group process rooted in feminism in which people with a common problem
share and explore their experiences in order to draw connections between the personal and the political.

In the 1970s, former mental patients used consciousness-raising as a tool to understand their
experiences in a social and political context. This helped people realize that many of their issues
were not individual problems related to their diagnoses, but the result of patterns of discrimination
and oppression. Ex-patients learned that their feelings of isolation, inadequacy, and powerlessness
were the result of real practices within the mental health system and real discrimination in the
community, not by-products of their “illnesses.”

Consciousness-raising also helped people to recognize their own internalized stigma—their

unconscious agreement with society’s negative stereotypes of “mental patients”—and to develop
new, more empowering beliefs about their ability to regain control of their lives.

In mental health, peer support in its modern form to the hierarchical roles of other behavioral health
began in the early 1970s among former mental patients professions. But in this guide, we define peer support
who were angry about the involuntary treatment they as an activity based on mutual relationships that
had received in state hospitals and other institutions. incorporate the principles described below.
Some of these people found each other and came
together in groups to share their outrage, support each
Principles of Peer Support 6
other’s healing, and demand changes in the system.
While peer support can be practiced in different
In those days, peer support—more commonly called
settings and through a variety of activities, there are
“self-help” at the time—was a communal activity. No
some important underlying values that make peer
one was paid, and people supported each other as they
support unique and valuable. As we discussed earlier,
became activists and advocates for positive change.
these principles have been developed by consensus
In the decades since, peer support has developed in a over the years by people who have been directly
number of different ways, many of which bear little involved in peer support as participants, researchers,
resemblance to the peer support groups of the 1970s. and writers.
Today, as a peer supporter, you may work in a paid
Peer support is voluntary. The most basic value of
or volunteer job in mainstream behavioral health
peer support is that people freely choose to participate.
programs such as outpatient clinics, inpatient units,
It is for people who want to be involved, not people
or emergency rooms. You might work in other service
who have been told they need it or who are pressured
systems, such as a homeless service program, the
to attend. The voluntary nature of peer support makes
justice system, or a domestic violence shelter. Maybe
it easier for us to build trust and connections with one
you are involved as a staff or volunteer in a peer-run
another.
program. Or perhaps you are a member of a free-
standing, independent support group that maintains Peer support is non-judgmental. In peer support, we
many of the qualities of peer support from the early meet people who have experiences, beliefs, or ways
days of the ex-patients’ movement. You may have of living their lives that may be different from our
had formal training by a peer-run organization or a own, despite the things we have in common. Being
state-certified program, or maybe you learned about non-judgmental means approaching each person with
peer support through reading articles and websites or openness, curiosity, and genuine interest.
through participating in a peer support group.

Some organizations—mainly programs that hire  6 

Many of the ideas in this section are adapted from an unpublished
Medicaid-reimbursable peer specialists—define manuscript by Shery Mead, Darby Penney, and Laura Prescott and are
heavily influenced by Shery Mead’s work on intentional peer support
peer support as a “helping relationship,” similar (see Resource section at the end of this chapter).

PAGE 14 / CHAPTER 3. PEER SUPPORT FUNDAMENTALS

Peer support is empathetic. Sometimes people call Peer support requires honest
this “putting yourself in the other person’s shoes.” It and direct communication.
means that we each make a genuine effort to imagine Each of us says what is on our
how the other person feels, what might have led to mind in a respectful way. Learning
those feelings, and how we would want someone to how to speak honestly but with
respond to us in that situation. compassion about difficult issues can be the most
challenging part of developing relationships with our
Peer support is respectful. Everyone is seen as having peers. Combining directness with caring requires that
something important and unique to contribute. We we move beyond our fear of hurting other people or
value everyone who wants to be a part of the group and making them angry and have honest conversations with
treat each other with kindness, warmth, and dignity. the people we need to address.
We accept each other and are open to sharing with
people from many ethnicities and cultures, educational Peer support involves mutual responsibility. We
levels, and religions. We honor and make room for each take responsibility for voicing our own needs and
everyone’s opinions and see each other as equally feelings. Each of us needs to understand that we are not
capable of contributing to the group. there to take care of the other, but that each participant
is responsible for making sure that everyone is heard.

Peer support is about sharing power. No one is in

RESEARCH SHOWS PEER charge and everyone is equally responsible. Sharing
SUPPORT’S EFFECTIVENESS power may be a new idea. If we have been in service
systems for a long time, we may have gotten used
Research on peer support has consistently to being told what to do. Sometimes when people
shown that people benefit by participating. suddenly have the freedom to make decisions, they
Ed Knight, a researcher with mental health
may act like the people who used to make decisions for
and substance abuse histories, reviewed
them. Some people may be more assertive than others
the findings of six peer support studies.
He reported that people with serious and it is important that they allow people who are
psychiatric diagnoses get great benefit quieter and less assertive to be involved in decisions.
from being part of peer support activi- When power is shared successfully, people give and
ties. Emotional distress and substance use take the lead in discussions, everyone is offered a
problems decrease. Participants do not chance to speak, and decisions are made by the group.
have as many crises and are hospitalized
less often. Peer support participants feel Peer support is reciprocal. Every person both gives
better about themselves and have more and receives in a fluid, constantly changing dynamic.
social skills and broader networks of This is very different from what we are used to in
friends. treatment programs, where we are usually seen as
people who need help and the staff are the people who
Other studies have had similar results.
give help. In peer support, we are aware that each of
These include improvements in:
us has things to teach and things to learn. This is true
• Self-esteem whether you are a paid peer supporter or part of an
• Hopefulness informal group.
• Inner strength
Types of Peer Support Activities
Participants also report greater awareness
of their rights and social justice issues and Formal support groups are structured groups in
greater feelings of empowerment. which people who share a common experience meet at
a regularly scheduled time to give each other support
Jean Campbell summarized the “Emerg- by sharing ideas through discussion and conversation.
ing Research Base of Peer-Run Support Usually the conversation focuses on an agreed-upon
Programs” at :
topic or question and the discussion is moderated by
a facilitator to ensure that the conversation stays on
http://www.power2u.org/ track and everyone has a chance to be heard. Support
emerging_research_base.html groups can take many shapes depending on what
works best for the people involved. Groups may follow

CHAPTER 3. PEER SUPPORT FUNDAMENTALS / PAGE 15

 an existing format, such as those used by 12-step own interests or their need to learn something new to
programs, Recovery International, Double Trouble, or help them deal with a current issue they face. Some
other organized models. Peer support groups may be examples might be people who form a study group to
focused on a particular issue or group of people, such prepare for the GED exam, people with diabetes and
as women who are trauma survivors. Members may other health issues learning together how to prepare
decide that the group will be ongoing and open-ended, healthy meals, or women trauma survivors starting
or that it may end after a certain number of meetings. a book club to read and discuss trauma recovery
materials.
Activity-focused peer support. Another way to
organize peer support is around a specific activity. Informal and one-on-one peer support. Some people
Some people just don’t like sitting around and are not joiners and just don’t feel at home in groups.
talking—they’d rather be doing something. This Peer support can happen in many different settings
could be a one-time event, like going with a group and doesn’t have to be highly structured. People can
to a film that has a positive message about recovery. support each other in pairs or in ad hoc small groups.
Or it could be an ongoing activity like a softball Peer support can happen casually on the phone or in
team of women trauma survivors that plays in a person, through email, on the street, or in a park or
neighborhood league. Other possibilities include arts coffee shop. One-on-one peer support can also happen
and creative expression or volunteering together to in a planned way in peer-run programs or with peer
work on community service projects. Doing things support staff in mainstream programs.
with others helps develop a common purpose, a group
identity, and a sense of belonging. Advocacy is a positive way to put peer support into
action. It’s about a group deciding what they want,
Educational activities. Learning new things with what changes are required to attain their goal, and
one’s peers can be exciting and less intimidating communicating effectively with the right people to
than trying to learn on one’s own. When people start make this happen. Working together to solve a common
thinking about what they want their lives to become, problem helps build connections among people and
instead of just talking about what went wrong in the improves their confidence in their ability to make
past, they can learn and create things together that their lives better. By taking action together, people
they might not be able to accomplish alone. They can move away from feeling helpless as they recognize the
create what’s called a “learning community” of people possibilities for making positive change together. Even
who teach and learn together about topics that interest when advocacy doesn’t result in all the changes people
them, without formal teacher/student relationships. want, they develop a sense of strength and purpose that
Most educational activities grow out of people’s can make them feel empowered and hopeful about the

ROOTS OF PEER SUPPORT: 12-STEP PROGRAMS

The 12-step movement was launched when one alcoholic turned to another for help in 1935.
Two men, Bill W. and Dr. Bob, began informally working with others to quit drinking and
stay sober through self-help techniques based on spirituality. In 1939, Bill W. wrote a book,
Alcoholics Anonymous, based on the 12 principles that he and Br. Bob developed for their
12-step recovery program.

Alcoholics Anonymous (AA) is “a fellowship of men and women who share their experience,
strength and hope with each other so that they may solve their common problem and help
others to recover from alcoholism.” Narcotics Anonymous (NA), founded later, is based on the
same principles. AA/NA believes that drinkers/drug users must stop drinking/using completely,
admit they are powerless over addiction, and rely on a higher power for help. Members also
believe that alcoholism and addiction are diseases. Anonymity, group unity, and shared
responsibility for leadership are important features of 12-step recovery groups.

Bill W. and other AA pioneers spread a radical new philosophy. It taught that people do not have
to rely on “experts” to change their lives, but can do so with the support of people who share
their experience.

PAGE 16 / CHAPTER 3. PEER SUPPORT FUNDAMENTALS

future. Many people have had experiences in their lives Internet peer support. Meeting
or in service systems where their wishes have been people in person can be hard.
ignored, they haven’t felt listened to, or where they Some people live in rural areas
have had things done to them, rather than with them. where travel is expensive or
As advocates, they can support each other as they learn public transportation is lacking.
how to make their voices heard, make sure their rights Others may feel socially awkward
are protected, and get supports and services that work after years of isolation in systems or because of the
for them on their terms. side effects of medication. People may be trying to
re-learn how to socialize without using alcohol or
drugs to numb their sense of insecurity in social
Where Does Peer Support Take Place?
situations. The Internet provides opportunities for
Peer support can be practiced in a variety of settings,
peer support through social networking sites like
each presenting particular challenges and opportunities.
Facebook, through blogs and websites, and through
Some of the common locations and situations where
online discussion groups. Using these tools, it’s
peer support happens include:
possible to safely meet new people who want to share
Independent, unincorporated peer support groups. information on vital issues and to build virtual online
These are voluntary groups developed by people communities of support.
to meet their own self-defined peer support needs.
Usually, such groups are not funded by government,
although they may raise funds to cover the costs of
their activities. This kind of group is not explicitly part PEER RECOVERY CENTERS
of a service system, even though its members may have Across the United States, more than 30 Peer
met each other through programs. Groups may meet in Recovery Centers have been established
members’ homes or in free community spaces such as with funding from SAMHSA’s Recovery
churches or libraries. Community Support Program to promote
sustained recovery from alcohol and drug
Peer-run programs. These are incorporated not-for- use disorders. Many who use these peer-
profit organizations that are run by people who have to-peer services are trauma survivors.
used behavioral health services, and are governed by
a majority peer board. They may receive government The RECOVER Project in Western
funding and/or private funding. Common types of Massachusetts is a large, welcoming space
in Greenfield offering peer-led activities
peer-run programs include peer support centers,
including art classes, free yoga and reiki,
drop-in centers, warmlines, housing programs,
sober social events, leadership training, and
employment programs, and crisis alternatives. mentoring. The RECOVER Project uses a
Peer support staff working in mainstream participatory process to ensure that decisions
are made by the recovery community as a
behavioral health programs. In many states, people
whole. Creating a trauma-informed center
are hired into positions called peer specialists (or
was a central goal, supporting their efforts to
similar titles) which may or may not require a state “provide support, services and solace to
certification. Typically, people in these positions families and individuals who are living in fear”
provide peer support services in inpatient units, and to “create conditions where every
emergency rooms, and a variety of community-based member can achieve a full and satisfying life
programs. People working as paid staff in traditional free of violence and its consequences.”
programs may face particular challenges in adhering
The RECOVER Project has developed a
to the values of peer support, as agencies that work
manual, How to Build Your Own Peer-to-Peer
from a medical model may not recognize the impact
Recovery Center From the Ground Up!
of trauma and may not understand the unique role of Available for download at:
peer support. Ideally, the role should be to facilitate
the development of peer support relationships and
http://www.recoverproject.org/
communities rather than to act in a hierarchy-based
“expert” role.

CHAPTER 3. PEER SUPPORT FUNDAMENTALS / PAGE 17

 CHAPTER SUMMARY: KEY POINTS
•  Peer support is a flexible approach that people who share common experiences can use to build
relationships that support each other’s growth and healing and open up new ways of understanding
oneself and others.
•  The core values of peer support focus on mutuality, reciprocity, being non-judgmental, and sharing
power in non-hierarchical ways.
•  Peer support can take different forms and can take place in a wide variety of settings.
•  In peer support, we support and challenge each other as we develop new ways to interpret and make
meaning of our life experiences, our relationships, and our futures.

RESOURCES
Campbell, J. (2005). Emerging Research Base of Peer-Run Support Programs. Available at
http://www.power2u.org/emerging_research_base.html

Campbell, J. & Leaver, J. (2003). Emerging New Practices in Organized Peer Support: Report to the National
Technical Assistance Center for State Mental Health Planning. Alexandria, VA: National Association of State
Mental Health Program Directors (NASMHPD). http://www.consumerstar.org/pubs/Emerging%20New%20
Practices%20in%20Oraganized%20Peer%20Support.pdf

Kalinowski, C., & Penney, D. (1998). Empowerment and women’s mental health services. In B. Levin, A.K.
Blanch, A. Jennings (Eds.), Women’s Mental Health Services: A Public Health Perspective. Thousand Oaks, CA:
Sage Publications.

Harp, H. & Zinman, S. (1994). Reaching Across II: Maintaining our roots/ The Challenge of Growth. Sacramento,
CA: California Network of Mental Health Clients.

Mead, S. (undated). Trauma Informed Peer Support. Available at http://www.familymentalhealthrecovery.org/

conference/handouts/Workshop%209/Trauma%20informed%20Peer%20Support.pdf

Mead, S. (2001). Peer Support and a Socio-Political Response to Trauma and Abuse. Available at
http://www.mentalhealthpeers.com/pdfs/PeerSupportSocioPoliticalResponse.pdf

Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric Rehabilitation
Journal 25, 134-141.

National Empowerment Center, http://www.power2u.org/consumerrun-statewide.html

National Mental Health Consumers Self-Help Clearinghouse, http://www.mhselfhelp.org

Recover Project, http://www.recoverproject.org/

The Substance Abuse and Mental Health Services Administration’s Recovery Community Services Program
(RCSP), http://www.samhsa.gov/grants/2011/ti_11_004.aspx

Starting and Maintaining Support Groups Library,

http://www.ccsr.wichita.edu/selfhelpgroupsupport_starting.htm

Zinman, S., Harp, H., & Budd, S. (1987). Reaching Across: Mental Health Clients Helping Each Other. Sacramento,
CA: California Network of Mental Health Clients.

PAGE 18 / CHAPTER 3. PEER SUPPORT FUNDAMENTALS

 CHAPTER

GENDER POLITICS AND THE CRIMINALIZATION OF WOMEN 4

Since both men and women experience trauma, why objectify women, and violence against women is

SECTION I. FUNDAMENTALS
create a manual that focuses on women? While men common. Until the early 1990s, women were routinely
experience high rates of trauma, we saw in Chapter 1 excluded from clinical medical research trials and
that women are more likely to experience violence at were overlooked in many systems—for example, in
the hands of people they know and trust, while men employment, jails, and homeless shelters. As a result,
are more likely to experience violence from strangers. many systems are basically designed for men, with
These differences have a profound impact on how women and children added as an afterthought. Gender-
women and men understand their trauma experiences, related issues are often overlooked. For example,
and on peer support relationships. When services are many mental health programs do not routinely ask the
“gender-neutral” and fail to recognize the unique issues women they serve about possible domestic violence or
related to betrayal, trust, safety, and shame—and their about whether they have children. As a peer supporter,
impact on engagement, connection, and relationships— you may encounter women who are struggling to get
women who have experienced trauma may find it their basic needs met. You can support them with
impossible to heal. Although you may not be in a understanding, information, and advocacy.
position to provide gender-specific peer support, it
is important to consider gender-specific needs.

But there are other reasons, too. Throughout history, INVISIBLE NO LONGER
women’s experience has been invisible, ignored, or
discounted. Women are socialized to take on certain In 2007, women represented 65% of the
sheltered homeless population.
roles, and if they don’t follow the rules, they may be
treated as sick or criminal. Understanding this will help Women with children who have sole
you better support the women you work with. This economic responsibility for their families
chapter will provide an overview of how gender role is one of the fastest growing sectors of
socialization contributes to violence and trauma, how homelessness.
social norms and institutions affect women survivors,
Over 90% of homeless mothers have been
and how gender may affect peer support relationships. seriously physically or sexually assaulted.
It will also set the stage for gender-based tools and
techniques described in later chapters. – From Laura Prescott, A Long Journey
Home, 2008

The Invisibility of Women Women make up 17% of the total popula-

Historically, women were considered to be the property tion of offenders in the justice system.
of men and were believed to be physically, mentally, They are more likely than male offenders
and women in the general population to
emotionally, and spiritually weaker than men. The
experience physical or sexual assault.
notion of women’s bodies as men’s property was
established in the Code of Hammurabi in 1800 BC, Many of the 3,000 jails across the country
codified in English Law in 1769, and adopted by the are too small to have separate facilities for
United States in 1776. It was not until 1962 that a U.S. men and women.
court first ruled that men do not have a right to beat
Girls are the fastest growing population
their wives, and not until the 1980s that U.S. courts in the juvenile justice system. Traditional
ruled that men do not have a right to rape their wives. justice practices may backfire with the
very high percentage of girls who are
Until relatively recently, women have been socially,
abuse survivors.
as well as legally, “invisible.” Girls still grow up
in a society where political and economic power – From Women and Trauma: Report of the
rests primarily with men, media and popular culture Federal Partners Committee on Women
and Trauma, 2011

CHAPTER 4. GENDER POLITICS AND THE CRIMINALIZATION OF WOMEN / PAGE 19