“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare”

As people in west London prepare for the second anniversary of the Grenfell Tower fire, many continue to suffer the after-effects of the June 14^th 2017 atrocity. Much has happened since that date to compound the community’s suffering and symptoms of trauma are evident across North Kensington. A new approach is needed in response to the limited, flawed and sometimes counter-productive trauma relief efforts so far. North Kensington is an appropriate place for some fresh thinking on trauma: how it manifests; how people and communities deal with it and the possibilities available if we are open to braver, better solutions.

The Brain and Trauma

Trauma can manifest in people who aren’t perceived to be unwell enough to be formally diagnosed with post-traumatic stress disorder (PTSD) or hospitalised. The traumatised person might not recognise that they are suffering, but the part of the brain that is devoted to our survival – the sympathetic nervous system – may have kicked in. This is described in simple terms as fight, flight, freeze – although responses differ in everybody. The result is a stream of experiences that are defined as trauma.

Dr Gabor Maté, the renowned speaker, author and trauma expert, identifies disconnection from ourselves as the essence of trauma: “trauma is not what happens to you, but what happens inside you as a result of what happens to you.”

Some typical symptoms include:

• Stress hormones are produced
• Unpleasant emotions arise
• Uncomfortable physical sensations
• The person might become impulsive and aggressive
• It becomes difficult for the person to filter the relevant from the irrelevant
• The traumatised person may feel less alive and less present

The impact of a single disaster trauma event can be large scale, shaping histories and whole cultures. The impact can also be felt on a smaller scale, affecting individuals’ minds, emotions, capacity for joy and physical health. The large-scale societal impact is dictated by the preponderance of trauma among a population. It follows that the ability of a society or culture to move on from trauma is dictated by the ability of the individuals within the population to recover.

Yet trauma doesn’t only manifest following big one-off, life-changing events; it can be caused by a series of smaller continuous events, such as adverse childhood experiences, racism, poverty, bereavement or illness. The link between all of these is that they trigger the same physiological responses. However, those who have already been impacted by long-term experiences of continuous trauma can have less resilience when big events occur.  

Traumatic events are, by their very nature, unbearable for humans, overwhelming their ability to cope. As people cannot tolerate the sensation, they instinctively push it away and try to move on in life. For some their experiences cause them to automatically dissociate – or disconnect – from what they are feeling or thinking as part of a survival mechanism. This coping mechanism leaves people unable to move on because they do not process the original experience and the energy charge generated becomes trapped in the physical body, potentially leading to other long-term health conditions.

This effectively means that the traumatising experience is not over. Triggers that cause the person to dissociate can come in many forms – sight, smell, sound, overwhelming situations, shock, anger etc. – and happen without warning. Existing mental health conditions and addictions often deteriorate in these circumstances and new addictions can emerge as ways to proactively disengage from reality or to numb from pain.

Vicarious Trauma

PTSD is widespread in North Kensington, estimated to be in the thousands. The trauma has been exacerbated by the prevailing sense of injustice, as if a whole community is paused, waiting for an appropriate response from those with the power to provide one. Vicarious trauma is also rife, with many people stretching themselves to support those affected by the fire. Vicarious trauma, not to be confused with exhaustion or compassion fatigue, is a rational response to the process of prolonged empathic engagement with traumatised people. It is impossible for people suffering from vicarious trauma to be effective in helping others while their own needs and feelings are bypassed.

Additionally for many, the thought of being judged as weak, vulnerable or unable to cope can trigger feelings of shame that add to the anguish of trauma. For many of us in North Kensington, there are people worse off than ourselves: bereaved; survivors; friends; witnesses. In this situation, there is a sense of guilt among those less directly affected.

Response

In response to the 2017 fire, the NHS offers trauma-focused Cognitive Behavioural Therapy. It also offers a link to a Kensington and Chelsea council (RBKC) flyer for other services including art therapy, youth clubs, a local charity and the Chickenshed theatre company. The offer is very limited, with figures revealing that hundreds of affected people stopped attending their therapy sessions in the year after the atrocity. The promotion of RBKC services by the NHS is problematic for obvious reasons.

One resident of Lancaster West (the estate where Grenfell Tower stands) engaged in talk therapy at St Charles’ Hospital, but told us that many people won’t go there as it is “too clinical” and “alien to people’s cultures,” especially elders and the young. She managed two sessions there but experienced it as overwhelming and switched to a service at an alternative, culturally-appropriate venue. There, she engaged in talk therapy, which was followed by qigong sessions. But when the funding was cut for that service, no replacement was offered.

On RBKC, North Kensington Law Centre issued a report stating that: “The Council’s interaction with residents in the period after the fire had the capacity to alleviate some of the trauma of survivors, but instead too often only exacerbated it…residents’ trauma has been unnecessarily exacerbated as they wait for what are often relatively simple or trivial matters to be resolved”.

One particular criticism was of the council’s “tick-box” approach: “Too often…Grenfell-affected residents have been treated with a business-as-usual attitude. A tick box approach to assessing needs in these exceptional circumstances will not result in a proper understanding of those needs”.

In a culture that is already trauma-ignorant, RBKC’s at times clumsy, at times callous approach, has not been good enough. 

What could be done?

It is important to honour the strength and courage of survivors, to nurture optimism. It is also important to know that people can overcome the symptoms of trauma; humans are very resilient and wired to survive. Studying communities that have been impacted by a single disaster suggests that 9 out of 10 people will learn and grow. People can recover to live hopeful and meaningful lives despite terrible experiences.

Dr Gabor Maté notes: “The essence of trauma is disconnection from ourselves. Trauma is not terrible things that happen from the other side—those are traumatic. But the trauma is that very separation from the body and emotions. So, the real question is, ‘How did we get separated and how do we reconnect?’”

Trauma-informed

For this reason, a Trauma-informed approach to local residents is crucial, and this should not be limited to the medication and short-term therapy on offer currently. Trauma symptoms can be managed through medication but recalling what has happened or expressing emotions is not enough. Contemporary thinking says that the key is to change the physiology of the body and switch the overactive part of the brain off. By learning self-regulation, the person can begin to master the part of the brain that has switched on overactive reflexes and learn to switch them off. In other words, while trauma can manifest as the disconnection of the person from the body and the present moment; healing comes from reconnecting to both.

It is necessary to see trauma recovery as an ongoing act of self-care and self-love. An event hosted by We Coproduce CIC to coincide with the Grenfell anniversary explores the latest thinking about trauma. It seeks to help people understand how the experience of trauma manifests in the physical body, how the brain responds to being overwhelmed and what can be done about it. Day One sees Dr Gabor Maté discuss his views on all types of trauma in a day-long workshop. Day Two has salon-style discussions and embodied practice workshops to explore various tools for self-care and managing the nervous system.

Self-care was described by the iconic American writer and activist Audre Lorde as “an act of political warfare” – as we mark the second anniversary of the Grenfell Tower atrocity and honour those who were so needlessly lost, perhaps one of the most proactive and powerful things that residents of North Kensington can do is to understand their own trauma and learn ways to care for themselves in order to survive and even thrive in the face of an ongoing injustice.

By Tom Charles and Jane McGrath

@tomhcharles

@wecoproduce

Trauma Matters, hosted by We Coproduce CIC, takes place at the Tabernacle on the weekend of 15^th-16^th June.

We have a limited number of free tickets to give away to North Kensington residents for day two. To request a ticket please email jane@wecoproduce.com

The authors of this article are not trauma experts and those suffering with trauma should consider seeking professional help. We wholeheartedly recommend the talks of Dr Maté, easily found on YouTube, as well as the books ‘Waking the Tiger’ by Peter Levine and ‘The Body Keeps the Score’ by Bessel van der Kolk.

We Coproduce CIC

Wecoproduce.com is a social consultancy owned and run by local people in West London to give local people an equal voice. We start from the position that in the 21st century our health and social care systems are flawed and need to be radically reimagined. To achieve this, we created a disruptive consultancy – ‘We Coproduce.’  We are commissioned to work with our communities to coproduce better and braver solutions to health and social care challenges – and we invest all of our profits into building resilient communities. Our national network of collaborators use authentic coproduction and radical disruptive innovation techniques to challenge systems that are not working. To do this effectively we use the arts, interactive technology and social media to facilitate democratic spaces for local people to collectively reimagine local health and social care outcomes.

We remain a small Community Interest Company.

Dr Gabor Mate

Dr. Maté has received the Hubert Evans Prize for Literary Non-Fiction; an Honorary Degree (Law) from the University of Northern British Columbia; an Outstanding Alumnus Award from Simon Fraser University; and the 2012 Martin Luther King Humanitarian Award from Mothers Against Teen Violence. For his ground-breaking medical work and writing he has been awarded the Order of Canada, his country’s highest civilian distinction, and the Civic Merit Award from his hometown, Vancouver.

Dr. Maté is the author of several best-selling books:

Scattered Minds: A New Look at the Origins and Healing of Attention Disorder;

When the Body Says No: The Cost of Hidden Stress;

Hold On To Your Kids: Why Parents Need to Matter More Than Peers and

In The Realm of Hungry Ghosts: Close Encounters With Addiction.

For more information on these titles, plus articles, speaking dates and links to videos go to his website: drgabormate.com. Many of his talks and interviews are also available for free on his YouTube channel: https://www.youtube.com/channel/UCsRF06lSFA8zV9L8_x9jzIA