TiD Moment: Why Do We Call it "Trauma-informed Design?"

TiD Moment

Why Do We Call it "Trauma-informed Design?"

In recent months, there has been a movement away from the term “Trauma-informed Design” towards “Designing for Dignity” or simply “Dignified Design.” This shift is intended to contribute to more positive, salutogenic language, recognizing that much of the research into trauma and its impacts stems from a pathogenic model, and is itself being promoted as a more trauma-informed way of speaking about the field of designing for resilience.

A key element that contributes to this way of thinking is that the general public does not recognize the true extent of trauma’s prevalence. There is a segment of the population that actively rejects the notion that they have experienced trauma. This is, in part, due to stigma and, in part, because they don't believe that whatever they experienced was "as bad" as someone else's more significant experience that is universally understood as traumatic. This view is where the notion of "Big T" and "little t" trauma came from—but science tells us that any event that a person experiences as emotionally or physically life-threatening and has long-term negative impacts on that person's outcomes is traumatic--so there's no distinction based on the size or type of event.

When we wrongfully assume that there are different levels of trauma, or that trauma is not virtually universal, it leads us to believe that Trauma-informed Design is only necessary for certain types of projects, such as behavioral health centers or transitional housing for the unhoused or survivors of domestic or intimate partner violence. And if the individuals who use those services do not see themselves as traumatized, the language of “Trauma-informed Design” can alienate the very people we wish to uphold and support. In this way, the shift to “Dignified Design” makes sense and seems appropriate.

The shift to the language of dignity can lead to a corresponding shift in our focus, however, and lead us to mistakenly center dignity, autonomy, or other ideals over the primacy of safety and the other domains of the Trauma-informed Design Framework. The goal of Trauma-informed Design is to improve long-term outcomes (beyond health) for individuals, by preventing traumatization in the first place and reducing the impacts and chances of re-traumatization for those who have already experienced trauma. We do this by reducing stressors and potential triggers in the built environment and creating spaces in which healthy relationships are fostered and users can strengthen their resiliency. We focus on stress because toxic stress is the mechanism by which adverse experiences become traumatic. We focus on triggers because they increase the likelihood of stress responses. We focus on relationships because they buffer stress and are the key to healthy attachments and world view. We focus on resiliency and associated skills because individuals can lean on these when they are not able to rely on their relationships.

Removing the word "trauma" from Trauma-informed Design can lead us to lose our focus. Since evidence shows that trauma negatively impacts long-term outcomes in a dose-response relationship, and since this relationship is largely not considered in the traditional design processes, the best way to improve long-term outcomes through design is to prevent traumatization in the first place and reduce the impacts of trauma on those that have experienced it. To achieve this, we focus on what we know works from care and therapeutic models and match it with design principles that can embody those principles in the built environment. In short, it is through understanding trauma that we can best attain our goals—centering it grounds our approach and illuminates our path forward to a healthier future for all.