Recognizing Intersectional Trauma, with Aisha T. McDonald, LMHC | EDB 328
Licensed Mental Health Counselor and Certified Trauma and Resiliency Expert Aisha T. McDonald, LMHC explains why trauma should be looked at through an intersectional lens.
Aisha T. McDonald, LMHC is a Licensed Mental Health Counselor and Certified Trauma and Resiliency Expert. She has worked in the social services field for over 12 years in a variety of capacities ranging from advocacy, direct service, and macro-focused positions. She is also a Diversity, Equity, Inclusion, and Belonging expert who aims to address the systemic barriers to equity in our community. Throughout her varied roles, Aisha has worked with marginalized populations within South Florida specifically those with severe and persistent mental illness, the forensic population in the criminal justice system and those incarcerated in local jail facilities, individuals with co-occurring mental health and substance use disorders, youth in the welfare system and those in the department of juvenile justice, and individuals who are involuntarily hospitalized under Florida’s Baker Act and Marchman Act laws.
She currently works for United Way of Broward County as the Director of Training Initiatives where she facilitates and moderates community-wide trainings and professional development workshops focused on mental health awareness and education, racial and cultural trauma, substance use issues, as well as diversity, inclusion and social equity. Aisha also serves as a Suicidologist for the American Association of Suicidology where she conducts Psychological Autopsy trainings for national and international groups. She has worked with FAU Sandler School of Social Work for a number of years to offer professional development workshops such as these in order to enhance professional and clinical skills for our community agencies and providers.
For more information about the United Way of Broward County: unitedwaybroward.org
For more about American Association of Suicidology: suicidology.org
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Note: the following transcription was automatically generated. Some imperfections may exist.
HACKIE REITMAN, MD (HR):
Hello there. I’m Dr Hackie Reitman. Welcome to another episode of Exploring Different Brains, and today I’m excited to have with us Aisha McDonald, who does so much for so many people at the United Way and other places. She’s a suicidologist. She’s a lot of different things, and she’s going to tell us all about it. Aisha, welcome to Different Brains.
AISHA McDONALD, LMHC (AM):
Thank you for having me. It’s so good to be here. I didn’t know what I expected, but this exceeds my expectation.
HR:
Well, that’s great. We’re happy, and you exceed our expectations. Now you can tell us all about what you do. Give yourself a proper introduction the way I did it.
AM:
Alright, I mean, talk about myself, little me. You don’t have to tell me twice. So I am technically by trade, a licensed mental health therapist. I significant part of my career was spent working in direct service as a clinician, working with individuals who just had a variety of mental health issues and concerns and just challenges that they were facing in their day to day life. And I did that for quite a few years in different areas. I worked with youth in the foster care system who had behavioral health challenges. I worked in the forensic system with treatment courts, mental health court, drug court, veterans court, wherever they called me to just helping individuals who had been incarcerated who had mental health needs, connecting them to care instead of leaving them incarcerated in facilities that weren’t going to provide adequate treatment. And then I also worked at two psychiatric hospitals with people who had been hospitalized because of their severe and persistent mental health issues. And so I did that for a very, very long time, and I loved it a lot, but I wanted to be able to do more and reach more, and rather than, you know, continue working on an individual basis with all these different individuals, I really wanted to expand my just skills in some way that I could reach more people. And so I started working with United Way of Broward County, where I be, have since become the director of training. And one of the things that I oversee is different training initiatives for professionals as well as community members throughout our county, so I can help now train the service providers who are providing the same type of services that I used to provide.
HR:
So mental health issues and psychological trauma and suicides have been going through the roof. Literally. They’ve increased greatly, multi factorially. Can you talk about some of the factors from your point of view that have led to these increases?
AM:
I think the a good place to start would be starting with trauma. I think trauma isn’t necessarily as understood as it should be when it’s a lot more widespread than people really can imagine it to be. And what I was seeing throughout my career was a lot of people had mental health challenges and complaints and problems that they wanted to address in therapy, and a lot of what was contributing to those problems was just the circumstances that they were living in or the experiences that they’ve had. And so one of the trainings that I do teach and oversee is a trauma training where we try to get people to have a broader understanding of how trauma impacts the brain, how trauma impacts people’s life, their day to day functioning. And one of the statistics that I quote all the time is that trauma is really the gateway drug to a lot of these issues and challenges that people have. There’s been a wide range of studies that have been done on trauma, and one of the things that have come out of a few different studies has been that for individuals with mental health diagnoses, about 80% of people with a mental illness have experienced trauma at least once in their lifetime. And then for people with a substance use diagnosis, it’s about 90% of them that have experienced trauma in their lifetime, and so a lot of the circumstances that people find themselves in and experiences was because of what had happened to them in the past. And the more we can better understand that it’s what happened to people that leads to a lot of these issues, the better we can. That understanding of how trauma impacts…
HR:
What percentage of the people who do not have mental health issues have sustained trauma?
AM:
I don’t know if we have a definite statistic for that, but at least half of our population experiences some type of trauma in some way at some time in their life, whether it’s childhood trauma, it’s individual, big tea traumas, a big circumstance that happened, or just even we call them the little teas, day to day traumatic incidents that happen. There’s things that we don’t even acknowledge and realize can be as traumatic as they are. A car accident, for instance, can be a traumatic incident that people go through. But that’s not to say that we’re all just living traumatized life. Not everybody who goes through trauma is going to have symptoms of trauma, but it occurs a lot more frequently than we think. And there’s even societal trauma, mass events that happen that impact communities at large that we don’t even realize have a long, lasting impact.
HR:
Can you talk about how trauma might look different from one community to the next, and the lack of understanding that can result from that being from a different community?
AM:
Oh, that’s a very, very good question. I think for certain groups of people, certain life events become so normalized that the situations that they go through, they may not even acknowledge and realize that this is a traumatic event, because for them, it’s just their day to day lives right growing up in certain environments and certain communities that have a higher impact of trauma, but it’s your just your normal daily living looks differently when I think of certain communities that are impacted by trauma more severely without even the full fledged recognition of it. I think of communities that have been marginalized in society, communities that have been historically oppressed, and even for me, one significant community that is impacted by trauma is the neurodivergent community, because trauma impacts the brain differently, and when you have people that are living with different brains already, what neurotypical people might recognize as a traumatic incident might not translate immediately to that for them, and we may not recognize that an incident is traumatic for them, because we don’t understand the functioning of their brain, because it doesn’t work like words do.
HR:
And when you look at the different cultures, certain cultures have more stigma attached to admitting you have mental health issues and going to seek help.
AM:
I talk about my own cultural background. When I talk about mental health a lot, because I come from, I say two cultures that don’t traditionally subscribe to mental health. I’m black, which is a culture within itself, but I’m also Caribbean, and in the islands, we don’t acknowledge mental health issues the way it’s acknowledged in the United States, not that it doesn’t happen. It’s not that it’s not occurring. We just don’t recognize it the same as, you know, westernized cultures oftentimes recognize it. And so in those communities, it’s not that it’s not happening. It’s just that it goes unsiad. And if it goes unsaid and there’s no open communication and conversation about these things, then a lot of the times, you’re taught to deal with it in ways that aren’t through using therapy.
AM:
Well, I won’t say that part, but I will say a lot of alternative coping mechanisms have been used in trying to address the things that we go through, or even just using different types of healing methods. For some communities, their healing is through religion and spirituality, and so they’re much more likely to something happens that causes me this type of stressful circumstance in my life. I’m gonna go talk to my pastor or my rabbi or my priest, not a therapist.
HR:
A lot of weed!
HR:
How important is an understanding of intersectionality in treating these individuals?
AM:
Intersectionality is a I want to say, for me, one of the priority items that I think needs to be focused on when it comes to treating any individual. And I will be at. Absolutely honest about just the nature of the field of psychology and how it was developed and created, doesn’t really teach us to treat intersectional identities very well. You know, a lot of the field of psychology is rooted in very Eurocentric models and ideals, and so you’re taught this method of treating it that doesn’t necessarily apply to the larger community. It applies to white people, and when you consider different intersectional identities and what people come into rooms with the lack of cultural awareness and the lack of awareness on how those intersectionalities conflict with each other sometimes, or how they contribute to each other, is important for us to know, because you are using a model that shouldn’t really be a one size fits all, because it doesn’t how I communicate with people differs based on their background, their nationality, their life experiences, their cultures, even the language that they speak, looks differently. And so having that concept of those intersectional identities and what people are bringing into the room with them is so important, because you have to make sure that you are individualizing how you approach people. Because I may have tried this different model with one person, and it worked perfectly, and then this other individual just doesn’t respond to that. And instead of thinking that, well, oh, this person is just resistant, it’s not about them being resistant is am I meeting their needs the way those need to be met.
HR:
And then if we get into a specific neurodiversity, let’s see, let’s speak, address a little bit of autism. The intersectionality of autism with this.
AM:
That is one that doesn’t just affect me professionally, I come from a family of neurodivergence individuals, right? And having family members who are on the spectrum, ADHD, ADHD, having a son who is on the autism spectrum makes it even more significantly important for me for people to be understanding of how their intersectional identities impact the therapeutic process or mental health or the trauma that they experience. I talk a lot when I teach my trainings about even just the concept of eye contact therapy is designed for us to sit across from each other, look each other in the eyes and share our deepest, darkest, private feelings and thoughts. And then I have family members who are on the spectrum who can’t make eye contact, can’t communicate the way that neurotypical individuals expect them to be able to communicate. Can’t sit still across from somebody for a whole entire hour of a therapy session, and if there’s no understanding of those particular traits and how that may delay communication or impact communication, then you are going to miss a huge part of who that person is and how they can be responsive to what their mental health needs are.
HR:
Is there anything we haven’t covered that you would like to cover today?
AM:
I think in understanding how trauma impacts the brain, I want to just delve a little bit into the fact that when we’re talking about trauma, we’re not just talking about these one time incidents. And then I have, you know, a negative reaction to it, and then I go back to living my life. Trauma impacts the brain in such adverse ways that it can have significant long term effects, but also it can change the neuro development of the brain itself. A traumatized brain grows differently. Receptors don’t connect like they should. Synapses don’t respond like they should. And when you expand that to other intersectionalities, when you think of neurodivergent brains that already have certain limitations in their development, and then you compound trauma with that, that reaction that the brain has can significantly impact a person’s functioning. And so when we think about how trauma impacts people, it is their day to day lives that may just have some limitations in ways that we don’t always understand. Yeah, and you don’t have to get it. I don’t expect everybody to become a trauma expert to be able to live their lives. But what I do hope that we start doing is stop asking people what’s wrong with them, and start asking people what happened to them. And when you ask somebody what happened to them, you get a whole different life story, because you’re not assuming that they’re inherently negative as a human being by asking them, oh, what’s wrong with you? Why are you this way? But you’re asking them, What were those experiences that shaped you and that shaped your brain to this outcome, and how can we combat those adverse effects.
HR:
What is one thing that you wish everyone understood about trauma?
AM:
I think one of the things that I wish people understood the most about trauma is that it happens so much more frequently than we think. We have different types of trauma. There’s different ranges. And it’s not to say that one traumatic event is more severe or serious than something else, but I’ll give some, I’ll give some levels of trauma, is what I call it, that we have we have aces, which is the adverse childhood experiences, which are things that happen in childhood that have an impact on long term growth and impact you when you’re as an adult, and may lead to secondary, chronic issues. We have big T traumas. The Big T traumas are the ones that people tend to recognize is a traumatic event, a mass shooting, a natural disaster. These are things that, as you see it on the news, you can go, Whoa, that’s a major issue. And I feel, you know, we instantly feel sympathy for the people who experienced it. And then there’s the little tea trauma. There’s the daily things that happen that we may not even recognize. May have been a traumatic event, but for the person experiencing it can have those negative, long term adverse reactions. You have historical trauma, and historical trauma is a hard one for people to grasp, because the concept of it is that I may not even personally go through these experiences, but be still be living with the impact of them. There’s three particular groups in the United States that are most impacted by the concept of historical trauma, and that is the Black and African American community, the Native American community, and the Hispanic and Latino community. And you only have to study the history of what this country has done to those Well, probably not in Florida. I don’t know what our history books look like with the current legislation, but if you have an understanding of what they’ve historically gone through, you can definitely try to comprehend how to this day they’re still being impacted. And there’s intergenerational trauma, which is just certain traumatic experiences that get passed on from generation to generation in families, and it’s become oftentimes so normalized in those families that they may not realize that they’re still experiencing these traumatic events, because that’s just our regular family tradition or family life.
HR:
And in the Jewish community, of course, the Holocaust and throughout history.
AM:
The Jewish community definitely was one of the communities that have been studied when they considered epigenetics of trauma and how trauma can become inherited and genetically passed down in family members, one of the particular studies when they started focusing on that was the prisoners of wards were in World War Two. And, you know, in bringing these individuals in for the study, they were looking at what were some of the symptomology that they were experiencing and going through, chronic medical issues, mental health issues, emotional challenges, and in their responses, a lot of them were reports in having offspring and even grandchildren who had the same symptoms. But those individuals had never been prisoners of war in World War 2. So how could you account for the fact that they had the same symptoms? And they started really expansively studying epigenetics, and it’s still a very controversial study. There’s a lot of support for it, and there’s a lot of contradiction. So it’s still something that the field is still even paying attention to, but trying to better understand how sometimes we’re inheriting things, even though we never went through these experiences,
HR:
Especially in the black community, I imagine.
AM:
And there’s one thing that I also want people to understand from trauma, is that, and I’m going to use a cliche that, I’m not gonna lie, I hated when my grandmother and my mother used as a child. But there’s this cliche that they always used to say to me when I complained about things, and it was, what doesn’t kill you makes you stronger. And I would roll my eyes, because I’m trying to complain right now, and you’re hitting me with this. And then I started studying trauma, and a lot of the focus was on PTSD, the post traumatic stress and the disorders that come from that. And then I came upon this concept of post traumatic growth, and I remember researching and looking further into post traumatic growth. And the premise of post traumatic growth is what doesn’t kill you makes you stronger. And I was like, darn it. Mommy was right. But it is the concept that sometimes, instead of having negative adverse reactions, we actually build better skills after traumatic events that allows us to navigate the world in different ways. And I think about my black community and my black experience, and I think about the historical trauma that we’ve experienced, the current trauma that we still experience in so many ways, all the isms that we face, and our general lack of subscribing to traditional therapeutic methods, but we’re still existing and surviving and in a lot of ways, thriving, and it is the relativity to that post traumatic growth that allows us to get through some of these daily life challenges, because a lot of us have historically struggled for so long that we’ve adapted coping skills to those struggles in ways that allows us to continue living despite what we’re going through. And you know, I want people to understand that the same way, epigenetics have shown us that you can inherit trauma experiences and symptoms. You can also pass on healing, and healing is a huge factor in protecting us against a lot of these mental health issues.
HR:
And on that note, I want to thank you, Aisha McDonald. Very uplifting and inspirational.
AM:
I try.
HR:
Keep up the great work you do at United Way of Broward and helping so many people. Thank you very much.
AM:
Thank you so much for having me, for having this conversation with me. I love a moment where I can talk about the things that my brain holds in and so you’ve allowed me to have a really good conversation today.
