At a recent meeting of the Editors’ Association of Canada, Iva Cheung, a researcher in knowledge translation and exchange, presented on trauma-informed editing. Here are a few notes based on her talk.
What is trauma?
There are various definitions of trauma. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, defines it in terms of being exposed to death, serious injury, or sexual violence, but other sources use a wider definition that acknowledges that many forms of violence, abuse, or other experiences that overwhelm a person’s ability to cope can result in trauma. I think of trauma as a psychological injury. Like bodily injuries, some psychological injuries heal on their own; others require health care intervention; many injuries have lasting consequences.
What is trauma-informed care?
Trauma-informed care is an approach within health care that recognizes the widespread incidence and impact of trauma and tries to integrate knowledge about trauma into practices to avoid re-traumatizing the patient. According to the Trauma-Informed Care Implementation Resource Center, the principles of trauma-informed care are:
- Safety: staff and patients feel physically and psychologically safe
- Trustworthiness and transparency: decisions are made with transparency
- Peer support: people with shared experiences are incorporated into the organization
- Collaboration: power differences are reduced with shared decision-making
- Empowerment: building on strengths
- Humility and responsiveness: biases and stereotypes are recognized and addressed
Trauma can have a variety of effects related to stress, not all of which are obvious. For example, lack of confidence in the ability to achieve goals or difficulty in navigating relationships. Stress is particularly likely to be caused by things that:
- Are new or unpredictable
- Threaten the ego (make a person feel their competence is questioned)
- Produce a sense of not having control
Writing for audiences who may have experienced trauma
When writing for audiences who may have experienced trauma, there are some measures you can take to reduce the risk of unintentionally harming someone.
Clearly describe the document’s contents
The most basic way to protect people is to be clear about what is in the document. You can use a content note to let people know what is in the document. A good table of contents and clear headings also help readers avoid any sections that may be a problem for them.
Guidelines for content notes:
- Don’t be too general, like the television warning “may be disturbing to some viewers.”
- On the other hand, don’t be too specific about the content, or you can replicate the harmful content. Say, for example, that the material describes a serious injury, or discusses sexual violence, but don’t give details.
- Keep in mind that images tend to have a greater impact than text descriptions.
Topics to consider writing content notes for:
- Death
- Abuse
- Suicide
- Colonialism and genocide
- Sexual violence
If a document contains discussion of topics that are likely to be very upsetting to some readers, you can add references to resources such as crisis lines. You can also offer options, such as a text document instead of a video, or a way to return to the material later or view it in short chunks.
What about trigger warnings? A trigger is a stimulus that prompts a memory. In some cases this can lead to retraumatization. Trigger warnings warn readers of potentially triggering material, but the term is often misused and also casts a negative light on the material. The word “warning” also implies that the material is dangerous, which can cause people to anticipate stress.
Use anti-oppressive publishing practices
Your documents will be less likely to cause harm if you use anti-oppressive practices. This is too big a topic to go into here, but for a start:
- Use respectful terms that affirm people’s humanity
- Watch out for stigmatizing language
- Present authentic voices
- Make sure a variety of people are represented in the document, or acknowledge that the document doesn’t deal with all experiences
- Watch out for appropriation
- Consider having an authenticity or sensitivity reading of the document and incorporating your reader’s feedback
Working with authors who may have trauma
If you consider the stressors mentioned before (new, unpredictable, threatens ego, sense of no control), you can address these risks with the four c’s:
- Consent: Get the author’s consent for changes; don’t make hidden changes.
- Control: Ask the author how they want to handle the work; give them input on tracking changes, what software to use, how to communicate with their editor.
- Collaboration: Give the author input in decisions.
- Communication: Let the author know ahead of time what your publishing process is. Let them know what opportunities to collaborate they will have and what their choices are. Let them know how you incorporated their input.
When to apply trauma-informed editing
Some people suggest that 75 percent of people in Canada will experience trauma in their lives, even using the restrictive DSM definition. About 9 percent will develop PTSD. That suggests that a lot of people have psychological injuries. Looking at the measures for trauma-informed publishing, you can see that they provide benefits for everyone: documents that state clearly what is in them, that show awareness about mental health resources where appropriate, and that use respectful language; a publishing process that emphasizes great communication and respectful collaboration with authors. I think it’s worth keeping these guidelines in mind at all times.
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