Visions Journal

Clare Ziemann, RN

Reprinted from the Intergenerational Trauma issue of Visions Journal, 2023, 18 (2), pp. 8-9

As an Indigenous registered nurse working in Vancouver’s Downtown Eastside (DTES) and a healing practitioner,¹ I know intimately well the experience and impact of “intergenerational trauma”—also known as colonization. Like many other Indigenous folks, I inherited the unhealed trauma of my parents, in addition to experiencing my own complex trauma: neglected, abused, pathologized and pushed to the edges of society. I have survived and found healing from those experiences. Now, in my work, I share that story of hope. 

The truth is, the trauma of colonization has impacted everyone, generation after generation, family after family. Indigenous peoples are more visibly impacted by more health disparities and inequities, as we see in the DTES community. But our interconnectedness as a species (physical, spiritual and mental) means none of us is truly separate from the harms done by colonization. I believe that our hope for freedom lies in each of us playing our individual and collective roles in healing from colonization.  

Rethinking trauma in health care

I have learned there are pitfalls in popularizing terms like trauma in the health care system. To me, trauma is what happens inside of you as a result of overwhelming experiences and lack of resources to cope. This feeling carries over as a lens through which we experience our lives, our thinking and our ability to regulate emotions. Because mind and body are interconnected, this experience of overwhelm translates into the medical and mental health problems that show up in our clinics and hospitals.

So yes, today, we name trauma experiences in health care, but we don’t often treat the causes and effects. The term trauma exists more as a descriptor or clinical box to tick, without carrying weight in terms of action. In treating trauma clinically, it’s routine to put the onus on individual people who are traumatized. Attention often gets diverted from the root of the problem to the effects of injustices. For example, we target visible signs of addiction, mental illness, poverty and homelessness without addressing the causes, such as social injustice and structural violence.

People do need help. And so we ration out money to try and change those who were harmed and “help” those showing the impacts of that harm, like people using substances to relieve the pain of oppression, or who feel depressed because they’re just surviving and can’t pay rent. The systems that created those harms don’t get fixed. When the traumatized individual can’t navigate a health care structure that uses many of the same tactics as colonialism, they are blamed and rejected. For example, a person living with addiction is judged on their willpower and labelled “treatment resistant,” while their past trauma isn’t addressed and they continue to experience traumatic environments.

Focusing only on clinical treatments of trauma has caused us to steer away from what is truly needed to heal; it makes us forget the collective responsibility for rebalancing harms caused by large institutionalized systems. I’ve experienced this working in many different areas of the mental health system, where misunderstandings of trauma and addictions have stopped us from seeing that you can’t heal in isolation or within systems of care that carry the legacy of colonialism.²

Rebuilding systems to avoid trauma

In my work, I have been intentional about existing in a place of hope. I’m interested in cocreating a world where being trauma-informed starts with making safe, accountable, empowering and loving environments. I want braver conversations around healing that are neither lofty or symbolic, nor another excuse to do nothing (like “it's too expensive”).

I want to strive for solutions that are by nature multi-faceted, holistic and sustainable. This comes from the bottom up, where the health of each person is an act of sustainability because they are included in a community of wellness, not a society of isolation and individualism. I want to hear more conversations about the root causes of intergenerational trauma and the lived experience of healing from it. We need to reach an understanding that true health and wellness come from abundance and investment, not capitalistic greed.

As I have begun to truly heal from my trauma, I’ve realized there never has been anything wrong with me. And in my practice, I believe strongly in aiming to support those I work with, not fixing them. In my view, each person’s personal sovereignty is the foundation for health and quality of life. I’ve turned away from fighting and fixing the systems that were benefiting from my harms, and towards creating the new system(s) I want to be part of.

I have spent a lot of time in my work and personally with people who have experienced intergenerational trauma. I have a strong vision of a better way. For me, it looks like supportive and ethical services that are built on knowledge of the mechanisms of trauma, including racism and colonization. A better way includes viewing people’s opportunities for growth, connection to culture and basic needs as human rights.

A better health care system will deliver accountable, innovative care. Health systems must be connected to the goal of rebalancing injustices. This can be done by emphasizing self-empowerment and new opportunities. For example, if we want to help women heal from trauma and violence, they first need safe, affordable housing, child care and healthy food. When they are safe, women can change the lens of their experience.

As more of us detach from colonial, capitalistic culture and programming and embrace community, collective ethics and sustainability, we are coming to the light and beginning to heal from intergenerational trauma! The systems in place to support those who are on this most challenging of healing journeys do not yet reflect this shift. They will need to if we are ever to make a true impact on problems facing Indigenous (and settler) communities today.  

When we heal, others heal. Life is cyclical like that, and we cannot move forward without breaking old patterns. Why not now?