ABSTRACT
When clinicians think of trauma, they consider an individual impacted on by certain life-altering experiences (the traumatising event) and how the individual’s thoughts, feelings, and behaviours are shaped by those events (the trauma response). The clinical encounter at the individual level is the focus rather than the individual in context of social and institutional groups that define the individual experience as well. Rarely is it considered that social groups or institutions are responsible for inflicting or passively allowing the traumatising event(s) to occur for individuals, and the ensuing negative consequences for the perpetrating group or institution. In clinical settings, despite concerted efforts, violence remains a persistent problem. The lens that clinicians use to understand violence can sometimes be too narrow to capture the multiple factors and antecedents at play in any single episode of violence, as well as its traumatising effects. What is necessary for a more comprehensive view is a merger of the mega, the macro, and the micro; in other words, a public health prevention understanding of the institutional and structural (primary and secondary), as well as the direct (tertiary) nature of a violent episode (Gilligan, 2000; Gilligan, 2012; Bloom, 2001; Substance Abuse & Mental Health Services Administration, 2014). This integration of the socio-ecological and the psychological contexts compels us to utilise new approaches to eliminate further violence and the traumatising sequelae.
