The Hidden History of Trauma: How Our Understanding Was Shaped by Systems of Power

How Is the Dominant Ontology of Trauma Sociohistorically Constructed?

The dominant ontology of trauma, rooted in the biomedical model, might appear as an objective framework for understanding and addressing trauma, but it is deeply shaped by sociohistorical forces. Its foundations lie in Western medicine’s history, entwined with specific cultural, political, and economic priorities that privilege individual pathology over systemic and relational dimensions. A deeper look into its origins, including examples like "railway spine," reveals how trauma became medicalized and why this model often fails to address the complexities of lived experience.

The Birth of the Biomedical Model

The biomedical model of trauma emerged alongside the industrial revolution in the 19th century, a time of rapid technological and societal change. One significant historical example is "railway spine," a condition identified in the mid-1800s among passengers and workers involved in train accidents. This diagnosis marked an early recognition of trauma as a physical and psychological condition.

Railway spine exemplified the shift toward medicalizing trauma. Physicians noted symptoms like chronic pain, anxiety, and emotional distress but struggled to explain them through observable injuries. The condition sparked debates about the mind-body connection, with some attributing symptoms to malingering or moral weakness—a reflection of societal attitudes toward productivity and individual responsibility. This medical framing laid the groundwork for understanding trauma as an individual issue, disconnected from systemic or relational factors.

The broader context of industrialization also played a role. As trains became symbols of progress, the emphasis on efficiency and productivity overshadowed considerations of safety and care. This mirrored a larger cultural shift: trauma was something to be "fixed" within the individual to restore them to their functional role in the industrial machine.

Colonial and Capitalist Influences

The rise of the biomedical model coincided with colonial expansion and the growth of capitalist systems. Colonialism imposed Western ways of knowing, erasing Indigenous and relational understandings of trauma and healing. Practices centred on community, spirituality, and land connection were dismissed as unscientific, replaced by frameworks that prioritized individualism and control.

Capitalism further shaped the biomedical model by commodifying health and efficiency. Trauma became something to diagnose, standardize, and treat quickly, often through scalable interventions that could generate profit. This approach de-contextualized trauma, focusing on individual symptoms rather than addressing systemic causes.

The Logic of Separation

Central to the biomedical model is the logic of separation—a dualistic worldview that divides mind from body, individual from community, and humans from nature. This logic was evident in early trauma diagnoses like railway spine, which sought to isolate symptoms rather than explore their broader relational and systemic contexts.

By framing trauma as an internal problem, the biomedical model often obscures the interconnectedness of trauma with societal forces like colonialism, racism, and environmental degradation. This focus on individual pathology absolves systems of accountability and limits opportunities for collective healing.

Challenging the Dominant Ontology

Recognizing the sociohistorical construction of the biomedical model allows us to question its limitations and explore alternative frameworks. Relational ontologies, for instance, view trauma as a rupture in relationships—between individuals, communities, and ecosystems. These perspectives prioritize collective healing and systemic transformation, offering a more holistic and inclusive approach.

The story of railway spine highlights the dangers of isolating trauma from its context. While it was a significant step in acknowledging trauma as a legitimate condition, its framing within the biomedical model reflects a history of ignoring relational and systemic factors. By challenging these frameworks, we can begin to imagine new possibilities for understanding and addressing trauma.

An Invitation

What if trauma wasn’t just an individual problem to solve but a relational and systemic issue to explore? How might this perspective open doors to deeper healing and transformation?

I invite you to reflect on how the sociohistorical construction of the biomedical model has shaped your understanding of trauma and to consider how relational approaches could provide more inclusive and transformative paths forward. Together, we can re-imagine trauma as a signal to reconnect, repair, and create systems that honour the complexities of life.