Trauma does not determine outcomes – rather it is the response of the person’s social group that is critical (Bloom, 2013). The realisation that humans tend to repeat traumatic experience has led to the fear that our society is suffering post-traumatic deterioration that could lead to self-destruction as it can do with individuals who remained locked into traumatic patterns. Trauma is not rare or unusual but normative. Trauma can become the central organising principle in a person’s life and likewise in a society and humanity generally. Without this understanding we will not attempt to create the changes we need, argues Sandra Bloom.

Bloom recounts how she and her colleagues realised that smaller systems embedded in larger systems are limited by the health of these larger ‘parent’ systems. Without change in the hierarchy of systems smaller healthcare systems would be faced with obstacles that impede progress. Total system change is needed – fixing the part without fixing the whole will lead to limited success.

In modern societies, community life has broken down and these webs of connections are critical to our survival. Bloom speaks about the need for ‘creating sanctuary’ – a sense of safety, wholeness, caring and home. This is something we create or destroy in every moment of our lives.


Bloom, S. L. (2013). Creating sanctuary: Toward the evolution of sane societies. Routledge.