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Decades of research point to the same conclusion: social support is one of the strongest protective factors in the face of trauma. But what happens when the way we've learned to relate to others gets in the way of that connection, especially in a profession where repeated trauma exposure is routine?
In this episode, Dr. Sacha McBain joins me to talk about the intersection of attachment, community, and trauma-informed care in medical settings. We start with the research: Australian psychologist Richard Bryant's work following the Black Saturday bushfires showed that it wasn't just individual relationships that predicted recovery; it was the shape of a person's whole social network. People who were diversely connected, and whose connections were also connected to each other, fared better. The overlapping network itself served as a buffer.
From there we turn to what happens inside hospitals. Sacha describes sitting in on resident onboarding and hearing the scare tactics used to keep new physicians in line: it's not if you'll be sued, it's when. Patients will find you in parking garages. Never admit you were wrong. The message underneath is essentially "be perfect, or a patient could destroy you.” And it makes co-regulation almost impossible with the very person you've been taught to fear.
What shifts when you see a distressed patient as a frightened, vulnerable human rather than a threat to your livelihood? What do you do when you can't find any empathy left and you're already overwhelmed? Sacha shares a piece of advice from a mentor that reframes curiosity as the thing you reach for when compassion isn't available. And we close on trauma-informed care as something fundamentally pragmatic, not a soft add-on, but a working set of practices around safety, transparency, power, collaboration, and cultural humility.
Sacha McBain, PhD, is a clinical psychologist and associate professor at Rush University System for Health in Chicago. A national leader in medical traumatic stress, she has published peer-reviewed research on the conceptualization and treatment of medical trauma, led national clinical trainings, and helped shape best practices for mental health screening and intervention after traumatic injury.
Previously at the University of Arkansas for Medical Sciences, she developed and led the Trauma Surgery Psychology Consult Service at Arkansas's only Level 1 Trauma Center and served as associate director of the Center for Trauma Prevention, Recovery, and Innovation. She contributed to the American College of Surgeons Mental Health and Substance Use Disorder Best Practice Guidelines Work Group and is an active member of the International Society for Traumatic Stress Studies.
Learn more about Sacha here.
