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Can Playing Dungeons & Dragons Be a Trauma Treatment Tool That Bridges the Victim-Offender Overlap?

It’s close to midnight when your party enters the roadside inn half a mile outside of the town of Waterdeep. You’re a rogue and thief wanted for murder, so you conceal your face. While your friends make their way over to the bar, you slink into a booth in the darkest corner of the dining room. As you note all the possible exits in the building, a waitress meets your gaze and begins to make her way over to where you are sitting. Before she can get close, two strangers block her path and start speaking to her in hushed but insistent tones. You succeed in rolling a perception check. The waitress seems extremely distressed, and you hear her say, “I said ‘no,’ now leave me alone.”

You’re a rogue and a thief. It would be best if you didn’t make a scene, but your character sheet also says that part of your background is that your family abused you, and you vowed never to let an innocent person be hurt by someone else. Your friends are distracted at the bar and don’t see the woman who needs help. It’s up to you. You roll a successful intimidation check and put a hand on the shoulder of one of the aggressors. “She asked you to leave,” you say. Thankfully, the strangers leave the inn, only looking a little annoyed. “Thank you,” the waitress says, stopping short when she sees you more clearly. Recognition flashes across her face. “It’s you!” Well, here it comes, you think. Off to jail, again. “Everyone, everyone!” she says, “It’s The Savior of Baldur’s Gate! Get this hero a drink!!” Oh yeah, you remember, I guess we did save that city a few sessions ago. Word travels fast.

~

In the first discussion post for this course, I was instantly drawn to van der Kolk’s (2015, p. 17) observation about imagination: “Imagination is absolutely critical to the quality of our lives [and] it is the essential launchpad for making our hopes come true.” From victims of child abuse using sand to play and act out narratives that they may not remember the words for (Rousseau, 2023b, p. 16) to veterans of war struggling to see peaceful images in inkblots (van der Kolk, 2015, p.16) to offenders of horrific crimes having to live with the trauma of institutionalization on top of learning to live a crime-free life (Rousseau, 2023c, p. 15), imagination is the most essential tool to build resilience in environments where inspiration is in short supply.

While the story I wrote above might seem goofy to you as the reader, I believe that as the player, and as your own main character, the choices you make and the actions you take can be exhilarating, and important at the very least. This is why I think we love knowing a little bit about our star sign, and why we take all those surveys that tell us which character of whatever TV show we would be. This can be a fun reverie for anyone, if, of course, your horoscope says you’re going to win the lottery and you’re most like the protagonist, hot girl, cool guy, etc. For people who may avoid their past or find that they are unable to leave their past behind them, I believe games, like trauma-informed Dungeons & Dragons (D&D), can be used to practice imagination, act as a complex form of talk, group, and exposure therapy, and instill a long-lasting resilience in people who have experienced many different forms of trauma and chronic stress.

If you’re unfamiliar with D&D, this is a great synopsis of the game, written by Blakinger (2023), who interviewed inmates on death row who used the game to cope with their death sentences: “[D&D is a] tabletop role-playing game known for its miniature figurines and 20-sided dice. It combines a choose-your-own-adventure structure with group performance[.] Participants create their own characters — often magical creatures like elves and wizards — to go on quests in fantasy worlds. A narrator and referee, known as the Dungeon Master, guides players through each twist and turn of the plot [with] an element of chance.”

Before you discount me completely, remember that playing games that improve our “physical, mental, emotional, and social resilience” can add years to our lives (McGonigal, 2012; Rousseau, 2023a, p. 8) and individuals who have experienced trauma and chronic stress may already have had the physical effects of stress take years off their life (Rousseau, 2023a, p. 4). Rousseau (2023a, p. 4) lists “uncertainty, loss of control, and a lack of information” as factors that trigger stress. It is unrealistic to imagine a future in which none of these factors occur, but the human body’s response to stress (van der Kolk, 2015) calls for treatment in safe spaces where we can learn how to deal with this natural response to past trauma. With every roll of the dice, the success of your decisions in this game is left completely to chance, but the player is always in control of what they decide to do and how they respond to successes and failures. While there is a lack of information, the Dungeon Master knows everything about this fantasy world. There are boundless opportunities to learn, explore, and discover the unknown.

In addition to the safe space that this game creates as a practice zone to cope with stress and possibly even face one’s fears, I believe that D&D can also be used as a tool for reclaiming positive narratives and labels, particularly for offenders. Labeling theory states that “people become stabilized in criminal roles when they are labeled as criminals” (Cullen et al., 2022, p. 7). A tool known as “redemption scripts” (Cullen et al., 2022, p. 248-250) has been used in efforts for people to discover their “true selves” or the best parts of them that could be the foundation for a crime-free life. I believe with guidance from a therapist or other trained mental health professional, the character creation portion of this game, which often takes place one-on-one and before the roleplaying part of the game, could be beneficial to offenders seeking a personal label change.

While this is just a brief exploration of this idea, it would be very interesting to see how resilient trauma-impacted individuals both inside and outside of prisons were after just a few sessions of playing D&D, and if they thought about their fantasy adventures outside of the sessions at all, and in what way. If you’ve never played D&D, I understand it might be confusing to think about how powerful this game can be. But, before you go, please look at the picture below. This is a D&D character sheet. It’s what you fill out for the character you play during the game. This is where you list your character’s strengths, weaknesses, background, personality, and if you’re inherently good, bad, or just straight chaotic. If you have a moment, read the categories on the sheet, and think about two things: 1. What would this sheet look like if I were the character in the story? Particularly, what would the four categories on the righthand column say? And 2. If I could be anyone, my true self, what would it say then?

Thank you very much for keeping an open mind, maybe learning more about something new, and considering my perspective!

(D&D Blank Character Sheet, 2023).

References

Blakinger, K. (2023, August 31). When Wizards and Orcs Came to Death Row. The Marshall Project. Retrieved December 11, 2023, from https://www.themarshallproject.org/2023/08/31/dungeons-and-dragons-texas-death-row-tdcj

Cullen, F. T., Agnew, R., & Wilcox, P. (2022). Criminological theory: Past to present (7th ed.). Oxford University Press.

D&D Blank Character Sheet [PDF]. (2023). Wizards of the Coast. Retrieved December 11, 2023, from https://dnd.wizards.com/resources/character-sheets

McGonigal, J. (2012, June). The game that can give you 10 extra years of life. TEDGlobal 2012. Retrieved December 11, 2023, from https://www.ted.com/talks/jane_mcgonigal_the_game_that_can_give_you_10_extra_years_of_life

Rousseau, D. (2023a). Trauma and Crisis Intervention Module 1. Retrieved December 11, 2023, from Blackboard [url].

Rousseau, D. (2023b). Trauma and Crisis Intervention Module 2. Retrieved December 11, 2023, from Blackboard [url].

Rousseau, D. (2023c). Trauma and Crisis Intervention Module 6. Retrieved December 11, 2023, from Blackboard [url].

van der Kolk, B. (2015). The Body Keeps the Score: Brain, Mind, And Body in the Healing of Trauma. Penguin Books.

Haitian Resilience, Natural Disasters & COVID-19

During the course, I read a piece by Guerda Nicolas about Haitians coping with the traumas associated with natural disasters and their resilience. Several post-disaster studies have found that there was notable prevalence of post-traumatic stress disorder (PTSD) and depression in the Haitian population. They have faced many political, economic, and environmental storms to include natural disasters (Nicolas et al, 2014, p. 93). Nicolas (2014) argues that the sociocultural traditions and customs of the Haitian people, family, religion, and community, are the reason for their resilience in the face of disaster. 

Some refer to the COVID-19 pandemic and its aftermath as a “collective trauma,” defined as the “psychological response of an entire group to a traumatic event, such as the Holocaust” (Kaubisch et al, 2022, p. 28). From a psychological point of view, the threat of serious illness or death, the loss of jobs, the increased stress, the disruption in daily lives, the growing uncertainty, and the disconnect and isolation generated by the pandemic led to the consideration of COVID-19 as a traumatic event. Research suggests that one in five people could experience psychological distress post-COVID-19, such as depression, anxiety, and PTSD (Kaubisch et al, 2022, p. 27). 

Prior to COVID-19, Haiti had just lifted restrictions from a political lockdown that had lasted almost a year and the country was also experiencing violent civil unrest triggered by an abrupt increase in fuel prices, a movement that became known as Peyi Lòk (Blanc et al, 2020). “When the first case of COVID-19 arrived in March 2020, the country was just beginning to regain a certain sense of normalcy despite the socio-economical and psychological ramifications of being on lockdown” (Blanc et al, 2020). Majority of the Haitian population continued to live their daily lives, as they were desensitized to the effects of disruption and forced isolation and distancing. Within three months, COVID-19 in Haiti had reached its peak and there was a decrease in the number of detected cases, predicting that the damage of the pandemic would not be too devastating to the country (Blanc et al, 2020). 

It is argued that other countries, such as the United States, could learn from the Haitian experience of coping with traumatic events. Resilience is possible after exposure to trauma. Factors that promote posttraumatic growth are “positive social support, gratitude, strong family ties, attachment, and meaning making, or the way in which a person interprets or makes sense of life events” (Rousseau, 2023). The country of Haiti was created after the only successful slave insurrections in history and the resilience of that revolution threads through its history of tremendous struggles.

References:

Blanc, J., Louis, E.F., Joseph, J., Castor, C., & Jean-Louis, G. (2020). What the world could learn from the Haitian resilience while managing COVID-19. Psychological Trauma, 12(6), 569–571. 

Kaubisch, L.T., Reck, C., von Tettenborn, A., & Woll, C.F. (2022). The COVID-19 pandemic as a traumatic event and the associated psychological impact on families – A systematic review. Journal of Affective Disorders, 319, 27–39.

Nicolas, G., Schwartz, B., & Pierre, E. (2014). WEATHERING THE STORMS LIKE BAMBOO: The Strengths of Haitians in Coping with Natural Disasters.

Rousseau, D. (2023). Module 1: Introduction to Trauma. Blackboard.

Overcoming Barriers to Trauma: Rural Women Facing Domestic Violence

Riley A. Thomas

Considerations surrounding rural and sparsely populated America and its criminogenic nature are overlooked. Therefore, much needed attention on rural centric crime considers factors not applicable to the urban. This fact may be related to issues that make society as a whole precieve rural criminology less important than metropolitan areas (Ceccato, 2018), where a majority of the American population lives. Therefore, a much greater emphasis and attention is needed for victims of traumatic crimes in rural areas due to the spatial differences than percieved mainstream criminology.

Aspects such as limited access to services, isolation, poverty, and rural cultural values make rural women more vulnerable to domestic violence than women living in urban areas (Ceccato, 2015). This post will mainly focus on rural women who suffer from intimate partner violence (IPV), and the geographic challenges of recieving treatment or support outside of the immediate area.

Examining intimate partner violence in this case is significant because it can be evaluated as one of the most underreported figures of crime. For example, Ceccato (2018) identifies that physical isolation may also lead to a disproportionately high declared fear of crime
because of individuals’ relative vulnerability. For a variety of reasons, women and victims of IPV may fall silent due to public perceptions, shame, guilt, or embarassment to name a few (van der Kolk, 2014). Reagrding trauma related to IPV, rates for violence against women vary geographically, making it difficult to untangle underreported cases between rural and areas (Ceccato, 2015). Additionally, the cohesive nature of rural areas adds another dimension of trauma support avoidance.

This consideration of a cohesive system stems from smaller communities being well versed with eachother, and the events that take place within the community. In other words, everyone knows everyone, and collective efficacy is rarely thrown off balance. Knowing this, woman may avoid support for their trauma with the fear of being ostracized by speaking out on violence, which may have the unintended effect of enabling domestic violence, and the inability to seek help for IPV trauma (Ceccato, 2015).

Knowing this the geographical difficulties of seeking help in rural IPV and trauma cases still remain prevalent. For example, rural communities and towns are in far geographical areas from metropolitan areas with greater support systems. In other words, long distances create isolation to a greater degree than urban areas (Ceccato, 2015). With these outlets out of reach, rural communities may lack the resources and support systems and highly populated areas have. This can lead to victims of trauma and IPV staying silent, since breaking the efficacy and cohesion of their community can have drastic effects on the abuser and the victim. The lack of support systems for women in rural areas can contribute for women to stay in their traumatic situations. Victims of traumatic domestic violence often cover up their abusers (van der Kolk, 2014) for a variety of reasons. Here, I can assume because of the limited access to getting treatment, and the unwillingness to face public embarrasmenterassment. Since the cohesive nature of small communities may put these victims of trauma in the shadows.

This post considers the challenges rural women may face when dealing with IPV and seeking treatment for their trauma. Knowing the spatial differences between the rural and the urban seek out potential barriers for women to attain the help that they need, due to factors such as isolation and reliance on their domestic partner. An attention on rural centric crime considers factors not applicable to the urban, and must be researched further to understand the hidden figures and perception of rural life.

Ceccato, V. (2015b). Rural crime and community safety. https://doi.org/10.4324/9780203725689

M.D., B.V.D. K. (2014). The Body Keeps the Score. Penguin US. https://bookshelf.vitalsource.com/books/9781101608302

Approaches to Childhood Trauma

I have always found the psychology of children a fascinating topic because much of our habits, actions, and language developments occur during our childhood years. So, I was excited to learn more about childhood trauma; more specifically, how children are impacted by trauma. Unlike adults, children experience, express, and cope with trauma differently compared to adults. Because of this, psychologists and psychiatrists have had a hard time recognizing and managing children who experience trauma. Although there are many tests to help guide these professional workers in diagnosing these children. In the documentary “PTSD In Children: Move in the Rhythm of the Child” directed and produced by Joyce Boaz, she highlighted the idea that there are children who are experiencing trauma who seek interventions, but there are children do not seek interventions. Children are vulnerable to their surroundings and their environment due to their sensitive nature. Trauma does not only change their perceptions of the world but also changes their neurobiological development (Rousseau, 2023). 

A biology approach to childhood trauma: 
Kolk’s chapter on “Developmental Trauma: The Hidden Epidemic” discusses the idea that trauma and stress may be involved in a more-than-just environmental impact, but rather could be a transfer of genetic makeup to progeny generations (Volk, 170). This idea is not a new idea, with understanding if our genes give rise to certain behaviors and traits. However, strong research has also found the importance of epigenetics which can certainly change behaviors (Kolk 2015). 

Currently, I am taking a course in Animal Behavior, and one of the case studies we looked at is the idea that genetics influences an individual's primary response, however, epigenetics (aka the impact of the environment on our DNA) can change this primary response. Similar to Szyf’s words, “major changes to our bodies can be made not just by chemicals and toxins, but also in the way the social world talks to the hard-wired world.” (Kolk, 2015) 

A social approach to childhood trauma: 
Now that we discovered the idea that trauma may impact a child differently depending on their innate genetic information, different children will respond and react to trauma differently. The “hard” part of this is how researchers can determine this. In Boaz’s documentary, she introduced us to multiple psychiatrists who specialize in treating children who have experienced trauma, and a consensus that all the psychiatrists agreed on is that children are hard to read. Sometimes they are unable to identify and express their feelings, and for this, therapeutic tools as well as diagnostic tools have been implemented to assist psychologists and psychiatrists to help with diagnosis and treatments. In our course, we looked at multiple different therapeutic tools including the art of yoga project, Sand Tray Therapy, and Trauma-Informed Behavioral Therapy (Rousseau, 2023). 

These tools and approaches are important for early interventions of children who experienced trauma, but I do want to recognize children who are unable to find interventions. The ACE study (Adverse childhood experiences) found with a sample size of 50,000 patients that: 
* One out of ten adults responded that he/she was a victim of some form of emotional abuse.
* More than one-quarter of respondents were victims of some form of physical abuse.
* Twenty-eight percent of the adult women and sixteen percent of the adult men responded that they were victims of some form of sexual abuse.
* One in eight of the adults responded that he/she witnessed his/her mother being a victim of abuse. 
(Taken from Rousseau 2023) 

In simple terms, trauma impacts a lot of children, and it continues to impact millions of children through different routes such as domestic abuse or school bullying. From 2021-2022, a total of 327 documented school shootings have occurred in US elementary to high school (National Center for educational statistics, 2023). This speaks words to not only the individuals who are causing the school violence but also individuals who experience the school violence. Domestic abuse has also been coined as a public health issue. Intervention is only provided when an individual seeks it, so I find it extremely disheartening for those who cannot seek it or don’t know how to seek it. Although there are many techniques and therapies involved, at the end of the day, only certain types of individuals can receive it. 


References:
National Center for Education Statistics (2023). Violent Deaths at School and Away From School, School Shootings, and Active Shooter Inceidents. Retrieved December 9, 2023, National Center for Education Statistics. https://nces.ed.gov/programs/coe/indicator/a01/violent-deaths-and-shootings
Boaz, J. (Director + Producer). (1995). PTSD In Children: Move in the Rhythm of the Child.
[Video/DVD] Gift from Within. https://video-alexanderstreet-com.ezproxy.bu.edu/watch/ptsd-in- children-move-in-the-rhythm-of-the-child/details?context=channel:counseling-therapy
Rousseau, D. (2023). Trauma and Crisis Intervention Module 1. Retrieved November 20, 2023,
from Blackboard.
Van der Kolk, B. (2015). The Body Keeps the Score: Brain, Mind, And Body in the Healing of
Trauma. Penguin Books.

childhood trauma

Childhood trauma, which includes experiences such as abuse and neglect, casts a long shadow on one's life, leaving indelible marks on one's mental health and relationships. Based on my personal experiences with difficulties, I've realized the profound impact it has on emotional well-being. Addressing childhood trauma is critical for healing, requiring compassion for oneself and a commitment to breaking the cycle of pain.

Childhood trauma is frequently manifested in mental health issues ranging from anxiety to depression. My journey has taught me the value of acknowledging the impact, encouraging open dialogue, and breaking the silence surrounding these experiences. By sharing our stories, we not only de-stigmatize the conversation about trauma, but also create a safe space for healing and resilience. Seeking professional help, participating in therapies, and developing a trusting network are all important steps in the ongoing journey toward recovery and self-discovery.