Abstract
Nadal (2018) captures the intersection of microaggressions and trauma, while extending the efforts of the International Classification of Diseases, 10th revision (World Health Organization, 1992) and the Diagnostic and Statistical Manual of the Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) descriptions of trauma. Utilizing a variety of theories (e.g., microaggression theory, feminist theory, critical race theory, and queer theory), Nadal is able to frame the experiences of women, people of color, lesbian, bisexual, gay, transgender, and queer populations in the United States impacted by violence, oppression, and systemic racism. These populations consistently endure experiences of subtle (unconscious or unintentional) types of discrimination, known as microaggressions, including “verbal, behavioral, and environmental manifestations of bias…” (p. 11) that typically lead to mental health distress and disorders. It should be noted that these individuals also endure deliberate forms of prejudice and discrimination, however, the premise of the book keenly critiques the experiences of microaggressions and trauma.
Nadal reviews the microaggression and trauma literature, then situates them within race, sexual orientation, gender identity, and gender in the context of culturally-informed treatment approaches. Nadal adeptly aligns the impact of microaggressions with the DSM-5 description of posttraumatic stress disorder symptoms and features. He indicates that therapists tend to neglect identifying discrimination as a form of trauma; he further supports the inclusion of microaggressions in the DSM. Nadal also captures the many ways in which vicarious, collective, historical, and intergenerational trauma have been experienced by oppressed populations and he intuitively applies culturally-relevant treatment approaches (e.g., feminist therapy, racial trauma recovery, queer affirmative therapy) to identified groups.
Nadal provides a historical progression of the development of microaggressions, from the 1970s to modern times, aligning experiences with significant events in United States history (e.g., HIV/AIDS epidemic, election of President Obama, Black Lives Matter movement). The organization of the book focuses on the aforementioned marginalized groups and provides (a) an overview of the selected oppressed group (including current history), (b) historical context of discrimination for the group, (c) a review of the literature of microaggression, and (d) a vignette with clinical strategies and recommendations.
The impact of the book is multifaceted, it provides empirical and theoretical support for aligning microaggressions with traumatic stress. This effort clearly contributes to the expansion of how clinicians might conceptualize trauma in the context of microaggressions, especially for oppressed group members. Additionally, the vignettes demonstrate application of theory and begins to establish a foundation for best practices in treating clients impacted by microaggressive trauma. This book is an important read for therapists, supervisors, educators, students, and professionals working with marginalized groups.
