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116 / Innovate with Empathy: Unpacking Trauma-Informed Design, with Matt Bernius

Hosted by Paul Gebel




Matt Bernius

Code for America

Using qualitative research methods and service design skills, Matt Bernius collaborates with communities to make government work better for everyone, especially the people who need it most.

He works at the intersection of technology and culture, researching how technology changes people and people change technology. Matt has planned and executed a wide range of user research engagements around the world for clients that include Autodesk, Boeing/Jeppesen, Excellus BlueCross BlueShield, Mozilla, National Oilwell Varco, Securian, and Verint.

It can be overwhelming to think about all of the impacts – both positive and negative – that our products might have on those who use them. In this episode of Product Momentum, Paul is joined by Matt Bernius, friend of ITX and Principal User Researcher at Code for America. Matt discusses trauma-informed design in an approachable way that will change how you think about your work.

Awareness should be your first step in working toward being trauma-informed and trauma-responsive, Matt offers. The simple act of listening to this episode puts you squarely on the right path.

Matt Bernius explains that experimentation that brings about even incremental changes can make a difference and be truly innovative. When we improve products for users who have experienced trauma, he says, we make them better for everyone using or building the product, regardless of their life experiences.

Through trauma-informed individuals we can build more resilient organizations. “It’s a responsibility of the organization to create an environment that doesn’t require extreme resilience,” Matt adds, “not the fault of an individual for not being resilient.” Matt points out.

We can all work toward developing resilience in ourselves and each other and, in the process, can create psychologically safe organizations where innovation thrives best.

Catch the whole episode to hear more of Matt’s practical tips and impactful insights:

  • About half of adults in the U.S. have experienced trauma of some form or another.
  • Trauma “lives in the body.”
  • Re-traumatization – when your body re-lives a traumatic experience – has long-term adverse impacts.
  • Listen to your innermost feelings, even in situations where you’re trained to be objective.

Paul [00:00:19] Hello and welcome to Product Momentum, where we hope to entertain, educate, and celebrate the amazing product people who are helping to shape our community’s way ahead. My name is Paul Gebel and I’m the Director of Product Innovation at ITX. Along with my co-host, Sean Flaherty, and our amazing production team and occasional guest host, we record and release a conversation with a product thought leader, writer, speaker, or maker who has something to share with the community every two weeks.

Paul [00:00:43] Hey everyone, and welcome to the pod. Today we have a bit of a special episode for you. We’re talking to Matt Bernius, who is a friend and colleague of mine for over a decade now. And I had the pleasure of sitting down to talk with him about trauma-informed design. Matt brings a body of knowledge and a wealth of research to back up his ideas and perspectives on how this can help inform what product managers and UX designers and researchers do every day. So I’d love you to take some time and really get into the topic that we’re about to explore and see if you can find a nugget that you can bring back to your team.

Paul [00:01:15] The things that I learned that I hope you’ll listen for are things like being aware of it is just the first step and becoming a little bit more sensitive to what trauma is and how people can react to our products and the experiences that we build for people can really come in really meaningful ways, even if they’re small ones. We don’t have to overhaul an entire process or organization in order to be trauma-informed, but even just thinking about things in small but meaningful ways can really make a big difference. So I hope you enjoy this conversation. It’s a little bit of a different one, but it really made a big difference in the way that I think and see the world. So let’s get after it.

Paul [00:01:53] Well hello and welcome to the pod. Today I am especially honored to be joined by a friend and colleague of mine, Matt Bernius. Matt applies concepts from the social sciences and design to create more equitable government systems and experiences. His current work at Code for America focuses on improving access to and delivery of social safety net services. Prior to joining Code for America, he worked on making criminal legal system data more transparent at Measures for Justice. Matt holds a Master’s degree in Social Sciences from the University of Chicago and was a Ph.D. student in Cultural Anthropology at Cornell. He also writes and speaks regularly on the topic of trauma-informed design. Matt, glad to have you on the show today. Thanks for being here.

Matt [00:02:33] Oh, it’s so great to be here. I’m really looking forward to this discussion.

Paul [00:02:36] Likewise. You know, just to jump in, this concept of trauma-informed design is probably a new concept for many of the folks listening. Can you start us out at a high level and just talk about, why is this important, especially for product managers and UX designers to be thinking about these things?

Matt [00:02:52] Sure. It’s a question that we often start with, so it’s a great jumping-off point. To understand trauma-informed and trauma-responsive design, we first really have to have a discussion about trauma. And given the last four years or three years since at least March of 2020, it’s a word that’s been circulating a lot for a number of really good reasons, one of the key ones being COVID, but also different armed conflicts, different types of civil unrest, political violence. All this stuff has been unfortunately swirling in the culture for quite a while.

Matt [00:03:20] So let’s begin with a quick explanation of that. So even before COVID hit, it was estimated that about 60% of men and about 50% of women would encounter at least one traumatic event in their lifetime, with at least 6% of the US population being diagnosed with post-traumatic stress syndrome, or what a lot of people are now just simply calling post-traumatic stress. And those numbers came from the National Center for PTSD. So what makes trauma trauma is when stress, or what we sometimes call use stress, and this is the idea of productive stress. So you can’t live a life that’s stress-free. And in fact, we need some stress in our life to move forward. We can’t move without some friction.

Matt [00:04:02] And so there’s a category of stress that’s often called eustress. E-U stress, and that eu comes from Greek for good. So kind of like euphoria. And eustress is learning stress. So when you encounter something new, you are put under a certain degree of stress. The problem comes when that experience happens too often at too much of an extreme or too fast, and that moves from eustress into what we call distress. And at that moment, as we cross over into distress, our bodies can no longer process it. And an important thing to think about this is we often think about having a mind-body disconnection. This goes back to Descartes and like the mind-body separation.

Matt [00:04:42] But the reality is, is that we’re always already experiencing things psychologically, emotionally, and physically at the same time. So when that distress becomes too much, it can tip into what we call trauma. And so the definition of trauma that myself and my writing partner, Rachael Dietkus, who couldn’t be with us today, like to use is one that comes from the therapist, social worker, and somatic abolitionist Resmaa Menakem. And it’s, trauma is a response to anything that’s overwhelming, that happens too much, too fast, too soon, or too long. And it’s coupled with a lack of protection or support.

Matt [00:05:22] So basically, when that happens, when we become so distressed and it’s prolonged, it’s too much, if we think about something like an accident can cause that, or routine interactions with somebody who’s really toxic and pushes us into a distress zone. And that other key piece that we don’t have the protection or support necessary to metabolize it and really process it, that turns into trauma. And so trauma lives in the body. It’s stored as sensations. So that can be pain or tension or lack of sensation like numbness. And the key thing about traumas is that they’re always present. And so it’s kind of like the past is always present.

Matt [00:06:02] And under similar situations, you hear a lot about trigger warnings and the idea of a trigger is that something happens that connects us back to that past trauma, and suddenly that trauma resurfaces through this thing called retraumatization, and that could suddenly be an angry outburst. There are the, I think it’s the five F’s. So we often talk about, like,, freeze, flight fight, and then the other ones that will often come in there is fawn and flop.

Paul [00:06:32] Okay.

Matt [00:06:32] So basically your body becomes overwhelmed. You start to literally, on a physical level, your body is reproducing the chemicals and all the endorphins and everything else that you experienced in that previous time, and you’re kind of stuck in a loop, a traumatic loop. And unfortunately, the process of that, again, is if we don’t have that protection or support to metabolize that, we become retraumatized, and that trauma sinks in even further.

Matt [00:06:58] And the stakes of this are actually really high because it’s literally changing our body chemistry, brain chemistry, physical chemistry. And that means that it’s going to impact the way that we both exist in that moment, but also moving forward. And we know that people who suffer from long-term trauma have lower health outcomes. They typically live shorter lives, but also it makes it really hard to process information at those times.

Paul [00:07:26] Yeah.

Matt [00:07:26] So that’s trauma. And so then there’s been a movement that comes out of the medical field and then has come into design and other spaces to use methods to acknowledge its existence and try to, whether it’s engaging in the design process or building actual products, account for the possibility of that occurring. And so I’m really excited to talk more about that process.

Paul [00:07:51] Absolutely. So let’s jump into something a little bit more practical. So the folks listening today are, you know, product managers, perhaps Directors of Product or are leading a team of product managers or designers, folks who are thinking about mostly users of software, to put a fine point on it. And one of the examples that you gave when we were talking before the show was kind of how we can somewhat innocuously and even innocently come on to these triggers. Like, if you’re in an icebreaker event and you’re asking sort of an innocent, almost anecdotal question like, “Tell me about a bad day.” That might be a trigger for someone who was in 9-11 or who is dealing with, you know, reprocessing these things. So how can we think about these things from a product perspective or from a design perspective to be more thoughtful about what may or may not be sensitive for people?

Matt [00:08:38] Totally. And in fact, the story that Paul just mentioned actually happened to someone I know. They were doing interviews for a large corporate food provider about cafeterias, and the person they were interviewing, without their knowledge, had been in one of the towers on 9-11 and had a complete retraumatization based on that question.

Matt [00:08:57] So the first most important thing is just to be aware of this possibility. And then as you become aware of it, there are a number of different systems for addressing this. The one that a lot of folks use is one that comes from the Substance Abuse and Mental Health Service Administration, or SAMHSA. It thinks about this work on six principles: one, safety and making sure that we’re trying to make the process as safe as possible, thinking about trustworthiness and transparency. so how can we communicate enough to make sure that people are able to be empowered to make a decision to participate and share their voice and make choices, including when to stop participating? It’s also got other aspects like collaboration, mutuality, peer support, and also an eye on cultural, historical, and gender issues.

Matt [00:09:42] So the first part of this is even beginning a process where you bring other people into it. One of the things I love about that idea of that collaboration mutuality is that you can never do trauma-informed work alone. And not only because no research or design process is ever done alone. You know, even though we might be interviewing somebody, the researcher themselves is also a participant in the process. In fact, I’ve been in an example where the opposite happened and a response or an interaction with a person I was interviewing actually triggered a trauma response in me.

Matt [00:10:18] So one of the key things about this process is really, it’s like that airline safety card, you know, you need to make sure that you put your mask on before helping anybody else. This is as much about a process that we apply to ourselves as much as the people that we’re working with. So one thing is to, whenever you’re asking questions and thinking through that, thinking about things that you can do to ensure that there’s enough consent in the research or design process. So like, for example, one thing that we do at Code for America is we review each other’s questions, make sure we’re only asking questions we’re going to use going forward, and additionally, also making sure that we communicate why we’re asking certain questions.

Matt [00:10:58] So because of the work the Code for America does, we’re often talking with people who are either on or need to use the social safety net. Some of them might have past interactions with the criminal legal system. So when we’re asking certain questions, we make it really clear that we’re asking more about the immediate experience, and we’re not trying to find out what that individual’s past was.

Matt [00:11:18] Another key thing that we do is we compensate actually at the beginning of interviews. And a reason for that is that if somebody begins to really have that acute reaction, we want to give them the ability to walk away. And conversely, it also gives us as researchers or designers the ability to walk away. We’ve had cases where people have just gotten into stuff that really made us uncomfortable as a whole. And so knowing that on both sides, we have that ability to take that step back and pause things and we can always opt to come back. That’s a really important thing.

Paul [00:11:51] That’s really interesting.

Matt [00:11:52] Yeah. It also gets the integrity of trustworthiness. You know, if you’re compensating somebody at the beginning of the interaction, we’re saying we trust that you’re going to stick around for this. We’re not going to like hold you hostage for the, you know, the $50 or $75 we might be paying for the session. The other piece with that is, and this is a really important one that I feel like we were talking about on the walk as well. A key aspect of this is getting your head in the right place and yourself in the right place so that you can recognize when something is happening. So often we’re trained to ignore feelings in some ways, especially when they’re uncomfortable. So it’s like, “Oh, I can feel it’s going in a bad direction, but I don’t want to admit it to myself.” And that only makes things a lot worse.

Matt [00:12:35] And so empowering the researcher or the desire to pause the conversation, say, you know, “Listen, I think we’re getting into heavy topics, this isn’t really required for the research, let’s just take a step back, take a couple of deep breaths and go at this again, or maybe we want to try talking about this at a different time.” And by the way, one thing I want to bring up with this is, you know, it’s really easy when you’re doing work like Code for America does, with people who have been marginalized, honestly marginalized by many of the systems we’re trying to fix, to be like, “Oh, trauma definitely has to, you know, this is something we have to be worried about here.”

Matt [00:13:12] But I think we can also apply that to so many business contexts. I mean, you and I share enough of a personal history to have gone through a couple of traumatic business events together.

Paul [00:13:20] Sure.

Matt [00:13:21] Including, you know, some mass layoffs and that type of stuff. I’m not saying that that necessarily traumatized us. And that’s a really important piece of that empowerment is it’s not to try and bubble wrap the people that you’re with and assume that you have trauma over this, but rather to just know that it’s a possibility.

Paul [00:13:37] Yeah.

Matt [00:13:37] And if we think about all of the different ways, and again, even before COVID, 60% of men and 50% of women were experiencing traumatic events, and some of those definitely happened in the office, that could be a bad boss, it could have been any type of harassment or anything else. So recognizing that even when we’re discussing about places where trauma isn’t supposed to be happening, it can still be there.

Paul [00:13:59] Yeah. So you’re touching on a couple of things, and I’m going to try to ask a two-parter question to get at two things since we just have time for just one or two more. And one aspect of the question I want to ask is about misconceptions, sort of what you were getting at in terms of, you know, they might be triggered by a certain event. You know, it might be something that someone is resilient and passing through, you know, without that trauma build-up. But then the second part is sort of how about everybody else? What does this do to products if you’re thinking about it?

Paul [00:14:25] So to put a fine point on it, I think you’re getting at some misconceptions about what trauma is and how it doesn’t necessarily even have to be one single event. It can accumulate over time, right? And I think that that’s something that might help reframe what people think of as trauma. But then on the maybe more optimistic or hopeful or positive side of the question, by taking these things into account, it can lead to better products for everyone. And I’m wondering if you can spend a little bit of time talking about these two things. Sort of, is trauma only relevant to the social services, or is it applicable to other industries? And how can it make designs and products better for everyone, whether there’s trauma in their history or not?

Matt [00:15:05] Great, great questions. So one thing to understand is the impacts of trauma. So, like, one of the things I mentioned, and this gets back to acute childhood trauma. We know that people who have had that in their past have a lot more problems regulating their emotion and kind of psychological state. And so I’m going to use social services for an example. That means that when you’re asking somebody to do something that’s potentially stressful, like filling out a form, that can actually cause them to have this cognitive load that makes it harder for them to do that. And so this is a case where making the form easier or more accessible or an interface easier or more accessible not only helps those with trauma, but it’s going to help those without trauma as well.

Matt [00:15:46] And I think the other piece about this is to understand that implementing these ideas, and yeah, we’re only able to touch the tip of this today, has real value for both teams and organizations as well. Just simply having these discussions necessitates thinking about things in a different way, I would argue a more humane way, that we’ll also say, “Well, what are our team activities?” And so a great example of that was at the ITX Product and Design Conference last week, Rich Mirinov, at the end of it, kind of talked about product waste versus engineering waste and that a lot of stuff that we call engineering waste is actually product waste because we’re building the wrong thing, and this was kind of a theme through all of these, and that ultimately that often happens before any design is done in any coding is done. And part of the reason is is that an organization isn’t able to have difficult conversations about that.

Matt [00:16:38] And so an organization that’s trying to be trauma-informed for its customers is also trying to be trauma-informed for its employees and for itself. And that means that it’s valuing the type of psychological safety that allows you to have those difficult conversations upfront. And again, not have everyone go sitting around the table, like, thinking, “Oh, this is a bad choice, but I don’t feel comfortable saying that or somebody else is already going to figure out and stop this.” You know, that’s often caused by lower-t trauma. So there are the big T’s, like an assault, war, these types of things. But we really don’t encourage people to participate in the trauma Olympics, it’s that microaggressions, just getting completely shut down time and time and time again at work and ground down in that way so you no longer feel comfortable speaking is a form of trauma. And it’s not just a sick individual.

Matt [00:17:27] And I love the fact you mentioned resilience. And yes, we should be trying to build things with an eye toward resilience, but I’m much more interested in building resilient organizations than I am resilient individuals because really it’s the responsibility of the organization to create an environment that doesn’t require extreme resilience, not a fault of an individual for not being resilient.

Paul [00:17:50] I love that. What a great thought. So normally at this point in the conversation, I ask something along the lines of, what is your definition of innovation? But given the sensitivity of the topic and really just the saliency of where we’ve been exploring the area, I’d like to ask it in a slightly different way and maybe you can jump in and address a little bit of a different take. Instead of asking for your definition of innovation, could you share, How can product managers and UX designers and researchers innovate in this space of trauma-informed design? What does it mean to innovate in this space today?

Matt [00:18:22] That’s such a great question. In my mind, it means experimenting. It means going out, and there’s an ever-growing body of knowledge on this topic, and looking within your own practice and within your own organization and thinking about how can you just expand things a little bit. We’re at a moment, we might be coming out of it, but because of COVID, all the things that we said earlier, where people are much more keyed to this topic and aware of this topic than they have been in the past. That means it’s a moment where we can potentially take larger actions.

Matt [00:18:52] At the same time, the key thing about this is we want change and what we learn from that to be sustainable. And so I think a lot of times people want to make the entire process trauma-informed right out the bat, and that’s not really realistic. So there’s a maturity model, that again, comes out of the medical field that I like a lot and I think with a lot. It’s kind of four points, and Rachael has always encouraged me to think of these more as, like, a river with a lot of tributaries than just a single path because there are so many different ways to implement this. But that first step is what we’re talking about today, which is really trauma awareness. So understanding that trauma is a thing, that it is pervasive in our society, that everyone might, may have been exposed to trauma, they may have internalized trauma, and start to think about what does that mean for the work that you’re doing?

Matt [00:19:41] Then kind of the second step is becoming more sensitive to it. So starting to, like, cultivate the skills where you’re thinking early on about how might we change some of our practices, whether it’s competency at the beginning, whether that might even go as far as to there are contractors, social workers with backgrounds in design that will consult on projects, especially projects where things seem like they could get into some dicey territory. I’m not saying every project needs to have the same level of alertness, but at least understanding that. And so you’re starting to actively apply some of those principles that I talked about before.

Matt [00:20:13] The next step is what we consider to be informed where really you’re starting to allow this notion of trauma, psychological safety, these things to really inform, not only the way you’re doing work, but the way that your organization is doing work. And the final piece and this is the one that I’m not sure anybody is at today, but it’s kind of the mind-twisting one to think about is responsiveness. So when you become trauma-responsive, how are you starting off with thinking about building equity into what you build, building healing? And that is a big and scary concept. And like I said, I’m not claiming many people are out there, but even that entire piece that may actually be much more internally-focused for your organization. So knowing that you’re going to have folks on staff who’ve come in and had, you know, bad interactions, interactions at work that cause them not to be able to contribute in the way that you hoped that they would. And now we’ve not only think about building products, but building processes, and how can you shift the way that your teams and your organization is working in a way that’s also trauma-informed?

Paul [00:21:15] Yeah. That’s such a thoughtful response and I really appreciate you taking the time to unpack that. As you were going through all those sort of phases of awareness and sensitivity, it really got my wheels turning about ways that I can and should be better. As we’re wrapping up our time together, Matt, there’s one obvious plug, so to speak, that you recently shared a paper in Amsterdam with your coauthor, Rachael, and we’ll certainly link to that. But if people want to learn more about this and get some exposure to the broader community, the field of study, body of knowledge that you’re contributing to, where might they go to find information or writing on trauma-informed design and maybe bring something, maybe just a little piece, maybe something more process-oriented, back to their organizations? What comes to mind as a book that might be on a product manager’s bookshelf?

Matt [00:21:58] Ooh, that’s a good one. To get a sense of where it’s moving, especially if you’re interested, not only on the individual side, but the broader side. There’s a book that just recently came out called Truth and Repair by Judith Herman, she’s a doctor, and that’s kind of one of the newest works on trauma. She’s actually one of the two people, the group of people, that helped establish PTSD as actually something that was recognized by the Diagnostic Services Manual. There are going to be some books, I don’t believe I can say who’s writing them, but that are going to be coming out, including one from MIT Press very soon. The author is great and somebody I have a very high feeling about. Some additional things if you’re interested. There is a monthly trauma-informed design group that meets. If you do a Google on the web, you can find that. I also want to plug something that will be coming up very soon. I actually had the opportunity to talk to a news product conference and do an entire session on this stuff with Robin Fawk from Dow Jones.

Paul [00:22:57] Wonderful.

Matt [00:22:57] There’s going to be a write-up of that and it includes some links to some cool resources that we came up with for that, too.

Paul [00:23:02] Awesome. Well, Matt, you and I go way back. I’ve been looking forward to talking to you about this for a long time, and I’m glad we finally got connected to hit record on this one. I think it’s going to help some people and I think it’s going to do some good in the world. So I’m really glad and excited to share this one. Thanks for taking the time to talk with us today.

Matt [00:23:18] Yeah, my pleasure. And by the way, everybody, please friend me on LinkedIn or link me on LinkedIn, whatever you do on LinkedIn. I always enjoy talking about this topic.

Paul [00:23:26] Awesome. Thanks, Matt. Cheers.

Matt [00:23:27] Cheers.

Paul [00:23:30] Well, that’s it for today. In line with our goals of transparency and listening, we really want to hear from you. Sean and I are committed to reading every piece of feedback that we get, so please leave a comment or a rating wherever you’re listening to this podcast. Not only does it help us continue to improve, but it also helps the show kind of the rankings so that we can help other listeners move, touch, and inspire the world, just like you’re doing. Thanks, everyone, we’ll see you next episode.

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