Christine “Cissy” White is an advocate for survivors of trauma. That’s partly because she is one herself.

When I first met her, she lived in Weymouth, Massachusetts, then with her teen daughter. Back then, she earned a living as a community facilitator for the nonprofit PACEs (Positive and Adverse Childhood Experiences) Connection.

Two years later, she showed me around her home: one bedroom in her house as a sanctuary, where she did downward dogs and wrote in a notebook, all to help her treat trauma symptoms, which included trouble sleeping.

The place had a very different temperature emotionally from the one she had grown up in.

White’s mother—who’d had three kids by the time she was a young adult—was just a teenager when she became pregnant with White’s older sister. White’s father was a Vietnam War veteran who struggled with alcohol after he came back from Southeast Asia. White barely knew him but understood he was often unhoused. All of this was part of larger unhappy pattern. Before the age of ten, she had experienced the divorce of her parents as well as physical and sexual abuse. Throughout much of White’s childhood, her mother was the sole provider. Growing up poor, White would hide the tape and paper clips that held her broken glasses together behind her bangs. When she went out with friends she was often starving as she was unable to afford food: to hide her embarrassment, she said she wasn’t hungry. She also used paper towels as pads when she was a teenager because she wasn’t provided money for those either. In that time, White and her family also moved frequently. Her family stabilized economically when her mother remarried for the third time to a relatively financially secure man who worked in what was then the digital sector. Her mother’s marriage was part of how White survived poverty and neglect.

This relief from indigence, for instance, was marked by her moving from Boston’s working-class neighborhood of Brighton and its Waltham suburb to the upper-middle-class town of Harvard, when she was a teenager. She said that showed her the difference between growing up in a place where the whole community is challenged by poverty and one where a single family is put upon, as hers was. White also discovered she had many more resources in her wealthier school district, for example. Due to these new splotches of social-class privilege, she learned enough about college and applications to try for plush Hampshire College in Amherst, Massachusetts. She was accepted and attended on a scholarship. College was a shocking experience for her. Her life shocked her classmates in turn. There, she was surprised to meet people who, in her eyes, had no palpable obstacles. “The presence or absence of adversity shapes us a lot,” White said.

From the beginning, White had always prickled when she was complimented for being so “resilient,” even though as the first person in her family to graduate from college she was often called that. She viewed her own story of resilience as one fortified by unexpected periods of economic freedom in her later youth and also of access to therapy, neither of which is emphasized or acknowledged in the typical bootstrapping story.

White herself reckons she grew up with a total of eight adverse childhood experiences (ACEs), from abuse to abandonment, and survived to become a counselor and an advocate. It’s hard to overstate how bad eight ACEs are. With four ACEs you’d have had childhood toxic stress, because your number of ACEs are like “a cholesterol score.” One gets one point for each type. The higher one’s ACEs score, the higher the risk to one’s health. (The understanding of ACEs starts with the original ACEs Study, the CDC-Kaiser Permanente Adverse Childhood Experiences Study.) White’s job was counseling survivors in need, usually over the internet, communicating with the ACEs social network of forty-five thousand.

The main reason why she took so well to the method that recognized ACEs first and foremost, White said, is that she had a severe distaste for the idea that she—or anyone—had lifted themselves up out of pain and poverty. Her own rare success could have reaffirmed that myth of bootstrapping: her career; her capacity to help others and have a balanced family; her modest but comfortable home with its gas fireplace and a robin’s-egg-blue wall and signs that offered encouragement like one that read “This Is Our Happy Place”; her put- together and pleasant appearance, with her ash blonde hair cut in a short, spikey do and her retro-cool cat’s-eye glasses. But all of these achievements produced the opposite effect, as she knew too many worthy people who hadn’t “gotten out” as she had. She also disliked individualism’s sister, resilience. She “rages” and “recoils” when she hears either word, which happens more and more.

Instead of terms like “resilience” or “grit,” White and others have embraced another solution, which her peer group embodies: “trauma-informed” community. These groups, according to White, are comprised of those who have experienced all manner of abuse and provide a place where people may congregate and seek services for free. White offered care to those who have undergone or were currently undergoing agonies like those she experienced. You might think of “trauma-informed” subcultures like White’s and others as psychological mutual aid networks.

The trauma-informed approach, and even those very words, taps into a method and appellation that has become, admittedly, wildly trendy. “Survivor-centered and survivor-aware care,” is what White also called it.

“It’s not a ‘how do we fix you’” model, as she put it. “It’s ‘I may have things to teach you about poverty, and you have things to tell me about navigating systems.’”

Whatever you call it, this emphasis has impacted arenas as disparate as welfare services and a university student’s life, trauma-informed policing, and trauma-informed lawyering. Because it’s a fashionable catchall, my friend the social worker rolls her eyes at the very phrase. A popular catchphrase can also represent real change, though: think of the proliferation and performative use of the term “the 99 percent.” In mental health, the way that the trauma-informed framework alters the aperture is that people are understood as needing far  more  personal agency in their own treatment. Their actions are also now understood through the lens of their trauma, rather than by tracking their troubling behavior and judging it, a scolding that might well replicate the original bad feeling.

This shift in emphasis to trauma can be particularly helpful when counselors or therapists treat people with less money: so much of what tends to set them back are corrosive externalities that they then have been required to internalize. In contrast, “self-reliance” meant a particular thing to White, and it wasn’t good.

In White’s case, understanding her own suffering through the trauma rubric also changed her personal life: she met her last partner, Tom, through a dating site where she listed in her bio that she had many adverse childhood experiences. Emphasizing personal trauma when seeking love might not seem to be the best idea on a romantic site, but Tom, like her, was working class, with a high ACEs score. (White tested him on his ACEs on their first date.) As a hobby, Tom also did household projects like rigging up a heating system for the birdbath in front of their home, so their wild feathered friends could gather together in the chilly Boston-area weather.

The rubric “trauma informed” also changed her professional existence. White is part of a growing number of therapeutic and mental health practitioners who focus on clients’ current and past economic realities. White emphasized in exchanges with her traumatized peers how she grew up working class and the way this background still wears down her older family members—an aunt, for instance, who has four part-time jobs and one full-time job.

I think of it all as “inequality therapy,” a set of therapeutic practices happening around the country. It’s not just some specialized new form of psychoanalysis coming out of some esoteric clinic. It’s more like a framework, in peer-to-peer counseling and networks as well as counseling with individuals, sometimes at considerably reduced cost to the patients, and research by scholars examining the intersection of emotional suffering and inequity, including the study of happiness and unhappiness.

Bootstrapped © 2023 by Alissa Quart. Published with permission of HarperCollins.

Alissa Quart is the executive director of the Economic Hardship Reporting Project, a journalism nonprofit devoted to covering inequality. The author of five nonfiction books (including Bootstrapped (2023) and two poetry collections, she has also contributed to The New York Times, The Guardian, and The New York Review of Books, among other publications.

Co-published with Teen Vogue.