From Personal Pain to Collective Purpose: The Future of Building Sustainable Equity Work
- Dr. Washington
- 6 days ago
- 16 min read
Trauma Isn’t Strategy, Healing Alone Won’t Deliver Equity in Healthcare
9, June 2025 Dr Sharon Washington
Table of Contents:
A Note Before We Begin: Who This Is (and Isn’t) For
This article speaks to a nuanced challenge facing DEIA spaces in healthcare and academic medicine—particularly those with racially diverse teams and a few years of equity infrastructure under their belt. If your institution is still fighting to diversify its hiring processes, navigating resistance to the basics of inclusion, or doesn’t yet have enough BIPOC representation for these dynamics to surface—this may not feel immediately relevant. That’s okay. Scroll on, take what applies, and come back when it resonates.
At the same time, let us be crystal clear: this critique is not an invitation to discredit DEIA or roll back the progress our communities have fought for. This is not fuel for those seeking to undermine equity work or mislabel accountability as “division.” Rather, it is a call within our movements—a call for clarity, integrity, and alignment. Because when we misuse the language of liberation to shield ourselves from feedback, to center only our pain, or to silence others under the guise of justice, we dilute the power of what DEIA was always meant to be: collective transformation.
This article is written with love and rigor for the people doing the work—and especially for those leading it under pressure. If we want sustainable, systemic change, we must name what’s working, what’s not, and where we are replicating the very dynamics we seek to disrupt. Let’s begin.
Introduction
The goal of diversity, equity, inclusion, and anti-racism (DEIA) work is not to invert existing racial hierarchies or to redistribute power solely to Black, Indigenous, and People of Color (BIPOC). Rather, it is about dismantling systemic barriers and fostering an inclusive, equitable, and just society where all individuals thrive. This distinction is critical, particularly within institutions where resistance to DEIA efforts has intensified since 2020. The COVID-19 pandemic, mass trauma, and mental health crises have further exacerbated strain, disproportionately affecting BIPOC professionals and learners in these environments.
The Rise of Hyper-Individualism in DEIA Spaces
In response to prolonged systemic harm, many BIPOC individuals in institutional settings have adopted an approach to DEIA that prioritizes self-preservation. This shift is understandable given the trauma and burnout experienced disproportionately by BIPOC professionals. However, an unintended consequence of this hyper-individualistic approach is a fragmented and sometimes incoherent push for equity. Instead of being grounded in collective vision and strategy, DEIA discourse in increasingly many spaces, reflects the individualized grievances of traumatized individuals navigating institutions that were not built with them in mind.
Particularly since 2020, some marginalized individuals are increasingly misusing the language of DEIA to deflect accountability, obstruct constructive feedback, and reinforce personal trauma narratives, all while framing their responses as aligned with collective justice. What emerges is not a shared commitment to transformation, but a defensive posture that leverages identity as a shield rather than a point of connection or responsibility.
This pattern is often driven by limited socio-political analysis beyond one’s own identity, which can lead to an overreliance on personal grievance in place of structural critique or shared purpose. When feedback is offered it can trigger externalization of blame, with assumptions of bias or punishment when disagreement arises. Instead of reflecting on how their behaviors impact the group or the goals of equity, some individuals weaponize DEIA language to silence others, resist feedback, or redirect responsibility—even toward other BIPOC leaders who are positioned to guide or support them. The following are examples seen in the last four years within academic medicine and healthcare institutions:
1. Feedback Avoidance through Identity Shielding
In this dynamic, identity is used as a form of protection from accountability. For example, a resident may reject constructive feedback from a faculty, asserting that it is unlikely that a white male peer would receive the same feedback, therefore to have it directed toward a woman or person of color is experienced as a form of punishment rather than a path to growth. Further, attempts of faculty of color trying to help the learner receive the feedback or learn from it, is met with the implication or assertion that leaders with shared marginalized identity should protect the learner from that form of critique. This not only avoids the substance of the feedback, but also places undue emotional burden on same-identity leaders, expecting them to prioritize loyalty over growth.
2. Misuse of “Centering” to Justify Superiority
“Centering marginalized voices” can be misunderstood and misrepresented as a call to pedestalize one group at the expense of others. In reality, centering is about restoring focus, repair, and visibility—not exclusion. It is about groups who have been subjugated to the margins of society and kept from decision-making are actively included, considered, and when issues are pertaining to their experience, their voices are ensured in the conversation. When individuals insist that their experience is ‘centered’ and that should mean their personal perspective should carry more weight than anyone else; or that disagreement is evidence that their experience is not being ‘centered,’ the concept is becoming a tool for exclusion and claiming dominance.
3. Labeling Feedback as “Tone Policing” Used to Excuse Harmful Communication
Recent culture shifts have created more space for diverse forms of authentic communication to be welcomed, and naming when ‘tone policing’ is happening as a mechanism to delegitimize the contributions of diverse voices. However, increasingly, marginalized team members carrying personal trauma, justify unkind, aggressive, or hostile behavior, especially in moments of interpersonal tension, and reject critique for this behavior by framing professional accountability for their communication as tone policing. While anger is a valid and powerful emotion, it is not an excuse for abusive or harmful conduct, and inviting accountability for how someone embodies their trauma in professional settings is not the same as silencing their voice.
4. ‘Impact Over Intent’ Taken to the Extreme
Years ago in DEI discourse, a common grounding agreement was to “trust the good intent” of others when they misspeak or cause unintentional harm. Overtime, the abuse of claiming good intent while being reckless with marginalized others was insufficient, and the offering of “focus on impact, rather than intent” emerged. This aimed to bring balance to the experiences of harm, that may not have been intentional, yet were negatively impactful. While it’s essential to validate how someone’s actions are experienced, there is growing misuse of the ‘impact over intent’ concept in ways that reject any opportunity for clarification, repair, or learning. When people state, “I don’t care what your intention was,” they may be blocking the possibility of trust, grace, or collaboration, even with colleagues who have demonstrated good faith and commitment over time. Ultimately, there must be a balance between valuing the good intent, while honoring the impact.
5. Misuse of “Flat Hierarchy” to Justify Role Entitlement
In some cases, language about the equitable aim of flattening hierarchies in medicine and healthcare is misapplied to argue for equal compensation or authority regardless of role, training, or risk level. Working with residency programs, I've heard residents suggest, "if we want to be equitable, as a third year resident or resident leader, I should be getting paid what a junior faculty gets paid." While DEIA work does aim to create respectful and psychologically safe environments for everyone, regardless of title, it does not erase the real structural differences between positions or professional responsibilities. Equality in treatment is not the same as equity in leadership or pay, particularly in high-risk fields and practices within healthcare.
To understand the dynamics at play in many DEIA spaces today, it’s helpful to consider the five levels of power:
Power over – domination or control of others, often through hierarchy, coercion, or fear.
Power under – powerlessness or perceived powerlessness, often manifesting in passive resistance, moral high ground, or victimhood as a form of control.
Power to – the ability to take action, make decisions, or create something new.
Power with – collaborative, shared power rooted in mutual respect and partnership.
Power within – a grounded sense of self-worth, integrity, and inner clarity; the ability to show up with humility, resilience, and purpose.
Many individuals enter DEIA spaces with lived experience of being on the receiving end of “power over.” But when that pain is unhealed or unexamined, it can lead to the internalization of a “power under” stance—where expressions of moral superiority, emotional reactivity, or identity-based defensiveness become the default mode of engagement, rather than shared responsibility or collective action. In these instances, DEIA language becomes a tool of control rather than liberation—used not to advance collective transformation but to reinforce personal protection, moral superiority, or self-interest.
This misalignment fractures trust, alienates potential allies, and undermines the integrity of the work. It also contributes to a culture of fear and silence, where disagreement is perceived as betrayal or bigotry, and feedback becomes a threat. Ultimately, the confusion between personal validation and collective justice hinders the very change DEIA efforts aim to achieve.
The Burden of Institutional Change on Early-Generation Desegregated BIPOC
Yet to fully understand the weight BIPOC professionals carry in DEIA spaces today, we must ground this moment in historical reality. The civil rights victories that cracked open access to education, housing, voting, and employment are recent—barely a generation or two old. Ruby Bridges, the brave six-year-old who integrated a New Orleans public school in 1960, is only 70 years old today—of retirement age for only a few years. She is a living reminder that desegregation is not ancient history—it is still within a single lifetime.
Even with the bold efforts to desegregate institutions in the mid-20th century, many spaces have still not fully integrated. There are still colleges, departments, and leadership structures where the first Black graduate, leader, or department chair is just now emerging. In many institutions, we are not post-desegregation—we are still in it. And in all others, we are at best first-generation desegregationists, inheriting systems that were never designed for our participation or success.
While the 1960s focused on diversity in access, most institutions didn’t begin grappling with inclusion until the 1980s and 1990s. The language of inclusion and belonging took root only in the last 20 years, and equity and antiracism have only become mainstream in the last 5 years. This timeline matters. It reveals just how new and fragile this work is—and how essential it is to approach it with both urgency and strategy.
BIPOC professionals today are often the first or second generation within their families to gain access to predominantly white institutions (PWI) at leadership levels. This reality places them in a complex position: inheriting systems that were not designed for them while simultaneously being expected to reform them. While it is necessary to challenge institutional exclusion and bias, it is equally important to recognize that these changes require sustained, strategic engagement rather than reactionary demands.
Given the historical context and the realities of ongoing institutional exclusion, the responsibility of BIPOC individuals working to advance equity cannot—and should not—be framed as a singular or uniform burden. Instead, it must be grounded in:
1. Sovereignty and Self-Determination: Each BIPOC individual must have the autonomy to define what their role looks like in advancing institutional equity. No one person should be expected to carry the full burden of transformation. Self-awareness, boundary setting, and self-preservation are not in conflict with leadership—they are prerequisites for it. Being self-determined requires self-awareness and accountability, which takes time and practice.
2. Strategic Engagement, Not Martyrdom: Too often, institutions expect BIPOC professionals to serve as both symbols and solutions. The work of equity must be approached strategically, not sacrificially. It is not every individual’s role to respond to every crisis, sit on every DEI committee, or take on unpaid emotional labor. Rather, each BIPOC professional should be empowered to choose when, where, and how they engage—based on their skills, interests, capacity, and well-being. This also requires folks who need to exercise their boundaries, to allow allies to carry the work forward when taking breaks.
3. Legacy-Building, Not Crisis Response: When we view ourselves as first- or second-generation desegregationists, it becomes clear that this work is generational. Our responsibility is not to complete the work, but to contribute meaningfully to a legacy—laying groundwork that others can continue to build upon. This means making thoughtful moves, documenting strategies, mentoring others, and shaping infrastructure—not just reacting to the moment. The language of "burn it down" that may carry the necessary charge on the frontline of protests, does not translate into workplaces, particularly in healthcare where marginalized communities are still in dire need of quality care and representation.
4. Collective Action Over Individual Heroism: This work cannot and should not be done alone. It must be collective, intergenerational, and interdependent. The responsibility of BIPOC professionals is to connect, collaborate, and co-create with others, both inside and outside the institution. Building coalitions, amplifying marginalized voices, and creating shared strategies makes the work more powerful—and more sustainable. A collective approach must ensure that marginalized individuals carrying significant trauma do not redefine 'equity' to center around them and their personal concerns, at the expense of honest and systematic change to promote inclusion for all.
5. Naming and Resisting the Gaslight: When equity efforts face pushback, it’s often framed as “divisive” or “unnecessary.” Part of the responsibility for those who choose to stay in the work is to skillfully name these dynamics, educate when possible, and advocate for truth-telling within institutions. But this should be done with discernment—not at the cost of one’s dignity, health, or humanity. Simultaneously, when harmed individuals insist on shaping the discourse to serve their own interests, or lambast others with social justice language, while calling for unbalanced or unethical practices that favor them, we must have the bravery to interrupt this as well.
6. Modeling Liberation: In a system built on exclusion, living joyfully, leading authentically, and thriving professionally is an act of resistance. The responsibility is not just to change systems, but also to model what it looks like to live outside of them—to find joy, connection, and care in community and culture, even when institutions lag behind. When marginalized team members insist on defining institutional equity, but refuse to engage in community building, ruminate in sorrow, and judge those who aim to embody balance, more space must be created for true diversity of experience.
By identifying and naming counterproductive patterns—and rooting our practice in power with and within—we create the possibility of returning DEIA to what it is meant to be: a courageous, collective, and emotionally honest path toward equity and healing. A culture of equity must be grounded in grace, accountability, shared responsibility, and emotional skillfulness—especially among those leading the work.
The Role of White Allies: Beyond Affirmation to Accountability
White allies play a critical role in institutional equity work—especially in this current moment when DEIA spaces under attack through political disinformation and divestment, and are vulnerable to fragmentation driven by individual trauma responses. But allyship must move beyond affirmation and validation to become a grounded force for balance, accountability, and healing within these spaces.
When BIPOC colleagues become caught in cycles of unhealed trauma or power-under dynamics, it is dangerous for white allies to respond with avoidance or pedestalizing under the guise of allyship. This does not serve the person, the team, or the work. Nor does it model the generative cross-racial relationships we must build to sustain equity. White allies must be prepared to:
Hold relationship and boundaries simultaneously
Support healing without surrendering standards
Challenge dysregulation compassionately and skillfully
Protect the collective purpose of DEIA work—not just individual narratives within it
Practice Relational Accountability, Not Performative Allyship
Don’t confuse centering with surrender. Genuine relationships require mutual respect and shared accountability—not silence or indulgence when trauma-based behaviors derail progress.
White allies should cultivate relationships where they can say: “I value you, and I want us both to grow. Here’s what I see happening, and I’m inviting us to do better together.”
Build Emotional Literacy to Stay Grounded Amid Dysregulation
When DEIA spaces are led by unresolved personal pain, group dynamics can become volatile. White allies must learn to:
Stay present through discomfort
Not mirror or escalate trauma responses
Bring calm, grounded leadership when others cannot
Track when conversations are no longer productive—and help reorient them toward collective goals
Use Positional Power to Protect Equity Work from Misuse
When individual behaviors begin distorting DEIA frameworks (e.g., demanding power-over under the language of centering), white allies in leadership must not abdicate responsibility:
Uphold institutional standards
Ensure that accountability applies across all identities
Protect DEIA spaces from becoming tools of personal retaliation or control
This allows BIPOC colleagues space to heal while protecting the shared work.
Interrupt White Silence and False Fragility
Retreating from cross-racial dialogue out of fear of “getting it wrong” or being called out for harm is not allyship—it is collusion with dysfunction. White allies must:
Stay engaged even when challenged
Name when trauma-driven behaviors are harming the collective
Model how to hold both accountability and compassion
Avoid leaving BIPOC colleagues who are doing healing-centered, relational DEIA work alone in this labor
Build Cross-Racial Accountability Practices
Develop norms within DEIA spaces where
White colleagues are allowed to name harm when it is happening—even when the person causing it is BIPOC
White allies model feedback rooted in care and collective responsibility, not moral superiority or guilt
Cross-racial relationships are seen as a site for shared growth—not tiptoeing or patronizing dynamics
Contribute Actively to Collective Healing
White allies must move beyond passively witnessing BIPOC pain toward actively supporting collective healing:
Co-create healing-centered practices in DEIA spaces
Encourage balance between honoring pain and advancing institutional change
Help rebuild the container of DEIA work so it remains a space of purpose, not individual venting or retraumatization
Bottom line: White allyship must mature—especially in this era of DEIA backlash, where trauma-driven distortion of equity spaces is both real and dangerous to the continued legacy of integration and inclusion.
Silence is complicity
Pedestalizing is disempowering
Performative validation is abandonment
What is needed is relational rigor—the ability to stay grounded, to hold standards and care simultaneously, and to help return DEIA work to its collective, transformative purpose.
As I call on BIPOC professionals to lead with sovereignty, legacy-building, and strategic engagement, I call equally on white allies to develop the emotional and relational maturity to help hold this work with us—not around us, not above us, not beneath us, but with us.
The Future of DEIA: Building Sustainable, Collective Equity
The work of equity and anti-racism cannot rest on individual emotions and trauma responses alone. While acknowledging historical and ongoing harm is essential, institutional change requires structured, sustainable efforts. It requires discipline. And it requires a shift from personal pain to collective purpose.
Given how recent our civil rights milestones are—how many institutions are still desegregating, still graduating their first Black women, still wrestling with the basic inclusion of marginalized groups—it is clear that we are still in the early architecture of equity work. That makes our choices now especially critical. If the work is reduced to cycles of reaction, cancellation, or personality-driven battles, we risk reinforcing the very exclusion and fragmentation our elders fought to dismantle. We cannot afford to replicate the chaos of injustice in our pursuit of justice.
To ensure this work is strategic and not reactionary, we need a different kind of leadership framework—one that prioritizes sustainability, transformation, and shared responsibility. We need BRIDGE.
BRIDGE is not just a model—it’s a mindset and a method for how institutions and individuals can move from intention to impact in their DEIA work. It offers a roadmap for equity that is rooted in emotional integrity, historical awareness, and collective responsibility.
B – Building (Laying the Foundation for Equity)
At the core of institutional transformation lies the necessity to confront historical exclusion, conduct structural evaluations, and lay down a solid foundation for equitable growth. From racially biased admissions policies in the 1950s to the rollback of race-conscious admissions today, healthcare systems have long reflected national inequities in access and representation. These patterns are sustained by contemporary attacks on affirmative action and racial justice education. Without a reckoning with this history and a grounded, data-informed assessment of present-day policies, DEIA work remains untethered and performative.
BRIDGE begins with this building phase—offering tools such as grounding assessments, climate surveys, and DEIA readiness audits to identify structural gaps, measure workforce preparedness, and orient leadership around the historical and current realities that shape inequities in healthcare access, education, and employment. This ensures individual experiences of harm and trauma are encapsulated within an inclusive process of gathering and tracking experiences across the organization.
R – Reflecting (Deepening Critical Consciousness)
Critical consciousness is not a luxury in healthcare—it is an ethical imperative. However, many professionals operate in a culture that discourages vulnerability, reflection, and the naming of power. The BRIDGE model insists on integrating structured reflection and systems-level self-examination as core professional competencies. By creating psychologically safe spaces, coaching leaders in emotional intelligence, and embedding trauma-informed reflection into DEIA committees and clinical debriefs, institutions can move beyond avoidance and toward self-aware, relationally skilled leadership.
Reflecting also includes equipping professionals to understand how racism, oppression, policy, and privilege shape care delivery, team dynamics, and institutional culture. This allows for root cause understanding of disparities, moving from “what’s wrong with this person?” to “what has this system produced?”
I – Impacting (Turning Insight into Measurable Action)
Insight without impact results in symbolic progress. The Impacting phase of BRIDGE focuses on embedding DEIA values into operational decisions—from compensation audits and promotion pipelines to procurement and patient care metrics. Institutions must go beyond diversity statements and track their effectiveness through KPIs tied to representation, retention, leadership diversity, psychological safety, and health equity outcomes.
D – Developing (Sustaining Growth and Professional Learning)
DEIA transformation is not a one-time event—it’s a lifelong learning process. Developing centers on longitudinal professional development, coaching, and mentorship for both emerging and established professionals. BRIDGE promotes the institutionalization of growth mindsets, equity literacy, and trauma-informed leadership across all levels of the organization.
G – Grounding (Integrating Somatic and Emotional Awareness)
Healthcare leaders and providers carry trauma—both personal and institutional. Burnout, racialized stress, secondary trauma, and toxic team dynamics are not just psychological—they are physiological. BRIDGE integrates grounding practices and somatic tools to help individuals and organizations recognize stress responses and regulate them in real time.
Grounding is not about asking marginalized staff to simply “be resilient” in the face of harm—it’s about designing systems that reduce harm. This includes trauma-informed leadership coaching, policies that embed psychological safety, and wellness strategies that support both frontline and administrative staff in high-stakes environments.
E – Ecological (Aligning Systems, Culture, and Policy)
Finally, the BRIDGE model expands from the individual to the system level through an ecological lens. Institutions must align DEIA principles across the individual, interpersonal, organizational, community, and policy levels. This includes integrating cultural humility into clinical workflows, ensuring equitable hiring and promotion, and forging partnerships with community stakeholders to co-create inclusive solutions.
Ecological alignment also demands that healthcare organizations participate in advocacy—engaging with communities in policy reform, legislative support, and public health equity efforts. BRIDGE supports institutions in designing community advisory boards, tracking patient demographic outcomes, and aligning public health goals with internal policy.
From Fragmentation to Framework: Returning DEIA to Its Collective Purpose
We are still in the early generations of desegregation in healthcare. Many of today’s leaders are first-generation desegregationists, navigating institutions not built for them. As equity discourse evolves—from access to diversity, to inclusion, to belonging, to antiracism—the strategies we employ must evolve too.
Yet, in this critical transition, a troubling pattern has emerged: the misuse of DEIA terminology to reinforce individual trauma responses, deflect accountability, or silence disagreement. Rather than serving as tools for collective liberation, concepts like “centering,” “tone policing,” or “impact over intent” are sometimes wielded to justify harmful behavior, avoid feedback, or displace responsibility—even toward allies or fellow BIPOC leaders. This dynamic undermines the integrity of the work, fracturing trust and confusing personal healing with structural transformation.
This is not what our ancestors fought and died for—fragmentation and reactive engagement will not lead to the systemic transformation needed for lasting equity. DEIA work cannot be sustained if it becomes a stage for unresolved pain rather than a blueprint for shared purpose.
The BRIDGE framework offers a path forward—one rooted in structure, reflection, and integrity. By building strong foundations, reflecting with critical consciousness, impacting systems through measurable change, developing resilient and skilled professionals, grounding in emotional and somatic awareness, and aligning ecologically across all levels of the institution, we can reclaim DEIA as a collective practice—not an individual shield.
Ready to Transform Your Institution's DEIA Practices?
Equity work must move beyond individual responses and become a collective, systemic transformation. The BRIDGE framework offers a clear, structured path forward—integrating reflection, accountability, and emotional awareness into every level of your organization.
Are you prepared to lead this change and create a culture of lasting equity? Reach out to SWC today to explore how we can implement the BRIDGE framework in your institution, align your practices, and drive meaningful, sustainable transformation.
Let's build a future of equity together.
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