The firm that helped cause the opioid crisis would like to teach you about trauma
I lost my brother to heroin addiction. It started with opioids — a path that was, at the time, being actively widened by pharmaceutical companies and the consultants advising them.
That loss shaped everything I now believe about how communication either meets people where they are — recognizing that they may not have full capacity — or ignores that reality entirely. It is what led me to discover trauma-informed practices, and to pursue a master’s degree in trauma-informed leadership.
So when McKinsey — the company that paid $1 billion for its role in accelerating the opioid crisis — published a piece on trauma-informed leadership, I had some thoughts.
In April, McKinsey's People & Organizational Performance practice published "How leaders can help their organizations metabolize strain."The piece draws on neuroscience, cites Body Keeps the Score author Bessel van der Kolk, and makes a case that trauma-informed leadership belongs in the executive toolkit.
As someone who advocates for trauma-informed employee communication — rooted in Substance Abuse and Mental Health Services Administration’s (SAMHSA) framework, organizational communication research, and the lived experience of employees inside polycrisis — it is a complicated thing to read.
The problem is that it's incomplete in ways that matter.
And because of who wrote it.
The number problem
The report leans on a McKinsey Health Institute survey of 30,000 employees across 30 countries. It finds that 33% report experiencing a traumatic event affecting their lives.
The authors acknowledge in a footnote that this number is probably low — "since not everyone chooses to disclose it or is accurately aware of the effects of a traumatic event." That's true. The World Mental Health Survey Consortium puts lifetime trauma exposure at roughly 70% of adults globally. That gap makes a big difference.
Trauma-informed practice recognizes prevalence. It assumes that in any given meeting, on any given team, the majority of people in the room have some adaptation that shapes how they receive information, process change, and respond to uncertainty.
The source problem
McKinsey advised Purdue Pharma on OxyContin sales strategy for over a decade — from 2004 to 2019, including after Purdue's 2007 felony guilty plea for misbranding. Court documents describe McKinsey helping to "turbocharge" OxyContin sales by targeting high-volume prescribers, developing messaging to convince physicians to prescribe more to more patients, and advising on how to circumvent pharmacy restrictions by delivering high-dose prescriptions directly to patients through mail-order channels.
When states began suing Purdue, McKinsey partners discussed deleting documents related to their work. McKinsey settled with all 50 states and the District of Columbia for $573 million in 2021, and reached a separate $650 million deferred prosecution agreement with the Department of Justice in 2024.
I am not raising this as a rhetorical point.
McKinsey also spent decades advising organizations on large-scale workforce reductions — industrializing layoffs as a financial lever, normalizing the practice of treating people as cost lines to be optimized. The restructuring methodology they helped popularize generated real organizational trauma, at scale, repeatedly.
A firm that helped manufacture one of the most devastating public health crises of our lifetimes, and that built much of its reputation on advising clients to cut the people inside their organizations, is now publishing guidance on how leaders can help employees heal.
This is late-stage capitalism at its finest.
The Trauma Industrial Complex
I've been talking about the Trauma Industrial Complex for a while now — the monetization of a lived experience without the accountability that trauma-informed work requires. When a body of practice built to respect vulnerable people gets adopted by management consulting firms as a product, something gets lost in the translation. The six SAMHSA principles become a leadership competency model. Accountability becomes mindfulness. Systems change becomes breathing exercises.
In a recent conversation with Stephanie Lemek, founder of The Wounded Workforce and a practitioner with 20 years inside corporate HR, we addressed this directly. Organizations and practitioners thinking a single training or a single initiative gets you to trauma-informed. Stephanie was direct about it — trauma-informed is an action, a choice, a way of being. A continuation, not a destination.
"If you are not doing this work primarily because you are called to do this work and live it, you shouldn't be doing this work," Stephanie said. "The root of this work is people being harmed. And if our goal is truly just to capitalize on that, to truly just profit, not to be part of solutions, not to call in other practitioners and offer support — go do something else."
McKinsey's piece does not clear that bar. Twelve pages, a proprietary survey, a handful of leadership vignettes, and one footnote acknowledging that the trauma prevalence data is probably wrong. No engagement with established principles. No discussion of the practitioners — in healthcare, social services, education, community trauma work — who built this framework over decades. No reckoning with the conditions organizations create, including conditions McKinsey has actively helped create.
A trauma-informed approach adopted as a product, in Stephanie's words, is checking a box. And if you're looking to check a box, this work isn't for you.
The systems problem
The McKinsey framework operates at three levels: the individual leader, the relationship, and the organization. That last level sounds promising. But in practice, "system" here means meeting structures, communication norms, and how feedback gets delivered.
What it does not mean is benefits, staffing levels, reorganization frequency, or whether the organization's decisions are generating the conditions that require trauma-informed leadership in the first place.
Genuine trauma-informed practice grounded in SAMHSA's six principles is explicitly about systems. Safety, trustworthiness, peer support, collaboration, empowerment, cultural responsiveness. These are organizational commitments. They require examining whether the conditions you've created are safe, whether your structures are trustworthy, and whether your decisions empower or deplete the people inside them.
That examination requires looking at things organizations often don't want to look at. A second consecutive restructuring in 18 months. Eliminating a mental health benefit during a period of elevated workforce stress. Communicating workforce decisions with vague language, delayed disclosure, and optimistic framing that contradicts what employees can plainly see.
All of this erodes the very trustworthiness that trauma-informed practice requires.
The language problem
A WorkPossible study found that 46% of employees have experienced the death of a loved one. Nearly half. Which means that in any room where a leader is reading draft company principles out loud, statistically, half the people listening are carrying that particular weight.
I know this because I was one of them.
Years ago, at a previous employer, a leader walked a group of us through a new set of employee principles still in draft form. One of them was "tough love" — a stated value, deliberately chosen, presumably workshopped. The moment I heard it, I was no longer in that room. I was in my kitchen, the night I learned my brother had died.
We’d been practicing tough love.
That leader had no idea. Why would they? My guess is "tough love" tested well in the C-Suite. It probably sounded honest, direct, caring-but-firm. It was intended to motivate. And for some people in that room, maybe it did.
Language doesn't only do what we intend it to do. It lands in the bodies and histories of the people receiving it, and it does its work there regardless of what we meant. That's a fundamental truth about how human beings receive information, and it's the reason trauma-informed communication requires more than good intentions and a careful edit
Which brings us to the McKinsey piece recommending that leaders introduce a recurring team ritual called a "funeral meeting."
A trauma-informed piece. Recommending. Funeral meetings.
If the authors had genuinely internalized what trauma-informed means — not just as a leadership framework but as a way of being present with other people's nervous systems — that phrase would not have survived the first edit. The fact that it did tells you something about the depth of the adoption. This is what it looks like when organizations take the concepts without doing the work.
(I'll be going deeper on the language of business at Flyover Festival this year.)
What this means for internal communicators
You are often the person in the room who sees this gap most clearly.
You know that the message your leadership wants to send and the message employees are actually receiving are not the same thing. You know that a town hall with a polished Q&A does not restore trust after a layoff. You know that the language used to announce a reorganization — however carefully crafted — lands differently in a nervous system that has been through several of them.
Trauma-informed communication demands more rigor than standard strategic communication, not less. It requires asking questions that go upstream of the message:
Is this decision trustworthy — not just: can we message it effectively?
What are we not saying, and what does that silence do? Ambiguity is not neutral. In the absence of information, people fill gaps with fear.
What has already happened in this organization? Context is cumulative. A message that would land fine in a stable environment lands differently after a year of repeated loss. History lives in the room.
Are we asking leaders to manage conditions they helped create? Individual leader behavior matters. And it is insufficient if the structural conditions — the workload, the uncertainty, the broken promises — remain unchanged.
The McKinsey piece ends with practical tools: breathing techniques, structured debriefs, and yes, funeral meetings. Leaders who regulate themselves do make better decisions. Teams that process loss do reengage faster. Those things are true.
But trauma-informed leadership that stops at individual behavior is missing the point.
The point is whether the organization itself — its decisions, its structures, its communication practices, its resource allocations — is generating unnecessary harm. And whether the people responsible for those decisions are willing to look at that honestly.
Written by Ellen Griley, founder of Equilibrious Communications, a trauma-informed employee communications consultancy based in Portland, OR. Her work bridges neuroscience, trauma-informed practice, and strategic organizational communication.