Excellent. I would add others: epistemic exclusion( 'we are experts ');Also where trauma means criticism of whole system it cannot be accepted (read https://blackwells.co.uk/bookshop/product/9781541602953?gC=5a105e8b&gclid=CjwKCAjwq4imBhBQEiwA9Nx1Bm3D3359eYA8MqVfgsgoh5JPPRBzq60mOKmcKZqgAlm_I8nuyQ0cexoCmNkQAvD_BwE ) also: interest ( professional, system, financial, personal, political, historical) meaning challenge is not possible because of implications. also 'othering'- patholigising , blaming, individualising. All linked. Solution: Patient inclusion, leadership, empowerment, centering. No one dares do this!