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This City is Killing Me: Community Trauma and Toxic Stress in Urban America
When Jonathan Foiles was a graduate student in social work, he had to choose between a mental health or policy focus. But once he began working, he found it impossible to tell the two apart. While working with poor patients from the South and West sides of Chicago, he realized personal therapy could not take into account the impact unemployment, poverty, housing, and other structural urban issues have on individual and community well-being. It is easy to be depressed if you live in a neighborhood that has few available supportive resources or is terrorized by gun violence. We are able to diagnose people with depression, but how does one heal a neighborhood?
This City Is Killing Me: Community Trauma and Toxic Stress in Urban America, brings policy and psychiatry together. Through a remarkable set of case studies, Foiles opens up his clinical door to allow us to overhear the stories of Jacqueline, Frida, Robert, Luis, Anthony, and other poor Chicagoans. As we listen, Foiles teaches us how he diagnoses, explains how psychiatrists before him would analyze these patients, and, through statistics and the example of Chicago, teaches us how policy decisions have contributed to these individuals’ suffering. It is a remarkable, unique work of social work and psychology with an urgent political call to action at its core.
This City Is Killing Me: Community Trauma and Toxic Stress in Urban America, brings policy and psychiatry together. Through a remarkable set of case studies, Foiles opens up his clinical door to allow us to overhear the stories of Jacqueline, Frida, Robert, Luis, Anthony, and other poor Chicagoans. As we listen, Foiles teaches us how he diagnoses, explains how psychiatrists before him would analyze these patients, and, through statistics and the example of Chicago, teaches us how policy decisions have contributed to these individuals’ suffering. It is a remarkable, unique work of social work and psychology with an urgent political call to action at its core.
176 pages, Paperback
First published August 6, 2019
18 people are currently reading
412 people want to read
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Displaying 1 - 29 of 29 reviews
February 17, 2020
This gives me hope for working with people in a fucked up world. Social work can too often feel like band aids in a shitty system and complicity and burnout. Foiles connects the micro- macro level practice so that we can truly see our clients and use their stories to bolster further actions.
Also I’m thinking of moving to Chicago so it gives me a little bit better an idea of the city......
Also I’m thinking of moving to Chicago so it gives me a little bit better an idea of the city......
June 9, 2020
I wanted so much more from this book--it felt like we were just skimming the surface!
Even though the author gave a caveat at the beginning, the contextualizing at the end was more helpful and all throughout there a little bit of a looking down upon these people vibe. It made me feel a little weird.
Even though the author gave a caveat at the beginning, the contextualizing at the end was more helpful and all throughout there a little bit of a looking down upon these people vibe. It made me feel a little weird.
November 7, 2022
This book is so important especially if you are working in community mental health. It talks about how government policies (specifically in Chicago but can be applied in other cities) are correlated with the trauma people in Chicago face.
March 15, 2022
Oh, the dreaded one star review! I'm conflicted about the one star. One star and five star reviews are the hardest for me to discuss bc in both cases my reaction seems unfair. Either my love for the book allows for me to swing too much wind at it's back and overrate it. Or my incompatibility with it makes my frustration spray over the pages in surprising ways.
In this case, I misunderstood what this book is or what it wants to be.
Whatever the case, it's just not a good book. Nobody born today, March 10, 2022, is going to do his sociology term paper in 20 years and resort to this book as any kind of measure of reality.
The books author is a mental health professional. I'm very much NOT that. Im not going to pretend I can even be conversant (on the topic) with anyone who is.
But neither is this book a medical thesis. It's no research. It's not "science."
It's more like a self indulgent op-ed that constantly references his degree. Doesn't it seem to you that a guy who doesn't expect his reason alone to carry his thesis, and who keeps mentioning the feathers in his cap as a substitute for good ideas and skill.
As I write, I begin to realize how annoyed I actually am, haha. I just want the truth. At least as close to the truth as the author can make. That's difficult, isn't it. It's much easier to just fart your vanities and prejudices (as often in favor of whatever as out of favor for others).
If you want naked political propaganda, here you are, enjoy! Likely you already know what it about and you already know how each little arc goes. This is the kind of book that preaches to the choir. No winning over hearts and minds.
I've had enough of this kind of divisive material. You're better off finding a newscast or pod cast on YouTube or elsewhere. There are professionals out there who do gather legitimate news and who want to share it.
In this case, I misunderstood what this book is or what it wants to be.
Whatever the case, it's just not a good book. Nobody born today, March 10, 2022, is going to do his sociology term paper in 20 years and resort to this book as any kind of measure of reality.
The books author is a mental health professional. I'm very much NOT that. Im not going to pretend I can even be conversant (on the topic) with anyone who is.
But neither is this book a medical thesis. It's no research. It's not "science."
It's more like a self indulgent op-ed that constantly references his degree. Doesn't it seem to you that a guy who doesn't expect his reason alone to carry his thesis, and who keeps mentioning the feathers in his cap as a substitute for good ideas and skill.
As I write, I begin to realize how annoyed I actually am, haha. I just want the truth. At least as close to the truth as the author can make. That's difficult, isn't it. It's much easier to just fart your vanities and prejudices (as often in favor of whatever as out of favor for others).
If you want naked political propaganda, here you are, enjoy! Likely you already know what it about and you already know how each little arc goes. This is the kind of book that preaches to the choir. No winning over hearts and minds.
I've had enough of this kind of divisive material. You're better off finding a newscast or pod cast on YouTube or elsewhere. There are professionals out there who do gather legitimate news and who want to share it.
May 2, 2024
I wanted to like this book and I felt like the author had a solid introduction to the text, but than we go on a bizarre case study based adventure.
The first client was a Trans Latine woman who the author uses her deadname (the name she was given at birth, and even though the client says it and the names are changed the point is for someone else to NOT refer to a Trans person by that name). Along with this the author sings the praises of Boystown (aka North Halsted) which is NOTORIOUSLY exclusionary and perpetuates racist, transphobic, and fatphobic harm. Obviously not all of North Halsted is like this, but it’s weird that it wasn’t mentioned when the author was discussing the intersectional identities the client holds. Also the author doesn’t mention intersectional identities nor the minority stress model at any point during this but often slightly dances around those theories.
I also found it weird the author didn’t mention that when money is needed for things that don’t help people (see the billions Chicago’s current Mayor found to redo Solider Field for the Chicago Football team, billions spent yearly on police, and the billions the US has used to support a genocide) suddenly there’s bountiful amounts of money. But when it comes to helping people who are experiencing homelessness and countless other issues, suddenly there’s not enough money in the budget. I really needed the author to go all the way and just fully flesh out and analyze this topic because so much nuance and importance was missed.
The first client was a Trans Latine woman who the author uses her deadname (the name she was given at birth, and even though the client says it and the names are changed the point is for someone else to NOT refer to a Trans person by that name). Along with this the author sings the praises of Boystown (aka North Halsted) which is NOTORIOUSLY exclusionary and perpetuates racist, transphobic, and fatphobic harm. Obviously not all of North Halsted is like this, but it’s weird that it wasn’t mentioned when the author was discussing the intersectional identities the client holds. Also the author doesn’t mention intersectional identities nor the minority stress model at any point during this but often slightly dances around those theories.
I also found it weird the author didn’t mention that when money is needed for things that don’t help people (see the billions Chicago’s current Mayor found to redo Solider Field for the Chicago Football team, billions spent yearly on police, and the billions the US has used to support a genocide) suddenly there’s bountiful amounts of money. But when it comes to helping people who are experiencing homelessness and countless other issues, suddenly there’s not enough money in the budget. I really needed the author to go all the way and just fully flesh out and analyze this topic because so much nuance and importance was missed.
May 13, 2022
Well-written and a good introduction to the ideas of community trauma, systemic injustice, and the intersections of race, class, and health. It’s not saying anything incredibly radical or diving deeply into the complexities of each issue, but offers insight via personal stories and experiences, which helps center the people who are most directly affected by the issues. Foiles is very aware of his privilege and his status as an outsider, and I appreciated how much care he took to be clear about his position and his inability to understand or explain certain topics/experiences. I wish the book would’ve gone deeper into the issues that were brought up or made more of an effort to connect the individual stories. While each story was compelling and hearing personal stories from/about the people who are living with the realities of systemic injustice every day is valuable in its own right, they didn’t build on each other all that much, even though they seemed to have a lot of connections and overlap. Definitely something I would recommend to someone who’s just starting to get interested in sociology/political writings.
November 21, 2023
This City is Killing Me is a humble book, short in length but large in impact. Readers follow a social workers journey through the inner city dwellings of Chicago, and we get to know 4 specific clients and their struggles with racism, classism, homophobia, hoarding, drug abuse, and trauma. This book is hard to read, yes, but necessary for anyone who wants to understand why social work and anti-capitalism go hand in hand. Many of the problems the clients face in this book are not caused by individual failures or decisions, but larger systems that are designed specifically to keep the oppressed in that space. Reading this book is eye opening even if you already know the mass impact of unregulated capitalism on the lower class. The individual stories provide a personal touch while still applying to the larger concept of capitalism, social work, and how urban communities get left in the dust.
July 31, 2020
Foiles’ lens as a mental health professional is how he approaches sharing five stories of his patients and how their trauma and mental health has been affected by their neighborhood and city. Set in Chicago, the systems and inequity in place lead to poor outcomes for the most vulnerable population and by sharing a few stories, humanizes the issue.
While I wanted more social psychology than stories, it worked to paint a broad picture and was a shallow dive into institutions and politics that must change to give everyone a fighting chance. Topics covered include the childcare and child welfare systems, substance abuse facilities, psych wards, treatment facilities, and homelessness.
I wanted more but know why he only went this deep. It was intelligent (I looked up three words I didn’t know!) and understandable.
While I wanted more social psychology than stories, it worked to paint a broad picture and was a shallow dive into institutions and politics that must change to give everyone a fighting chance. Topics covered include the childcare and child welfare systems, substance abuse facilities, psych wards, treatment facilities, and homelessness.
I wanted more but know why he only went this deep. It was intelligent (I looked up three words I didn’t know!) and understandable.
January 2, 2020
A nice nonfiction read that mixed powerful and well written narratives of people’s experiences dealing with trauma in Chicago with some background about the structural inequities that lead to the same groups of people and neighborhoods being subject to more trauma. I would have loved to hear a little more about education, as a CPS teacher myself, partly because of my own self interest and partly because the author does mention the impact of education but sparingly. I’m general, I would have liked for a short chapter at the end about ways to change these systems but perhaps that is for another book.
March 9, 2021
Damn.
Again, Audible books can feel like getting a coffee with interesting people.
Jonathan Foiles has a lot to say and he deserves to be heard. He's a social worker in Chicago. He works as a therapist to the downtrodden in the city.
He profiles specific clients of his in this book. Their stories are not easily forgotten. They're brutal. You see reality from a much different place when you're done with this one.
You might not agree with his exact political perspectives, but you'll see why he has his views after you're done with this book. The number of stark realities he deals with on a day-to-day basis is astonishing.
Again, Audible books can feel like getting a coffee with interesting people.
Jonathan Foiles has a lot to say and he deserves to be heard. He's a social worker in Chicago. He works as a therapist to the downtrodden in the city.
He profiles specific clients of his in this book. Their stories are not easily forgotten. They're brutal. You see reality from a much different place when you're done with this one.
You might not agree with his exact political perspectives, but you'll see why he has his views after you're done with this book. The number of stark realities he deals with on a day-to-day basis is astonishing.
December 9, 2022
I don’t recommend this book to any POC who has experienced trauma in an urban setting.
This was a book that highlighted experiences and essential resiliency for the benefit of White education and without conceptualization of sustainable solutions.
It was a hard, unnecessary read that despite the intro rejecting white saviorism, still managed to center white experience.
Without the dedication to significant solutions, this just felt like a white man profiting off of people of color’s trauma.
This was a book that highlighted experiences and essential resiliency for the benefit of White education and without conceptualization of sustainable solutions.
It was a hard, unnecessary read that despite the intro rejecting white saviorism, still managed to center white experience.
Without the dedication to significant solutions, this just felt like a white man profiting off of people of color’s trauma.
November 5, 2019
This was an interesting book. It had personal stories of people the author has counseled, but it also was interspersed throughout with facts (and sometimes what felt like lectures - hence the 3 stars and not 4). But it was interesting still. I believe it should have something about Chicago in the title, even though the author states that these traumas and stresses happen in all large urban cities.
September 21, 2021
While I would have enjoyed reading this one in a more academic setting, reading this on my own worked just fine. I wish the connections in both Robert and Juans stories were explored a bit more, because I feel like they were given a bit of a surface level explanation. Nevertheless, a quick and interesting read. I will probably return to this one to annotate it.
May 29, 2024
An interesting read about mental health and its connection to people’s socioeconomic backgrounds. I especially enjoyed that the case studies used were folks living in/around Chicago. I could better conceptualize patients’ living situations & environment since I know a decent bit about Chicago and its history.
October 7, 2019
Kept me turning them pages. Gave insight on the history of some areas in Chicago. Also, the most important insight into the lives of people who don't have the community resources to get the help they need.
November 25, 2020
Harrowing and eye-opening stories of real accounts from vulnerable, underprivileged, mental health challenged Chicago-ites, narrated by mental health professional Jonathan Foiles.
A very short, sharp and powerful read. Highly recommended
A very short, sharp and powerful read. Highly recommended
July 25, 2023
The author does a great job of showing just how policy affects the individual clients he has. Really glad I read this before going into my first counseling internship. Can’t wait to read his other books!
February 1, 2020
Fantastic book - highly recommend it as it examines some of the broader social factors that influence mental health. Eager to read more from this author.
January 2, 2021
Helpful look at individual case studies of mental illness and how community level trauma and unjust systems contribute to those issues in those people.
October 13, 2021
This is superb. It is a wonderful exploration of community trauma and I wish it was so much longer.
March 4, 2022
Excellent!
July 26, 2022
Important read if you’re interested in urban issues and inequalities, and just how people are well…suffering
December 29, 2024
More needs to be written on the social causes of mental illness.
October 15, 2023
this was extremely good but towards the end got quite repetitive. it wasn’t anything revolutionary or unknown, but a great book clearly showing complexities and realities for real people, in a way any reader can understand.
August 10, 2021
This psychotherapist based in Chicago, IL profiles cases studies of patients affected by various failed policies of the city. Foiles profiles city residents negatively experiencing crises with mental health, the Department of Child and Family Services, the Chicago Housing Authority, Chicago Public Schools, and the violence of Chicago itself.
It is a quick read and reminds me briefly of the HBO television show the Wire in which the chapters are organized around the patient and the services provided by each industry - and how the supports are found lacking, despite best intentions of various taxpayer funded agencies.
As some reviewers have noted, I also wanted 'more' from this book. It felt as though is was heavy on patient details and light on policy details that created the issues in the first place. Anyone that has followed public education in the US in the last decade is very aware of the destruction Rahm Emanuel wrought on the Chicago Public School system. The author mentions that Emanuel closed over 50 public schools as mayor in 2013; but the Chicago Teachers' Union strike of 2012 is not mentioned in context of this. Perhaps that topic is another book altogether.
It is a quick read and reminds me briefly of the HBO television show the Wire in which the chapters are organized around the patient and the services provided by each industry - and how the supports are found lacking, despite best intentions of various taxpayer funded agencies.
As some reviewers have noted, I also wanted 'more' from this book. It felt as though is was heavy on patient details and light on policy details that created the issues in the first place. Anyone that has followed public education in the US in the last decade is very aware of the destruction Rahm Emanuel wrought on the Chicago Public School system. The author mentions that Emanuel closed over 50 public schools as mayor in 2013; but the Chicago Teachers' Union strike of 2012 is not mentioned in context of this. Perhaps that topic is another book altogether.
June 22, 2025
Full disclosure: I was a patient of the author’s for three months.
This book lost me on page 2, when he shares news of his wife’s pregnancy in an attempt to cheer up a transgender female patient who is about to be hospitalized: “I show her ultrasound pictures on my phone while we wait for her name to be called” (Foiles 2).
Not only do I question the professionalism of the self-disclosure, but I wonder if a trans woman would experience gender dysphoria while looking at pictures of a cisgender woman’s uterus.
It’s one thing to proclaim yourself a queer ally. It’s quite another to behave in a way that is sensitive to queer people’s lived experiences.
This book lost me on page 2, when he shares news of his wife’s pregnancy in an attempt to cheer up a transgender female patient who is about to be hospitalized: “I show her ultrasound pictures on my phone while we wait for her name to be called” (Foiles 2).
Not only do I question the professionalism of the self-disclosure, but I wonder if a trans woman would experience gender dysphoria while looking at pictures of a cisgender woman’s uterus.
It’s one thing to proclaim yourself a queer ally. It’s quite another to behave in a way that is sensitive to queer people’s lived experiences.
November 3, 2023
Foiles uses his real patients and background in social work to examine how policies affect those in traumatic environments, at a personal and community scale. Through statistics and real life examples, Foiles explains how the history of disinvestment in mental health support and social programs for low income and impoverished people in Chicago and around the country have led to the current crisis. While there are no easy answers to these questions, it is clear Foiles has been considering them for an ample amount of time and wants to make the world a better place.
March 14, 2020
Focused on the five case studies and less on broad policy prescriptions. I thought this could have been so much more. Mental health providers on the front lines of a broken social services system have so much to add to the conversation on services in this country and this book felt like the author pulled his punches.
September 1, 2019
Definitely an engaging read but I wanted a deeper dive into urban toxicity in general. The book is more of a case study of five individuals with struggles somewhat related to or caused by city life. It was definitely an interesting read, but i can't help but feel like it could have done a bit more.
Displaying 1 - 29 of 29 reviews