The distress of populations affected by genocide, war, and the specific phenomenon often referred to as “ethnic cleansing” and political violence is typically viewed through the lens of trauma and posttraumatic stress disorder (PTSD) (the word “war” is used in the rest of this chapter to refer specifically to “ethnic cleansing”). However, there have been increasing critiques of the assumed universal applicability of the trauma paradigm, from psychologists and psychiatrists, as well as anthropologists and sociologists, engaged with individuals and societies affected by mass violence. This chapter reviews how the specific characteristics of genocide, war, and political violence pose challenges to biomedical and Western psychological framings of trauma. It argues the need for greater attention to cultural context, intersecting structural oppressions, and social justice and considers how narrative- and arts-based tools, underpinned by principles drawn from multicultural and decolonial approaches, may assist in this endeavor.