Racism and PTSD

Post traumatic stress disorder usually makes us think of  combat veterans or terrified rape victims, but new research indicates that racism can also be a cause of PTSD.   I’m focusing this on the Black community since that is the community I know most about since I’m  a Black woman in the United States however other people of color may also suffer from PTSD and racism.

Racism-related experiences can range from frequent “microaggressions” to blatant hate crimes and physical assault. Racial microaggressions are subtle acts of racism,  these can be brief remarks such as “You’re not like other Black people”, vague insults, or non-verbal exchanges, such as a refusal to sit next to a Black person on the subway. When experiencing microaggressions, the person  loses  mental resources trying figure out the intention of  the one committing the act. These events may happen frequently, making it difficult to mentally manage the volume of racial stressors. The unpredictable and  often anxiety-provoking nature of the events, which are often  dismissed by others, can lead to victims feeling as if they are “going crazy.” Chronic fear of these experiences may lead to constant vigilance  which can result in traumatization or contribute to PTSD when a more stressful event occurs later.

While most people can understand why a violent hate crime could be traumatizing, the traumatizing role of microaggressions can be difficult to understand, especially among those who do not experience them.   Many African Americans also often wonder if what they’re experiencing is a microaggression and often worry that they will be perceived as being overly sensitive.

Studies also show that African Americans with PTSD experience significant impairment due to trauma, indicating greater difficulty carrying out daily activities and increased barriers to receiving effective treatment.  Racism  has also been linked to other problems, including serious psychological distress, physical health problems, depression and  anxiety.   A strong, positive Black  identity can be a potential protective factor against symptoms of anxiety and depression, but this not adequate protection when the discriminatory events are severe.

Trauma can also  alter one’s perceptions of overall safety in society.  Black people with PTSD have been found to have lower expectations about the positivity of the world than Whites.  This adds to the suspicion many Black people have of the motives of Whites.

Once sensitized through ongoing racism, routine slights may take an increasingly greater toll.  Microaggressions, such as being followed by security guards in a department store, or seeing a White woman clutching her purse in an elevator when a Black man enters, is  another trigger for racial stress.     I’ve experienced microaggressions myself on many occasions.  For example,  once when I was a social work intern making home visits, I had to visit a White family in a predominantly White area in New York City,  and one day the family had a visitor and asked me to hide in another room because they couldn’t explain to their friend why a Black woman would be in their home.  I remember feeling helpless, angry, and confused.  I  felt that I had a good relationship with this family and couldn’t believe they wanted me to hide, when I visited other families, if anyone came over they would introduce me as a friend or a social worker for their children.

Sometimes I wonder how people continue to remain resilient in the face of ongoing, undeserved discrimination. Within the Black community, positive coping with racism may involve faith, humor or optimism.  These cultural values have allowed African Americans to persevere for centuries even under the most oppressive conditions. I don’t think it is reasonable to expect that we can “fix” people to enable them to manage constant, ongoing acts of prejudice with a smile, and ask them to be perpetually polite, productive, and forgiving.  I believe we  need a shift in our social consciousness to understand the toll this takes on the psyche of victims so that even small acts of racism become unacceptable. We  also need people who witnesses racism to speak out and victims to be believed.

African American Women and Mental Health

There’s often a fear of putting our business in the street . . . of somehow revealing too much. Black women often perceive going to a therapist as something we don’t do.

African American women have the highest mortality rate for heart disease and stroke and the highest prevalence of high blood pressure and obesity. Recent research indicates that mental health plays a role in these health disparities. While many black women know and discuss the threats to their physical health, when it comes to mental health, there’s often silence and inaction.
Many black women are struggling with mental health issues but are not seeking professional help. Improving black women’s access to mental health treatment as a crucial element to addressing the serious, but often manageable, illnesses plaguing their physical health.

Women Who Need Care Go Without
Despite the emotional and physical consequences of mental-health problems, black women are less likely to seek treatment. The percentage of African Americans overall who receive needed mental-health care is only half that of whites, according to a Surgeon General report on mental health. By some estimates, only 7 percent of black women suffering from depression receive any treatment, compared with 20 percent of the general population.
The California Black Women’s Health Project, released the results of a study of more than 1,300 African American women across the state. The subjects in the study revealed that they tended to repress feelings, let frustration build and release tension through tears or conflict. The findings of the study, which included a series of focus group discussions across the state, led to a launch of a mental health initiative to improve African American women’s acceptance of and access to mental health treatment.

It’s important for African American women to realize that self care is not selfish and you must take care of you so you can take care of others. It is also important to recognize something is wrong and you deserve to feel well.

Many Black women have a distrust and place a stigma that black women on mental-health treatment, in part from their difficulty in finding a therapist to whom they can readily relate. African Americans comprise less than 6 percent of mental-health care providers nationally. Overcoming this shortage may be crucial to improving treatment outcomes for African American women. In my work in the mental health field, I have found from interviews with clients that mental-health practitioners “don’t get it when they are working with people who don’t look like them.”

African American women also struggle against the stigma associated with mental-health treatment.
One study found that the proportion of African Americans who feared mental-health treatment was more than twice that of whites, according to the surgeon general’s report. Part of the fear stems from wariness of the medical establishment that arises from past abuses, such as the Tuskegee experiment. (In 1932, the federal government sponsored a study to examine the impact of untreated syphilis involving black men. The experiment went on until 1972 without the test subjects’ knowledge and most of the subjects died without receiving treatment.) As a result of the distrust engendered by the now-infamous experiment and the stigma associated with seeking help, many black women rely on spiritual leaders and community members to handle personal problems. There’s also an added pressure from the ethic of the strong black woman, a cultural value that promotes toughness and self-sacrifice. They often think ‘My mother suffered. My grandmother suffered. It’s just the lot of black women in America. It doesn’t have to be that way.
There’s a deep-seated feeling that going to seek professional help is a sign of weakness. These ideas and feelings must change in order for all women to function at their best ability.

Online Therapy

Online counseling  also known as  e-therapy – is when a professional counselor or psychotherapist talks with you over the Internet, to give you emotional support, mental health advice or some other professional service.

Online therapy is an  alternative source of help when traditional psychotherapy is not accessible. Its effective. Its private. Its conducted by skilled, qualified, ethical professionals.  It works as well as face to face therapy with most clients.

Online therapy is usually offered either by private practitioners who will meet with you in a secure site which is HIPPA  compliant or there are online therapy clinics where you chose the therapist whom you would like to work with from a list of mental health practitioners.

Some websites such as Talkspace offer email and text based counseling.  This type of counseling is not the same as psychotherapy because you do not see the person and it’s difficult to gauge how well the person is doing via text and also you may not be able to have a continuous conversation with the person.

 

Online therapy works well if you have a very busy schedule, you live somewhere without many therapists, you have young children at home or it’s difficult for you to get to an office.  Online therapy is not suitable for people suffering from severe mental illness such as schizophrenia or schizoaffective disorder.  It is very helpful for people with anxiety or depression.  While online therapy is not for everyone it is a viable alternative to face to face psychotherapy.

Transforming Lives: How One Woman Is Making Culturally Sensitive Therapy Accessible To Black Women And Children

This is the excerpt for your very first post.

I have been a therapist in New York City for a long time. In all my years of providing services, the one thing I have noticed is a severe lack of culturally sensitive treatment in psychotherapy. Less than 10% of therapists in the United States are people of color (Black, Latino, Asian or Native American) yet in some communities the majority of clients are people of color, in particular, Black women and children. While I think most therapists try to care for and about their clients regardless of race, I do think there is a certain disconnect and bias that often comes when White therapists work with communities of color. It’s not necessarily overt but it’s often seen in the interaction as well as how some therapists describe and talk about their non-white clients.

I received my Masters Degree in Clinical Social Work in 1994 from The Silberman School of Social Work at Hunter College in New York City. Hunter is one of the most selective social work schools in the country and the program is very rigorous and inclusive. However even though the school is located in a diverse city, my graduating class had very few other students who were also Black. In my field placement at Jewish Board in the Bronx, there was only 1 Black social worker and I was the only Black intern. I was hired at the Jewish Board following graduation and remained for a number of years however throughout my time at the agency there were very few therapists of color despite the agency stating that they had an initiative to hire more Black and Latino therapists. Throughout my career at various agencies in New York City and Westchester County in NY, I was often the only Black therapist and was often looked to as being an “expert” on the Black community. Many White therapists would often consciously or unconsciously pathologize the behavior of marginalized communities because they were unable to empathize with or understand the cultural differences. This led me to begin providing cultural diversity workshops throughout New York City and Westchester to help therapists be better able to understand the differences in people’s cultures.

Many therapists would often say they didn’t see color and that we’re all the same, I would explain that we’re not all the same and communities of color are not asking for them to not see our color but to treat us with respect and not pathologize our background because it’s different from their own upbringing.

During all my work in agencies, I always had a dream of having my own private practice where I would provide psychotherapy to families of color in particularly Black women and children. I often had clients in agencies ask me if they could continue working with me outside of the agency setting because they felt that I was always understanding, respectful and kind to them. They also often told me that they felt that I could understand them because as a Black woman even if we grew up in different places I had a deeper understanding of their lives and culture. I wanted to start working for myself however circumstances did not allow me to begin my private practice until earlier this year.

Transforming Lives Counseling Service was born out of my desire to help others and to give back to my community. Many people desire and need mental health care but due to the stigma won’t get treatment or feel that therapists from the White culture won’t understand their lives or how racism affects them on an almost daily basis. It’s so important to feel that your therapist, the person who you will share intimate details of your life with will understand you and not have their view of you colored by racism either overtly or covertly. My practice focuses on the treatment of Women of Color and Families because there is such a need in these communities. Many of my clients come to me because they have had very negative experiences with White therapists and have purposely wanted to work with a Black woman. My areas of expertise are childhood trauma, anxiety, and addiction, these are all issues which are very common in marginalized communities but are rarely talked about in families. I also charge sliding scale fees for my services so that no one will be denied therapy because of their inability to pay. I offer therapy in office as well as on a video platform. The online video platform is an added level of privacy and confidentiality for my clients. I’m so pleased to offer my services to people who may not otherwise have therapy. I truly love being a therapist and helping people to achieve the happiness and peace they deserve in their lives.