April is National Minority Health Month.
A woman of color begins suffering from depression after hearing jokes about her ethnicity on a regular basis at work. Another woman feels anxious when she drives too close to a police cruiser. Yet another woman stops taking her regular walks outside, fearful that her race might make her a target for violence.
All three scenarios can be considered examples of racial trauma — the emotional response resulting from negative experiences that happen because of a person’s race. Racial or race-based trauma can have a significant impact on mental, emotional and physical health, especially if that person faces continued exposure to discrimination.
Amy Beck, Ph.D., a health psychologist, can relate to her patients who express fears about “driving while Black” and potentially interacting with law enforcement if they’re caught for a minor traffic infraction.
“Who else is having to think about not going over the speed limit because of what might happen if they get pulled over?” Beck asked. “When you think about chronic stress, it’s these examples of continually having to think about what could happen to you because of your race or ethnicity. Race-based trauma is a massive stressor that can be ongoing because you’re always going to be Black or a person of color. That’s never going to change.”
Read: Black Women Have Many Risks to Their Mental Health. For Me, Juneteenth Is a Day of Healing. >>
Racial discrimination as a cause of trauma has gained more international attention in recent years, notably after the murder of George Floyd launched a national reckoning about the treatment of people of color by police. Attacks on Asian women during the early days of the pandemic increased awareness of hate crimes against the Asian community, as Asian people were targeted by others who blamed them for Covid simply because the virus started in China.
A study in 2019 found 50% to 75% of Black, Hispanic and Asian people in the U.S. reported experiencing racial discrimination. Another study on racial trauma cited research that found that people who have experienced “complex trauma,” which is repeated exposure to ongoing traumatic events have higher rates of depression, posttraumatic stress disorder (PTSD), anxiety, sleep problems, substance abuse and behavioral disorders, among other mental health issues. Physical conditions including hypertension, diabetes, digestive issues, obesity and cardiovascular concerns have also been linked with complex trauma. The researchers make the case that racial trauma is complex trauma because it is ongoing and unrelenting.
“Trauma affects your body, mind and spirit,” Beck said. “We know there is evidence that trauma can change brain neurodevelopment based on its intensity and when the trauma was experienced. Racial trauma absolutely can affect the way brains develop and the way they are wired, which can have long term effects.”
What is racial trauma?
Racial trauma, or race-based trauma, can result from experiencing discrimination that falls into the following general categories.
- Interpersonal discrimination is a direct action done by one person to another. This is the category that often has the most public visibility, and includes actions often classified as hate crimes.
- Systemic/institutional discrimination consists of inequities rooted in an organization or culture that lead to worse outcomes for those affected. Practices like redlining ( denying people credit based on where they live) or attending historically underfunded educational institutions are examples of this type of discrimination.
- Intrapersonal discrimination is when a person absorbs negative experiences and messages related to their race and internalizes them. This can impact one’s self-esteem and self-image because those affected might feel less qualified or not good enough for something positive because of their race.
In addition to negative effects on one’s health, racial trauma can also contribute to damaged relationships with others and socioeconomic consequences, such as difficulty maintaining a job, unemployment and poverty.
“When you put all these things together, it takes a lot of work to grow a resilient spirit to fight back against these pressures from the outside, and limit the absorption of this trauma into your existence,” Beck said.
How to find help for racial trauma
Research is limited on effective treatments for racial trauma, but positive results have been seen from
mindfulness programs that center people of color, including RiSE (Resilience, Stress and Ethnicity), a program designed to help Black women facing cardiovascular risks develop coping skills related to race-based stress and trauma. One study of psychedelic use found improvements in the symptoms of racial trauma, traumatic stress, anxiety and depression for people of color.
Therapy and mental health treatment are beneficial, but it’s important to find a mental health provider who understands the impact of racial discrimination and how it can trigger trauma. Beck said addressing racial trauma should take a holistic approach that addresses mental, emotional and physical issues.
Read: Closing the Mental Health Gap for Women of Color >>
“There has been a lot of recognition that who you are affects not only your experience of healthcare, but your health in the world, and that needs to be incorporated into your healthcare treatment,” Beck said. “It’s hard for even the most privileged, non-vulnerable populations to receive comprehensive healthcare, so it’s especially more difficult for many people of color. When you think about the fact that most people of color are underrepresented in all healthcare disciplines, it can be difficult to find someone trained in this.”
Access to qualified mental health providers has increased in other ways, however. Telehealth has expanded options for care, as has PSYPACT, a multistate compact that allows approved practitioners to offer therapy across state lines in 39 (as of now) states, with more scheduled to join. Women in participating states can look for providers in online directories of specialists from a particular ethnic or racial group or through a general internet search.
“In therapy, there are specific treatments designed to help women manage and improve after negative experiences of trauma, but treatment can also include elements like nutrition and exercise,” she said. “There’s interesting data looking at the impact of the
gut on mental health. All of those things work together.”
Most importantly, Beck said to become your own mental health advocate. When meeting with a provider, ask questions and be honest about your experiences. If you don’t feel you’re being heard, tell the provider and consider finding another specialist who’s a better fit.
“You deserve to feel good and be healthy,” Beck said. “Don’t normalize feeling less than your best and fullest self. If you’re not feeling that way, reach out because there are people who truly want to help you achieve that.”
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