Racial trauma: causes, symptoms and how to deal with it

CNN
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When CNN’s chief medical correspondent, Dr. Sanjay Gupta, was growing up in a small rural town in Michigan, he wanted to change his name to Steve – hoping it would put an end to the anti-Asian taunts he faced at school since he was 6 or 7 years old, he said in a summer episode of his podcast, “In pursuit of life.”

“There was no one who looked like me, who had a name that looked like mine, who ate the foods that we ate,” Gupta said. “If I changed my name to Steve, that would solve all my problems. … I would just be totally assimilated.

Psychology professor Monnica Williams said she also weighed a big change when she experienced racism as an adult in a former university position, through a colleague who would prevent Williams students to access opportunities and would discourage them from working with Williams.

“It was very frustrating not being able to convince anyone to do anything,” said Williams, who now holds the Canada Research Chair in Mental Health Disparities in the University’s School of Psychology. from Ottawa. Williams is African American. “Part of what contributes to the problem is that you’re constantly under fire, not being listened to, and the problems are getting worse.”

Williams eventually had to quit her job “because I failed to get the help or resources I needed to get this person to stop harassing my students and making my work environment inhospitable,” a- she declared.

What Gupta and Williams experienced could be described as racial trauma, the “emotional and perhaps mental hurt that comes from people facing racial prejudice and discrimination and ultimately forms of racism, which can include hate crimes,” said Nevin Heard, director of cross-cultural relations at Lake Forest College in Illinois.

The experience of racial trauma can be the result of specific people’s actions or a by-product of a larger system. It can affect someone vicariously – perhaps in see videos hate crimes — or intergenerational, as with the lasting emotional scars of the Holocaust or the enslavement of African Americans, according to Mental Health America.

“People don’t have to directly experience an incident of racial discrimination or prejudice to have negative emotional consequences,” Heard said.

Racial trauma usually isn’t induced by “a single incident,” Williams said. “Usually it’s a lot of incidents that have accumulated to the point where the person becomes traumatized.” Many ethnic and racial groups in the United States experience higher rates of post-traumatic stress disorder than white Americans, and one explanation for this is the experience of racism, according to the American Psychological Association.

However, diagnosing and treating racial trauma, in particular, can be difficult, in part because of how it is understood in the health care community.

Unlike post-traumatic stress disorder, racial trauma — also known as race-based traumatic stress — is not considered an official mental health disorder or diagnosis in the American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disordersthe authoritative guide used by medical professionals to diagnose mental disorders.

“It’s not a separate category because, on the one hand, it’s not clear if it’s just PTSD that’s caused by something else. And so we don’t necessarily have different types of PTSD depending on what caused it,” Williams said. “Also, we don’t yet have enough research to really say exactly what the differences between PTSD and racial trauma would be.”

The fact that the DSM-V listing of PTSD does not include racism as one of the causes is problematic, she said. “When clinicians see people in distress because of racism, they don’t necessarily think, ‘Oh, that could be PTSD.’ So it must be there either listed as a potential cause of PTSD or as a different but related diagnosis.

There’s “a lot of talk” about it among experts, but the DSM is based on existing research, which is lacking when it comes to racial trauma – although work on the subject “has picked up very quickly”, Williams said.

“The DSM Review Process is open to proposals from interested parties for revisions to the DSM, as long as appropriate data can be provided to support the proposal,” said Dr. Paul S. Appelbaum, Chair of the Steering Committee. of the DSM and professor at Dollard. of Psychiatry, Medicine, and Law at Columbia University, via email.

“To date, we have not received any proposals to change the criteria for PTSD to include racial trauma as a trigger or to establish it as an independent diagnosis,” he added. “However, in the recent text revision of the DSM (DSM-5-TR), released last year, a systematic effort has been made to highlight in the text those conditions for which there is evidence that racial discrimination , whether overt or structural, could contribute to the disorder.

Regardless of its classification status, racial trauma affects the well-being of individuals and communities, Williams said.

People affected by racial trauma might exhibit some of the physical symptoms of stress, called somatization, Heard said. “It could be upset stomach, faster heartbeat, feelings of hypervigilance and chronic stress. They may also experience avoidance, which happens with PTSD, but there also has the reliving of distressing events.

Other symptoms include difficulty sleeping, fatigue, depression, anxiety, impaired gut health, anger, recurring thoughts of the event, nightmares, sweating, tremors, suspiciousness, self-blame, low self-esteem, headaches and chest pains, according to Heard, Williams and Mental Health America.

Racial trauma does not just affect the individual. “Like PTSD, racial trauma leads to disability, whether temporary or long-term, such as lost work days and lost productivity, increased medical expenses, and more suffering overall,” Williams said. “The more people have these problems, the greater the cost will be to society, these communities and their families.”

Her experience of racism in a previous job affected Williams’ psyche as she sought new work opportunities. “It was difficult because I had to move and I didn’t want to move my family. And it’s hard to explain to your kids why you’re moving again and starting over and having to say goodbye to my graduate students and not being able to complete their training,” she said.

“Of course professionally it could be a setback,” added Williams. “And then if you go somewhere else and start seeing some of those same things again, that can definitely be very alarming, because you feel like you’re having a flashback.”

To be diagnosed with PTSD, there must be an identifiable traumatic event, Williams said — so having directly or indirectly experienced racial abuse would easily meet the criteria for PTSD. But if someone has trauma from repeated disability at work because of their race, that wouldn’t meet the criteria. However, mental health professionals would still be able to diagnose and treat any effects of racial trauma – such as depression or anxiety – even if they cannot diagnose PTSD itself based on race. .

It’s good to know if your symptoms are due to racial trauma, mental health issues, or general mood issues. This is where it helps to have an evaluation by a psychologist or other clinician who understands racial trauma, Williams said. You can find out what an expert knows about the subject by researching them online before you meet, or by asking them directly during a date, she added.

If your mental health professional doesn’t know much about racial trauma, getting help might be difficult because they wouldn’t know where to start, Williams said.

To cope, getting out of the trigger situation is important but not always possible, Williams said. Try to build a good support system of people you can talk to about your struggles with and stay engaged in your daily life, she said.

While it’s okay to take a break to give your mind a chance to rest and recuperate, the more you avoid, the smaller your world becomes, Williams said.

“Ultimately, this also involves learning new ways to deal with racism when it arises,” as how to react to microaggressions, she added. “People will often deal with racism much longer than they should, because they don’t know what else to do, or maybe they have low self-esteem and feel think they deserve to be mistreated.

“It’s really important that people understand their own worth and also believe in their experiences and not be enlightened by people who say it’s not there – but trust their instincts and what they see,” Williams said.

Learning new ways to cope with these experiences is a process, she added, but important for developing a sense of autonomy and empowerment.