by Erin Newton, LCPC

Part III: Holding the Burden: Collective Trauma in The Black Community

Hello and welcome to part three of our series! If you’re just now starting, please go back and read parts one and two. For the last two weeks I have been using my platform at Wellness & Co. to elevate the stories and experiences of six Black women about what it means to be a Black mom in America. We’ve explored the maternal health system, pregnancy, birth trauma, the myth of the angry Black women, and the importance of representation.

Today, we are taking a look at healthcare challenges in general that Black women face, the myth of the disinterested father, and the collective trauma experienced by the Black community and how that manifests into physical symptoms that up until now you might have thought were explained by race. 

Subpar Care

Throughout my interviews, there were many times these women shared experiences where they believe they received subpar medical treatment because of their race. In some of these experiences, I feel that staff were guilty of not explaining their reasoning for something, even if they felt that what was going on was typical medical procedure. We call that informed consent (and I know I’ve talked about it before) and it is required in all medical situations (even if a lot of people don’t truly get it).    

For example, Natalia shared that during the birth of her second child, they kept attaching a monitor to her baby’s head – which can be a standard procedure – but no one explained to her why or what they needed it there for. I myself had this procedure during my oldest daughter’s birth, but the doctor explained to me why they needed it and answered my questions before they attached it. Why didn’t that happen to Natalia? 

Shizuko reports she suffered physical mistreatment at the hands of medical providers, including enduring a pap smear without lubrication – which is, in my opinion, barbaric. You likely remember Jess from our last two blogs – she was officially diagnosed with PCOS after the death of her first daughter, Aubrey, and before she got pregnant with her now nearly two year old, Anastasia. …except, no one actually told her that. She says doctors continued to tell her that they didn’t know why she lost Aubrey and it wasn’t until she took a look at her chart that she saw the official diagnosis. She says it was then that she confronted the doctor about this…only to be told that she was being aggressive. 

Jayme describes two terrifying incidents where she feels that her race impacted the care of her children. Around the time her son turned two years old, she noticed that his eye was turning yellow and mentioned it to her doctor. The doctor told her that it was normal for eyes to change color and that he was sure he was fine. His eye continued to look worse, and one night, around 3:00 AM, Jayme took her son to the emergency room. The staff there mentioned that she “looked tired” (as if that was the reason she was concerned) but Jayme says she worked late and that was when she got off work and was able to take him. Even though she needed a specialist, the staff there refused to give her a referral because she didn’t have insurance. As they were leaving, a nurse followed her and gave her the paper she needed for a referral, telling Jayme not to tell anyone. At his first visit to an eye specialist, they diagnosed him with a retinoblastoma (cancer of the retina) and he had surgery to remove his eye four days later. What would have happened without that surgery is something Jayme does not want to think about.        

Several years later, when her younger son was a baby, she noticed that both his skin and eyes were starting to turn yellow. Concerned, she took him to the emergency room, where she was told that she was probably tired and needed to “go home and get some sleep” (I should also mention here that Jayme did not have insurance and feels that was part of why she was treated this way). After a few days, he wasn’t getting any better, and he was starting to vomit what looked like poop. She went back to the hospital, where she was dismissed again, which left her feeling neglected and angry. She says that the nurses “were just letting him sit there, dying in his own poop, not doing anything.” Terrified for her son, she decided to lock herself and her baby in a hospital room, demanding that someone take her seriously. She was locked in that room for over 30 minutes. When the doctor finally looked at her son, they discovered that she was right to be concerned – his intestines were in a knot. He was transferred to another hospital where he was in surgery 11 minutes after he arrived. Jayme says she was given consent forms and death papers to sign and that staff told her they didn’t know if her son would survive. All the staff told her she did the right thing, that her son would have died had she not intervened. There were no charges – which she was worried about considering she was acting aggressive by locking the door and refusing to open it. She did what she needed to save her son.     

Last week, the episode of Terrible, Thanks For Asking (my absolute favorite podcast!) detailed a very similar situation with a woman named Dana and her son, Drayden. Dana was ignored by her doctors too, even after she expressed repeated concerns about her son’s development. At the time, she had three other children, all around the same age (she had two sets of twins 11 months apart!) and was well versed in what her son should have been doing at his age. But just like Jayme, it took a nurse giving her information secretively for her to find someone who would hear her. You can listen to her story here.  

Let me say that when I was listening to these stories, there were times I was getting confused about what was happening. I have a slight medical background (my mother was a nurse for 41 years) but even I was struggling to figure out what was going on. These ladies had a lot of information, but no explanations. It was pretty clear no one was giving them the necessary explanations for their care in a way that they could understand. In other words, none of them had full informed consent.  

“We hold a lot of burdens.”

I’m sure you’ve heard the statistic before that Black people have higher blood pressure and are at a higher risk for hypertension, diabetes, and obesity. I learned it in grad school. What I didn’t learn was why. In last week’s blog, we discussed the myth that several doctors set out to prove – that Black people are different physically from that of other races. That myth has been disproven. Physically, there is no reason for these differences. So why do they exist?

Every mother I interviewed expressed fear and anxiety on a near daily basis about her life or the life of her children. Jess stated that with everything she does her “race comes into play.” She told me that even doing something as simple as grocery shopping, she thinks about what she wears and carries (no hoodie, no purse) and that she’s been accused of stealing before – while holding her own chapstick.  

Shizuko stated that she feels like she has to be harder on her daughter than the parents of her White friends. She discussed policing her clothing, not allowing “booty shorts” or anything that’s too revealing. She said she does this because “you want people to take you seriously.” “There are certain things you can’t do,” she says, also stating that she is very careful about who she lets her children associate with, because certain people can put them at a higher risk. She says she doesn’t want them to “fall into the stereotype.” 

All women stated that they feel they have to advocate for and protect their children constantly. They cited racism in schools (and that “angry Black woman” stereotype we examined last week), including the stereotype that Black parents do not want to be involved in their children’s academic lives. Michelle states that she was told that many times from her peers – “that if you’re not always in the classroom, they will ignore your child” and “the more involved you are [with your child’s schooling], the more involved they will be with your child.”         

Natalia stated that Black women have a history of trying to keep families together and that this creates a kind of “natural anxiety.” Unfortunately, there is also a long held stigma against therapy in the Black community, and so a lot of that anxiety goes untreated. But really, even if Black men and women sought out treatment for their anxiety, how helpful is traditional psychotherapy going to be? It can give them a place to process and to feel seen, but how do we treat trauma in someone who is living in it everyday? 

Erin stated that she struggles to let her kids keep living their lives “without holding them hostage.” She says that sometimes her anxiety tries to completely consume her, that she struggles to breathe. She says she fears for her son, because he doesn’t always do well with following directions, something she worries could get him killed.  Michelle’s children are multiple races and she echoed this sentiment, stating “no matter how many races they have in them, they are Black. They are Black men.”  Racial profiling is at work here as well, along with the fear and distrust that many Black people feel for the police. The news is a constant stream of injustices, Black men and women shot for things most White people would not be. Michelle also states that she has had extensive conversations with her sons about what to do if they are approached by the police. She has told them, “Do not resist. Get arrested if you have to. We’ll figure it out later. I just need you to be alive.” She says that, “letting them go in the real world terrifies [her].” She thinks about this everyday.    

With all of this worry and anxiety, is it really any wonder that the risk for hypertension and other related illnesses goes up? Why wouldn’t it? A study referenced here found that Black people who endure life altering incidences due to discrimination are ⅓ to ½ times more likely to develop high blood pressure (reality check: hypertension affects 54% of Black Americans!). The article goes on to say that racism and discrimnation have been shown to affect health in a negative way. By the way, a life altering event did not have to be violent. Something as simple as not getting a job or a car loan due to race (something that several of the moms interviewed  told me about) would count in this study. 

Experts are reporting that anxiety in Black Americans is at an all time high, citing violent police encounters with Black people dominating news headlines. US Census Bureau Data found that in the weeks following George Floyd’s death, anxiety among Black Americans had increased by 26% and depression by 22% (read that article though – George Floyd was certainly not the first case, just the most recent). Seeing these interactions play out on the news over and over is bringing that everyday anxiety to a fever pitch, enhancing the fears that a lot of Black people already carry with them; it’s creating a kind of secondary trauma. The study I cited also found that police killings are affecting the everyday functioning of Black americans, everything from being hyper-vigilant when they are outside, to having a panic attack if they are pulled over by police. 

And finally, the most fascinating and damning evidence that systemic racism is the cause for increased blood pressure and other physical issues in Black Americans? Transgenerational trauma. This is a term that means trauma experienced by a person can be passed down genetically to their offspring. Research has found that trauma is actually encoded in our DNA, meaning that if you are the offspring of slaves, your trauma, and physical and emotional responses to that trauma, is already coded into your genetic makeup. When we say systemic racism, this is part of what we’re referring to. As a White person, is it your fault that your Black friends may be suffering from trauma that happened to their ancestors hundreds of years ago? Of course not! Does it mean they are at a disadvantage that you are not? Yes. Yes it does.  

The Myth of Uninvolved Black Fathers 

The last thing that we want to touch on is a pervasive myth about the Black community that fathers are uninvolved with their families. I’ll be honest, I definitely have some stereotypes inside me (and you do too, if you’re brave enough to look) about Black men and their involvement with their children. I worked primarily with the Black population for four years as a therapist, and while I met many single moms, I saw very few dads. When I did find them, they felt special, like an anomaly. But my experience is not everyone’s experience, it is a snapshot and not the whole picture. 

Jess and I discussed this; she told me there is a “misconception that Black men don’t want to be in their kid’s lives.” The school to prison pipeline (which is well documented) is surely part of this disconnect. Black children are expelled or suspended three times more frequently than White students. They make up 16% of school enrolled children, but 31% of all arrests and 48% of all children suspended more than once are Black. How can Black men be involved in their families lives when there are six times as many of them in prison as there are White men? (though it should be noted, those numbers, while still nowhere near even when compared to the population, are falling). Michelle stated the same, and shared with me that there are whole families out there who want to be involved with their children and who are involved. 

There is also a perception that Section 8 housing and other welfare programs are only for women and children, something that has persisted since the early 70’s. It is true that some states had such rules in the 60’s, but they were struck down in 1968 by the Supreme Court. Still, how many families in need of help believe this to be true and do not encourage involvement from fathers because of it? 

Takeaways

I know that all of this is difficult to read, and if we’re not careful, we could chalk these experiences up to something palatable like “doctors are human” or “there must be more to the story” in many, many cases. But why didn’t Natalia’s doctor explain the reason for the monitor on her baby’s head? Why didn’t Jess’s doctor talk to her about her PCOS, especially when she was looking for answers? Why wouldn’t Shizuko’s doctor use lubrication for a pap smear, something that’s a standard procedure? And why did Jayme have to lock herself in a hospital room to get anyone to pay attention to her baby? Do you think I would have to resort to the same measures? And if I did, do you think the news would call me a hero? Do you think they called Jayme one, or did they write her off as an angry Black woman?   

Friends, if you had to worry about your safety pretty much every time you left your house, (and sometimes even in your house) wouldn’t that affect your health? If you had to worry if your kids were going to come home or if you were going to have to hear about their death on the news, wouldn’t that hurt your stomach, make you hyper vigilant? If you had to watch the news and see children who looked like you murdered on a regular basis, wouldn’t that raise your blood pressure? 

Next week, join us for the last blog post in this series where we explore names, society, and racism, as well as explore what change really means and how we can seek to choose it.