Dr. Smith illustrates the unique racial and ethnic issues involved in doing psychotherapy with individuals of Afro-Caribbean descent who have relocated outside of the Caribbean Basin.
(Dr. Smith's practice is located the England.) She focuses upon the psychological impact that generations of slavery have had on the psychological well-being of Caribbean peoples of African decent. She specifically focuses upon the impact that these generational memories have upon the issues of personal trust, racial paranoia, truncated gender relations, and reliance upon an extended matriarchal families. She notes that coping mechanisms and learned behaviors from the Afro-Caribbean culture will appear notably dysfunctional and maladaptive when the individual relocate outside the Caribbean culture and attempt to readjust to an Anglo-European culture. She illustrates her findings with a literary analysis and eight case studies in which these unique cultural traits are demonstrated. Each of her case histories include a familial and individual histories, the case progress, a Freudian analysis, and her own personal learning experiences about doing psychoanalysis with Afro-Caribbean individuals.
How Slavery’s Legacy Affects the Mental Health of Black Americans.
Since slavery, the church has been a formidable force for the survival of blacks in an America still grappling with the residual effects of white supremacy.
Evidence of racism’s impact on mental health
Harvard psychiatrist Alvin Poussaint asked why suicide rates among black males doubled between 1980 and 1995.
the hardships of the slave system, he argues that one of the reasons for this increase is that African-American young men may see the afterlife as a better place.
“post-traumatic slave syndrome” as a theory for explaining the effects of unresolved trauma on the behaviors of blacks that is transmitted from generation to generation.
Research released this July that shows suicide rates among black elementary school pupils significantly increasing between 1993 and 2012.
As the Centers for Disease Control and Prevention concluded in a May 2014 research report, undiagnosed childhood neglect or trauma is widespread among American adults and is the root cause of mental health and behavioral problems in adulthood.
Indeed, it is now the recommendation of the National Council for Behavioral Health that trauma-informed care be integrated into all assessment and treatment procedures.
This emphasis on trauma provides a new lens for developing research into the impact of slavery—and its legacy of structural and institutional racism—on black mental health today.
A difficult topic of conversation
For blacks descended from slaves, the subject evokes feelings of shame and embarrassment associated with the degradations of slavery. For whites whose ancestry makes them complicit, there are feelings of guilt about a system that is incongruent with the democratic ideals on which this country was founded.
Cloaked in a veil of silence or portrayed as a benevolent system that was in the best interest of blacks, slavery—much like mental illness—has become shrouded in secrecy and stigma.
Associated emotions are pushed away.
Anger, however, is a healthy emotion, as even the Scriptures acknowledge.
The God of the Old Testament is angry and vengeful. In the New Testament, Jesus vents his anger in driving the money changers from the Temple.
As research (including my own) has shown, when anger is internalized and driven deep into the unconscious, contaminated by unresolved pain, it becomes problematic.
So what happens to the anger felt by people discriminated against and, in extreme cases, physically targeted because of their race?
Not enough is known about the relationship between clinical depression and race. But there are extensive findings (including reports by the Surgeon General) that attribute racial disparities in mental health outcomes for African Americans and whites to clinician bias, socioeconomic status and environmental stressors (such as high rates of crime and poor housing). And there is evidence of a link between perceived racism and adverse psychological outcomes such as increased levels of anxiety, depression and other psychiatric symptoms.
The numbers tell a story. According to the Minority Health Office of the Department of Health and Human Services, black adults are 20 percent more likely to report serious psychological distress than white adults and are more likely to have feelings of sadness, hopelessness and worthlessness than do their white counterparts.
And yet there continues to be reluctance to forthrightly confront the impact of racism on mental health. Some of my colleagues, for example, say that content on race and racism is the most challenging content for them to teach. Authentic dialogue on race is constrained by the fear of being “politically incorrect.” It takes less effort to promote the more inclusive liberal view that we live in a “color-blind society.”
It may be easier to allow everyone to remain in their comfort zone. But today as the U.S. faces what would appear to be an epidemic of race-based attacks committed by whites, it is time to examine how our history of racism affects the mental health of African Americans as well as that of whites.
In his book, Beyond Mental Slavery: A Guide to Breaking Free and Thinking Clearly.
Steve Gillman explains that we all have subconscious, reactive programs and mental processes which guide many of our thoughts and decisions and limit the clarity and effectiveness of our thinking.
Quick rationalizations provide obvious but ‘untrue’ reasons for our beliefs and actions, biases prevent us from examining new ideas, and desires push us to win arguments rather than search for truth. We are led around by these parts of our minds that we’re only vaguely aware of. ….[W]e can either use the mind or be used by it. "Steve Gillman"
To break free, think clearly, and go beyond the mental slavery of our minds, Gillman suggests the following:
Challenge your own thinking. Use your reasoning power against itself to make logical arguments for opposing beliefs and theories. Be honest with yourself and recognize your own biases.
Pay attention to your thoughts. Learn to observe your mind by developing self-awareness and consciousness. Routinely challenge your assumptions and their origins. Be willing to see how conditioned you might be. Start with a desire for the truth – no matter what it might be. Meditation and mindfulness practices are a great way to do this.
Gillman advises that an essential step in breaking free of mental slavery is for a person to make the commitment to themselves to do so. Like most everything in life, mental slavery can only happen if we allow it. I can attest that taking control of your mind is taking control of your life. It has allowed me to dramatically change myself and my life for the better. Gillman writes:
Your progress toward a mind that truly serves your highest purpose will always depend on your willingness to observe yourself. When you do that, you’ll start to see where you are giving your freedom away in bits and pieces to this or that momentary master. "Steve Gillman"