Transcript African Americans and Trauma

African Americans and
Trauma: Lessons Learned
from Disasters
Nancy Boyd-Franklin, Ph.D.
Rutgers University
Email: [email protected]
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Focus
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African Americans and Trauma
Lessons Learned from Natural
Disasters
Case Example of Hurricane
Katrina
Victimization Experiences
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Overview of the
Presentation
Racism as Trauma
 Lessons from Hurricane Katrina about
Race and Class in disaster situations
 Mental Health Interventions and Disaster
Response with African Americans
 Cultural Issues in our work with African
Americans in Disaster Situations
* The importance of an extended family
centered perspective
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Religion and Spirituality
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In the lives of African Americans
Extremely important in terms of
spiritual resilience
Healing in Times of Trauma
WILL BE DISCUSSED IN MY
PRESENTATION THIS
AFTERNOON
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Hurricane Katrina:
Disproportionate Impact
on Poor African Americans
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Individuals from all racial and
socioeconomic groups impacted by
Katrina
67% of New Orleans residents who were
African American and poor
Disproportionately impacted by
devastation of Katrina
And by post-hurricane traumatic
experiences
Dyson, 2006; Troutt, 2006
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Impact of Race and Class
on Disaster Response
Poor Black People: the “Invisible”
Americans
 Double Jeopardy of Race and
Poverty
 The forgotten Americans
 Often not considered in disaster
planning
 No plans made for Black, poor
residents with no transportation
 Underlying Institutional Racism
(Dyson, 2006; Boyd-Franklin, 2009)
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Different Perceptions of
Race and Class
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CNN poll (Sept. 13, 2005)
Katrina highlighted racial divide in
this country
60% of Blacks viewed race as a
factor in slow response to Katrina
victims
Only 12% of Whites saw race as a
factor
63% of Blacks saw poverty of
victims as a factor; 21% of Whites
(Boyd-Franklin, 2008)
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Psychological Trauma of
Perceived Racism
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Research has documented the
psychological trauma of
perceived racism
Carter, 2007
Clark et al, 1999
Utsey, Chae, Brown & Kelly, 2002
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Hurricane Katrina:
Double Trauma
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Trauma due to the hurricane
disaster
*Death of Loved Ones
*Loss of Extended Family
*Loss of homes
*Loss of Community
* Trauma due to Racism
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The Trauma of Racism
* Racism as trauma
 Family’s experience of the trauma
of racism
 Children observing disrespect
toward their parents
 Harrell (2000)
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Racism-related Life
Events: Hurricane Katrina
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Extreme poverty of Black people in New
Orleans’ 9th Ward
20,000 people at the Convention Center
and 20,000 at the Superdome left
without food and water
Overwhelming number of Black faces at
both locations
Many African Americans have lost their
homes in New Orleans and cannot afford
to rebuild.
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Vicarious Experiences
of Racism
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Can also involve strangers, who are also
African American (Harrell, 2000)
Millions of African Americans watched in
horror as “their People” were ignored
during the Katrina disaster.
Trauma of Racism Experienced
Collectively
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Racism-related
Psychological Trauma
and PTSD
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Racism can be a form of
psychological trauma for African
Americans
It involves negative, rejecting,
and/or demeaning societal
messages that undermine self
esteem
(Butts, 2002)
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African American
Survivors of Katrina
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PTSD
Some had flashbacks
Nightmares
Recurrent Experiences
Not just of the trauma of the hurricane
Also of the inhuman conditions and the
racism experienced at the superdome
and the convention center
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Mental Health Providers
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Must be trained to be culturally
sensitive
African American clients may
experience psychological trauma
due to racism
In disaster situations.
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Challenges for Mental
Health Providers
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Resistance to understanding our clients’
subjective experiences of racism
Many African Americans may be hesitant
to address these issues directly in crossracial treatment
The desire to debate the client’s
perception of racism
Allowing African Americans the space to
express their anger at racism in our
sessions with them
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Challenges During
Responses to Disasters
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Risk re-traumatizing the client by
ignoring or not recognizing their
perception of racism
Manifestations of racism are often
subtle and can easily be denied
Building Trust in the midst of
chaotic crisis interventions
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Any Natural Disaster Can Be
Exacerbated by the Trauma of
Racism
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The Example of Katrina
Many African Americans have
experienced racism during other
disaster responses
The manifestations of racism are
often denied by others
The emotional consequences of
this denial for African Americans
(Boyd-Franklin, 2009)
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Cultural Insensitivity:
Lessons from Katrina
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Lack of cultural understanding
Limited the effectiveness of first
responders
Need to connect with African American
Survivors
Recruit responders from African
American & other ethnic minority
backgrounds
(Dass-Brailsford, 2006; Law, 2006;
Boyd-Franklin, 2008).
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Cultural Issues
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The Importance of Family
Who is considered “family”
The Role of Extended Family
Non-Blood “family”
The Importance of “Community”
Kinship Care
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African American
Extended Families
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African American families
Often extended families
Strong Kinship Networks
Blood and non-blood family
members
Church family
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Extended Family Issues
in Times of Disaster
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Multigenerational family structures
Elderly family members refused to
leave their homes
Trauma related to inability to reach
extended family members during
Katrina
Kinship Care by elderly who also
faced medical crises
(Boyd-Franklin, 2009)
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Helping to locate extended
family members
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Major Intervention to help African
American families in times of
disaster
Establish a reliable information and
contact system
Online resources
Phone lines for those who are not
computer literate
Role of the media
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Many First Responders and Disaster
Workers Did Not Understand the
Concept of “Home” for Older African
Americans
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Implications for Hurricane Katrina
evacuation efforts
Sustaining and supporting those
who insist on staying
(Boyd-Franklin, 2008)
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The Concept of Home for
Older African Americans
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Central to the concept of self
The “Family Home”
Haven in a Cruel world
Neighborhood and Community
Define Their World
Value of Home Ownership
“This is all I have in the world.”
Fear of loss, theft or damage to
their property
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Significance of “Home”
for African Americans
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“Home” or “homeplace”= refuge in
a harsh world
Multigenerational “safe place”
Heal from the ravages of racism,
poverty, deprivation
Part of the Survival skills
Affirmed minds and hearts
Resilience for future generations
(Burton, et al, 2004)
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“Home or Homeplace”
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Encompassed not just the house
Communities & neighborhoods
Church homes
Close communal network of people
Multigenerational web of familiarity,
safety and love
ALL LOST IN THE DEVASTATION
OF THE HURRICANE
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Survivors of Katrina
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It is estimated that 80% of African
Americans, particularly those who
are poor, may never be able to
return to their homes.
Many of the unique aspects of the
African American pre-Katrina New
Orleans community may never be
recreated or replaced. (Troutt,
2006; Dyson, 2006; Boyd-Franklin,
2008).
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Problems with
Evacuation
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Reluctance to leave
multigenerational home
Refusal to leave elderly relatives
who refused to go
Factors Related to poverty
Lack of Transportation
Lack of Money & Credit Cards
No place to stay
Entire family lived in disaster zone
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Losses on Many Levels
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Death of family members, friends, and
loved ones.
Unresolved mourning
No funeral
Deep and painful yearning for home and
community
Mental health and social service workers
often focus on finding new homes
without acknowledging the profound
sadness and “soul wound” created by
loss of their home. (Boyd-Franklin, 2008)
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Grief Counseling
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Different kinds of grief
Death and loss of loved ones
Loss of home and community
Unresolved mourning
Cultural messages to “be strong”
“Tears of Strength and Love”
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African American Clients’
Responses to the Trauma
of Racism
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Healthy Cultural Suspicion
Feelings of Abandonment
Anger
Resentment
Losses of loved ones, home, and
community exacerbated by the
experiences of racism and
disrespect.
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Negative Experiences
During Relocation
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Difficulty renting homes in new
cities after leaving shelters
Negative experiences for African
American youth in new
communities
Racial Profiling (DWB)
No Ability to Return
Family Separated
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Cultural Responses to
Therapy
Stereotypes:
*for sick or crazy people
* for White folks
* for rich folks
* for weak folks
*Re-label “therapy” as “counseling”
* Less stigma attached
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Joining with African American
Clients in Disaster Situations
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Be warm and welcoming
Introduce yourself
Do not present in a formal, rigid,
“professional manner.”
Connect in a human, responsive way
Be “down to earth.”
Be respectful
Address everyone present (not just children or
parents).
Ask adults their names and how they would like
you to address them
With older African Americans avoid using their
first names unless they give their permission
(Boyd-Franklin, 2003)
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Guidelines for Mental
Health Professionals
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Particularly important in cross-racial situations
Perceived racism can be equally traumatic
Try not to personalize the client’s response or
anger
This is not about you but about your client’s
experience of racism
Don’t be defensive
Try to understand the client’s perspective
Allow persons to share their stories or narratives
Do not debate whether or not racism was
involved
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Cautions
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Do not assume that all Black
people will perceive racism in a
given situation
Do not assume that a Black client
will be comfortable talking about
racism particularly in cross-racial
situations
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When a Black Client
Raises the Issue of Race
or Racism
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Be open
Say “Tell me more about it.”
Elicit the Client’s narrative or story about
the experience
Ask what the client was feeling when the
incident occurred
Validate the client’s feelings
In Cross-racial situations, ask how the
client feels discussing this issue with a
White therapist
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Resilience of African
Americans in the Face
of Disaster, Trauma &
Racism
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Historic resilience of Black People
Survival Skills
“This is not our first disaster and it won’t
be our last.”
Strengths
How have you overcome traumatic
experiences in the past?
How have you dealt with racism in the
past?
Role of Religion and Spirituality
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Strength-Based
Interventions
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Clients in the midst of disasters
present first with their problems,
fears, and anxieties
Importance of recognizing
strengths
Cultural strengths
Validate: “You are a survivor.”
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Importance of a FamilyCentered Approach
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Even when working with individual
African Americans
Contextualize within a family and
extended family
After a traumatic experience
Be flexible in terms of involving
family members and significant
others in the healing process.
(Boyd-Franklin, 2003)
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Family Therapy
Interventions with African
Americans
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Culturally appropriate treatment
intervention for African Americans
Healing after disaster and trauma
Need for collective healing
Processing the Separation of the
family and the fear for each other
Processing experiences of racism
or discrimination if they occurred
(Boyd-Franklin, 2003)
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Narrative Therapy
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African Americans are storytellers
Give people the opportunity to
share their stories
They may need to repeat their
stories many times
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Empowerment
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Our job is empowerment not just
helping
As quickly as possible empower
our clients to take over
Question: Are we doing too much?
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Therapeutic Support
Groups
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Valuable resource for helping
African Americans through
traumatic situations
Reconnect with a sense of
community after disaster
Encourage interaction outside of
the group
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In Shelters after a
Disaster
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Groups
Multiple Family Groups
Art Therapy Groups for Children
Music & Song
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Support for Healers in
Disaster Areas
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Support for our mental health
colleagues in disaster areas
Support for Doctors, Nurses and
Emergency Responders
Many of them were also living in
trailers and had lost everything
Support for ministers
Teachers and counselors in
schools
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Mental Health Providers
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Training as an Antidote to Burnout
Trainings addressing issues of
race
Connect to mental health providers
of different races and cultures
Develop your own professional
support system
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