Our bodies keep score.
That’s what I had on my mind as I entered into my June 22 conversation about the trauma experienced by Black folks with Akua Boateng, a licensed psychotherapist. In the email exchange we had setting up the conversation, Boateng had brought up this idea of the physical ways our lived experiences manifest, and it stuck with me. It was indicative of something I’ve always felt and wondered about: How has my body been affected by trauma? How does it follow me? How do I carry it? Is this why I have migraines? (Yes.) Is it the cause of other health issues I experience? (Possibly.)
I went into Conversations, a limited live series for Slate, with this in mind. Boateng had so many answers and invaluable insight. Mostly we went over curatives and how folks can take care of themselves. The trauma Black people experience is frequently discussed, but media outlets don’t dedicate as much energy to covering healing and self-care. Above you can watch our chat—produced by Britt Pullie and Faith Smith—and below is a transcript of the discussion.
I hope you walk away with something valuable.
Hi everyone. I’m Julia Craven. Today, I have with me Dr. Akua Boateng, a licensed psychotherapist in Philadelphia, and we’re going to discuss trauma and we’re going to talk about the physiological impacts of it. We’re going to start talking about how Black people in particular experience it a lot and how we can heal from it. So thank you. I’m so happy that you were able to join me for the first installment of Conversations with Julia Craven, a limited series that Slate is doing. How are you today?
Akua Boateng: I am great. Thank you so much for having me. I’m really excited to talk about trauma as well. Given the times that we’re in, I think it’s important to be able to talk about the need for resources that people need right now. So I’m excited to talk about this.
All right. Well, let’s get to it. The first thing I wanted to ask you was, give us a definition of trauma. What are the symptoms of it and how does it impact you?
Trauma is really an experience that we have that overwhelms our ability to cope. It’s unique. It’s out of the scope of normal. It’s an experience that you go through that really impacts every part of your brain. And when you’re going through an experience that you have limited resources for, limited supply for, and there’s a great demand on you; your system, your brain, your body starts to try to navigate and integrate this information, and it has trouble doing that. And so, during this time the person might feel total helplessness. They may feel a total lack of resources. And during this time the brain gets frozen in either hyperawareness or paralysis. That is the devastation of trauma.
Wow. So your brain gets frozen. Tell me, what does that mean? Is that why whenever … yeah, just explain to the audience what you mean by that.
Yeah. Typically what the appropriate type of coping is is when a person goes through an experience, we take it in through our five senses, right? And via our five senses, we’re able to smell it, we’re able to see it, we’re being able to taste it, and we can make sense of it, put files in our brains that help us to make sense of it, put it away in long-term memory and short-term memory, right? And so that’s how information goes in. It’s integrated into our sense of self, who we believe we are, how we see the world, our outlook.
But the challenge with trauma is when you’re going through something that exhausts that coping strategy and exhausts the ability for you to integrate that information, your brain gets frozen, right? It kind of gets jammed up and it is not able to make those files. It’s not able to now see the resources that you have to tap into to take care of that challenge or to make sure that you integrate it into who you sense you are, how you view the world, your relationships and all of that. And so, the devastation of trauma really is a person’s inability to take in this really significant event and make sense of it.
Wow. And so, how does that apply to our world currently? Because there’s so many different things going on, right? We’re still in the middle of the coronavirus pandemic, we are in the middle of a, let’s call it a new spark has been lit under the Black Lives Matter movement. And so, we’re taking all of this in and it feels constant. How does that affect us, just the onslaught of pretty bad news?
Yeah. I mean, again, we’re taking it a lot nowadays, right? Sometimes what’s happening with a lot of people is we’re taking in too much information, we’re taking in too much media, we’re taking in too many new things and our brain and our body doesn’t have the time to catch up, right? We’re getting this kind of big log of information, not being able to process it regularly day to day, or not even having the resources to be able to process it. And so a lot of people are experiencing secondary trauma, even to the level of post-traumatic stress disorder because the symptoms that they’re having are really debilitating, right? Loss of ability to concentrate, insomnia, lack of emotional balance, you can’t think clearly. I have so many people that are coming to me right now saying, “I’m having so many nightmares in dreams about the things that are going on in the world and I can’t cope with it.”
But really we were not meant to take in such high levels of information and data at one time. We get it on our phone, we get it on television, we talk to our partners and our friends about it, we get it on our watches, right? Every moment these challenges are right in front of us. Do we have a moment to just breathe? Have we had a moment to actually sit down and process this information, to journal, to have self-reflection? Oftentimes we may not have that. And so we’re not processing, we’re not filtering this information down and our systems are being exhausted.
So, how does being a Black person make that worse?
Yeah. So many different things, right? So many different things. The legacy of trauma has been within the Black community for so long, right? We have the secondary trauma that’s happening. We’re watching these images, we’re witnessing these images. It has to really go down into an arsenal of history and information that is already within us given our intergenerational trauma, right? And so, why that is specific to the Black community is because we have heard the stories of our pain growing up generation after generation after generation. That is paired with lack of resources in order to deal with some of the pain that we’re dealing with, feeling helpless in systems that don’t support our growth in our ability to deal with these challenges. And also, being in a situation where we are constantly retraumatized, right?
You may even be able to deal with one trauma, which is hearing the experiences of your parents or your caregivers or your family members. But then you experience it too. You go out into the world and you experience profiling or you experience an incident with the cops or you experience microaggressions at work. It’s a retraumatization after retraumatization after retraumatization. And again, all of that may not necessarily register as trauma to a person, but it has to be paired with the lack of resources and the ability to process the information and do something about it. That place of total helplessness is really the significance that we experience systemically, interpersonally, so many different dimensions.
Yeah. I often think about and tell people about how when I was 7 or 8 years old, that was the first time I got followed in the store. I didn’t realize what was happening because I was a kid, so I didn’t know what was going on. This was during the height of America’s Most Wanted. When my grandmother pulls me out of the store and tells me that someone was following me, I’m just like, “Oh.” I was about to be on this TV show like something really bad was about to happen, and it could have but not necessarily in that sense, right?
That moment in her explaining to me that being Black meant that I had to conduct myself differently everywhere, no matter where I was, it completely changed the way I operated in public and how I operate in stores to this day. When I walk out of a grocery store or any store, I don’t put my hands in my pocket. I don’t rustle or move around too fast. I stay as stoic as I can and I get away from the store and then I start shifting in my bags and then I start digging for something that I just bought that I want to snack on on my way home.
Yeah. And so really what’s happening to you, Julia, in that situation is that you’re experiencing that hyperawareness because you’ve heard the stories about and the messages and narratives that the world may not be a safe place for you. You have to be aware, you have to be on guard. And what happens in those situations is that we are living in an operation and an internal mechanism of survival, right? And so, biologically and physically we’re experiencing a lot of stress internally in order to be ready for what could potentially be a threat or be ready for the world that is not safe to us. And so, living in and normalizing this really high stress internal environment and external environment causes wear and tear on us, right?
Many research studies talk about that it’s linked to inflammatory diseases, right? We’re not meant to have all of this cortisol, which is a stress hormone, we’re not meant to have high levels of this hormone in our body for extended amounts of time. And so, when you’re in this space of hypervigilance, hyperawareness, defensiveness in order to protect yourself, your body is in a mode that is only meant to be in temporarily.
Right. I mean, it does. That sounds like PTSD. We walk around just traumatized as a culture, as a people. Just to kind of go on the physiological effects of that; how else do our bodies, as you put it earlier when we were talking before we got on camera, how do our bodies keep score? Because I think about how I had this bizarre lower back pain for a year and no physician could figure out what was wrong with me. And then I started going to therapy and it went away in like a week or two.
Yes, that happens. Some people talk to me about that all the time. When we’re having undiagnosed physical pain, that typically manifests, especially for women, in our lower back or in our shoulders. Our muscle fibers are actually holding that pain. It is literally a physiological experience that we’re going through. We are holding the pain. And not only that, we have compromised immune systems because of the high levels of cortisol, the stress response that’s happening. Our immune systems are inflamed and compromised as a result of that. Sometimes people even get migraines or cluster headaches. You’d get that? Yes, people have that. They get cluster headaches or migraines. Insomnia is a very big symptom that people talk about having, not being able to sleep.
We have to be able to relax to sleep. And so if we’re not relaxed, our body has the tendency to not want to go into that REM sleep. Of course the mental health affects our physical effects as well. So depression, having fatigue, low energy, low mood, lots of sadness, and then anxiety, right? Anxiety is the hyperawareness part of that trauma, which is hyperfixation, rehearsing things, avoiding potential threats, needing to have control over a lot of things that are in your life. Sometimes people even talk about that being associated with sometimes how Black mothers raise us to be really mindful of everything, right? Mindful of your surroundings, mindful of the people that you have contact with. All of that can be a hypervigilance that’s happening within the body.
That’s every Black woman who played a role in raising me, just right there. It’s each one of them. And of course as a kid, you don’t see them as being anxious and you don’t necessarily understand or realize that that anxiety is likely going to get passed down to you because that also describes me.
And so it goes into these familial narratives that we get, right? So it’s in our body, it’s the way that we cope, it’s also now the way that we live, the way that we speak, the way that we parent, our outlook on the world, even how we make sense of our future. There is a study that talked about people that experience trauma having a shortened view of their life. That I don’t know if I’m going to live past 25, I don’t know if I’m going to live past 14. And so, that’s how I begin to set up my day to day as it pertains to goals, as it pertains to relationships. And so, it’s pretty pervasive.
And so now I want to switch gears and talk about the healing side of things. What can we do to start the healing process in our community?
Yeah. Well, the first part I think is education, right? Many people have experienced trauma. They don’t realize it’s trauma, right? They might call it culture, they might call it just how our family is. And so, education around how this is impacting you, what trauma looks like, have you been through it is really the first step because if a person doesn’t know they’re traumatized or have experienced trauma, how would they even know they need healing? And so, education I think is really, really valuable. Healing comes on two levels, right? The first level is a systemic one, I believe, as well as an interpersonal and individual healing. The systemic part of healing is really we need high level recovery, being able to regain those resources that we’ve lost.
If a person is traumatized and does not feel that they have resources in their environment, in their community, in their world that will help them to grow and thrive, they remain traumatized. And so we need systems that allow people to have safety, we need systems that allow people to not have to live in survival tendencies and hypervigilance. That’s why I’ve been really excited about people talking about, what does it look like to decrease and eradicate oppression in our community? That is really pivotal when it comes to trauma, right? If we’re oppressed, again, that has to do with our outlet. So it aligns with our outlet, it aligns with what we think about the world, what our potential is, our future. And so being able to do the things that social justice allows us to do to minimize oppression, create systems that are better for us, create policy that really works in our favor to help us grow is really, really valuable.
So that’s the systemic healing, I think, and recovery that’s important. And then there is an interpersonal and individual healing that’s important. Integration is the curative for trauma. Where things have been misaligned, integration brings them back together. Oftentimes when people are traumatized, we want to zone out, don’t we? I don’t want to feel the pain. There are so many people that I hear, “I just need a drink. I need to zone out. There’s too much going on. I can’t really think about these things.” You’ve heard that before.
And I think that … I can’t speak for all, I can only speak to my experiences and my family and the people I know. And that in many different ways sounds like everyone I know, right? In my family, it’s just like, I’m going to detach in these various different ways. And as we know, most people don’t separate themselves in a healthy way, which also kind of links back to, well not kind of, it links back to these broader systemic issues that we see in our communities, the high rates of alcoholism, the high rates of drug use, etc.
Right. If I don’t have the resources, if I don’t have the potential of being able to grow in an adaptive and healthy way, I’m going to have to cope anyway I can cope. And so being able to have this integration looks like instead of zoning out, I really need to sit within. Mindfulness is really helpful for that, self-care practices are really important for that. Empathy is important for that, interpersonal support. All of these things are literally changing the molecules of your brain. When you have these resources that are available to you, it now rewrites the damage of trauma. And so, being able to have a change in perspective, right? Having access to new ways of thinking about your family, about having a relationship, about being in a partnership. Therapy can really be helpful in being able to change some of these things for people as well.
Anytime anybody comes to me and they’re going through something, I love to say: A, you need a therapist, and I’m not saying that to be condescending or mean, but I’m saying it because it’s helpful. It’s very helpful to have someone who is trained to help you help you. But as you and I both know, that isn’t necessarily accessible to everyone. And so, what are some resources? How can people access therapy if they don’t have insurance or if there aren’t any, frankly, well, culturally trained therapists in their area?
Yeah. And that can be a problem, that can be a challenge to do that. There are so many resources out there for people to link up with a therapist. I tell people to go on BlackFemaleTherapists.com, which also they include Black male therapists at this time. Therapy for Black Girls, I think, has been a great resource for so many people. The prices that people have are typically on the website, or if you call some practitioners, they have sliding scales, they have discounted prices for people. And then there are environments that you can go into that work with individuals that are not able to pay for therapy at all. And so some behavioral health centers that might be in your community might be able to help you. If you work for a company, sometimes companies have employee assistance programs, and those programs allow you to have three to 10 sessions for free sometimes.
Many people have that within the framework of their job and they don’t realize it. And so making sure that you ask your job, do I have any resources for behavioral health care, and tapping into looking for a therapist that might suit you would be important. There are two initiatives that I’m a part of that are really helpful. First one is Dark Beauty Healing. It’s a campaign that is seeking to do 10,000 hours of free virtual therapy for women of color. I think it’s very important. And so if you go onto their website, you can find and link up with a therapist for free and be able to work with one of the practitioners there. Also the Boris Henson Foundation, which is Taraji P. Henson’s nonprofit, is also doing free therapy for individuals of color. And they’ve expanded to those that have experienced traumatic experience for the past two months.
So why, because we were talking a little bit earlier about how a lot of this starts in childhood. And so how can parents or caretakers, teachers, whoever is working with the child, how can they talk to children about the trauma associated with being Black without burdening them?
That’s important. You want to talk to your child on the level of their understanding, right? We don’t want to inject trauma where trauma has not been experienced. And so being able to, first of all, allow your children to have self-care practices that are normalized. Being able to talk about their emotions, having spaces where you literally just start to process things as they’re going through it. If a child comes to you and they’ve experienced something that is at school or on the playground or something that they’re going through, you want to put that information into context, right?
And so, let’s say that someone is on the playground and they say something that’s racist to your child and your child comes back and talks to you about it. Having a healthy conversation around the differences that people have, having healthy conversations around what we want to do as a family and how we treat people as a family, as opposed to how other people may treat us in certain circumstances is going to be important. So having that conversation, putting it into context as it comes up, not injecting it before it comes up because sometimes it can be really traumatizing and stressful to a child if they don’t have that experience yet and we now put them into that hyper awareness and hypervigilance before they really need it. So, those conversations are really valuable early on and as they come up.
Got you. So another, how do we eradicate the stigma within communities surrounding mental health services? And obviously this is not just a Black community thing as I feel it’s often painted to me, but how do we convince people that they should even go to therapy?
I think education is really important. There is a lot of misinformation and stigma around mental health and that is really because of history, right? Because psychology has had a schism with the Black community because of practices that have been harmful to us historically. And so, education looks like being able to have Black therapists do programs and have resources in the community to meet people, right? People talking about their experiences in therapy openly is really important. Recognizing that, “Oh, I know someone that has a therapist. And oh, they actually enjoy it. It wasn’t harmful to them. Oh, there’s nothing wrong with them. Oh, they’re not crazy.” And so, having that close contact with someone that goes to therapy can be really helpful as well as getting to know a therapist in your community that normalizes the idea of it.
And then also other practitioners like doctors, primary care physicians, suggesting that is really important. Referring people to therapists is really important, from their medical doctor. I know that a lot of people have had a change of heart when they have been in their spiritual communities and their pastor has told them that they have gone to therapy or has referred them to a therapist. And so, again, making sure that the people that have understanding and new ways of thinking of therapy and mental health are open and often speaking to people about their experiences. And then us as professionals providing education in the community can be really, really helpful.
And so how do mental health professionals meet communities where they are, especially if you’re working with people who are resistant to the idea for whatever reason?
Yes. Well, again, through speaking through platforms like this, through going to community events, which I often try to do, and having moments where you speak about what you do. Sometimes even mentoring people in community and programs nonprofits, being able to be a resource to nonprofits that are doing work in the community with young people or with mothers or with families. Having that close proximity is what it is that you need to have. As well as being able to have that in the media I think is really important too. People consume a lot of media. So they see it on Insecure and they say, “OK,” or they see it in a program like this, or they see the stories of Black people get included in normalized therapy and mental health services, and it helps them see it.
Yeah. This reminds me, there’s this great meme. It’s Miguel talking to, I think, Drake. The meme basically has Miguel saying like, “OK, but we’re still going to need a therapist though.” I love that thing because it’s like, yeah, I don’t know what you’re saying, I don’t know what this fictional conversation is about but whatever, that’s great. I’m glad you came to that realization. You still need a therapist though. Like you still have to work through things, and we constantly… One of the best things my mama has ever told me is that everything is a process, and that includes healing. You’re always working at it.
That is so true. Your mom is right. It is a process. It’s a journey. It’s a lifelong process sometimes for people as well. And so, being able to normalize that in therapy is something that I find myself doing a lot to counteract the intergenerational narrative that therapy is not for us, right?
Or the narrative that something is wrong with you if you go to a therapist. And so, being able to have this in context and make sense of it in the process is something that really is healing to people.
Absolutely. Before we get into the questions that we got from folks who are watching, what are some self-care tips, some examples of self-care practices that people can feasibly work into their daily lives?
Great. I’m glad you got to that. I think it’s important because in order to know when you need self-care, you have to know yourself, right? And so, self-awareness becomes the gateway to being able to have self-care practices. What you see on someone else’s Instagram may not be useful for you. And so anticipate … right? Knowing yourself is very important, and anticipating your needs before they come up is going to be valuable to you. There are physical self-care strategies that you can employ. Some of those physical things are really just having a safe housing experience, eating healthy, regular medical care, taking a bath, sleeping. And when I say these things, people look at me and say, what do you mean, Akua? That’s pretty typical and normal. It may not be for everyone.
You might be a mom that has an infant and sleeping is not happening right now, right? And so being able to ask for help in order to sleep is a physical self-care practice that you can implement right now. I think that everyone right now can turn off their phone for some portion of the day. Turn off your notifications, take a break from Instagram or social media and/or getting the news, being able to take a walk, asking for help, right? Or even sexual support from your partner, being able to connect with human beings, right? So that’s a physical way of doing it.
Psychologically: self-reflection, therapy can help, journaling, sensory engagement. Doing things like listening to music, being in a support group is really helpful, or even going to a concert, maybe not at this time but as the pandemic lifts, right? Being able to be in experiences that are life-giving to you. Emotionally: self-affirmations. Tell yourself you love yourself today, right? Being in spaces where people care for you, laughing, watching movies, flirting. All of these things help us to decompress, to relieve stress and change some of the narratives that trauma has inputted within our experiences.
Spiritually: having a spiritual community can be important. Meditating can be important. Having time for just praying is also really important part of that. Social justice is a part of self-care. Some people don’t know that. It helps us to have agency and autonomy to engage in social justice, but it’s important to know what is best for you and what does not trigger your own trauma and the things that have been historically challenging for you. Professionally: taking some time off, making sure that you take your lunch break, asking for help, and then personally making sure that you have goals, short term and longterm, in knowing who you are. So many ways to take care of yourself.
And that’s all fantastic. That’s great. Thank you for giving us insight that is very feasible and not just something quick packaged for Instagram. So yeah, let’s get into the questions that we have. John asked, do people on average have the same internal “amounts” of coping resources?
No. And by amount, I’m not sure if he means the type. It could be a person grows up with several resources, right? We can even categorize that as privilege, right? And so each person doesn’t have the same amount of resources, but access to resources that you do have, maybe agency in order to get those things, is something that we could have in common. And so again, being able to have people that support you, having finances to take care of yourself, having future orientation is going to be important if you’re not in survival mode. And so, some of those things can be really different for people. That’s not to say that they may not have resources, it might look different for every person.
And so what is future orientation? What does that mean?
Being able to have a positive outlook for the future, right? I know how to make goals for myself, I can see myself in the future, I feel positive about it, but then also I feel like I can handle what comes up in the future.
Got you. And just to ask you another take on that question because they may have meant, do people have the same capacity for coping resources? Like do people have the same, I guess, capability to handle certain coping mechanisms? Just a different spin on it so that way in case that’s what they meant, we can also get that information to them too.
Sure. Our capacity looks very different and it’s based on how we grew up, it’s based on if we have preexisting mental health illnesses, it looks very different based on our socioeconomic status. And so, our capacity really is impacted by our environment and it’s impacted by what has happened to us psychologically as well. And so, our capacity can look quite different. And so, being able to get into therapy, talking about the implications of the things that you’ve been through does help you to have a greater self awareness of your capacities, what it looks like. And even if your capacities are limited, there is hope for expanding them with healing, with integration and many of the things that we’ve talked about.
Another question that we got is, so what do normal levels of information intake, sorry, what does that look like? What is considered normal, especially now?
Right. When we talk about what normal is, it’s important to know that who you are matters, right? That it really depends on the person and what it means to them. So if a person has been through or is in a family where several people have been harmed or they have been shot or something has happened to their family, what might be traumatizing to them may not be traumatizing to another person, right? And so, really knowing who this person is and what meaning they make of the things that they’re taking in is going to be important. And so, I always advise people to listen to their body, listen to the symptoms that might be coming up.
If you’re having trouble sleeping, if you’re kind of fixating on information, if you are having feelings of hopelessness or sadness, heart palpitations, having hard time breathing after you’re taking in the media that you typically do, you know it’s too much, right? And so, minimizing that to the degree that you feel like you can thrive, attend to tasks on your day-to-day basis and have a good level of functioning is going to be important. I tell people on average it might be helpful for them to tap into media and social media maybe once or twice a day. And so having an hour here, an hour there on a daily basis may not be too much for most people, but listening to your body is really going to be important. Several hours, probably not a good idea.
That’s now achievable. And then I think about how often I’m on the internet and I’m just like, “Oh yeah, this is my job.” And it’s just like, “I could probably log off though.” But then I don’t know.
Yeah. And the thing is you can take that media, take that information and go offline to do something with it. Let’s say you go online, you need to get information, you get the information, you log off and you either write down what’s going on, you start typing about your thoughts and feelings about this issue. And so it doesn’t necessarily mean that you have to have all this input. We have to pair it with output, and you being able to have self-reflection and have thoughts that you’re generating, making sure you’re still creative and not being given information on how to think about things. All of this is something that’s helpful and adaptive.
Absolutely. Because after this I’m going on a long walk. I hope my editor is not watching because I’m really about to disappear on him for like an hour.
Yeah, it’s needed. It’s needed, right?
Yeah, it is. But thank you so, so much for your time today. This conversation was great. I feel like it was informative and I think that our viewers will too. Thank you everyone at home for watching. Next week I’ll be back to talk to somebody else. Tell us, do you have a website plug? Is there a way that people in Philadelphia can reach you?
Yes. You can reach me at my website, AkuaKBoateng.com. That’s the same on Instagram and Facebook as well as Twitter. And hopefully I’ll connect with many people.
I hope so too. All right. Thanks everyone. I hope that you all have a good day and go for a walk. Get off Twitter.
Yes, please do.
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