Racial Trauma: Your Questions Answered, Part 1

Stories and images of racism and violence against Black, Indigenous, and People of Color (BIPOC) has spurred a national discussion around racism and its impact. For those in health and human services, this has led to more discussions around racial trauma—what it is, who it affects, and how clinicians and organization can better understand and respond to this type of trauma.

Dr. Jamila Holcomb, Ph.D., LMFT, provided an insightful and powerful webinar for Relias on racial trauma and how it affects the Black community specifically. Dr. Holcomb, a faculty member at Florida State University specializing in trauma counseling in children and families, described how racial trauma affects the mental, emotional, and physical health of Black Americans, as well as the impact of racial discrimination on Black youth and emerging adults.

A wide array of thoughtful and insightful questions came out of the webinar. The following questions cover topics around screening for racial trauma, issues of racism facing BIPOC clinicians, and how children are affected by racism.

Screening for Racial Trauma

Should you address racial trauma for all clients or only clients of color? How should we assess for racial trauma?

Given that everyone has a race, I would absolutely explore possible racial trauma with all clients. We can simply ask every client what their relationship is with their race and what their experiences have been like, then see what fits for the client. We should assess for racial trauma in the same way we assess for other traumas and include it in our intake paperwork.

While we absolutely don’t want to assume all people of color have experienced racial trauma, once you clearly understand the systemic nature of racism it would be hard to find someone who could say that they have not been impacted by it in some way. Asking about racial trauma itself does not re-traumatize the client either; rather, it makes them feel seen. In a clinical setting, including racial trauma within our assessment gathering gives us the data to determine if this is something that the client experiences and if they want to process it.

Racism and Racial Trauma Among Clinicians

For BIPOC in this field, how do we bring attention to these issues and the importance of decolonizing our field and practices in our agencies, when we ourselves, as BIPOC therapists/mental health professionals, are pathologized when we speak out?

That is the eternal struggle, right? How can we make the voices of the historically marginalized be loud and powerful enough to create change? We unfortunately need allies if we want to create change within the systems we are already in. I think there is also something to be said about creating new systems that more equitably benefit BIPOC. Even if we don’t have allies though, that doesn’t mean we stop advocating for change! This is a long road. It took over 400 years to establish the racist system that we are in, so it will take time to dismantle it.

I also want to say, please do not feel that it is your responsibility to educate your peers and staff. If you want to take this task on, by all means do so—but do so in a way so that you are able to take good care of yourself. Racial battle fatigue is real! I suggest bringing your concerns to your peers and staff and organizing trainings or other opportunities for them to learn more.

As a supervisor who is Black, I find it challenging talking to supervisees who are white. What are some tips in navigating this?

My first suggestion is for you to consistently encourage them to explore their bias and learn about the history of BIPOC, as well as challenge them in your supervision. This is our ethical responsibility as gatekeepers in the field. We cannot send clinicians out to work with clients facing racial trauma if they are then re-traumatizing them.

How can therapists who are the same race as their clients be careful to not over-identify and miss client-specific experiences?

This is very important; if the therapist is of the same race as their client, they are going to have to be careful not to project their experiences onto the client or over-identify with the client. There should be space to allow for therapist and client to identify and relate with each other, but the therapist should make sure they are utilizing supervision and/or consultation regarding their possibility for countertransference.

How do we change the lack of acknowledging Racial Trauma in the DSM?

I think we can begin to do this by advocating for this change to the American Psychiatric Association. We also need to make sure that there is diversity among those who create and edit the DSM so that all voices and experiences are represented and heard at that table. We need to advocate for this inclusion.

Children and Racial Bias

Is the racial awareness of young infants based on the race of the caregivers?  Does the infant notice difference in race if it is different from their caregivers?

Yes, the racial preference is based on who the child is around the most. So, if they are primarily around Black individuals, when placed in front of a white individual they may look for the Black individuals. At this young age, infants don’t know what race they are, so it wouldn’t matter if they are of a different race than the caregiver. What’s important about this information is that we want to expose children to people of all races and ethnicities so that they feel comfortable around them and do not display bias or fear of other groups.

Eventually, children will begin categorizing race on their own, but it is likely that once they start displaying bias based on those categories, they are either being taught this bias at home OR they are simply not being corrected by their parents.

Could you speak to how to best support children/teens impacted by racial trauma?  Also, how to best educate all children?

The best way to educate children is to have the conversation and not shy away from it. Conversations about racism have to be honest and vulnerable. However, before we educate children, we ourselves need to make sure we are also educated and are aware of our own biases, so that we can feel comfortable addressing this topic.

If you are an educator, make sure that BIPOC children are positively represented in your course materials (books, videos, handouts, etc.). Also try to establish support groups for BIPOC students (especially if they are the minority in your school system). Use culturally inclusive language and materials in the classroom, and make sure teachers are exposing children to the full history of their BIPOC students and not just glossing over it (or only focusing on slavery). Teachers must also be aware of how their bias can impact their interactions with BIPOC students (who they call on, who they discipline, what types of discipline they give out, etc.). I think a lot of the same recommendations for teachers can apply directly to clinicians and parents as well.

You mention that asking questions such as “Why is your hair different?” could be considered a microaggression from a child. What if “Why is your hair different?” is just a child’s initial question in learning?

So, a kid simply asking, “Why is your hair different?” can be hurtful, but we know that kids will point out differences as they learn to categorize, and that’s not a bad thing! What’s important is for parents or teachers to step in and provide healthy responses, such as: “Their hair is different because everyone has different textures of hair, and all textures are beautiful”. That way, the child who asked the question does not learn to treat someone with different hair textures as “less than”, and the child with the hair texture can feel good about themselves and it won’t negatively impact their self-esteem. If that conversation is not had by the adults, then children internalize those negative comments as “something is wrong with me”, and the child who asked the question is left to make their own assumptions about people with different hair textures.

Does the ACEs include anything to assess racial trauma?

There is not a specific racial trauma question in the ACEs study. You have identified yet another way that systemic racism plays out in the mental health field, where the unique experiences of BIPOC are largely ignored and invalidated. I think we absolutely should bring this to the attention the ACE creators and advocate for its inclusion in future studies around ACEs.

Can you recommend Relias courses for non-clinical, direct-care staff?

Relias has a wide variety of courses that can help staff (both clinical and non-clinical staff) begin to understand how racial bias can negatively impact persons served and organizations as a whole. We provide content on trauma-informed care that includes ways non-clinical staff can be trauma-informed. We also provide courses on cultural competency, unconscious (implicit) bias, and effective communication that are beneficial for any staff member. Additionally, we offer courses for staff in health services on topics like social determinants of health that can help provide deeper understanding around racial disparities in healthcare.

Dr. Holcomb is happy to address any other questions you have, so please feel free to send her an email at [email protected]