African Americans and Trauma: Lessons Learned from Disasters

1. African Americans and Trauma: Lessons Learned from Disasters Nancy Boyd-Franklin, Ph.D. Rutgers University Email: boydfrank@aol.com

2. Focus • African Americans and Trauma • Lessons Learned from Natural Disasters • Case Example of Hurricane Katrina • Victimization Experiences

3. 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

4. Religion and Spirituality • 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

5. Hurricane Katrina: Disproportionate Impact on Poor African Americans • 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

6. 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)

7. Different Perceptions of Race and Class • 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)

8. Psychological Trauma of Perceived Racism • Research has documented the psychological trauma of perceived racism • Carter, 2007 • Clark et al, 1999 • Utsey, Chae, Brown & Kelly, 2002

9. Hurricane Katrina: Double Trauma • Trauma due to the hurricane disaster • *Death of Loved Ones *Loss of Extended Family *Loss of homes *Loss of Community * Trauma due to Racism

10. The Trauma of Racism * Racism as trauma • Family’s experience of the trauma of racism • Children observing disrespect toward their parents • Harrell (2000)

11. Racism-related Life Events: Hurricane Katrina • 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.

12. Vicarious Experiences of Racism • 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

13. Racism-related Psychological Trauma and PTSD • 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)

14. African American Survivors of Katrina • 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

15. Mental Health Providers • Must be trained to be culturally sensitive • African American clients may experience psychological trauma due to racism • In disaster situations.

16. Challenges for Mental Health Providers • Resistance to understanding our clients’ subjective experiences of racism • Many African Americans may be hesitant to address these issues directly in cross-racial 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

17. Challenges During Responses to Disasters • 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

18. Any Natural Disaster Can Be Exacerbated by the Trauma of Racism • 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)

19. Cultural Insensitivity: Lessons from Katrina • 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).

20. Cultural Issues • The Importance of Family • Who is considered “family” • The Role of Extended Family • Non-Blood “family” • The Importance of “Community” • Kinship Care

21. African American Extended Families • African American families • Often extended families • Strong Kinship Networks • Blood and non-blood family members • Church family

22. Extended Family Issues in Times of Disaster • 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)

23. Helping to locate extended family members • 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

24. Many First Responders and Disaster Workers Did Not Understand the Concept of “Home” for Older African Americans • Implications for Hurricane Katrina evacuation efforts • Sustaining and supporting those who insist on staying (Boyd-Franklin, 2008)

25. The Concept of Home for Older African Americans • 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

26. Significance of “Home” for African Americans • “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)

27. “Home or Homeplace” • 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

28. Survivors of Katrina • 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).

29. Problems with Evacuation • 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

30. Losses on Many Levels • 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)

31. Grief Counseling • 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”

32. African American Clients’ Responses to the Trauma of Racism • Healthy Cultural Suspicion • Feelings of Abandonment • Anger • Resentment • Losses of loved ones, home, and community exacerbated by the experiences of racism and disrespect.

33. Negative Experiences During Relocation • 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

34. 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

35. Joining with African American Clients in Disaster Situations • 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)

36. Guidelines for Mental Health Professionals • 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

37. Cautions • 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

38. When a Black Client Raises the Issue of Race or Racism • 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

39. Resilience of African Americans in the Face of Disaster, Trauma & Racism • 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

40. Strength-Based Interventions • 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.”

41. Importance of a Family-Centered Approach • 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)

42. Family Therapy Interventions with African Americans • 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)

43. Narrative Therapy • African Americans are storytellers • Give people the opportunity to share their stories • They may need to repeat their stories many times

44. Empowerment • Our job is empowerment not just helping • As quickly as possible empower our clients to take over • Question: Are we doing too much?

45. Therapeutic Support Groups • Valuable resource for helping African Americans through traumatic situations • Reconnect with a sense of community after disaster • Encourage interaction outside of the group

46. In Shelters after a Disaster • Groups • Multiple Family Groups • Art Therapy Groups for Children • Music & Song

47. Support for Healers in Disaster Areas • 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

48. Mental Health Providers • 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