Racism hate, is psychological/emotional violence?
To me, any bigotry commited aganist others whether racism, secism, homophobia, transfobia, etc is a hate attack mentally perpetrating a form of psychological/emotional violence to the other (who it is positioned against) and will likely inflict a violation to the other’s dignity. Often, this form of psychological/emotional violence penetrates to their very core stability, comfort of being, and safety in the world. Racism hate, thus can and often, will create a feeling of violation or trauma. To me, racism hate is psychological/emotional violence. So they are not innocent to me in causing societal harm like all terrorists. The alt right racists promote emotional terror and so that should be very strongly condemned and challenged but I only agree to physical violence as direct self defence or other defence fro physical attack or imminent attack. I am not ok with just a limited equality of homosexualty, bisexuality or pansexuality in a offten blatantanit hetrosexistist sociaty, what is needed is to remove as much as possible the hetrosexistism or heteronormative bias, as until we do such people are not truly equal. I am not ok with just a limited racial equality in a often blatantly racist society against people of color, what is needed is to remove as much as possible the raceism, as until we do such people are not truly equal. I am not ok with just a limited equality of Trans people in a often blatantly transphobic society, what is needed is to remove as much as possible the cissexist, transphobia,or transsexism, as until we do such people are not truly equal. I am not ok with just a limited equality of women in a often blatantly sexist society, what is needed is to remove as much as possible the patriarchy, misogyny or sexism, as until we do such people are not truly equal.

Right-wing hate groups do not cause prejudice in the United States — they exploit it. What we clearly see as objectionable bigotry surfacing in Extreme Right movements, is actually the magnified form of oppressions that swim silently in the familiar yet obscured eddies of “mainstream” society. Racism, sexism, heterosexism, and antisemitism are the major forms of supremacy that create oppression and defend and expand inequitable power and privilege; but there are others based on class, age, ability, language, ethnicity, immigrant status, size, religion, and more. These oppressions exist independent of the Extreme Right in U.S. society. In her book Racism, Sexism, Power and Ideology, Colette Guillaumin argues that the great irony of the rise of modern egalitarianism and democracy was the ascendance of the idea that “human groups were no longer formed by divine decree or royal pleasure, but an irreversible diktat of nature.” This “served to justify the system of oppression which was being built at the same time. By proposing a scheme of immanent physical causality (by race, colour, sex, nature), that system provides an irrefutable justification for the crushing… classes and peoples, and the legitimacy of the elite.” Ref

Charlottesville, hate crimes are public health issue, experts say

 BY ,

CHARLOTTESVILLE, Va. — As a white nationalist rally in Charlottesville, Virginia, turned deadly on Saturday, doctors and public health leaders were among those watching events unfold on their television screens and social media. Dr. Georges Benjamin, executive director of the American Public Health Association, was at a car dealership getting his vehicle inspected when he saw news reports of a car plowing into a group of counterprotesters. “I was horrified,” he said. Dr. Elizabeth Samuels, an emergency physician in New Haven, Connecticut, and Providence, Rhode Island, was closely following the events in Charlottesville from home. “I had actually been following the news, went out for a run and saw (counterprotester) Heather (Heyer) had been killed when I got back home,” she said. Dr. Jack Ende, president of the American College of Physicians and a professor at the University of Pennsylvania’s Perelman School of Medicine, also was watching from home. “I was shocked to see what was going on,” he said. “I was shocked and saddened.” Benjamin, Samuels and Ende all agree that the expressions of hate seen in Charlottesville over the weekend were a public health problem.

‘This is a public health issue’

Hate crimes directed at people based on their race, ethnicity, gender, nationality, sexual orientation, religion or other characteristics are a public health issue, according to a policy statement from the American College of Physicians that was posted on its website Monday. “Is it appropriate for a medical organization to take a stance on hate crimes? The American College of Physicians said, ‘Yes, it was,’ ” Ende said. “There are data indicating the public health ramifications of both the hate crime itself but also of the stigma of bias, the stigma of prejudice and hatred directed against somebody because of their sexual orientation, because of their race, because of their ethnicity or their country of origin,” he said. “For that reason, we felt that this is a public health issue, and we joined with other medical organizations to take a stance against hate crimes.” The American Psychological Association, the American Medical Association and the American Academy of Family Physicians also have issued policy statements on hate crime as a public health concern. The American Public Health Association has a site devoted to racism’s negative impact on public health and launched a national campaign against racism, including hate crimes. “We studied the statements of our sister groups before we came out with our own,” Ende said. “There is a consensus within the medical societies that this really needs to be kept on our radar.” The American College of Physicians’ statement, which its board of regents approved last month, calls for more research on the impact of hate crimes, the understanding and prevention of hate crimes and interventions to address the needs of hate crime survivors and their communities. “By identifying discrimination and hate crimes as public health issues, the ACP not only acknowledges the impact these factors have on our patients but also our role and responsibility to address them as part of our professional dedication to the health of our patients and the public,” said Samuels, who was not involved in the policy statement but attended a vigil in Providence on Sunday where people reflected on the violence. “When I have cared for patients assaulted because of their race, religion, gender, sexual orientation, age or disability, what has stood out to me is not so much the physical injuries inflicted — which are not to be minimized — but the psychological harm,” she said. “Hate-based violence and systemic racism are detrimental to public health.”

How hate hurts public health

Several studies suggest that experiences of racism or discrimination raise the risk of emotional and physical health problems, including depressionhypertensioncardiovascular disease and even death. A study of 1,016 Arab-Americans found that their reports of abuse and discrimination after September 11, 2001, were associated with higher levels of distress, lower levels of happiness and worse overall health. The study was published in the American Journal of Public Health in 2010. As for hate crimes in particular, a study found that lesbian, gay, bisexual and transgender high school students living in neighborhoods with higher rates of LGBT assault hate crimes were significantly more likely to report having suicidal thoughts or suicide attempts than students in neighborhoods with lower rates of hate crime. That study was published in the American Journal of Public Health in 2014. “Bottom line is that hate has physical and mental health consequences and should be considered within the remit of public health,” said Dr. Sandro Galea, dean and professor at the Boston University School of Public Health, who was not involved in the American College of Physicians’ latest policy statement. In other words, being considered within the remit of public health means that hate crimes have significant public health consequences, such as being associated with mental and physical problems. Galea said that he agreed with the policy statement, adding that what appears to be a recent rise in divisive language and outward expressions of hate is “deeply troubling” both as a citizen and as a doctor. He pointed to the weekend’s rally in Charlottesville as an example of that expression of hate. “The escalation to outright violence, including the killing of one person, are the tip of the iceberg, the ultimate manifestation of the consequences of hate,” Galea said. The American College of Physicians is not the first health organization to recognize hate crimes as a public health concern — and Charlottesville certainly is not the first city to see hateful rhetoric sweep its streets. Nor will it be the last, with rallies planned in other cities this weekend. America’s narrative includes not only the Civil Rights Act of 1968, the first federal statute to recognize hate crimes, but a haunting history of violent Ku Klux Klan gatherings and lynch mobs. As for why the American College of Physicians and other health organizations are only now recognizing hate crimes as a public health issue, Ende said the health community has evolved and become more “sophisticated in our sensitivity” to determinants of illness and social issues. Now, some medical groups are seeking out public health solutions.

‘We have the capacity as a nation to … fix this’

The American Academy of Family Physicians points to educational programs directed at the prevention of hate crimes as a possible solution, and such programs could be implemented in community centers and schools. The American Psychological Association cites research suggesting that getting people from conflicting groups in the same room in a peaceful way to hear each other’s perspectives, such as in a town hall meeting, or teaching the history of hate in America — such as how there was prejudice against German culture during World War I — are both approaches to turning bias around and possibly preventing hate. The American Medical Association even urges the expedient passage of appropriate hate crimes legislation. The American Public Health Association’s campaign against racism includes three potential public health solutions to hate crimes and racism, Benjamin said. They mostly focus on public discussions. “The first one is naming it. Identifying it. That is a very, very important first step, you know, putting it on the agenda,” Benjamin said. In other words, he said, calling out a hate crime or racism by name can initiate public discussions. Then, as part of that discussion, the second step would be to identify how racism is driving policies, practices or social norms, he said. For instance, “when you have two societies that live on different sides of the railroad tracks and there’s differences in their economic well-being and health … was that constructed?” Benjamin asked. The third step would be taking action, such as promoting or facilitating research and interventions through educational programs or community forums, to address racism and hate crimes from a public health perspective. “The public health community is good at understanding the data, thinking about the population-based impact of it and then working with others, because we don’t do this alone. We work across many sectors to find solutions,” Benjamin said. “I think we need to recognize Charlottesville is an overt expression of something that has been going on for a long time in our country,” he said. “That is a stain and a terrible, terrible situation in our country that we have to fix, and we need to do it now. We have the capacity as a nation to come together and fix this.” Ref


Can Racism Cause PTSD? Implications for DSM-5

By Monnica T. Williams, Ph.D.

Monnica T. Williams, is a licensed clinical psychologist and associate professor

at the University of Connecticut in the department of Psychological Sciences.

Allen was a young African American man working at a retail store. Although he enjoyed and valued his job, he struggled with the way he was treated by his boss.  He was frequently demeaned, given menial tasks, and even required to track African American customers in the store to make sure they weren’t stealing. He began to suffer from symptoms of depression, generalized anxiety, low self-esteem, and feelings of humiliation. After filing a complaint, he was threatened by his boss and then fired. Allen’s symptoms worsened. He had intrusive thoughts, flashbacks, difficulty concentrating, irritability, and jumpiness – all hallmarks of posttraumatic stress disorder (PTSD). Allen later sued his employer for job-related discrimination, and five employees supported his allegations. Allen was found to be suffering from race-based trauma (from Carter & Forsyth, 2009)

Epidemiology of PTSD in Minorities

PTSD is a severe and chronic condition that may occur in response to any traumatic event. The National Survey of American Life (NSAL) found that African Americans show a prevalence rate of 9.1% for PTSD versus 6.8% in non-Hispanic Whites, indicating a notable mental health disparity (Himle et al., 2009).  Incresed rates of PTSD have been found in other groups as well, including Hispanic Americans, Native Americans, Pacific Islander Americans. and Southeast Asian refugees (Pole et al., 2008). Furthermore, PTSD may be more disabling for minorities; for example, African Americans with PTSD experience significantly more impairment at work and carrying out everyday activities (Himle, et al. 2009).

Racism and PTSD

One major factor in understanding PTSD in ethnoracial minorities is the impact of racism on emotional and psychological well-being. Racism continues to be a daily part of American culture, and racial barriers have an overwhelming impact on the oppressed. Much research has been conducted on the social, economic, and political effects of racism, but little research recognizes the psychological effects of racism on people of color (Carter, 2007).Chou, Asnaani, and Hofmann (2012) found that perceived racial discrimination was associated with increased mental disorders in African Americans, Hispanic Americans, and Asian Americans, suggesting that racism may in itself be a traumatic experience.

PTSD in the DSM-IV

Currently, the DSM recognizes racism as trauma only when an individual meets DSM criteria for PTSD in relation to a discrete racist event, such as an assault. This is problematic given that many minorities experience cumulative experiences of racism as traumatic, with perhaps a minor event acting as “the last straw” in triggering trauma reactions (Carter, 2007). Thus, current conceptualizations of trauma as a discrete event may be limiting for diverse populations.  Moreover, existing PTSD measures aimed at identifying an index trauma typically fail to include racism among listed choice response options, leaving such events to be reported as “other” or squeezed into an existing category that may not fully capture the nature of the trauma.  This can be especially problematic as minorities may be reluctant to volunteer experiences of racism to White therapists, who comprise the majority of mental health clinicians. Clients may worry that the therapist will not understand, feel attacked, or express disbelief. Additionally, minority clients also may not link current PTSD symptoms to cumulative experiences of discrimination if queried about a single event.

Implications for Treatment

Racism is not typically considered a PTSD Criterion A event, i.e., a qualifying trauma. Mental health difficulties attributed to racist incidents are often questioned or downplayed, a response that only perpetuates the victim’s anxieties (Carter, 2007). Thus, clients who seek out mental healthcare to address race-based trauma may be further traumatized by microaggressions — subtle racist slights — from their own therapists (Sue et al., 2007). Mental health professionals must be willing and able to assess race-based trauma in their minority clients.  Psychologists assessing ethnoracial minorities are encouraged to directly inquire about the client’s experiences of racism when determining trauma history. Some forms of race-based trauma may include racial harassment, discrimination, witnessing ethnoviolence or discrimination of another person, historical or personal memory of racism, institutional racism, microaggressions, and the constant threat of racial discrimination (Helms et al., 2012). The more subtle forms of racism mentioned may be commonplace, leading to constant vigilance, or “cultural paranoia,” which may be a protective mechanism against racist incidents. However subtle, the culmination of different forms of racism may result in victimization of an individual parallel to that induced by physical or life-threatening trauma. Bryant-Davis and Ocampo (2005) noted similar courses of psychopathology between rape victims and victims of racism. Both events are an assault on the personhood and integrity of the victim.  Similar to rape victims, race-related trauma victims may respond with disbelief, shock, or dissociation, which can prevent them from responding to the incident in a healthy manner. The victim may then feel shame and self-blame because they were unable to respond or defend themselves, which may lead to low self-concept and self-destructive behaviors. In the same study, a parallel was drawn between race-related trauma victims and victims of domestic violence. Both survivors are made to feel shame over allowing themselves to be victimized. For instance, someone who may have experienced a racist incident may be told that if they are polite, work hard, and/or dress in a certain way, they will not encounter racism. When these rules are followed yet racism persists, powerlessness, hyper vigilance, and other symptoms associated with PTSD may develop or worsen (Bryant-Davis & Ocampo, 2005).

Changes in the DSM-5

Proposed changes to PTSD criteria in the DSM-5 have been made to improve diagnostic accuracy in light of current research (Friedman et al., 2011). The first section involving the experienced trauma has changed moderately, reflecting findings in clinical experience as well as empirical research. If a person has learned about a traumatic event involving a close friend or family member, or if a person is repeatedly exposed to details about trauma, they may now be eligible for a PTSD diagnosis. These changes were made to include those exposed in their occupational fields, such as police officers or emergency medical technicians. However, this could be applicable to those suffering from the cumulative effects of racism as well. The requirement of responding to the event with intense fear, helplessness, or horror has been removed. It was found that in many cases, such as soldiers trained in combat, emotional responses are only felt afterward, once removed from the traumatic setting. The most notable change to the criterion is from a three to a four-factor model. The proposed factors are intrusion symptoms, persistent avoidance, alterations in cognition and mood, and hyperarousal/reactivity symptoms. Three new symptoms have been added – persistent distorted blame of self or others, persistent negative emotional state, and reckless or self-destructive behavior. All of these symptoms may be also seen in those victimized by race-based trauma.

Summary

The changes to the DSM increase the potential for better recognition of race-based trauma, although more research will be needed to understand the mechanism by which this occurs. Additionally, current instruments should be expanded and a culturally competent model of PTSD must be developed to address how culture may differentially influence traumatic stress. In the meantime, clinicians should educate themselves about the impact of racism in lives of their ethnic minority clients, specifically the connection between racist events and trauma (Williams et al., 2014). Ref


The Link Between Racism and PTSD

A psychologist explains race-based stress and trauma in Black Americans.

Posttraumatic stress disorder (PTSD) – the diagnosis conjures up images of hollow-eyed combat veterans or terrified rape victims, but new research indicates that racism can be just as devastating as gunfire or sexual assault. In a previous article I posed the question, Can Racism Cause PTSD?  The answer is yes, and changes in the DSM-5 open the door for a better understanding of this phenomenon. Here I discuss the psychological research in this area, as well as clinical observations and how these relate to my own experiences as a person of color. Several people have asked me why I focus on African Americans, given the many similar experiences faced by other ethnic/racial groups, immigrants, sexual minorities, disabled people, and other stigmatized individuals. I want to state up front that the problems faced by those groups are real and deserve attention too, however in this article I am going to stick to what I know, the Black experience in America. Racism-related experiences can range from frequent ambiguous “microaggressions” to blatant hate crimes and physical assault. Racial microaggressions are subtle, yet pervasive acts of racism; these can be brief remarks, vague insults, or even non-verbal exchanges, such as a scowl or refusal to sit next to a Black person on the subway. When experiencing microaggressions, the target loses vital mental resources trying figure out the intention of one committing the act. These events may happen frequently, making it difficult to mentally manage the sheer volume of racial stressors. The unpredictable and anxiety-provoking nature of the events, which may be dismissed by others, can lead to victims feeling as if they are “going crazy.” Chronic fear of these experiences may lead to constant vigilance or even paranoia, which over time may result in traumatization or contribute to PTSD when a more stressful event occurs later (Carter, 2007). In fact, one study of female veterans found that African Americans scored higher on measures of ideas of persecution and paranoia, which the authors attributed to an adaptive response to racism (C’de Baca, Castillo, & Qualls, 2012). While most of us can understand why a violent hate crime could be traumatizing, the traumatizing role of microaggressions can be difficult to comprehend, especially among those who do not experience them. One study of racial discrimination and psychopathology across three U.S. ethnic minority groups found that African Americans experienced significantly more instances of discrimination than either Asian or Hispanic Americans (Chao, Asnaani, Hofmann, 2012). Non-Hispanic Whites experience the least discrimination (11% for Whites versus 81% for Blacks; Cokley, Hall-Clark, & Hicks, 2011). Furthermore, those African Americans who experienced the most racism were significantly more likely to experience symptoms of PTSD as well. Make no mistake, Asian and Hispanic Americans receive their unfair share of racism too, and research shows that it may even be harder to manage for individuals in these groups. But each ethnic/racial group has its own package of negative stereotypes that impact the form of racism experienced, so it’s not surprising that PTSD prevalence differs by race and ethnicity. Findings from large-scale national studies indicate that, while African Americans have a lower risk for many anxiety disorders, they have a 9.1% prevalence rate for PTSD, compared to 6.8% in Whites (Himle et al, 2009). That means that almost one in ten Black people becomes traumatized, and I think these rates may actually be higher since diagnosticians are usually not considering the role of racism in causing trauma (Malcoun, Williams, & Bahojb-Nouri, 2015). Studies also show that African Americans with PTSD experience significantly more impairment due to trauma, indicating greater difficulty carrying out daily activities and increased barriers to receiving effective treatment. Research has linked racism to a host of other problems, including serious psychological distress, physical health problems, depression, anxiety, binge drinking, and even disordered eating (Williams et al., 2014). A strong, positive African American identity can be potential protective factor against symptoms of anxiety and depression, but this not adequate protection when the discriminatory events are severe (Chae et al., 2011; Williams, Chapman, Wong, & Turkheimer, 2012). I have spoken to African Americans all over the country about their experiences with race-based stress and trauma. One veteran in Colorado told me about how the bullets he faced in combat were nothing compared to the mistreatment he experienced at the hands of his fellow soldiers in arms. When he searched for treatment for his resulting mental health issues, the VA system could not find a qualified therapist to help him.  I recently assessed a woman for whom the racial climate at work became so oppressive that she was no longer able to function at her job. She tearfully described the ongoing racial-harassment she experienced from her supervisor, while co-workers turned a blind eye. She carried a stack of documents to prove everything that had happened to her because she didn’t think anyone would believe it. My heart breaks because I have heard her story in many forms, more than once (Williams et al., 2014). It’s important to understand that race-based stress and trauma extends beyond the direct behaviors of prejudiced individuals. We are surrounded by constant reminders that race-related danger can occur at any time, anywhere, to anyone. We might see clips on the nightly news featuring unarmed African Americans being killed on the street, in a holding cell, or even in a church. Learning of these events brings up an array of painful racially-charged memories, and what has been termed “vicarious traumatization.” Even if the specific tragic news item has never happened to us directly, we may have had parents or aunts who have had similar experiences, or we know people in our community who have, and their stories have been passed down.  Over the centuries the Black community has developed a cultural knowledge of these sorts of horrific events, which then primes us for traumatization when we hear about yet another act of violence. Another unarmed Black man has been shot by police in our communities and nowhere feels safe. Research shows that trauma can alter one’s perceptions of overall safety in society. Black people with PTSD have been found to have lower expectations about the benevolence of the world than Whites. When comparing Black and White Americans, one study reported that African Americans held more negative perceptions of the world, appearing more skeptical and mistrustful (Zoellner, Feeny, Fitzgibbons, Foa, 1999). Experiencing a traumatic event changed perceptions of the world in White victims from positive to negative, yet the perceptions of Black victims were not impacted by traumatic experiences. My take on this is that they are already traumatized by life in America. Most of us with dark skin know the world is not safe. Once sensitized through ongoing racism, routine slights may take an increasingly greater toll.  Microaggressions, such as being followed by security guards in a department store, or seeing a White woman clutching her purse in an elevator when a Black man enters, is just another trigger for racial stress.  Social messages and stereotypes may blame the victim, and tell us that Blacks need to stop “dressing like thugs,” “get off welfare,” and assimilate into White culture to gain acceptance. But these experiences can happen to any Black person of any social status.  Sometimes higher status Black people experience more discrimination because they threaten the social order and thus draw increased hate from others (e.g., Gaertner & Dovidio, 2005). I’ve experienced this myself on plenty of occasions. For example once when I was working as a psychological intern in a metropolitan hospital, I was followed by security guards to my car after work. Apparently, a co-worker was frightened by me simply because I was Black. It did not matter that I was a qualified medical professional engaged in patient care and with no history of violence.  I remember feeling helpless, angry, and confused. I went over the experience in my mind repeatedly, and tried to figure out who had made the call and why. Victims often feel powerless to stop these experiences because the discrimination is so persistent. Those who are exposed to this type of racial oppression may turn their frustration inward, resulting in depression and disability, or respond outwardly through aggression or violence. I often wonder how people can continue to remain resilient in the face of ongoing, undeserved discrimination. Within the Black community, positive coping with racism may involve faithforgivenesshumor, and optimism.  These cultural values have allowed African Americans to persevere for centuries even under the most oppressive conditions. One area we are currently studying in my research lab is how African Americans can proactively cope with racism. We are also developing treatments for race-based stress and trauma to enable those who are suffering to move beyond their painful experiences and become stronger, so they can re-engage in larger society. But patching up injured victims of racism one-by-one only goes so far.  I don’t think it is reasonable to expect that we can “fix” people to enable them to manage constant, ongoing acts of prejudice with a smile, and ask them to be perpetually polite, productive, and forgiving. What we really need is a large-scale shift in our social consciousness to understand the toll this takes on the psyche of victims so that even small acts of racism become unacceptable. We need those who witnesses racism to speak out and victims to be believed. To learn more about our work in reducing racism, measuring microaggressions, and promoting racial harmony, visit www.mentalhealthdisparities.orgRead Dr. Williams’ interview about race-based stress and trauma in the New York TimesRacism’s Psychological Toll. Ref

References

Carter, R. T. (2007). Racism and psychological and emotional injury: Recognizing and assessing race-based traumatic stress. The Counseling Psychologist, 35(1), 13-105.

C’de Baca, J., Castillo, D., & Qualls, C. (2012). Ethnic differences in symptoms among female veterans diagnosed with PTSD. Journal of Traumatic Stress, 25(3), 353-357.

Chae, D. H., Lincoln, K. D., & Jackson, J. S. (2011). Discrimination, attribution, and racial group identification: Implications for psychological distress among Black Americans in the National Survey of American Life (2001–2003). American Journal of Orthopsychiatry, 81(4), 498-506.

Chou, T., Asnaani, A., & Hofmann, S. G. (2012). Perception of racial discrimination and psychopathology across three U.S. ethnic minority groups. Cultural Diversity and Ethnic Minority Psychology, 18(1), 74-81.

Cokley, K., Hall-Clark, B., & Hicks, D. (2011). Ethnic minority-majority status and mental health: The mediating role of perceived discrimination. Journal of Mental Health Counseling, 33(3), 243-263.

Gaertner, S. L. & Dovidio, J. F. (2005). Understanding and Addressing Contemporary Racism: From Aversive Racism to the Common Ingroup Identity Model. Journal of Social Issues, 61(3), 615-639.

Himle, J. A., Baser, R. E., Taylor, R. J., Campbell, R. D., & Jackson, J. S. (2009). Anxiety disorders among African Americans, Blacks of Caribbean Descent, and Non-Hispanic Whites in the United States. Journal of Anxiety Disorders, 23, 578–590.

Malcoun, E., Williams, M. T., & Bahojb-Nouri, L. V. (2015). Assessment of Posttraumatic Stress Disorder in African Americans. In L. T. Benuto & B. D. Leany (Eds.), Guide to Psychological Assessment with African Americans, New York: Springer. ISBN: 978-1-4939-1003-8.

Pieterse, A. L., Todd, N. R., Neville, H. A., & Carter, R. T. (2012). Perceived racism and mental health among Black American adults: A meta-analytic review. Journal Of Counseling Psychology, 59(1), 1-9.

Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. B., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271-286.

Williams, M. T., Chapman, L. K., Wong, J., & Turkheimer, E. (2012). The Role of Ethnic Identity in Symptoms of Anxiety and Depression in African Americans. PsychiatryResearch, 199, 31-36.

Williams, M. T., Malcoun, E., Sawyer, B., Davis, D. M., Bahojb-Nouri, L. V., & Leavell Bruce, S. (2014). Cultural Adaptations of Prolonged Exposure Therapy for Treatment and Prevention of Posttraumatic Stress Disorder in African Americans. Behavioral Sciences, 4(2), 102-124.

Zoellner, L. A., Feeny, N. C., Fitzgibbons, L. A., & Foa, E. B. (1999). Response of African American and Caucasian Women to Cognitive Behavioral Therapy for PTSD. Behavior Therapy, 30(4), 581-595.


 Racism’s Psychological Toll

Our screens and feeds are filled with news and images of black Americans dying or being brutalized. A brief and yet still-too-long list: Trayvon MartinTamir RiceWalter ScottEric GarnerRenisha McBride. The image of a white police officer straddling a black teenager on a lawn in McKinney, Tex., had barely faded before we were forced to grapple with the racially motivated shooting in Charleston, S.C. I’ve had numerous conversations with friends and colleagues who are stressed out by the recent string of events; our anxiety and fear is palpable. A few days ago, a friend sent a text message that read, “I’m honestly terrified this will happen to us or someone we know.” Twitter and Facebook are teeming with anguish, and within my own social network (which admittedly consists largely of writers, academics and activists), I’ve seen several ad hoc databases of clinics and counselors crop up to help those struggling to cope. Instagram and Twitter have become a means to circulate information about yoga, meditation and holistic treatment services for African-Americans worn down by the barrage of reports about black deaths and police brutality, and I’ve been invited to several small gatherings dedicated to discussing these events. A handful of friends recently took off for Morocco for a few months with the explicit goal of escaping the psychic weight of life in America. It was against this backdrop that I first encountered the research of Monnica Williams, a psychologist, professor and the director of the University of Louisville’s Center for Mental Health Disparities. Several years ago, Williams treated a “high-functioning patient, with two master’s degrees and a job at a company that anyone would recognize.” The woman, who was African-American, had been devastated by racial harassment by a director within her company. Williams recalls being stunned by how drastically her patient’s condition deteriorated as a result of the treatment. “She completely withdrew and was suffering from extreme emotional anxiety,” she told me. “And that’s what made me say, ‘Wow, we have to focus on this.’ ” In a 2013 Psychology Today article, Williams wrote that “much research has been conducted on the social, economic and political effects of racism, but little research recognizes the psychological effects of racism on people of color.” Williams now studies the link between racism and post-traumatic stress disorder, which is known as race-based traumatic stress injury, or the emotional distress a person may feel after encountering racial harassment or hostility. Although much of Williams’s work focuses on individuals who have been directly targeted by racial discrimination or aggression, she says race-based stress reactions can be triggered by events that are experienced vicariously, or externally, through a third party — like social media or national news events. She argues that racism should be included as a cause of PTSD in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (D.S.M.). Williams is in the process of opening a clinical program that will exclusively treat race-based stress and trauma, in a predominantly black neighborhood in Louisville. Shortly after the Charleston shooting, I called Williams to discuss her work; what follows is a lightly edited and condensed transcript of our conversation.

What is race-based stress and trauma?

It’s a natural byproduct of the types of experiences that minorities have to deal with on a regular basis. I would argue that it is pathological, which means it is a disorder that we can assess and treat. To me, that means these are symptoms that are a diagnosable disorder that require a clinical intervention. It goes largely unrecognized in most people, and that’s based on my experience as a clinician.

What are the symptoms?

Depression, intrusion (the inability to get the thoughts about what happened out of one’s mind), vigilance (an inability to sleep, out of fear of danger), anger, loss of appetite, apathy and avoidance symptoms and emotional numbing. My training and study has been on post-traumatic stress disorder for a long time, and the two look very much alike. Over the weekend, I received several distressing emails and texts from friends who were suffering from feelings of anxiety and depression. Do you think we should all be in treatment? I think everyone could benefit from psychotherapy, but I think just talking to someone and processing the feelings can be very effective. It doesn’t have to be with a therapist; it could be with a pastor, family, friends and people who understand it and aren’t going to make it worse by telling you to stop complaining. What do you think about the #selfcare hashtags on social media and the role of “Black Twitter” as resources for people who may not have the resources they need to help process this? Are online interactions like that more meaningful than they initially might seem? Ref


The Impact of Hate Violence on Victims

Emotional and Behavioral Responses to Attacks

Criminal acts stemming from prejudice based on race, religion, sexual orientation, or ethnicity—frequently referred to as “hate violence”—have increased during recent years. This study explored the nature of hate attacks and victims’ responses to them. The sample consisted of 59 victims and included black, white, and Southeast Asian people. Data were obtained through focus group meetings, individual interviews, and questionnaires. More than half of the victims reported experiencing a series of attacks rather than a single attack. Anger, fear, and sadness were the emotional responses most frequently reported by victims. About one-third of the victims reported behavioral responses such as moving from the neighborhood or purchasing a gun. The responses of hate violence victims were similar to those of victims of other types of personal crime. Implications for social work intervention are discussed. The importance of crime as a major social problem in the United States has been well documented (Bureau of Justice Statistics, 1988). Since the mid-1960s, American society has been increasingly concerned about the problems experienced by victims of crime (Greenberg & Ruback, 1984). This interest has led to the development of a variety of victim service programs (Elias, 1986; Schultz, 1987) and a new area of social research that focuses on victims rather than on criminals (Ochberg, 1988). However, the plight of one class of crime victims, those experiencing hate violence, has been little changed by these developments. Hate violence crimes are those directed against persons, families, groups, or organizations because of their racial, ethnic, religious, or sexual identities or their sexual orientation or condition of disability. These crimes include arson of homes and businesses, harassment, destruction of religious property, cross burnings, personal assaults, and homicides. Hate violence has a long history in the United States (Brown, 1989). Although it is difficult to estimate the current prevalence of hate violence in the United States (U.S. Commission on Civil Rights, 1986; Weiss, 1990), many sources suggest that the level of this type of crime has increased in the past several years (Anti-Defamation League of B’nai B’rith, 1991; Community Relations Service, 1990). Also, in recent years the media have increasingly provided information on the explosion of hate violence on college campuses (Collison, 1987) and on the capacity of hate violence to spark large-scale urban disturbances (“Black Child,” 1991). With the passage of the Hate Crime Statistics Act, data on the prevalence of ethnoviolence (hate violence on the basis of race or ethnicity) nationwide will be compiled by the U.S. Attorney General for the years 1990 through 1994 (National Institute Against Prejudice and Violence, 1990). Research is beginning to identify the effects of various types of personal crime on victims (Davis & Friedman, 1985). However, despite the social importance of hate violence, there is little available information on how it affects victims (Weiss & Ephross, 1986). The present study examines the nature of hate violence and the impact of these crimes on victims.

Method

Research Design and Sampling

Using an exploratory research design, the National Institute Against Prejudice and Violence conducted a pilot study of the effects of hate violence on minority group members (Ephross, Barnes, Ehrlich, Sandnes, & Weiss, 1986). A purposive sample of victims was obtained by contacts between members of the instituteÕs staff and officials of human rights agencies, social services agencies, community relations agencies, and special units of police departments in several urban areas. These areas included Alexandria, Virginia; Baltimore; Cleveland; Philadelphia; Oakland, California; Rockville, Maryland; San Jose, California; Suffolk County, New York; and Statesville, North Carolina.

Data Collection and Analysis

The technique of focus group interviewing was used in the study. A focus group is a small group convened to share feelings, thoughts, and reactions to a particular subject (Lydecker, 1986). Ten focus group meetings and some individual interviews were held at sites in the victimsÕ communities. Each focus group meeting was conducted by two members of the institute’s research staff. The institute’s staff guided the interviews by posing a prepared set of open-ended questions for each group. With the permission of the participants, each meeting was audiotaped. Participants were assured of confidentiality. Participants also completed questionnaires. Initially, the questionnaires obtained data on the demographic characteristics of victims and the types of crime they experienced. After the third focus group, the questionnaires were revised to include seven items measuring victims’ emotional responses to the hate violence incidents. The audiotape of each interview was reviewed by pairs of institute researchers working independently. Vignettes describing each victim’s experience were written by the first reviewer and then checked for reliability by a second reviewer. In addition to these procedures, the first author analyzed each audiotape using a content analysis procedure (Mostyn, 1985). Complete results from the content analysis were not available for inclusion in the pilot study report (Ephross et al., 1986).

Findings

Study Sample

The current report deals with the 59 focus group participants (out of 72) for whom complete information is available. The ethnic and religious backgrounds of the study sample are presented in Table 1. The diversity of the group is apparent, although the nonsystematic method of sampling resulted in a seeming oversampling of Southeast Asian victims and an undersampling of Hispanic victims. Forty-one percent of the 59 victims were foreign born. They were almost equally divided by sex (54 percent male, 46 percent female) and ranged in age from 16 to 67 years. The median age was 39 years. Sixty-three percent of the participants were married. The sample’s median household income was $15,500; the range was from $5,000 or less to over $50,000.

Acts of Violence

The interviews focused primarily on the most recent personal attack that participants had experienced. The total number of recent attacks for the sample was 53, rather than 59, because the sample included six couples who mutually experienced six attacks. As indicated in Table 2, for slightly more than two out of five respondents (44.1 percent), the most recent attack had occurred in a single time period and had been their first hate violence victimization. One-tenth of the respondents (10.2 percent) reported experiencing one or more prior hate violence incidents that appeared to be unrelated to the most recent attack. For slightly more than two out of five respondents (45.8 percent), the most recent incident was actually the latest in a series of related attacks. Some of these serial attacks ranged over several months and some over three years. Some of the most recent attacks reported by respondents included multiple crimes that occurred on the same date (Table 2). Because of the multiple nature of some attacks, the total number of crimes experienced by victims in recent attacks was 68 rather than 53. Physical assault, verbal harassment, and mail or telephone threats were the most frequently reported crimes (Table 2). These three categories together accounted for almost 49 percent of the experiences of respondents. The next most common attacks (14.7 percent) were symbols or slogans of hate on or near the personal property of victims. Attacks on homes and other acts of vandalism, respectively, accounted for 8.8 percent and 7.4 percent of the incidents. Robberies and attempted robberies were considered possible hate violence attacks because the motives of the offenders were unclear. However, it should be noted that victims of these crimes perceived them as crimes motivated by prejudice.

Impact of Attacks on Victims and Their Families

The majority of the 59 victims (76 percent) did not receive physical injuries as a result of the most recent attack. Minor injuries were sustained by 10 percent, and 9 percent received medical treatment for injuries inflicted in the attack. The severe injuries inflicted on 5 percent of the victims required hospitalization. In 41 percent of the most recent attacks, victims incurred property damage. Participants identified several emotional reactions to the most recent attack on them (Table 3). Irwin, a Jewish victim who had a swastika spray- painted on his mailbox, identified his response as “mostly a feeling of anger.” The most prevalent emotion was anger at the perpetrator, which nearly 68 percent of the participants reported. Fear of injury was the next most frequently cited emotion, with nearly 51 percent of the participants indicating fear that they or their families would be physically injured. A number of victims (approximately 36 percent) were saddened by the incident. About one-third of the participants (33.9 percent) reported behavioral changes as both coping responses to the most recent attack and as attempts to avoid potential future victimization. These behavioral changes included moving out of the neighborhood, decreasing social participation, purchasing a gun or increasing readiness to use a gun, buying initial or additional home security devices, and increasing safety precautions for children in the family. Somala, a Cambodian refugee, was assaulted by a black man in a suburban park. Shortly after the attack, Somala moved to another county. She moved because of fear that the man would find her and attack again, and she subsequently avoided the county in which the attack occurred. Somala’s responses represent the avoidance behavioral coping that some victims adopted. In contrast to avoidance, the behavioral coping of some victims consisted of preparations for retaliation. One black man stated, “I am scared that I might catch one of these people. . . . The scariest thing is I got guns and can use them.”

Discussion and Implications

In examining the most recent hate violence incidents, the study found considerable variation in both the type and intensity of attacks. This finding is consistent with those of other recent investigations of hate violence (for example, U.S. Commission on Civil Rights, 1986; Wexler & Marx, 1986). The characteristics of some attacks appeared to be consistent with conventional definitions of social terrorism (Gurr, 1989), particularly evident in the finding of the current study that more than half of the participants experienced multiple attacks. In comparing the emotional and behavioral responses of victims of hate violence with those of victims of personal crimes such as assault and rape, several similarities were identified. Investigators have reported intense rage or anger (Bard & Sangrey, 1986); fear of injury, death, and future victimization (Davis & Friedman, 1985); sadness (Ochberg, 1988); and depression (Shapland, Willmore, & Duff, 1985) as elements of victims’ potential reactions to crime. Thus, to some extent, the predominant emotional responses of hate violence victims appear similar to those of victims of other types of personal crime. The behavioral coping responses of hate violence victims are also similar to those used by other victims of crime (Davis & Friedman, 1985; Wirtz & Harrell, 1987). Crime victims often experience feelings of powerlessness and increased suspicion of other people (Bard & Sangrey, 1986). These emotions were also reported by victims of hate violence. A major difference in the emotional response of hate violence victims appears to be the absence of lowered self-esteem. The ability of some hate violence victims to maintain their self-esteem may be associated with their attribution of responsibility for the attacks to the prejudice and racism of the perpetrators. Some limitations of this study need to be mentioned. First, the participants interviewed in the study had all contacted the police, human rights agencies, or other organizations. Thus, study findings are most relevant to the population of victims who report hate violence. Second, the general-izability of the findings to this population may be affected by the relatively small size and nonrandom nature of the sample. Although responsibility for responding to hate violence is primarily allocated to community relations agencies, social workers in a wide array of settings encounter clients who have experienced this type of victimization. Thus, social workers must have knowledge of characteristics of hate violence, victims’ reactions to attacks, and community resources that address hate violence. Practitioners can assist victims in managing the stress of hate violence. As with victims of other types of crime, short-term interventions appear best suited for meeting the needs of hate violence victims (Young, 1988). Group work services may also be beneficial (Weiss & Ephross, 1986). With highly traumatized victims, specialized psychotherapy may be required (Ochberg, 1988). To prevent hate violence, social workers need to assist in educating citizens about this problem (Weiss, 1990). Ref

References

Anti-Defamation League of B’nai B’rith. (1991). 1990 audit of anti-Semitic incidents. New York: Author.

Bard, M., & Sangrey, D. (1986). The crime victim’s book (2nd ed.). New York: Brunner/Mazel.

Black child and a Hasidic man die, igniting clashes in Brooklyn. (1991, August 21). New York Times, p. A1.

Brown, R. M. (1989). Historical patterns of violence. In T. R. Gurr (Ed.), Violence in America: Protest, rebellion, reform (Vol. 2, pp. 23-61). Newbury Park, CA: Sage Publications.

Bureau of Justice Statistics. (1988). Report to the nation on crime and justice (2nd ed.). Washington, DC: U.S. Department of Justice.

Collison, M. N.-K. (1987, March 18). Racial incidents worry campus officials, prompt U. of Massachusetts study. Chronicle of Higher Education, pp. 1, 41-43.

Community Relations Service. (1990). The annual report of the Community Relations Service. Washington, DC: U.S. Department of Justice.

Davis, R. C., & Friedman, L. N. (1985). The emotional aftermath of crime and violence. In C. R. Figley (Ed.), Trauma and its wake (pp. 90-112). New York: Brunner/Mazel.

Elias, R. (1986). The politics of victimization: Victims, victimology and human rights. New York: Oxford University Press

Ephross, P. H., Barnes, A., Ehrlich, H. J., Sandnes, K. R., & Weiss, J. C. (1986). The ethnoviolence project: Pilot study. Baltimore: National Institute Against Prejudice and Violence.

Greenberg, M. S., & Ruback, R. B. (1984). Criminal victimization: Introduction and overview. Journal of Social Issues, 40(1), 1-7.

Gurr, T. R. (1989). Political terrorism: Historical antecedents and contemporary trends. In T. R. Gurr (Ed.), Violence in America: Protest, rebellion, reform (Vol. 2, pp. 201-230). Newbury Park, CA: Sage Publications.

Lydecker, T. H. (1986, March). Focus group dynamics. Association Management, pp. 73-78.

Mostyn, B. (1985). The content analysis of qualitative research data: A dynamic approach. In M. Brenner, J. Brown, & D. Cantor (Eds.), The research interview: Uses and approaches (pp. 115-145). Orlando, FL: Academic Press.

National Institute Against Prejudice and Violence. (1990). Federal Hate Crime Statistics Act signed into law. FORUM, 5(2), 5.

Ochberg, F. M. (1988). Post-traumatic therapy and victims of violence. In F. M. Ochberg (Ed.), Post-traumatic therapy and victims of violence (pp. 3-19). New York: Brunner/Mazel.

Schultz, L. G. (1987). Victimization programs and victims of crime. In A. Minahan (Ed.-in-Chief), Encyclopedia of social work (18th ed., Vol. 2, pp. 817-822). Silver Spring, MD: National Association of Social Workers.

Shapland, J., Willmore, J., & Duff, P. (1985). Victims in the criminal justice system. Brookfield, VT: Gower.

U. S. Commission on Civil Rights. (1986). Recent activities against citizens and residents of Asian descent. Washington, DC: Author.

Weiss, J. C. (1990). Ethnoviolence: Violence motivated by bigotry. In L. Ginsberg et al. (Eds.), Encyclopedia of social work (18th ed., 1990 Suppl., pp. 307-319). Silver Spring, MD: NASW Press.

Weiss, J. C., & Ephross, P. H. (1986). Group work approaches to “hate violence” incidents. Social Work, 31, 132-136.

Wexler, C., & Marx, G. T. (1986). When law and order works: Boston’s innovative approach to the problem of racial violence. Crime & Delinquency, 32, 205-223.

Wirtz, P. W., & Harrell, A. V. (1987). Victim and crime characteristics, coping responses, and short- and long-term recovery from victimization. Journal of Consulting and Clinical Psychology, 55, 866-871.

Young, M. A. (1988). Support services for victims. In F. M. Ochberg (Ed.), Post-traumatic therapy and victims of violence (pp. 330-351). New York: Brunner/Mazel.

Arnold Barnes, PhD, is assistant professor, Indiana University School of Social Work, Education/Social Work Building 4138, 902 West New York Street, Indianapolis, IN 46202-5156. Paul H. Ephross, PhD, is professor, School of Social Work, University of Maryland at Baltimore.


How Racism Impacts the Response to Emotional Abuse

Within the context of immigration (particularly from the Caribbean), author Joan Wilkinson examines racism and emotional abuse. The findings reveal the need for more cultural sensitivity and awareness. Canadian Statistics tells us that 29% of women have been victims of wife abuse. The immigrant woman is not excluded from this group. Frequently women who immigrate to Canada from the Caribbean are vulnerable to emotional abuse to the extent that it affects their ability to seek social support. They often find themselves in abusive situations in their home, at their place of employment or even in their churches.  Incapable of finding a safe way to escape their violent circumstances, many women blame themselves or may even rationalize the abuse they are experiencing, which, over time, results in significant impact on the self-esteem, self-confidence and/or the parenting capacity of these women. Unfortunately, due to a lack of cultural awareness and systemic racism, those who are placed in positions of power aimed at protecting society, for instance in the legal and judiciary system, may react with indifference or ignorance. For example, a woman may be told that women from her culture are known to prefer men who abuse them. This lack of knowledge regarding abuse and its impact on the victim only serve to contribute to the immigrant woman’s fear of reporting the various forms of abuse that have been inflicted upon her. As such, poor responses strengthen the feelings of distrust an immigrant woman has about various institutions, such as social work practitioners, the education and judicial systems. From another perspective, the failure to establish a supportive workable intervention with an abused woman should be viewed as revictimizing her.  The response to immigrant women is often buttressed by racial stereotypes specific to a certain culture, and by societal norms that state women are supposed to be submissive. Often an immigrant woman is not aware of the societal support systems and is therefore unable to use them. The emotional abuse may also undermine her ability to seek economic independence. Unfortunately, she may soon forget her own inner resources and the resilience that helped her to migrate to begin a new life. Service providers such as counselors, police and settlement workers must consider the complexity of the issues facing immigrant women. They should possess knowledge of the woman’s culture and understand each woman individually within her own cultural context culture in order to be effective, while avoiding stereotypes when dealing with women of colour. This awareness would facilitate a more effective intervention with this often hidden and misunderstood client group. Ref


Emotional violence

Emotional violence and controlling behaviour is behaviour which does not give equal importance and respect to another person’s feelings and experiences. It is often the most difficult to pinpoint or identify. Emotional violence includes the refusal to listen to, or denial of, another person’s feelings, telling people what they do or do not feel and ridiculing or shaming of their feelings. It happens when one person believes they have a right to control or dominate another person. Bullying External Link, threatening, harassing, isolating and name calling are all forms of control. They can make people feel bad and worry about what is going to happen next. Emotional violence can also make people feel powerless, fearful or angry about the violence. Ref


What Is Psychological Violence?

by Andrea Borghini

Violence is a central concept for describing social relationships among humans, a concept loaded with ethical and political significance. Yet, what is violence? What forms can it take? Can human life be void of violence, and should it be? These are some of the hard questions that a theory of violence shall address. In this article we shall address psychological violence, which will be kept distinct from physical violence and verbal violence. Other questions, such as Why are humans violent?, or Can violence ever be just?, or Should humans aspire to non-violence? will be left for another occasion.

PSYCHOLOGICAL VIOLENCE

In a first approximation, psychological violence may be defined as that sort of violence which involves a psychological damage on the part of the agent who is being violated. You do have psychological violence, that is, any time that an agent voluntarily inflicts some psychological distress on an agent. Psychological violence is compatible with physical violence or verbal violence. The damage done to a person that has been the victim of a sexual assault is not only the damage deriving from the physical injuries to her or his body; the psychological trauma the event may provoke is part and parcel of the violence perpetrated, which is a psychological sort of violence.

THE POLITICS OF PSYCHOLOGICAL VIOLENCE

Psychological violence is of the utmost importance from a political point of view. Racism and sexism have been indeed analyzed as forms of violence that a government, or a sect of society, was inflicting on some individuals. From a legal perspective, to recognize that racism is a form of violence even when no physical damage is provoked to the victim of a racist behavior, is an important instrument for putting some pressure (that is, exercising some form of coercion) on those whose behavior is racist. On the other hand, as it is often difficult to assess a psychological damage (who can tell whether a woman is really suffering because of the sexist behavior of her acquaintances rather than because of her own personal issues?), the critics of psychological violence often try to find an easy apologetic way out. While disentangling causes in the psychological sphere is difficult, however, there is little doubt that discriminatory attitudes of all sorts do put some psychological pressure on agents: such a sensation is quite familiar to all human beings, since childhood.

REACTING TO PSYCHOLOGICAL VIOLENCE

Psychological violence poses also some important and difficult ethical dilemmas. First and foremost, is it justified to react with physical violence to an act of psychological violence? Can we, for instance, excuse bloody or physically violent revolts that were perpetrated as a reaction to situations of psychological violence? Consider even a simple case of mobbing, which (at least in part) involves some dose of psychological violence: can it be justified reacting in a physically violent manner to mobbing? The questions just raised divide harshly those who debate violence. On one hand stand those who regard physical violence as a higher variant of violent behavior: reacting to psychological violence by perpetrating physical violence means to escalateviolence. On the other hand, some maintain that certain forms of psychological violence may be more atrocious than any form of physical violence: it is indeed the case that some of the worst forms of torture are psychological and may involve no direct physical damage be inflicted on the tortured.

UNDERSTANDING PSYCHOLOGICAL VIOLENCE

While the majority of human beings may have been victim of some form of psychological violence at some point of their life, without a proper notion of a self it is difficult to devise effective strategies for coping with the damages inflicted by those violent acts. What does it take to heal from a psychological trauma or damage? How to cultivate the well-being of a self? Those may possibly be among the most difficult and central questions that philosophers, psychologists, and social scientists have to answer in order to cultivate the well-being of individuals. Ref


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