Black Women’s Acts of Resistance and Resilience to Trauma

Dineen skillfully dug her purple latex-swathed fingers into my bare left shoulder blade, and I yelped, “O-o-o-uch!”

“Sor-ry!” Dineen cheerfully apologized. If I didn’t know better, I would think that she enjoyed torturing me. But this wasn’t that kind of relationship. Dineen is a petite, dark-haired, twenty-something Filipina physical therapist I’ve been working with since October 2019 to get rid of my upper back pain.

I started physical therapy because I was tired of being in pain. I suspected that my overzealous efforts to get physically stronger were the root cause of it. In February 2019, I began working with Malik, a twenty-three-year-old physical trainer, and bodybuilder at the budget gym across the street from my apartment. In addition to running, I’d been lifting weights almost daily and loved how my muscles responded to Malik’s training regimen. I decided to start working with a personal trainer just before I turned fifty last year because my parents’ sudden deaths reminded me how short life is. Also, as a Black female survivor of childhood sexual assault and race-related trauma, moving with ease and physically defending myself has always been vital for my mental wellbeing.

Part of being mentally healthy for me is being committed to not just surviving the multiple forms of oppression I face as a Black, queer, middle-aged, straight-passing woman (i.e., misogynoir, anti-Black racism, sexism, gendered ageism, and heterosexism), but also to thriving and aging well despite them. According to the World Health Organization, healthy aging is “the process of developing and maintaining the functional ability that enables wellbeing in older age.” This means being able to meet my basic needs, be mobile, build and maintain relationships, and contribute to society without too many injuries, diseases, or age-related changes.

As a U.S.-born, Black psychotherapist whose parents died before the age of sixty-nine (the life expectancy for their age peers is eighty-six years) and whose ancestry in this country goes are far back as 1834, it’s understandable that I’m concerned about my quality of life and my life expectancy. Between the two of them, my working-class parents reached the lower-middle-class status they strove for by working government jobs for over thirty years, yet they both died within two to five years of retiring. When you combine these aspects of my identity, statistically speaking, my odds of living past age seventy aren’t great; hence, why I was at the gym working out with Malik.

***
“Sorry. You’ve got a knot right here,” Dineen said ruefully as she kneaded the taut, tender muscles in my upper back.

In July 2019, Dr. Cage, a thirty-something-year-old, male orthopedic surgeon, diagnosed me with tendonitis in the top of my left bicep and impingement in my left rotator cuff. Basically, I lifted weights so often and increased the weight so quickly that my left shoulder became swollen, was hot to the touch, and cracked and ached when I moved it. It got so bad that the pain woke me up at night. In physical therapy, Dineen helped decrease the swelling by manipulating, massaging, and re-adjusting my left shoulder. The impingement went away, but early into our work together, Dineen discovered several, one- to four-inch knots in both my shoulders and under my shoulder blades. By November 2019, I developed a pain on the left side of my neck. Dineen suggested that the pain was related to the knots in my left shoulder.

Growing up with a mother who was a psychiatric nurse taught me to view medical and mental health providers as collaborators in my health and ask questions if something doesn’t make sense to me. So one day, I asked Dineen, “What causes knots to form in our backs?” I wanted to understand why I’ve had knots in my shoulders for most of my adult life. Romantic partners mentioned them when they gave me massages: “It feels like you’ve got boulders in your shoulders,” or, “Dang, girl! Whatchu been doin’?” I never knew how to answer them and usually shrugged sheepishly; I thought knots were normal to have. In between wincing and groaning in response to Dineen’s pulling, poking, and prodding, I was starting to learn otherwise.

***
When we started working together, I began to suspect that the rocks in my shoulders were connected to childhood trauma: when I was six years old, I was sexually assaulted by a stepbrother. As a result, I made myself small and hid in my room as often as possible. At age twelve, I was sexually assaulted in school by a group of male classmates. Afterward, I assumed that hiding my breasts by slouching, wearing baggy tops, and avoiding crowds would keep me safe. Over the years, I developed an unconscious habit of steeling myself before leaving the house and when in public places, always needing to sit facing the door. As a result, my posture was poor.

In response to my question, Dineen paused and thoughtfully looked down at me. “The knots build up over time from muscle contractions.”

I pondered this for a minute and then asked, “So, the knots in my shoulders are the result of habitual clenching up?”

Nodding, Dineen replied, “Yes, overfatigue of the muscle.”

Hmmm. That’s what I thought, I mused. My decades-long, physical responses to trauma (folding my body into itself, physically bracing myself) that were initially protective and recent efforts to increase my physical strength so that I could stop being hypervigilant, had harmed me and were now causing me physical discomfort. Even though the ways I uniquely responded to trauma differed from how my clients have, the results were similar: That which was once protective was now harmful and put my health at risk.

***
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately fifty-six percent of adults in the U.S. have experienced at least one type of traumatic event. SAMHSA defines individual-level trauma as the result of “an event, series of events, or set of circumstances that is experienced by an individual as physically, or emotionally harmful or life-threatening, that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual wellbeing.”

Compared to other women of color in the U.S. and after Indigenous/Native American women, Black women experience higher rates of individual-, family-, and community-level trauma. When people experience trauma—whether once or several times—many have both emotional and physical reactions to the trauma (“trauma responses”), some trauma responses decrease with time and emotional support. In contrast, others become problematic and hinder our development.

The Diagnostic and Statistical Manual, a problematic yet widely-used handbook created to help mental health providers assess and diagnose mental health issues, states that some of these reactions include, but are not limited to: involuntarily re-experiencing the event through memories or dreams; avoiding situations and thoughts that remind us of an aspect of the traumatic event; negative thoughts and feelings about oneself that arose as a result of the event; and significant changes in how stimulated or reactive we are after the event. When these reactions last for more than a month and negatively impair our ability to function, one can be diagnosed as having Posttraumatic Stress Disorder (PTSD). Ideally, support from family members and our community of origin is enough, but sometimes we need the help of a trained mental health professional to begin a process of healing and recovery.

However, systemic oppression, societal and cultural pressures have led to the “strong Black woman” ideology, convincing generations of Black women that we can’t express feelings or show vulnerability to survive in this world. As a result, many Black women won’t receive the kind of emotional support that we need—which makes matters worse.

As Dutch psychiatrist Bessel van der Kolk wrote, the body keeps score, and these emotionally-rooted physical reactions can eventually manifest as physical pain or injury. In addition to receiving physical therapy from Dineen and engaging in my religious and spiritual practices of Yoruba-Lukumi, I sought (and thankfully found) a female psychotherapist of color with whom I could work with, in my own trauma-focused psychotherapy.

The reason I chose Dineen and a female therapist of color are because as a psychotherapist; I think about trauma and Black women’s mental, physical, financial, and spiritual health almost daily because the majority of my clients are queer and heterosexual women of color (Asian, Black, Latina, Middle Eastern, and mixed-race). They contact me to address a range of concerns: anxiety, depression, low self-esteem, poor self-concept, work-related problems, loss and bereavement, relationships with romantic partners and family, and unresolved trauma.

I’ve had activists, artists, sex workers, techies, graduate students, office workers, educators, lawyers, healthcare providers, and real estate agents honor me by sharing their life stories with me. Most choose to work with me because, in addition to my skills and training, they want to work with a Black woman who understands how mental health and wellbeing are shaped by the social, cultural, and political systems in which we live. They know that my work is rooted in the fundamental beliefs that humans are resilient and that people have the capacity to change. My psychotherapy practice is informed by the study of mainstream psychology, Black psychology, social work, and West African and Afro-Latino spiritual traditions.

When I first meet with potential clients, not only do I ask about the various types of oppression they face from systems and individuals, but I also ask how they’ve survived, what their strengths are, and their support networks, because research shows that the type, frequency, and one’s experience of trauma, along with how much support one has immediately afterward all influence trauma’s short and long-term effects. I’m also a Yoruba-Lukumi priest, so I ask about their spiritual health and what their body tells them. I explore these things with them because I personally and professionally know how misogynoir, racism, xenophobia, ableism, sexism, monosexism, and other types of trauma affect Black women, our families, and our communities. Even if it is not initially named as an issue, eighty percent of the time, unresolved individual, intergenerational, and/or community trauma are at the root of the challenges faced by many of my Black female clients.

My clients and I discuss how they’ve learned to protect and care for themselves due to trauma they’ve experienced at the hands of familiars and strangers, and whether those coping skills are still useful. Usually, by the time my clients come to see me, they realize that those coping skills are no longer effective, and in some instances, are causing them harm. For one of my clients, an Afro-Latina who survived childhood sexual assault, and a rageful father who struggled with undiagnosed depression, smoking weed daily distracts her from the pain that still lingers. While she has been able to have romantic and sexual relationships, her experiences with trauma have prevented her from forming the lasting and deep emotional connection she seeks.

Another client, a Ghanaian-American woman whose father was violent with her mother and siblings (but not her), survived by striving to be “perfect” in every aspect of her life. For this woman, perfection included being “strong” (never, ever displaying sadness or anger, not sharing her feelings with close friends), being unusually distressed if she did not receive ‘A’ grades in school, being extremely particular about her physical appearance, and attempting to control every area of her adult life. As a result, she experiences undue anxiety and sadness when people or situations disrupt her plan for her life.

Several of my clients witnessed domestic violence and substance dependence as children or experienced intimate partner violence in their teens but didn’t realize the impact of these incidents until they found themselves in emotionally abusive relationships or struggling with their own substance use or misuse in adulthood. Some attempted to exercise the little bit of control they had over the one thing they could—their bodies—and developed disordered eating (anorexia, bulimia, binge-eating).

In my work with all of my clients, I use various tools that are designed to deepen their self-awareness and self-compassion and bring them long-lasting relief from their emotional distress. As a Black female psychotherapist whose background is similar to many of my clients, I recognize that mental health challenges are sometimes a normal, healthy reaction to one’s experiences of systemic oppression. As such, I use an integrative style in my approach to psychotherapy that takes an intersectional, sociopolitical view of the world and incorporates elements of EMDR (Eye Movement Desensitization and Reprocessing), family systems theory, psychodynamic theory, harm reduction psychotherapy, and writing therapy. EMDR is a form of psychotherapy that is effective in helping children, adolescents, and adults heal from trauma and other distressing events, both immediately and years later. This, in conjunction with tools from the other types of therapy, has supported many of my Black female clients’ efforts to reclaim and improve their lives.

***
One of the first things I tell potential clients is that my only agenda is to help them get to their ‘most evolved self.’ I want to support them in getting free or, at least, freer. What I mean is that although the traumatic events that we’ve experienced are not our fault, we’re often left to deal with the repercussions of them. As a result, many survivors who haven’t recovered from trauma aren’t free: free to live fully, free to breathe deeply, free to think about other things besides protecting oneself, free to feel more than pain, sadness, and regret, and free to love as deeply and widely as possible.

I continue to be amazed by trauma’s effectiveness as a weapon that isolates its survivors. Regardless of when and the types of trauma we’ve experienced–on an individual level, with our families of origin or of choice, and in our communities–our brain’s and body’s natural response to it is to retreat and withdraw within ourselves, to lick our proverbial wounds. As a result, for many trauma survivors, our very basic human need for connection goes unmet, and the trauma becomes an unhealed wound. In turn, these wounds color our perceptions of ourselves and others.

Those of us who had the right kind and amount of social support when they experienced traumatic events tend to go on with their lives without having long-term negative effects. For the rest of us, however, it is imperative that we address not only the traumatic experiences we’ve had, but also look at our trauma responses. We need to examine how we consciously or unconsciously responded to traumatic events. Then, we need to appreciate the parts of ourselves that made it possible for us to survive.

One of the main reasons that I am still a psychotherapist is because I am constantly impressed by the resilience and resistance of those who are most socially marginalized. Some of the ways that I have seen Black women uniquely resist and demonstrate resilience when it comes to trauma are similar to what my clients and I have personally done. When necessary, seeking out mental health providers who are culturally-humble and provide individual or group EMDR therapy can be very helpful in not only addressing the negative moods and beliefs and re-experiencing of trauma but also in replacing these things with positive beliefs and memories of how one survived the traumatic or distressing events.

For example, I find working with a Chinese female psychotherapist who is certified in EMDR has been healing and restorative for me; to be seen for who I am and not have to explain my cultural and spiritual background is priceless. As a result, I don’t have the additional stress of continually having to explain myself, and I’m able to focus on the ‘real’ work needed to deal with recovering from trauma. Besides therapy, being in nature is curative for me, and committing to finding time to be outside has been life-changing for me. Running outdoors, hiking in the woods, scrambling across rocks in the middle of rivers, and walking alongside the ocean allows me to reconnect with the Earth. Honoring ancestors who were previously known and unknown to me helped me recognize that the traumatic events I’ve experienced are linked with intergenerational family and community trauma.

Some of my clients undergo bodywork of all kinds, from acupuncture and acupressure to trauma-informed yoga and massage. Others practice mindfulness and meditation when negative self-thoughts creep up. Some of my clients find that writing about their story is restorative. As a creative nonfiction writer, I can personally relate to this. Many of my clients try to remember that moving one’s body regularly (dance, Zumba, Soca N Sweat, walking, bicycling, running, etc.) makes them feel better. Those with romantic partners, close family members, and friends report that talking with loved ones about how they feel when feeling reactive or re-experiencing a traumatic event helps them get grounded and feel validated.

Some Black women find that self-help groups such as Rational Recovery, Survivors of Incest Anonymous, and Codependents Anonymous provide them with a space to speak in confidence with others going through the same things, using a common language. In addition, others practice earth-based, Abrahamic, Buddhist, and West-African based religious or spiritual practices, which provide them with a sense of being connected to something greater than themselves and cared for by a higher power. All of my clients found and continue to find ways to resist the impacts of trauma and move beyond surviving to thrive.

While I’m glad that more Black people are talking about trauma—what it is, how to tell if someone has experienced it, and the usefulness of psychotherapy to address it—I believe that we also need to recognize how Black women have shown resilience all this time. It’s clear that we cannot turn to mainstream media to inform us of what’s going in our communities and our hearts. What if we were to use the various forms of social media that many of us stare at religiously to share tools for how to heal and recover from trauma or to develop new and even better-coping skills?

As a Black psychotherapist who has the privilege of working with Black women and other women of color, I have a front-row seat to the toll that surviving under white supremacy, patriarchy, and capitalism have on people, especially Black women who are survivors of trauma. These women’s fierce determination to persevere despite emotional pain, and uncertainty that change would lead to something better, inspired me to re-examine my own recovery process and personal decisions around psychotherapy and physical health. I am forever grateful for the opportunity to do this work.

All clients mentioned in this essay are composites of clients in order to maintain confidentiality and anonymity.

Photo Credit: DioBurto Flickr via Compfight cc