Question 1

Can you explain how racial stress has a transdiagnostic effect on mental health?

Broderick Sawyer · Accepted Answer

The traumatizing stimuli or stressor (racism) is a dominant, largely unconscious global philosophy, and touches every aspect of daily life for both people of color and white people. The idea and philosophy of racism is that white people are more human, or more ‘deserving’ of compassion than people of color. White supremacy roots itself deeply into the physical and psychological experiences of people of color by touching all aspects of daily life. Racial stress dynamically and energetically exacerbates lifetime stress in people of color not because of white supremacy alone, but because of the normalization of white supremacy. An important point on racism as a stressor, is that the behavior that causes racial stress and trauma is globally normalized and often unpunished. This very sanctioning of racist behavior is what allows it to be such an expansive, all-pervading stressor. In this way, racism can certainly exacerbate stress and push the ‘stress threshold’ in people of color with psychiatric diagnoses, leading to an exacerbation in symptoms (across diagnostic categories). Therefore, it is best to frame racial stress as a culturally normalized stressor which adds significant lifetime stress, and is further exacerbated by said global normalization, via gaslighting victims of racism (that is, experience of racism as an everyday stressor, with global narratives of a ‘post-racial’ society).

Question 2

What are core symptoms of racial stress that therapists should be aware of?

Broderick Sawyer · Accepted Answer

Racial trauma is less of an individual disorder with individual ‘symptoms’, and better framed as normal reactions to the harm of global white supremacy. A primary difference between post-traumatic stress and racial trauma is that racial harm is ongoing. For someone who is combating ongoing harm, emotions like fear, anger, and sadness are not pathological. In this way, we want to help our clients protect their mental health from racism, not label their healthy survival instincts as ‘pathological’. When treating racial trauma it is best to focus on value-aligned behavior, self-soothing skills for particular emotions, and self-compassion, as opposed to our traditional focus on diagnostic categories. For example, fear in the context of racism is helpful – it sends a message of ‘not safe’ to clients. Guiding clients in a process of self-knowledge and empowerment, we can help them prevent racial stress by effectively engaging in and listening to the wisdom of their natural emotional responses. In developing a relationship with clients, work to understand their lived experience and reported current and lifetime stressors, including racism. That said, here are several  emotional/mental survival responses to racism commonly experienced by people of color. Severity in this case is highly contextual, with people of color having varying levels of a systemic understanding of racism, different coping skills, and different points of emphasis in their preference for healing. At times, a client’s rage, grief, or fear may promote helpful solutions to racism and connect them to their authenticity: Fear of racism happening again, leading to attempts to control one’s inner or outer environment (that is, adaptive/non-adaptive avoidance, numbing, hypervigilance). Sadness, grief, hopelessness and despair that racism will never stop. Low self-esteem following repeated discrimination. Overwhelming rage towards past and potential perpetrators of racism.

Question 3

Intergenerational trauma is worldwide. What would be your best advice when working with indigenous people who are traumatized and trying to find answers?

Broderick Sawyer · Accepted Answer

The process of healing intergenerational trauma within individuals is rooted in the wisdom of non-duality, self-compassionate presence, and mental ‘one-pointedness’. Thus, we can build certain skills that decenter internalized white supremacy, without the need to leave the culture of white supremacy. The path begins with the acceptance of a tough, non-dual ‘trialectic’: racism will not stop anytime soon;  non-white people cannot be completely emotionally open without risking harm; and despite this, achieving value-aligned contentment with one’s life is completely possible. Sadly, the non-white global majority will continue to be traumatized by racism until global systems change. Rather than continue to internalize and experience racial stress on white supremacy’s terms, the following suggestions are designed to increase empowerment, resilience, and self-contained wellbeing. The first step is to cultivate feelings of empowerment and self-compassion, by increasing feelings of personal control over one’s mental and emotional wellbeing. This is accomplished with a daily ‘cleansing’, through the adoption of a daily practice in mental health hygiene. Racism is an aggressive, persistent stressor, so we must be equally persistent in our wellbeing practices. By developing awareness of what personally nourishes or depletes our energy and wellbeing, choosing nourishing relationships, hobbies, foods, and work environments becomes easier. This practice is also enhanced by practicing present-moment attention throughout the day to increase nourishing decision-making, by ‘sensing’ the quality of each moment with mindfulness. Now that wellbeing has been cultivated and is practiced as a daily life philosophy, a form of ‘psychological armor’ has been built, and is being maintained by our newly created habits. To further maintain this armor, we can then choose outer environments that reflect our inner self-compassionate one, limiting internalized racism by intentionally limiting contact with racism when possible. White supremacy promotes a negative image of non-white people by creating racist environments. This can be counteracted by choosing environments that reflect a positive image of ourselves. While it is not currently possible to stop others from racially traumatizing us, we can live from a place of value-aligned self-compassion, pay intimate attention to ourselves and decision-making, and not cause our own suffering, wherever possible.

Question 4

How can white clinicians help historically oppressed clients without perpetuating more harm?

Broderick Sawyer · Accepted Answer

The essence of the challenge most white clinicians have when helping historically oppressed clients, is a lack of conscious awareness of the psychological conditioning that white supremacy creates. Most white clinicians who cause harm are not consciously aware of the racist attitudes and generational conditioning they hold. As clinicians, we are taught to see ourselves as unbiased, but the truth is that being unbiased is an everyday, every moment practice. Just like male clinicians working with women, white clinicians working with historically oppressed groups must work hard to understand white culture and monitor one’s own triggers, aggression, and stress while in session. There is deep, unconscious, and culturally ‘normal’ countertransference that white individuals have towards the non-white global majority that appears in the therapy room, and it must be constantly attended to. In the context of therapy, the primary unconscious conditioning that promotes harm for white clinicians is the unconscious attitude that white people are more ‘human’ and ‘deserving’ of compassion than non-white people. It can be difficult to be consistently aware of such strong, generationally-normalized countertransference without intentionally building two skills – attention and embodied self-compassion. By helping the clinician focus on the present moment with a relaxed, flexible, self-soothed presence, aggression and fear-based behavior is limited, and compassionate attunement is increased. In this way, it is possible to ‘override’ the generational white conditioning of having less empathy for people of color. In essence, the job of white clinicians is to embody a particular state of inner awareness and wellness as a form of harm reduction. Racist behavior thrives on a lack of compassionate attunement to the present moment, preventing emotional awareness of harm done to others. This requires that clinicians maintain an ongoing level of emotional sensitivity to the present moment. Further, without self-compassion, shame may result when white clinicians commit unconscious racist harm. Without self-compassion, shame can spiral, increasing fear that we might make another mistake, thereby motivating us to either criticize ourselves and become self-focused in session, or downplay our mistakes (clinician avoidance), both of which harm historically oppressed clients. When we aren’t attached to the present moment from a place of self-soothed regulation, it makes it more likely that our unconscious conditioning drives our behavior rather than the compassion needed in the present moment.

Question 5

What does Eastern philosophy have to say about racial trauma and healing?

Broderick Sawyer · Accepted Answer

Eastern philosophy would say that we have developed a ‘conditioned relationship’ with skin color, such that we categorize and have opinions about people automatically because of that color. At some point in history, white, European culture developed the philosophy that abstract cognitions, or thoughts, are better indicators of reality than the present moment. This style of relationship with the world makes it difficult to see things as they are, and increases denial and dissociation by over-identifying with more mental abstractions that are more pleasurable than the present moment. By relating with reality in this way, if the present moment is upsetting or I am at fault for my behavior, I can create and identify with a new, more pleasant story than what is in the present moment. Based on this logic, when one harms another with a good ‘reason’, then the actual harm being done does not ‘exist’. In essence, Eastern philosophy might see a basic misunderstanding of reality, as in, abstract thoughts, words, and descriptions, are not the same experience as the present moment. By over-identifying with thoughts, we identify with ideas about reality, not reality itself. When we are not attached to the present moment, we are also not attuned to our own suffering or that of others. This puts us at risk of harming others, or internalizing the abstract ideas that others give us about ourselves (such as internalized racism, internalized sexism, internalized oppression). Global healing for all in this context would be a matter of first sorting this misunderstanding out through practices that bring us into the present moment, until we can sense the difference between our minds and the moment. Compassion also develops, because when we enter the uncontrollable present moment and experience disappointment and suffering without looking away, compassion becomes a reflex – it becomes common sense. A person of color who can sense their own suffering in the present moment might have an easier time navigating racial stress because they can ‘sense’ the people and environments that cause it. A white person who can sense their own suffering in the present moment is less likely to deny their stress and project it onto others, and is more likely to sense and attune to the suffering of people of color. I’d also say that other forms of oppression (such as patriarchy, homophobia, and so on) have the same cross-psychological dynamic.

Question 6

How can meditation help clinicians and clients connect deeply with themselves and others to achieve a truly egalitarian society and clinical practice?

Broderick Sawyer · Accepted Answer

Meditation is the art of tuning ourselves to the present moment, instead of thoughts, likes, dislikes, beliefs, opinions, or fears. If everyone saw reality as-it-is, beyond thought forms and projections, an egalitarian society would be realized, because the solid-truth of compassion and interconnection would be realized. Our thoughts are subjectively rooted in language, serve as a barrier between our suffering and that of others, and sometimes our thoughts serve as a barrier between ourselves and our own suffering. We cannot soothe suffering we resist or look away from, and in that way, awareness and personal experience of suffering is the catalyst that transforms compassion into a reflex, instead of a ‘good’ idea. Compassion is not a mental philosophy that is practiced, it is realized as the most sensible approach to life. Through meditation we become aware of this logic by becoming sensitive to the way reality and suffering works inside of us. This begins by sitting intimately with ourselves, and then by maintaining an intimate awareness of ourselves throughout all of our activities, we see how our inner resistance and lack of self-compassion creates harm for ourselves and others. Over time, our bare attention guides us to the truth – everyone experiences the pain of change, frustration, loss, and each moment we can decide to make the pain of existence worse by resisting it, or soothe pain with compassion. This realization moves further, because the more aware we are, the less we see aggression and resisting reality as helpful in solving the problem of suffering. Meditation, as originally intended by various Eastern cultures, is a tool to increase our capacity to see reality as-it-is, beyond personal or social projections. Meditation functions to make one more receptive to reality, and less receptive to what one’s thought-forms or cognitions say about reality. The primary barrier to living in the present moment is a combination of two globally-dominant philosophies – thoughts are more important than the present moment, and it is better to direct attention toward thoughts instead of the present moment. Retooling these philosophies with meditation is accomplished traditionally by a formal practice of focusing on one point in the present moment and softly pulling one’s mind away from thoughts, or letting go of all focus completely. With practice, our behavior is no longer guided by our thought-chatter, but by our attention. With enough attention, we experience the tenderness and sadness related to impermanence, pain, and frustration in the present moment. This experience of tenderness then tunes us into the cycles of the heart, rather than the mind; this happens not as a choice, but as conviction, based on seeing what is.

Race-Based Stress and Trauma