It was 7pm in my apartment situated just south of Boston where I have spent much of the recent months participating in antiracism efforts largely rooted in the tragic murder of a Black man. As I sat down in my red office chair to await the start of a psychoanalytic discussion on racism, I attempted to firmly embody the power and passion its color evoked. I made a point to glance at the wall art hanging just to the right of my Zoom frame, a necessary ritual. Shown on the canvas is a black woman, a crown of natural curls adorning her head, seated beneath the words “know your worth, then add tax.” Somewhere deep in the recesses of my mind, the words felt both comforting and mocking.
She had been in this moment before and she knew that this invitation to speak on racism would stir up a trauma response that White racial others rarely recognize. She knows that many of these meetings have harmful impacts though are well intentioned. She knows that good intentions do not make the re-exposed wounds hurt any less. She knows that my scripted role requires self-harm to occur in service of aspirational goals for an antiracist reconstruction of racist structures. She knows I do not have a real choice in the matter for there is much work to do to reimagine antiracism in the field of medicine.
As I logged into the meeting, I customarily counted the visible faces of minoritization and hoped I would at least make use of one entire hand. Though not a guarantee, minoritized persons in the meeting usually signal a shared labor and sometimes a potential rescue once pinned against the wall on the stage of my re-traumatization. Out of more than fifty squares on the screen, there were a few faces representing safety and I secretly hoped we would meet more intimately in a breakout room. I was thankful for their activated cameras or profile photos and I could almost sense their keen awareness of their otherness. I sent a customary private message to my closest colleagues to ensure they knew I was glad to be in a space with them. I then settled back into my chair to enjoy the early meeting moments before the stage presented itself.
As a community psychiatrist, trauma is the bread and butter of my specialty though its racial forms are the neglected stepchild in the field. Thus, I didn’t recognize it in my own body until my professional development as a psychiatrist led to crossing paths with experts in race based traumatic stress. Trauma and I were long time acquaintances who didn’t recognize each other openly. That is, until we bumped into each other repeatedly in these spaces so much so that it became almost silly not to say “Hello, don’t I know you from somewhere?”
My trauma response arrives in the now familiar form of shallow breaths that make it hard to speak comfortably and a distinct tension in the majority of my muscles that can be hidden well under the Zoom gazes. A fly on the wall during these meetings might observe that I clench my fists and sit in the chair with my legs and feet positioned as if almost prepared to run at the earliest sign of danger. The anticipatory anxiety and fear of my upcoming role results in a hyper vigilance that makes small talk nearly impossible. How can others in the room not feel as I do? Are they not aware of my star role in otherness and its consequences? I can not bring myself to discuss the weather when my body’s alarm signals are on full alert.
During these meetings on racism, I experience guilt at what can seem like too high of an expectation for others to fully see me and a parallel shame at my inability to relax. Ultimately, I begin to feel impatient and make efforts to reduce my irritability by checking emails, browsing social media and, when lucky, enjoying my toddler daughter’s play in between glances at the screen. I have somehow convinced myself that multitasking can solve this trauma problem. Deep down, I know all too well that is not how trauma works. What is it that I tell my patients, again?
The speaker had finished and it was now time for the breakout rooms. This usually feels like a cruel game of chance and with ingrained muscle memory, I crossed my fingers and toes that it would be a game I win this time. Once in the breakout room, I smiled at the recognition of a senior Black psychiatrist and felt a bit more relaxed in my seat. The rescue cavalry was here, I thought, as a visible sigh of relief betrayed my calm exterior.
Our group prompt was to discuss our first moments of racial awareness. These discussion prompts, which inevitably make front and center the experiences of the racialized other, are painfully common. Despite a lived and learned expertise in the matter as a BIPOC, these activities are assumed to be beneficial to all present. It is rare for the White group members to arrive with a racial awareness that recognizes the stage we stand on and the subtle power dynamics that make some roles optional and others required. This question asks of me to pour out of a cup that is already empty, yet, I signed up to be here, right?
I sat silent awaiting the nearly predictable responses of the two White women in the group. Unlike others in the Zoom room, I had sat through this scene many times before. I have also read extensively on White racial socialization as a scholarly interest and act of self-preservation. Each White woman shared briefly recounting their racial experiences in adolescence filled with themes of innocence, shame and guilt. The second White woman jolted me into performing with an innocent yet pressured inquiry of “well what about you? You mentioned you were from the southern U.S., you must have experienced racism there?” Her curiosity compelled my mouth to open before my brain could even register the warning signals.
I listened to myself share a trauma that occurred when I was 12 years old. I listened to myself share a trauma in a space with strangers who I could not guarantee would be the proper care takers for it. I re-experienced all of the consequences of re-traumatization behind an exterior that was communicating signals the room could not read. When it was over, I sat through their expressions of horror at what was standard racism for those who possess bodies like mine. I was ashamed. I learned the lesson again that I had not yet learned my worth let alone added the tax necessary to demonstrate my inherent value by setting boundaries in these spaces.
The re-experiencing evoked by lack of preparation in groups discussing racism is shaving years off of my life. I have feared since the first year of medical school that my telomeres may be unable to shorten any further. Yet, here we are in the moment of racial reckoning, stumbling through the work of antiracism with little attention paid to the toll it takes on bodies like mine. When is enough, enough?
We must decide that these experiences of BIPOC represent an urgency worthy of a pause in the work. We must reset and consider how lack of a trauma-informed approach to collaboration and coalition building is harmful to the very persons who are often times championing the work. While the approach is typically considered in the creation and modification of existing clinical services, it would be prudent for organizers and participants to consider its principles in spaces organizing around racial justice.
Four R’s of a Trauma Informed Approach to Antiracism (adapted from SAMHSA TIC Recommendations)
All present should have a basic realization of racial trauma and understand how trauma can affect families, groups, organizations, and communities as well as individuals.
Example: The meeting materials can include an introduction to race based traumatic stress and the potential for harm to occur, even unintentionally. Participants can be required to view these materials prior to attendance.
All present must be able to recognize the signs of trauma.
Example: An overview of racial trauma responses can be highlighted including emotional reactivity so that participants can properly interpret both verbal and non-verbal cues
The program, organization, or system should have the capacity to respond to trauma by applying the principles of a trauma-informed approach to all areas of functioning, including facilitated discussions and trainings.
Example: All those involved in coordinating and implementing antiracism efforts should undergo training on trauma-informed approaches to coalition-building and facilitation
A trauma-informed approach seeks to resist re-traumatization thus leaders and participants should be weary of inadvertently creating stressful or toxic environments for BIPOC
Example: Proactive measures to avoid re-traumatization, including empowering participants to exercise voice and choice on how much to share, should be emphasized
First, understand and prepare for the reality that trauma is a difficult phenomenon that evokes emotional reactivity. Second, recognize the signs of a trauma response in its diversity of forms including non-verbal cues. Third, ensure safety is available psychologically and physically for participants, especially those who are BIPOC who take great risk in sharing the reality of their experiences.
Finally, take great care in allowing participants to exercise their voice and choice during the gathering. The invitation to the lead role in these gatherings is often implicitly offered and understood to be implicitly required as a BIPOC in a space with White people discussing racism.
My worth is woven into the words on this page. My story is representative of the silent suffering that is occurring during antiracism work in spaces ill-prepared to convene safely. Those BIPOC participants can and must be taken care of as we labor to disrupt racist structures that would just as soon destroy us rather than bend to our collective will.