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

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

3. 3 Overview of the Presentation Racism as Trauma Lessons from Hurricane Katrina about Race and Class in disaster situations Mental Health Interventions and Disaster Response with African Americans Cultural Issues in our work with African Americans in Disaster Situations * The importance of an extended family centered perspective

4. 4 Religion and Spirituality In the lives of African Americans Extremely important in terms of spiritual resilience Healing in Times of Trauma WILL BE DISCUSSED IN MY PRESENTATION THIS AFTERNOON

5. 5 Hurricane Katrina: Disproportionate Impact on Poor African Americans Individuals from all racial and socioeconomic groups impacted by Katrina 67% of New Orleans residents who were African American and poor Disproportionately impacted by devastation of Katrina And by post-hurricane traumatic experiences Dyson, 2006; Troutt, 2006

6. 6 Impact of Race and Class on Disaster Response Poor Black People: the “Invisible” Americans Double Jeopardy of Race and Poverty The forgotten Americans Often not considered in disaster planning No plans made for Black, poor residents with no transportation Underlying Institutional Racism (Dyson, 2006; Boyd-Franklin, 2009)

7. 7 Different Perceptions of Race and Class CNN poll (Sept. 13, 2005) Katrina highlighted racial divide in this country 60% of Blacks viewed race as a factor in slow response to Katrina victims Only 12% of Whites saw race as a factor 63% of Blacks saw poverty of victims as a factor; 21% of Whites (Boyd-Franklin, 2008)

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

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

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

11. 11 Racism-related Life Events: Hurricane Katrina Extreme poverty of Black people in New Orleans’ 9 th Ward 20,000 people at the Convention Center and 20,000 at the Superdome left without food and water Overwhelming number of Black faces at both locations Many African Americans have lost their homes in New Orleans and cannot afford to rebuild.

12. 12 Vicarious Experiences of Racism Can also involve strangers, who are also African American (Harrell, 2000) Millions of African Americans watched in horror as “their People” were ignored during the Katrina disaster. Trauma of Racism Experienced Collectively

13. 13 Racism-related Psychological Trauma and PTSD Racism can be a form of psychological trauma for African Americans It involves negative, rejecting, and/or demeaning societal messages that undermine self esteem (Butts, 2002)

14. 14 African American Survivors of Katrina PTSD Some had flashbacks Nightmares Recurrent Experiences Not just of the trauma of the hurricane Also of the inhuman conditions and the racism experienced at the superdome and the convention center

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

16. 16 Challenges for Mental Health Providers Resistance to understanding our clients’ subjective experiences of racism Many African Americans may be hesitant to address these issues directly in cross- racial treatment The desire to debate the client’s perception of racism Allowing African Americans the space to express their anger at racism in our sessions with them

17. 17 Challenges During Responses to Disasters Risk re-traumatizing the client by ignoring or not recognizing their perception of racism Manifestations of racism are often subtle and can easily be denied Building Trust in the midst of chaotic crisis interventions

18. 18 Any Natural Disaster Can Be Exacerbated by the Trauma of Racism The Example of Katrina Many African Americans have experienced racism during other disaster responses The manifestations of racism are often denied by others The emotional consequences of this denial for African Americans (Boyd-Franklin, 2009)

19. 19 Cultural Insensitivity: Lessons from Katrina Lack of cultural understanding Limited the effectiveness of first responders Need to connect with African American Survivors Recruit responders from African American & other ethnic minority backgrounds (Dass-Brailsford, 2006; Law, 2006; Boyd-Franklin, 2008).

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

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

22. 22 Extended Family Issues in Times of Disaster Multigenerational family structures Elderly family members refused to leave their homes Trauma related to inability to reach extended family members during Katrina Kinship Care by elderly who also faced medical crises (Boyd-Franklin, 2009)

23. 23 Helping to locate extended family members Major Intervention to help African American families in times of disaster Establish a reliable information and contact system Online resources Phone lines for those who are not computer literate Role of the media

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

25. 25 The Concept of Home for Older African Americans Central to the concept of self The “Family Home” Haven in a Cruel world Neighborhood and Community Define Their World Value of Home Ownership “This is all I have in the world.” Fear of loss, theft or damage to their property

26. 26 Significance of “Home” for African Americans “Home” or “homeplace”= refuge in a harsh world Multigenerational “safe place” Heal from the ravages of racism, poverty, deprivation Part of the Survival skills Affirmed minds and hearts Resilience for future generations (Burton, et al, 2004)

27. 27 “Home or Homeplace” Encompassed not just the house Communities & neighborhoods Church homes Close communal network of people Multigenerational web of familiarity, safety and love ALL LOST IN THE DEVASTATION OF THE HURRICANE

28. 28 Survivors of Katrina It is estimated that 80% of African Americans, particularly those who are poor, may never be able to return to their homes. Many of the unique aspects of the African American pre-Katrina New Orleans community may never be recreated or replaced. (Troutt, 2006; Dyson, 2006; Boyd-Franklin, 2008).

29. 29 Problems with Evacuation Reluctance to leave multigenerational home Refusal to leave elderly relatives who refused to go Factors Related to poverty Lack of Transportation Lack of Money & Credit Cards No place to stay Entire family lived in disaster zone

30. 30 Losses on Many Levels Death of family members, friends, and loved ones. Unresolved mourning No funeral Deep and painful yearning for home and community Mental health and social service workers often focus on finding new homes without acknowledging the profound sadness and “soul wound” created by loss of their home. (Boyd-Franklin, 2008)

31. 31 Grief Counseling Different kinds of grief Death and loss of loved ones Loss of home and community Unresolved mourning Cultural messages to “be strong” “Tears of Strength and Love”

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

33. 33 Negative Experiences During Relocation Difficulty renting homes in new cities after leaving shelters Negative experiences for African American youth in new communities Racial Profiling (DWB) No Ability to Return Family Separated

34. 34 Cultural Responses to Therapy Stereotypes: *for sick or crazy people * for White folks * for rich folks * for weak folks *Re-label “therapy” as “counseling” * Less stigma attached

35. 35 Joining with African American Clients in Disaster Situations Be warm and welcoming Introduce yourself Do not present in a formal, rigid, “professional manner.” Connect in a human, responsive way Be “down to earth.” Be respectful Address everyone present (not just children or parents). Ask adults their names and how they would like you to address them With older African Americans avoid using their first names unless they give their permission (Boyd-Franklin, 2003)

36. 36 Guidelines for Mental Health Professionals Particularly important in cross-racial situations Perceived racism can be equally traumatic Try not to personalize the client’s response or anger This is not about you but about your client’s experience of racism Don’t be defensive Try to understand the client’s perspective Allow persons to share their stories or narratives Do not debate whether or not racism was involved

37. 37 Cautions Do not assume that all Black people will perceive racism in a given situation Do not assume that a Black client will be comfortable talking about racism particularly in cross-racial situations

38. 38 When a Black Client Raises the Issue of Race or Racism Be open Say “Tell me more about it.” Elicit the Client’s narrative or story about the experience Ask what the client was feeling when the incident occurred Validate the client’s feelings In Cross-racial situations, ask how the client feels discussing this issue with a White therapist

39. 39 Resilience of African Americans in the Face of Disaster, Trauma & Racism Historic resilience of Black People Survival Skills “This is not our first disaster and it won’t be our last.” Strengths How have you overcome traumatic experiences in the past? How have you dealt with racism in the past? Role of Religion and Spirituality

40. 40 Strength-Based Interventions Clients in the midst of disasters present first with their problems, fears, and anxieties Importance of recognizing strengths Cultural strengths Validate: “You are a survivor.”

41. 41 Importance of a Family- Centered Approach Even when working with individual African Americans Contextualize within a family and extended family After a traumatic experience Be flexible in terms of involving family members and significant others in the healing process. (Boyd-Franklin, 2003)

42. 42 Family Therapy Interventions with African Americans Culturally appropriate treatment intervention for African Americans Healing after disaster and trauma Need for collective healing Processing the Separation of the family and the fear for each other Processing experiences of racism or discrimination if they occurred (Boyd-Franklin, 2003)

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

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

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

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

47. 47 Support for Healers in Disaster Areas Support for our mental health colleagues in disaster areas Support for Doctors, Nurses and Emergency Responders Many of them were also living in trailers and had lost everything Support for ministers Teachers and counselors in schools

48. 48 Mental Health Providers Training as an Antidote to Burnout Trainings addressing issues of race Connect to mental health providers of different races and cultures Develop your own professional support system