In March, as businesses across the country closed and the death rate from the new coronavirus climbed into the thousands, Dr. Jennifer Mullan, a psychologist in New Jersey, suddenly found herself busier than usual.
"I was working triple time," she said. "I was inundated with calls from people I usually see on a weekly basis saying they needed to be seen immediately."
Her clients in New York City who don't have washers and dryers in their apartments were panicking because laundromats in the city had closed. Others were worried because they had been showing symptoms of the virus but were turned away when they sought help at doctor's offices.
Then, in May, George Floyd was killed by a white police officer in Minneapolis, launching weeks of protests against police brutality and racial injustice — and, for many Black Americans, bringing to the surface decades of racial trauma. Once again, Mullan's workload skyrocketed.
Many clients were bringing up the videos of police brutality they had watched on the news and on social media. The videos alone can be triggers, she said.
"Witnessing George Floyd screaming for his mother — that in itself can be extremely traumatic for many black-identifying Americans, because many people are saying, that could be my son, that could be my father," Mullan said.
"A lot of individuals I'm working with right now are feeling absolutely exhausted and burnt out, and consistently feeling like it is unsafe to leave the house," she added. "Breonna Taylor was murdered in her bed. That is bringing trauma. People don't feel safe in their homes. There is that constant feeling of, could I be next?"
Dr. Richard Orbe-Austin, a psychologist in New York, said he too is hearing about the police killings from his clients.
“It is something that has been indeed very triggering,” he said. “Some of my clients have talked about the pain of seeing (those killings) and how it triggered particular feelings of anxiety and fear, or their own experiences of being stopped by the police.”
What is racial trauma?
Racial trauma is the cumulative effect of racism on someone's mental and physical health.
That includes direct acts of racism such as hate crimes or being discriminated against at work; systemic racism, which includes health disparities, pay inequity, lack of diversity and more; as well as microaggressions, which are more subtle acts of racism in the form of comments or questions that often perpetuate racial stereotypes.
Add all that to the recent police killings as well as the COVID-19 pandemic, which disproportionately affects African American communities, and therapists aren't surprised that this moment in time is having a profound psychological effect on their Black patients.
What does racial trauma look like?
Racial trauma looks a lot like post-traumatic stress disorder, therapists said.
"The symptoms of PTSD are similar to how the trauma of racism shows up in people," said Brittney R. Cobb, a licensed clinical social worker in North Carolina, who runs the Instagram account @ablackfemaletherapist.
That means irritability, low self-esteem, poor concentration, feelings of hopelessness, fatigue, anxiety and depression. And that psychological stress in turn can lead to physical health problems — hypertension, heart attacks, diabetes and obesity, for example, which are all disorders that disproportionately affect Black people.
Part of what therapists are doing is helping patients simply identify their own racial trauma and where it comes from.
“I think a lot of people might not understand that this is part of a larger system of systematic oppression,” Mullan said. “I really take time to break things down in tangible ways and say, ‘This is what historical trauma means.’”
There is always a bit of anger and trauma underneath the surface for many people of color.
“When we talk about racial trauma, we think of present-day occurrences,” she added, pointing to the police brutality and the coronavirus pandemic. “But what we’re not always considering is the intergenerational trauma, the cumulative effects of slavery. How it gets passed down, and how it directly affects the sense of well-being. There is always a bit of anger and trauma underneath the surface for many people of color.”
Children are feeling the pressure, too
Young people can also experience race-based stress. A recent study found that Black adolescents on average experience racial discrimination more than five times a day, often online in the form of microaggressions, and that this is associated with an increase in depressive symptoms.
Orbe-Austin also pointed to school resource officers as potential stressors — although many schools have been reconsidering their relationships with police in recent weeks.
“Many elected officials hide behind this notion that having police officers in schools leads to safety, but having police officers in schools is another form of trauma,” he said. “Children feel they are being policed in a learning environment, which is not healthy emotionally or mentally.”
Cobb, who works primarily with children and their families, is seeing heightened stress among her teenage patients in particular. Recently she spoke to the mother of a 13-year-old boy about how he should behave if he is approached by a police officer and how to manage his anxiety about the possibility of that happening.
“He received a shot today in the clinic and was as sensitive and nervous as any other 13-year-old boy would be,” she said. “And although we see him as a Black, gentle boy, the world may see him as a threat.”
How to cope with it all — and stay engaged
Therapists understand that many people are struggling to balance taking care of their own trauma with supporting the greater cause — going to the protests, posting on social media about racial injustice, growing the Black Lives Matter movement. But they all say it’s vital that people take care of their own mental health first. That means getting enough sleep, eating well and exercising. In moments of anxiety, simple tools such as journaling, meditation or just going outside can go a long way.
“One of the first things I ask people is, ‘Do you know how to practice deep breathing?’” Cobb said. “We do grounding techniques to bring mindfulness into the body. Visualization techniques — think about what your favorite place is and use all five senses to put yourself in that space.”
On the flip side, people who feel hopeless or powerless may find that activism in itself is a great coping tool.
“Being able to activate agency is critical — doing things that allow you to feel like you are activating change,” Orbe-Austin said.
Mullan pointed out that, for those who feel safe doing so, protesting can be a great way to release anger.
“Anyone who has been to a protest knows how healing that is and the goosebumps that pass over your body when you’re with hundreds of other people asking for peace and justice,” Mullan said. “That is a beautiful release of rage for many people.”