Last Friday, February 26, 800 people filled the Laguna Honda Hospital & Rehabilitation Center in the beautiful Twin Peaks area of San Francisco. They were there for a Black History Month event coordinated by the San Francisco Health Network. The event featured presentations from two outstanding clinicians: Dr. Joy DeGruy, researcher, educator, and author of Post Traumatic Slave Syndrome: America’s Legacy of Enduring Injury and Healing; and Dr. Ken Hardy, professor at Drexel University College of Nursing and Health Professions, and director of the Eikenberg Institute for Relationships in New York City.

The full conference title was: 

Racial Trauma: Healing Ourselves, Our Clients, & Our Communities: Addressing the aftermath of historical trauma and today’s societal need for racial humility

Dr. DeGruy framed the day’s conversation when she drew a compelling correlation between the DSM V (Diagnostic and Statistical Manual of Mental Disorders) criteria for Post-Traumatic Stress Disorder, and the experiences that have defined life for African Americans in the US for 400 years, from enslavement through today’s epidemic of disproportionate state violence and incarceration plaguing the African American community.

With this correlation, Dr. DeGruy made a strong, clear argument for why race and racism need careful consideration by ACEs communities as we attempt to address and remediate trauma. Effective strategies for screening for adverse childhood experiences, as well as strategies for building resilience, will need to account for how racism traumatizes communities. And these strategies will necessarily need to adapt to the unique ways different communities experience racism.

“Truthfulness is the foundation of health. It is secrets that make us ill"

Dr. DeGruy’s presentation turned on a central theme: that part of the reason people struggle to heal from racial trauma, why generations continue to have trauma inflicted upon them, is that American society has been unwilling to truthfully address its history of racism. Her book, Post Traumatic Slave Syndrome, as well as her body of work and presentations to wide-ranging, global audiences, attempt to fill this gap by providing historical details which most Americans have never learned. Dr. DeGruy discussed how the silence around racism, and the work it takes to maintain that silence, impacts both victims and beneficiaries of racism alike. In the context of anti-black racism in American society, Dr. DeGruy notes that white Americans have had their ability to feel and to empathize, impaired. This impairment needs to be acknowledged, addressed, and healed. The pathway to this healing is to embrace historically accurate knowledge. When there are secrets, no one escapes unwounded.

The implications for those who serve as providers to society’s most vulnerable communities -- those struggling with a variety of forms of trauma -- is that providers must work to break down that clinical distance, for the sake of their clients’, as well as their own, health. Dr. DeGruy advised, To systemically traumatized communities, relationship is more important than traditional, distancing clinical "rapport". And that stance of distance is equally harmful to providers who have not reckoned with the historical trauma of racism.

"Invisible Wounds of Trauma"

Dr. Hardy’s message was just as powerful. He focused on the “invisible wounds of trauma” that science shows send many African Americans to an early death. He believes that learning to talk about the pain of racism could literally save lives. His message of the day was to help African American communities find their voice. 

Dr. Hardy issued a strong public health argument for addressing the trauma of racism at the individual level. He has observed in his clients over the years, that the constant wounds of racism, the assaults on dignity, the continuous energy expended to find ways to circumvent the effects of racism on one’s life, create wounds that manifest as mental health diagnoses. He has also found that when people are en/abled to talk about these experiences of racism, they find relief from their distress.

This was a phenomenal insight, one that links right to the root of the original ACEs work. Dr. Vincent Felitti found that having people fill out an extended bio-psycho-social questionnaire and then having a nurse-practitioner talk with them about their ACEs at their first visit, was enough to reduce ER and physician visits. Just the acknowledgement of their trauma, as well as the ability to have another person listen without judging, was healing. Later research found that this effect persisted over years. If we are to accept that racism traumatizes, then we must find ways to provide the interventions necessary to reduce and heal that trauma.

Both Dr. DeGruy and Dr. Hardy observed that this traumatization of African American communities -- unbroken since Africans were first brought to these colonies, until today -- has gone without therapy to address and remediate the trauma. Dr. Hardy stated, “When you’re dehumanized, there is no expectation that you even need healing”.

This painful truth becomes a powerful starting point for ACEs work: to teach the clinical, policy, and practice worlds that there is, indeed, a need for healing.

Click here for the storified live-tweets from the conference.

For more on this event, go to ACEs Connection member Alicia St. Andrews post at: https://www.pacesconnection.com/...ble-wounds-of-trauma