Being a ‘Strong Black Woman’ & Our pain

April 23, 2019

black woman in blazer looking out window

The mind and body are connected right, so here I am talking about our physical health and medical treatment. Increasingly in social media articles & videos we have seen more about the experiences of Black women and our health. Celebrities such as Serena Williams & Beyoncéshared their traumatic childbirth experiences. As a result there has been more exposure about the significant disparity of Black women dying in childbirth & Black infant mortality. A video circulated about Judge Glenda Hackett’s son testifying to Congress about the death of his wife shortly after giving birth to their second son after pleading with staff for hours that something was wrong as she  was dying from internal bleeding. A few months ago Kim Porter passed away due to complications of pneumonia at 48 years old, although it was reported she was under the care of a physician for weeks prior to her death. And what we know is that these disparities are not due to the factors that often impact access to care such as socioeconomic status and lack of insurance coverage. It is healthcare racial bias.

The common theme of many of these stories is that many health care providers health care providers do not believe Black women when we say we are in pain. Although physical pain is a subjective experience research has revealed that some health care providers believe that African Americans have a higher resistance to pain, either do not offer pain medication at the same rate as white patients or assess African Americans pain level as less than White patients. Psychologist Dr Joy DeGruy discussed in her book, ‘Post Traumatic Slave Syndrome’ that culturally the majority population had to have ‘cognitive dissonance’ to see African Americans as less than human and desensitize our pain in order to justify slavery and our treatment as second class citizens.

As a counselor who regularly receives referrals from and has collaborated with physicians in the treatment of my clients I have learned that we can minimize our symptoms, pain, or general sense that something is ‘off’ with our bodies. We often take on The Strong Black Woman (SBW) persona, which signifies “strength and self-sufficiency”. The SBWdescribes a Black woman who is more resilient than others, being a caretaker for others while overlooking her own needs, and able to overcome most obstacles. These characteristics are often perceived as inherent to being an African American woman and being anything less than would be considered weak. African American women may embrace this personification, but it also may make us vulnerable if we are not expressing the full range of our experience  to those who are entrusted with our healthcare.

While there is work being done on the advocacy side, unfortunately it has to be our responsibility to ensure our voices are heard in order to save our lives in many cases. We must bridge the gap between what we are expressing and how that is perceived to our health care providers. Here is what you can do to ensure that your healthcare providers can best help with your mental and physical health:

*Have doctors you like & trust-I have strongly encouraged clients to switch physicians if they did not feel listened to by their doctors. Yes you can switch doctors if you feel rushed or dismissed. Acknowledge if cultural competence is important to you and you prefer a provider who understands your culture. This is easier done in cities like Atlanta where I live, but take the time to find a physician who is a good fit for you. And if you mention you have been struggling with anxiety, depression, difficulty sleeping they should be able to provide you with a referral for mental health counseling, not just medication.

*Explore your own comfort level in expressing pain-physical & emotional. We are known for being ‘SBW’, which can be adaptive when it comes to taking care of our families or pushing through obstacles at school or work, but it’s unhealthy to operate in chronic stress which makes us vulnerable when we are struggling and it actually weakens our immune system. We must be honest with ourselves about our symptoms or when something doesn’t feel right. We need to be assertive regarding our healthcare needs with our health care providers. Use the 1-10 pain scale to describe any pain and keep a journal of symptoms to tell the doctor. This also helps you see your symptoms as real and you are less likely to minimize them.

*Explore your past trauma related to the healthcare system & lack of trust. Many of us know there is a general distrust by the African American community of the healthcare system due to events like the Tuskegee experiment. But our own fear can be much more personal, such as learning of a serious health diagnosis, like a stroke or heart attack, miscarriage & perinatal loss, or STD (sexually transmitted disease). Physicians may not think to refer their patients for mental health counseling for these issues so be honest with yourself if you have avoided going to the doctor out of fear & avoidance. Establish a relationship with a counselor to recover from past trauma which affects us mentally and physically.

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