For so many years, being Black to me had meant, being tough, being strong and not showing any signs of vulnerability or weakness.  I would say things to myself, like “girl…you are strong, you got this.”  I would praise myself for accomplishing difficult tasks by myself without asking for help.  I thought that this was a normal part of adult life as a Black middle class person.  I wasn’t impoverished enough to get government assistance and not wealthy enough to hire paid help. 

I would watch television and watch White women and Spanish women cry and express vulnerability.  Black people often expressed anger and roughed their way through whatever it was that they were going through.  I thought that this was normal.  I didn’t believe that Black people could experience depression and anxiety.  Mental health was something that was almost never discussed.  Everyone was advised to go to church and pray about it, if they had any issues.  Keep in mind that I have nothing against the church, especially the Black church.  I believe that the church serves its purpose.  Church is a great place for fellowship, support and a source of strength.  I just know that church is not the end all be all to your mental health needs.

During the midst of my career as a social worker, I worked at an organization that, while their services were available to the general public, they primarily provided their services to the Jewish community.  I provided therapy services to persons who had been in therapy most of their lives and found it normal to see their therapist even when they weren’t in crisis.  I learned that in other communities, a therapist was just another part of their personal support system.  The kids had therapists, the parents had therapists, the therapists had therapists.  They engaged in couple’s therapy and family therapy.  Therapy was a part of their normal functioning and there was no shame nor stigma involved. 

As a therapist at that organization, I listened to homemakers with their own personal staff (nannies, cooks and cleaning ladies) vent about how challenging their lives were.  I also listened to people who were business owners or self-employed talk about the level of pressure that they were under, which was all initially very difficult for me to comprehend.  They were all seeking to create additional support for themselves as they navigated their way through life and addressed their mental health needs.  It was normal for them to request to see the psychiatrist for medication management to help them ease their anxiety and manage their mood. 

I eventually came to realize how different Black mental health needs can be.  My Black clients were often meeting with a therapist for the first time as an adult, or experienced therapy before as a child, but did not have a positive experience their first time in therapy, because they had difficulty connecting to their White therapist.  A lot of my Black clients were only seeking therapy due to a crisis and entered into the therapeutic relationship with feelings of ambivalence about being in therapy.  They held onto a lot of shame about needing to see a therapist and found it to be both comforting to see a therapist who looked like them, but also found themselves feeling ashamed to express their vulnerabilities with someone who looked like them.  They were not sure how I would respond to their tears and sadness and therefore struggled with being vulnerable in therapy.  Would I tell them that they needed to “pull themselves up by their bootstraps and tough things out” or would I refer them back to church to pray or would I tell them that “Black people don’t need therapy!!”  I think that their biggest fear of all was being referred to the psychiatrist and being prescribed medication.

I eventually got used to having Black female clients and knew that as our therapeutic alliance developed my clients would be able to trust me enough to be vulnerable in therapy.  I also got used to the idea that most Black men who were sitting in my office, had been dragged to therapy by their partners or some other women in their lives that they trusted and that I would have to work a little harder to develop a trusting relationship.  The resistance to the idea of being in therapy within the Black community was real.  A lot of my clients would spend their time trying to convince me that they were ok and feared being “labeled” (diagnosed).  They treated the idea of a mental health diagnosis like the scarlet letter hovering over them wherever they went. 

While the Black community continues to adjust to the idea that it is okay to be in therapy and actually quite beneficial, there are so many of us who have gone undiagnosed, untreated and therefore misunderstood.  So many of us were treated as though we were just acting out and therefore disciplined instead of helped.  Having the knowledge that I have today, I look back at so many people and situations and see it so differently.  I no longer see a bad kid or bad person, I see a community and families that went through trauma and are in need of help and support.

And while I know that the experiences of being Black in America can vary tremendously, I think that a lot of us have some shared experiences that shaped who we are and impacted our mental health.  I think specifically about what it means to be Black in America and the trauma that it can come with.  Being and feeling displaced, unwanted, unprotected, unsafe, misunderstood and targeted, I then have a better understanding of our challenges as a collective.  Even if you have not experienced certain things personally, to witness it and to learn about frightening things happening to a person that you can identify with can be traumatic.  Like when we learn about yet another senseless police killing of an unarmed Black man, this sends a sense of fear throughout the community.  It frightens parents into fearing for their children, especially the Black male, which then causes us to live in fear and raise our children through that fear.

I think about the experiences of Black families in America and the challenging expectations to succeed.  Black people are more likely to have limited opportunities and resources to help them to get to their next level of life.  We are more likely to be misunderstood and experience discrimination.  Studies show that Black persons who live below the poverty lines are more likely to report serious psychological distress than those of a higher socioeconomic status and Black adults in America are more likely to experience persistent symptoms of depression in comparison to White adults in America.

There are quite a few Black people who neither have health insurance nor the financial resources to afford psychotherapy.  Even when we can afford it, we weren’t raised to believe in hiring help.  We weren’t raised to trust others with our problems.  We were raised to believe that our strengths were tied to our independence and how hard we can work and how much we can endure. 

I want to shake up your belief system, just a little bit.  Black folks need therapy too and we don’t need to be in crisis to talk to someone.  Your Blackness does not need to be tied to how much you can tolerate or endure.  “Taking it to God in prayer” is only one part of the solution.  Being in therapy does not make you crazy.  Meeting with a therapist regularly, whether virtually or in-person can give you some insight and help you gain self-awareness.  Working with a psychotherapist can offer you a new perspective on things, which might just be what you need to get to your next level of life.  If you are struggling with your mental health, seeing a therapist can help you gain the skills that you need to cope and to heal.

Having a psychotherapist who is racially and culturally competent can make a world of difference with being diagnosed and treated appropriately.  Certain things just won’t need to be explained and you will be less likely to be misunderstood.