A Psychological Approach to wellness: SUMMARy III

Photo by Alex Green

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

Summary III PART FOUR:      The Imprint of Trauma

In this section, chapter eleven, Van der Kolk addresses the problem of recurrence. He writes: “Whether we remember a particular event at all, and how accurate our memories of it are, largely depends on how personally meaningful it was and how we felt about it at the time.” (van der Kolk, 2014, p. 177) He briefly takes us back to Section II, Chapter Four, where he first gave us the physical structure of the brain (the limbic system and brain stem) and how memories are transmitted and stored. When examining the literature, he learned that it was in the late nineteenth century that medicine first began the systematic study of mental problems, and that the physiological and neurological effects of what was labeled as hysteria(a mental disorder characterized by emotional outbursts, susceptibility to suggestion, and contractions and paralysis) drew intense study. Jean-Martin Charcot, Sigmund Freud, and Pierre Janet were pioneers in the field. They helped to develop treatment approaches that enabled traumatized patients to reproduce repressed and fragmented memories through acting them out as a way of creating a narrative from which they could begin putting into words what they had experienced. According to Freud and his Viennese mentor, Josef Breuer, “Recollection without affect almost invariably produces no result.” This discovery became the origins of the “Talking Cure” or modern-day psychoanalysis, and psychotherapeutic (CBT) approaches. (van der Kolk, 2014, pp. 183-184)

One of the things that has helped to garner international attention to trauma is the aftermath of war. In chapter 12, van der Kolk describes how, in both Europe and America, the military and their respective governments were forced to examine trauma’s impact on the soldiers who fought in them. The recognition was slow. He writes: “Denial of the consequences of trauma can wreak havoc with the social fabric of society.” (van der Kolk, 2014, p. 188)

Van der Kolk recalled an experience that I identified with during my years at the VA. He writes: “I was puzzled by that the vast majority of the patients we saw on the psychiatry service were young, recently discharged Vietnam veterans, while the corridors and elevators that led to the medical departments were filled by old men. Curious about this disparity, I conducted a survey of World War II veterans at medical clinics in 1983. The vast majority of them scored positive for PTSD on the rating scales that I administered, but their treatment focused on medical rather than psychiatric complaints. These vets communicated their distress via stomach cramps and chest pains rather than with nightmares and rage, from which my research showed they also suffered. Doctors shape how their patients communicate their distress: When a patient complains of terrifying nightmares and his doctor orders a chest X-ray, the patient realizes that he’ll get better care if he focuses on his physical problems. Most of these men were extremely reluctant to share their experiences. My sense was that neither the doctors nor their patients wanted to revisit the war.” (van der Kolk, 2014, pp. 189-190)

My own experience was similar to van der Kolk’s. I witnessed this same phenomenon during my time at the VA. It made perfect sense. As noted by van der Kolk, this disparity would play out over the years until research in the mid-1990s confirmed the seriousness of mental illness among the veteran population and the public’s acknowledgment that both men and women who returned home post-deployment were not the same. I know in retrospect that the stigma of a psychiatric diagnosis was a massive threat to the future of these young (WWII and Korean War) veterans who still had much of their lives ahead of them. Prior to the 1990s, average Americans had limited experiences with post-traumatic stress, and often didn’t know how to respond to friends and family members who had suffered from combat trauma. This experience often led veterans to disassociate and deny their symptoms in order to avoid becoming stigmatized and estranged from the important people in their lives. Many who returned home brought the war home with them.

It wasn’t until I became an adult that I understood how my own father, who fought in World War II and was also a Prisoner of War, was impacted by trauma. He was never diagnosed with PTSD. However, he had the classic symptoms: nightmares, depression, irritability, detachment, and estrangement from others. He also had physical wounds and chronic medical diagnoses resulting from being severely wounded and cold injury exposure. I remember a couple of times, as a young boy, asking my father about his military experiences. He talked only about those experiences that he felt good about. He never talked about his nightmares, his imprisonment, his treatment, or his fears. I quickly learned that these subjects were not open for discussion. And much later, I realized that many of these memories were repressed, buried, and forbidden topics, without a narrative to explain them.

When speaking about an independent study van der Kolk conducted with several colleagues in 1994, he describes normal (positive) versus traumatic memory by noting the following distinctions: “There were two major differences between how people talked about memories of positive versus traumatic experiences: (1) how the memories were organized, and (2) their physical reactions to them. . . Remembering the trauma with all its associated effects does not. . . resolve it. . . finding words to describe what has happened to you can be transformative, but it does not always abolish flashbacks or improve concentration, stimulate vital involvement in your life, or reduce hypersensitivity to disappointments and perceived injuries. (van der Kolk, 2014, pp. 195-196)

Van der Kolk concludes this section by stating the following: “The essence of trauma is that it is overwhelming, unbelievable, and unbearable. Each patient demands that we suspend our sense of what is normal and accept that we are dealing with a dual reality: the reality of a relatively secure and predictable present that lives side by side with a ruinous, ever-present past.” (van der Kolk, 2014, p. 197)

Summary III PART FIVE:      Paths to Recovery

In this final section, van der Kolk focuses on the process of healing from trauma. He opens with a sobering statement: “Nobody can treat a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of the trauma on body, mind, and soul.” (van der Kolk, 2014, p. 205)

He first outlines what that means in summary form, then in greater detail. He says that trauma robs us of what he refers to as self-leadership, and the challenges to self-leadership: “feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed, or collapsed.” (van der Kolk, 2014, p. 205)

Recovery is measured differently for each person. However, in general, it embodies the following four characteristics:

(1) Finding a way to become calm and focused.

(2) Learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past.

(3) Finding a way to be fully alive in the present and engaged with the people around you.

(4) Not having to keep secrets from yourself, including secrets about the ways that you have managed to survive.

This four-step process is not linear but rather holistic and creative, incorporating these approaches in a multifactorial manner with overlap and repetition. (van der Kolk, 2014, p. 205-206)

The true extreme states that prevent recovery are (1) hyper-arousal or (2) shutdown. Learning to avoid extremes involves restoring executive function, self-confidence, and the capacity for playfulness and creativity. (van der Kolk, 2014, p. 207)

Van der Kolk identifies somatic and non-somatic therapies and processes that lead to calm and becoming fully present. Among the several therapies cited, he begins with breath work. Breathing calmly and remaining in a state of relative relaxation, even while accessing painful and horrifying memories, is an essential tool for recovery. (van der Kolk, 2014, p. 209) In chapters thirteen through seventeen, he also discusses cognitive-behavioral therapy (CBT), Internal Family Systems Therapy (IFS), Eye Movement Desensitization and Reprocessing (EMDR), and the role of medications.

Similarly reported are studies by the National Institutes of Health that affirm yoga practice has shown to markedly reduce PTSD symptoms of patients who failed medication trials or other forms of treatment. van der Kolk writes: Mainstream Western psychiatric and psychological healing traditions have paid scant attention to self-management. In contrast to the Western reliance on drugs and verbal therapies, other traditions from around the world rely on mindfulness, movement, rhythms, and action. (van der Kolk, 2014, p. 209)

Among the somatic therapies that van der Kolk has utilized, either independently or in collaboration with others, he emphasizes that their effectiveness lies in the context of relationships. He defines this as “physical and emotional safety, including safety from feeling shamed, admonished or judged, and to bolster the courage to tolerate, face and process the reality of what has happened.” (van der Kolk, 2014, p. 212) The problem is that many who experience trauma attempt to manage their anxiety, anger, and frustration by themself because the promise of closeness often evokes fear of getting hurt, betrayed, and abandoned, which poses a real challenge to recovery. (van der Kolk, 2014, p. 213)

In addition to Breathwork, Yoga, Art, Music, and Dance as add-ons to traditional Talk-therapy, the author explores other modes of accessing and expressing inner feelings as a treatment modality with certain clients. Often referred to as Narrative Therapy, a process in which individuals learn to separate themselves from their problems and ultimately reauthor their life stories, turning negative experiences into empowering outcomes. Van der Kolk cites the work of James Pennebaker, PhD, a social psychologist and researcher who concluded that analyzing the words that people use in their daily lives can offer insights into their emotions, motivations, and personality. He proposed that expressive writing can serve as a tool or an antibiotic for the negative experiences of trauma, whenever there is a need for grounding and emotional healing.

I enjoy utilizing this modality, primarily in the form of journaling, and have done so for most of my adult life. It serves as a catharsis and allows for the release of strong emotions that otherwise would be repressed and potentially forgotten, while leaving behind the invisible effects of the initial trauma.

Van der Kolk comments that writing about trauma can prove to be a safer alternative than talking about it for some. “Families and organizations may reject members who air the dirty laundry; friends and family can lose patience with people who get stuck in their grief or hurt” (van der Kolk, 2014, p. 246) This is why groups like Alcoholics Anonymous, Adult Children of Alcoholics, Narcotics Anonymous, and other support groups can be so critical.

In chapter eighteen, van der Kolk introduces a concept I was not familiar with —Pesso-Boyden System (PBSP) Psychomotor therapy. Developed in 1961 by Albert Pesso and Diane Boyden-Pesso. It is a body-based, experiential psychotherapy designed to heal emotional deficits and trauma by creating new, symbolic, and positive memories through movement and interaction. Van der Kolk refers to the technique used by Pesso as “Restructuring Inner Maps,” in which the therapist guides the client by creating a metaphorical chessboard as placeholders for important people in their life. These placeholders can then be moved closer or further away from the client to mirror the proximity and type of relationships similar to those in the client’s early childhood or young adult history. (van der Kolk, 2014, p.301).

The goal of the therapy is to enable the client to rescript their life as an imaginary ideal. The interventions in this type of therapy fascinate me. The approach appears similar to Gestalt therapy developed by Fritz and Laura Perls during the 1950s, which focuses on increasing self-awareness, personal responsibility, and present-moment experience. However, unlike Gestalt therapy, PBSP requires clients to revisit their past and to request stand-in protagonists and antagonists to serve as parents, guardians, and authority figures in place of the client’s real parents or guardians from the client's childhood. The therapist serves as a witness to the emotional state of the client and provides cues to what they (the witness) observe in the client. The therapist may also direct the protagonists to help create a supportive, positive experience for the client. Van der Kolk writes that “Structures” promote one of the essential conditions for big therapeutic change in which multiple realities, past and present can live side by side, past and present. (van der Kolk, 2014, p.301).

In the final chapters, van der Kolk returns to the subject of Applied Neuroscience in chapter nineteen, which he first introduced in chapter five on the Body-Brain Connection. Here, he outlines the history of mapping the brain's electrical circuits and the birth of Neurofeedback. In chapter twenty, the author outlines his experiences treating trauma through theater, collaborating with gifted artists who worked individually with clients with unresolved trauma histories. He writes, “Traumatized people are afraid of conflict. They fear losing control and ending up on the losing side once again. Conflict is central to theater— inner conflicts, interpersonal conflicts, family conflicts, social conflicts, and their consequences. Trauma is about trying to forget, hiding how scared, enraged, or helpless you are. Theater is about finding ways to tell the truth and convey deep truths to your audience. (van der Kolk, 2014, p.337).

In the Epilogue, van der Kolk summarizes this voluminous work by saying that feeling safe with other people defines mental health more than anything else. Safe connections are meaningful and result in satisfying lives. Trauma reveals our fragility in its attempts to destroy our humanity. Despite this reality, trauma also supplies us with extraordinary resilience. As a practitioner, he has learned to view trauma symptoms as a part of sufferers’ strength. Many of those who have suffered from trauma go on be great instigators of social change. (van der Kolk, 2014, p.354).

“Trauma is now our most urgent public health issue; we have the knowledge necessary to respond effectively. The choice is ours to act on what we know.” (van der Kolk, 2014, p.301).

Conclusion:

Where to begin.  I wish I had read this text when it was first released.  Having done so would have provided me with greater depth and the ability to apply neuropsychology to my work as a therapist.  Dr. van der Kolk keeps the focus on what his own research, combined with that of his predecessors, has revealed.

The Body Keeps the Score is a timeless work. It has remained on The New York Times Best Sellers list since its publication in 2014.  An extraordinarily long run that demonstrates its value to both the academic community and the public at large. The Appendix and additional references add value for students and practitioners alike.

What I like specifically is that he uses empirical data to substantiate his conclusions.  While reminding readers that he is an MD and that the research is his own, the result of hours of independent and collaborative study at some of the world's most elite academic institutions.  He demonstrates a broad understanding of the literature.

Another positive is his compassion, which the reader feels from the very first chapter. He has taken a special interest in highlighting the experiences of traumatized persons and their desire to be freed from traumatic memories and their negative impact.  This is where van der Kolk shines.  Many of the patients he has researched have been ignored by mainstream psychiatry.

Concerning the negative, I have nothing. I think van der Kolk accomplished his goal:  to shed light on the unexamined trauma experiences that remain trapped within the mind, that are often expressed negatively, without a clear path for release or remedy.  This is no small feat.  Some who have reviewed the book criticize the author for his overemphasis on the individual and their neurological responses and not enough on the social, political, and historical contexts (like racism or systemic oppression) that create trauma.  I disagree with this criticism.  To do this, van der Kolk would need to address trauma in each of those contexts.  He, however, leaves that to the sociologists and historians to sort through.  The author, as a medical doctor, confines his research to his known area of expertise: the human body and the way trauma is experienced by those he has observed and treated clinically.

I recommend this book without reservation as an enlightening and transformative work, and a great read that offers hope for de-stigmatizing PTSD and mental illness.

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References:

Kolk, V. D., & Bessel, A. (2014). The body keeps the score: brain, mind, and body in the healing of trauma. In Medical Entomology and Zoology. https://ci.nii.ac.jp/ncid/BB19708339

Market Economics: Empathy

‍Photo by rovaindus

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"What happens to another, whether it be a joy or a sorrow, happens to you.” —Meister Eckhart

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

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In 2023, I wrote a four-part series on several essential qualities and skills for navigating interpersonal relationships titled “Market Economics”. My focus was on marriage and long-term partnerships, based on my years of working with couples. I used economic concepts to frame the following emotional qualities (Patience, Gratitude, Intuition, and Teachable) to explain how our worldviews are more than metaphors that shape our thoughts.

Recently, I stumbled upon an article that I had saved around the same time I wrote the series. I had saved it then to read later. That time is now. After reading the article, I had a serendipitous moment. It occurred to me that while each of the four emotional qualities is important, empathy is indispensable for any meaningful relationship to thrive and often functions independently apart from love. For example, in a dysfunctional relationship, a partner can have a deep, sustained emotional attachment, which is “love,” but be unable to empathize or exercise the ability to understand or share their partner’s feelings.

‍Mental health practitioners often use reflective listening to engage clients and/or couples in meaningful dialogue. I use it in building rapport with clients, but rarely in group settings. It first became apparent to me in 2024, after I attended a four-day workshop in July for facilitators working with psychoeducational groups, where I learned how to conduct an Empathy Circle. The concept of the empathy circle is to cultivate deep listening and mutual understanding by creating a safe space where participants feel fully heard, seen, and validated. It aims to shift communication away from polarization by providing a safe space to express emotions and process personal issues, even when viewpoints conflict. American psychologist Carl Rogers, PhD (1902-1987), popularized the concept by developing a therapeutic approach he labeled client-centered (or person-centered) therapy, which focuses on empathy, genuineness, and unconditional positive regard to facilitate personal growth and self-actualization.

The practice of empathy circles grew out of this approach and is a relatively new concept that emerged in 2008, when Edwin Rutsch founded The Center for Building a Culture of Empathy. ‍ Rutsch applied deep listening and mutual understanding to the types of social relationships that often create conflict in groups, where the metaphors we use to structure our worldview influence our emotions and our understanding of “moral politics”. In a moment, I will give a case example of this concept using economic terms, as I did in my 2023 essays.

‍Initiating an empathy circle requires a facilitator and participants to take turns sharing and receiving back what was said. The focus is on making the speaker feel fully heard ("empathy out loud"), ensuring understanding, not just agreement. Participants take turns speaking and listening for allotted time periods, until each person has had the opportunity to do both. The key to its effectiveness is that the person doing the active listening must, when finished, repeat back to the speaker what they heard. At the end of the listener’s feedback, the speaker decides if they have been heard accurately. If they believe so, they inform the listener by stating that they feel fully heard and understood. If the listener’s response fails to accurately convey to the speaker what was stated, the speaker may briefly clarify for the listener what was said and have the listener repeat it back.

During that 2024 workshop, participants were allowed to give and receive feedback and to comment on its effect, namely, to enhance similarities over differences in worldviews that tend to divide rather than promote mutual understanding. Since their inception, empathy circles have been used to bridge political divides, build community, and promote a more empathetic culture. They are used by diverse groups —corporate teams, community mediators, activist organizations, and support groups—to foster deep listening and enhance emotional connection.

The poem titled “Human Family” (1990) by Maya Angelou (1928-2014) describes the core goal of the empathy circle. The poem compares and contrasts the author’s experiences traveling the world, noting the obvious differences within the human family, and, at the end, draws a conclusion that frames her observations and closes the poem in a tripartite succession: “We are more alike, my friends, than we are unalike.” The premise is a plea for harmony, arguing that differences in skin tone or cultural background do not outweigh the fundamental similarities that bind humanity together.

‍The concept of the empathy circle helped me better understand and frame my own observations about marriage and long-term partnerships. The article that follows has helped me identify the fifth emotional quality that bridges the other four (Patience, Gratitude, Intuition, and Teachable) qualities together—Empathy. I will provide a brief outline of the article and share my observations.

The article titled “What to Do When Your Spouse Lacks Empathy” by author John Daum, attempts to answer the following three questions within the context of marriage:

‍[1] What is Empathy?

‍[2] Why is Empathy Important? And,

‍[3] How Do We Navigate the Absence of Empathy?

‍I will now unpack how the author answers each of these three questions for readers, along with his suggestions for building empathy, and summarize his conclusions.

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What is Empathy?

‍Daum begins with the belief that empathy is a skill that can be developed. He describes a common phenomenon that can be seen in varying degrees among all couples. He writes, “You want your spouse to be fully present and with you in your feelings, thoughts, and situations in life.” You’ve opened up to them, but your partner seems unable or uninterested in responding empathetically. (Daum, 2022)

A definition we can agree on should sound something like this: Empathy is the ability to understand, share, and resonate with another person's feelings and perspectives. It involves stepping outside your own biases to view the world from another's perspective, fostering trust and connection. Daum then goes even further because the above definition can be confusing. He borrows from social work researcher Brene Brown, PhD, who describes two types of empathy:

‍1. Cognitive Empathy is sometimes called perspective-taking or mentalizing. It is the ability to recognize and understand another’s emotions. “Your best friend told a bunch of people something you confided in them! It’s completely understandable to feel betrayed. I get you.”

‍2. Affective Empathy is often called experience-sharing. It is one person’s emotional attunement with another’s experience. “Your best friend told a bunch of people something you confided in them! I feel that sting of betrayal. I feel you.” (Brown, 2021, as cited in Daum, 2022)

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Why is Empathy Important?

Daum writes: “Your spouse is the one person you hope will get you and feel you. Why? So they can be there for you. (in whatever way you need them to be).” Daum (2022)

Sincerity is often best expressed in simplicity. Phrases like “I am with you”. “You are not alone” embodies what it means to be empathetic. The language of empathy, according to Daum, “should lead your spouse to put self aside, be present for your story, and absorb it. They understand, believe, and validate it, and you... they don’t judge, criticize, or dismiss it and you. (And they definitely don’t make it about them.) Empathy is the catalyst to respond with appropriate, compassionate actions.” (Daum, 2022)

The actions associated with empathy involve knowing how to respond rather than react. And how to pause, reframe, and rephrase. Let’s take a closer look.

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How Do We Navigate the Absence of Empathy?

‍Respond vs. React:

‍Duam suggests that the best way to help a spouse who lacks empathy is to fine-tune your own communication, being clear and direct about what you need. He says that we must invite them into our story and frame the conversation by saying something like this, “At the moment, I’m not looking for you to judge me, give me advice, or share your opinion. I need to feel heard and understood.” (Daum, 2022)

‍Pause, Reframe, Rephrase:

‍“Empathetic conversations can lead to tangible, actionable things for a caring spouse.” (Daum, 2022) You can set measurable goals around the following “I” statements:

• Understand how I feel and care about my feelings.

• Listen to what I’m thinking and consider my thoughts.

• Hear me and care. I need to know that I have your full attention.

• Support me and be my partner in this situation.

• Understand this part of me I’m trying to share with you.

• Understand how important this is to me. (Daum, 2022)

‍I would now like to revisit the couple (Len and Liz), whom I introduced to readers in my essay titled “Market Economics - Intuition”‍ ‍(Aug 2023). I’m using this fictional account to illustrate how the absence of empathy can do emotional harm in committed relationships.

A Case Example:

When we first met Len and Liz in 2023,  they had been married for four years.  They've now been together for seven.  They have two children.  A son aged three and a one-year-old daughter.  The problems that initially prompted the couple to seek therapy remain-  conflicts related to finances,  poor communication, anxiety, resentment, and a lack of intimacy. Beneath each of these concerns lies the inability to be seen and to feel heard.

Preschool-aged children have added several layers of responsibility to their relationship, straining Len and Liz’s communication and requiring mutual agreement on how to navigate shared responsibilities affecting their children.  

Both Len and Liz are employed full-time.  Len's schedule is not always the same.  In some months, his shift rotates, and he works nights.  While the couple has historically been unable to agree on financial matters, they did agree on childcare and are generally satisfied with the care their children receive.

The “time” variable is inescapable.  Before becoming a parent, Len was free to work late or go to the gym.  Liz also benefited from spending time with her friends on weekends.  Both enjoyed being less concerned about managing time because they were independent adults making choices primarily about how to schedule their leisure time around work.  While Len and Liz would still do things together as a couple, they operated with fewer constraints.

When their first child was born, Len's younger sister lived a short commute from her brother and sister-in-law.  Len's sister would often babysit for the couple.  However, by the time their second child was born, Len's sister had relocated out of state, and the couple was forced to find a more permanent child-care arrangement.  Problems involving accountability and time management only grew worse.  Conflict and competition became a constant source of resentment, leading to a “zero-sum mentality” in which each believed a  win-win was no longer possible.  Under such conditions, for one partner to benefit by gaining more time, the other partner must lose or surrender their time at an equal or greater value.  Negotiation and trade-offs for the collective (family) good often result in a lack of empathy for the partner who experiences a deficit in their ability to use personal time as they would prefer.  In therapy, family-of-origin issues come up for this couple.    Len recalls how his mother would leave him to care for his younger sister.  He knew his mom had to work long hours due to his father's chronic unemployment and the financial burden it placed on the three of them after his father left the family and his mother filed for divorce.   That was years ago, but Len still feels a twinge of displeasure whenever Liz deviates from their schedule for discretionary fundraisers, concerts, sporting events, and other leisure activities.

Len acknowledged in therapy his own insecurities about becoming a father and how that impacts his involvement with his children.  Liz, on the other hand, felt ready for motherhood but was unprepared to balance the challenges of being a full-time mom with her full-time job.  The couple considered hiring a nanny.  But in the end, realized that it would be as expensive as, if not more expensive than, the childcare they already have in place.

Liz, too, becomes irritated when she loses time and feels the “leisure tax” of the time she fails to get back from Len for exceeding his time allotment.  Weekends with friends, going out for lunch, and shopping on Amazon are all desirable for Liz.  Similarly, Len enjoys playing golf on some Saturdays during the summer months and going camping several weekends each year in the Fall.  But the frequency and costs associated with these activities have been scaled back.  To further complicate things, Liz would like to relocate outside of the city, where they can purchase a home, get out of the apartment, and have more room for the kids.  Len has been hesitant to consider such a move. “It’s a seller’s market... “  he complains to Liz. Len has been unwilling to sit down with a financial planner to see how they could work toward purchasing a home.

Parenting preschool children requires both Len and Liz to make sacrifices due to the lack of support from their extended families.  Both, at times, accuse the other of lacking empathy. However, Liz lays the greater claim to resentment at Len's unempathetic response to the challenges she argues entitle her to an equal amount of scheduled personal time.  Len admits to avoiding some of the issues that lead to their conflicts, as indicated by his statements during therapy sessions.  However, he engages in cognitive empathy rather than affective empathy, which requires him to respond positively to what he has heard Liz say.  

During the session, Liz demonstrates that she can exercise both cognitive and affective empathy.  But because of Len's lack of initiative to spend time with the children, Liz uses Len's failures to justify her indiscriminate spending.

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Therapeutic Considerations

The Daum article emphasizes that building empathy is a skill that requires time.  Daum admits that some people are not naturally inclined to recognize others' feelings and that these relationships involve hard choices.  In short, each partner must resist attempts to "fix" the other.  

None of the methods for navigating the absence of empathy is guaranteed, but for the therapist working with this couple, it's helpful to reinforce the couple's need to work through their own emotions stemming from Genetics, Socialization, or Childhood trauma that limit their inability to empathize with their partner.  The therapist should support each partner's efforts while also addressing resistance, as it manifests differently in each partner.  Each partner must own their own stuff.  Therapeutic approaches should aim to support and encourage growth where it is languishing.  (Daum, 2022)  

To apply this to our Case Example, Len and Liz must model "out loud" and perform empathy work where they both can see it.  For example:

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Modeling empathy for your spouse

• Len could begin by asking Liz how she felt when he decided to work late and didn't call to let her know.

• Liz could describe how she felt when Len failed to call, letting her know he planned to work late.  Because she was hoping to run an errand before dinner.

• Len might tell Liz how he felt as a young adolescent, unable to participate in extracurricular and after-school activities because he had to look out for his sister, since their mom had to work.

• Liz could describe to Len her sense of being unable to secure her parents' affection and affirmation growing up, that as a young girl, her emotional needs shifted from people to things, and how she longs for validation from Len in her efforts to be a good mother and loving wife.

When partners practice talking about their emotions with each other, they are modeling what they need from each other.  They are communicating in ways that help them be seen and feel heard.  

‍One of the easiest ways I've found for couples to begin modeling is to use "I" Statements to frame discussions around your feelings rather than your partner’s, which can reduce defensiveness. For example, "I feel alone when. . ."

‍Another way couples can reduce emotional dependence is to engage in hobbies, work, and friendships that bring them joy and a sense of validation independently of their spouse.  This, when not overdone, can be surprisingly effective.

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Tools to facilitate positive communication

‍The article also points out that, because building empathy is a skill, it is helpful to have the appropriate tools to aid partners in improving their comfort level.  There are scores of books, games, apps, and websites with "get to know” questions and conversation starters.   Daum writes— “This can be a helpful practice for discussing your interior lives.  Make it a "Judgment Free Zone” and a safe sharing space.  (Daum, 2022)  

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Final thoughts

Living with a spouse who isn't empathetic can be draining and demanding.  Because your spouse lacks empathy, they might be critical, cruel, or unforgiving.  They may react with anger when they feel like you are being too ‘sensitive’.  They could be oblivious to how their behavior affects you or be unresponsive to your needs.  Unfortunately, this might be your reality. It's one thing to be patient with the change process and to support your spouse’s growth.  It's quite another to be hurting all the time and in over your head.     (Daum, 2022)  

‍In addition to seeking professional help, as we witnessed with Len and Liz, it may be helpful to find validation from within and from other supportive people in your life.  Understanding that you cannot allow your self-worth to be tied up solely in your partner's ability to empathize with you.  Turning to trusted friends can be beneficial for sharing your thoughts and feelings.  (Daum, 2022)  

‍"Many couples have successfully maintained their marriage, knowing that their spouse may have many positive traits, but being empathetic is not one of them.  You can set boundaries with your spouse and still have your need for empathy met in other healthy ways...  Fine-tune what empathy looks like in your relationships... Dig deeper into understanding and believing in each other.  Recognize and appreciate any progress toward more empathy— it's a process that will bring you closer together in the end." (Daum, 2022)  

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References

‍Daum, J. (2022, April 5). What to do when your spouse lacks empathy. First Things First. https://firstthings.org/spouse-lacks-empathy/

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A Psychological Approach to wellness: SUMMARy II

Photo by Alex Green

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

Summary II PART THREE:     The Minds of Children

In this section, van der Kolk devotes four entire chapters to the neurobiological development of children and what happens when that development gets disrupted by trauma.  As in the previous section, I found his analysis closely reflected what I have seen in practice with families, even though I do not work directly with children. He asks good questions throughout the text, as any good researcher, that lead him and other trauma-informed researchers to conclusions that help guide treatment objectives.  He makes the following observations:

“As we grow up, we gradually learn to take care of ourselves both physically and emotionally, but we get our first lessons in self-care from the way we are cared for.... Children whose parents are reliable sources of comfort and strength have a lifetime advantage— a kind of buffer against the worst that fate can hand them.” (van der Kolk, 2014, p. 112)

Van der Kolk examines the work of J. Bowlby and D. Winnicott, pioneering British psychiatrists in child development theory, particularly the impact of early relationships and the role of attachment as a buffer against traumatic experiences.  He notes several distinct types of attachment that can influence patterns of child development.  (pp. 117-122).

The following attachment styles in children are generally accepted by mental health practitioners:

• Secure Attachment: Children feel secure, seen, and safe. They explore freely when the caregiver is present, are distressed upon separation, and happy upon reunion. They rely on their caregiver for comfort.

• Avoidant Attachment (Insecure): Children appear indifferent to the caregiver’s presence or absence, and may avoid or ignore the caregiver upon return. They often learn to manage distress independently due to caregivers who consistently ignore their emotional needs.

• Ambivalent/Resistant Attachment (Insecure): Children are often highly distressed when the caregiver leaves, but behave inconsistently (clinging and rejecting) upon return. This stems from inconsistent care, where the caregiver's response is unpredictable.

• Disorganized Attachment (Insecure): Children show no consistent coping mechanism and exhibit fearful or erratic behaviors, often associated with caregivers who are a source of fear.

Van der Kolk notes that the need for attachment never lessens.  Most humans are unable to tolerate being disengaged from others very long.  People who fail to connect through work, friendships, or family often find other ways to connect, such as through illness, lawsuits, or family feuds.  The latter being preferable to feeling irrelevant and alienated.  (van der Kolk, 2014, p. 117)

Children are said to create internal maps of their world based on their experiences with their caretakers.  Van der Kolk gives plenty of examples that inform his conclusions on how traumatized children remain traumatized into adulthood.   So, as clinicians who seek to understand and interpret these maps, the question we must ask is: Is it possible to help the minds and brains of brutalized children to redraw their inner maps and incorporate a sense of trust and confidence in the future?  (van der Kolk, 2014, p. 111)

According to Bowlby, attachment provides a secure base from which a child can explore and move into the world. Research over five decades supports the conclusion that when attachment is secure, children become more independent and display empathy toward others, forming thoughts that are both similar to and different from their own within their environment. Essential skills such as self-awareness, impulse control, and self-motivation enable them to become contributing members of broader society. In children who lack secure attachments, these qualities are painfully absent. (van der Kolk, 2014, p. 113)

The author begins to answer this question at the end of chapter seven, cautioning therapists treating trauma not to equate knowing with cure.  He notes that our relationship maps are implicit, etched into the emotional brain, and not reversible simply by understanding how they were created.  You may realize that your fear of intimacy has something to do with a past traumatic event or a prolonged period of dysfunctional parenting, but that alone is unlikely to open you to happy, trusting engagement with others. (van der Kolk, 2014, p. 124)

He does, however, voice a ray of hope: “Adults who were abused or neglected as children can still learn the beauty of intimacy and mutual trust or have a deep spiritual experience that opens them to a larger universe. (van der Kolk, 2014, p. 131). He then outlines his method for helping patients re-route their internal maps, but cautions those in the field of Psychiatric medicine to avoid becoming overly precise when assigning diagnostic labels. He writes: Given the complexity of mind, brain, and human attachment systems, we have not even come close to achieving the sort of precision often attributed to biological diseases. (van der Kolk, 2014, p. 139) “Understanding what is ‘wrong’ with people currently is more a question of the mindset of the practitioner (and of what insurance companies will pay for) than verifiable objective facts.) (van der Kolk, 2014, p. 139)

Because categories are narrow, therapists often have to assign 3 or 4 different codes to describe a single complex person. Secondly, codes focus on what the symptoms are, not why they are happening. Context is Ignored: codes often fail to account for poverty, racism, or systemic oppression. And lastly, to get insurance reimbursement, the therapist may have to "up-code" or pick a more severe diagnosis than what they actually see, which stays on the client's permanent medical record. Each of these represents a conflict between what qualifies for reimbursement and what the therapist may actually see in the client.

In chapter nine, he recounts the attempts by the American Psychological Association (APA) to create the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), which was first released in 1980.  This is the same manual I used in graduate school.  I continue to use the recent edition (DSM-5) sparingly when I need distinct categories for what I am seeing.  

Van der Kolk cites the difficulties inherent when obtaining a precise diagnosis using the DSM alone.  And the overreliance on diagnosis codes has led to some patients being treated incorrectly, not to mention a diagnostic label that others (as well as the patients themselves) will use to define them.  He believes the reason for this inconsistency is due to the lack of a complete trauma history.  He, along with other researchers, acknowledge that the absence of a complete trauma history will likely result in an incomplete diagnosis at best, and failed treatment at worst.  To address this problem, he and several colleagues designed a new study using the Traumatic Antecedents Questionnaire (TAQ), which they developed. (van der Kolk, 2014, p. 140)

I appreciated this because it’s what every therapist needs to complete, if not in its entirety, then in some abbreviated form.  The forty-item questionnaire is available online for download along with instructions for scoring.

Van der Kolk concludes chapter nine by providing a brief history of the development of the Adverse Childhood Experiences (ACE) studies and noting that many adverse experiences are interrelated, even though they are usually studied separately. (van der Kolk, 2014, p. 147)

According to van der Kolk, the results from these studies confirm the implications of childhood abuse and neglect as a determinant of psychological function in adulthood, but fail to have the effect that other similar studies have had on reducing risk factors associated with negative outcomes, as in the link between smoking and the increased risk of developing lung cancer. (van der Kolk, 2014, p. 150)

The final chapter in this section (chapter ten) highlights what occurs developmentally in childhood and is expressed in adulthood when the developmental history was abusive or neglectful.  In such cases, the devastation of this trauma will likely be described in negative ways that impact the lives of individuals, families, and communities.  

This research compares trauma and its impact on developing primates, which share a genome similar to that of humans. And how parent-child relationships among primates mirror human parent-child relationships, and how these relationships are developed and socialized.

In the third and final summary, I will examine “The Imprint of Trauma” and “Pathways to Recovery,” followed by my conclusion.

___________________________________________________

References:

Kolk, V. D., & Bessel, A. (2014). The body keeps the score: brain, mind, and body in the healing of trauma. In Medical Entomology and Zoology. https://ci.nii.ac.jp/ncid/BB19708339

A Psychological Approach to wellness: SUMMARy I

Photo by isco

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, by Dr. Bessel van der Kolk, is the culmination of the author’s forty years of research, along with that of others.  Van der Kolk presents traumatic reactions not simply as disturbances of fear and anxiety but also as the provocateur of interpersonal relationships that create trauma, which is stored in the body.  Understanding the neurobiological connection is key to addressing psychic gridlock and past experiences that prevent positive behavioral change.   The book is well vetted by internationally known researchers in the field and praised as an authoritative guide that outlines the scientific advances in understanding the effects of trauma on the brain and body.

The text is accessible to both academics and the general public, offering innovative tools for working with those affected by trauma.  The book contains five sections and has 445 pages, including the index.  Due to its length, I have divided this book review into three summaries, each of which can be read independently. The titles in the summaries match those in the book and are numbered chronologically.

The first summary will focus on:

PART ONE        The Rediscovery of Trauma, and

PART TWO        This is your Brain on Trauma

The second summary will focus on:

PART THREE     The Minds of Children

The third and final summary will focus on:

PART FOUR      The Imprint of Trauma, and

PART FIVE       Paths to Recovery

I will pull key points and quotations from each of the five sections of the text and share my personal insights and opinions when applicable.

Summary I, PART ONE:        The Rediscovery of Trauma

We don’t find trauma; it finds us.  For Dr. van der Kolk, it was at the Boston Veterans Administration Clinic, where he first observed the effects of war in many of the patients he treated.   He acknowledged that nothing in his psychiatric training had prepared him to deal with the symptoms some patients presented.  He began his research with a simple premise: to trust only what he could learn from his patients and his own experience.  He recalled the words spoken by one of his faculty advisors: “The greatest sources of suffering are the lies we tell ourselves.”   (van der Kolk, 2014, p.11)   Most avoid experiences associated with trauma.  He writes, We don’t really want to know what soldiers go through in combat, or how many children are being molested and abused, or how many couples engage in violence at some point during their relationship.   We prefer instead to think of our country as populated by enlightened and civilized people.  And that cruelty occurs only in faraway places.  (van der Kolk, 2014, p.11-12)   One of the salient features of trauma is the inability to engage in intimate relationships.  This is true regardless of whether trauma is the result of something done to you or something you yourself have done.  

Seeing patients in the clinic and running therapeutic groups taught him that those who have experienced trauma sharply divide the world between those who know and those who don’t.  And that people who have not shared that particular traumatic experience cannot be trusted, because they can’t understand it.  (van der Kolk, 2014, p.18)

Between his first and second year of medical school in the late 1960s, van der Kolk took a year off and worked as a research attendant at a leading psychiatric hospital in Boston.  It was there that he spent long hours on the ward getting to know patients after many of the day staff had gone home.  Since he was not directly involved in the research itself, he had time to listen to the stories of traumatized patients who were close in age to him.  His primary role during this time was to keep them involved in regular daily recreational activities, both in-house and out in the local community.  It was there that he learned to deal with irrational outbursts and terrified withdrawal.   He also learned that “most human suffering is related to love and loss, and that the job of therapists is to help people’ acknowledge, experience, and bear’ the reality of life.”  (van der Kolk, 2014, p.26-27).  Moreover, according to a favorite professor, healing depends on experiential knowledge, and you can be fully in charge of your life only if you acknowledge the reality of your body in all its visceral dimensions.

He concludes this first section by framing the question of how we should respond to trauma.  And how our response is often tailored to whether we see trauma as something that requires adaptation, or is it purely a disease that can be chemically treated.  Suppose practitioners see trauma and its effects only as chemical imbalances in the brain that can be corrected with specific drugs.  In that case, they will deflect attention from dealing with the underlying issues.  (van der Kolk, 2014, p.36-37)   Van der Kolk provides us with four fundamental truths to help practitioners avoid this one-sided thinking.  I have summarized these truths in the list below:

[1]   Restoring relationships and community is central to restoring well-being.

[2]   Language gives us the power to change ourselves and others by communicating our experiences.

[3]   We can regulate our own physiology:  (breathing, moving, touching).

[4]   Changing social conditions to create safe environments will allow children and adults to feel safe and thrive.

Summary I, PART TWO:        This is your Brain on Trauma

Trauma affects the entire human organism- body, mind, and brain.   The brain’s job is to ensure our survival.  Our brains generate internal signals that register what our bodies need physically and then create a map of the world to direct us to where to go to satisfy those needs while generating the necessary energy and actions to get us there, warn us of danger and opportunity along the way, and adjust our actions to the requirements of the moment  (van der Kolk, 2014, pp. 53, 55)

Van der Kolk then goes into extensive detail, describing the Triune brain for the reader, composed of three parts: the Prefrontal Cortex, the Limbic brain, and the Brain Stem.  Each of these develops separately, with specific yet interconnected roles that organize basic life-sustaining functions throughout our lives.  He states that the amygdala (part of the prefrontal cortex or the temporal lobe) is like a smoke detector.  The amygdala is good at detecting danger cues, but trauma increases the risk of misinterpreting whether a particular situation is dangerous or safe.  We are in a state of constant adjustment, continually adjusting our behavior.  Faulty alarm systems lead to blow-ups or shutdowns in response to innocuous comments or facial expressions.   (van der Kolk, 2014, p. 62)

Significant attention is given to the triune brain and the communication and information processing it receives.  Unlike the amygdala, which is designed to detect potential threats, the Medial Prefrontal Cortex (MPFC) functions as a watchtower, serving as a hub for interpreting, decision-making, and social and emotional regulation.  Any impairment in communication between the smoke-detector and watchtower results in highly intense emotional states.  He says that achieving a balance between these two parts of the brain requires a dual approach.  

First, a bottom-up approach requires individuals who have experienced trauma to change their physiology in response to their bodily sensations.  For example, tossing a ball back and forth, drawing a picture, or dancing to music.  Body-based therapies (Breathwork, Dance/Yoga, Body Scan, Pendulation) help individuals identify and/or connect specific emotions with their body's reactions to those emotions.   Whereas a top-down approach may focus on breathing patterns, listening to music, and other mindful approaches. (van der Kolk, 2014, pp. 63-64, 72) 

Mind-based therapies  (Meditation, CBT, Guided Imagery, Biofeedback )  begin with your thinking brain and allow you to process your experiences through thoughts and words, making meaning through the narrative you create.  It allows you to discern your thought patterns and find ways to shift your experiences and/or change what emotions you associate with specific situations or how you react to them.

The challenge within trauma treatment is teaching victims of trauma to live in the present.  Desensitization to traumatic experiences may lower your reactivity to them.  Still, if you cannot feel satisfaction in ordinary, everyday, non-threatening, and/or pleasurable activities, life will pass you by.  (van der Kolk, 2014, p. 73)

Van der Kolk turned to the works of Charles Darwin to deepen his understanding of the foundations of our emotional life, as cited in Darwin's lesser-known work titled The Expression of Emotions in Man and Animals (1872).  In it, Darwin asserted that mammalian emotions are fundamentally rooted in biology and an indispensable source of motivation for initiating action. “Movement that will restore the organism to safety and physical equilibrium." (van der Kolk, 2014, p. 75)

Intrigued by Darwin, van der Kolk also studied the works of Russian scientist Ivan Pavlov (1849 - 1936) on what he termed “Reflex of Purpose,” which helps answer the question: How do people regain the energy to engage with life and develop themselves to the fullest?  Pavlov's question is the same question that Maslow attempted to answer with his hierarchy of needs pyramid, which I cited in my essay titled "A Psychological Approach to Wellness: An Introduction."

While many concepts seek to explain what helps to regain or sustain life energy, “Safety and Reciprocity” resonates deeply for me.  Van der Kolk writes:  “Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives. . . Social support is not the same as merely being in the presence of others.  The critical issue is reciprocity: being truly heard and seen by the people around us, feeling we are held in someone else's mind and heart. (van der Kolk, 2014, p. 81)

Safety is identified at three distinct levels according to American psychologist Stephen Porges, who developed the Polyvagal Theory.  This theory, cited by van der Kolk, emphasizes the role of the autonomic nervous system (ANS): (1) The Ventral Vagal State, (2) The Sympathetic State, and (3) The Dorsal Vagal State.  Each level represents an evolutionary hierarchy that influences our ability to connect, cope, or dissociate. (van der Kolk, 2014, p. 82)

Regarding this theory, van der Kolk observes that many people feel safe as long as they can limit their social contact to superficial conversations, but actual physical contact can trigger intense reactions.  However, any sort of deep intimacy— a close embrace, sleeping with a mate, and sex requires allowing oneself to experience immobilization without fear.  It is especially challenging for traumatized people to discern when they are actually safe and to be able to activate their defenses when they are in danger. (van der Kolk, 2014, p. 87)

This is challenging because of the number of experiences required to restore one's equilibrium and a sense of feeling safe.  As a therapist, I frequently see evidence of this.  Safety is established, only to be threatened.  Where there is no safety, there can be no trust.  Years of progress toward reaching safety can evaporate in a matter of seconds.  At the first hint of danger.  Re-traumatization involves repeated encounters with a supposed lack of safety or becoming a victim.  A cycle is then initiated, which repeats over time, fostering a sense of hopeless withdrawal and inability to engage.  Even when there is no immediate threat.

Since trauma is encoded in the viscera of our bodies (i.e., the body's autoimmune system), the brain's safety system demands that we utilize treatment approaches that incorporate Mind-Body techniques.

Our sensory interior signals us to what is safe, life-sustaining, or threatening, even if we cannot name it.  Van der Kolk refers to this as our "Gut" feelings, which help us evaluate what is going on around us.  However, traumatized people chronically feel unsafe inside their bodies.  These individuals often ignore internal warning signs, leaving them bewildered, confused, and ashamed.  He concludes with— “The price for ignoring or distorting the body's messages is being unable to detect what is truly dangerous or harmful for you, and just as bad, what is safe or nourishing.” (van der Kolk, 2014, p. 99).  Ignorance of this type is seen as an inability to self-regulate, or to “have a friendly relationship with your body.”  Persons who do not have this awareness and ability to self-regulate rely on external regulation— medication, drugs like alcohol, constant reassurance, or compliance with the wishes of others. (van der Kolk, 2014, p. 99)

Of particular interest is the term “Alexithymia,” a Greek word for not having words for feelings.  Van der Kolk says that people with alexithymia tend to register emotions as physical problems rather than as signals that something deserves their attention. “Instead of feeling angry or sad, they experience muscle pain, bowel irregularities, or other symptoms for which no cause can be found. “ (van der Kolk, 2014, p. 100)

People with this condition are said to improve only by learning to recognize the relationship between their physical sensations and their emotions.

Van der Kolk concludes this section with several questions and probable resolutions:  

1. How can people open up to explore their internal world of sensations and emotions?

2. What happens in chronically traumatized people when they make face-to-face contact?

3. What does this (chronic traumatization) mean for their ability to make friends and get along with others, and benefit from therapy?

To answer these questions, the author describes his approach to working with people impacted by trauma and assisting patients by helping them to describe the feelings in their bodies and not their emotions.  When patients become aware of their physical sensations, they can, with practice, connect these sensations to psychological events.  When this happens for the first time, it can be distressing.  However, with proper guidance, torrents of emotions can be stemmed.  School teachers, nurses, and police officers are often very skilled at bringing calm to traumatized persons, because many of them are confronted almost daily with out-of-control or painfully disorganized people. (van der Kolk, 2014, p. 104)

To have genuine relationships, you have to be able to experience others, each with his or her particular motivations and intentions.  While you need to be able to stand up for yourself, you also need to recognize that other people have their own agendas.  Trauma can make all that hazy and gray.  (van der Kolk, 2014, p. 104)

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References:

Kolk, V. D., & Bessel, A. (2014). The body keeps the score: brain, mind, and body in the healing of trauma. In Medical Entomology and Zoology. https://ci.nii.ac.jp/ncid/BB19708339

A Psychological Approach to Wellness: AN INtroduction

Photo by Madison Lavern

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

We are hardwired for the drive toward human potential.  And, only when we have been stripped of the foundational building blocks that move us toward life will our initiative toward satisfaction and fulfillment cease. This is a complex topic that I cannot hope to examine thoroughly in a few pages.  My intent here is to briefly explore what factors contribute to or detract from individuals reaching their full potential. 

Cognitive Behavior theorists and Health Practitioners are mostly in agreement that our intrinsic construction requires that our physiological and psychological needs be met to avoid ill health.  Abraham Maslow, PhD, (1908-1970) and others like him identified the foundational building blocks that lead to achieving fulfillment in life. Maslow did this using a hierarchical arrangement familiar to most.  Maslow identified 5 Needs common to all humanity, regardless of ethnicity or culture.   He uses a pyramid to illustrate how each of these physical and psychological needs is interdependent, enabling one or more other needs to be met in succession.

It can be said that social and cultural differences may affect the identification or expression of such needs to varying degrees, but the needs themselves remain evident.   Below is an example of the 5 Needs he identifies common to the human species.  The most important needs, which are physiological, are identified at the base of the pyramid with psychological needs that are subsequent and dependent on the physical or environmental needs closer to the top.  Maslow believed that optimal health results when each of these needs has been met.  And, throughout our lives, we are attempting to reach our full potential.  Maslow would refer to this as becoming “self-actualized,” which he defines as the final state of an individual's linear growth. Moreover, self-actualized individuals understand their abilities and limitations and experience a drive to be creative in all aspects of their lives.  Because this is a linear model and self-actualization would not occur without more basic or environmental needs being met first, not everyone will reach self-actualization.  From this hierarchy, we learn that self-actualized individuals, regardless of background or occupation, can cultivate deep, meaningful relationships with others.

I will talk more about the role of the environment, which I believe is a critical component when examining optimum wellness, a bit later. Let’s continue our examination of Maslow’s theoretical framework for wellness.  In his book titled Toward A Psychology of Being, (Wilder Publications, 2011)  Maslow in Chapter 5 on Values defines 10 characteristics of the healthy human specimen.  Given that the usage of the term “health” means different things relative to the context of reference, Maslow attempted to provide a universal definition, notwithstanding socio-cultural distinctions.

‍ Figure 1: Maslow’s Hierarchy of Needs

A Universal Definition of Health

1.    Clearer, more efficient perception of reality

2.    More openness to experience

3.    Increased integration, wholeness, and unity of the person

4.    Increased spontaneity, expressiveness, fully functioning

5.    A real self, a firm identity; autonomy, uniqueness.

6.    Increased objectivity, detachment, transcendence of self.

7.    Recovery of creativeness.

8.    Ability to fuse concreteness and abstractness.

9.    Democratic character structure.

10. Ability to love, etc.   (Maslow, 2011, pp. 120-121)

There is significant overlap in this list.  However, his point is that all healthy people, to varying degrees, should possess several of these traits. And the absence of these traits would indicate a lack of health or a diseased state. 

While the intended effort is to generalize these traits,  it is clear that this approach creates some empirical challenges. Namely, the creation of a naturalistic values system that differentiates subjective freedom of choice.  Maslow writes, “Healthy people, permitted to choose freely, are observed to choose this or that. His is like asking, “What are the values of the best human beings,” rather than, “What should be their values?” Or, what ought they be?”  (Maslow 2011, p. 121)

Another complication cited is that the transcendence of selfish and personal motivations entails giving up “lower” desires in favor of “higher” ones.  An example of this is the effort to differentiate between intellectual and peaceful pursuits and the desire for money, power, and status.

He concludes that self-actualization is a relatively achieved “state of affairs” in a few people, that can be described as a hope, a yearning, a drive, a something wished for but not yet achieved, showing itself clinically as a drive toward health.

The drive toward human potential, while inherent in each of us, is not a constant.  It is subordinate to both a physical and mental state of being that is not in conflict within the individual.  The biological term for this state of being is homeostasis.

Homeostasis is best defined as the self-regulating process by which organisms maintain stability while adjusting to conditions that support their survival.  An example of this would be maintaining a healthy blood pressure. 

The heart can sense changes in blood pressure, sending signals to the brain, which then sends specific instructions back to the heart.  If blood pressure becomes too high, the heart should slow down; if it becomes too low, the heart should speed up.   Other examples include pH, sodium, and glucose levels in the body.  The human body requires specific homeostatic mechanisms to sustain its optimal functioning.  Optimal functioning is dependent on a given homeostatic range.  If we move outside of this range, an imbalance is created.  And if this imbalance persists and the body can no longer perform its normal functions, the living organism will eventually become dysfunctional, fail, and die.

What becomes clear is that homeostasis depends on multiple variables.  Some of which we know little about.  Our lack of this knowledge is what drives us to conduct research on various systems (human, biological, environmental, and mechanical) and to learn how to identify and manipulate specific variables to achieve desired outcomes.

I will now return to the environment as a factor in determining wellness, because I believe it is a necessary variable that can drive positive outcomes in wellness.

When I was preparing to leave Chicago in the early 1980s, several years after completing my studies, I remember focusing on the environment, which had become etched in my psyche. I wanted to capture my thoughts and emotions associated with that experience.  I wanted to capture and reflect on specific aspects of that experience in the future.  I wrote in my journal- 

 “I’m counting all the people, places, and things that I hold.  Like a garden filled with flowers on a bright sunny day, a walk downtown on icy, covered sidewalks.  The aroma of food from restaurant kitchens.  The smile of a lady inside the market.  Walking alone on a littered beach. Running laps at Lake Shore Park. The books, the classes, exams, and papers.  Deep thoughts, profound truths, serious emotions, empty chatter filled with laughter, sorrow, and shame.  A man named Bill in Cabrini.  I read to him. Sippin' coffee at McDonald's with a lady named Bernice.  Janitorial work at night in the campus kitchen and weekend jobs in old Greystones on the North Shore. Riding the  L both north and south of the city.  Worship on Sundays in the inner-city and in the outer-suburbs…”

These thoughts are linked to a material environment with people and things. And whenever I read this entry, I mentally rehearse these experiences. Many of these experiences helped me move closer to becoming more self-actualized, in Maslow’s terms.  A few experiences during this time also pushed me further away.

We each do this when we take a photograph with our camera, or save an obituary or a letter written to us by a loved one.  Or, when we purchase a book after meeting the author or a recording after attending a live performance.  These environmental markers influence our lives in unique and memorable ways, for better or worse. 

If we’re fortunate, environmental experiences will produce more positive than negative influences in our lives and give us a sense of accomplishment, enabling us to move closer toward reaching our full potential. 

To Maslow’s credit, he clearly identifies the challenges in doing so.  He cannot do otherwise because his worldview is both static and linear, placing the burden entirely on the human organism to resolve the problems that prevent us from becoming self-actualized.  Maslow is a psychologist and is just being consistent with a cognitive-behavioral approach toward wellness.  However, there’s a missing element— trauma and its impact on the human condition, and the cognitive distortions that arise from trauma that dismantle Maslow’s neat pyramid. His system hints at this but excludes what more recent theorists consider a key factor within psychodynamic theory- when viewed through the lens of neuroscience, and how cognitive distortions interfere with social and emotional regulation, and the drive toward self-actualization. Neuroscience, I believe, is the missing link that was historically unavailable to Maslow. It began to emerge soon after his death.

When cognitive distortions are identified, we are better able to tailor treatment approaches that remove impediments to psychological growth and encourage behavioral change. We strengthen our resilience to the effects of deeply distressing or disturbing experiences known as trauma.

To examine the literature more closely and extract the findings cited by neuroscience research that impact health, I recently read “The Body Keeps The Score” by Bessel Van der Kolk, MD. The book is a comprehensive and informative guide to the science of trauma and its treatment. It provides a compassionate and accessible look at this complex topic, offering hope and practical strategies for recovery. 

What sets this book apart from others that address the subject of trauma research is that the author is both a psychiatrist and researcher with a long history of measuring the effect of trauma on brain function, memory, and treatment outcomes, in addition to being an active therapist who keeps learning from his patients what benefits them most.

The central theme of the book is to demonstrate how trauma reshapes both the brain and body, impacting memory, emotions, and even physical health. The book explains the brain–body connection, how trauma can lead to chronic stress and pain, why survivors may feel stuck in the past, and how healing is possible. van der Kolk’s findings are essential to view alongside behavioral theories like Maslow’s because they explain why such theories alone fail to address the biopsychosocial factors that prevent self-actualization.

In the summaries that follow, I will highlight key points from the book and present my general conclusions.

___________________________________________________

References:

Maslow, A. H. (2011). Toward a psychology of being. Wilder Publications.

When craft becomes art: How We Honor Those Who Love Us

Photo by Carol Highsmith

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

While reading through the literature for Retracing Our Paths, I began to reflect on what has been lost.  Every society and culture experiences loss.  The question is not whether loss will occur, but what things should we preserve and protect from becoming absent and unknown?  Generally, most cultures that become industrialized lose some of their distinct identity.  This is expected.  However, often what remains after men and women who hold the knowledge of their craft die is an incomplete history.

 It is said that craft focuses on skill and utility, whereas art emphasizes creative expression and aesthetic or intellectual content. A craft is often functional, but the materials used or the process in which it is made, traditionally, can elevate materials beyond their specific purpose.  In some cultures, there is no distinction made between craftwork and artistic expression.  They are seen as one.

An example of this is found in the photograph at the top of this page.  Quilt making, or “Quilting” as it is called, is the process of joining several layers of fabric together, either manually using a needle and thread or mechanically with a sewing machine. The photo depicts a woman and a young girl sitting at a quilting frame.  Although not explicitly stated, something is transpiring between the woman and the girl.  The woman is closely observing the young girl and perhaps assisting the girl with a stitch on the quilt that is stretched over the quilting frame.  The hands of both the woman and the girl appear to be touching as they rest on the quilt.  Because the photographer doesn’t write the narrative for us, we must use our own imagination and social references to conclude that a form of communication and knowledge is being shared between the two.

It’s this exchange, and what is verbally acknowledged and visually observed in both the woman and the young girl, that moves the task from being purely functional to an expression aimed at creating a powerful social and cultural narrative, transforming their quilt-making from craft to art.  Perhaps the two are related, and biological and emotional bonds already exist between them, which the process of quilting is helping to mend.  However, we are not told this.  It is only my assumption.  What is important are the stories that are told, remembered, and passed on long after the quilt is gone.

The young girl is witnessing and receiving instruction on the craft— knowledge.  How to make a quilt, its purpose, and its function as a covering for warmth.  Along with its functional purpose, the quilt also serves to preserve a valuable skill that reinforces identity, independence, and creativity.  Since all sewing was initially done by hand, it became essential for one's survival.

A quilt, similar to a book, has many pages in the form of cloth patches of varying sizes, shapes, and colors.  The process of producing a quilt usually involves two or more women working together for months at a time.  It is often pieced together by hand, requiring close stitching and the coordination of cloth by pattern, size, shape, and color. It is a learned skill that has to be taught and is therefore educational.

Like most crafts, the art of instruction is the life stories we share about how to live and navigate in the world of work.  How to collaborate with people who disagree with us.  How to suffer and celebrate the seasons of life and seasons of the heart.

Each quilt tells a story.  If you listen to the women (and some men) who are quilters, you will discover how they trace their history and family origins using the cloth patches sewn into the quilt during its creation. These oral histories are repeated many times over to eventually become lore.

The quilt then transforms into a “living” cloth, known best by those who labored to fashion it. Quilts then become a tapestry filled with old and new fabrics that tell the stories of a generation.

The aesthetic beauty of these finished works is appreciated by many.  But if they are to be fully treasured as works of art for their value by others unfamiliar with the craft, the story of each quilt must be told separately.

*     *     *     *

 My grandmother lived to be ninety-eight and retained her cognitive function until the very end.  She created numerous quilts throughout her lifetime.  She worked independently, sewing by hand and using a 1953 treadle Singer machine that she purchased new.

 My grandmother was a storyteller who told stories that made others listen intently and laugh often.  She enjoyed reminiscing about farm life, sharecropping, and her childhood experiences and relations with other family, friends, and strangers.

 She died in 1998 and lived not far from where I grew up.  I spent several summers with her and have fond memories of sitting in her kitchen while she prepared more food than I could eat in one meal.  She was used to preparing meals for large households and had difficulty unlearning this skill, even when caring for just me.  My grandmother was spiritually aware of her role in life and lived with a sense of purpose and grit.  She had a deep knowledge of the soil and crops and maintained a small garden plot that she worked independently into her eighties. 

As a young woman, she worked in kitchens and helped out in the fields.  And even served for a brief time as a birth midwife, assisting with the delivery of several children. 

Warm summer evenings were spent sitting on her screened porch, listening to crickets and watching whippoorwills dash about in the darkness.  We counted fireflies and expressed imagination and curiosity at the sounds of the night. It was during these times that she would often tell stories of her migration, searching for work and living in substandard housing, surrounded by strange sights and sounds.  Occurrences that were nothing less than paranormal.

My grandmother enjoyed collecting material for quilting.  She had grocery bags and boxes full of fabric and clothing that she would use.  She proudly showed me these and told stories about how she got them and planned to use them in sewing quilts.

Sadly, for me, those stories have faded, like black-and-white photos that have succumbed to the passage of time.  A few photos, her sewing machine, and two quilts are all that remain of her visible legacy.  I wish I had recorded the stories that go with them.  Her life experiences are what matter to me.  The artifacts from her life are ways that I choose to still connect with her.  Only then do they become valuable and can be labeled as art.  True art always tells a story.

In 1984, I attended a performance at the Kennedy Center in Washington, DC.  The play was titled “Quilters”.  It is a play set in the Midwest colonial era that depicts the role that women played in the work of caring for hearth and home.  Quilting and other forms of textile work were used to produce bed coverings, window and door coverings, and clothing designed for warmth.

 I was a young college student at the time, and inspired by the play. So, I penned the following poem —a tribute to the legacy of labor from women like my grandmother.  Women of all races and nationalities who contributed to the greatness of the United States in ways that today receive little recognition.  I believed then, as I do now, that their sacrifices and arduous work should not be forgotten or obscured in the retelling of our history.

 *     *    *     *

Q  u  i  l  t  e  r  s

Caught on the edge of the present and days gone by.  A trip into the lives of American women and the way they shaped our heritage through craft.  The beauty of them all.  Both young and old.  I salute you.

You whose eyes have seen the seasons of the year unfold, both good and bad.  You were there to bear the weight of all our troubles and preserve our traditions.

You, whose able body brought fruit from the womb, and names that would be remembered for generations to come.

You, whose words were well spoken and whose songs were a joy to hear.  They served as a guide and a warning.

For the feet that have walked the breadth of this land and carried little ones from house to house, pails of water from the well, wood from the forest, and sacks of grain from the barn to the fields.

And for all of the women whose strong arms and hands preserved the stories of our lives through their art in the American tradition.

—S.M. Hawkins

I now return to the question I asked at the beginning—What things should we preserve and protect from becoming absent and unknown? 

I believe the answer is found in the things that remind us of who we are, where we've come from, how we have changed, and how we have not.  Timeless things that define our inward character and not just our outward appearance.  Things that cause us to believe that we can learn from everyone about what is good and what is not.  Things that will destroy kinship and family relations, and things that will preserve these relationships, keeping them strong and bound in ways that are healthy. These characteristics are inherent in the soul or ethos of all people.

Restarting conversations and resuming the rituals of coming together requires supporting the efforts of individuals, families, and groups within our communities engaged in a skilled craft, whatever it is.  And by identifying shared experiences, opportunities for mentoring, and committing to work collaboratively on goals that rebuild trust, we can then prepare those who will follow us.

As a clinical social worker, I believe that these practices should be integrated into the way we retell our stories, whether they are pleasant or painful.  When we do this, we create a space for reflection, healing, and rediscovering who we are, where we are going, and what we are becoming as individuals and as a culture. If we do these things well, the outcome will be a legacy that will influence future generations.

In the words of Eric Overby, “We never fully move on; we leave a piece of ourselves behind like leaves and trunks molded into the earth and the forest floor.  We give what we know, and others take it up and use it to grow.  [We] stand under the shade of giants.”

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References

PBS NewsHour. (2022, March 26). Famed Gee’s Bend Quilters are now on the runway and online [Video]. YouTube. https://www.youtube.com/watch?v=0QdGxVXPCME

Women’s Theater Workshop. (2019, April 21). Women’s Theatre Workshop Quilters by Molly Newman and Barbara Damashek [Video]. YouTube. https://www.youtube.com/watch?v=wqMGE3h0BuU

Intertwine

Photo by Marino Linic

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

What’s on your mind as we come to the end of another year? I will share with you what I’m thinking about as we bring 2025 to a close. Celebrating life and what is good while acknowledging death and refuting the evil that incites it requires that we find meaning, foster connection, and plan for the future, even when the immediate future remains bleak.

Reflecting on 2025, I’m reminded again of how fragile life is and how much we take for granted, assuming it will remain untouched, permanent, and familiar. We have become more accustomed to certain things and, in the process, more tolerant, more resilient, and more accepting of the things that inevitably change the ways we think and live.

“Intertwine” is how I have come to define the intricate dance we have in the liminal space between good and evil. Not only the changes that impact our bodies (healthy aging vs. disease), but also the contradictory philosophical, social, and political beliefs, we are forced to rethink and hold simultaneously. Psychology refers to this as cognitive dissonance. For this essay, I will refer to this as Intertwine, defined in the Cambridge Dictionary as: to twist or be twisted together, or to be connected and difficult to separate.

Though not exclusive, I believe three public concerns have captured growing sentiment and the attention of advocates for social justice, with the debate over which legislative policies would best serve the country.

Health Care for All:

Despite numerous high-level political commitments to achieve Universal Health Coverage (UHC) by 2030, more than half of the world’s population still lacks access to essential health services. One in four people face financial hardship when paying for health care out of their own pockets-often at the expense of basic needs such as food, education, or housing.  (Universal Health Coverage Day 2025, n.d.)
We must ask the question: Is health care considered a right or a commodity?

Expanded Expedited Removal:

is a procedure that allows U.S. Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) officials to rapidly deport noncitizens who are said to be undocumented or who have committed misrepresentation or fraud. Under expedited removal processes, certain noncitizens are deported in as little as a single day without an immigration court hearing or other appearance before an Immigration judge. More individuals are being apprehended across the U.S., requiring quick removal if they cannot prove two years of residency. Many reside legally in the US under Employment-based (EB), Family-based (FB), and Academic Study (F-1) visas, but are not afforded Due process. The only exception would be those who have entered the country illegally with the intent of seeking asylum. We must ask: What are the ethical and human rights implications of current immigration enforcement on immigrant communities’ mental health and integration?

Gun Control Policy:

The rate of firearm-related deaths in our nation is rising. While mass shooting deaths represent only about 1% of firearm-related deaths in the U.S., mass shootings in general cause outsized collective trauma on society and have a strong negative effect on the public’s perception of safety. The impacts of this violence are felt across entire communities, contributing to generations of trauma and collective grief. (General, 2024)

Although there is no correlation to mass shootings, gun homicides on average disproportionately impact communities of color. Gun violence is the number one killer of African Americans aged 15 to 34. Even though African Americans make up only 13% of the U.S. population, we represent nearly 50% of all gun homicide victims. Concerning U.S. gun policy, we must ask: How should the constitutional right to bear arms be interpreted and balanced against the government’s duty to ensure public safety? (NAACP, 2021)

Embedded in each of these questions are conflicting beliefs and polarizing views that are intertwined, dividing individuals and the country. However, an inability to arrive at a satisfactory resolution should not be a reason to abandon the fight for access, domicile, and safety. Each statement seeks to address specific considerations, and most will agree that they have some merit. Yet I can’t help but experience injustice when I see social policies or the lack thereof that are subversive, dehumanizing, and their result is evil. Why is this?

The late Nobel-winning poet and essayist Joseph Brodsky (1940-1996), in a 1984 commencement address, best summarizes my thoughts:

“No matter how daring or cautious you may choose to be, in the course of your life you are bound to come into direct physical contact with what’s known as Evil. . . No amount of good nature or cunning calculations will prevent this encounter. . . Such is the structure of life that what we regard as Evil is capable of a fairly ubiquitous presence if only because it tends to appear in the guise of good. You never see it crossing your threshold, announcing itself: “Hi, I’m Evil!” That, of course, indicates its secondary nature, but the comfort one may derive from this observation gets dulled by its frequency.” (Brodsky & Brodsky, 2020)

Brodsky concludes, “The surest defense against Evil is extreme individualism, originality of thinking, whimsicality, even if you will— eccentricity. That is something that can’t be feigned, faked, imitated; something even a seasoned imposter couldn’t be happy with. Something, in other words, that can’t be shared, like your own skin.” (Brodsky & Brodsky, 2020)

Brodsky and other essayists influenced by him (including people of color, Gwendolyn Brooks, Robert Hayden, etc.) suggest in their writing that the concepts of equality and inclusion require democracy, something we are being challenged to reconsider. The questions that advocates for social justice must ask are: What constitutes a moral victory? And what would this type of victory look like in our present day?

In 2026, those of us in the helping professions must re-examine what battles we are willing to fight and possibly die for, if current trends continue. We must also accept that some problems are larger than past solutions we proposed to fix them.

As the year ends, we must mourn our losses and celebrate our wins, as well as what good remains in both individuals and their actions—the intertwine. We must do so with the potential for contentment and with a commitment to refocus our efforts, balancing the things we cherish with what we have condemned and judged as equal to death. We must, in every chapter of life, learn from history, not ours alone, but from others. And to carefully twist the strands of dissension and unanimity in ways that preserve what we most want to see and communicate to the world. Our values and how we wish to be remembered by those who knew us. In short, we must continue to endure in what we believe, while educating those who will listen to what seems irreconcilable. We must press forward. We must fight. We must continue the work.

 ___________________________________________________

References:

Brodsky, J., & Brodsky, J. (2020, September 16). A commencement address. The New York Review of Books. https://www.nybooks.com/articles/1984/08/16/a-commencement-address/

General, O. O. T. S. (2024). Firearm violence in the U.S.: Death and injury. Firearm Violence: A Public Health Crisis in America - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK605168/

NAACP. (2021, July 7). Gun Violence Prevention Issue Brief. https://naacp.org/resources/gun-violence-prevention-issue-brief

Universal Health Coverage Day 2025. (n.d.). https://www.who.int/campaigns/universal-health-coverage-day/2025

Retracing our Paths - Remembering Our Origins

Photo by Lindsey Mataeo

B E L I E F

“When it feels disheartening to learn that trauma changes the brain, remember that healing changes the brain too.”

-Poppy Leigh

By Sterling Hawkins, MSW, LCSW, LICSW

I want to end this series with "Belief" because beliefs shape our values and define our spiritual, moral, and ethical core.  Belief is more than a religion.  It's also about a connection to something greater than oneself.  There are many types of Belief Systems.  Let’s examine some of them:

Religious- embodies questions about the nature of the divine, the afterlife, and moral standards.

Scientific- influences our understanding and interpretation of natural and physical phenomena.

Philosophical- seeks to answer life’s fundamental questions about our existence, reality, knowledge, values, and morality.

Political- shapes how societies should be organized, and the distribution of power, rights, and resources for the populace.

Economic- defines how societies produce, distribute, and consume goods and services.

Cultural- examines a collection of beliefs, values, and attitudes that are shared by members of a particular culture, that shape their worldview.  (Drew, 2023)

From this short list, we see that Belief Systems are diverse, complex, and share some things in common.

In the beginning, before civilizations evolved, there was a connection, an attachment, an intimacy, and rootedness in the sacredness of everyday life, which philosopher Thomas Moore calls the primary source of religion.  (Moore, 1992, p.203)

 Religious belief systems must provide a sense of structure and predictability, in conjunction with established guidelines that aid a person's ability to distinguish right from wrong when coping with difficult life circumstances.  It should also teach compassion, forgiveness, and gratitude.  And finally, it should provide a community that offers support and safe social engagement.  (Nami & Nami, 2024)

However, over time, this awareness of the sacred was lost.  While many reasons can be attributed to this, it is critical to understand what has happened in the context of forced migration that was experienced by Black people who were enslaved along with other Indigenous groups for 300 years (1500s - 1860s).

What was lost was more than a native homeland, property, and cultural wealth.  What was lost was an identity centered on traditional and legendary stories woven into rituals and origins of myth and historical facts.

African Americans, due to the many atrocities described in my previous essays, have both a fragile and durable sense of identity because of what has been taken from us.  And because of what we have had to do to rebuild and restore it.  Fragile in the sense that many of us have been in recovery for decades from retracing the effects of racism, sexism, ageism, and economic injustice.  At the same time, we are made more durable by remembering our origins- community, family, faith, perseverance, and social justice.

Intergenerational Trauma is at the root of many evils.  Our trauma experiences shape what we believe and influence how we behave, even without our conscious awareness. 

When Africans were transported to an alien land and enslaved, the effect was no less than shattering.  Dispossession destroyed their traditional culture and disrupted social organization, depriving them of their orientation to the world as it had previously been known.  "The organization of labour and the system of social control and discipline on the plantation both tended to prevent the development of social cohesion on the basis of whatever remnants of African culture might have survived or on the basis of the Negroes’ role in the plantation economy." (Frazier 1969, p.3)

Colonization and enslavement prohibited Africans from preserving their native language.  The transient nature of plantation life, where man, woman, or child could be sold on a whim, contributed to this loss of cultural heritage.  Moreover, it was nearly impossible for the enslaved to meet openly or assemble without the presence of a white overseer.  This applied especially to their gathering for religious purposes.  (Frazier, 1969, p.3)

“Men, women, and children who were captured and transported to the Americas on slave ships brought with them their own religious beliefs and practices.  Some were practitioners of African traditional religions like Yoruba and Vodun; others were Muslim or Catholic.  But they were all often seen as heathens by the colonists, who found justification for enslaving them in interpretations of biblical scriptures.  " (Hannah-Jones & Magazine, 2022, p. 340)

Yoruba and Vodun were the primary West African-based religions with shared origins.  Both believe in a supreme God and venerate deities that serve as intermediaries between God and humanity.  Both utilize divination to seek guidance and insight into current and future situations.  They each utilize rituals, ceremonies, and offerings to connect with the spiritual world and to seek blessings and guidance.   (Encyclopedia of African Religion, 2009)

Their differences are minor.  First, geographically, Vodun originated primarily among West African cultures, and Yoruba was practiced mainly in southwestern Nigeria.  Second, rituals and ceremonies - While both religions share the veneration of ancestors, Vodun differs in that it incorporates more elements of nature and physical objects.  In contrast, Yoruba culture emphasizes honoring the spirits of the dead, who are believed to have a profound influence on the living.  (Encyclopedia of African Religion, 2009)

While there are other religious belief systems throughout the African continent, most traditional African religions share similarities with the Yoruba and Vodou practices.

Enslaved Africans in time, however, would gradually be introduced into the religious life of their white masters and learn to adapt many of their beliefs from the old world to the new.  (Frazier, 1969, p.3).

Traditional beliefs in West African religions can be further categorized by examining the characteristics that define the unity of most religious belief systems, both ancient and modern.  I have listed below what I believe to be the five most essential characteristics that have remained and that have been integrated into contemporary culture:

Belief in a Supreme Being - Ancient and modern religions acknowledge the belief in a single, all-powerful creator or deity.

Afterlife and the Soul - When a person dies, their soul continues to exist in a different realm or state.

Ancestral Reverence - Honoring and respecting ancestors, both living and dead, is a way to remain connected to the past.

Sacredness in Nature - The natural environment offers humanity resources both for survival and for its beauty to be admired.

Moral Codes and Ethics - Ancient and modern beliefs incorporate moral codes and ethical guidelines that govern social behavior and interaction.

 It's interesting to note that many of these general characteristics are found not only in traditional African religions but also in religious beliefs worldwide, making them universal.

I cannot speak about Black culture without acknowledging the Black church.  You may be asking what the Black church is, and how the Black church differs from any other church.  I want to take a few minutes to explore the concept of the Black church from a historical perspective, rather than a contemporary or denominational one.

The term "the Black Church" evolved from the phrase "the Negro Church," the title of a pioneering sociological study of African American Protestant churches at the turn of the century (1903) by W.E.B. Du Bois.  African Americans, however, preferred instead to think of themselves as belonging to denominational affiliations such as Methodist, Baptist, Presbyterian, or Catholic. "The Black church was never monolithic.  Its people are diverse and its churches highly decentralized." (God in America- the Black Church, n.d.)

"The black church refers to the collective religious institutions and communities established by African Americans, which serve as a foundation for spiritual growth, cultural identity, and social activism.  This institution has played a crucial role in the development of African American religious traditions, providing a space for worship, community building, and resistance against oppression throughout history.”  (Intro to African American Studies Review- Key Term- the Black Church, n.d.)

There is general agreement with this definition and the concepts have broad implications.  While the contemporary expression of religious beliefs within the African American community may be diverse, all mainstream denominations share a common root in the belief in a Supreme Being or Creator, as well as a Moral and Ethical Code.  The application of this belief varies among multi-ethnic churches.  But, because of the injustice inflicted on African Americans, most Black churches focus on a theology that integrates education, economic empowerment, and social welfare with how all of humanity should live and be treated by others.  Racial oppression resulted in the loss of social cohesion within the Black community, and the need to retain and pass down the practices that have preserved the culture, however challenging that might be.

Social cohesion is the strength of relationships and the solidarity among members of a community. It influences how people interact, collaborate, and support one another.  It is the integration of diverse individuals into a unified whole, promoting a sense of trust and mutual respect among members, reducing social conflict, and enhancing cooperation.  Various factors contribute to social cohesion, including cultural, economic, political, and religious elements. "Religion often plays a significant role by providing a common set of values and beliefs that unify individuals and strengthen community bonds." (Devappa, 2014)

The Black Church comprises all of these things.  And like all major religions, it establishes a rationale for belief.  A rationale some may find hard to define or refuse to accept but exists nonetheless within the soul of every living being.

Because the influence of religious belief is so prevalent not only within the African American community but among society in general, I cannot ignore its potential to aid those afflicted by the effects of Intergenerational Trauma or provide insight that may explain the psychosocial dilemmas that have become woven into our daily habits and interpersonal relationships.

As a clinical social worker, this is where I find myself- working through my own trauma and the collective traumas of others, while asking the question- What are the most helpful therapeutic practices that bring healing to those who identify with a religious belief system in the African American community?

So, when working with African American clients who acknowledge a history that is assessed by a therapist to be linked to intergenerational trauma, and who engage in some form of spiritual (religious or unidentified) belief system, the following list provides several essentials for working with this population.

Historical Context:

Mental health providers working with African American clients should be aware of the unique historical and cultural context that has shaped their clients' experiences.  This includes understanding the impact of slavery, Jim Crow, and institutional racism on mental health.

Cultural Competence:

Providers must be sensitive to the cultural beliefs and values of African American families, while respecting their diverse experiences and acknowledging the significant roles of community and family in the healing process.

Addressing Stigma:

African Americans may face stigma surrounding mental health treatment.  Therefore, providers should create an environment that allows clients to feel comfortable seeking help.

Family History:

Encouraging clients to explore their family history can help them understand the origins of intergenerational trauma and identify patterns of resilience and survival.

Empowerment and Resilience:

Providers of services should emphasize the strength and resilience of African American individuals and their families, helping them identify their sources of strength and effective coping mechanisms.

A Final Word

Many clients have distanced themselves from their religious beliefs (if they were raised in a particular faith tradition) because they have experienced emotional and/or physical trauma from persons who were once deemed trustworthy but proved otherwise.  Or, for reasons more germane to its (religion's) perceived failure in providing relevant alternatives in line with a secular worldview.  Regardless of the reasons, practitioners working with all individuals, irrespective of their ethnicity, must first be aware of their own positive or negative experiences with a faith tradition and work with clients who express an interest in exploring their spirituality within or outside of their identified faith tradition with curiosity and non-judgment.  (Spirituality and Therapy: Reinvention, Doubt and Healing, 2024)

As with all trauma-work, clients who present with complicated histories involving intergenerational trauma require a safe space to be heard by the therapist and allowed to tell their unique story, while expressing emotions that have been repressed, that are labeled as bitterness, shame, or guilt in relating how they have felt betrayed by their faith or family who committed harm in the name of religion.

African Americans may need help re-examining their belief systems, values, and faith traditions, while expressing doubt and struggling with contradictions between what they were taught and their lived experiences.  This can involve identifying sources of conflict, finding new meaning in or interpretations of traditional beliefs and practices, and creating new spiritual practices aimed at personal transformation.

Ultimately, by inviting people of color to retrace their past and remember their origins, mental health providers are educating others to find religious and/or spiritual practices aimed at healing from trauma.  The healing of longstanding wounds resulting from intergenerational trauma is a process that requires grieving the loss, developing meaningful personal rituals or social activities, and remembrances aligned with the client's interest and knowledge about what they think will be helpful, not only in addressing their own trauma but also similar trauma identified within their families and their community.

____________________________________________________

References

Devappa, M. K. (2014). THE ROLE OF RELIGION IN SOCIAL COHESION. In International Journal of Research and Analytical Reviews (IJRAR), International Journal of Research and Analytical Reviews (IJRAR) (Vol. 1, Issue 3, pp. 360–362) [Journal-article]. https://www.ijrar.org/papers/IJRAR19D5972.pdf

Drew, C. (2023, September 7). Belief Systems: Definition, Characteristics & Examples (2025). Helpful Professor. https://helpfulprofessor.com/belief-systems/

Encyclopedia of African Religion. (2009). Sage Publications. Retrieved May 28, 2025, from https://afroart.ru/books/Encyclopedia-of-African-religion.pdf?srsltid=AfmBOopCBfvbf-hX-0dsLkzwvEtBTGrJmJly5uU0JUEQCFkLODLMdPF2

Frazier, E. F. (1969). The Negro Church in America [by] E. Franklin Frazier.

God in America- the Black Church. (n.d.). https://www.pbs.org/wgbh/americanexperience/features/godinamerica-black. Retrieved May 28, 2025, from https://www.pbs.org/wgbh/americanexperience/features/godinamerica-black

Hannah-Jones, N., & Magazine, N. Y. T. (2022). The 1619 project: A New Origin Story. National Geographic Books.

Intro to African American Studies Review- Key Term- The Black Church. (n.d.). https://library.fiveable.me/key-terms/introduction-african-american-studies/black-church. Retrieved May 28, 2025, from https://library.fiveable.me/key-terms/introduction-african-american-studies/black-church

Moore, T. (1992). Care of the Soul : How to add depth and meaning to your everyday life. http://ci.nii.ac.jp/ncid/BA46460909

Nami, & Nami. (2024, February 7). The mental health benefits of religion & spirituality. National Alliance on Mental Illness (NAMI). https://www.nami.org/faith-community-leader/the-mental-health-benefits-of-religion-spirituality/

Spirituality and therapy: Reinvention, doubt and Healing. (2024, December 12). Heal Your Roots Wellness. https://www.healyourrootswellness.com/blog/spirituality-and-therapy-reinvention-doubt-and-healing-from-religious-trauma/?srsltid=AfmBOorESHaRdFxjHvdD_qgO4uoA9VWwoD7WlZ2M7GhKOGE1AbbX2IyH

Retracing Our Paths - Remembering Our Origins

Photo by. Yan. Krukau

P R O F I T - NOW

“Wealth is not only a question of financial savings; it provides access to the political process and therefore, exerts political influence. . . Eliminating the disparities between Black and white wealth is a generational undertaking, but it is one this country can and must tackle.”

—Center for American Progress

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

While the focus of this essay is on financial wealth, it’s important to see wealth as distinct from income. For the Black community, wealth has always represented social power and influence that provides access to education, housing, and healthcare. Therefore, wealth is best defined as a state of being. The concept of wealth is one that endures both within and across generations. And this is why Blacks have struggled to attain it. And over the last century, African Americans have experienced some gains. Financial wellbeing is the first step that allows individual families and communities to meet current and ongoing financial commitments while feeling secure about their future.

In 1921, two Black American entrepreneurs, O.W. Gurley and J.B. Stratford formed an informal partnership to develop Greenwood, an all-Black district in Tulsa, Oklahoma. Both men shared a vision of self-sufficiency—a community where they could remain independent from white communities and escape the Jim Crow South. Their story began in 1906 when Gurley arrived in Tulsa, purchased land, began subdividing it, and sold plots exclusively to other Blacks.

Stratford, who was already a resident of Tulsa, focused on real estate, building rental units and eventually a luxury hotel that became the symbol of Greenwood’s prosperity. Their estimated net worth was over $150,000—equivalent to nearly 7.5 million today.

Between 1910 - 1920 Tulsa’s population grew nearly fourfold. The Greenwood district famously known as the Black Wallstreet of America grew into almost 40 city blocks, home to 108 Black-owned businesses (physicians, lawyers, bankers and businessmen and women) with its own hospital, banks, theaters, library, salons, restaurants, and numerous churches, serving a population of over 11,000 people.  (Long, 2025)

“On the morning of June 1, 1921, this financially independent and vibrant community that had been built and sustained by Blacks became the site of one of the worst race massacres in US History, fueled by white supremacists, where hundreds of people were killed, thousands were left homeless by fires, and hard-earned, substantial Black wealth and prosperity were destroyed.”  (South et al., 2022)

The conflict arose when two Black men (not Gurley and Stratford) were falsely accused and charged with assault. In retaliation, a white mob looted and burned businesses, churches, homes, and community institutions. “Many residents saw their wealth reduced to ashes. This was not an isolated event, but part of a broader pattern whereby racist Americans have used violence and discriminatory policies— such as redlining, gentrification, and economic exclusion to suppress Black advancement.”  (Long, 2025b)

Present-day racial exclusion is attributable to the many government and institutional policies that were historically instituted by whites to suppress African American progress. “While Blacks contributed to 12 generations of unpaid labor during enslavement that generated tremendous wealth for White families and shored up the U.S. economy, they entered the era of Reconstruction with little to nothing. During the Jim Crow period, laws designed to bolster economic outcomes for specific vulnerable populations— for example, Social Security for older adults and the G.I. Bill for veterans — were structured and executed in such a way to exclude Black people.”  (South et al., 2022b)

To complicate the situation, Blacks were subject to predatory lending by large U.S. banks accompanied by discrimination within the real estate industry that targeted Blacks living in low-income housing. U.S. tax law further complicates these intergenerational disparities, which provide preferential treatment for inherited assets.   (South et al., 2022c)

The impact of such policies creates significant challenges to overcome. The result is seen in culturally defined patterns that explain why some African Americans have suffered more than other marginalized racial groups. Discriminatory public policies have created functional deficits that have become internalized by families and whole communities that are in response to the wealth gap trauma in relation to impaired mental health. Let me explain.

Research studies conclude that individuals from socioeconomically disadvantaged households have higher levels of trauma resulting from unmet needs. The original ACE (Adverse Childhood Experiences) studies began in 1985 as a collaborative research project between the Centers for Disease Control and Kaiser Permanente Health to examine the correlation between childhood trauma and later-life health outcomes.   While the research did not focus on race or ethnicity it did examine “experience”. The childhood experiences labeled as trauma I believe are inclusive and representative of all ethnic groups subjected to prolonged trauma. This includes African American children whose trauma would occur at higher percentages than whites who at the very least possessed some form of health insurance.  (Goldstein et al., 2020)

Researchers examined the following types of trauma— Abuse (physical, emotional, sexual), Neglect (physical and emotional), and finally, Household Challenges (parental separation or divorce, substance abuse, mental illness, incarceration, or domestic violence ).  If any one member within a single household directly experienced one or more of these conditions, their risk for adverse health outcomes increased in proportion to the number of adverse experiences during that individual’s lifespan. Childhood environments that are abusive, neglectful, or present physical and emotional challenges do impact the biopsychosocial development of children. And these experiences have a cumulative effect that extends well into adulthood. Parents and guardians who themselves have experienced trauma may be at a disadvantage in offering their dependent children what they have failed to attain for themselves.  (Goldstein et al., 2020b)

The original ACE study has expanded into branches of new and independent research concerning the effects of trauma. Studies now include— Environments (i.e. the context in which trauma occurs) where individual experiences often originate. Some of these environments include Poverty/ Discrimination/ Community Disruption/ Poor Housing Quality and Affordability/ and Violence.  (“Adverse Childhood Experiences,” 2022)

More recent studies on individual experiences and environmental conditions have reached similar conclusions. Adverse childhood experiences are often linked to adverse family experiences. And adverse family experiences heighten distress, often creating family conflicts and a disruption of primary support systems, role confusion, and shame.   (Reese et al., 2022)

Economic wellness is a critical component of good health. When we examine the outcomes from 200 years of oppression, it’s no mystery to conclude that enslavement, discrimination, and wealth deprivation have dealt a huge physical and psychological blow to many in the African American community.

A strong correlation exists between a safe and stable living environment and optimum mental health. Types of trauma closely associated with economic instability include, but are not limited to, prolonged physical and social conditions involving unemployment, the lack of affordable housing, education, and health care, which often result in toxic levels of distress. Some experience this as chronic depression, anger, avoidance behaviors, anxiety, impulsive decision-making, difficulty with goal setting and problem-solving, interpersonal/relationship conflicts, and denial. Each of these negative cognitive and affective states can be observed existing alone or in combination with other symptoms suggestive of cognitive-behavioral dysfunction. The outcome of unmet needs can be seen in how Black Americans cope with reducing the symptoms associated with financial instability.  

These are tough, multi-systemic problems that are inextricably rooted in generational trauma. It would be unfair to attribute such problems to the absence of wealth alone. However, given that so much of our psychological identity comprises what we own and our perceived net worth, it can't be easily dismissed or ignored.

We cannot ignore or dismiss the severity of intergenerational trauma and its impact on building Black wealth.  What is the solution? How can mental health practitioners best help African American clients affected by low income and financial insecurity?

There are numerous ways to get there, and none without challenges. However, it’s important not to become too enmeshed in the numbers. The research describes what we’ve long believed: that no progress will be made without major social and political shifts toward removing barriers preventing African Americans from competing economically and building wealth.

When working as individuals, it’s helpful to begin on a micro-level and help clients ask themselves, “What can I do to eliminate or minimize how exclusionary policies impact me personally?” When we begin with where the client is, the task becomes more manageable and perhaps more personal in ways that allow clients to see that small changes over time can make a difference in their future and the choices available to their children. These decisions may lead to outcomes that will positively alter their present circumstances and the next generation for their future good. The following three approaches may be helpful.

Talking About Money:

Often, parents wait to start teaching their children about money until they are adolescents. However, understanding money, what it is, and what it can and cannot do for us is foundational to understanding its value and how we choose to allow it to shape our actions.  Such an education begins in early childhood.   If we have always chased after money only to fail and/or to lose it or have it taken away, our experiences will be reflected in those lessons (implicit and explicit) about money we teach others.

We fail to talk about money because of the pain associated with not having it.  As African Americans we need to be aware that our relationship with money is connected to our collective trauma of being without it.  Some of us grew up in less-than-desirable circumstances and never had enough of what we needed.  Therefore, if we are fortunate enough to escape those conditions, we may try to compensate for those losses in ways counterproductive to building wealth.

What this looks like will depend on whatever is lacking.   For some, it was food insecurity; for others, it was being unable to afford nice clothing, a new car, an education, a vacation, or a home.  The thing we always wanted when we were young, but no one in our family possessed.  Or we were told that we couldn't have it because it costs too much, we don’t earn enough, are already in debt, and no one will buy it for us.  All of these scenarios begin with a conversation about money.  (How Black Families Can Build Generational Wealth|U.S. Bank, 2025)

Increasing Financial Literacy:

Talking about money begins with understanding “currency” a fluid concept that can be applied to money and anything with an attached “value”.  As an adult, it’s crucial to define money’s role in your own life before you attempt to teach the concept to your children.  Defining the role that money serves in your life and the value it creates beyond the material things it allows you to purchase is the beginning of developing a healthy relationship with money and its relation to wealth. Because of racial and ethnic disparities, access to financial resources has historically been limited. Now, education on building wealth abounds on numerous social-media platforms. There are also many Blacks serving in the role of: CFP, CFA, CIMA, and CPA, who, through their professional training, are qualified to educate and inform their clients on how best to save, spend, and invest their money.

Clients and Consumers of financial services should do their homework and complete background checks for those individuals and firms they wish to utilize for help. They should compare and contrast what they observe across multiple sources to validate credibility and build a general knowledge base that will allow them to set short- and long-term goals and develop the skills to navigate complex financial environments and systems, access capital, and create economic opportunities.  (Shrm-Cp, 2023)

Adopting an Investment Mindset:

Over the years, African Americans have had a bitter-sweet relationship with investing. Financial investment seems like a foreign concept when you’re worried about the mortgage, rent, or paying for groceries and school fees. I stated previously that it’s complicated because of our history and inability to earn, save, or properly invest for the future. However, developing an investment mindset requires a vision for the future. Your future. Creating a realistic vision based on actual numbers will enable you to grow and expand. It requires a commitment to identifying things that are within your control and things that can be accurately measured. There are multiple ways to adopt an investment mindset. For those seeking to begin the process, I offer the following suggestions:

Start Small: Even investing or saving a small amount of money can be a powerful first step. Experiencing the process of buying and potentially selling an asset, and observing its value fluctuate, provides firsthand learning.

Learn from your Mistakes: Experiencing investment losses (a normal part of the process) and analyzing what went wrong can be a valuable learning opportunity, fostering a more cautious and informed approach in the future.

Regulate your Emotions: Allow skilled mental health therapists to help you develop self-regulation while learning to manage emotions like fear and greed, which can lead to impulsive investment decisions. Emotional regulation requires delayed gratification and patience that prioritizes security.

I believe that, as Black people, our psychological healing with wealth can be summarized in the following quote: “Never ever chase money. You should chase success because with success, money follows.” – Wilfred Emmanuel-Jones  

According to Jones, a successful Black farmer and entrepreneur, having money results from success. What success looks like for you or me may be very different. However, if we fail to define individual success, all we'll do is chase money.  The implication is that we should chase “meaning” with a purpose in mind and not money as an end.  A purpose that is sustainable even in the absence of monetary rewards.

From a generational perspective, we must first ask ourselves what success looks like for our families, neighbors, and communities. When we begin to answer these questions, we will discover that true success has little to do with money.  It's much more than money. It involves reciprocity, giving back, and getting something in return. Then, we can begin to heal, and when we begin to heal, we will begin leaving a rich legacy of wealth that will endure for generations to come.

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References:

Adverse Childhood Experiences. (2022). In https://www.ncsl.org/health/adverse-childhood-experiences. National Conference of State Legislatures. Retrieved April 27, 2025, from https://www.ncsl.org/health/adverse-childhood-experiences

Goldstein, E., Benton, S. F., & Barrett, B. (2020). Health risk behaviors and resilience among Low-Income, Black primary Care patients. Family & Community Health, 43(3), 187–199. https://doi.org/10.1097/fch.0000000000000260

How Black families can build generational wealth | U.S. Bank. (2025, April 23). https://www.usbank.com/wealth-management/financial-perspectives/financial-planning/black-families-build-generational-wealth.html

Long, L. V., Sr. (2025, February 25). Rebuilding Black Wealth: Lessons from Black Wall Street. Forbes. https://www.forbes.com/sites/lenwoodvlongsr/2025/02/25/rebuilding-black-wealth-lessons-from-black-wall-street/

Reese, E. M., Barlow, M. J., Dillon, M., Villalon, S., Barnes, M. D., & Crandall, A. (2022). Intergenerational Transmission of Trauma: The mediating effects of family health. International Journal of Environmental Research and Public Health, 19(10), 5944. https://doi.org/10.3390/ijerph19105944

Shrm-Cp, T. G. M. A. (2023, December 29). Breaking Barriers: The power of Black financial literacy. Money Talk With Tiff. https://moneytalkwitht.com/blog/black-financial-literacy/

South, E., Venkataramani, A., & Dalembert, G. (2022). Building Black Wealth — The role of health systems in closing the gap. New England Journal of Medicine, 387(9), 844–849. https://doi.org/10.1056/nejmms2209521

Retracing Our Paths - Remembering Our Origins

Photo by Pratikxox

P R O F I T - THEN

“White households have been able to build wealth for themselves and their descendants, while whatever wealth Black families could amass was regularly stripped away.”

—Center for American Progress

By Sterling Hawkins, MSW, LCSW, LICSW

African Americans have historically had a strained relationship with wealth, which is intertwined with economic, human, physical, and social capital. When Blacks proved valuable to a developing Republic, we were exploited for our labor. When our labor became less profitable due to mechanization, we were physically and socially oppressed, unable to buy and sell property. We were denied due process, judged, and condemned as undeserving.

Whenever a person of color rose above insurmountable odds, they became targets, were vilified, and made an example of what can happen when you reach too far and dream too big. The lesson Blacks learned from systemic racism is that practices embedded in American society were designed to perpetuate inequality. Under such practices in many American institutions, Blacks spent their whole lives just trying to avoid being singled out. They were less ambitious, less hopeful, and often fearful for reasons, having less to do with their competence and resourcefulness and more to do with their denial and punishment.  

This is how intergenerational trauma began to manifest and then become embedded over time into the fabric of the Black community. Social scientists believe these are adaptive strategies aimed at survival and avoiding harm (psychological and physical).

The downside of Capitalism is the inability to attain wealth or lose it simply because others believe you don’t deserve it. Wealth and power require checks and balances. Something that America has struggled with since its infancy.  Equality and Want coexist but are rivals under a democratic system. An example of this can be seen in the New Deal Policies proposed by President Franklin D. Roosevelt (1882 - 1945).  

FDR’s New Deal forced many Black farmers off their land and failed to support them in their efforts to create opportunities for social justice.  Two such policies- Relief for the Poor and Unemployed and the Agricultural Adjustment Administration were of no benefit to Blacks due to discrimination and exclusionary practices.  Blacks were excluded under Jim Crow (1865 1968)- a system of segregation and disenfranchisement introduced in the South to preserve racial discrimination.  On April 11, 1968, The  U.S. Congress and President Lyndon B. Johnson passed the Civil Rights Act of 1968 that prohibited discrimination concerning the sale, rental, and financing of housing based on race, religion, and other factors.

In the twenty-first century, all American citizens expected their government to protect their civil rights. Before the 1960s, most Americans embraced the notion that police powers (i.e., laws that govern safety, health, welfare, and morals) were reserved for individual states and did not envision the federal government protecting their health and safety.  Black civil rights organizations of the 1950s and 1960s campaigned against laws that discriminated against people of color that had existed from the early 1900s. (NAACP’s Anti-Lynching Campaigns: The Quest for Social Justice in the Interwar Years, n.d.)

Under state law, Blacks were often subject to arrest, conviction, and incarceration without a jury. Under Jim Crow, the 6th and 7th Amendments (1791), which guarantee individuals the right to trial by jury in both civil and criminal cases, were not enforced or equitably applied in cases involving Black defendants. The result was that many Blacks were charged for crimes that they never committed.  Having been denied due process, we had our property confiscated from us simply because we demonstrated industry and ambition that our white neighbors found threatening.  

In the South, death by lynching was a probable outcome for Blacks wrongly convicted.  It is estimated that there were approximately 6,500 documented racially motivated lynchings between 1865 and 1950.  (Reconstruction in America - Report Overview | Equal Justice Initiative, 2022).

Employment for Black households In the Jim Crow South was often limited, with low wages; when men were removed from the home without expectation of returning, families dependent on such income frequently failed, allowing the state to come and repossess our property and personal belongings, leaving many families destitute.  From 1901 to the 1930s, American wealth was primarily found in land and property ownership.

Land rights have historically always been prized by all (whites and Blacks) in an agricultural society. Blacks, too, were tied to the land through their suffering enslavement and by the potential it held to free them from a life of poverty. If only they could acquire it and hold onto it.

The following account highlights the challenges that many Blacks who were fortunate enough to own property faced.

“For years, I always heard my mother speak about "the land." Often, when she spoke about it, it would be with that somewhat shy and embarrassed tone that educated black folks living up north use when talking about the folks they left back home. It was one of those pieces of history that over time had to become myth or else you would spend too much time worrying over it. . .  Larry Boy, my mother's cousin, who was just a few years older then me, carried around a briefcase full of papers. Every now and then, he would call us, soliciting funds for a lawsuit over the land. I reacted like my mother until one day, I went to Natchez [Mississippi] for a family reunion and looked at Larry's papers. The papers told a pretty straightforward story, though I cannot remember it all now. It seems that we could have been oil barons.

Apparently, my mother's father or great-grandfather had a piece of land back in the 1920s that I think was given to him by the owners of a plantation where he was a slave. He kept this land until the 1920s, when someone claimed he had not paid taxes on the land. The land was then seized, auctioned and purchased by one of the rich families of Natchez. Then, oil was found on the land. This is the story Larry told me as he pulled a photocopy of a tax receipt showing that my great-grandfather had paid his taxes and that the land was really stolen from him. Then he showed me more papers about the lawsuit filed against the thieves by my mother's uncle and papers declaring an old aunt, the rightful heir, insane so they could file the suit.

Everybody agreed that he shouldn't have. He was probably cheated. But this was 1950s Natchez, now. He was black. Not well educated. They were white, and they were the law. What more was there to say? So everyone got a couple of hundred dollars rather than tens of thousands, perhaps. It could have given my family some real wealth, something for us to inherit that would put us on equal footing rather than a legacy of oppression and slavery that everyone tries to convince us is more myth than real. Today, Larry Boy still goes to city hall, poring over records and worrying about a piece of land that must now be a superfund site. So whenever people mention the word reparations, I think of the land (and so must the heirs of those who stole it).”

Stephen Casmier
St. Louis, MO (American Public Media, n.d.)

What do we hear in this person’s story? We should hear disbelief that a loss of this type has occurred. And that this type of loss in a just, democratic society is preventable.

Accompanying disbelief is denial. Denial in the sense that a person’s livelihood and wealth has been intentionally and illegally stolen from them without pretense. We should feel the succession of time and the efforts to correct a wrong that in the end is likely to remain unchanged.

Finally, we should hear the shame in the words “somewhat shy and embarrassed” in the telling of this story and how those who hear the shame avoid repeating it. An untold story is not repeated and becomes unknown to the next generation. Such stories are eventually forgotten.

This is an example of how trauma is passed from one generation to the next involving wealth. There are thousands of stories like this. Most are undocumented and forgotten. Some of these stories involve real estate or homes. Others involve equipment, livestock, or business interests. All of these stories represent wealth that absconded from rightful ownership.

If you are a mental health provider who serves individuals and families who have experienced this type of trauma related to wealth, what is one thing you can do that may help heal the emotional wounds that result from disentitlement?

I believe the one thing mental health providers can do is to allow people who have experienced this type of trauma to tell their stories and share their experiences in a safe and supportive environment. The focus of this type of storytelling should be to assist families with adjusting or building adaptive skills that correct misinformation, clarify interpretations and attributions, and develop empathy for the pain inherent in the story. The goal is to build resilience that may help the family cope with future stressors. Families who narrate the best and worst life experiences can pass down a heritage of memories from one generation to the next. Through story-telling, families can illuminate and combine their separate experiences into a meaningful whole. (Kiser et al., 2010)

The impact of story-telling on the education of children is critical. “Families using a coordinated narrative interaction style teach their children that they are part of a unified, cohesive family whose members understand and work through positive. and negative life experiences together. (Kiser et al., 2010)

In the end, we must remember to help others reflect on their loss, what remains in the aftermath, and what still needs to be preserved or reclaimed. And in the words of the late author and activist W.E.B Du Bois, we must remember that “the cost of liberty is less than the price of repression.”

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References:

American Public Media. (n.d.). Blacks remember Jim Crow | Remembering Jim Crow. https://americanradioworks.publicradio.org/features/remembering/blacks.html

Kiser, L. J., Baumgardner, B., & Dorado, J. (2010). Who are we, but for the stories we tell: Family stories and healing. Psychological Trauma Theory Research Practice and Policy, 2(3), 243–249. https://doi.org/10.1037/a0019893

NAACP’s Anti-Lynching Campaigns: The quest for social justice in the interwar years. (n.d.). NEH-Edsitement. https://edsitement.neh.gov/curricula/naacps-anti-lynching-campaigns-quest-social-justice-interwar-years

Reconstruction in America - Report Overview | Equal Justice Initiative. (2022, October 25). Equal Justice Initiative. https://eji.org/reports/reconstruction-in-america-overview/