When Dr. Price Cobbs and Dr. William Grier wrote the first draft of their book Black Rage in 1968, the two psychiatrists decided it was not candid enough and rewrote it.
“We realized that the truth we had discovered was not being served by the way in which we were describing it,” Dr. Cobbs wrote. “We needed a language that told the truth, in the way that it had been told to us by Black people everywhere.”
More than 50 years later, Cobbs and Grier’s clinical work to define the deep-seated anger felt by many Black Americans continues to offer a window into this community’s psychological continuum. But since the book’s publishing, little has changed in the U.S. mental healthcare system. Little has been done to recognize the unique language of the oppressed and in particular the impact of the legacy of racism on the Black community. I know this because I made the hard slog through our unequal mental healthcare system. I experienced firsthand the invisible barriers to wellbeing that exist for people of color. I experienced the effects of sitting through therapy sessions that did not hold space for my race or honor my culture. And until I found a therapist that did, I was a statistic: Black people are 50% more likely to drop out of therapy, even though they are 20% more likely to suffer from mental health problems like depression and anxiety.
This year, more than ever, we cannot afford these statistics. In the wake of George Floyd’s killing and amid protests this year, the U.S. Census Bureau found that Asians and Black Americans showed sharp increases in mental health problems, while white Americans were relatively untouched. In particular, the rate of Black Americans showing clinically significant signs of anxiety or depressive disorders jumped from 36 percent to 41 percent in the week after the video of Floyd’s death became public. The euphoria that has swept the globe following the announcement of Joe Biden and Kamala Harris as president- and vice president-elect offers a long-awaited exhale of relief for many people of color. However, the news does not heal the ancient wounds that “grow out of oppression and capricious cruelty,” as Cobbs and Grier wrote at the height of their generation’s racial justice movement in 1968.
Cultural humility offers a means to heal these ancient wounds. It offers a path to health equity across racial lines by way of reformation. At Hurdle, we are in the business of reformation. We recognize that the U.S. mental healthcare system was not designed for everyone.
“We live in racially isolating social contexts,” says Norma Day-Vines, Ph.D., Associate Dean for Faculty Development at Johns Hopkins, and advisor to Hurdle. “Therapists and counselors often don’t have the needed level of cultural context, and instead operate on a continuum of either being oriented to social justice activities on one end, or not being comfortable talking about race or culture on the other end.”
In the current system:
- It is well-documented in counseling and psychology literature that when therapists in training are required to address racially provocative topics (e.g. affirmative action, interracial relationships), they often become rhetorically incoherent or redirect the conversation using semantic tactics that preface otherwise racially charged statements.
- Therapists will often use phrases like “I’m not racist, but…” or “I’m not Black, so I can’t understand…”
- Rhetorical incoherence, passive semantic tactics, and non-verbal cues are forms of microaggressions and communicate to people of color that the therapist can’t handle their truth.
- As a result, oftentimes, people of color will intentionally or unintentionally conceal their culture in therapy sessions, which leads to dissatisfaction, higher rates of termination of therapy, and ultimately health disparities across racial lines.
Hurdle’s therapists are licensed, background checked, and receive ongoing evidence-based training to improve cultural humility and responsiveness. We glean from the brightest minds behind the empirical research of racial health disparities in order to inform the transformation of our mental healthcare system — people like Dr. Day-Vines, Dr. Harold ‘Woody’ Neighbors, and Dr. Sherman James.
In our mental healthcare model, the concepts of cultural competence and patient-centered care intersect in meaningful ways. We hold space for “that language that tells the truth in the way that it has been told to us” by historically oppressed and underserved groups. It is a language that holds space for the eloquence of rage and the subtlety of joy by addressing what is germane to the client and acknowledging multiple identity dimensions that have similar forms of oppression — be that oppression by race, gender, social class position, education, etc.
"At Hurdle, we hold space for “that language that tells the truth in the way that it has been told to us” by historically oppressed and underserved groups. It is a language that holds space for the eloquence of rage and the subtlety of joy."
- Kevin Dedner, MPH
A Window of Opportunity for Systemic Change
We are on the cusp of a rebirth of the racial justice movement. This year, the pandemic and the death of George Floyd served as cataclysmic events that opened a window for change, a time when, as Ibram X. Kendi writes “we are living in the midst of an anti-racist revolution.” But history tells us that the window will only stay open for so long. All too quickly the heat of racial justice movements cools, whether it was in the lull of the Civil Rights movement following the assassination of Dr. Martin Luther King, Jr. in 1968, or the ‘cooling-off’ in the years following the launch of the Black Lives Matter movement after Trayvon Benjamin Martin’s death in 2013. At Hurdle, we are ready to strike while the iron is hot.
If history repeats itself (and it does), then we are due for a period of time that historians will one day look back and describe as a time of urgent, creative change. Now is the time to knock down the invisible barriers that make it harder for people of color to get the mental healthcare they need and deserve. Now is the time for reformation. Now is the time for cultural humility.