On Being “Strengths-Based” and Having “Thick Skin”

By Madhuri Jha, LCSW, MPH (she/hers), Director of the Kennedy-Satcher Center for Mental Health Equity

 

The start of the year feels like a social media sprint through the first few annual “awareness months.” Black History Month, Women’s History Month, and before we know it, Mental Health Awareness Equity Month. As a leader in the equity space, for me, awareness months can be both motivational and overwhelming. Inequity is so intersectional in nature. It is persistently challenging to simplify scope. While it is widely known that oppression has influenced and caused deficiencies, I find that our historical records are not strengths-based enough. A study conducted in 2016 illuminated that many doctors exhibit racially biased and false beliefs that pain tolerance is biologically different between blacks and whites — quite simply, that black people have “thicker skin” than white people do. Evidence shows that in the United States, the foundations of these beliefs stemmed from the documented actions of pro-slavery physicians, like Thomas Hamilton and Samuel A. Cartwright, the notorious source of the psychiatric diagnosis “drapetomania.” The way the American medical system has told women of color, specifically, to have “thick skin” perpetuates harmful narratives that influence their experiences accessing care. In my psychotherapy practice, my client base is predominantly female survivors of trauma. A humbling and important reminder of what it means to be strengths-based, I spend two nights a week striking a balance between giving my clients a space for their trauma narrative, while cultivating acknowledgment that they are powerful, capable, and brilliant. Closing Women’s History Month, I wonder how our narratives would shift if we approached evaluating, researching, and defining equity for mothers and daughters from a more strengths-based perspective?

The Mothers and Daughters of Understanding Attachment. There are demonstrated research efforts to understand the impact of colonial and intergenerational trauma in American Indian/Alaska Native women. But only recently, have we begun to appropriately reckon with many, related traumatic realities they face – like, for example, the traumatic impact of forcible separation of children from their mothers due to Compulsory Boarding School Policies. While recent news has been rocked by discovery of frequent sexual abuse and unmarked graves of thousands of children who were forced to attend these schools, we must honor that we know about these stories only because of the bravery and resiliency of those who survived them, like Denise Lajimodiere (Ojibwe) and Yvonne Walker-Keshik (Odawa).

The Mothers and Daughters of Gynecological Wellness. In 1934, the New York Academy of Medicine installed a statue in Central Park of Dr. J. Marion Sims. Dubbed by some as the “father of surgical gynecology,” the statue commemorated his scientific achievements in techniques to repair female reproductive organ dysfunction. Some years later, the Journal of Medical Ethics exposed he developed these techniques by experimenting on enslaved black women, without the use of anesthesia. While we do not know the names of many of the victims, via Sims’ logs, we know the names of three: Anarcha, Lucy and Betsey. The records of the three women showed that they not only repeatedly healed each other but developed concepts of gynecological and surgical nursing that are still practiced today. In 2018, the New York City mayor had the statue of Sims removed, acknowledging that failing to honor the legacies of these women was a systemic injustice. Ironically in that same year, one of the greatest athletes of all time, Serena Williams, was initially not believed by doctors, when she could sense that her history with blood clots had resurfaced during her pregnancy. She harrowingly escaped maternal mortality while giving birth to her daughter Olympia and won the French Open just eight months post-delivery.

Much evidence shows that women are twice more likely to be diagnosed with depression than men. Rates of depression and anxiety in Black, Latina, and American Indian/Alaska Native women, however, are higher than their white female counterparts. They are also less likely to seek care. It is arguable that BIPOC women are hesitant to seek outside help because they have been met with such historically traumatic and biased outcomes. And when one reflects on the stories outlined above, and countless others like them, it is harmful, and sometimes life-threatening, to purport that someone’s race or gender, or both, is the primary risk factor or cause for disease or mental illness. The inclusion of champions of healing and resilience in the way we define health and mental health is critical and paramount to advancing equity. We must find means to ensure that understanding barriers to access is complemented by the intentional evaluation, research, and creation of policies based on existing resiliency. For an equitable future, our records must never again doubt that mothers and daughters, especially those of color, are powerful, capable, and brilliant.

 

About the author/for immediate inquiry: Madhuri Jha, LCSW, MPH is the Director of the Kennedy-Satcher Center for Mental Health Equity – an entity of the Satcher Health Leadership Institute at the Morehouse School of Medicine. She has over a decade of service devoted to being a clinical practitioner, consultant, and leader in the public mental health and health equity fields. For immediate inquiries about the author or the work being done at KSCMHE, contact kennedysatcher@msm.edu.