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by Angela Neal-Barnett, PhD

Anxiety disorders are the most common mental health disorder in the United States. Data show that for Black women, anxiety is more chronic and the symptoms more intense than their White counterparts. This description, however, only tells half the story. What it does not tell us is how anxiety is perceived and experienced daily by Black women. 

Images of Black Women 

To fully understand anxiety and Black women, we must understand how Black women are viewed in this country. Research and history tell us that three basic images exist-the Strong Black Woman, the Angry Black Woman, and the Jezebel/Video Vixen. These images affect how other people see Black women and how they see themselves. They also play a role in the development and maintenance of anxiety. 

Strong Black Women are legendary. Harriet Tubman, Sojourner Truth, and every Black grandmother is renowned for her persistence and perseverance. There are many positive aspects about being a Strong Black Woman, but there are negatives as well. A Strong Black Woman “keeps on keeping on “even when she knows she should stop, placing her mental and physical health at risk. 

An Angry Black Woman will “cuss” you out before hearing you out. Tyler Perry’s Madea is a classic example of the Angry Black Woman. Our work with these women has found that many of them are anxious. The anger is an outward expression of their discomfort with negative affect associated with anxiety. 

The Jezebel/Video Vixen represents the sexualized Black woman. The term Jezebel comes from the Biblical Queen who turned her husband against God. Since slavery, Black women have been sexualized in derogatory ways, often represented in rap and hip-hop videos. Black women, particularly professional Black women work hard to dispel the Jezebel/Video Vixen image. 

Social Anxiety 

In workplaces, college and professional school settings around the country, Black women often find themselves the only one or the first one. In these situations, they have been taught that they have to be twice as good to go half as far, that they are representing the race and that they are being watched more closely than their white counterparts; beliefs that  are not necessarily inaccurate. These beliefs coupled with the Strong Black Woman image increase risk for social anxiety. 


Another social anxiety risk factor in the workplace and college/graduate/professional school setting is the acting white accusation. As the images attest, far too often we forget that there are more than three (3) ways to be a Black woman in this country. The acting White accusation, has nothing to do with wanting to be White and everything to do with what it means to be Black. In other words, it is an attack on one’s racial identity which in turn, can create anxiety. 

PTSD

The rate of sexual assault among Black women is 3.5 times higher than that of any other group in this country. Black women are also less likely to report their assault. Many suffer in silence for years, never sharing with anyone what has happened to them. Thus, the trauma remains unnamed, unknown and untreated and the symptoms worsen. 

Racism is a form of trauma that disproportionality affects Black women (and men). Trauma in the form of racism can be directly or indirectly experienced. Driving while Black, shopping while Black, and everyday racial micoraggressions are direct examples of racial trauma. The most common indirect examples are the viral videos of unarmed Black women and men being killed. Vicariously witnessing race-based trauma, can be as devastating as the direct form. 

Help Seeking 

Slowly, the stigma associated with seeking help for anxiety is disappearing. Women have begun to understand that an anxious Black woman is not crazy, she is simply anxious and with assistance can reclaim her life. Black women who seek help want a therapist who understands their issues. Imagine telling you someone you are tired of being a strong Black woman and they recommend you stop working out. It’s happened! Therefore, it is important that therapists enhance their cultural competence and be open to culturally adapting anxiety interventions. Cultural competence involves, but is not limited to, familiarity with stereotypical images of Black women, racism as trauma and the acting white accusation. Cultural adaptation can include assessment and discussion of racial trauma and the deconstruction of images of Black women. 

Another form of cultural adaptation involves how an intervention is delivered. In our program, we use sister circles, an indigenous form of healing. Within the circles, we adapt CBT for a Black female populations. As example, rather than use cognitive restructuring to replace erroneous thoughts, we teach musical cognitive restructuring. Research has found both the method and content to be feasible and effective. 


About the Author

Angela Neal-Barnett.jpgDr. Angela Neal-Barnett is a professor of Psychological Sciences and director of the Program for Research on Anxiety Disorders among African Americans at Kent State University. She is the author of Soothe Your Nerves: The Black Women’s Guide to Understanding and Overcoming Anxiety, Panic, and Fear (Simon & Schuster). Dr. Neal-Barnett is the recipient of numerous grants and has authored numerous journal and  general public articles on Black females and anxiety. Dr. Neal-Barnett is a member of ADAA's Multicultural Advances SIG and the Women's SIG

In the final paragraph, the author writes, "In our program, we use sister circles, an indigenous form of healing." Is there a link available to the program referenced? Are there additional resources and/or readings available regarding how, specifically, the program referenced--or the author herself--finds, establishes, or supports these sister circles to engender healing in multiple locales?

Thank you for any assistance you're able to provide.

Provide the source to the data that shows black women have more chronic anxiety and more intense symptoms then their white counterparts.

Why wouldn’t black women have more chronic anxiety and intense symptoms than white women? Do white women have to deal with anti-black racism AND sexism at the exact same time? What is your problem? And stop demanding information that any kindergartener could look up on google. Why don’t you google information on black women and anxiety so you won’t have to “ask” inane questions about why black women would be more anxious than white women in a racist country.

This article hit the nail right on the head. These are things that even myself go through daily. Black women can't even wear their GOD given hair without stares from all other people. So we have to try and fit into other peoples image instead of GODS image.

thank you having a place to share my story a former military spouse low income not able to work an apartment not in good condition I was homeless for several years in tampa fl I am in treatment now its going well now

I like how this article pointed out three different general directions that are choices for black woman. I also like how the state of being of a black woman was discussed and organized. There is a sense of understanding and compassion that seeps through in different scenarios that a black woman could find herself. It would be nice to view additional options for solutions with an equal amount of exploration.

So many women can benefit from these therapies. I hope to see an expansion soon. Often we hear of the 'superman' syndrome; however many rarely comment on the 'superwoman' expectation in Black women; often connected to the Strong Black women, partly because we get less credibility for the work that we do.

I have some comments here within several articles on AfricanAmerican women that I have written.

Link:
independent.academia.edu/AlishaGray

Perhaps they will helpful in your therapy sessions as well.

Mrs. Carolyn Clavon

October 5, 2019

I really appreciate and respect your article. It is an honor to congratulate you on all of your life achievements. When there is a time convenient for you, would you be able to help the black community understand why black women steer more into the direction of tearing each other down vs the path of equality, respect, encouragement, wisdom, compassion and spirituality?

Thank you so much for this. I would carry this article with me anytime I was going into therapy, having a bad day at work, and in routine checkups too. Therapy was horrible experience after horrible experience. Being misunderstood. Touted as 'strong and brave' but treated as mentally ill/crazy because I 'intimidated' the medical professional from my look or my backstory alone. I was often told that I seemed intimidating and I haven't even spoke. This is on the first visit. I wish they just would have say then that they can't handle me and my struggles, instead of refusing to stop mishandling me altogether.

Since I didn't show the typical sign of depression or anxiety, I should have quit while I was ahead. It would have saved me so much money on unnecessary meds and counter side effect meds, ineffective thus harmful therapy, and inpatient hospitalizations, because none of the other things were working. The time and effort trying to lose all the weight and rebuilding my professional from such a trial and error process. I'm still reeling from it and I am only in my 30s. I can see why we hold it in, It's like the don't even try and because of that we get hurt. Really bad. Too much medicine so we can 'calm down' or complete dismissal of any pain we have. Seeking professional help? Damned if you do, damned if don't. ...so why even bother? But, I am hopeful since articles like this are more prevalent and more POCs are in members of the medical community. It's motivated me to in psychology in someway. I can't imagine letting this kind of substandard care happen to anyone else that is so deserving of relief and compassion instead. Thank you again!

Thanks so much. It's so appreciated that someone understands, this article really helped me to calm down and experience the love and peace that I asked the universe to send me today. I see articles like this as an act of love because some of us really are out here hurting and living in so much fear at times while also feeling isolated. I live in a black where the black population is less than one percent and it's here where I've learned so much more about racism and it's origins. It's empowering to know that we can experience such things and still thrive. I will say I have experienced a lot of what I've read in the comments here, especially the re traumatizing therapy and medication stories. This morning I was doing some meditation and visualization excercises and I was imagining being in a circle of black women swaying and healing using our vocals to release the pain and trauma and show support, so I know it's not a coincidence o came across this. A lot of us crave that kind of interaction with other black woman and I believe we have a subtle remembrance of those customs. I'm really glad the circle exist, and as a black woman who has been primarily self managing her mental health since childhood I super appreciate you for writing this and I wish you and ever woman on here infinite love and blessings.

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