How Black American Women Cope with Daily Living Challenges

Carr, Syzmanski, Taha, West & Kaslow (2014), studied the connection between multiple oppressions and depression among African American women and the role played by internalization. In particular, their study focused on the intersecting experiences of oppression, such as racism, gendered racism, and sexual objectification, as predictors of depression. Carr et al. (2014) also explored coping with oppression via internalization. In fact, this study speaks to three demographic groups that potentially suffer from oppression (socioeconomic status, race/ ethnicity, and gender). Carr et al. (2014) found that when sexual objectification, racism, and gendered racism are measured synchronously, exposure to racist situations was the only salient predictor of depressive symptoms.

Watson and Hunter (2015) studied the Strong Black American Woman (SBW) race- gender theory, which endorses the notion that African- American women use self- silence and self- reliance as ways to cope with stressors. These coping strategies may intensify symptoms of anxiety and depression when coupled with negative attitudes, or reluctance to seek mental health services. Presently, the SBW race- gender theory has been acknowledged as an important aspect of the African- American identity.  This theory involves the idea of African- American women being “strong” and able to triumph despite various forms of oppression (Watson & Hunter, 2015). The SBW theory has encouraged African- American women to be self- efficacious when faced with difficult circumstances.

Beauboeuf- Lafontant (2005) stated that the concept of a “strong Black woman” is limiting rather than empowering. It is limiting in the sense that the “strength” and selflessness is causing internalized problems. Nonetheless, Black-American women have historically made strength a part of their identity. Black American women defined strength as not crying, “keeping it together”, and being selfless. This suppression of emotions can, however, result in health issues such as obesity, high blood pressure, and mental health disorders, most of which are undiagnosed. According to Beauboeuf- Lafontant (2005), Black American women’s rates of obesity are more likely due to compulsive eating, as opposed to eating unhealthy foods or a lack of exercise. This speaks to the stress that Black American women may be experiencing but are not discussing.

According to Beauboeuf- Lafontant (2008, p. 392), strength depicts not only “Black feminine goodness”, but is also a major contributor to depressive episodes. While being stoic, along with silence and selflessness, is often promoted in Black American culture. The silence has been found to be more representative of the internalized emotions that Black American women experience. Beauboeuf- Lafontant (2008) found that “voice- centeredness”: the process of providing a space for Black American women to express themselves without shame, brings a voice to a demographic that is often silenced. Since this silence is linked to depression, voice- centeredness illuminates areas of conflict between individual meaning-making, and cultural roles and expectations.  This approach also brings a needed layer of sensitivity to depression as it helps to normalize the distress.

Interestingly, Black American women are perceived by American society as resilient and without mental health issues, yet these same women are more likely to experience higher unemployment rates, lower incomes, poorer physical health, and are less likely to be married (Hamilton-Mason, Hall & Everett, 2009). This suggests that Black American women may be more likely to experience stress even if they do not express it. Black American women have been conditioned to minimize their problems. The belief, here, is that feelings of deep sadness are a normal part of life, and only the “insane” seek help for these issues (Hamilton- Mason et al., 2009).

Due to the heavy physical and sexual victimization during slavery, societal views of Black American women differ from White American women (Thomas, Witherspoon & Speight, 2004). Black American women are viewed by, themselves included, as being more susceptible to the hardships of life. Some middle class Black American women experience “survivor’s guilt” in addition to the need to be “strong”; they feel pressure to sacrifice more for others when they feel undeserving of their success (Thomas, Witherspoon & Speight, 2004). Feeling undeserving may also lead to “imposter syndrome”: preoccupation of the fear of being discovered as a “phony” (Thomas, Witherspoon & Speight, 2004).

Historical Trauma

According to Hunn and Craig (2009), the effects of Jim Crow laws of the 1960s in the United States reverberate to the current day, and experiences of discrimination cause Black American women’s life experiences to be distinctly different from White women and Black American men. Behaviors observed in Black American women encapsulate a complex set of generational, chronic, gendered, and extreme life stressors (Hunn & Craig, 2009).

Strikingly, Many Black American Americans show signs of John Henryism. John Henry was a folk hero that worked himself to death in order to out-do a machine. The nondisclosure of stress symptoms in order to display control and independence is a sign of John Henryism (Hunn & Craig, 2009). Here, hard work is seen as a coping mechanism used to overcome obstacles, Yet, physical and mental health is affected (Hunn & Craig, 2009). Other factors impacting Black American women’s vulnerability to depression are lack of mate availability, single motherhood, intimate partner abuse, and loneliness (Hunn & Craig, 2009).

Another monumental factor in Black American women’s depression is the high death rate of Black American men, coupled with the high incarceration rates. As a result, Black American women in many families are forced to cope with the traumatic loss of fathers, husbands, brothers, and sons (Hunn & Craig, 2009). Years of enslavement, both figurative and literal, have brought a collective manifestation of psychological conditions of sadness, hostility, self- hatred, and self- destructive behaviors (Hunn & Craig, 2009). Dysthymia manifests in the form of self- destructive and self- hatred behaviors (Hunn & Craig, 2009).

Black American Female Stereotypes

White Americans viewed Mammy as docile, non-threatening and nurturing. The internalization of this stereotype leads Black American women to adopt a façade of strength in order to be overly supportive for others, even at their own expense (Thomas, Witherspoon & Speight, 2004).  In actuality, the SBW theory is a recapitulation of the Mammy image (Greene, 1996).  Sapphire is a Black American woman that is not taken seriously and is often mocked. She internalizes this, as Black American women experiencing difficulty with being assertive, expressing needs and anger often do (Thomas, Witherspoon & Speight, 2004). Jezebel is portrayed as a hypersexual, insatiable being. Internalization of this stereotyped may cause repression of her sexual feelings, as will also the view that sexuality is one of only a few coveted traits (Thomas, Witherspoon & Speight, 2004).

Mammy-ism has been conveyed as a mental illness in which Black American women scorn their cultural background due to internalized racism, appease Whites, especially in the workplace. This results in poor self- esteem and negative self- perception (Neville, Tynes, & Utsey, 2008).

Thomas, Witherspoon, and Speight (2004) found that Mammy and Sapphire are correlated with low self- esteem. The more a Black American woman is compelled to serve and be nurturing, the lower their self- esteem is. In addition, Black American women whose racial identity is not salient to them also have lower self- esteem. High sense of racial identity is correlated with higher self- esteem (Thomas, Witherspoon & Speight, 2004). The Superwoman schema in this study was also correlated with lower self – esteem, which was contrary to the hypothesis.

Strong Black Woman (SBW) Ideology

This symbol emerged as an intellectualization of slavery as Black American women were viewed as being psychologically resilient and physically stronger than White women (Harrington, Crowther & Shipherd, 2010). A central theme is that Black American women are “inherently” resilient and strong and therefore, these are seen as fundamental qualities of Black American womanhood. Self- reliance, and containment are also high standards that are to be upheld (Harrington, Crowther & Shipherd,2010). The cultural expectation of Black American women “carrying” the community has evolved over the last few centuries, beginning with Mammy figures (Jackson, Phillips, Hogue & Curry- Owens, 2001).

According to Shorter-Gooden (1996), strength serves as a buffer against the intersecting stressors of sexism and racism, Black American women with a strength- centered identity are psychologically healthier in comparison to Black American women that do not.

Adding to this continuing perception of Black American women having boundless strength, are the portrayals of the SBW in the media through television and music of Black American women being independent and self- reliant (Abrams, Maxwell, Pope, & Belgrave, 2014). Musicians that affirm this notion are Mary J. Blige and Chaka Khan. Some examples of Black American women in the media that fit the SBW Schema are former First Lady, Dr. Michelle Obama and public figure Oprah Winfrey. It is also this sense of confidence that serves as a protective factor (Abrams, Maxwell, Pope, & Belgrave, 2014).

Sisterella Complex

An offshoot of the SBW Theory is the Sisterella Complex in which depressed Black American women that embody aspects of SBW, internalize and suffer in silence as they work unremittingly to meet the expectations of their family, career and larger society. Instead of help-seeking, these Sisterellas turn inward and feel guilty when they are unable to meet the unrealistic expectations set upon them (Abrams, Maxwell, Pope, & Belgrave, 2014). To make matters worse, the Sisterella’s pain is masked by a façade of supreme strength (Abrams, Maxwell, Pope, & Belgrave, 2014). This complex defines the SBW as a resilient caretaker and provider that succeeds without proper self- care (Abrams, Maxwell, Pope, & Belgrave, 2014).

Microaggressions

According to Lewis, Mendenhall, Harwood & Huntt (2013), White Americans may be unaware of their racism, and how that negatively affects others of color. This is because undetectable forms of stereotypes and prejudice can operate on an unconscious level (Mendenhall, Harwood & Huntt, 2012).  Microaggressions are common daily behavioral, verbal, environmental dishonors that convey demeaning racial slights, and can be both unintentional and intentional (Lewis, Mendenhall, Harwood & Huntt, 2013).

Colorism

Historically, Black American women with European features, lighter skin, and straighter hair have been deemed more valuable than darker- skinned Black American women (Neville, Tynes, &Utsey, 2008). Darker skinned women may face more ostracizing, however, while lighter skinned women may not feel “Black enough”. It is common for Black American women of all complexions to internalize some degree of racism and sexism due to images of beauty, as well as feelings of shame or low self- worth (Neville, Tynes, & Utsey, 2008).

Perspectives on Femininity

Often, women who fail to conform to gender traits that include appearance, personality, and beliefs of gender roles, are censured socially (Cole & Zucker, 2007). For instance, people tend to negatively respond to women who are assertive leaders, as well as those that choose not to be mothers (Cole & Zucker, 2007).  Among both White and Black American men, as well as White American women, Black American women are concerned most with their appearance (Cole & Zucker, 2007). Black American women have a tendency devote a great amount of effort, time and resources into not only achieving but maintaining a feminine aesthetic (Cole & Zucker, 2007). Black American femininity is comprehended as embracing aspects of instrumentality, expressiveness, and resilience.

Black American women concurrently engage in and reject hegemonic femininity (Cole & Zucker, 2007). An example of this would be a Black American woman encouraging their daughter to be both a “warrior” and a “lady” (Cole & Zucker, 2007). In order to defy historical stereotypes of Black American women being improper and sexually vulgar, Black American women have implemented a tactic of being meticulously groomed (Cole & Zucker, 2007). In Cole and Zucker’s (2007) study, for Black American women, a significant positive predictor of feminism was a high level of importance in wearing feminine clothes, whereas, high level of importance on education was a significant negative predictor (Cole & Zucker, 2007).

LGBT Black American Women

Black American lesbians are often combating the image of being “masculine”, which is in line with the image Black American women may already face as being substandard in today’s society (Neville, Tynes, & Utsey, 2008).

Career and Work Life

When compared to White and Latina women, Black American women are more likely to work in the labor force (Neville, Tynes, & Utsey, 2008). Black American women are also more likely to be the sole provider for their children (Neville, Tynes, & Utsey, 2008).

Intimate Relationships

While Black American men are more likely to marry Black American women than any other racial group, there is a disparity in the pool of “marriageable” Black American men and women. The amount of Black American men that are available to be married are impacted by incarceration, homicide, and underemployment (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013).  According to Borum (2012), marriage is less of a protective factor for suicide or depression for Black American women than it is for their White counterparts.

Negative Physical Health Effects

When discussing the physical health problems that affect Black American women, one of the most profound issues is the astoundingly high rates of hypertension that exceeds the rates of Black American men as well as other ethnic groups (Artinian, Washington, Flock, Hockman &Jen, 2006). Often, Black American women with elevated levels of depression will also have higher rates of blood pressure, greater stress, and lower social support (Artinian et al, 2006). Black American women with higher diastolic blood pressure and depression are more likely to have more stress, less social support, are less likely to eat nutritious foods such as fruits and vegetables, and are more likely to smoke (Artinian et al, 2006). Ultimately, the reasons for these disparities are not known. For Black American women, especially those in urban areas, exposure to stressful social experiences and environments, increases mental health outcomes such as depression (Artinian et al, 2006). It is noted that hypertension and depression share the common factor of stress. This suggests that psychosocial factors exacerbate sympathetic nervous system activity over time, which also up regulates blood pressure (Artininian et al, 2006). According to Artinian et al, (2006), when Black American and White women are analyzed separately, and Black American and White men are grouped together, negative affect significantly predicted hypertension in all three groups. However, the largest effect was seen in the group containing Black American women.

While weight loss might increase one’s satisfaction with their body and improve depression (Steinberg, Askew, Lanpher, Foley, Levine & Bennett, 2014), Black American women socially accept higher weights at a larger rate. They conducted a “maintain-don’t-gain” approach to weight loss and it was found that the more obese a participant was, the more depressed they were. Exercise might have also played a part in depression reduction. Black American women compulsively eat as a way to desensitize and escape from daily realities (Mendenhall, Harwood & Huntt, 2012).

In a study conducted by Harrington, Crowther, and Shipherd (2010), 179 Black American female trauma survivors completed questionnaires about traumatic experiences, as well as the internalization of the “Strong Black Woman” ideology. Results supported that inhibiting emotions, and psychological eating mediated the relationship between binge eating and distress. Binge eating is common after trauma. Though rates of Black American female binge eaters are not known, it appears to be widespread in Black American women. After exposure to trauma, many difficulties can occur such as depression, anxiety, substance abuse and eating problems faced accompanied with a sense of a loss of control (Harrington, Crowther &Shipherd, 2010).  About 32 percent of White women and 41 percent of Latinas are obese, whereas 60 percent of Black American women are obese (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Across racial groups, obese women are at an increased risk for depression and suicidal ideation,  regardless of socioeconomic status  (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Obese Black American women are also more likely to feel anxious, have more of a family history of psychological issues and poorer perceptions of physical health (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Depressed Black American women are more likely to gain weight than lose weight. In addition, Black American females that experience depressive symptoms in adolescence are more at risk for obesity in emerging adulthood (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013).

A study by Jackson, Phillips, Hogue and Curry Owens (2001), examined the impact of gendered racism on college- educated Black American women and the results were striking. It appears that the societal stresses surely have an effect on pregnancies. When 474 Black American women were interviewed, participated in focus groups and administered pilot stress instruments, it was found that Black American women felt a sense of needing to protect children from racism. The association between the concerns of providing for their children and specific racist events in the workplace were significant (r= 0.408,p <.001).  Noteworthy, the stress that the women faced in the workplace also affected their pregnancies (Jackson, Phillips, Hogue & Curry- Owens, 2001). Gender and race are both lived experiences, where re negotiations occur in not only large political, cultural and societal arenas, but also in the microlevel through day-to-day interpersonal interactions (Jackson, Phillips, Hogue & Curry- Owens, 2001). Stressors weather Black American women and cause them to be more vulnerable to adverse health outcomes (Jackson, Phillips, Hogue & Curry- Owens, 2001). Black American women view their perceived obligation to protect children from racism as stressful, leading to the conclusion that gendered racism is an aspect of the stress that impacts pregnancy outcomes (Jackson, Phillips, Hogue & Curry- Owens, 2001). As a part of the gendered role of being a nurturer, Black American women may feel powerless in providing their children adequate resources for their psychological and educational needs. A woman in this study stated, “I have to go outside of the African- American community to provide the education and other resources I desire for my children” (Jackson, Phillips, Hogue & Curry- Owens, 2001, p.105). This also speaks to how disproportionate resources are in many Black American communities.

Negative Mental Health Effects

Depression is a leading cause of disability as well as non-fatal disease (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Among Black Americans, depression is often under-reported, undetected, under- diagnosed, and under- treated (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). For Black American women, only seven percent receive mental health services (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Various factors include cultural stigma against mental health, disproportionately low numbers of Black American psychologists and counselors, and disparities in mental health care and access (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Dysthymia denotes a consistently depressed mood that occurs most days for at least two years (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013).  Black American women are more likely than White American women to have a dysthymic disorder and remarkably, with higher education attainment not acting as a protective factor for Black American women with dysthymic disorder (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Interestingly, the symptoms become such an everyday occurrence that unless specifically asked, many do not report the symptoms in a clinical interview (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). It is as if these symptoms have become cemented into the daily living and routine.  Poor self- image is also common amongst those with dysthymia (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Coupled with the multiple jeopardies and oppressions that Black American women face, having a poor self- image or self- perception can be crippling.

Among Black American women, factors associated with depression include: microaggressions, poverty, obesity, social factors, racism, diabetes, and exposure to violence (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Depressed Black American women may dress up to combat negative stereotypes of Black Americans being “dirty and poor” (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Racism can influence feelings of worthlessness (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Significantly, 66 percent of Black Americans state that they utilize faith to treat their depression “almost all of the time”. Phrases such as “going home to see Jesus” may speak of the fatigue and existential woes that depression carries (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Using spirituality and faith is how 43 percent of Black Americans address health concerns such as heart disease, cancer, and depression (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013).

Regarding mental health stigma in the Black American community, mental illness has been often associated with shame. Many of those affected and their family members may conceal which can then impose an internalized stigma (Woods- Giscombe, Robinson, Carthon, Devane- Johnson & Corbie-Smith, 2016).

Suicidality

Borum (2012) found that having a solid sense of cultural identity was a protective factor against depression and suicide, suggested the two might be culturally influenced and articulated. According to Borum (2012), multiple researchers have found that minority patients have lower rates of treatment due to physicians’ inability to treat, diagnose, and refer those not from the majority. Black American women in Borum’s (2012) study identified spirituality and religiosity as protective factors against suicide.

Coping

After coping with many racist events, and their tax stress- ameliorating factors, many Black American women are left with very few resources to cope with sexist events (Moradi & Subich,2003).

Black American women utilize multiple resistance strategies, both internal and external. Some of these strategies include drawing strength from African ancestors, sustaining a positive self-image, relying on faith, and social support. Black American women often cope by drawing from spirituality. (Shorter-Gooden, 2004) Role flexing involves an indirect action that aims to solve a problem without directly confronting the problem. For example, avoiding is a form of indirect coping. In Black American women, role flexing for gender bias usually involves wanting to appear more “traditionally” female. For racial bias, it includes wanting to appear “more White” or “less Black American”.( Look back at article for more in-depth…) Black American women rely on social support as a central coping strategy (Shorter-Gooden, 2004). Social support is an external resource whereas spirituality is an internal resource (Shorter-Gooden, 2004). It has been found that the type of coping strategy implemented depends on the situation encountered, therefore it is not fitting to assume that the manner in which Black American women cope with general daily issues is akin to how they cope with the stress of oppression (Shorter-Gooden, 2004). Black Americans have the tendency to detach cognitively and suppress feelings in order to cope (Shorter-Gooden, 2004). Black Americans’ coping style is both complex and flexible (Shorter-Gooden, 2004). It is important to remember that racial stress is more challenging to manage than general stress (Shorter-Gooden, 2004). Regarding gendered racism, it is even more challenging to discern sexism and racism that Black American women are faced with (Shorter-Gooden, 2004).

Regarding discrimination and being faced with unfair treatment, Black American women who are silent about mistreatment are 4.4 times more likely to report hypertension than Black American women who spoke with others and took action (Shorter-Gooden, 2004).

Avoidant coping, coping by not thinking about the stressful event is not helpful in reducing the stress of gendered racism (Mendenhall, Harwood & Huntt, 2013).  Black American women also cope by “picking their battles” however deciding if the situation is “worth” addressing of not expends cognitive energy (Mendenhall, Harwood & Huntt, 2013). An active form of resistance that Black American women utilize is “using their voice” to step into their power. However, women realize that this way of coping can cause them to be perceived as an “Angry Black Woman”. Black American women are then forced to weigh the benefits of speaking up as it can potentially lead to further microaggressions (Mendenhall, Harwood & Huntt, 2013).

Black American women also mention the fear of wearing traditionally African hairstyles or their natural hair in the workplace out of fear of being perceived as unprofessional in comparison to European hairstyles (Mendenhall, Harwood & Huntt, 2013). Black American women engage in self- protective coping, which are inactive strategies used to minimize gendered racial microaggressions that accumulate over time (Mendenhall, Harwood & Huntt, 2013).  Black American women may also become “workaholics” to prove themselves as being deserving of success and also pouring themselves into work may serve as a distraction (Mendenhall, Harwood & Huntt, 2013). Cognitive dissonance also plays a role in the practice of desensitizing in order to “remain sane” (Mendenhall, Harwood & Huntt, 2013). Black American women may feel compelled to “armor” as a way to protect themselves from microaggressions (Mendenhall, Harwood & Huntt, 2013).

According to Greer (2011), Black American women often “shift” which is the practice of adjusting to indirect social contexts that involve gender and race. This is in response to stereotypes of Black American women as poorer, hypersexual and resilient matriarchs (Greer, 2011). Some Black American women report having a sense of solidarity with White women, while some report racism from White women and women from other racial groups (Greer, 2011).

Spirituality as a coping factor

Despite family income, health, age, level of educational attainment and geographic region being controlled for, Black Americans are more religious than White Americans (Borum 2012). According to Bacchus and Holley (2015), the majority of professional Black American women do not distinguish between spirituality and religion. Black American women use meditation, prayer, and inspirational texts to find inner peace and gain strength in order to cope with stress in the work place. When defining spirituality, several themes emerged such as recognition and acknowledgment of connections and relationships among all lifeforms, relationships as a context for developing spirituality, physical embodiment of the spirit, and finding life ‘s meaning through self- transcendence. “Cognitively, spirituality offers a paradigm that attaches meaning to life events. In the affective dimension, spiritual ideology also provides individuals with a sense of being able to give and receive love which usually includes a sense of compassion towards all life. Behaviorally, spirituality offers ethical and moral bases for behavior p. 67”

For Black American women, Spirituality is often labeled of a core factor in the ability to cope with adversity and life struggles associated with classism, racism, sexism, family responsibilities, illness, psychological distress, and daily stress. Historically, Black American women have utilized the Bible, the Black American church, spirituality, and religion as transformative and transgressive spaces. For Black American women, “turning things over” to a higher power is an imperative part of coping. Spirituality also aids in realizing destiny and finding life purpose which allows Black American women to confront and accept reality. The work environment is a huge source of stress for Black American women. In addition, Black American women are overrepresented in low-status occupations albeit in professional tracks, while underrepresented in high and middle-class professions. Therefore, Black American women are faced with labor market discrimination as they are often paid less, denied access to positions, harassed more by coworkers and promoted less quickly. It is important for practitioners to work collaboratively with clients in incorporating spirituality into therapeutic work.

Research with Black American Women

Alice Walker coined the term “womanist” which is defined as… When working with Black American women, it is important to collaboratively work towards helping them utilize personal experience as a developmental foundation and also to develop a sense of their authentic voice (Banks- Wallace,2000). Researchers ought to provide a “breathing space” and an opportunity for the women to have a sense of rejuvenation (Banks- Wallace, 2000). Common themes emerge when working with Black American women from a womanist standpoint. Such themes are the parallel struggle for self-definition and independence coupled with the effects of classism, racism, and sexism (Banks- Wallace, 2000). There is the common thread of fighting against multiple forms of oppression. In addition to carrying this weight, there is the weight of being a Black American woman encompassed with these experiences and still finding the ability to maintain overall well- being and health-promoting behaviors (Banks- Wallace, 2000). As Walker has defined womanist, it allows the chance to address the relationships between Black American men and women, recognize the distinctive experience of Black American women, and articulate the similarities and differences between Black American women and other women of color (Banks- Wallace, 2000). Womanist thought is defined by the interdependence of consciousness, experience, and action (Banks- Wallace, 2000). It is important or researchers to be mindful of other theories when working with Black American women in addition to womanist thought such as the intersections of Afrocentric and feminist theories. Yet, it is important to note that even though feminist and Afrocentric theories overlap, neither fully account for being both Black and woman in the way that womanist theory does as Afrocentric theory focuses on the identity of being a descendant of the African diaspora and feminism is based on the identity of being a woman in general, no matter which background (Banks- Wallace, 2000). In working to provide health- promotion interventions for Black American women, an evaluation of the participant includes three interrelated aspects that comprise an ethic of caring, which are empathy, emotions, and personal expressiveness.  Personal expressiveness is highly garnered in womanist epistemological frameworks as it incorporates African tradition and the understanding that each individual is a unique and divine being (Banks- Wallace, 2000). The goal of establishing rapport with clients and participants is the development of an institution that can improve the condition of Black American women overall (Banks- Wallace, 2000). Effective interventions for rejuvenating Black American female participants include sharing poetry or short stories, taking breaks to hug or chat, praying or sharing a meal all add to nurturing spiritual development which is a coping skill for many Black American women. Many Black American people are weary of science and research due to past and current abuses in science, therefore it is imperative to be empathetic to this concern.

Psychotherapy Interventions

It is proposed that the daily lives of Black American women are shaped by social inequalities that are a function of the intersectionality of gender, race, sexual orientation and other aspects (Greene, 1996).  Regarding psychotherapy interventions, Black American women are often labeled with multiple devalued identities.  Traditionally, feminist therapy proposes that social inequalities between the sexes are at the origin of mental health issues for women (Greene, 1997). It is important that psychotherapy with Black American women incorporates feminist techniques that are sensitive to Black American culture (Greene, 1997).  A common misconception is that gender oppression creates stronger bonds between White women and women of color than between men and women that face racial oppression, however doing this diminishes the ties that Black American men and women have when they face constant struggles with racism and places the racial oppression in a secondary position  (Greene, 1997). It is also important to note and acknowledge the identities that women may have in addition to being Black American such as lesbian, disabled, poor. Historically, Black American women did the work that White men did not want to do and which White women were protected from. this internalization of not having their bodies and minds belong to them has also invoked self-blame when things are unable to be completed or carried through (Greene, 1997).  In addition, this self- blame provides grounds for emotional abuse as Black American women may feel that they need to be supportive and forgiving of their partners as their partners are also going through struggles and racial abuse, once again belittling themselves (Greene, 1996).  When treating Black American women it is important to consider aspects of institutional heterosexism, sexism, and racism that are at play (Greene, 1997). Therefore being able to discern between intrapsychic issues and realistic societal issues are key (Greene, 1997). The therapist should be aware of systemic factors, especially as Black American women have a tendency to have strong collective ties to other systems and subsystems such as the family.

The Theory of Optimal Psychology is based on an Afrocentric worldview. In comparing worldviews, there is a parallel between the optimal and suboptimal worldview (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). The Eurocentric worldview is seen as self- worth being based on external validation, which is how American society operates (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). The suboptimal worldview causes individuals to search for more of a purpose as life’s purpose is based on external factors. Whereas the optimal worldview focuses on yielding internal factors joy, harmony, and peace.

Resistance Theory was developed for Black American adolescent girls in 1991 to address gender and racial identity in a female’s life. This theory was constructed to assist Black American females in utilizing optimal resistance strategies (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). An important part of optimal resistance is seeking mental health services. This is in conjunction with other prevention and intervention resources such as pharmacology, exercise, spiritual and community resources (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Regardless of whether or not the stressor ceases, resistance is methodical, intentional and proactive (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013). Optimal resistance requires cognitive energy but also replenishes it. A caveat is that this theory does not claim that Black American women who resist optimally will eliminate depression, but resistance is conducive to healing and health (Martin, Boadi, Fernandes, Watt & Robinson- Wood, 2013).

For psychotherapy with Black American women, it is crucial to consider intersectionality, especially between gender and race, integrating spirituality and religiosity, as well as the therapeutic alliance (Neville, Tynes, Utsey, 2008). This is vital as Black American women may tend to present as “put together” in therapy which may cause them be more guarded about discussing feelings of sadness (Neville, Tynes, Utsey, 2008). Therapists ought to create space for Black American women to share beliefs and encourage them to utilize spirituality as a resource. In addition, Black American women may have feelings of betrayal or anger towards God and these painful feelings should be processed (Neville, Tynes, Utsey, 2008).

When examining interventions and programs that have been effective in encouraging self- care amongst Black American women, groups and digital story telling projects were effective in building a network and connecting with women who were experiencing similar situations. Barlow (2016) discussed a digital archive space called Saving Our Sisters (SOS) where Black American women are able to grow and learn about mental health, self- care and well- being from each other. The network allows Black American women to know that they are not alone. Barlow (2016) stated that only 12 percent of Black American women seek help for depression, yet the numbers of those affected are much higher.  The commitments that Black American women have to family and community can result in reduced self- care, obesity, heart disease and unhealthy body images.  In addition, racism further complicates the issue of measuring stress, coping strategies and resilience. Black American women have a tendency to value relational supports from family, church, and community rather than mental health services (Hamilton- Mason et al., 2009).

Theoretical Framework

Black American women cope with gender- race bias by internalized coping practices such as prayer, spiritual interactions with ancestors, maintaining a positive self-image, and avoiding “negative” situations and individuals (Hamilton- Mason et al., 2009). In addition, the reluctance of some Whites to acknowledge racial strife contributes to a sense of emotional isolation that Black American women experience. Theories such as Relational Cultural Theory (RCT) and, Black American feminist thought have been utilized to explain daily stress and coping for Black American women (Hamilton- Mason et al., 2009). As Black American women transition through developmental stages, issues regarding trust, self- worth, industry, care- taking, and sexual intimacy are experienced differently than they are for White women (Hamilton- Mason et al., 2009). Black American feminist thought consists of theories produced by Black American women. Black American feminist thought provides a voice and self- defined Black American female standpoint, especially as family, work and cultural experiences suggest that as a group, Black American females experience a world that is much different than those who are not both Black American and female (Hamilton- Mason et al., 2009).

Purpose

The purpose of the proposed dissertation is to explore somatic and psychological effects of stress and how self- identified professional Black American women cope with daily living challenges. The goal of the dissertation is to create effective and healthy ways for Black  American women to self- soothe, and engage in self- care. I also discuss the Superwoman Syndrome phenomena in Black American women that is also connected to perceived cultural expectations and mental health stigma.

There is a gap in the literature about culture-specific ways of coping. (Greer, 2011). This study serves to examine the way that Black American women cope with daily challenges of motherhood, childbirth, employment, personal illness, social network coupled with the effects of gendered racism on mental and physical health. (Stevens- Watkins, Perry, Pullen, Jewell &, Oser, 2014).  A question remains of how to engage Black American women into treatment. As an SBW may have the courage to attend therapy, however, it may not be seen as a priority to be consistent if other circumstances enter the picture (Abrams, Maxwell, Pope, & Belgrave, 2014). For many, therapy may be seen as a luxury especially when there are other expectations and responsibilities (Abrams, Maxwell, Pope, & Belgrave, 2014).

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