Abstract

This commentary advocates for integrating specific theories in understanding the grief process of African Americans, emphasizing the importance of trained therapists and clinicians. By incorporating cultural and historical trauma theories, mental health counselors can better address the unique experiences of African Americans in grief. Future discussion should focus on enhancing traditional interventions by deepening understanding of the needs of grieving African Americans. Despite existing research on the impact of culture and historical trauma on grief experiences, further studies are needed to assess the effectiveness of treatment approaches.

Keywords: Grief, Black Americans, Oppression, Systemic racism Subjects: Grief, Coping Strategies, Theory, African Americans, Black Americans, Culture, Historical Trauma

Introduction

Assessing grief interventions for African Americans, Moore et al; [1], recommend the cultural context model and historical trauma response theory to therapists to increase understanding of how African Americans cope with grief. In addition to discussing theories of grief that are associated with spirituality, religion, and Black Americans, the authors demonstrate the importance of mental health professionals understanding the historical traumas of African Americans. Over the years, changes have been added to the body of research related to grief and cultural interventions. Still, they are insufficient, like extant research that assessed unresolved grief among Jewish Holocaust survivors and its relation to historical trauma [2]. Although culture and grief have been studied, formal literature on grief, and the inclusion of cultural interventions specifically for Black Americans, appears to be a new concept that continues to evolve. Moore et al.’s [1] discussion of interventions should appeal to those (e.g., social work students, pastors, and medical providers) who provide services to Black Americans with the intent of understanding the influence grief has on a population confronted with surmounting issues related to livelihood, security, and loss of cultural identity. Professionals who provide grief services to Black Americans understand the need for greater specialized interventions. The cultural context model and historical trauma response theory provide a foundation for professionals who work with Black Americans and develop specialized treatment modalities. Some notable observations include limited studies on Black American grief, the history of oppression and racism, and grief counseling implications for mental health providers who serve Black Americans. Contributing authors and extant research address one or more of these themes, evidencing the need for more understanding of the history of Black people and culturally appropriate interventions that address coping strategies for them.

Loss of Cultural Heritage

African Americans continue to be underrepresented in research [3,6]. Historically, the context of death for Black Americans has been based on White America. Extant studies on how people grieve are universal in their research approaches, basing measures on norms for grieving among White and European populations [7-9]. Granek and Sagy [10] assess African Americans and how they grieve in comparison to universal norms of White and European cultures, providing a systematic review of research published during the last 2 decades. Bullock et al. [11], Lee et al. [12], and Richardson et al. [13] assess culture, religion, depression, and beliefs regarding grief, but a gap remains in the literature related to grief interventions for Black Americans. A review of recent and older literature reveals a deficiency in the number of African Americans represented in grief literature in comparison to White Americans, whose grief patterns are a collective phenomenon, built on religious and spiritual foundations.

Research continues to emphasize improving cultural-specific grief interventions for African Americans, and educating and training mental health professionals, but incorporating theory into practice is difficult. Culture influences individuals and communities and provides an understanding of traumatic events affording people to make sense of things that do not always have control over [14]. Due to complex issues and the extensiveness involved when addressing cultural issues, providing training in this area is similarly difficult. Grief and loss are embedded in the fabric of African American culture, and it thus requires individuals to think beyond what they have been taught and have accepted about grief to create nuances that allow them to grieve without barriers. Too little culturally specific research on grief has been conducted among African Americans and other ethnic groups that fall under the Black community, and most extant studies on the topic use Euro-centric perspectives. Research suggests that African Americans use different approaches to grief due to past and current oppressions, and they thus cannot be generalized to the majority. African Americans and other people of color have suffered from various historical traumas, including systematic oppression, police brutality, and poverty, and they have been stripped of culturally relevant traditions [15,16], complicating their grief experiences.

The aftermath of unresolved individual and community grief and trauma among African Americans is evidenced by overpopulated prisons that primarily comprise Black men, lack of education and employment opportunities, and rising violence in underserved communities. Black people comprise only 12.3% of the U.S. population, and yet they represent over one-third of the prison population, suggesting disproportionate policing and enforcement [17]. It is common for African American males to be diagnosed with post-traumatic stress disorder because of their lived experience with discrimination [18]. The world recently learned of a young man named George Floyd who lost his life at the hands of those sworn to protect victims, leaving most Americans in a state of shock, and searching for reasons to make sense of his death. Some decided it was easier to blame the victim rather than seek an understanding of systemic issues that caused his death. Grief is everywhere; no one is immune to it, but Black Americans live with the threat of loss daily, leaving them questioning their future and sense of belonging.

Stripped of their culture, people feel displaced, depressed, and bewildered about their own identities. Schreiber and Hernandez (2016) use the term dual consciousness to describe the confusion that some Black Americans experience when trying to process their African roots and American experiences, which makes grieving a multidimensional experience. Black Americans experience post traumatic stress at higher rates than other ethnic groups [19,20]. Stressing factors such as systemic racism, historical trauma, discrimination, and lack of culturally competent mental health providers lead to more serious diagnoses among African Americans when grieving the loss of a loved one. Historically, religious beliefs and spirituality provide a foundation for African Americans, which should be considered when addressing past traumas and prescribing therapeutic treatment for those who might experience complicated grief.

Grief and Trauma

No one appears to acknowledge how traumatic events will impact the next generation. Erikson (1959) argues that people are members of their society, but they also have past links between generations. African Americans have not only passed down their own traditions and experiences with loss and trauma to their children but also how to deal with them in a way that often lowers the expectations and dreams they have for themselves [21]. It is common for a group of people who have experienced so much loss and devastation in their lives to find ways to suppress emotions and feelings. They might begin to normalize grief, trauma, and loss, or see them as a way of life. In the aftermath of world casualties, grief has become a public health concern for many people presenting a need for more mental health services [22]. The term complicated grief has been described as delayed grief or a reaction that is postponed. Delayed reactions cause individuals to hide their emotions and feelings under a mask, which is simply an expression of the individuals they choose to be. Although the duration of grief varies across people, research suggests that grief symptoms become less intense within 6 months. It was not until recent years that grief was recognized as a legitimate disorder; it was redefined under the category of Prolonged Grief in 2013. Clinicians refer to the Diagnostic Statistical Manual (DSM-5) extensively, used to determine and recognize the difference between normal and abnormal grief [23]. African Americans often suffer from a sense of a foreshortened future, which is symptomatic of PTSD.

Loss has become the norm in Black communities, with residents no longer seeing the need to prolong or fight the process involved with dying [24]. Loss and trauma among Black Americans are not new. They often feel as though their voices have been marginalized; they have been told when and why they should grieve, and many skip grieving to move on. African Americans are born into a system that presents different challenges to their success, and when past griefs, losses, and traumas remain unresolved, they cry out to be resolved. Today’s loss triggers the loss of yesterday’s pain, leaving people looking for ways to cope, whether publicly or in political discourse. Historically, Black Americans have relied on family and friends, and spirituality, to cope with loss [25,26], but they are now finding different ways to attach purpose and meaning to their lives.

Mclyor [27] brought attention to how the Black Lives Matter movement has allowed African Americans the opportunity to bring awareness of loss and its relationship to politics, and how they grieve individually and as a group. Various forms of loss are leaving Black Americans questioning their future and the future of the communities in which they reside. Traumatic experiences influence how people see the world, and how they see themselves in it. Post-traumatic slave syndrome explains the lasting effects of depression and oppression suffered by generations of enslaved African Americans and the future of generations [29]. Most Black Americans and people of color cannot process one loss before they experience another, and they anticipate when and where the next will occur. Black Americans are traumatized by the loss of men and women who become victims of police brutality, and they protect their children by preparing them for encounters with police. If African Americans and people of color are not allowed to express grief in a healthy way, they suppress their emotions and view it as a loss that is unimportant in society. Disenfranchised, anticipated, and compound grief are just some of the types of grief that professionals who work in marginalized communities must address when considering various treatments.

Grief Interventions for African Americans

In a review of problems that African Americans experience when grieving lost loved ones, Schreiber and Hernandez (2022) argue that interventions that include cultural contexts and historical traumas offer benefits. Thus, multifaceted interventions that improve African Americans’ grief are needed. It is theorized that incorporating specialized interventions related to culture helps with grieving, and it is equally important to help Black people understand that trauma is not their culture but something that has invaded their culture, and it can be addressed. Offering comprehensive services in urban communities that include Trauma Recovery Centers, and building infrastructures of violence prevention will also provide a way for Black people to express their grief and exposure to other traumatic events. Humanitarian approaches that include access to trained mental health clinicians in communities, education and self-awareness, and culturally sensitive training for mental health professionals are essential to effective treatment. Carlton-LaNey [29] suggests that professional social workers who do not consider historical contexts when working with Black Americans have led most to overlook the creativity and skill set of the population. Instead, social work literature, education, and practice accentuate pathology. Clinicians should thus be aware of the dual identity of African Americans when considering strategies for this population.

Conclusion

Moore et al; [1] suggest it is essential for mental health providers to have an awareness of how Black people grieve in order to have a positive relationship with their clients (p. 197). It is time for African Americans to confront their pain and replace the mask they wear by creating safe spaces for them to express grief, without reservation, by incorporating proactive strategies. Healing circles are cultural context models that include a therapist who offers clients opportunities to process grief as they learn about the influences of oppression and intersectionality [30]. Given this development, more discussions are needed on how grief, loss, and trauma influence the future of African Americans, and how they cope and survive during challenging times. It is important to understand how Black people confront trauma and loss daily in their families and communities. In addition, Moore et al; [1] postulate that clinicians, counselors, and others who provide grief services to Black Americans would benefit from a deeper understanding of this population and how their specific needs can be met. Professionals should also recognize their own traumas when working with this population, and they should understand that they will not have all the answers; this is an ongoing learning process.

Competing interests:

The authors declare that they have no competing interests.

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