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N.H. Counselor On How Racial Discrimination Leads To Race-Based Trauma

Therapy by telephone can work about as well as the in-person variety.
"When it comes to observing racially traumatic events, it can also increase that sense of feeling unsafe, that this could be me, too, for any individual who identifies as Black or brown," counselor Nicole Sublette says.

Acts of racial discrimination and living within racist systems and institutions can result in race-based trauma for Black and brown people. In New Hampshire, non-white people make up about 7 percent of the state’s population.

Licensed clinical mental health counselor Nicole Sublette has her own practice in Concord. She led a webinar this week with NAMI NH on race-based trauma. NHPR’s Morning Edition host Rick Ganley spoke with Sublette about how she recognizes and treats the long-term effects of racism on the mental health of her patients of color.

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Rick Ganley: Nicole, can you explain some of the signs and symptoms of race-based trauma? How have you seen it present itself in the patients that you've worked with?

Nicole Sublette: So race-based traumatic stress looks very similar to PTSD, which is post-traumatic stress disorder. And so some of the symptoms could be re-experiencing, which could be intrusive thoughts, nightmares, flashbacks. Another set of symptoms is arousal, which means just being in a heightened emotional state, which could be angry outbursts, jumpiness, hypervigilance, a sense of agitation.

Rick Ganley: It does sound like a lot of the symptoms of PTSD.

Nicole Sublette: Yes, very, very similar. One of the primary differences, though, with PTSD and race-based traumatic stress is that with PTSD, sometimes it can be one significant event, whereas racial trauma can be [the] accumulation of multiple events and having an impact, which is called weathering. Just a wearing down of one's self because it's a repeated incident after repeated incident, after repeated incident.

Rick Ganley: I'm wondering if you could talk about how news and current events play a role in this kind of trauma. You know, Black and brown trauma is often on display in the media.

Nicole Sublette: The news and media can certainly contribute to this because there's that piece of vicarious traumatization. When one watches a violent event, that can have an internal impact on us. It can have a physiological impact upon us. Also, when it comes to observing racially traumatic events, it can also increase that sense of feeling unsafe, that this could be me, too, for any individual who identifies as Black or brown.

Rick Ganley: And I know this webinar that you're leading today is for other mental health professionals. Can you explain more about the importance for therapists to have better cultural competence and understanding when working with these patients?

Nicole Sublette: Absolutely. It's important to understand who is sitting across from you, the context of what they are going through, and also understanding the power and privilege and also power differential that can come in a therapeutic setting and having a discussion. So it's not having that elephant in the room. And it's also not offering canned solutions like, oh, it's going to be okay, don't worry about it, just work harder.

It's really important to understand contextually where the client is at and working together to build the resiliency skills. And then also, as I said before, acknowledging the power differentials and how that might have an interplay in the therapeutic dynamic. And also with the power differential really examining one's self as where they sit as a professional and examining their own biases, which can be very hard. We all have implicit bias. And then not minimizing the concerns of the client. And I know specifically, though, in the state there are very few Black and brown therapists. So it certainly can be a challenge.

Rick Ganley: Do you have some other general guidance that you can give to people who are dealing with race-based trauma?

Nicole Sublette: I do. Another way to seek help is through community. And so it's being involved with organizations who promote advocacy, equity, churches, family, peers. Any kind of support system is really important to decrease the sense of isolation. So it's finding community and connection where you can. And I know that finding support groups as well can be very beneficial.

Rick Ganley: So there are other resources out there.

Nicole Sublette: There are other resources out there, yes. With all that is going on, I just want to add that it's so important that if one is experiencing any symptoms and they're not feeling well to really seek support, to really seek help, to find a sense of community and to not give up in hope in that there are many of us out there. We're advocating and are really working to create change and to create equity. And joining in advocacy and joining movements can be very important, very powerful, and can help to create meaning.