Measuring the Effects of Racism, by Robert T. Carter and Alex L. Pieterse (introduction)

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elements of American society, structural aspects without which the United States (and its predecessor colonies) could not function well or be prosperous. Much of the country’s political and social activity has been dedicated to establishing a racial caste system and maintaining it at all costs.1 Racism in the New World colonies and, later, in the United States did not begin as a system of racial oppression, a point that is a matter of debate among scholars; rather, some contend that it evolved over time and later was justified to support its continuation. Others note that Africans and Native Americans were from the outset considered and treated as inferior people. In the early years of the colonies, people who provided labor were indentured servants, and people of all colors and religious backgrounds held the status of servant.2 Various historians tell dif ferent stories of the history of race and racism within America, but there are some important distinctions to make for the full story to be told. Lerone Bennett Jr. states that “for two hundred years black, brown, and yellow men and women were held in bondage in America.”3 George Marsh Fredrickson argues that racism (i.e., unequal status between racial groups) as a conscious belief and an ideology should be distinguished from prejudice since prejudice is a matter of feeling but discrimination is based on action.4 He contends that the explicit or conscious forms of racism that characterized the nineteenth and twentieth centuries differ from what he calls implicit or societal racism, which is based on actual social relations and was dominant in the eighteenth century. For Fredrickson, when one racial group treats the other as inferior, even in the absence of any conscious belief, it is still racism. And societal racism can exist long after the rationale has been discredited.

RACE AND RACISM ARE INTEGRAL

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Europeans are said to have had a negative perception of Africans based on contact with Africa in the fifteenth century and on assumptions made about the difference in physical appearance and cultural practices between White Europeans and Black Africans.5 Blackness was equated with uncivilized people, and the color black was associated with evil in the language and customs of England. Ignored in these early contacts was the rich and long history of civilization and culture that existed in Africa before these encounters.6 Africans were not savages; they and other people (e.g., in South America and Asia) had lifestyles and cultural practices distinct from those of Europe.7 The arrival of Europeans in the New World resulted in the subjugation of the Native people, referred to as “Indians” by the European explorers. During the colonial period of 1492–1776, Native Americans were enslaved by explorers and colonists; however, Native American slaves succumbed to illness and escaped in large numbers; they were subsequently replaced by Africans brought to America via the slave trade.8 Between 1619 and 1649, a small number of Africans were introduced into Virginia as “servants. Some, and perhaps most, of these early arrivals were freed after a limited term of service.”9 James Horton and Lois Horton observe that the “Africans brought to Jamestown in the early seventeenth century were bound laborers, not all were treated as slaves. . . . During the early colonial period, American concepts about race, slavery, and standards for race relations were still being formulated and were not yet as fixed as they would become in the eighteenth century.”10 There is an ongoing debate as to the status of Africans in the colonies, specifically whether Africans in the early colonial period in North America were treated as slaves or servants, and the precise factors contributing to their eventual nonhuman status is also a matter of debate. Some contend that international law meant that Africans were slaves regardless of where they were taken; others argue that race prejudice combined with physical differences are the determining factors that sealed the fate of Africans. From another perspective, it is suggested that Africans were segregated from the colonists, and it was this that made their enslavement possible.11 Nevertheless, societal racism—the conviction that Africans and people of color in general were inferior because of their race and should be treated accordingly—held sway from the early seventeenth century until an ideological justification to maintain slavery and establish a system of racism was instituted in the nineteenth century.12 That people of African descent (hereafter

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referred to as Blacks) were inferior was taken for granted and required no justification in the early years of the colonies. Societal racism operated without an explicitly stated ideological rationale for well over one hundred years, until the late eighteenth century, when a few citizens of the new United States of America argued that the nation should live up to its principles of equality and abolish slavery and all it represented. In response, supporters of the status quo provided a justification that Fredrickson describes as “explicit racism, a public ideology based on the doctrinaire conception of the black man as a natural underling developed therefore directly out of the need to defend slavery against nineteenth- century humanitarianism.”13 This racist ideology became ascendant toward the end of the nineteenth century, when it was justified by scientific views of race that replaced the religious justifications of the past.14 During this time the emerging discipline of psychology built on the earlier notions of the biological inferiority of Blacks (see Jefferson’s 1784 Notes on the State of Virginia) by providing empirical support for the apparent intellectual inferiority of Blacks, thereby bolstering the work of anthropologists who had already outlined a scientific racial hierarchy that would in time fuel the eugenics movement.15 This racist ideology both contributed to and was energized by the effort in the South to establish legal segregation and continue oppression of Blacks well after the order of emancipation was signed by President Abraham Lincoln in 1863.

It is clear that the long and ongoing story of American racism, “first as a way of life (societal racism) and then as a system of thought (explicit racism),”16 is still being enacted.17 That racial ideas and feelings have shifted and changed over time is clear, but many would argue that the racial arrangement of White domination and subjection of people of color that marks the beginning of the nation is essentially unchanged at its core.18 It is also clear that “America . . . was not born racist; it became so gradually as the result of a series of crimes against black humanity [and other people of color] that stemmed primarily from selfishness, greed, and the pursuit of privilege.”19 There is evidence that, since about 2001, the United States has seen a rise in more overt racial tensions and official support of Whites and White racial causes. This is reflected in actions taken by the Trump administration and his appointees and in other events that show how race continues to be a central and disturbing feature of U.S. society. Some would argue that racism has saturated the society, though it sometimes fades from clear view and at other times assumes a more dominant position. To illustrate, in August 2017 Sari Horwitz and Emma Brown, writing in the Washington Post, reported

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that the Justice Department, under the new leadership of Jeff Sessions, the U.S. attorney general, was “planning a new project to investigate and sue universities over affirmative action admissions policies they determine discriminate against white applicants.”20 This plan, which has since been put into action, is just the latest in a long history of attempts to maintain White dominance in the United States. There was a notion that—with the election of a Black man, Barack Obama, as president in 2008 and 2012—race had become less salient and the issues and concerns of people regarding race and racism had diminished. Yet evidence to the contrary has emerged to show that race, racial inequality, and racism remain central factors in the social and political lives of the U.S. population and that consideration of race still divides the country.

Some cite as evidence the role of race in the election of Donald Trump as the forty-fifth president of the United States: “Our analysis . . . indicates that Donald Trump successfully leveraged existing resentment towards African Americans in combination with emerging fears of increased racial diversity in America to reshape the presidential electorate.”21 Trump was explicit about his thoughts regarding people of color and immigrants (mostly of color) and played to Whites’ negative racial attitudes to build support for his candidacy. Some of the actions taken by his administration and his comments toward White nationalists (e.g., following the Charlottesville, Virginia, protests of August 2017) fuel fear that he harbors hostility toward people of color.

E. J. Dionne and colleagues note that “studies suggest that to ignore or downplay the role of race and immigration in creating the Trump coalition is to be willfully blind to the obvious. . . . It also requires ignoring strong racial undercurrents on the websites of the far right, including an increasingly open embrace of white supremacy.”22 In starker terms, some suggest that the election of Donald Trump was in part a reflection of the fear that Whites hold of Blacks and other people of color, a fear that for many is not explicit or even acknowledged. Ta-Nehisi Coates states: I think the old fear of Good Negro Government has much explanatory power for what might seem a shocking turn—the election of Donald Trump. It has been said that the first black presidency was mostly “symbolic,” a dismissal that deeply underestimates the power of symbols. Symbols don’t just represent reality but can become tools to change it. The symbol of Barack Obama’s presidency—that whiteness was no longer strong enough to prevent peons from taking up residency in the castle—assaulted

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the most deeply rooted notions of white supremacy and instilled fear in its adherents and adversaries. And it was that fear that gave the symbols Donald Trump deployed—the symbols of racism—enough potency to make him president, and thus put him in position to injure the world.23

Indeed, empirical data support the role of racism within voting patterns of the 2016 election. Brian Schaffner, Matthew Macwilliams, and Tatishe Nteta find that among voters strongly affiliated with being White, being told that people of color would outnumber Whites by 2042 resulted in these individuals being more likely to support and vote for Donald Trump.24 Some conclude that a main driving force of President Trump’s election and postelection support has been racial resentment on the part of Whites. As the first year of Trump’s presidency came to a close, the social commentator and journalist German Lopez wrote, “Economic anxiety isn’t driving racial resentment; rather, racial resentment is driving economic anxiety. . . . Racial resentment is the biggest predictor of white vulnerability among white millennials. Economic variables like education, income and employment made a negligible difference.”25 The evidence therefore suggests that the current political reality has its roots in the past and that race continues to be power ful in shaping American society, just as it was when the foundations of the United States were being laid many centuries ago. Unlike other countries, the United States has been unable to attend to or acknowledge the impact of its racial history. South Africa and Canada also carry shameful histories surrounding race, but they have used processes such as truth and reconciliation commissions to help address and take responsibility for their systems of racial oppression in an effort to change the present and the future. In 2017 the Canadian government settled a legal action by indigenous people whose children had been removed from them and placed in foster homes and boarding schools. The government admitted to its actions and agreed to pay damages and set up systems to remedy the harm as much as possible and to ensure that similar actions do not occur in the future. As Ian Austen reported in the New York Times, “For decades, Canadian social workers forcibly separated indigenous children from their families, putting them up for adoption to nonnative families in Canada and around the world. On Friday the Canadian government took the step to make amends for that adoption program, which began in the 1960s and lasted till the 1980s, by agreeing to pay 750 million in Canadian dollars in legal settlement.”26 In stark contrast, in the United States we debate the

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meaning of statues honoring leaders of the Confederacy. An article on the BBC website states: It has been 150 years since the last shots were fired in the U.S. Civil war, but a debate still rages over how history will remember the losing side. Hundreds of statues dedicated to the Confederacy exist all throughout the Unites States, and often serve as an offensive reminder of American’s history of slavery and racial oppression. Recent decisions by local governments to remove those memorials have triggered a backlash from a vocal group of Americans who see their removal as an attempt to subvert U.S. history and southern culture.27

Although race continues to be a profound and provocative aspect of the American experience, what receives less attention are the ways in which people are racially oppressed,28 as well as the harm that such practices bring to those unable to prevent the negative outcomes associated with segregated educational systems and housing, unequal employment opportunities, constant surveillance of non-White communities by law enforcement, and mass incarceration of Blacks and Latinos/as. Throughout 2019, leading into the presidential election of 2020, Trump has fanned the flames of racism with a series of comments, actions, and statements.29 The Atlantic devoted an entire issue—titled “An Oral History of Trump’s Bigotry”—to the topic.30 Systemic racism has been a part of North American society for centuries, initially as slavery and racial segregation and today as overt and covert practices of racial discrimination. In the mid-twentieth century, traditional or oldfashioned (legally sanctioned) racism abated somewhat (for a short time) and then was reasserted in various forms disguised as focusing on something other than race—social class or cultural disadvantage.31 Now, in the twentyfirst century, issues of racism in many areas of everyday life have resurfaced, and overt expressions of racial hostility are again reflected in national and local media coverage and other sources (i.e., court decisions and litigation).

Racism has recently been implicated in law enforcement, higher education, health care, housing, and employment. For example, consider the events regarding racist comments, symbols, and songs on college campuses, and protests by racial-minority college and university students occurring across the country.32 There has been a weakening of voting rights for racial minorities;33 many people of color continue to encounter racial discrimination in housing;34 at least twenty-six African American men and women have received

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violently unequal treatment by law enforcement authorities in New York, Cleveland, Ferguson, Baltimore, Tulsa, and other cities;35 and awareness continues to grow regarding the persistent disparities in treatment of racial minorities and immigrants in the health care, civic engagement, and criminal justice systems.36 It has fallen to those who contend that racial inequality is harmful to document the various ways in which injustice affects the physical and psychological well-being of individuals and groups. In the twentieth and twenty-first centuries, researchers have shown through empirical investigations how the ideology of racism and its accompanying behavioral manifestation—racial discrimination—affect psychological functioning. What has emerged from the effort, which we describe in more detail in this volume, is an approach for understanding, assessing, measuring, and treating the psychological effects of racism. We document the presence of race-based traumatic stress (RBTS) as racial trauma and show how mental health professionals can measure the harm or injuries from racism.

Empirical evidence has accumulated over several decades documenting the psychological and emotional effects of racism and racial discrimination.

In general, researchers have found that people who are exposed to racism experience stress37 and have adverse health outcomes such as depression, anxiety, and hypertension.38 It is therefore imperative that a more complete understanding of the health effects of racism and racial discrimination be established. The purpose of this book is to examine the psychological and emotional responses to racism, which are discussed as a form of oppression.

Many scholars describe oppression as a system in which the dominant group uses its power to restrict the subordinate group’s access to resources, resulting in gross systematic disparities.39 Oppression is a process of dehumanization that creates social and physical isolation, lack of access to all types of resources, and blocked opportunities. In North America, people of color (i.e., historically disenfranchised Black, Native, Hispanic, Asian American, and other groups) have been longstanding targets of oppression,40 with racism the most prevalent contributing factor in health disparities and social inequality between Whites and people of color.41 Evidence from integrative reviews and meta-analyses indicate that exposure to racism and racial discrimination is negatively associated with psychological health and positively associated with psychological and physical distress.42 Given the presence of racism in society, valid and sound conceptual models, measures, and procedures that access the emotional outcomes specific

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to race and racism are needed. While various useful instruments exist to measure the stress from racism,43 many capture only the frequency and magnitude of the stressors and do not determine whether one’s reactions reflect RBTS as racial trauma.

Robert T. Carter’s conceptualization of RBTS injury as racial trauma links emotional reactions to a specific encounter with racism or racial discrimination, showing the ways in which dif ferent dimensions of racism may generate dif ferent kinds of stress responses, including traumatic reactions.44 This volume is designed to acquaint the reader with the various aspects of the models and measures associated with RBTS as racial trauma. We guide the reader through illustrations of racial encounters that have occurred in stores, housing complexes, schools, and workplaces to show instances of racial discrimination and to highlight how the model of racial trauma evolved and is applied to these complex situations. To illustrate, consider Mark, a healthy, middle- class African American man in his late twenties. He worked as a salesman in a retail store for a few years. During his employment in the store, Mark alleges that he was denied time off, given menial assignments (e.g., mopping), and spoken to in a demeaning manner by his store manager, treatment that was not experienced by other employees. In addition, he claims he was required to ensure that Black customers did not steal anything. He was disturbed and upset by this treatment and the tasks he was asked to perform. Mark states that he followed documented and published procedures to file several complaints against his manager during his employment. Mark alleges that his store manager retaliated by threatening to fire him. He endured the mistreatment and threats of termination because he needed the job. He was fired nevertheless. We outline the psychological implications of experiences like those encountered by Mark, herein understood as RBTS, and we provide clinicians a way of assessing and responding to those experiences in a manner that is effective and therapeutic.

The book is organized into three parts. In the first, we review what we know about racism and health by addressing the use of common terms and concepts, including race, mental health, people of color, culture, and racism.

We discuss and address research associated with the concepts of stress and trauma and present a selective review of the literature on discrimination and race-related stress and its mental health effects. We also define classes of racial encounters that are used to connect those encounters with mental health effects. Finally, we explore individual and contextually based variables like socioeconomic status, race-related coping, and racial identity ego statuses

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that account for the various ways in which individuals and groups respond to racial stress and trauma.

The second part focuses on what we need to know about racial trauma and describes the framework of RBTS, including empirical evidence to support the model. The chapters provide an assessment procedure for RBTS. We describe the Race-Based Traumatic Stress Symptom Scale, review its application and use, and show the research evidence that has been generated to support the instrument. We also discuss the utility of an interview schedule that accompanies the RBTSSS and introduce a short-form version of the RBTSSS. The last part of the book focuses on what mental health professionals must do for clients dealing with racial trauma. We discuss the clinical utility of the RBTS, offer guidelines for treating RBTS as racial trauma, and provide recommendations for practice. We discuss forensic applications and offer strategies for testimony in legal settings and assessment. Case illustrations and vignettes are used to highlight the clinical utility of the RBTS model.

We conclude by addressing the training of mental health professions for dealing with racial trauma, and discussing emerging issues for prevention and policy.

We believe that you will find this volume to be a critical and urgent addition to the developing literature on the psychological impact of experiences of racism and racial trauma.

A large body of research has established a causal relationship between experiences of racial discrimination and adverse effects on mental and physical health.

Measuring the Effects of Racism is a guide for mental health professionals on how to understand, assess, and treat the effects of racism as a psychological injury. Robert T. Carter and Alex L. Pieterse offer a new framework of race-based traumatic stress that helps legitimize psychological reactions to experiences of racism.

“Carter and Pieterse increase our understanding of—and the treatability of— traumatic stress that results from racism. The proposals proffered in Measuring the Effects of Racism will lead to better treatment methods of race-based trauma and increase the evidence base for advocacy and agendas for social justice.”

—HUGO KAMYA, Simmons University

“Drawing on decades of experience, Carter and Pieterse have given us a tour de force exploration of new research on race-based traumatic stress. Introducing an invaluable new theoretical model and assessment, they have provided an indispensable resource for researchers, practitioners, and trainees interested in systematically addressing the ill effects of racism in our society.”

—HELEN A. NEVILLE, coauthor of Counseling the Culturally Diverse

“Measuring the Effects of Racism is the definitive guide to understanding the scope of the psychological impact of racism. Providing a clear and comprehensive conceptual framework and assessment strategy, Carter and Pieterse have written a book that will be of great benefit to educators, researchers, practitioners, and policy makers.”

—MATTHEW MILLER, associate editor of the Journal of Counseling Psychology

ROBERT T. CARTER is professor emeritus of psychology and education at Teachers College, Columbia University. His many books include Confronting Racism: Integrating Mental Health Research into Legal Strategies and Reforms (2020).

ALEX L. PIETERSE is associate professor and director of doctoral training in the program of counseling psychology at the State University of New York at Albany. He also serves as a racial diversity consultant and practices as a licensed psychologist.

COLUMBIA UNIVERSITY PRESS NEW YORK cup.columbia.edu

Printed in the U.S.A.