Causes of PTSD – Racial Trauma

Causes of PTSD & C-PTSD - Racial Trauma

Race-based trauma is increasingly recognised within psychology as a distinct type of trauma, leaving lasting imprints on the mental health of those who endure it.  “Racial trauma” refers to the accumulation of emotional and mental injuries caused by racist incidents, racism, and racial discrimination in someone’s life.

Experiencing racial trauma has been linked to various mental health challenges, and the connection between racial discrimination and symptoms of PTSD is particularly strong. Both Post Traumatic Stress Disorder (PTSD) and Complex PTSD (C-PTSD) can arise in the aftermath of such trauma, so understanding, support, and proactive measures to address this pervasive issue are vital.

Understanding Racial Assaults and Trauma

Racial trauma, encompassing physical, verbal, or systemic attacks based on an individual’s race or ethnicity, can trigger profound psychological and emotional distress. The experience of being targeted with racial bias, ethnic discrimination, racism or hate crimes because of one’s racial background can shatter a person’s sense of safety and belonging, leading to a cascade of mental health challenges.

Racial trauma can manifest in various ways, including:

  1. Racial trauma from a specific incident: This form involves experiences like racist assaults, hate crimes, or sexual violence. Therapists often define this as trauma when an individual undergoes or witnesses a frightening event, feeling their safety is seriously at risk.
  2. ‘Microaggressions’: Microaggressions are subtle acts of racism, like brief comments or non-verbal gestures, that can be challenging for the recipient to interpret. These incidents can occur frequently, making it mentally taxing for individuals to handle the constant racial stress. The unpredictable and anxiety-inducing nature of these events, often overlooked by others, can make victims feel overwhelmed and as if they are losing their grip on reality. Constant fear of these experiences may lead to persistent vigilance or even paranoia, contributing to trauma or PTSD if a more stressful event occurs later on.
  3. Vicarious trauma: Also termed secondary trauma, this occurs when you are present for, witness, or learn about horrifying events. Examples include watching videos of racial violence, targeted mass shootings, or reports of discrimination against your community.
  4. Intergenerational or historical trauma: This type of racial trauma involves psychological wounds passed down through generations. It stems from the struggles of ancestors, parents, and grandparents with issues like slavery, genocide, oppression, or racist laws and policies. It’s often referenced in communities like Jewish individuals with Holocaust survivor relatives or Native and African American communities.
  5. Chronic stress related to racism: Race-based traumatic stress encompasses ongoing experiences that become increasingly challenging to handle as the burden accumulates. Examples include being bullied, stereotyped, or discriminated against due to racism; facing challenges or feeling pressured to succeed due to fewer wealth, privilege, support, and resources resulting from racist laws and policies; or having a higher likelihood of arrest and imprisonment due to racist policing and sentencing practices.

The Psychological Impact

Betrayal of Trust: Racial assaults frequently involve a betrayal of trust, as individuals experience harm from others who are supposed to share the same societal values. This breach can instil a pervasive fear and scepticism that seeps into various aspects of daily life.

Persistent Fear and Anxiety: The trauma inflicted by racial assaults can fuel a constant state of hypervigilance and anxiety. Individuals may become hyperaware of their surroundings, anticipating further harm, and struggling to find respite from the emotional toll.

Impact on Identity: Racial assaults can deeply wound a person’s sense of self, causing feelings of shame, guilt, and questioning one’s worth. For many, these attacks challenge the core of their identity and place in society, contributing to a profound sense of alienation.

Recurring Traumatic Memories: Flashbacks and intrusive thoughts related to the racial assault can plague individuals long after the incident, intensifying feelings of distress and making it challenging to move forward.

Avoidance and hypervigilance: According to a 2022 survey, almost one-third of Black Americans (32%) and one-fifth (21%) of Asian Americans expressed daily concerns or nearly daily worries about potential threats or attacks based on their race or ethnicity. In contrast, only 4% of White Americans reported similar fears. Additionally, a significant number of individuals from minority communities altered their daily routines to steer clear of potential attacks.

Prevalence and Statistics

The prevalence of racial assaults and their connection to PTSD and C-PTSD is a critical concern that demands attention. According to a study published in the American Journal of Public Health, the risk of developing PTSD after experiencing a racial assault is significant, with individuals facing a higher likelihood compared to those who experience trauma unrelated to race.

Results from extensive national studies in the USA reveal that, although African Americans have a lower risk for many anxiety disorders, they exhibit a 9.1% prevalence rate for PTSD, whereas White Americans have a 6.8%, however, it’s expected these rates might be even higher because diagnosticians often overlook the role of racism as a trauma factor. Studies further indicate that African Americans with PTSD encounter more significant challenges due to trauma, leading to increased difficulty in performing daily activities and encountering more obstacles in accessing effective treatment.

Assessment and Diagnosis of PTSD & C-PTSD from Racial trauma

Recent developments in this area have seen researchers create tools to assess racial trauma in clinical settings. The Race-Based Traumatic Stress Symptom Scale (RBTSSS) was the first, but it has limitations like being lengthy, having a complex scoring process, and not providing a diagnosis. Another tool is the Trauma Symptoms of Discrimination Scale (TSDS) by Williams et al. (2018), which covers PTSD symptoms related to anxiety caused by discrimination. However, it’s only validated for African American and multiracial individuals and, like RBTSSS, doesn’t give a diagnosis.

Williams et al. (2018) addressed this by creating the UConn Racial/Ethnic Stress & Trauma Survey. It’s a clinician-administered interview that aids in diagnosing PTSD due to discrimination, based on the criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The Path to Healing

Different forms of racism and racial trauma such as like intergenerational racial trauma, racial microaggressions, discrimination, and overt racism can lead to different stress or trauma responses.

If you’re experiencing any symptoms of PTSD such as flashbacks, nightmares, depression, anxiety and suicidal thoughts, talking to your GP is the first step to getting help and treatment.

NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for PTSD and C-PTSD specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT). However, understanding the different ways racial trauma can be caused, and manifest is useful for developing specific, additional treatments for these specific trauma types.

For example, when supporting people who have experienced oppression, Kira (2010) proposes that encouraging victims to forgive those who collaborated in an oppressive system can help mental and physical health results. It also plays a role in fostering reconciliation. On the other hand, supporting feelings of anger towards the oppressor and aiding the victim in pursuing retributive justice is connected to healing and positive mental health outcomes. This is particularly related to recovering self-control and executive functions.

Cultivating Cultural Competence: Education and awareness play pivotal roles in dismantling the structures that perpetuate racial assaults. By fostering cultural competence and understanding, societies can work towards preventing these traumatic incidents.

Access to Mental Health Support: Recognising the unique challenges faced by survivors of racial assaults, increased accessibility to culturally competent mental health services is crucial. This includes ensuring that therapeutic interventions consider the link of race and trauma.

Community Support and Solidarity: Establishing safe spaces for survivors within communities is essential. Encouraging open dialogue, shared experiences, and mutual support can contribute to the healing process and empower survivors to reclaim their sense of agency.

Empowerment: Many studies show that interventions that empower victims of oppression and boost their perceived control, can reducing traumatisation by enhancing self-control and executive functioning.

Post Traumatic Growth: Certainly, the concept of “post” traumatic growth encounters difficulties when applied to racial trauma. This is because incidents of racial trauma tend to be ‘persistent, recurrent, and cumulative rather than one-time, discrete events’. Complexities in treatments and healing arise due to the ‘open-ended nature of race-based trauma for racial minorities.’

We still have much work ahead to address the reality of racial trauma. Important steps include making sure clinicians are aware of racial trauma and it’s impact. Racial trauma represents a deeply entrenched issue with far-reaching consequences on mental health. Understanding the nuanced impact of these traumas on individuals, along with implementing proactive measures to prevent and address them, is imperative. By fostering empathy, education, and a collective commitment to justice, societies can move towards healing the wounds inflicted by racial trauma and creating a safer, more inclusive world.


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Treatments for PTSD

It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).

Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.