What I didn’t know about growing up Black in America; I thought I pulled myself up by my bootstraps, but….; the 3 year anniversary of losing my wife.

In SAVVY, I learnt a lot from three African American young people. I was aware of some of their experiences but others were totally new to me. Rethinking the terms “microaggressions” and “cultural competence”.

In SKILLS, being person-centered and focused on the individual in their social context addresses siloed initiatives and projects. I thought I pulled myself up by my own bootstraps. But a look at my generational history exposed the myth of meritocracy.

In SOUL, it is three years since the sudden loss of my wife. Current thoughts on my process in Work, Love and Play.

savvy

You would think that a 72 year old psychiatrist who is reasonably socially aware and has lived in the USA since 1974, would be savvy about what it is like to grow up Black in America. In honor of Black History Month, I thought I would interview three Black young people and see what I knew or didn’t know. I found out to my chagrin, that there was quite a lot that I didn’t know I didn’t know.

A reminder, Black History Month (February 1- March 1) is “an annual observance originating in the United States, where it is also known as African American History Month. It has received official recognition from governments in the United States and Canada, and more recently has been observed in Ireland, and the United Kingdom.”

Tip 1

What I didn’t know I didn’t know about growing up Black in America

Here are a variety of experiences that combine what I heard from two African American young women Reid, 22 and Tazama, 27 years old.

You may be quite familiar with these experiences already. I had awareness of some of these while there were others that had never crossed my mind. As I talked with them, their stories touched me vividly. Can you appreciate what it must feel like to face these issues daily, all because of the color of your skin:

• To be walking on the sidewalk minding your own business, only to have people look at you suspiciously; cross the street until you pass by; flinch and look back over their shoulder with anxiety and fear?
• To have a person talk down to you as if you have an intellectual development disorder – explaining things in a slow, simplistic, condescending tone of voice.
• To have someone reach out and touch your hair as if you are a curiosity and specimen to be examined.
• Tazama mentioned cultural appropriation, a term I had heard but knew very little about. So I had to look it up: cultural appropriation – “the inappropriate or unacknowledged adoption of an element or elements of one culture or identity by members of another culture or identity. This can be controversial when members of a dominant culture appropriate from minority cultures.” Both Reid and Tazama talked about white women who have the option to culturally appropriate black hairstyles as a fun fashion style. Black women have had to deny their natural hair style to accommodate to white standards and expectations in the workplace and it has not been a choice for them. Only more recently is there tolerance for different hairstyles that honor people’s culture.
• Reid talked about a term with which I was not familiar. She talked of hearing people mock African American Vernacular English – “also referred to as Black English, Black English Vernacular, or occasionally Ebonics, is the variety of English natively spoken, particularly in urban communities, by most working- and middle-class African Americans and some Black Canadians.”
• I was touched when Reid started crying about how people misunderstand and are unempathetic to the anger and outrage she and other Black Americans feel over current injustices – rage borne out of generations of discrimination and injustice. She raised what happened on January 6, 2021 and asked me a question “Do you think there would have been a blood bath if all those people were Black Americans?”. I hadn’t thought about that much so I looked it up and found that others had written about “How would this have played out if many of the rioters were Black?” I didn’t know specifics about those who stormed the Capitol on January 6.
• Of the 377 arrested, 95 percent were white, 85 percent male, and were middle and upper middle class. So I do wonder about Reid’s confronting question, what would have happened if those who entered and fought with police had been 95% Black Americans?
• To know that no matter what I have on, Reid said, or what I have accomplished, I can still be put down just for being Black. Reid said her brother graduated from college at 15 years of age and still suffered slurs like being called a “monkey”. Tazama is afraid when she rides with her brother in his car for fear of being pulled over by police. Once when I was a kid in elementary school a boy derided me with “Ching Chong Chinaman”, and my white Aussie friend immediately came to my defense. But I have never had to suffer frequent verbal abuse.
• Tazama said that if she is pulled over by the police, she is deliberate to verbalize every move for fear of being shot for reaching for a weapon. She said she choreographs every movement slowly: “I am now going to use my right hand to reach into the glove compartment to get my car registration. I am reaching into my purse to find my license to show you.” I have never thought of needing to do that. When pulled over for speeding, I simply reach over to the glove compartment without any thought of commentating on what I am doing.
• When I go shopping, I don’t have to think at all about being followed and watched to be sure I am not shoplifting.

Tip 2

What I hadn’t thought before about the terms “microagressions” and “cultural competence”

I had a very informative discussion with a smart, well-read and ambitious half-black, half-white 39 year old young man, Izaak Williams. He got me thinking and realizing the limitations of two terms relevant to Black History Month.

Microaggressions

“A comment or action that subtly and often unconsciously or unintentionally expresses a prejudiced attitude toward a member of a marginalized group (such as a racial minority).” Many of the experiences in Tip 1 above are examples of microaggressions.

For detailed Examples of Racial Microaggressions take a look at this tabulated list for multiple cultural groups.

Here’s how my thinking evolved:

• What is said or done is subtle, unconscious and unintentional. But the word “aggression” conjures up an active act of a perpetrator towards a recipient, helpless victim.
• The person may well have a prejudiced attitude, but does not however perceive themselves as an aggressor. So it doesn’t win friends and influence people to change their thinking by starting with a tone that they are a perpetrator. 
• Likewise, it is not empowering to perpetuate and assign Black Americans to the role of “victims” of aggression. That sets up any interaction as a defensive, fearful or angry response.
• Words matter and so if we want to promote dialogue, empathy and understanding, “microaggressions” is not a mutually-empathic, joining and bonding word or concept.
• Who knows what a better term would be? Maybe “Micro-misconceptions”, “Micro-misunderstandings”, “Micro-misrepresentations”, “Micro-opportunites” for understanding our misconceptions and creating opportunities for mutual positive regard.

Cultural Competence

“Cultural competence — loosely defined as the ability to understand, appreciate and interact with people from cultures or belief systems different from one’s own.”

Here’s how my thinking evolved:

• When trained about another culture or belief system, inherent in such “competence” is that you now are in a better position to understand, appreciate and interact with a person from that culture.
• Cultural competence too commonly centers on “Othering” racial/ethnic groups with an outsized focus on gaining a text-book understanding of the “Other”.
• The problem is that not everyone in that “other” culture or belief system is exactly the same. I joke that if you have had training on understanding Asians and you met me, your competence would be poor because I am a “banana” – yellow on the outside, white on the inside. I associated with White Australians and culture 99% of the time and all my friends were white as was my wife and all my siblings’ spouses. My culture was far more “white” than it was Asian (except I do use chopsticks well). 
• A so-called culturally competent person may make the mistake that they can interact well with the other, when what the training has done is to reinforce stereotypes and generalizations about people in that culture.
• Sensitivity to possible common customs, beliefs and behaviors in the culture different from your own can give you a jump start to knowing this particular person. But avoid making assumptions more focused on the commonalities and generalizations of this person’s culture, than on getting to know this particular individual. 
• Who knows what a better term would be? Maybe “Cultural Communication”, “Cultural Collaboration”, “Cultural-opportunites” for understanding our misconceptions and prejudices and creating opportunities for collaboration and communication.

skills

Tip 1 

Being person-centered takes care of all the buzz word initiatives

Cultural Competence, Gender-specific Services, Integrated Co-Occurring Disorders Treatment, LGBTQ Services, Trauma Informed Services, and Recovery-Oriented Systems of Care. The list of old and new initiatives goes on and on. Advocates correctly raise our awareness about the specific needs of each population served. Without dismissing or minimizing the importance of these initiatives, there is a common thread that can unify our efforts and minimize fragmentation of human and financial resources.

Be person-centered and establish systems that focus on the individual in their social context.

Advantages of bringing all initiatives under a person-centered umbrella:

• A common mission and vision creates economies of scale instead of duplicative administration, funding streams and fragmented energies inherent with siloed initiatives and projects.
• As discussed above in SAVVY Tip 2, even within a particular initiative like Cultural Competence, a person-centered and individualized approach should always take precedence over assumptions, commonalities and generalizations about any particular population served.
• Clinicians and systems already feel overwhelmed with the volume and variety of needs. Anything that minimizes fragmentation of resources, personal energy and improves clinical focus will aid compassion fatigue and enhance the ability to be fully present with the people we serve.
• With a focus on the individual in their social context, each new initiative is not a project to be added to or replace a clinician’s core competencies. Rather, it can be framed as tweaking and adjusting a clinician’s core competencies and a system’s processes.

Tip 2

Reflect on your own generational history before you are too quick to pat yourself on the back about your accomplishments.

I was born and raised in Australia as an ABC (Australian-born Chinese). As such, I was a minority in a predominantly white society. In fact there was an explicit policy, the White Australia policy, “that effectively stopped all non-European immigration into the country and that contributed to the development of a racially insulated white society.”

The White Australia policy encapsulated “a set of historical policies that aimed to forbid people of non-European ethnic origin, especially Asians (primarily Chinese) and Pacific Islanders, from immigrating to Australia, starting in 1901.”

It wasn’t until 1973, when I turned 24 years of age, that “the Whitlam Labor government definitively renounced the White Australia policy. In its place it established a policy of multiculturalism in a nation that is now home to migrants from nearly 200 different countries.”

Fast forward to this month when I was exploring racism in America with Izaak, my 39 year old colleague and friend. I told him that I was gratified with my career and that in good American Dream style, I had worked hard, taken initiative to rise above discrimination and achieved a measure of success and accomplishments that have served others and myself well.

I proceeded to wonder out loud (and judgmentally) why don’t other minorities, and in particular African Americans, do the same thing – work hard and rise above discrimination like I and others have done. This is when my fellow explorer shot me down and explained the myth of meritocracy. This is a whole comprehensive subject beyond what I can do in this edition of Tips and Topics.

It got me thinking to introspect about my own generational history. We don’t all start with the same blank slate en route to the American Dream. Here’s what I realized was the substrate for any success I have had. It wasn’t just me, myself and I who pulled myself up by my bootstraps to achieve my accomplishments:

• I grew up in a loving intact family, free from any physical, emotional or sexual abuse with parents and an extended family that valued education.
• While my father never went to high school and my mother never graduated from high school, somehow my parents found the resources to send me to a highly regarded, private, all boys high school where academic excellence was prized and reinforced.
• I had an uncle who emigrated to the USA and became a professor of obstetrics and gynecology at Yale University; an older cousin, brother and sister who were all physicians.
• Australia back then had a system of University scholarships that because of reasonably good, but not brilliant academic grades gave me 6 years of medical school for free. No post graduation debt.
• While I never considered our family to be upper middle class, we always lived in owned and operated single family homes. As my father built a new home into which we moved, we progressively improved the size and location and built family equity.
• When I married, my father bought us our first house. Admittedly this is in Australia in 1972 and the house was just $10,500, small and old but cute. But how many young people get to start life in their own fully paid for home?

You get the picture. It is almost laughable if it wasn’t so insensitive, to have me think that it was purely my personal efforts and initiative that account for my achievements. Disadvantaged generational, systemic, structural and social determinants drag on any one’s personal efforts to succeed. In contrast, I started with a whole variety of generational advantages and a “Can-do” mindset – my bootstraps went way back to multiple life experiences and supports that set me up for success.

soul

February 23 is the third year anniversary of my wife’s passing. Last February, in SOUL I linked readers to previous editions if they wished to track my grief process. I also reflected on where I was at two years later in Work, Love and Play. Now three years later, I revisit Work, Love and Play to update my process of who I am and where I am at.

Work

• With no dependents to support and by law, required to withdraw a certain amount from my retirement fund, there is no financial pressure to continue to work and generate income.
• Some people Work to Live, others Live to Work. I don’t want or need to work to live, nor live to work. In other words I don’t need to work for income nor self esteem nor for something to do.
• My childhood friend and best man at my wedding retired from his dental practice a few years ago. When he left his practice, he gave up his license and said he was done with dentistry. I didn’t understand that at the time, thinking he might want to continue some consulting or teaching. But now I understand his decision and know how he felt.
• I am focused now on who we are as people and professionals behind the work we do – especially in behavioral health and healthcare in general where who we are is what counts and affects the people we serve more potently than what we do.

Love

• For years I have pondered how can we nurture relationships based on love, positive regard, honesty, transparency, compassion, empathy, mutual commitment and understanding.
• Too many relationships deteriorate and become based on resentment, anger, frustration, lying to ourselves and our partner, cheating, quiet desperation, apathy, and disdain.
• I ponder about new paradigms of relationships that don’t have to end in bitterness, divorce, family fractures, devastated children, financial ruin, and crashed careers?
• Being alone and not wanting to rush into any primary partnership or marriage, has afforded me time to look introspectively to illuminate who I am and what do I want?
• Labels before were easy: Husband, father, bread-winner and provider, psychiatrist, trainer and consultant, educator. Now I am the creator of my identity in work, love and play.

  Play

• I am doing more reading, something I have neglected in the busy-ness of work, business travel and supporting a family. While that doesn’t stop many from reading, somehow I got stuck on reading journals and professional books. Now I am embracing fiction and joined my local library for the first time in 25 years. (Embarrassed to say).
• I can’t wait for the world to open up so I can travel internationally to Australia, South America, Europe and the list goes on.
• As I said in last month’s SOUL, if anything or anyone doesn’t bring joy to my life and doesn’t think I am a joy in their life, it doesn’t deserve my time or energy. So I’m still having fun monitoring my ‘joy’ meter.