Using Acupuncture and Traditional Asian Medicine to treat Post Traumatic Slave Syndrome and Racial Battle Fatigue
Dr. Tenisha Dandridge LAc, DACM
Racism is alive and well in this United States of America. Many folks like to sweep the notion under the rug with sentiments like: “ it’s better than it was”, “it’s not that bad”, “slavery was a long time ago.” Words such as “microaggression” and other minimalistic remarks are often used to minimize the trauma of racism. To the African Americans living under the effects of the constant assault, the daily impact of racism has had tangible negative effects on psychological and physical wellbeing. The legacy of slavery and its aftermath is not just in people’s heads. For hundreds of years, People of Color (POC) in general and African Americans specifically, have been the victims of a constant daily trauma in the form of systemic white racism. (4,5,8) This has resulted in a multigenerational legacy of trauma known as Post Traumatic Slave Syndrome (PTSS). The continued daily trauma of living with these conditions in white spaces is called Racial Battle Fatigue(RBF).
What effect does this have on the humans and the bodies they inhabit under such an all-encompassing onslaught? Turns out quite a bit; the effects of which are accurately predicted and described in the theories of Acupuncture and Traditional Asian Medicine (ATAM). This same ancient modality also offers hope for helping to restore the body. Trauma is said to affect the heart and the kidney in ATAM. The anger, indignation, grief, and terror of living with systemic white racism would affect the Liver, Heart, and Kidney systems. These 3 organ systems accurately predict the effects of PTSS and RBF. This is not to undervalue the role of other systems but just to serve as a cut off point for this paper. To understand how we have to travel down the proverbial rabbit hole.
Racism, and the trauma it causes, is now being linked to the health disparity gap that is experienced in the African American population. For most of the 15 leading causes of death including heart disease, cancer, stroke, diabetes, kidney disease, hypertension, liver cirrhosis, and homicide, African Americans have higher death rates than whites (3,12). The health disparities also extend to the reproductive health and birth statics of African American women who have a higher rate of preterm labor, low birth weight, infant mortality, postpartum complications, endometriosis, and fibroids. (1) This is true even when adjusting for social-political factors and negligent care purposely doled out to POC. Perceived racism has even been linked to decreased kidney function and cardiovascular disease (4). There is a link between racism depression, anxiety, trauma, PTSD, and impudent rage that goes unrecognized and untreated (9).
Post Traumatic Slave Syndrome
Post Traumatic Slave Syndrome (PTSS) is a theory developed by Dr. Joy Degruy that explains the origins of many survival behaviors in African Americans. (9) These behaviors stem from the trauma of centuries of chattel slavery and the continued oppression of Africans and their descendants. It is categorized by multigenerational trauma, continued injury, and an absence of the chance to heal. Individuals suffering from PTSS have predictable behavior patterns including;
· “Vacant Esteem, along with feelings of hopelessness, depression, and a general self-destructive outlook.
· Marked Propensity for Anger and Violence Extreme feelings of suspicion perceived negative motivations of others. Violence against self, property, and others, including the members of one’s own group
· Racist Socialization and (internalized racism)
Learned Helplessness, literacy deprivation, distorted self-concept, antipathy or aversion towards one’s own identified cultural/ethnic group, heritage, and physical characteristic” (9)
In her book, Post Traumatic Slave Syndrome, Dr. Degruy also discusses the many ways African Americans continue to be injured by the racist practices and policies endemic in America. Dr. Degruy also lists healing methods and modalities that may be more effective for African Americans - including the theory of triadic influence and the need for a “village” based healing that includes community and familial ties.
Racial Battle Fatigue
Racial Battle Fatigue (RBF) is the theory developed by W. A. Smith originally to describe the experiences of African American men at predominantly white intuitions of learning. (20). RBF describes the chronic stress that results from longitudinal effects of constant exposure to racism and discrimination. Institutionalized racism creates organizations and systems that create an atmosphere that is overflowing with discriminatory practices and blocked opportunities. African Americans live undercurrents of tension and disrespect, the inability to change one’s environment, and knowing that as a black person you will have to work twice as hard to get half as much. (20, 26) RBF is the result of living and working under racial micro-aggressive and macro-aggressive conditions leading to emotional, psychological, and physiological distress. There is an inability to feel safe and be able to let one’s guard down. How can one let one’s guard down when you can be denied jobs, housing, scholarships, or bodily autonomy for wearing your natural hair (20, 30)?
Some racial encounters are experienced as a sudden, traumatic event that is out of one’s control and highly negatively and emotionally painful. This trauma can produce a symptom cluster that includes intrusion, arousal, and avoidance, as well as anxiety, anger, depression, low self-esteem, shame, and guilt. There is not currently a systematic method to recognize and assess race-based traumatic stress. That said, there are some instruments that measure the frequency and intensity of stress associated with racism and discrimination. (5, 6) Unfortunately, there is a woeful lack of mental health resources and care in the African American community. (25)
Multigenerational Trauma
What is a multigenerational legacy of trauma? It means that children inherit the trauma of their parents. African Americans in the United States have been inheriting traumas for several hundred years without an opportunity to recover. Slavery, reconstruction, Jim Crow, the civil rights era, school to prison pipeline, the Black Lives Matter movement, the surge in racist incidents as a direct correlation to Trump’s presidency have been just a few historical considerations in the ever-present face of systemic racism.
Just as parents can pass on genetic characteristics to their children, they may also pass “acquired” (or epigenetic) characteristics, especially if these were based on powerful life-threatening experiences, such as survival from starvation, torture, or persecution. The Oxford definition of epigenetics is the study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself. This means that environmental conditions can leave a “mark” on the genetic material in eggs and sperm, without changing the DNA, and pass along new traits even in a single generation. (8) These newly acquired markers are of course activated and exacerbated by stress. This process of transgenerational transmission of trauma (TTT) has been repeatedly described in the academic literature. (8). What does that mean for African Americans? Well for a start it begins to explain the racial health disparities gap.
Trauma and Mental Health in African American Communities
Unhealed trauma can cause chronic autonomic dysregulation. The sympathetic system gets stuck in hyper-arousal (fight-or-flight) or hypo-arousal (freeze) and is unable to return to “normal”. The problem for humans with complex traumas from ongoing omnipresent sources is Fight-or-flight becomes “normal.” This has major physical and emotional costs: it shuts down the prefrontal cortex, inflammation, exhaustion, depletion of reserves, insomnia, suppressed immune system, digestion issues, problems with attention span, heart rate, quality of relationships, harm to reproductive organs, and more (2, 5, 18).
The physiological impact is the same whether or not the threat is actually present because trauma’s neuropsychology makes a person’s body and mind react as though the original trauma were happening again at full intensity in the present, every time. When combined with constant new and frequent psychic trauma, this results in African Americans being particularly susceptible to dysregulation. This is further complicated by the societal pressures in the African American community to present one’s self as “fine” in the face of everyday trauma. (9) Since everyone is so busy “being fine”, no one is getting any help.
There is a mental health care crisis in the African American community that is finally being illuminated. A 2005 study of inner-city African Americans at a mental health clinic showed that when properly interviewed 43% of those interviewed had PTSD. Unfortunately, only about 11% had been previously diagnosed (19). This meant that the rest were not getting the appropriate treatment - even in a mental health clinic. There are individual, environmental, and institutional barriers to accessing mental health care in the African American community(24). Recent research has shown that acupressure and acupuncture are useful in treating stress, compassion fatigue, and anxiety, yet it remains an underutilized resource in African American communities(15, 21, 27, 28).
How Acupuncture and Traditional Asian Medicine Fit In.
Acupuncture and Oriental medicine (ATAM) is a system of medicine that actually acknowledges emotions as a source of disease. Anger, grief, fear, worry, and joy can be both the result and the outcome of an imbalance in the body. Long before epigenetics became a buzz word, ATAM understood that children can inherit their parents’ emotional and physiological baggage through the Kidney Jing. Within this system, all emotions affect the Heart, which houses the mind or Shen (spirit) (11). Therefore, all trauma causes a Heart Shen disturbance. The Heart and Kidney are related via a pathway called the Chong. The Chong is related to the Vagus nerve in Western medicine. (14, 16, 22)
ATAM principles are applicable to the treatment of psychiatric disorders. (16) This system is dependent on the restoration of balance. The Su Wen of the Huang di Nei Jing (Fundamental Questions of the Yellow Emperor's Inner Classic) says that the nature of any entity, living or not, is determined by the intrinsic balance between opposing states, Yin and Yang. Disturbances in balance result in changes in nature often expressed in living systems in the form of symptoms or signs of disease. In the case of trauma, there is an imbalance in the five spirits. These are: the Hun (the non-corporeal spirit), the Po (the corporeal spirit), the Zhi (the will), the Yi (the intellect), and the Shen (the mind and the connecting spirit.) (16)
The Five Spirits
· Hun-The Hun is associated with the Liver Qi. Hun is called non-corporeal because it is not dependent upon physical being for existence and continues after death. This spirit is responsible for benevolence (loving-kindness), awareness of suffering, empathy, compassion, and tolerance; and serves as a reservoir for ideas that bring meaning into life. Disharmonies that affect the Hun may lead to anger, frustration, resentment, unkindness, and feeling “cut-off” from the meaning of life. (14)
· Po-The Po exists only during physical life. Associated with the Lung Qi, the Po animates the being, is responsible for sensation, and for emotional and physical responses to circumstances; it promotes justice and fairness. Disharmonies of the Po may lead to complicated grief, sadness, a blunted affect, a tendency to overreact, or unjust/immoral behavior. (14)
· Zhi-The Zhi is the will (i.e., the force that determines the basic trajectory in life). Zhi is the spiritual aspect that resides in the Kidneys. The Yang (or active) Zhi provides the motivation for self-determination and the Yin (or passive) Zhi leads one down the path to an unknowable fate. Disharmony may cause illogical fears (anxiety) or, the opposite, reckless behaviors. (14)
· Yi-The Yi might be called the intellect. It is the platform for conscious reasoning. The Yi enables creative vision and proper courses of action. The Yi is associated with the Spleen, and disharmonies may lead to worry and overthinking (perseveration). (14)
· Shen-By allowing the inner being to connect with the outer world, and the outer world to connect with the inner being, the Shen might be considered the “connector spirit.” In that sense, it is responsible for both inward and outward expressions of spiritual nature and for the establishment of meaningful relationships. It is also the mind, where thoughts and feelings are experienced. Associated with the Heart Qi, disharmonies of the Shen may lead to edginess, shyness, social awkwardness, or, in extreme cases, agitation and delusions. (14)
The heart in ATAM has the primary function of controlling the blood and blood vessels as well as housing the mind. It is related to the element of fire and the emotion of joy. Joy, in this sense, can mean happiness, play, and contentedness with life. Joy can also refer to a balance of emotional and mental equilibrium that allows for the smooth flow of qi. This is why all trauma affects the Heart -because it will disrupt this equilibrium. The Heart also has a direct relationship with the Kidneys that can affect menstruation. Without the downward movement of the heart qi and blood, there cannot be menstruation. (16)
The Heart and Kidney organs form the root of the cosmological sequence. The Heart houses the mind and is related to fire. The kidney stores the Jing (genetic material) and is related to fire. Heart fire moves down to warm the Kidneys; the water of the Kidneys rises to nourish the Heart yin. This up and down movement is a fundamental factor that the body depends on to keep yin and yang in balance. Because there is always damage to the Heart with any kind of trauma, the Kidneys are vulnerable to damage through its connection with the Heart.
The Kidneys in ATAM are considered the root of life. They are related to the element of water and the emotion of fear. The Kidney stores the pre-heaven essence (or genetic material) received from the parents and is the foundation for the yin and yang in the body. The Kidney is also responsible for controlling birth, growth, reproduction, determines aging, and produces marrow and fills up the brain. The Kidneys control what western medicine considers genetics, many reproductive hormonal changes, and women’s health in addition to water regulation. (16)
The only emotion not yet covered from an ATAM perspective is anger. The Liver is considered the General in charge of the overall planning and execution of the body’s functions. It is related to the element of wood and the emotion of anger. In the cosmological axis, it is paired with the Lung to form the outer wheel. The Liver also houses blood and controls the sinews. The Liver is an organ that is particularly susceptible to everyday frustrations. (16)
The Liver and Gall Bladder are organ pairs and it worth noting that many perceived Liver disharmonies found in individuals suffering from living with systemic white racism have an underlying Gall Bladder issue. The Gall Bladder’s functions include decision making and courage. (16) Living under a daily attack means that African Americans are constantly faced with an overwhelming number of decisions, many of them potentially life-altering or life-threatening. Since society is generally not in support of African Americans, even when they have done nothing wrong, living courageously, openly, and honestly is not always a safe option. African Americans constantly find themselves in a situation where they must decide in a split second how they will respond to a racist situation and survive without experiencing a loss…loss of income, loss of freedom, or loss of our very lives.
People of Color living under the influence of the extreme emotional burden of Post Traumatic Slavery Syndrome and Racial Battle Fatigue have a variety of health challenges stemming from the emotional and mental trauma of living in a society that denies one’s basic right to even complain about the blatant inequality. Extreme morbidity, complications of reproductive health and pregnancy, heart disease, kidney disease, chronic autonomic dysregulation, and mental health issues with anxiety depression, and even anger management are the direct result of the internalization of trauma and stress. Liver qi stagnation is simply plain old stress and is the most common diagnosis. In light of this research, it is important to note the role of the Heart, Kidney, Liver, and even Gall Bladder play in a person suffering from PTSS and RBF. Allopathic medical therapy is limited in its approach and capacity to treat these extreme disturbances.
Some of these limits stem from the inherent racist practices within the western medical establishment that are taught and inflicted upon People of Color - including the idea that Black people feel less pain or have thicker skin. (25) There is also an established mistrust due to a long history of medical apartheid that has been present in this country for hundreds of years, substandard care, and/or unwitting and detrimental experimentation. As a result, many in the African-American community are inherently afraid of receiving care. (17) Western medicine does not have an effective treatment to help reduce the allostatic load of individuals who have been living in these extreme conditions. There is also the further complication that racism is generally not perceived as a cause for disease or stress. The most common mental health therapy is prescription drugs and talk therapy. Too often the talk therapy is provided by White individuals who knowingly or unknowingly may retrigger the trauma during treatment.
ATAM however, has been treating emotional disturbances and its subsequent pathologies for thousands of years. The way such extreme emotional burdens can affect everything from fertility to headaches is well documented. There are established proven treatments like the Auricular Trauma Protocol, the NADA protocol, and ghost points that may help the body cope with an overburdened allostatic load. (11) These treatments are proven to help individuals deal with and process stress so that the body can return to “normal.” A brief description of three protocols and the effects of their points follow.
The NADA protocol: (23)
1. Autonomic Point which calms the nervous system, fight or flight, and helps with overall relaxation;
2. Shen Men This point is bi-directional, either calming or enlivening heart fire, depending on what the body needs. It is often used for pain, anxiety, depression, insomnia, and stress;
3. Kidney Point, for calming fears, anxiety and healing internal organs;
4. Lung Point, which promotes inspiration and helps clients let go of grief;
5. Liver Point for detoxification, blood purification, and to quell aggression
The Auricular Trauma Protocol(11)
1. Hypothalamus – stimulates the parasympathetic functions, calms, centers, focuses, helps with decision making and anxiety control;
2. Amygdala – helps modulate irritability, anger, fear, and aggression;
3. Hippocampus – has a lot to do with memory storage and emotional experiences, memory, and concentration;
4. Master Cerebral – a master point for psycho-emotional and psychosomatic problems, emotions that come along with chronic pain, and even the pain itself;
5. Point Zero – very strong auricular point for the mind, the emotions, and for homeostatic balance for the body;
6. Shen men – This point is bi-directional, either calming or enlivening heart fire, depending on what the body needs. It’s often used for pain, anxiety, depression, insomnia, and stress.
During part of the early history of ATAM in the United States, social activist groups such as the Black Panthers and Young Lords, and individuals such as Dr. Mutulu Shakur, were using the NADA protocols to help individuals deal with stress and drug addiction in communities of color. (7) Because of a systematic and deliberate discrediting of these groups and individuals, these social organizations are no longer active participants in spreading the benefits of acupuncture among People of Color. Fortunately, community acupuncture clinics have recently become an available model in the spirit of once was a low-cost option offered by those social activist groups.
Ghost Points (30)
The use of ghost points in treating psycho-spiritual emotional disorders can be very effective in treating the conscious and subconscious to transform the effects of trauma:
ST 6 – Ghost Point
This point is perfect for Post-Traumatic Stress Disorder. Patients with PTSD have a tendency to clench their jaw, so ST 6 acts as a jaw relaxer as well.
BL 62 – Ghost Point
Clinically, Bl 62 can be used for long-standing childhood trauma related to sexual abuse, leading to anxiety and/or depression as an adult.
LI 11 – Ghost Point
LI 11 clears heat and balances the digestive system. This is used for patients who like to be in control, but get diarrhea or suffer from IBS when they feel out of control.
SP 1 – Ghost Point
Bleeding SP 1 is generally used for patients who have poor body image and eat their feelings (as in Bulimia).
PC 7 – Ghost Point
This acupuncture point is the protector of the heart. This makes it the perfect point to needle for those who are emotionally upset (broken-hearted) after a relationship ends.
PC 8 – Ghost Point
This is a good point for patients who have lost their sense of self, are manic with hallucinations, anxious or experience paranoia (e.g. schizophrenia).
Lu 11 – Ghost Point
This acupuncture point is perfect when a vow, contract, or an important agreement is broken and results in anger. Appropriate during or after a bitter divorce, or a business partnership which goes sour.
Ren 1 – Ghost Point
For patients who are ashamed of their body and their sexuality, especially for women after childbirth. Works well for women who suffer from urinary incontinence, low libido, or cannot reach orgasm.
Ren 24 – Ghost Point
This is a great acupuncture point for people who are always worried and are consumed by their dark thoughts for years. They don’t ever smile or laugh.
Du 16 – Ghost Point
Because of its location, Du 16 is often overlooked because it is deemed a dangerous point. But it is a good one for patients who resist change and are inflexible.
Du 23 – Ghost Point
For unresponsive people who have years of phlegm misting the mind, and become catatonic, late-stage Alzheimer’s patients.
Du 26 – Ghost Point
Often used for intergenerational trauma; leads to spontaneous laughing for no reason.
Yin Tang – Ghost Point
This 13th Ghost point is controversial. In some texts, the extra point, Gui Feng (under the tongue), is deemed a Ghost point. However, because of its location, Yin Tang has been used instead. Both are used for enlightening the mind, seeking knowledge and wisdom.
Conclusion
ATAM has the capacity to individualize treatments so that each aspect of dysfunction can be brought into balance. Auricular protocols can be used to help POC just deal with the everyday stress of PTSS and RBF. The beauty of ATAM is that it has the added capacity to specifically target the resulting health concerns for that individual. This includes leading causes of death such as heart disease, cancer, stroke, diabetes, kidney disease, hypertension, liver cirrhosis, and homicide (as it relates to out of control rage). ATAM can help treat reproductive health like preterm labor, low birth weight, infant mortality, postpartum complications, endometriosis, and fibroids. ATAM can even address issues with chronic autonomic dysregulation that presents as inflammation, exhaustion, depletion of reserves, insomnia, suppressed immune system, digestion issues, problems with attention span, and heart rate.
With the upcoming changes in the insurance coverage of Acupuncture and Traditional Asian Medicine in this country, it is this author’s sincere hope that more People of Color suffering through systemic white racism will be able to get more treatment. Hopefully, ATAM will eventually be used in schools to help children who have inherited this unjust emotional and physical burden that has been passed down for hundreds of years. In the coming years, there will hopefully be more beautiful brown faces with ear seeds and asp needles to help manage the everyday stress of living in this country and being Black.
Biography.
Dr. Tenisha Dandridge LAc. Graduated from Bastyr University in 2008 with a BSACM and MSACM and received her DACM from PCHS in 2018. She has been practicing acupuncture since 2009 and is the co-founder and President of the Black Acupuncture Association. Currently, she has a private practice Everyone’s Place as a mobile acupuncturist in Sacramento, CA.
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