Can therapy ease the trauma of U.S. racist attacks and systemic racism?

Chinese-American mental health counselor Monica Band started getting a flood of calls and emails soon after former U.S. President Donald Trump began blaming China for the deadly COVID-19 pandemic.

News followed of the killings of six Asian-born spa workers in Atlanta and brutal attacks on people of Asian descent nationwide. Band's mostly Asian-American clients in the Washington, D.C., area have been spat on, called racist names and in one case physically assaulted on a commuter rail line by an assailant yelling, "Go back to China!"

To help, Band is drawing on a still-developing treatment field pioneered by African-American clinicians who have been working for years to help ease the debilitating pain of racist attacks and systemic racism that can be passed down generations.

Black Americans are suffering amid heightened visibility of racism since the police murder of George Floyd in Minneapolis last year and numerous other high-profile killings.

Talk therapy and other treatments have been developed for survivors of such catastrophes as war and customized to meet the needs of people from different cultures and backgrounds.

To help people cope with stress, the Association of Black Psychologists organized online group therapy "healing circles" during the trial of the former policeman who killed Floyd, New York area psychologist Jennifer Jones-Damis said. That trial ended with guilty verdicts earlier this month.

Therapists say individuals traumatized by racism can experience flashbacks, crying spells and unrelenting worry. Repeated exposure to graphic images and rising attacks make some fear leaving home and feel vulnerable.

RISING HATE

The Center for the Study of Hate and Extremism tracked a rise in hate crimes against Asian Americans of 149% in 2020 in 16 major cities compared to 2019 in the wake of rhetoric blaming China for the pandemic that started in that country.

The number of people seeking help also rose - and counselors to treat them are in short supply, according to therapists interviewed by Reuters. Band in February started a support group for people who suffered anti-Asian hate incidents or were upset by attacks on others. She also works one-on-one with clients but has a months-long waiting list.

Of about 3,700 Americans of Asian-American and Pacific Islander descent surveyed by DePaul University psychologist Anne Saw, 75% said they believe the United States has become more dangerous for them, preliminary data shared exclusively with Reuters showed.

Of 421 people who agreed to be interviewed about racist incidents they had experienced and reported to the group Stop AAPI Hate, 95% said the United States had become more dangerous, said Saw, who conducted a portion of her research in collaboration with the group.

About 40% of the 421 Stop AAPI Hate respondents said they had experienced at least one symptom of racism-based traumatic stress, including depression, hypervigilance, anger, intrusive thoughts and lowered self-esteem.

"We're seeing numbers of folks experience anxiety depression, racial trauma symptoms that are like nothing we've ever seen before," Saw said.

But trauma caused by racist attacks or racism does not have a formal mental health diagnosis.

"If a phenomenon is not named, it is generally not recognized, and when it's not recognized, it's not treated," said New York therapist and author Kenneth Hardy, a pioneer in the field of racism trauma.

Over the past year, more than 400 clinicians have sought training in one of the few formal protocols for treating racial stress and trauma. Psychologist Steven Kniffley's 12-week program at Spalding University in Louisville, Kentucky first helps clients to learn, for example, whether they have internalized racist views of themselves. Next, words or other means are used to retell and process experiences. Finally, tools for dealing with future incidents, such as seeking support from observers, are discussed.

Connecticut therapist Danielle Spearman-Camblard said she would like a diagnosis of racial trauma added to psychiatry's Diagnostic and Statistical Manual. A designation would make it easier to bill insurance companies for treatment, and show that the psychological effects of racism are real, she said.

Robert Carter, a Columbia University psychologist who led efforts to educate mental health professionals about the impacts of racism, said racism-caused injuries should be treated. But he said people who have been impacted by racism are not mentally ill, and should not be subjected to the stigma that can accompany a diagnosis.

Carter opposes the use of treatments developed for post-traumatic stress disorder for patients who, for example, develop anxiety and hopelessness after being denied an apartment or a job because of race. He believes the stress caused by racism is different psychologically from trauma.

Dr. Paul Appelbaum, who chairs the American Psychiatric Association's DSM steering committee, said an upcoming new edition of the manual will not list racial trauma as a condition, but will explicitly reference racism as a possible underlying cause of several diagnoses including depression.

Tracy Park, 37, didn't seek therapy, citing a dearth of Asian-American counselors, after she and her family were targeted by racists.

In February 2020, as COVID-19 began to spread in the United States, the animator took her toddler and newborn baby to a Los Angeles park.

As she pushed her stroller toward the exit on her way to the library, a white man shouted at her: "Get your coronavirus babies the f--k out of here!"

Her 65-year-old mother was threatened by another white man later.

Park, anxious and at times depressed, developed trouble sleeping and was constantly on guard.

She found solace among a group of mothers who had also experienced anti-Asian hate and held online "unpacking sessions." And she wrote a "zine" expressing her anger and other feelings.

But "I'm still scanning the horizon looking for anyone charging toward us," Park said. "And that's no way to live."