Amongst the Masses But All Alone
Raphael Travis Jr. and Alhaji Jalloh
The connection between mind, body and environment is captured well in the most recent studio album by Pharoahe Monch titled PTSD: Post-traumatic Stress Disorder. Through his legendary wordplay he reflects on the depths of his own depressive episodes, along with the stressful realities of a military veteran and being Black in the United States. Ultimately he helps us recognize that we cannot stand on the sidelines. Note: an abbreviated version of this entry can be found at healthyblackmen.org
May is Mental Health month in the US, and May 4th was National Mental Health and Dignity Day. This year’s theme, “Mind Your Health” reminds us to focus our energy on keeping a healthy mind as much as a healthy body.
Pharoahe Monch’s album PTSD a refreshing addition in the world of Hip Hop. It offers hope amidst emotional suffering, freedom despite oppression, connection after alienation, and some level of transparency around mental health in African American communities. To Monch, PTSD is as much a challenge as it is an opportunity. He follows a rich legacy of emcees that put pen to paper on mental health, coping, resilience and growth, like Guru of Gang Starr on “Moment of Truth”:
The situation that I’m facing, is mad amazing
To think such problems can arise from minor confrontations
Now I’m contemplating in my bedroom pacing
Dark clouds over my head, my heart’s racing
Suicide? Nah, I’m not a foolish guy
Don’t even feel like drinking, or even getting high
Because all that’s going to do really, is accelerate
The anxieties that I wish I could alleviate
But wait, I’ve been through a whole lot of other sh*t, before
So I ought to be able, to withstand some more.
We can learn from the success stories. We can learn from people like Monch who on his title track “Post Traumatic Stress Disorder” is brave enough to share his experiences. We can learn from those that found supportive spaces, and those that have seen brighter days.
Video: P.T.S.D. Live
Authentically True and Real
A challenge we face as society, is to recognize how serious the situation is for those struggling with stress and trauma without perpetuating stigma and bias (“pathologizing”). For example, the term “Hood Disease” was recently circulated in the media (and thankfully quickly put to rest) as another misguided buzzword to capture the world’s imagination about what happens to youth living in our nation’s low income communities. The issue is real, but framed all wrong.
Another recent story came from Kansas City, MO, shedding light on the continued misunderstanding of and isolation felt by veterans suffering from PTSD. An altercation occurred in which a veteran was ultimately killed by law enforcement officials. This particular veteran was on a long waiting list for a mental health appointment with the VA. This type of falling through the cracks in an environment of misunderstanding and complex needs is the reality for too many of our veterans.
Let’s not pretend that the physical, social, and economic environments of our poorest communities which put its residents at excess and ongoing risk for negative health outcomes is a disease. Let’s also not pretend that the social, political and economic environments that our young veterans return to is set up for a successful transition into civilian. Their challenges are not their problems. Their challenges are our challenges.
Instead, let us recognize the mental health hurdles many of our youth and young adults face every day with the focus and dignity that May 4th is meant to represent. The issues are real. Our youth and young adults deserve our respect and undivided attention. Even more so, it is not enough to just know and understand, we must act.
A clock without a minute hand. An hourglass without sand. Suspended within space and time. I walk a thin line. Amongst the masses all alone. A furnished house with no one home. I see through walls that’s hard to climb. I’m losing my mind. – Monch “Losing My Mind”
Past, Present and Future Trauma
Among youth 10-24, suicide is the third leading cause of death, with about 4600 deaths (CDC, 2014). However, 157,000 youth are seen yearly in emergency rooms from self-inflicted injuries. Every 65 minutes a military veteran commits suicide (i.e., 22 per day)(Department of Veterans Affairs, 2012).
Suicide is only one of the many sequelae of undesirable responses to stress and trauma. Stress can be helpful or harmful, harmful if there is not enough support to help. Trauma shatters your sense of security. PTSD is “an intense physical and emotional response to thoughts and reminders of the event that last long after the traumatic event” (CDC, 2014). The three broad and often overlapping symptoms of PTSD are: intrusive re-living (flashbacks and intense emotions), numbing and avoidance (of any reminder of trauma), and hyperarousal (on edge, easily provoked). It often co-occurs with depression, from distress and inability to cope.
Now flashbacks wake me abruptly when police pass by Lights flash, if i could only put the past on a flash drive I’d For peace of mind, install an external drive So I’d be more driven internally to survive. – Monch “Losing My Mind”
PTSD should be considered alongside Continuous Traumatic Stress (CTS) as a phenomena in many of our communities where the persistent, unpredictable and faceless nature of stress is coupled with an absence of sufficient support. Thoughts and behaviors center not on the past, but on how to stay safe now and in the future.
You gotta speak orangutan slang or pull capers The cops are the cheetahs and the trees are the skyscrapers… When you come through, you could get bumped too If you don’t got at least 4 to 5 gorillas amongst you. – Monch “Jungle”
The accumulation of neighborhood stressors, or traumatic events is also especially troublesome. This is associated with earlier trauma experiences, greater problems in functioning, a longer duration of problems, and a greater likelihood of co-occurring with depression and anxiety. These individuals are much more likely to have elevated hyperarousal, to experience partner violence, and physical assault. Cumulative stress and trauma also causes a literal “piling up” of stress and wear and tear on the body(“allostatic load”), which often leads to negative long-term health outcomes. In neighborhoods with the highest levels of cumulative risk, have adolescents with the highest levels of allostatic load.
#YesAllWomen, Girls and Trauma
There are many ways that women and girls experience stress and trauma differently than men and boys. The #YesAllWomen campaign spotlights one unique gendered aspect of stress and trauma. The phrase “the female fear” was coined by researchers Gordon and Riger (1989) to describe the consistent fear of victimization faced by many women, from street harassment on one end to rape at the other extreme. Reports range from 1 in 3 to 1 in 6 women will experience sexual assault in their lifetime. When zeroing in on African American women, we see high rates of trauma, increasing the chances of PTSD and co-occurring depression. These and other findings deserve our attention, especially for those of lower income, which poses a host of unique challenges.
- First, women are more likely to have been victims of physical or sexual abuse/forced sexual contact as a child or adult.
- Second, if alcohol or drugs are the coping strategy of choice then it may put them in situations that increase their risk for victimization; they can lose the capacity to give consent for sexual activity and may more easily socialize with a greater number of unfamiliar or predatory males (although, most often the victimized know their attacker). This does not make them “wrong” or deserving of victimization, it simply increases the risk.
- Third, and too often related, within Hip Hop culture, is the consistent tension around the perpetuation of high risk misogynistic messages, especially among mainstream media outlets. As an example, Rick Ross was in the headlines over lyrics from the song U.O.E.N.O. (“you don’t even know [it]”) that can be interpreted as putting the drug “Molly” in a woman’s drink without her permission and then having sex with her without her consent, “Put Molly all in her champagne, she ain’t even know it. I took her home and I enjoyed that, she ain’t even know it.” This should not be misconstrued that this is only in Hip Hop culture.
These concerns are consistent with concerns about exploitive representations of women in any popularized capacity. Ultimately, it is the threat of victimization that is too familiar for those at risk, but minimized within popular discourse. The current #YesAllWomen Twitter campaign similarly has evolved as a collective act of solidarity against harassment and victimization of women and girls, and a culture that appears to be complicit in its normalization. The debate persists about who is most at fault, a few individuals at the extreme or society and our entire culture. Yet, what is not up for debate is that at their worst, the confluence of the above stressors and traumas create a web of harassment, victimization of many forms (e.g., rape, abuse, and sex-trafficking/prostitution), and addiction within which too many women and girls are caught.
Within Blog Spotlight: Misunderstood but Overstanding
People handle stress and trauma differently. Some seek outside help. It may be a mental health professional such as a psychiatrist who may prescribe medicine, or a therapist who may offer talk therapy. In the African American community outside help is often accepted from a minister or the church community. Many do not seek outside help. For many families feelings of shame, guilt, and mistrust/fear are associated with mental health treatment.
My family customs were not accustomed to dealing with mental health It was more or less an issue for white families with wealth. – Monch “Losing My Mind”
For some service members, it is considered a sign of weakness to seek mental health treatment. For others, they seek help that is unavailable, inefficient, or too slow. Too often, the suffering stays hidden.
That’s Why We Get High, Because You Never Know When We’re Gonna Go
Feeling alone, misunderstood, scared, angry or that you are going to snap at the slightest provocation lead many to substance use. These people use alcohol and other drugs to feel better. This type of self-medication helps people cope by, at least temporarily, lessening negative emotions, increasing positive emotions, and easing their ability to interact socially.
They told me to see the glass half full because some see it as half empty, I chose to see the glass twice the size it needed to be Smashed it against the wall in the kitchen, on the floor going through withdrawals I was itching She rescued me, my heroine to the end, but then she morphed into heroin in a syringe Around my bicep, I would tie a shoestring Tap! Five times to find a vein in there Squeeze 7 cc’s so I could see the seven seas And CC all my friends so they could see what I was seeing. – Monch “Broken Again”
At their best, in the short-term, substances help people regulate emotions, relax and take the edge off. Unfortunately, this also drastically increases the chances of new and different negative outcomes, such as addiction, strained relationships, neglect of responsibilities, injury, illness and major performance declines at school or work.
Music and Well Being
People have learned to use music, as a form of self-health “to get better.” This is no different for Hip Hop. This may occur as a casual/everyday listener, or as a creator of beats/lyrics/music. This can be especially valuable for people that are less willing to seek out third party help – unwilling to go to or continue with a counselor, and ambivalent about or unable to reach out to a parent, guardian or mentor. It can be a powerful alternative to more risky coping strategies as well.
I rediscovered my soul between the lines inside my journal Trapped within a Penn State of mind, Joe Paterno External gratification is not happiness eternal Interject, intellect, intercept, Internet. – Monch “Eht Dnarg Niosulli”
People, programs and organizations have picked up on this and have been working to provide outlets and opportunities for youth to express themselves and engage music in a meaningful way… such as Words, Beats and Life, Inc., Today’s Future Sound, and H.Y.P.E.
Hip Hop Speaks on Connection, Community, Citizenship
Hip Hop artists have also helped bring the conversation on stress and coping full circleoutside of the studio. Like Monch did in the studio on the track “TIME2”, other artists have shared their own experiences with stress and trauma, even on camera. Kid Cudi has been honest about feeling alone, lacking confidence and suicidality and what it is taking to maintain his own positive mental health. He aims for his music to help youth going through similar struggles. Kanye West has spoken on his own past suicidal ideation. DMX has been open about the trauma of childhood emotional neglect and an absence of maternal connection. LL Cool J has publicly explored his early life trauma and physical abuse. Frankly much of Hip Hop is filled with narratives of stress and trauma, but Monch couples this with the discussion of pathways to resilience [“PTSD”], growth [“D.R.E.A.M.”], and a greater sense of community and civic engagement [“STAND YOUR GROUND”].
The legendary MC Lyte, reflecting on her Foundation’s role in helping young girls and women, recognizes that active engagement is essential, “To protect our girls, women have to step in… It’s extremely important for me to be able to give back in that way because I am a woman and I was a young girl, and I know what it means to have positive images and I know what it means not to.”
Taking a stand for better community conditions, and challenging the stressful and traumatic stranglehold of community violence was the goal of Chicago emcee Chance the Rapper in his successful alignment with the #SaveChicago Twitter campaign over Memorial Day weekend. He joined forces with his father (connection), about Chicago a city he values and takes pride in (community), and was active in working toward better conditions (engaged citizenship). Chicago was homicide free for 42 hours.
What Can I Do? Remember… Listen, Think, Act!
Do not despair, breathe, fight For there is more life to live, believe More insight to share, retrieve Was the dead at the illustrious Exhale, hold, inhale, receive and live… Live… Live… Live… – Pharoahe Monch “P.T.S.D.”
The album PTSD, albeit one small step, provides opportunities for self-reflection and a broad societal discussion on stress and trauma. We as a society have the capacity to work in tandem with service veterans and other trauma survivors. By working together we promote belonging and inclusiveness, not alienation and stigmatization.
Be a Safe Space
Stop the Shame. Erase the Stigma. Be a Place of Trust, Safety and Dialogue. Do not pretend to know all the answers for how to help, but be honest when you see a need for professional help. Note the strategies that take into account the best of Hip Hop Culture like FlowStory’s interactive curricula and toolkits [sample Fatherhood Toolkit], and Beats Rhymes and Life’s Hip Hop Therapy. Think outside the box and create new pathways of expression and community like The Wilmington Trap Stars Exhibition spearheaded by Dr. Yasser Payne.
These opportunities for dialogue and expressive activities can help sort out truth and fiction, shed light on the nature of trauma (past or present), and develop safer and healthier ways to deal with the stress. Be a positive mentor and role model for youth. Provide youth-friendly spaces that offer breaks from the drama and the chance to be young and authentic. Create opportunities for growth and for community engagement for youth. You can be source for #SafeSpaces.
This blog’s guest contributor is Alhaji M. Jalloh, currently a graduate level Social Work student at Texas State University in San Marcos, Texas. Mr. Jalloh is also currently an Active Duty Air Force personnel with tours to Royal Air Force Lakenheath, United Kingdom, Bagram Air base, Afghanistan, Tinker AFB Oklahoma, Lackland Air Force Base, and Brooke Army Medical Center in Texas. He served in a variety of positions including Aerospace Ground Equipment technician, and most recently the position of Non-Commissioned Officer In-Charge of the Air Forces largest mental health clinic, providing services to 36,000 beneficiaries annually.