“I think there’s a difference between dwelling and ruminating on the past and intentionally thinking about or reflecting on your past in order to do two things: one, place context to your situation, and two, reclaim your narrative.” – Ryan Sutton

According to the World Health Organization, social determinants of health “are the conditions in which people are born, grow, live, work and age,” and “are mostly responsible for health inequities – the unfair and avoidable differences in health status.”

By this definition, history is a key social determinant of health. A recent article in the Journal of Racial and Ethnic Health Disparities makes this connection explicit. Titled, “The Past Does Matter: a Nursing Perspective on Post Traumatic Slave Syndrome (PTSS)”, it argues that slavery was a major stress event for black people in the United States, with trans-generational effects that persist to the present.

One of the article co-authors is Dr. Ryan Sutton, director of the African American Male Research Initiative at The University of Texas at Austin. In recognition of Minority Mental Health Awareness Month, we take a dive into the deep relationship between the terrible stress events of the past and the wounds of the present.

A Look at the Evidence

According to Sutton, the concept of PTSS was first developed by Dr. Joy Degruy, who argued for its validity in her 2005 book, Post Traumatic Slave Syndrome – America’s Legacy of Enduring Injury and Healing. PTSS is a shorthand for the complex matrix of “cognitions, thoughts, emotions that exist within the African American community, or even black communities throughout the Diaspora, that are rooted in slavery or the oppressive history that black communities have experienced over time,” said Sutton.

PTSS has one key feature that would be familiar to any therapist who specializes in trauma: defensive coping strategies that become maladaptive. Sutton illustrates the point with a story:

“When I think about something like that, I think about a story that people typically often tell or that you might [have heard] before of a woman basting her turkey over Thanksgiving, and her daughter looks at her and says, ‘Why you break off the legs of the turkey?’ and she says, ‘I don’t know. My mom always did it.’”

“Then [the woman] calls up her mom and says, ‘Mom, why do we break off the legs of the turkey when we go to baste they turkey?’ and her mom says, ‘Because I couldn’t afford a bigger pot.’”

Sutton uses the story to drive home his point about how the survival strategies of the past can obscure new possibilities in the present. In short: it may no longer be necessary to break those turkey legs.

“The times have changed to where the daughter can afford a bigger pot, but we still practice sometimes those things that were adaptive at other points of time,” said Sutton. “So it’s important to take a look at that and how it’s really impacting us.”

Healing through Reflection

For African Americans, history in general, but slavery especially, poses a dilemma: the need to respect the past without being smothered by it. How do we honor what our predecessors went through without short-selling our own desire to get out from under it? Sutton brings his counseling perspective to bear on the problem.

“I think there’s a difference between dwelling and ruminating on the past and intentionally thinking about or reflecting on your past in order to do two things: one, place context to your situation, and two, reclaim your narrative,” said Sutton. “There’s times (sic) where as a society in this country we have chosen to ignore issues of race and just ‘move on.’ It doesn’t solve anything.”

Getting beyond past hurts is always the goal, but it’s futile to try to impose a timetable for that happening. “Processing is important, and there’s no timeline on how long the processing process should take,” said Sutton.

For Sutton, historical literacy is just another dimension of cultural competence, which always involves a level of mutual vulnerability.

“It’s really related to emotional IQ,” said Sutton. “Do I understand what’s going on with me? Do I understand my own feelings, thoughts and perceptions? And then be able to understand that of somebody else in order to make our dynamic that much more healing, that much more transformative, that much more relational.”