July is Bibi Moore Campbell National Minority Mental Health Awareness Month.
Chajuana Mayes, 36, has reached her limit.
She had moved to a new state with her daughters and new husband, and was struggling to balance the expectations of being a mother and wife while juggling two jobs and running a household. She also struggled with guilt. She had taken her daughters away from their father and was worried about how they were coping.
Mayes said she began overeating and drinking to manage stress, which led to excessive weight gain, other physical health problems, and fatigue.
“Every day I wake up, look in the mirror, cry, and say to myself, “This can’t be my life. “This alone is not enough,” she said. “I was creating too much unnecessary pain because I believed that when I became a wife and mother, I had to be everything to everyone.”
Mayes’ story is common for many women reaching or approaching middle age, but there was an additional layer to her physical and emotional exhaustion. Through the examples of the women in her family and cultural representations of black women in the media, there was an implicit understanding that her efforts were expected of strong black women in America.
Cheryl L. Woods Giscombé, Ph.D., RN, a professor at the University of North Carolina at Chapel Hill, developed a framework for the frequently used Strong Black Woman (SBW) schema. The black women she studied characterized the “superwoman” role by five key ideas: the obligation to express strength, the obligation to help others, the obligation to suppress emotions, the pressure to show resistance to being vulnerable or dependent, and the need to demonstrate determination to succeed despite limited resources.
Duality of the Strong Black Woman Schema
SBW schemas often contain paradoxes. In some cases, it can encourage positive self-worth and self-esteem. A study published in the Annals of the New York Academy of Sciences found that this schema provides protection against the negative health effects of chronic racism, even when black women feel they need to demonstrate strength and resilience under adverse conditions. However, more harmful aspects of the SBW schema can undermine the physical and mental health and well-being of Black women.
Tysha Caldwell-Harvey, Ph.D., As a licensed psychologist and founder of the therapy practice The Black Girl Doctor, he regularly works with women managing the duality of the SBW schema.
“In reality, it seems like a woman who serves as the emotional, financial and spiritual backbone of everyone around her, but there is no socially acceptable space for her to feel vulnerable, tired, sick or in need of help,” Caldwell-Harvey said. “At the same time, it’s important to say: For many of us, this is not just a pattern of behavior, it is an identity. In my work with black women, I call it cultural pride and a survival strategy. Also, take an honest look at how much it costs.”
In her conversations with patients, Caldwell-Harvey discovered three signs of the negative aspects of the SBW schema, which she said all affect the physical and mental health of black women.
Too much independence and overwork “put Black women in situations where they shoulder everything on their own, working ‘twice as hard’ at home and work and still never feeling like ‘enough is enough,’” she said.
There is emotional repression, which causes “difficulty naming sadness, fear, and trauma because ‘I have to be strong’ and delaying seeking help until a crisis arises.” Then there are the physical and maternal health risks of being “suffering, minimizing symptoms, and being dismissed by health care providers who assume Black women can tolerate more, contributing to dangerous gaps in care and morbidity and mortality among Black mothers.”
The 2023 KFF Survey on Racism, Discrimination and Health: Experiences and Impacts Across Racial and Ethnic Groups illustrates some of these potential associations.
Among black adults, women were more likely to say they had been treated unfairly by health care providers because of their race or ethnic background (21% to 13%). Black adults say they are more likely than white adults to have difficulty finding a health care provider who understands their background and experiences (46% to 38%), and 24% of black adults report negative experiences with health care providers, including making assumptions about their lives without asking, blaming them for their health problems, refusing to prescribe painkillers, or ignoring direct requests and questions.
Vanessa Anyanso, Ph.D., who earned her doctorate in counseling psychology from the University of Minnesota, studied the positive and negative mental health outcomes of Black women associated with the SBW schema for her dissertation. Anyanso, who is a descendant of Nigerian immigrants, also wanted to look at the experiences of black women with a family history of recent immigration and found that they had similar SBW schema concepts within the context familiar to their culture.
“Everyone had a very complex relationship with the SBW schema,” Anyanso said of the women in her study. “They said high achievement was positive and something that motivated them to succeed. Many women took pride in being leaders and being able to care for their families and wider communities. They saw resilience as a positive thing, the understanding that they could overcome and do whatever was necessary.”
At the same time, respondents spoke about the mental and physical costs of living up to the expectations inherent in the SBW metaphor.
“They say it’s like a mask. The pressure of having to wear it, of having to live by it, is exhausting,” she said. “There is a feeling that you have to suppress your emotions and suppress your desires because you have to finish a big project or take care of someone else.”
Make the SBW schema work for you
Seeking culturally competent mental health counseling may also help Black women work to address their relationship to the SBW schema. In her practice Rather than simply telling Black women to “stop being strong Black women,” Caldwell-Harvey said she teaches them to treat it as an option rather than an obligation.
“I would say, ‘Let’s talk about these strong Black women,’” she said. “You can pick it up when you need it and put it down when you don’t. We know very specifically what ‘letting go’ looks like: asking for help, saying no, delegating, resting without guilt, and being someone you can trust to make a change.”
Mayes was ready to change when she realized that continuing to push beyond her limits would only worsen her physical and mental health. She started with small steps after her breaking point. For example, saying “no” more often at home and thinking of ways your family can help with household chores. She said taking time for self-care has made her a stronger, healthier wife, mother, and employee.
Now 47, Mayes has channeled her energy into starting a health and wellness coaching business with the mindset of helping herself and others make personal changes.
“I’m no longer in a space where I’m living life on autopilot based on belief systems that aren’t mine,” Mayes said. “Now my life is all about what’s best for me, even if others don’t agree with my decisions. This allows me to be who I really am and live the life I enjoy.”
Caldwell-Harvey identifies generational changes in how Black women approach the SBW schema. While older generations may identify more strongly with this idea, younger millennials and Gen Z women see the schema as a burden and reject it more actively, she said.
“It tells us that the culture is ready to honor what this archetype has given us and imagine more humane ways to be black and female,” she said. “You can be strong, you can be soft, you can be holding on, you can be angry, you can be joyful, you can be exhausted, you can be deeply needy – all of these are legitimate ways to be a Black woman.”
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