Chapter 26.How Our Mind Becomes Racialized

Race, no matter how hard we consciously fight the reality, is a bedrock descriptor and hierarchical organizer of difference in American society. A dual racial reality in the United States creates dual subjectivities—for Black and for white—and this is foundational. Although race is a biological fiction, it endures as a social construct that defines identity and helps create the social, political, and cultural worlds within which we live. Specific to our discussion here, health care practice and delivery are affected on all levels by racial discrimination. Racism has an effect on people as adults, but the influence begins even before birth. Accumulated interpersonal experience with racism causes chronic stress in Black women, with low birth weights and increased infant mortality for their children (Collins et al. 2004). The damaging health consequences of discrimination and related restrictions on diagnosis and treatment are the subject of current research, but that research has rarely been integrated into the education of mental health clinicians. Signs of change can be found, but how unconscious scripts of the personal, the developmental, the emotional, the cultural, and the historical are integrated will direct how this change plays out on the health care stage.