Let’s be honest, talking about Black mental health myths in the community hasn’t always been easy. For generations, we’ve been taught to be strong, keep pushing, pray harder, and keep our business in the family. Vulnerability was often seen as weakness, and therapy? That was for “other people.”

But here’s the truth: strength is not the absence of struggle. Addressing mental health myths directly helps us break stigma and find the support we deserve.

I can’t tell you how many times I’ve heard a friend or client whisper, “I thought I was the only one going through this.” And yet, studies show that Black adults are 20% more likely than white adults to report serious psychological distress, yet we’re half as likely to receive the care we need.

Why? Because myths, stigma, and systemic barriers keep too many of us from seeking help. It’s time to change that. Let’s unpack five common Black mental health myths and replace them with truth, healing, and hope.

Myth 1: “Therapy Is for White People”

I grew up hearing this one on repeat. Therapy was often painted as a “luxury” for other folks. In many Black families, the idea of talking to a stranger about private struggles was almost unthinkable.

But here’s the reality: therapy is for everyone.

Therapists who specialize in working with Black clients understand that mental health challenges don’t mean we’re “weak”,  they mean we’re human. Whether it’s managing stress, unpacking generational trauma, or navigating everyday pressures, therapy can provide tools that our families and communities were never given.

The shift is happening, too: more Black therapists are entering the field, and more Black clients are prioritizing wellness. According to the Association of Black Psychologists, while only 4% of psychologists are currently Black, initiatives are underway to expand the workforce.

Seeking help isn’t abandoning our culture, it’s expanding our strength.

Myth 2: “If I Have Faith, I Don’t Need Therapy”

Faith and spirituality have always been the heartbeat of our communities, and prayer can be powerful. But prayer and therapy are not competitors; they’re partners.

Imagine this: you pray for healing from a broken leg, but you still see a doctor to set the bone. Mental health is no different.

A culturally competent therapist will respect your faith and, if you choose, integrate it into your healing journey. Research on culturally competent therapy shows that therapy doesn’t take you away from God; it can bring you closer; helping you process pain, strengthen resilience, and find peace without shame.

Take Action: Looking for faith-integrated therapy? Browse our directory of culturally aware providers who can honor your beliefs while supporting your mental wellness.

Myth 3: “I Don’t Have Time for Therapy”

Between work, caregiving, church, and community responsibilities, many Black families are doing everything for everyone else. We push ourselves until we’re running on fumes and convince ourselves we don’t have time to pause.

But here’s the thing: burnout doesn’t ask for permission. Neither does anxiety, depression, or grief.

Therapy isn’t “one more thing on your list”,  it’s a space to refill your cup so you can keep showing up for the people you love. And with virtual sessions and flexible scheduling, accessing therapy has never been easier.

Your healing is not a luxury. It’s a priority.

Myth 4: “I Can’t Afford Therapy”

Money can be a real barrier but it doesn’t have to be a dealbreaker.

There are more affordable options today than ever before:

• Sliding-scale therapy based on income
• Community clinics that offer free or low-cost sessions
• Employer assistance programs (EAPs) that include counseling benefits
• Virtual therapy platforms with reduced rates
• Referral networks (like ours!) that connect you with identity-affirming, cost-conscious providers

You deserve care that fits your life and your budget. Healing should not be reserved for the wealthy, and thankfully, it doesn’t have to be.

For help understanding stigma across different communities, read: 11 Organizations That Challenge Mental Health Stigma.

Myth 5: “Therapists Don’t Understand Black People”

This one is personal and for many, it’s true if you don’t find the right therapist.

Mental health care hasn’t always served Black communities well. Historically, many providers lacked cultural awareness, leaving clients feeling unseen or judged. But things are changing.

More Black therapists and culturally competent providers are practicing than ever before. Even if your therapist doesn’t share your identity, what matters most is cultural humility, a provider’s ability to listen, affirm, and adapt to your lived experiences.

Research shows that broaching,  when therapists acknowledge racial and cultural differences, strengthens the therapeutic relationship.

You deserve a therapist who doesn’t just hear your words but understands your world.

Take Action: Finding the right therapist matters. Our network includes providers trained in multicultural competence who understand the unique experiences of Black communities. You can also find support through GoodTherapy’s BIPOC therapist directory.

Shifting the Narrative on Black Mental Health Myths

Here’s what’s real:

• Your pain is valid.
• Your healing matters.
• Therapy is not weakness; it’s power.

According to Mental Health America, 19.7% of Black and African American adults experience a mental health condition each year, yet only one in three receives treatment. When we release stigma and embrace culturally responsive care, we create room for joy, resilience, and thriving.

You don’t have to carry everything alone.

Take Action: Your Path to Healing

It’s time to shift the narrative:

1. Reflect on what you’ve been taught about mental health
2. Realign your beliefs with your needs and your worth
3. Rise into healing for yourself, your family, and generations to come

Understanding the intersection of mental health challenges is crucial. Learn about related issues that affect our community: The Last Taboo: Breaking Down the Stigma of Depression.

FAQ: Black Mental Health Myths

What are the biggest barriers to Black mental health care?

The primary barriers include stigma within the community, lack of culturally competent providers (only 4% of psychologists are Black), financial constraints, and historical mistrust of healthcare systems due to past medical discrimination.

How do I find a therapist who understands Black experiences?

Look for therapists who explicitly mention cultural competence, have experience with racial trauma, or are Black themselves. Use specialized directories, ask about their training in multicultural issues, and don’t hesitate to interview potential providers.

Can therapy work alongside my faith?

Absolutely. Many therapists integrate spirituality into treatment when clients request it. Faith-based therapy can strengthen your spiritual connection while providing professional mental health support.

What’s the difference between feeling sad and clinical depression?

While everyone experiences sadness, clinical depression involves persistent symptoms lasting weeks or months that interfere with daily functioning. These may include sleep changes, loss of interest in activities, feelings of hopelessness, and physical symptoms.

How much does therapy typically cost?

Therapy costs vary widely, from $50-200+ per session. Many options exist for reduced costs: sliding-scale fees, community mental health centers, employee assistance programs, and some insurance plans cover mental health services.

Is virtual therapy as effective as in-person sessions?

Research shows virtual therapy is equally effective for many mental health conditions. It also increases access for those in areas with limited providers or those facing transportation barriers.

Finding the right therapist doesn’t have to be overwhelming. Our referral network connects you with culturally responsive, identity-affirming providers who understand the unique challenges and strengths of Black communities.

Understanding Intergenerational Trauma: An Introduction for Clinicians

January 8, 2021 • By Dr. Fabiana Franco, PhD, DAAETS

by Dr. Fabiana Franco, PhD, DAEETS
Simple trauma describes a single, circumscribed traumatic event (such as an assault). Complex trauma occurs when a person experiences a series of repeated traumatic events or when new, unique traumatic incidents occur such as natural disasters. Complex trauma early in life can damage multiple aspects of the child’s development. Complex trauma may involve entire families in incidents of violence, addiction, or poverty. (1)

Historical Trauma

Historical trauma refers to traumatic experiences or events that are shared by a group of people within a society, or even by an entire community, ethnic, or national group. Historical trauma meets three criteria: widespread effects, collective suffering, and malicious intent (2). Historical Trauma Response (HTR) can manifest as substance abuse, suicidal thoughts, depression, anxiety, low self-esteem, anger, violence, and difficulty in emotional regulation (3)

Intergenerational Trauma

Intergenerational trauma (sometimes referred to as trans- or multigenerational trauma) is defined as trauma that gets passed down from those who directly experience an incident to subsequent generations. Intergenerational trauma may begin with a traumatic event affecting an individual, traumatic events affecting multiple family members, or collective trauma affecting larger community, cultural, racial, ethnic, or other groups/populations (historical trauma). Those affected by intergenerational trauma might experience symptoms similar to that of post-traumatic stress disorder (PTSD), including hypervigilance, anxiety, and mood dysregulation.

Intergenerational trauma was first identified among the children of Holocaust survivors (4), but recent research has identified intergenerational trauma among other groups such as indigenous populations in North America and Australia (3)(5). In 1988, one study showed that children of Holocaust survivors were overrepresented in psychiatric referrals by 300% (6). The subjects were selected based on having at least one parent or grandparent who was a survivor.

Parenting as an Explanation for the Phenomenon of Intergenerational Trauma

While the existence of intergenerational trauma is well documented in multiple studies across several cultures, the mechanisms of transmission of intergenerational trauma remain unclear.

Trauma’s Effects on Parents

Parents may transmit inborn genetic vulnerabilities triggered by their own traumatic experience or via parenting styles that have been impacted by their trauma (7). Trauma survivors face many challenges when they are parents, including difficulty bonding to and creating healthy emotional attachments with their children. Yael Danieli categorized four adaptation styles amongst the families of survivors: Numb, Victim, Fighters, and Those Who Made It. Survivors who become numb seek silence by self-isolating, have a very low tolerance for stimulation of any kind, and are minimally involved in raising their children. Victims fear and distrust the outside world, try to remain inconspicuous, and are frequently depressed and quarrelsome. Fighters focus on succeeding at all costs and retaining an armor of strength, making them intolerant of weakness or self-pity. Those Who Made It are characterized by their pursuit of socio-economic success but also by the ways in which they intentionally distance themselves both from their experience of trauma and from other survivors (8).

Effects on Children

Children experience and understand the world primarily through direct caregivers and are, therefore, profoundly affected by their parents’ modeling. Children both mimic their parents’ behaviors and learn to navigate future relationships based on how they learned to relate to their parents. Enduring coping mechanisms due to the effects of trauma may be forged out of efforts to avoid and/or “fix” a parent’s abusive behavior, anger, depression, neglect, or other problematic behaviors.

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The Great Famine in Ukraine of 1932-1933 and Intergenerational Trauma 

The Holodomor (derived from the Ukrainian “to kill by starvation”‘) is also known as the Famine-Genocide in Ukraine, the Terror-Famine, the Great Famine, or the Ukrainian Genocide of 1932–33. It resulted from deliberate actions on the part of the authorities in Soviet Ukraine who, under the direction of Joseph Stalin, sought to force collectivization on the ethnic Ukrainian peasant population. This resulted in the deaths of millions (11).

In 2010, Brent Bezo conducted a pilot study to understand the generational impact of the Holodomor. Bezo interviewed 45 people from three generations of 15 Ukrainian families. The first generation survived through the Holodomor: the second and third generations were their children and grandchildren.

The study revealed that the coping mechanisms that the direct survivors had developed during the genocide were retained in the family system and passed down to their children and grandchildren. They described living in “survival mode,” including difficulty trusting people, a food-scarcity mentality, low self-worth, hoarding, social hostility, and risky health behaviors (10).

Aboriginal Communities in Canada and Intergenerational Trauma 

Aboriginal communities in Canada suffered from sustained trauma. For generations, Canada tried to forcibly assimilate Aboriginal people by placing them in residential schools, removing children from their families, and generally attempting to eradicate their culture and traditions (5).

The effects of this prolonged trauma have impacted First Nations groups on individual and collective levels, including markedly high rates of depression and self-destructive behaviors compared to the non-Aboriginal population. One of the challenges for mental health professionals working with community members is to understand the effects of intergenerational trauma on their clients, including a well-earned mistrust in the ministries of outsiders.

When Trauma is not Acknowledged – Learning From the Armenian Genocide

Mental health professionals are often unfamiliar with the history of those they seek to treat. Unrecognized and, therefore, unacknowledged traumatic events, such as family trauma or childhood trauma will go on to pose unique challenges for both client and clinician.

Trauma Denied

The Armenian Genocide, during which the Ottoman Turkish Empire massacred 1.5 million Armenians in 1915, is an example of historical trauma that has often been either minimized or denied outright. In fact, the mass murder of Armenians, Assyrian, Greek, and other Christian and religious minority populations of the Ottoman Empire between 1914 and 1923 has yet to be acknowledged as a genocide by the Turkish government (11). It can be especially challenging to cope with an injury while you are still fighting for its acknowledgment a century after it was inflicted. Additionally, due to this lack of formal recognition, Armenian survivors find it difficult to trust non-Armenian mental health professionals with their history and pain (12).

Coping: Family Closeness

Dagirmanjian suggested narrative therapy as a treatment with Armenians (12). Narrative therapy allows survivors to embody and settle into their perception and view of themselves (11). Another important key to working with Armenians is understanding the way Armenians value family closeness. This trait has sometimes been misunderstood and even considered unhealthy by Western clinicians who have been trained to approach family therapy with the goal of promoting individuation (12). In general, it is crucial for the mental health professional to understand the cultural context of the person suffering from trauma, including intergenerational trauma, to provide the most effective and sensitive treatment.

When Trauma Attacks the Core of a Person’s Identity 

Systematic attacks on a person or group’s identity, such as the Holocaust or the Aboriginal experience, are particularly damaging because identity and tradition are essential to perceived meaning in life. Victor Frankl, in his book, Man’s Search for Meaning, describes the imperative for people to feel securely connected to meaning in their life: without specific meaning, it is literally impossible to live (13).

In approaching survivors of historical trauma in which the intent was not only to inflict pain or kill but to demean and, ultimately, erase the identity of an entire people, the therapist must be aware that recovery requires the restoration of morale, identity, and purpose.

Culturally-Mindful Interventions

In Canada’s Aboriginal communities, intergenerational trauma treatment is complicated due to high substance use (which is itself likely a sequela of historical trauma). A valuable 2015 study (14) demonstrated the importance of blending Aboriginal and Western healing methods to treat intergenerational trauma when it was associated with substance use disorder among Aboriginal people in Canada (14). A vital element in this approach is reclaiming and recovering Aboriginal identity, including traditions, philosophies, and practices, and adapting them to current circumstances and needs. Programs that enhanced identity through cultural affiliations, increased cultural awareness through healing circles and family involvement, and were strongly influenced by traditional Aboriginal spirituality contributed significantly to decreases in substance use, domestic violence (which are often associated with substance use), and an overall increase in individual and communal healing (14).

The Role of Epigenetics in Intergenerational Transmission of Trauma 

Maternal stress and trauma are associated with health consequences for both mother and child, including low birth weight, fetal growth, and preterm delivery (15). The effect of maternal stress and trauma translate into additional risks for the infant later in life, including hypertension, heart disease, Type II diabetes mellitus, and even cancer (16).

Epigenetics refers to the study of heritable changes in gene expression in response to behavioral and environmental factors that do not change the underlying DNA sequence. In other words, epigenetics is the study of inherited changes in phenotypical properties without a difference in the inherited genetic makeup. Recent studies demonstrate that traumatic events can induce genetic changes in the parents, which may then be transmitted to their children with adverse effects (17).

In 2005, a study conducted to better understand the relationship between the PTSD symptoms of women exposed to the World Trade Center collapse on September 11, 2001, and their infant children’s cortisol levels found lower cortisol levels both in the mothers and their babies (18). Cortisol is a hormone released through the adrenal gland which helps regulate stress response. These findings speak to the importance of factoring epigenetic effects into our evolving understanding of how posttraumatic effects may be transmitted across generations (18).

Take Away Lessons for Mental Health Professionals Treating Intergenerational Trauma 

Intergenerational trauma may be transmitted through parenting behaviors, changes in gene expression, and/or other pathways that we have yet to understand fully. These may be biological, social, psychological, and/or a mixture of all three. As we trace these modes of transmission, practitioners will be better able to match interventions to specific factors that either propagate traumatic effects across generations or mitigate against their transmission. Different sources of intergenerational trauma will likely require different approaches. Innovative treatments for multigenerational trauma that borrow from indigenous cultures, acknowledge historical trauma, connect to group identity, and support survivors in finding meaning and purpose in their experience and that of their family and people are already providing practical tools for practitioners and point the way towards future progress for future generations.

References

(1) Courtois, C. A. (2008). Complex trauma, complex reactions: Assessment and treatment. Psychological Trauma: Theory, Research, Practice, and Policy, S(1), 86-100. Accessed August 24, 2017.

(2) O’Neill L, Fraser T, Kitchenham A, McDonald V (June 2018). “Hidden Burdens: a Review of Intergenerational, Historical and Complex Trauma, Implications for Indigenous Families”. Journal of Child & Adolescent Trauma. 11 (2): 173–186.

(3) Maria Yellow Horse Brave Heart “The historical trauma response among natives and its relationship to substance abuse: A Lakota illustration.” Journal of Psychoactive Drugs 35(1).

(4) Fossion P, Rejas MC, Servais L, Pelc I, Hirsch S (2003). “Family approach with grandchildren of Holocaust survivors”. American Journal of Psychotherapy. 57 (4): 519–27.

(5) Aguiar, W. & Halseth, R. (2015). Aboriginal peoples and Historic Trauma: The processes of intergenerational transmission. Prince George, BC: National Collaborating Centre for Aboriginal Health.

(6) Sigal, J. J., Dinicola, V. F., & Buonvino, M. (1988). Grandchildren of Survivors: Can Negative Effects of Prolonged Exposure to Excessive Stress be Observed Two Generations Later? The Canadian Journal of Psychiatry, 33(3), 207–212.

(7) Bowers, M. E., & Yehuda, R. (2016). Intergenerational Transmission of Stress in Humans. Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology, 41(1), 232–244.

(8) Danieli, Y. (1981). Differing adaptational styles in families of survivors of the Nazi Holocaust: Some implications for treatment. Children Today, 10: 6-10.

(9) Werth, Nicolas. 2007. “La grande famine ukrainienne de 1932–1933.” In La terreur et le désarroi: Staline et son système, edited by N. Werth. Paris. ISBN 2-262-02462-6. p. 132.

(10) DeAngelis, T. (2019, February). The legacy of trauma. Monitor on Psychology, 50(2). http://www.apa.org/monitor/2019/02/legacy-trauma

(11) Mangassarian, Selina L. (2016). 100 Years of Trauma: the Armenian Genocide and Intergenerational Cultural Trauma, Journal of Aggression, Maltreatment & Trauma, 25:4, 371-381

(12) Dagirmanjian, S. (2005). Armenian families. In G. McGoldrick & N. Garcia-Preto (Eds.), Ethnicity and family therapy (pp. 437–450). New York, NY: Guilford.

(13) Frankl, V. E. (1984). Man’s search for meaning: An introduction to logotherapy. New York: Simon & Schuster.

(14) Marsh, T.N., Coholic, D., Cote-Meek, S. et al. Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in Northeastern Ontario, Canada. Harm Reduct J 12, 14 (2015).

(15) Dunkel-Schetter, C, Wadhwa, P, & Stanton, AL. (2000). Stress and reproduction: Introduction to the special section. Health Psychol; 19(6): 507-509.

(16) Barker, D. J. P. (1998). Mothers, babies and health in later life (2nd ed,). Edinburgh: Churchill Livingstone.

(17) Yehuda R, Bierer LM (2009). The relevance of epigenetics to PTSD: implications for the DSM-V. J Trauma Stress 22: 427–434.

(18) Yehuda, Rachel, Mulherin Engel, Stephanie, Brand, Sarah R., Seckl, Jonathan, Marcus, Sue M., Berkowitz, Gertrud S., Transgenerational Effects of Posttraumatic Stress Disorder in Babies of Mothers Exposed to the World Trade Center Attacks during Pregnancy, The Journal of Clinical Endocrinology & Metabolism, Volume 90, Issue 7, 1 July 2005, Pages 4115–4118.

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© Copyright 2021 GoodTherapy.org. All rights reserved. Permission to publish granted by Dr. Fabiana Franco, PhD, DAAETS