Racism Is An Addiction

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As people gather to protest the murder of George Floyd, Breonna Taylor, Ahmed Arbery and so many Black people before them, Nzinga takes the opportunity to talk about how racism biologically and psychologically impacts our black and brown communities. Yes, this kind of chronic trauma leads to increased substance use disorders. But even more so, this episode explores how racism itself is the addiction of America.

Please note, In Recovery contains mature themes and may not be appropriate for all audiences.

Show Notes 

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[00:03] Dr. Nzinga Harrison: Hey, everybody. Thanks for listening. This is Nzinga Harrison, chief medical officer and co-founder of Eleanor Health, co-founder of Physicians for Criminal Justice Reform, physician, psychiatrist, addiction expert, black woman, wife to Joel Harrison, who is a black man. Daughter to Mmoja Ajabu, who is a black man. Sister to Kofi Modibo Ajabu and Paul Huff — he had his own mother, that’s why he has the last name Huff — who are both black men. And mother to my two sons, Zahir and Nasir, 13 and 14, who now that they are older than the age of eight, no longer look like cute little boys to white people and police officers, but instead look like threatening black men. And by the way, I’m proud of myself for making it through that part about my kids without crying, that may be the first time.

[01:04] Dr. Nzinga Harrison: You could tell by that introduction that we’re gonna talk about racism today. So we had a different show cued up, but hopefully everyone is aware of what we’re all going through as a country as a result of the police killing of George Floyd. And I want to say that George Floyd’s murder is actually laying on top of three other kind of high-profile events that have happened back to back to back. And this is how it seems to come, in clusters, and just sap all of your energy all at once. But it’s only been a few weeks since the police kicked in the door at Breonna Taylor’s house and shot her in a case of mistaken identity. Ahmaud Arbery was jogging through a neighborhood and then got chased by two white men who then shot him and killed him dead. And it’s only been a few days since Christian Cooper videotaped Amy Cooper, of no relation, calling 911, honestly, to try to use the threat of police brutality to scare him.


[02:15] Dr. Nzinga Harrison: And so we were already dealing with having a hard time getting a media response for Breonna, getting a media response for Ahmaud, getting a media response for Christian. So all of these were going along around social media, but kind of Covid, social distancing was really making it difficult to bring together that in-person presence to really start driving kind of media attention and then wider country attention. And then George Floyd was killed. And that kind of laid on top of these other three very recent events, for what I call for myself as a black woman, but for black people in general, the posts that I made on my Facebook page — and I don’t pretend to be the voice of the black people — but the post that I made on my Facebook page was this feels like an abusive relationship. So when you’re in a lull, and then bam, bam, bam, you get punched in the face, kicked in the stomach, knocked down, thrown down the stairs. At first you’re angry at the abuser, but then you’re angry at yourself because you knew it was coming and still somehow you weren’t prepared. And so it is an excruciatingly emotional time. I was saying to Claire before we officially started this episode that as much as this is an emotionally exhausting time, I actually see it as an opportunity. And so we were not going to miss this opportunity on In Recovery to raise our voices and talk about racism maybe through a little bit of a different lens than people are used to talking about it. 


[04:09] Dr. Nzinga Harrison: So, you know, on this show, we talk about all things addiction. And so I want to talk about racism as America’s addiction today. I want to talk about the cumulative trauma that we’re experiencing, and so I couldn’t even begin to give you a long enough list of names of people, black folks who have been killed both by police, not by police, but just in unjust killings. But I’ll tell you, from my own personal experience, my dad was commander of the Black Panther militia when I was growing up in Indianapolis, Indiana. Super amazing advocate. I can legitimately say, Indianapolis is a different place today than it would be not for the advocacy efforts of my dad and the Black Panther militia under his leadership. One of the first big cases that I remember my dad working when I was little, I was probably, I don’t know, seven, eight, nine, 10, was this kid, Michael Taylor, who was 17 years old, who was shot in the head while he was handcuffed in the back of a police car. And the Indianapolis Police Department said that it was suicide. That while his hands were cuffed behind his back, he somehow reached down into his sock to pull out a gun that they had not found when they searched him to shoot himself in the head. 


[05:46] Dr. Nzinga Harrison: This is the first memory I have. And the reason I’m telling my own personal experiences is because what I want people to know is that this is not just happening to them. Like these are our own experiences. I grew up with a set of twins, the Blair twins, in Indianapolis, Indiana. I should say, the Blair brothers, because there were more than just the twins. My freshman year in the fall of college, I heard that Chad Blair had been found hanging from a tree with a padlock wrapped around his neck. They called it suicide. And we all believe, to this day, that it is probably very difficult to padlock chain yourself around a tree and hang. 


[06:44] Dr. Nzinga Harrison: And so when we talk about Michael Brown and Philando Castile, Breonna Taylor and Ahmaud Arbery and Christian Cooper, George Floyd and Laquan McDonald and John Crawford and Tanisha Anderson, and I could spend the entire rest of this hour reading off people’s names. We’re talking about people that look like our fathers. That look like our husbands. That look like our sons. That look like my friend in high school that was killed. That look like my friend from college, Paris, who was an all-star athlete, college graduate, mentor, pulled over on a routine traffic stop, killed by police. That was during medical school. We are talking about our own people. And so when we think about racism as an addiction, the definition of addiction that we’re using on this show is “continued behavior despite negative consequences.” And what I just ran down is the ultimate negative consequence: getting killed. That’s as negative as the consequence gets.


[08:07] Dr. Nzinga Harrison: What we have to think about also is that those people paid the ultimate consequence of racism, but the negative consequences spill out everywhere else. So the people who are left behind, the racism in the healthcare system, looking at health disparities; the racism in our financial institutions, looking at home ownership; the racism in our education institutions, looking at punitive actions in elementary schools all the way up to graduation rates; the racism in our criminal justice systems, looking at mass incarceration and the “war on drugs.” All of which are pinned directly in this legacy of slavery and oppression that really built this country. And so the other thing we talk about on this show — I mean, I think, Claire, can you agree this is continued behavior despite negative consequences? 


[09:16] Claire Jones: Yes, 100 percent. 


[09:18] Dr. Nzinga Harrison: OK. Because if you are like, no, I was gonna be like, there’s a lot of work to be done. So we can agree there. And then the second part that we always talk about on this show is, “and yet humans don’t continue a behavior that has zero benefits.” We have to look at who is benefiting, because if we’re what we’re basically doing — oh, Claire raised her hand. 


[09:45] Claire Jones: Me, I’m white. I benefit from this. 


[09:48] Dr. Nzinga Harrison: You know you my girl. That runs deep. And so even if you don’t want to benefit from it — I think that’s where a lot of my white friends and colleagues and white people that I don’t know get hung up on it, is that you don’t want to be benefiting from racism. And so what do we do? The same thing we do with addiction. We shove it in the dark and say, “no, I’m not contributing to that. I don’t have any part of that. That doesn’t exist. I don’t understand.” And that is just making it worse and worse and worse and worse and worse. And so, yes, people who appear white benefit from racism. Because inherently racism oppresses people of color. Racism in this country oppressed people of color. And so what we have to do is make the consequences against racism outweigh the benefits of racism. 


[10:48] Dr. Nzinga Harrison: And what’s so difficult about that right now, which we’re starting to see change, but what’s so difficult about that is that all the negative consequences are falling on black people and other people of color. And all of the benefits are falling on white people, or the race considered to be in the majority. And so consequences have to start flowing to the white race so that consequences can start outweighing the benefits, even if the benefits are passive. And so what I want to do on this show is start talking about how, one, we can just open our eyes. So like black folks, we don’t have to open our eyes because we live it every single day. Even if I didn’t want to open my eyes, racism is literally like prying my eyeballs open every day, like, no, I don’t want to see it. You can’t help but not see it. It’s our everyday existence. Things are changing. Things are changing. Things are changing and things are changing in the right direction. But one of the most common things that we used to hear all the time when you would bring up race would be, “why does it always have to be about race? Does it always have to be about race?” And my answer to that would be uhh, yes. Because there is not one experience I have in my entire life in which I’m not a black woman. So you can’t ask me to have it not be about race, because every single space that I show up in, is about race. Because I’m a black woman.


[12:25] Claire Jones: Will you give just a quick, simple example of that, I think, to help make it concrete for some listeners? 


[12:32] Dr. Nzinga Harrison: Yes, I can give a quick example of that. So, for example, I go to the grocery store. When I go to the grocery store in an area where there’s going to be a mixed-racial crowd in the grocery store, literally, I go in the grocery store and many of the white people don’t see me. They don’t even take note. They don’t acknowledge, no eye contact, no “how are you doing?” Like, it’s literally as if I’m invisible. This is especially if I’m in a grocery store where it’s going to be majority white people. So I’m in a neighborhood where it’s majority white people. If there is one black person in that store, we saw each other. They looked me in the eye. They gave me the head nod, like, “I see you.” They gave me a smile. And so you could say maybe the white people in that store don’t see anyone. But I see you walk past the black worker and ask the white worker to help you. I see you walked past me and, as the white woman who is just a few steps from me, what she thinks about this product that you were looking at. And so the privilege, like we always talk about white privilege — and whenever you’re in a majority group, there are always privileges. So I always qualify that and say I have privileges. Like, I have privileges being able-bodied. I have privileges being tall. I have privileges being thin. I have privileges being in the socioeconomic group that I am in. 


[14:15] Dr. Nzinga Harrison: When you have privilege to not have to think about those things, that is what the privilege is. So like, does a white person have to find another white person in that space to create a sense of safety? No, that’s a privilege. And that privilege is a direct benefit of racism in this country. Do you, Clare, have to blame yourself for having that privilege? No, you don’t have to blame yourself for having that privilege. Do you have to accept that you have that privilege? If you want to make a change, yes. If you don’t want to be complicit in protecting the infrastructure of racism, then, yes, you have to accept, you know what? Purely by appearing as a white person, when I go into public spaces, I have a privilege. And then do you have to accept the responsibility to use your privilege to raise your voice on behalf of people that don’t have that privilege? If you want to be part and change! If you want to not be part of the problem. And so I’m gonna talk about racism exactly the same way I talk about addiction. So you don’t hear me calling people “addicts.” I say they are people with addiction. 


[15:37] Dr. Nzinga Harrison: Now, you will hear me call people “racist.” If I were trying to be completely congruent, I would say they are people with racism. Because racism is an illness that has biological, psychological, social, cultural, political for sure, inputs and things that we can do. And so just know when you hear me call somebody racist, if you look at my Twitter right now, Amy Cooper gave her apology and said, I’m not racist. And I said, “Amy, yes, you are.”


[16:12] Dr. Nzinga Harrison: Just know, my emotions are high when I do that. Because I can think about it very intellectually and cognitively and say this person has racism. This person’s actions were racist. Because that’s actually like truly that’s what it is. The person then who is “racist” — and the reason I put that in quotes is because nobody has to keep that identity. And in some ways, when we say that person is “racist,” we’re actually letting them off the hook to do the work that it takes to not behave in racist ways. Or to not do racist things. So in that way, I don’t want to call people racist because I don’t want to let you off the hook. But what I would call racist is when, you know you called the police on that man because he was black. And, you know you lied on the phone about what was happening. And you said it’s an African-American man because you knew you would benefit from the racism that comes from hearing a white woman be attacked or threatened by a black man. That is ground in a whole lot of history in this country, and you knew that, and you did that intentionally. 


[17:43] Dr. Nzinga Harrison: And so the people that I call racist, even though I’m like, I’m going on the record, I’m telling y’all, I’m working on it. I’m trying to move myself to a more intellectual position on it. But it’s emotional. Because when you intentionally do racist things, then I’m gonna call you racist. When you do things that are racist and you’re like, “oh, snap. That truly was not my intention. Here is what I am doing to rectify that. Here is the introspective work that I’m doing. Here are the reparations that I’m making to undo that mistake that I made.” Then I can say because all of us, all of us, all of us, all of us are gonna make those kind of mistakes. And so it’s very, so much easier for me in that position to say that person is not racist. They just did racist things. When you’re being, like, “I’m not racist, that’s not what I meant.” Yes, it is. 


[21:43] Dr. Nzinga Harrison: I want to quote Ijeoma Oluo, whose quote I have been putting everywhere, everywhere, everywhere, everywhere. And this is really what I want to pin today’s episode on, because, y’all know, I’m highly emotional right now. So I’m at risk for just talking and talking and talking and not like giving some actual resources. And I don’t want to talk, talk, talk. Even though we need that, and we need to hear the emotion, I also want to be a little cognitive about it and sneak peek like thinking is one of my coping mechanisms. But I want to read this quote by Ijeoma Oluo. And this is gonna be a call to action for my In Recovery listeners, for all of us to make the commitment to be anti-racist. And so it says “the beauty of anti-racism is that you don’t have to pretend to be free of racism to be anti-racist. Anti-racism is the commitment to fight racism wherever you find it, including in yourself. And it’s the only way forward.” And I’m pointing this quote at all of us, because guess what, black people have internalized racism. There is no way not to. Everybody who has grown up in the United States of America, from the time we come out of the womb, we are inundated with images in media, we are inundated with policies and procedures, inundated with laws and regulations, and inundated with neighborhoods and experiences that ingrained racism. So our brains learn by patterns. And so there’s no way to not learn this pattern when it is being repeated over and over and over and over and over in your brains. 


[23:38] Dr. Nzinga Harrison: And so that quote has to point at me as a black person also. Like, when I see racism in myself towards black people, I have to be committed to fighting that racism as much as Claire, I’m asking you to be committed to fighting racism when you see it in yourself. I mean, like fighting in yourself, that is hard work. Sometimes the harder work is fighting it in somebody close to you, right? Your mom, your dad, your husband, your brother, your sister, your kids. I’m asking us to make the commitment to do that hard work. You know, what else is hard work? Fighting it in somebody who, for some reason, has more power than you, or in a system that has more power than you. And so I’m asking In Recovery listeners, make the commitment to do that hard work. And I know that does not come without risk. Raising your voice does not come without risk. But the same way we ask people on this podcast, we ask people with active addiction to show themselves, and take the risk of reaching out for help. We ask them to take the risk of helping somebody else with addiction. If we’re asking people with other addictions, substance use disorders, to do that work, then we have to ask ourselves to do that work for the addiction that is racism.


[25:14] Dr. Nzinga Harrison: And so I’ll take this moment to just share my effusive gratitude for Eleanor Health. I’m a co-founder at Eleanor Health. And so on Saturday, I emailed a picture — because I’ve been on fire, if you follow me on social media, I’ve been on fire! Posting, posting, posting, posting. My brother Reggie put up just this black box with a white quote on it that said, “It’s not the words of our enemies that we’ll remember, it’s the silence of our friends.” And I forwarded that to the leadership team at Eleanor Health. And I said, we cannot be silent. And so I was like, I see a few opportunities kind of with our existing meeting cadence to talk about this in the company and I was like, we have an extended leadership team meeting this week. I think we should touch on it for a few minutes there. Give them the heads up. We have our all-hands meeting, where everybody in the company gets together every week as part of our coronavirus response. And so in that meeting every week, we have a moment of silence. It’s called the Covid moment. So I think we should repurpose the Covid moment to be in solidarity, a solidarity moment. And so I was not worried that I would get any response other than, “of course.”


[26:38] Dr. Nzinga Harrison: But, man! I ran out of words right there at the response that I got because the response was a “few minutes in this meeting is not enough. A solidarity moment is not enough.” Like we need to make a statement. And we need to do it right now. We can’t wait until Tuesday. Tuesday is too late. We need to give the whole meeting. We need to create ongoing dialog about this. We need to give people resources. And I was like, this is some anti-racism in action. Because Corbin, our CEO, she’s a white woman. Michael, our chief people officer, he’s a white man. Srishti is an Indian woman. Beau is a white man. Every single one of them was like, we have our own experiences, none of them rises to the racism that black people are experiencing every single day. Our people are not getting killed at these same rates. It is on us to not make Nzinga come up with the whole Eleanor Health response. These jokers were like and this. And this. And this. And this. And you know what that does? That feeds me. 


[27:53] Dr. Nzinga Harrison: When I feel like I don’t have enough, that feeds me. When I feel like I don’t have another ounce to give, somebody else is giving an ounce. And so we put together just this beautiful letter pointed directly to our staff at Eleanor Health, we call our staff team members. So we call everybody, the people we take care of, community members and the people who are serving team members, all as part of one community is our culture at Eleanor Health. And I said one of the things that is most difficult — and this is finally where you see where my thought process is going, because I know I be talking and you be like, what is this woman talking about? Where my thought process is going is that I recognize work is one of the hardest places to raise your voice. And so what we’ve all been socialized and we’ve all — I’m talking about black people — is that we may be having just excruciating horror and pain and fear for our husbands and fathers and brothers and sons. And when we go to work, you just pull it together and you just go to work as usual, because there is no space at work for this conversation. And so what we decided at Eleanor Health is that we would not ask our people to do that. So we’re not saying you have to come to work and share this. We’re just saying you don’t have to come to work and pretend to be OK. You can show up at work as who you are, and we are going to be here to support you in that. And so what I’m hoping for the people listening to this In Recovery podcast right now is that, just like white people are in the position of privilege, and it is your responsibility to be anti-racist and to create space for this dialog. For people of all races, and trust me, I recognized for my black folks at the executive level, there is risk and there is a high bar. Like I get it all. But for people at the executive levels of companies, if you have not created the space at work for this dialog, that is your responsibility. That is your responsibility. And I recognize it as a risk. And I’m asking you to take the risk.


[30:20] Dr. Nzinga Harrison: Because what happened was we quite possibly could have still been silent at Eleanor Health. I cracked the door and it turned out that my colleagues had an infinite bucket of ideas. Infinite, infinite bucket of ideas! All of which were flipping amazing. But a lot of times the risk, you don’t know. Is at my place to bring up these ideas? Is it my place to speak out about this? And what I’m saying is, yes, it is your place, whoever you are, whatever race you are, especially if you’re in a position of power. It is your place. And sometimes you just crack that door and rainbows and unicorns flood out. So take the risk. Take the risk to crack that door. And then maybe you crack the door, and it gets slammed shut in your face. You have more information. At least you know what you’re dealing with. But if you don’t crack the door, maybe there’s a missed opportunity there. And so it’s the same way — taking it back to this idea of racism as an addiction — that we talked about taking care of the whole person. In this metaphor, I’m using America as the person. When we talk about that as an individual, we say taking care of the mental health, taking care of the physical health. Looking at those social drivers of health, which are income, education, support, meaningful connectedness, ethnic identity. So when we talk about America, we also need to take that whole-person approach to racism for America. 


[31:55] Dr. Nzinga Harrison: And so you don’t have to do it all. You literally only have to do one little thing, but you have to do it over and over and over and over and over. So when this media coverage dies down — this is what I put on my personal Facebook page. I said, “to my white friends who are reaching out to me” — I actually said to my non-black friends, because I also want to raise up that there are more than just black people and white people in this country. I said, “to my non-black friends, who are reaching out. I appreciate you. Your outrage gives me hope. Your outrage helps me see the path forward. We need you. We cannot rise up on our own. We all have to rise up all together. But the most common question I’m getting is ‘what can I do?’ And I said, and I’m gonna say it here, at the risk of sounding impolite, what you can do is not put the burden on me to figure out what you can do! We live in the age of the Google, the Google will tell you what you can do.” And so what I put on my personal Facebook post was the only thing — because I think what underlies that statement is “I don’t want to do the wrong thing.” The only thing you can do that would be wrong is staying silent. Doing nothing. That is the only wrong thing. And so if you are doing anything else besides that — now, I did point to this article called “Five Things Why People Can Do Right Now.” Google it. It’s great.


[33:52] Claire Jones: We also have very long show notes. I put down an article that says “71 things that white people can do for racial justice.” There’s a Google doc full of articles that you can read, movies that you can watch, podcasts you can listen to, a reading list. I also put down an anti-racist reading list. And something from the Racial Healing Handbook that is a way to ask yourself questions about racism and anti-racism. We have places to donate. And how you can learn more. And vote in your local elections, because those are also very important for things like this.

[34:31] Dr. Nzinga Harrison: So you know what Claire did not do? Claire did not email Nzinga and say, “can you give me some resources for the show notes?” OK?


[34:42] Claire Jones: Right. Because not your job. It’s not your job. 


[34:46] Dr. Nzinga Harrison: I love this because I was talking to, ooh, who was it? It was Steph. And she said, like, “I’m not going to ask you how you’re doing because clearly the world is burning and things are trash right now.” And I was like yeah. And so she was like giving some ideas how we can repurpose the show. We can put the audio that I sent in and all this kind of stuff. And I said to her, you know what? Thank you for not asking me what you could do, but instead just come to me and being like, here are my ideas. Like, what do you think about these? 


[35:15] Dr. Nzinga Harrison: And she said, Yeah. It’s like when someone has a loved one die, and you call them up and say, what can I do? I don’t have the emotional — but like just bring a casserole to my house. Don’t ask me, what’s your favorite restaurant? What address should I have it delivered to? Do you already have a frequent meal eater plan there? Like just tell Uber Eats to bring me some food. And so part of being anti-racist. Y’all know I always bring it back. This is where we started. Is actively looking for what you can do, and literally just doing it. So yes, donate, magnify the voices of people who are already working in this space. Show your face. People are like, oh, these social media activists. Listen, social media activism is a lot of the reason why we have made more progress in the last five years than feels like in the last 25 years. Because if you see something — you know, you’re riding down the street and you see police officers have somebody pulled over and you get out and you start videotaping. That is powerful. You quite potentially changed the outcome of that stop. We don’t know what the outcome was going to be. But you quite possibly influenced it. Even if something crazy goes down, and you put that video on social media, that drives a movement. Become a recurring donor to a cause that you believe in. Choose any part of the person that is America, right? Choose the education system. Choose criminal justice, choose healthcare, choose housing, choose finance. Wherever your skill set and your gifts and your talents lie, apply those talents to being anti-racist. 


[37:20] Dr. Nzinga Harrison: And a huge part of that is just speaking up despite the risks. Speaking up, despite the risks. We need you to take the risk to look at yourself. And I’m talking to all of us. I’m not just talking to white people, even though I’m especially talking to white people. You are the biggest position of power. And so when I say stuff like that, I always hear back — and it’s legitimate — from white people who are in poverty. And I like trust and believe I am not in a position of power. And I get that. I get it 100 percent wholeheartedly, and I magnify your voice and I honor that. But trust and believe you could go get a makeover right now, and suddenly be perceived as a person in power. I can go get all the makeovers I want to get, and when I walk in the room, I’m going to be a black woman walking in the room. And so this is not to say we don’t have other injustices, because the United States of America is full of injustices around every corner. And to be anti-racist is to raise our voices against all of those injustices. 

[38:37] Dr. Nzinga Harrison: OK, Nasir is 13. So this is all over their social media also. And we’re talking about them. And we had them in a three-hour town hall last night about how to make it out of a police stop alive as a young black man. You heard me stumble on calling my kids men because they’re kids. But they appear as men to the outside world, even though they’re kids. But so they were in that town hall. But Nasir showed me a TikTock. And I was like, you know what? TikTok on the activism. This is what I’m talking about. And it was this white kid, young teenager, maybe like 14, 15. As a matter of fact, I’m going to get the link from Nasir so we can drop this in the show resources. That’s right, In recovery uses TikTok as show resources. It was amazing. And basically, the kid was like, OK. OK, OK. He was like, let me explain to you Black Lives Matter. He was like, if you have five kids and one of the kids gets a cut, are you gonna give all five kids band-aids? No, because all five kids don’t need band-aids. The kids with the cut need the band aid. But do we care about those other kids? Yes. It’s just that they don’t need a band-aid right now. And that’s Black Lives Matter. And I was like this is brilliant. This is brilliant. 


[40:08] Dr. Nzinga Harrison: That reminds me, I need to get that link because I’ve been doing a series of tweets. This is anti-racism. I need to get that link because that is anti-racism. That is a white kid who is in a position of privilege using his voice in the way he knows how to speak up against racism. And so it literally can be that simple. Just like we say in the 12 steps, because we’re conceptualizing racism as an addiction. The first step is recognizing we have a problem. Now, us black folks, we can’t help but recognize it because it’s our everyday existence. For people for whom it’s not, your everyday existence, it’s letting your eyes open and recognizing that, yes, we have a problem and that you can be part of the solution. You can help us drive this country towards the change that we need to drive this country forward. 


[43:34] Dr. Nzinga Harrison: OK, Claire, ask me about the neurobiology of racism.


[43:39] Claire Jones: OK. Tell me about how racism affects our neurobiology. I’m also really curious to know how things like racism, in the form of microaggressions and the experiences that you have every day, how and why those are felt on a cellular level. And how that leads to black people dying sooner in their lives, and how that leads to health disparities.


[44:09] Dr. Nzinga Harrison: What we know — you’re talking about this term that has been coined weathering.  And it’s the cumulative degradation of health as a result of racism and oppression. So what we know is that all of our life experiences get coded into electrical and chemical and hormonal signals in our bodies. And racism is a form of chronic stress. Oppression is a form of chronic stress. Racism and oppression are forms of chronic trauma. And so when we take — I mean, there is just a beautiful medical research that is developing around this — when you take what we know about chronic stress and chronic trauma, what we know is that chronic stress ratchets up the system in your body, which is called the cortisol axis. And what the court is all access feeds is your fight or flight. It is designed to keep you alive, to keep you alert for when there is a threat. It is designed to keep you in a posture that you can recognize a threat quickly and either fight that threat or flee from that threat. Fight or flight. 

[45:21] Dr. Nzinga Harrison: And so what we know when your cortisol axis is at baseline, chronically being activated, that raises blood pressure. So then we can make a direct line to heart disease. That reduces activity in the prefrontal cortex and increases activity in the amygdala. So the amygdala is the part of your brain where fear and anxiety reside. And so you can make a direct line to that, to the increased levels of psychological distress, depression and anxiety that we see in black people. Your cortisol level increases your steroid hormones, and your steroids hormones actually increase your blood sugar. You can draw a direct line from that to the health disparities we see in diabetes. You can draw a direct line from that to the health disparities that we see in cholesterol and heart attacks and strokes. We know that people with trauma, anxiety, depression and persistent fight or flight positioning are at increased risk for developing substance use disorders. So you can draw a direct line from racism and oppression to substance use disorders. So that’s the biology of it. The psychology of it is that the systems that we need to help us with those things — education, health care, criminal justice, finances — are not safe systems. So psychologically, you know you need help. But you also know that you’re going to experience the root cause, racism and oppression, when you go to those systems that are supposed to be designed to help you. That’s the psychological aspect. And so then you get into hopelessness and anger, which ratchets up that cortisol system, which makes you run faster on that direct line. And then, OK, you get yourself there. You get yourself to the system. And we know that less than half the time does a black person that has an opioid overdose get follow up treatment for that substance use disorder than a non white person. We know that when you go to the emergency room in pain as a black person, you’re more likely to be discharged without treatment and without care.


[47:43] Dr. Nzinga Harrison: We know that one in five black people in the last five years says that they have experienced racism and discrimination in a healthcare setting. We know that you’re more likely to die during childbirth as a result of the care that you receive in the hospital if you’re a black woman. We know all of these things. So all of those social, cultural, political inputs are compounding the psychological injury that comes from racism and oppression. And by the way, all of those systems are the way they are because they literally are born from slavery. And so at the same time, every single day, our experiences are biologically putting us at risk. The psycho-social-cultural environment is compounding that risk. And that’s what gives you the outcomes that we have today. So, you know I always like to talk about, so then what can we do? The easiest first step, and I love teaching about this, I teach about it all the time. What’s the first step, Claire? Recognize that we have a problem. And so the way you do that systematically is with data. So wherever you are professionally, health care, education, finance, criminal justice, all of these other systems that we have. Coronavirus testing, cases, deaths. If you are not looking at that data cut by race, ethnicity, socio-economic status, also gender identity and sexual orientation. If you’re not looking at it, you’re part of the problem. Because what you’re doing is refusing to open your eyes, because if you don’t see the disparity, you can’t work on the disparity.


[49:34] Dr. Nzinga Harrison: And so the very, very first easy step we can do — say you’re not a data person, you’re not in a position to be collecting data, find an organization that is collecting data about something that you care about and donate to them, or post their articles, forward them around on social media. Volunteer for them. Like, whatever you can do. Or an organization that should be cutting their data, like at work. You at work. You should be cutting your data by race and ethnicity. And if you’re not, be like, hey, why aren’t we cutting this data by race, ethnicity, socio-economic, class, gender and sexual identity. Those are the biggest disparities we have in this country. And so if we want to make a difference, a smart person once said — and I heard about this from Melinda at Eleanor Health on our quality team. “Things they get measured, get better.” You put your eye on the ball and it gets better. So that was the long answer to how does racism turn into health disparities? Which leads us directly into neurobiology. Because I talked about the prefrontal cortex and the amygdala, both of those are in the brain. This is so incredibly important to me, and this goes back to my personal work that I’m doing to try not to call people racist. Which is that it really is the way the brain works to categorize patterns based on previous experience. 


[51:08] Dr. Nzinga Harrison: It just is, OK? And so I don’t know if I took you through this exercise before, Claire, but I could show you even just — I’m just going to describe to you a beautiful, red, shiny apple. Your mouth is watering. Because your experience with bright red, crispy, shiny apples is that they’re delicious. Now, I didn’t even give you a real apple, but I generated a whole physiological response for you. That started, guess what, in your motivation pathway with a dopamine signal that went forward to your prefrontal cortex and said — first of all, your dopamine pathway said mouth, water, stomach, rumble. Prefrontal cortex: Do you see our mouth-watering? Do you see our stomach rumbling? All of this is because you need to go get a red, shiny, crispy apple right now. That’s what just happened, neurobiologically, all without your intention. Your stomach rumbled, your mouth watered. Your prefrontal cortex conjured up an image of the most amazing apple you’ve ever seen. All without your conscious input. Same thing if I showed you — and this is for Americans, because I learned this when I was teaching this and I loved it. It was a beautiful moment for me. If I show you a brown apple with brown spots, a yellow apple with brown spots, looks like it might be soft. Clare’s little face even just got disappointed on the Zoom. So she was so disappointed in this apple. 


[53:07] Dr. Nzinga Harrison: You have not tasted either one of these imaginary apples, but your brain has already developed a physiological response and assigned a value to each of those apples. This apple is amazing. This apple sucks. That’s just how the brain works. And so am I gonna call you an apple-ist? No! We don’t think about it that way. The exact same thing happens with people. And so what I want people to know is that — this is why Ijeoma Oluo quote is so beautiful to me, because it has neurobiology all over it. We are not asking you to be free of racism, because that is not possible. So much of your reaction to people happens before it even lands on your prefrontal cortex and you have the opportunity to grab conscious control of it. It has already happened. So you can’t judge yourself if you see a young black kid in a hoodie with his pants sagging and you get a fear signal. You can’t judge yourself for that fear signal because you’ve been trained into that fear signal. Your brain has been trained into that. What you then do is, when that fear signal rises to your consciousness, then you say, oh, snap. I just got a fear signal about this kid. What is it about this kid that gave me this fear single? Oh, it’s because he’s black. Oh, it’s because the way he’s dressed. Oh, it’s his age range. What are my experiences that are informing this fear signal? Is this fear signal — look at the rest of the context clues in this situation. Because like I always say, just like you don’t automatically know that black kid is dangerous, you don’t automatically know that black kid is not dangerous. So take in the rest of the context clues. Take yourself through a cognitive exercise that, one, identifies the reaction you’re having. So what we’re doing is creating the space of anti-racism. One, I recognize this in myself. Two, examine it. What is this based on? Like, did you just see that kid push somebody down and spit on them? 


[55:30] Dr. Nzinga Harrison: Or even though you just saw that kid open the door and help an older person out, you still got a fear signal, the context clues say that’s you. And so take the opportunity, just see that every single time you get that ping, like, I might see racism in myself. Don’t judge yourself for that. Take that as an opportunity. And then when you execute that opportunity, when you think it all the way through and talk to somebody else about it, because, you know, it’s hard to be objective about ourselves, right? When you do that, give yourself the props. Like that was hard work. And the more you do it, the more you do it, the more anti-racist you are. The more it becomes a habit, the more you’re decoupling the racism that has been programmed in all of our brains. 


[56:23] Claire Jones: OK, I have just a quick message for fellow white people. One, I think guilt, white guilt, is a real thing. It’s a real thing. It’s hard to see our fellow Americans being murdered by the police. And it’s hard to see as you become more and more aware of how prominent racism is in our country, it’s really hard to not feel sad, knowing that as a white person like you are constantly perpetuating systems of oppression by existing. But I think that guilt is not productive. And the best thing that we can do is recognize that guilty and understand it comes from the privilege that we have, and then let it go. And start to take action, start to do research and start to ask yourselves the questions of how do you benefit from whiteness? And recognizing that allows you to question yourself, and then it also allows you to become more aware and open your eyes to this. Because we do have the benefit of just not seeing this. And the best thing that we can do is start to learn about how we benefit every single day from whiteness. Acknowledging and understanding our privilege without feeling guilty is hard, but is essential in order for us to be good, strong allies.


[57:34] Claire Jones: And then start asking yourself the hard questions, and once you feel like you’re at a good position where you are learning, don’t stop. As has happened so many times — like after 2014, this died down until 2016 when Freddie Gray was murdered. And then it died down and now it’s 2020 and it’s happening again. So set reminders for yourself. In six months, hey, are you still working on anti-racism? Hey, are you still reading books? Hey, are you still thinking about this and asking yourself questions? Because exactly like the quote that Nzinga said, there is no end goal here. This is a constant thing that we have to do and take action against. So there’s a ton of resources that we’ll put in the show notes. Talk to other white people about this. And use Google and use Instagram and social media. There are so many resources out there. It’s gonna be really uncomfortable. It’s gonna make you feel pretty bad. And that’s OK. We got this. We want to be there for our brothers and sisters. 


[58:33] Dr. Nzinga Harrison: That’s right. We got this. So, first of all, you took me to church with that little speech, Claire, because that was spot-on. And guilt is really designed to make us shove things in the closet. And so that’s all we’re doing. That’s what we’re doing on In Recovery. The whole reason we pushed our whole production schedule to change, to make sure that we did this racism episode today, is to shine a light on something that we absolutely have the ability to create change. We have it. We have the power. And there are more of us anti-racists than there are intentional racists. There are more of us. And so we just have to, you know, work together to challenge the systems that try to keep us quiet, to challenge the emotions that try to keep us quiet.


[59:33] Claire Jones: Yeah. I’m going to add one more thing, too, because I just thought of it. There are a lot of times in the past where I have been afraid to do anything because I’ve been scared of doing the wrong thing. And here’s the reality: you are going to do the wrong thing. And I’ve been afraid to do something because I’m afraid it’s going to come off as racist. You are racist. It’s the country that we’re born in. And it’s not your fault. And it’s OK to make mistakes as long as you’re open to receiving feedback and still moving forward and trying to improve from that. You’re going to do stuff wrong. I’m going to do stuff wrong, but we’ve got to just keep doing work. 


[01:01:07] Dr. Nzinga Harrison: I cosign this message. 


[01:01:09] Claire Jones: Thank you, everyone, for listening to this episode of In Recovery. It’s really important, and we appreciate you going along for the ride of addiction in all forms. And we will see you next week. 


[01:01:22] Dr. Nzinga Harrison: I feel like I need a closing statement. Power of the People! Black Lives Matter!


[01:01:34] Dr. Nzinga Harrison: In Recovery is a Lemonada Media original. The show is produced by Claire Jones and edited by Ivan Kuraev. Music is by Dan Molad. Jessica Cordova Kramer and Stephanie Wittels Wachs are our executive producers. Rate and review us and say nice things. And follow us @LemonadaMedia across all social platforms, or find me on Twitter @naharrisonmd. If you’ve learned from us, share the show with your others. Let’s help destigmatize addiction together. 

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