The hidden life of a Top Boy

'Leaders are calling for disenfranchised youth to be listened to and understood': Loski – Intro

Local gangs shaped my childhood. Growing up as a Black man in London, I found myself accustomed and affiliated to 'gang life'. I experienced firsthand the violence that gang-involved young adults are at increased risk of as victims, perpetrators and witnesses. Now, as an aspiring clinical psychologist, I want the voices of young, Black men suffering with trauma to be heard. Their personal stories can deepen our empathy and understanding of how they feel after experiencing a traumatic event. The UK rap scene affirms their pain, traumas and redemption, so I have scattered lyrics from prominent UK rappers throughout this piece. 

The cycle of trauma

'So many man my age have got PTSD and I don't think that it's hit them, If you envision the way that we're living, the things that we had seen, situations that we'd been in': Dave – My 19th Birthday. [I'm pictured with Dave above... he's on the left]

People are quick to marginalise and criminalise young, Black men, but rarely comprehend the vicious webs they are trapped within. Our souls are wounded. We need to heal before this cycle of trauma rolls on to the next generation. We have a long way to go in addressing this, but it is crucial that we do, especially since various factors including the social, political and economic disadvantages faced by Black men leave them at greater risk of developing issues with their mental health.

A UK study found that 90 per cent of male gang members (aged 18 to 34) had been involved in violence in the past five years with 80 per cent reporting at least three violent incidents (Coid et al., 2013). The media coverage shapes the narrative around 'Black on Black' crime, as if this is some form of racial, culturally-induced violence that doesn't occur amongst other groups. 

Whenever I hear about violent assault or murder amongst the Black community, I think past those media accounts and the way the stories are portrayed. My mind is drawn to the aspects often omitted. One is the trauma experienced by young, Black men as the result of witnessing or being directly involved within violent activity (Cuff & Matheson, 2015).

Research shows that approximately 62 per cent of Black men have directly experienced a traumatic event in their lifetime, 72 per cent witnessed a traumatic event and 59 per cent have learned of a traumatic event involving a friend or family member (Motley & Banks, 2018). Exposure to trauma through violence is unfortunately a daily reality for many young, Black men (Bertram & Dartt, 2008). One way or another, many young Black men are carrying around the burden of trauma. I see their heavy shoulders. 'Yeah, we know how to handle a threat, but I don't know how I handle the stress, PTSD coulda had me in a mental home but I'd rather a mansion instead': Konan in Abracadabra – Seen it all 

PTSD is an anxiety disorder which occurs following exposure to an extremely threatening or catastrophic event like severe violence. Complex PTSD occurs when people are repeatedly exposed to these traumatic events. It is thought to be more severe if the person experienced the trauma for a long time and was alone during the trauma. Individuals with either of these labels may re-experience the trauma, avoid stimuli associated with the trauma and will have increased arousal. This can lead to increased irritability, outbursts of anger, difficulty managing emotions, feelings of shame or guilt and suicidal ideation. Traumatic experiences lead to altered perceptions of safety within everyday life, causing people to remain in a heightened state of threat and panic (Overstreet & Braun, 2000). 'Anxiety every time I hear the door knock I gotta be brave': Little Torment – Stress. 

As a result, people who have experienced trauma may cut themselves off from friends and family, and engage in yet more risky behaviours. High levels of PTSD are linked to violent experiences, and the more violence a young person is exposed to the greater the PTSD symptoms (Abram et al., 2004). And so the cycle continues… can we help to break it?

The response

In my personal and professional life, I see young Black men struggling to acknowledge or cope with the symptomology that comes with trauma. That begins with barriers to seeking help in the first place. Black men are approximately half as likely as their White counterparts to use professional mental health services (Hankerson et al., 2011). 

One of the biggest factors preventing young, Black men from accessing support, from what I've seen, are the norms and social constructs which govern their response to situations. Young Black men may be influenced by both internal and external expectations to 'man up' or to 'get over it'. They are left to deal with the emotional, psychological and physical ramifications of their traumas alone.  

Some young Black men also have internalised cultural beliefs about therapy. They believe that by engaging within therapeutic interventions, they may be 'snitching' if they end up disclosing pertinent details about a traumatic event. That's against the 'street code': they must handle the situation themselves. 'I can't trust the police force': Headie One – Don't Judge Me. 

Some will self-medicate with alcohol or drugs. It is common for young, Black men to use cannabis to help numb their feelings and symptoms. There is a strong relationship between violent injury, trauma and substance use. 'Just to get away I take a toke': Stormzy – Lay Me Bare. 'Mummy telling me I need a counsellor 'cause I'm drinking too much and there's smoke in my lungs': Ramz – Think Twice About Suicide

Some will isolate and withdraw into their homes, avoiding people and the streets. 'Took a little break from the game, started praying, man, I had to get my mind right': Stormzy – First Things First

Some will escape their residential areas and stay with other family members, with the hope of appeasing their feelings of anxiety. 'How can this be home when I feel I wanna flee here?': Headie One – Don't Judge Me

Some will walk around with weapons in order to feel somewhat safer. 'To be safe, I gotta pick my gun up, Just in case cah they just might run up, They want me dead and I just can't let up, That's just the usual': Abracadabra – How we living

Some will be forced to remain in their environment, surrounded by triggers and reminders of the trauma. They may also face possible retaliation of serious injury or death. People will arm themselves or recruit friends to exact revenge (Rich & Grey, 2005). 'They took an L but made sure the next letter coming was M': Ghetts – Window Pain. 'Billy died but I've been sleeping better, and that's ever since an opp went to sleep forever': Fredo – Ready 

Retaliation appears to be the most probable response after people have witnessed a friend or loved one be killed. 'Retaliation is a must when I buck my opps there's no remorse': Dutchavelli – Bando Diaries 

Safety, strength and self-esteem

We need to do better as a community to ensure their needs are being met. How are we providing a safe space for young, Black men to discuss their traumas? 'Torn between seeing a therapist or a pastor, Think about it, Heaven or Hell, what would you rather? I've lost friends I still hope to see in this life after': Chip – 0420; R.I.P Black The Ripper. 

How are they coping with what they've seen and done? 'How can I talk about killing my opps and in the same breath say Black Lives Matter? My issues are deep rooted': Ghetts – Mad About Bars S5: E7 

What sense are they making of these experiences? 'I don't know why me and dem oppers started beefin, do I blame me or the Willie Lynch theory?': Headie One – Don't Judge Me. 

If cultural context is important when seeking mental health care, what provisions are in place for young Black men to access support from mental health professionals? How will professionals bridge the gap to identify and understand the intricacies that get people entangled within gang life and violence? Representation is powerful: 6 October 2020 was the first time I saw and was lectured by a Black male clinical psychologist. 

Mental health services have a troubling relationship with us; we are undertreated in the community but yet over-represented on psychiatric wards. We are more likely to access services through coercive pathways and less likely to access help ourselves. Interventions need to take all this into account in establishing a sense of safety, strength and self-esteem. 

'Some of you may know, I'm currently going through mental health problems. As a young black boy it was, or should I say, it is very tough to come out and tell people that, you know, you're going through those things, Some may look at it as embarrassing or such a scary thing to do, cos you don't know if people will understand what you're actually going through': Ramz – Before it's too late

Systems

Bronfenbrenner's ecological theory explains how an individual is located within a nested structure of 'systems'; influenced by their social context and relationships with others such as family, friends and institutions. At the micro level, psychoeducation around relaxation skills, coping strategies and emotion-regulation could be helpful before trauma-specific aspects are addressed (Cohen, Berliner & Mannarino, 2010). But the intervention can't stop there! We need to be cognisant of the mesosystems, exosystems and macrosystems surrounding young Black men: to work with them to understand their struggles and the rationale behind harmful behaviours. We also need to better understand the impact of the violence and subsequent trauma on the family system overall. 'I come from where the mothers are worried, sun comes up and their sons haven't come in': Ghetts – Proud Family 

To facilitate help-seeking we must work more collaboratively with the Black community, support volunteer organisations and provide better community in-reach programmes. Targeted campaigns enlisting the help of role models could also help raise awareness around trauma. At the macrosystem level, we need legislation and policies created to foster mental health care, specifically focusing on the adverse outcomes and traumatic experiences of young, Black men. At this level we also need to be addressing the narrative that surrounds this group. We are more than the threatening, fear-inducing stereotypes forced upon us. We need culturally-sensitive, curious psychologists who show humility. We need to involve them and the Black community in service development, so we are creating interventions which are relatable for this population (Lindsay, Strand & Davis, 2011): 'with' them and not 'for' them. 'No more betrayal, we need permanent changes, so we can move forward without turning back pages': Headie One – Don't Judge Me

Think twice

I believe we live in an unequal society with racial injustice, and some young Black men have learnt to adjust within this society to make life easier. Yet when they do wrong, we neglect the community and psychological approaches which could help to break the cycle. I have known victims, perpetrators and witnesses of violent and traumatic events. I do not see these men as 'less than', yet I feel our society has de-humanised them. 'Like what have I done to deserve this life?, I got brothers in the pen that will never see again, Got my brothers dem servin' life, And I know that you think that it serves 'em right, But I come from a place where you burn or die, Or we turn and ride, So don't blame us when we turn to the dirt we tried, I just pray we fly': Stormzy – Don't Cry For me

So think twice when you next walk past a young, Black man with his hoody up. Think twice about the feelings and possible anxieties this stirs in you. Think about the traumas they may have endured. We all have a responsibility to provide the nurture and support that may be lacking in the lives of our young, Black men.

'I didn't choose to be me, so why discriminate me?': Headie One – Don't Judge Me

Ron Dodzro 

Twitter: @NDodzro

Key sources

Abram, K. M., Teplin, L. A., Charles, D. R., Longworth, S. L., McClelland, G. M., & Dulcan, M. K. (2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of general psychiatry, 61(4), 403-410.

Bertram, R. M., & Dartt, J. L. (2009). Post traumatic stress disorder: A diagnosis for youth from violent, impoverished communities. Journal of Child and Family Studies, 18(3), 294-302. 

Cohen, J. A., Berliner, L., & Mannarino, A. (2010). Trauma focused CBT for children with co-occurring trauma and behavior problems. Child abuse & neglect, 34(4), 215-224.

Coid, J. W., Ullrich, S., Keers, R., Bebbington, P., DeStavola, B. L., Kallis, C., ... & Donnelly, P. (2013). Gang membership, violence, and psychiatric morbidity. American journal of psychiatry, 170(9), 985-993.

Cuff, R., & Matheson,  F.I. (2015). Women, trauma & incarceration: What they say, how we work.

Hankerson, S. H., Fenton, M. C., Geier, T. J., Keyes, K. M., Weissman, M. M., & Hasin, D. S. (2011). Racial differences in symptoms, comorbidity, and treatment for major depressive disorder among black and white adults. Journal of the National Medical Association, 103(7), 576-584.

Lindsay, G., Strand, S., & Davis, H. (2011). A comparison of the effectiveness of three parenting programmes in improving parenting skills, parent mental-well being and children's behaviour when implemented on a large scale in community settings in 18 English local authorities: the parenting early intervention pathfinder (PEIP). BMC Public Health, 11(1), 1-13.

Motley, R., & Banks, A. (2018). Black males, trauma, and mental health service use: A systematic review. Perspectives on social work: the journal of the doctoral students of the University of Houston Graduate School of Social Work, 14(1), 4.

Overstreet, S., & Braun, S. (2000). Exposure to community violence and post‐traumatic stress symptoms: Mediating factors. American Journal of Orthopsychiatry, 70(2), 263-271.

Rich, J. A., & Grey, C. M. (2005). Pathways to recurrent trauma among young black men: traumatic stress, substance use, and the "code of the street". American Journal of Public Health, 95(5), 816-824.