A Trauma-Informed Perspective on Hypertension in African Americans

African Americans who endure life-altering instances of racism and discrimination are more likely to develop high blood pressure than those who have not been traumatized. High blood pressure, also known as hypertension, is one of the major health outcomes that affect African Americans in the United States. There is a higher prevalence of hypertension in Blacks living in the United States rather than Africa, due to environmental and behavioral characteristics of Black Americans in the United States.

Black Americans develop high blood pressure at younger ages than any other age group in the United States. African Americans have a much higher rate of hypertension by the age of 50 than any other racial group. Black Americans are more likely to develop complications associated with high blood pressure, including stroke, kidney disease, blindness, dementia, and heart disease.

Researchers have not discovered exactly why hypertension is so common in Black individuals and communities, however, there is a belief that hypertension may be triggered by the following:

Genetic factors, such as Black Americans responding differently to high blood pressure medication than other racial/ethnic groups. Black Americans seem to be more sensitive to salt, which increases the risk of developing high blood pressure.

Environmental factors, in that scientists believe that high blood pressure in Black Americans is due to the factors unique to the African-American experience in the United States.  In the United States, 41 percent of Black Americans have high blood pressure, compared to 27% of White Americans. Social and economic factors, including racism, discrimination, and economic inequity, are responsible for these differences.

In a majority of the cases that involve hypertension, there are multiple causes that may be involved. There are no clear instances where the cause of hypertension can be determined. While there are factors such as high blood pressure or a stressful lifestyle that may contribute to hypertension, it also may be helpful to address unresolved repressed emotional pain and tension from the past.

John Henryism as a Coping Mechanism

John Henryism, a term coined by an African-American epidemiologist and public health researcher, Sherman James, investigated racial health disparities between African Americans and other racial groups in North Carolina, particularly working class African American men between 17 and 60 years of age.  James theorized that in some cases, African American men attempt to control their environment through similar attempts at superhuman performance, which may involve working harder and longer to prove one’s sense of worth. 

The term, John Henryism, originated out of a fable folk hero, John Henry, who was an African American man who worked vigorously to compete successfully with a steam powered machine, but died as a result of his effort.  The story of John Henry was a metaphor for the literature that links active coping with psycho-social stress to dysregulation of the sympathetic nervous system, which heightens blood pressure and risk for hypertension. 

African Americans have been going against the machine in a racist environment where there is a need to prove that they are better than what is perceived about African Americans in society and culture. This is a condition stemming from the inferiority complex developed since the institution of slavery from the past.

Some of the internalized messages that lead African Americans to participate in John Henryism are statements such as “When you are Black, you have to work twice as hard” or “Never let them see you sweat”.  These are the internalized messages that we must transform one's natural capacities and abilities to a hyper, supernatural level to accomplish normal objectives and goals.  These beliefs and perceptions can be dangerous and harmful to the physical, emotional, and mental health of African Americans.

Many African Americans may have grown up in emotionally and psychologically stressful living environments where the expectations for performance was unreasonably high. Children may have had parents who were not able to be present with their anger and frustrations, so they grow up without learning how to cope and manage their anger. Some came from family systems with strict and rigid political and religious views and perspectives, so they learned to hold on firmly to these perspectives. They also were conditioned to eat foods that put the body and mind under more stress, which breeds bacteria, yeast, molds, heavy metals, parasites, and viruses. Children may have learned very little on how to keep oneself physically and emotionally fit.

African American children grow up and go to work in stressful and toxic work environments, where the same habits from their families are being repeated. Avoiding one's feelings and emotions about the past rather than addressing them may contribute to high blood pressure which leads to hypertension. There is old, unhealed, repressed trauma that can play significant factor in high blood pressure. It is the hidden emotions, the ones that often are not felt or experienced, that could lead to hypertension, and many other health-related disorders.

Energetically, high blood pressure is about the stressful, unrealistic pressure that has been internalized and placed upon ourselves. This pressure leads to a sense of overwhelm, helplessness, frustration, and exhaustion. Being rigid in one's expectations, it can leave a person  unwilling to trust themselves and others.

What can African Americans do emotionally to address hypertension?
We are living in a time where the light is getting much brighter. It is become more difficult to hold onto our inner darkness -- our old, unhealed, unprocessed pain and fear. The failure to release those dark old emotions, and releasing them fully, increases our chances of becoming ill, whether it is high blood pressure or some other health condition. We have been socially programmed and conditioned to be afraid of our tears, rage, and our grief. It is not the feelings that are the issue. It is bottling up the feelings and emotions that is the presenting problem.

Self-care is important in addressing John Henryism and effects. For some, reading this may bring up feelings and emotions that require a release. Others may need the assistance of a skilled psychotherapist, bodyworker, or medical practitioner. If you have high blood pressure or hypertension, consult with your health care provider to find out which combination of treatments would work best for you, given your individual health and lifestyle.

Becoming knowledgeable about John Henryism and its harmful effects may prompt one to make changes in their lifestyle habits such as stress management, exercise and diet. Giving oneself the permission and opportunities to get comfortable with the discomfort, chaos, lower standards, and no control.

Spending time in nature is a great place to learn about the wonders of chaos and imperfection because it is all around, and we can find peace in its crooked edges, unpredictable growth patterns, and erratic sounds.

Holding enough space for anger, frustration, and rage to be felt and experienced with compassion can serve as a meditative experience for those who have hypertension in their body. Compassion naturally dissolves the charge and invites an experience of emotional clarity and understanding.

Laughing at life, as much as possible, can serve as an emotional release to reduce high blood pressure. Finding opportunities to laugh and find humor in the imperfections of life, and shifting our perspective makes life much more interesting than it is.

Here is one affirmation that can assist with the pulling and releasing of any of the repressed emotions and feelings that may need to come up:

Change me into someone who can easily release anything that is hidden in my mind and heart, anything that I may be holding -- even if I do not even know about it or what it is. I need some help with recognizing and naming whatever it is that I am feeling, and then releasing everything that needs to come up and out of me. I know that I am safe and I know that all is well with me. 

References:
High Blood Pressure and Blacks - https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-in-african-americans#091e9c5e800919ec-3-6

The Downside of "John Henryism" - https://www.hsph.harvard.edu/news/features/the-downside-of-john-henryism/​
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