Enough: When Sacrifice Has Gone Too Far

"Black women will do anything for people they love but not for themselves. 'Some other time' never comes." ~ Darlene

For too long I have heard iterations of this quote from my patients, all with the same underlying message: We sacrifice ourselves daily. The needs and desires of everyone else that we love come before our own. We are the last to be cared for and healed. We do not give from an overflow but rather from a lack -- a lack of time, energy and/or money. Then there is nothing left for us to use to support and nurture ourselves.

We are following in the footsteps of Sojourner Truth, the prototype for the archetype of the Superwoman -- someone who can seemingly do it all, sacrificing herself for the collective good. Her resiliency and strength in the face of the most inhumane circumstances were heroic, and she deserves the praise she's received. But when an entire nation of women tries to take on that burden, giving more than we have, running up a debt on our emotional, physical, and spiritual resources, we pay a terrible price.

Years after we were denigrated as chattel slaves, we were depicted negatively in popular culture as "Mammy" or "Aunt Jemima." These portrayals characterized us as inept, inferior, and ignorant as well as devoted to the white family. Then of course there was the "Jezebel" persona, which labeled us as temptresses to excuse our being sexually exploited in slavery. In response to these characterizations, the reference to us as "Superwoman" was born to highlight the positive attributes that developed as a result of oppression and adversity.

The dehumanizing experiences that we've endured for generations created a legacy of independence, strength and self-determination. Our resilience and perseverance enabled us to survive. We have learned how to protect ourselves, our families, and our communities.

But there are disadvantages to the Superwoman persona. As Regina E. Romero states in The Icon of the Strong Black Woman, "An overused asset that develops uncritically without ongoing evaluation and attention to changing needs and demands runs the risk of becoming a liability."

African-American women who have been vigilant, strong, resilient and brave in the face of tragedy have also suffered from inordinate amounts of stress. Even Superman has his kryptonite.

With a 40% higher death rate from heart disease and 140% higher death rate from diabetes than white women, black women are dying faster and younger from illnesses we know are related to stress and lifestyle. It is no secret that we are disproportionately represented in every major chronic disease statistic. We have greater morbidity and mortality rates than white women for nearly every major illness (American Heart Journal and National Center for Health Statistics).

According to the Centers for Disease Control, 38.1% of all African-American men over 20 are obese, and 37.6% of the same population are hypertensive. For women it is even worse: 54.2% of all African-American women over 20 are obese (and 80% are overweight), and 45.7% are hypertensive, compared to 28% of white women in the same category.

Regardless of class and socioeconomic status, not one of us is exempt from stress's debilitating effects. Racism, one of the most destructive and violent sources of sickness in America, creates stress. And it is as closely tied to us as the color of our skin. It is woven into the history of this country, it shapes our behaviors and responses to life, and it invites stress to wreak havoc. Racism results in measurable health risks for black American women, and recent studies have linked everyday discrimination to increased risk of heart problems and even cancer.

Research shows that the cumulative effects of discrimination trigger abnormal physiologic responses and poor health in African-American women through a process of constant, chronic stress described as "weathering." This physical and emotional wear and tear provokes disease and accelerates aging. Health disparities are physiological manifestations of social inequalities and the disadvantages of coping with stress.

Our health statistics are directly related to our overwhelming responsibilities of being the emotional, physical, financial, and spiritual support for our communities.

There are cumulative effects of being Superwomen -- also referred to as the Sojourner Syndrome -- we must learn to manage our stress and treat the effects. Over the last 25 years, I have treated and/or prevented all of these conditions and more with naturopathic medicine, which involves the use of nature and its elements to support the immune system's healing. The treatment may include botanical or herbal medicine, nutritional (diet) changes, nutraceuticals (vitamins, minerals and enzymes), homeopathic medicine, stress reduction techniques, and exercise routines.

Naturopathy understands that disease is the disturbance of the vital force (energy of the immune system) unique to each individual, manifesting as a state of mind and via varying physical symptoms. By integrating the use of different therapies, including botanical medicine, homeopathic medicine, and nutritional therapy, my patients have found great results and increased their quality of life. Naturopaths are licensed, medical professionals who treat people not just conditions.

Though naturopathic medicine has been around for centuries, many people, especially black people, haven't taken full advantage of this heritage. African slaves had a significant role in developing and using botanical medicine, a main component of naturopathy, from the beginning of our existence here in America. We were the "Secret Doctors." Slave narratives tell us that slaves rejected the harsh medicine given them by their masters' doctors and chose instead more familiar remedies from food, roots and herbs, almost all of which had African origins. Herbs such as Valerian, Passiflora and Chamomilla, for example, I consistently use today as part of a treatment protocol for anxiety and sleeplessness due to stress; and I use Marrubium for bronchitis, for example.

We can retreat from the brink of disaster by reclaiming a form of medicine that is our legacy: naturopathic medicine, the use of lifestyle changes and natural substances to support the body's healing mechanisms. We must use our strengths and remaining discipline to heal ourselves. Let us proclaim, Enough!

Healing Our Superwomen

Answer honestly.

Aren't you tired of being sluggish, overweight, and feeling and looking unhealthy? Aren't you tired of being in the rut of sleeping beyond the noise of the alarm clock, drinking coffee and eating donuts or a fast-food sandwich for breakfast, and eating fast food for lunch and maybe dinner, or eating no lunch at all, just a candy bar? Aren't you tired of the muscle aches, joint aches, headaches and backaches? Aren't you tired of time on the couch in front of that plug-in-drug television, sitting but not relaxing.? And most importantly, aren't you tired of all the medications, some of which are prescribed to mitigate the symptoms caused by the first medication? Aren't you tired of all the negative thoughts, feelings and energy, the resentments, guilt, fear and shame that you carry around day in and day out? Aren't you tired of being irritable, impatient, angry and anxious? Aren't you tired of taking care of everybody but yourself? Aren't you, as Fannie Lou Hammer was, just sick and tired of being sick and tired?

Apparently we as African-American women are not sick and tired enough. We continue to do what we have always done, hoping for a different result. As they say, that really is crazy. But I understand it. I understand our hearts are big and our heritage is one of being caretakers, not carefree. I understand we are the most stressed and disregarded group in America (along with, perhaps, African-American men). I understand we bear others' burdens, but no one helps us with ours. I understand we feel responsible for fulfilling everyone else's needs and desires before allowing ourselves to notice our own. And I understand why African-American women have the highest rates of long-term chronic disease out of any group in America.

African-American women also bear the brunt of the effects of job discrimination, single parenting, and alcoholic or drug-addicted partners or parents. Some of us have even suffered sexual abuse at the hands of a father, brother, mother, uncle, babysitter, grandfather, or neighbor. These detrimental effects influence how we view the world and ourselves, and how we handle life's situations. As a result from years of neglect and abuse, our mental, emotional, and spiritual health suffer to the extent that our physical health is seriously affected.

We are Superwomen.

Cheryl worked in corporate America for many years. While "successful," she was constantly aware of being African-American and female, and struggled with the pressure to perform better than her colleagues. She realized she had been underpaid in her work and brought it to her supervisors' attention, only to be met with a subsequent unsatisfactory evaluation. But her employment was the tip of the iceberg. Cheryl was obese and suffered from depression, which we traced back to her multiple childhood sexual molestations. Further conversation revealed she was the main breadwinner for her household and had been for years, as her husband was not employed. She also financially assisted one of her four siblings over the last several years. She told me that some days she just wanted to "take flight." She is a Superwoman.

Darlene is retired, but not by choice. She came to me with diabetes and depression. Many members of her family have diabetes and she, like many patients, felt she could not escape it. So she ate lots of sweets, pastries and candy and fulfilled the prophecy. She turned back to the same foods for comfort when her father passed, followed by her brother, sister and then mother. She took care of her father as he was recovering from a stroke, and her brother, who was obese. When they passed on, she began to take care of her mother, who called her all night long to get things or do things.

Darlene was so exhausted that she fell asleep at work, and ultimately had to quit after missing work when her mother's caretakers failed to come punctually. She felt her mother thought more of Darlene's siblings -- who were of a lighter complexion and who did not help her or come to see her -- than she did of Darlene. The siblings would tell Darlene what she wasn't doing correctly and how to do it better. She wept as she said, "I thought I was doing good and they were saying I wasn't. I feel guilty thinking, 'Did I do enough to help?' I just miss my father and mother and family so much. It is like a hole in my heart. I have spent all my life trying to do for others, even if they didn't ask me to. I always think I will be fine. I am finding out I am not."

Darlene Is a Superwoman.

As a sociologist and naturopathic physician, I believe that slavery and the subsequent disease of racism affects all Americans and is responsible for aggravating the underlying causes of long-term chronic diseases. Within our own families, many African-American women are treated differently from our own siblings simply because our skin tones are lighter or darker.

Whether it is depression, diabetes, hypertension, systemic lupus, arthritis, obesity or cancer, there is a story from patients in my practice of stress from abuse, anger, shame or guilt and poor self-esteem. These stories stem from the violent behaviors and fears that plague our society, behaviors that have been passed on from generation to generation. The resulting stress then suppresses the immune system and causes an imbalance between the parasympathetic and sympathetic nervous systems.

As I reflect on the diseases plaguing our community as mentioned in the previous case studies, I am acutely aware that these are not exotic, rare, mysterious ailments without treatment or understanding. These conditions are understandable, preventable and treatable, requiring lifestyle changes and treatments beyond pharmaceutical drugs.

These are chronic diseases of modern life, caused by high stress coupled with feelings of isolation and unworthiness. Whether it is as simple (or difficult) as saying "no" or walking 10 minutes three times a week, naturopathic medicine teaches necessary and effective tools for building and maintaining wellness.

It is imperative we make new choices, but we have to know and understand what they are. We have to be educated. As a naturopathic physician, I teach people how to care for themselves. It is critical at this point in our history to get back to some of the principles and practices we knew when we were first brought to America.

Choosing Style Over Health

Our perceived lack of purposeful contributions, whether from evaluations from our bosses or partners, unfulfilled relationships and dreams, the need for instant gratification, and of course the media and advertising encouraging food addictions allow us to romanticize, and desire clothing, shoes and material things more than good health.

Some of us make choices to spend our money on the best clothing, cars, jewelry, nails, hair, handbags, and tattoos. But we won't invest that same money into our health and well-being. I know that retail therapy is an important part of the American lifestyle. But when we don't take the time to put our money where our health is, we now have a very expensive handbag and hypertension.

We have to recognize that we have a choice and that we must use our choices to empower ourselves. We will be the victim of poor choices as long as we continue to make them. I've heard so many of my patients tell me that they don't have enough money to eat better or seek alternative health care. But the truth is, the money is there when we begin to prioritize our choices. One (or two!) fewer handbags per year or stretching out your trips to the hair salon could mean the difference between just looking good and really feeling good from the inside out.

A potential client told me that she could not afford to eat well, but she regularly spends upwards of $300 per month to color her hair and maintain her weave. Her monthly "looking good" budget also includes $50 for pedicures and manicures, and money for shopping sprees at Nordstrom, and monthly gambling at the local casino.

Our health is beyond crisis level. If we continue to do what we have always done, we will continue to endure what we've suffered before -- a diseased body and a weakened spirit. And what about our choice of foods? We may choose to move forward and embrace health food as a way of life, because we already know that eating soul food and processed convenience food is a way of a potentially early death.

Is It Really "Soul" Food?

As a society, until recently, Americans did not value health and the impact that poor health has on our lives, and our country. When patients come to me, I'm often their last resort after subjecting themselves to years of physical, mental, and emotional stress. For many, it's only when they are truly experiencing a life-altering tragedy or they can barely function that they reach out for assistance.

What else would you expect after being at the mercy of a society and a culture that promotes eating chemically laden substances and calling it food? We've been fooled for so long into thinking that just because it tastes good, that's it's good for you. We've actually been indulging in the opposite of what Random House dictionary defines as food, which is "any nourishing substance, eaten, drunk, or otherwise taken into the body to sustain life, provide energy, and promote growth." That definition certainly doesn't sound like most Standard American Diet (SAD).

Are We Sacrificing Good Looks for Well-Being?

Health has not traditionally been a top priority for African American women. We live in communities where our fuller bosoms and curvier hips are celebrated. White Americans and African Americans have almost opposite perspectives about what is acceptable regarding weight. Anorexia and bulimia continue to be huge problems, particularly for White female teens, while in African American culture, originating with African culture, it is acceptable to be heavier and endowed with a larger buttocks.

Historically and currently in South Africa, having more weight has been viewed as something positive. There is a dignity and respect associated with weight that represents good health and a good life. Massai men in central Africa have "fattening periods" to be more attractive to the women. It is thought that heavier bodies protect against wasting and illness. In modern times, when a person is thin in many African cultures, it is assumed that that person is going through a difficult time, a severe illness , drug addiction, or even battling HIV.

While our African brothers and sisters have packed on the pounds with traditional yams, cassava plants, and rice, we in America think that we can do the same with yams that are smothered with marshmallows or greens that have been cooked beyond their nutritional value and soaked with ham hocks and turkey necks. While most of our African counterparts are walking for miles each day, the most exercise that many African-Americans get is walking from the front door to our cars. Our curves are indeed beautiful, but we can't sacrifice shapely curves for the state of our well-being.

In Africa, we ate yams, but not with marshmallows and white sugar. We ate greens, but not with ham hocks or hog maws! We call these things "soul food," but they don't nurture our souls--they separate our souls from our bodies by inviting disease and premature death. Our diets of processed and packaged foods, dark meat chicken and saturated fats, are stressful; combined with emotional stress and repeated negative thinking and related behaviors, it's all killing us. This food may provide warm feelings and memories of home, but it may actually take you to your home-going service faster than you anticipate.

What About Stress?

When stressed, the sympathetic nervous system gives off the "fight or flight" response. Cheryl said it in the introduction: she wanted to "take flight." When we cannot respond in those ways, we endure continual stress. There are physiological consequences to this--like increased adrenal hormones, which play an important role in regulating blood pressure, and reduced blood sugar utilization and insulin sensitivity, making us more susceptible to hypertension and diabetes.
Stress also inhibits the immune function--the system responsible for destroying foreign microorganisms and generally maintaining our health--and hinders white blood cell function and production. (White blood cells make antibodies and respond to foreign substances in the body, like bacteria and viruses.)

With every indiscretion in thought, word, or deed, with every poor dietary choice, we are slowly but surely shortening our time on this planet and inviting suffering.

Sojourner Truth was revolutionary in her words and behavior. African-American women have to step into that revolutionary spirit -creating a radical departure from business as usual. We must be revolutionary in our thinking, speaking, vision and behavior. We must empower ourselves. We must take care of ourselves by creating healthier lifestyles for our bodies, minds, and souls. The revolution must begin within each of us and it must begin now.

We must shed the cape of Superwoman that we have used to guide, protect, support, nourish, nurture, and love everyone else but ourselves. We now have to don a cape that is woven with threads of awareness about self-love, good health and well-being. We are entitled to have good health and have it more abundantly. Do you really think that God put us here to be sick, broke, and to forget about us? NO!

So ENOUGH of the sedentary life style, watching TV, and snacking. ENOUGH of fighting fatigue and eating poorly. ENOUGH of struggling with weight, and a lack of motivation to exercise. ENOUGH of the gossip, negative self- talk, not loving yourself, and not recognizing that you're your greatest asset. ENOUGH of saying "Yes" all the time and doing for everyone else accept yourself. ENOUGH of dimming your light, so others may shine. ENOUGH of the guilt, anger, resentment, and shame. ENOUGH of the dis-eases, and medications. It's time to declare ENOUGH!