For Isha Metzger, it’s a chicken and egg question. Which came first—her interest in psychology, or her interest in helping minority populations cope with trauma?
“I had the interest, and then psychology gave me a means to a solution,” said Metzger, assistant professor of clinical psychology in the Franklin College of Arts and Sciences. “Because I had the overall goal of helping populations as well as individuals, after getting my degree in clinical psychology, I did a clinical psych postdoc in treatment development, and then I also did a postdoc in public health.”
As director of the EMPOWER Lab, she focuses on “Engaging Minorities in Prevention, Outreach, Wellness, Education and Research,” with the aim of reducing mental health disparities in the Black community, particularly for Black youth. She’s interested in preventing risky behaviors and understanding the factors that influence problematic outcomes like STI/HIV exposure, unintended pregnancies and revictimization.
One way Metzger is addressing these issues is through Project NaviGAte, a five-year, $1 million project exploring HIV and substance misuse in Cobb, Dekalb, Fulton and Gwinnett counties—four of the 48 federally designated “hotspots” hardest hit by the HIV epidemic. Project NaviGAte is funded by the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services.
Tell me about Project NaviGAte.
A lot of people in the Atlanta area aren’t aware that they are living right in the epicenter of the HIV epidemic. Project NaviGAte will connect the organizations that are providing prevention, testing and treatment for trauma, HIV and substance use. We’ll [also] look at what folks need. How can we make these services more culturally relevant to target the risk factors that lead to trauma exposure, HIV risk and substance use?
A focus of my research, and hopefully what we’ll be integrating into those centers, is the consideration of racial trauma for ethnic minority populations—making sure that they’re getting comprehensive mental health treatment.
We’re also going to conduct a public health messaging campaign. Not only for people who are already receiving services, but for the public, as well, because they are being repeatedly exposed to racial stressors. We know that 60% of people say they experience some sort of interpersonal stressor. If we’re talking about racial stressors, nine out of 10 Black or ethnic minority people say they experience those on a daily basis. The messaging campaign will equip people with skills and resources to cope with these stressors.
The final goal is to increase opportunities for testing and to spread awareness so people know where to go for culturally sensitive treatment, prevention and testing. Hopefully people will start to know more about racial trauma, and strategies for treating it and addressing it will be commonplace, just like “wash your hands” is a known way to flatten the curve of COVID-19.
How did you become interested in doing this kind of work?
I’m from a family of refugees from a civil war in Sierra Leone, so I was interested in coping responses that individuals, families and communities utilize to overcome interpersonal trauma. And then my vocabulary, my experiences and my interests expanded beyond just interpersonal trauma in the form of displacement, child abuse and sexual abuse, for example, to also include racial stressors like microaggressions and discrimination.
My overall goal was to make people aware of the connection between what we experience and how we can cope and heal. Clinical and community psychology, public health, education and awareness are how you can do that. But if I wasn’t a psychologist, I’d still be doing this work in some other way. I’d be a day care worker or a community organizer or an elementary school teacher.
Does your upbringing influence your work?
My house growing up was so influential. There were 14 of us over the years, many at the same time. We had our parents, and we had our aunts, uncles, biological and adopted siblings and cousins, but we really saw ourselves as a big nuclear family.
My dad was very intentional. He started an organization called the Association for Sierra Leoneans in Georgia. Because of the civil war, we were doing fundraisers for funerals and for family still trying to make it to America, but we also did activities locally to keep us connected back home, like African dance classes and African drum classes. We put on plays, we carved soap. We continued practicing our traditions to make sure the younger generation didn’t lose sight of our heritage and culture.
I grew up in College Park, but I was bused to Sandy Springs for school as part of what was called the minority-to-majority program. My environment growing up was very African in my immediate household and very Black American in College Park, and then very white when I got bused to school. I was engrained in all of those cultures.
I experienced going to school and facing discrimination and microaggressions from my classmates. But on the other side of that, I came home and had a father and a mom and a community that combatted all of that through racial pride messages that told me, “You come from a long history of kings and queens, and here are some of the ways we have overcome adversity and stressors.”
As I do my research now, I see the benefit of racial socialization or “the talk” as a protective factor, as something that boosts racial identity and self-esteem and the resilience of Black youth. I buy into it personally because I lived it. Academically, I’m able to conduct research that considers two people who experienced the same stressors and asks, “What in their family environment and what in their community allows one to succeed? How can we utilize strategies in our mental health treatment that will prevent the other one from struggling with harmful thoughts, negative feelings and maladaptive behaviors?”
In June 2019, Isha Metzger was a visiting professor at Yale University’s Center for Interdisciplinary Research on AIDS. Pilot funding from CIRA allowed her to develop the initial racial socialization adaptation that will be used for Project NaviGAte to deliver trauma-informed cognitive behavioral therapy and services in a culturally sensitive way. Metzger (top left) is shown with (left to right) Raquel Ramos, Barbara Guthrie, her mentor, Jasmine Abrams, Trace Kershaw, CIRA director, and Jessica Jaiswal. (Photo courtesy of Isha Metzger)
Let’s talk about “the talk” and your research.
“The talk” is a component of racial socialization. It’s how Black families talk to their kids about what it means to be Black in America. Families talk about the birds and the bees in order to protect kids from unhealthy relationships and outcomes like sexually transmitted diseases and unintended pregnancies. We also protect our kids by saying, “Look both ways before you cross a street” because it protects them and also teaches them the rules of society.
Black families are having the talk in a similar way that says, “If you get pulled over by the police, your hands go to 10 and 2, and you say, ‘yes, sir, no, sir.’ If you’re in class, you might have to raise your hand twice as much to get called on. You’re going to have to work twice as hard to get ahead.” The talk is a series of conversations you have with your child to prepare them for racial stressors. These conversations get very concrete in terms of talking about racial barriers, and they start early, and they happen often.
The talk also has racial pride messages. Previously, those were to combat a lack of representation—here’s a Black role model, or here’s what we know about Black history because you’re not reading about it in your school books. Now racial pride messages combat messages that we’re receiving with [current] events in the news. These barrier messages prepare our youth, but also teach them how to respond and how to heal after experiencing racial stressors.
Part of the work I’m doing is to integrate these messages into cognitive behavioral therapy, which allows individuals to make the connection between what they’re thinking and what they feel. It helps them to not internalize or participate in harmful outlets for coping with the race-based experiences they’re having.
My recent work includes creating a cultural adaptation to trauma-focused cognitive behavior therapy that integrates “the talk” in order to improve engagement and decrease negative consequences, an approach that will be used in Project NaviGAte. This work is influenced by my previous research evaluating existing treatment and prevention programs for African American youth.
Other recent work delves deeper into the impacts of trauma on minority populations. One such study found that exposure to violence, crime and drug usage led to collective feelings of hopelessness in Black and Latinx youth, which was associated with a host of negative outcomes.
My work has also examined racial disparities in other psychological outcomes, including a study that explored mechanisms contributing to increased suicide rates among Black youth. The results indicated that socioeconomic status, racism and discrimination, and sexual and gender minority status are important factors.
Do you feel encouraged by increasing awareness of issues facing minority citizens?
I’m definitely encouraged by the attention that’s being placed on the harmful effects of racism right now. I think initially people were overwhelmed with the media coverage. For myself and many of my colleagues, our response personally was, “Welcome.” This is work that we’ve been doing for a long time; this is work that we’ve known is important and necessary.
A lot of my work now is in reminding people that it’s OK to unplug as a behavioral strategy for coping with racial stressors. You don’t have to become oversaturated with negative messages. Once you’ve restructured your thoughts and channeled your anger into proactive strategies like calling your senators and getting out to vote, you must be sure to rest. Recover. Restore yourself. Smile. Racism takes a physical and mental toll, and one of the things we can do while combatting it is to hold on to the joy that racism tries to stem.
The clinical skills we’re teaching like mindfulness are thought to foster “Black joy” and to emphasize celebrating all of our strengths and successes as we continue this exhausting but necessary work. So yes, I’m encouraged that the work is being done, and also I’m intentional about making sure that as we’re working, working, working, we’re also recovering and restoring ourselves. Those are equally important—to eradicate racism, and to rest.
