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Gloria Johnson-Powell, M.D.:
Second speaker at Creation of a Self: Color and Trauma in the Life of a Child

The second speaker reminded the audience that clinicians need to keep context in mind throughout their work. Mixing autobiographical reflections from her own childhood with experiences as a physician in different contexts, Dr. Johnson-Powell highlighted the central point of her talk, "disregard context at your own and your patients peril."

Living in a Multi-Cultural World

This presentation began with Dr. Johnson-Powell telling the story of her job interview with the Dean of Harvard Medical School. In an expectedly posh surround she was surprised to see that the Dean appeared nervous. She wasn't sure why and wondered what kinds of potentially uncomfortable political confrontations he was possibly expecting from her, would she confront him about employment practices, affirmative action and the like -- after all, Dr. Johnson-Powell did go on to be the first tenured African-American woman at HMS. Finally, as the interview wound down, he asked, "do you have any questions?" In response, both calming and surprising the Dean, she said she wanted to know how safe the government of Massachusetts is. She said she's been through 5 coups in Africa, the L.A. race riots, and she's learned that the basic concern is safety. First make sure you're safe, then deal with the politics.

She went on to describe some of the details of her own life. She grew up in Boston, and went to Girl's Latin School. She recalled an episode when she was a school girl. Black history month was approaching and she suggested to her school principal that the school should take a day to talk about Negro history. His response was dismissive. He went on that such idea would lead them to have to look at all of the ethnic groups in the school, which was very ethnically diverse. And she remembers thinking that "such a thing would be wonderful." Turks, Polish, African-Americans and all the rest all learning about who they are and where they cam from. In fact, that idea from grade school is behind her new book, Transcultural Child Development: A Portrait of America's Children.

About her recent book:

Transcultural Child Development : Psychological Assessment and Treatment
by Gloria J. Powell (Editor), Joe Yamamoto (Editor), Gail E. Wyatt (Editor)
John Wiley & Sons, 1997

From the Publisher, John Wiley & Sons

"To learn more about a child's development and life-shaping experiences, the editors study not only the behavior, learning ability and emotional expression of children, but also the cultural, ethnic and racial backgrounds. Many chapters are written by members of the cultural groups discussed. The information given in this book, combined with the background studies, will enable the practitioner and/or clinician to provide "culturally sensitive or appropriate" assessment and treatment."

All these experiences and thoughts converge on the importance of a multi-cultural paradigm for research and clinical work. Her perspective also includes the history of school desegregation in this country, the traumas of childhood, and the violence that children in Africa are exposed to. The last is important because in Africa the violence is blacks annihilating blacks. A multi-cultural perspective needs to encompass these tragic facts as well. Prejudice is often thought of exclusively in black-white terms. However, there's a consensus that the black-white model will not be sufficient for addressing racism in a multi-cultural world. Context is central even for understanding racism.

Biography of a Welfare Mother

Dr. Johnson-Powell, along with her own daughter, is currently writing a biography of her mother, someone who raised her children on welfare, although at a very different time when being a "welfare mother" had very different connotations than today. In the course of this work, she has reflected on her own experiences with racism. As a child she was obedient and bookish; good student, honor roll. Her achievements in school were a way of finding her own place in family of 5 children. Whenever she brought home an honor roll card she was rewarded with a trip to the movies and an ice cream sundae with her mother, who had not been able to go to school herself. But they soon ran into a problem since her capacity to achieve exceeded the family budget for things like movies and ice cream. She and her mother were able to negotiate a happy compromise with these rewards being saved for the main report cards.

And then there as we her great-aunt Carrie. She was quiet, a good student, and wanted to be a doctor. In her words she displayed "genteel qualities and high aspirations." Great-aunt Carrie singled her out as her favorite for these reasons and called her "her little white girl." The aunt could not have realized the suffering such a statement caused Powell and her siblings. The message was clear; if to be a quiet, good student was white, then to be black was to be the opposite -- bad. This was a message cruel to her and cruel to her siblings. She recalled one occasion where her siblings finally tired of this and retaliated against her by covering her with white flour. Mother then explained to the aunt that the title was cruel and inappropriate.

Her great-aunts expression, "little white girl" is memorable in part because it strikes to the core of the experience many children face trying to assimilate. The experience of upward mobility often has conflicts built in to it. Moving out of the ghetto brings gratification but also presents the culturally different child with many conflicts, duel messages received at home, school, church, etc. and it is a common problem for children to navigate these conflicting messages. We as clinicians can only help if we understand.

Hybridization and Living in Two Worlds

She recalled how in 1st grade a blonde child asked her how it felt to be colored. She stood out in a New England white environment as different. Her color was seen but she felt invisible as a thinking and feeling person. She was excluded from social interactions. She was outside, different. Eventually she rose to this challenge and learned to live in two worlds. She became, in her words, "a hybrid person." Again, it is not enough just to understand white to black racism. It is necessary to understand all relevant contexts. And understanding this hybridization is central to helping culturally diverse children deal with coming from a culture where, unfortunately aunt Carrie's ideas remain and "white is right, brown you can hang around, black step way back."

Transcultural Child Development : Psychological Assessment and Treatment
Table of Contents

1. A Portrait of America's Children: Social, Cultural, and Historical Context (G Johnson-Powell)

2. Puerto Rican Children in the United States (I Canino & L Zayas)
3. Children from the Middle East (W Shekim)
4. Filipino American Children (R Santos)
5. Native Hawaiian Children (F Untalan, et al.)
6. Korean American Children (W Kim, et al.)
7. Chinese Children (A Lung & S Sue)
8. West African Children (J Tuakli-Williams)
9. Children of Micronesia (F Untalan & J Camacho)
10. Children from the Former Soviet Union (D Plotkin, et al.)

11. The Culturologic Interview (G Johnson-Powell).

One way Dr. Johnson-Powell found to understand all this was by using Margaret Beal Spencer's phenomenological variant of ecological theory. This attempts to integrate findings from child development and clinical research by looking at individual, context-specific and context-dependant experience. Emphasis is placed here on understanding the individual's unique perception of an experience and how this can impact the coping responses and well being of a child. For example, Dr. Johnson-Powell says that her mother never thought of herself as a welfare mother. Similarly she did not consider herself a welfare child; "how do you know you're poor when you have music lessons, camp, girl scouts and there was always food to eat." Economic indices do not explain her development. Her experience was not the same as the children she now sees in urban elementary schools and head start programs, where children worry about not having something to eat. In the context of what a welfare child connotes today, she was not as impoverished and her experience was far different.

All behavior is learned in a social context, beginning with the family. And those contexts are also where experience gets organized. Dr. Bell in his talk talked about the specific contexts of the children he works with, those contexts need to be understood in order to help all children, those exposed daily to violence and those exposed through television. Contextual variations must be understood. There are many different ways of expressing well being and the absence of well being.

An Easier Path to Heaven

After finishing medical school she went to Ethiopia. She did pediatric and ob/gyn. Everyone was expected to do do everything. She describes the long lines outside her clinic. Every day she had 300 children waiting to see her. And inside, in the clinic, she had enough medical supplies to help, really help only five of them. How can one understand what this experience was like?

She went on to describe how Adis Ababa is 9,000 feet above sea level. It is a cold climate. She noticed that parents were dressed warmly but the young children all arrived shoeless and in gunny sacks. She could not understand. She was perplexed that parents could take care of their own needs and not their childrens' most basic needs. She finally asked about this, asking why small children were so scantily clad and poorly provided for. Via several levels of translations her answer came back and she learned never again to disregard context. She was told, "so that he may be snatched more easily away to heaven."

The facts were clear and helped make sense of this. In Ethiopia there is a 50% mortality rate before 5. The average income was less than $10 a year and there often was not medicine to buy. It was too costly for parents to provide shoes, clothes, blankets, etc. for all children. Therefore, a cultural norm evolved of waiting till the child reached age of viability, 6 or 7, to provide for them. The most they could hope for those who did not survive to that age was a quick and painless death -- for them to be easily snatched to heaven. Dr. Johnson-Powell notes that her interpretation of these circumstances was initially limited because she simply did not understand the cultural context, in this case one heavily influenced by the extremely impoverished conditions.


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