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Healing the 'Invisible Ache' behind the suicide crisis among Black men and boys


If you or someone you know may be considering suicide or is in crisis, call or text988 to reach the Suicide & Crisis Lifeline.

Actor Courtney B. Vance was a young actor on Broadway in the 1990s when he received a call from his mother that would tear his world apart: His father was dead, she said, by suicide. Years later, Vance's godson, a promising college student, would also die by suicide.

In the wake of these devastating losses, Vance has focused on peeling back the layers of both his father's pain and his own struggles as a Black man in America. In a new book, The Invisible Ache, Vance and psychologist Robin L. Smith (who often goes by Dr. Robin) explore the trauma unique to Black men and boys, and address what they see as an urgent need to change the conversation about mental health.

"[With] Black boys and Black men, the rates of suicide is increasing," Smith says. "The rate is accelerating fasterthan any other group in the country, in the United States. And so we have to ask why."

Smith points to a modern culture of isolation and loneliness, which the surgeon general has referred to as a public health emergency. But, she adds, those factors are compounded for Black men and boys.

Courtney B. Vance is an award-winning actor, known for his roles in <em>The Hunt For Red October, The Preacher's Wife, The People v. O.J. Simpson </em>and<em> Lovecraft Country.</em>
Matthew Jordan Smith / Hatchette
Courtney B. Vance is an award-winning actor, known for his roles in The Hunt For Red October, The Preacher's Wife, The People v. O.J. Simpson and Lovecraft Country.

"If we then put race and racism with isolation and loneliness, surely we understand that Black boys and Black men are up against historical trauma as well as current-day trauma," Smith says.

Though the book is focused on the mental health of Black boys and men, Vance says the issue has universal implications: "We are all interconnected. ... My ache is your ache. If I'm aching, [and] you [are] clutching your purse as I walk by, you're aching. You're as much in a prison as I am," he says.

Interview highlights

On Vance's father

Vance: He was my hero, and he was the smartest man in the room and was able to talk on any topic, which was very intimidating to me.

Smith: His father is still his hero. His father did not lose his stature because he died by suicide. And I think it's really important for us to know that when we understand that someone had a struggle that we didn't know anything about, that we don't need to punish them or ourselves for the mystery of what was unknown.

On the silence around suicide and mental health

Robin L. Smith (aka "Dr. Robin") is a licensed psychologist, <em>New York Times</em> best-selling author, and talk show host. She's known for her regular appearances as the on-air therapist for <em>The Oprah Winfrey Show.</em>
Nick Onken / Hatchette
Robin L. Smith (aka "Dr. Robin") is a licensed psychologist, New York Times best-selling author, and talk show host. She's known for her regular appearances as the on-air therapist for The Oprah Winfrey Show.

Smith: We hear the old adage that silence is golden, [but] we often don't hear the times in which silence is deadly, because there is so much moving in the inner world of a person. And if they feel isolated, if they feel that there is no safe place to explore and express what's going on inside, that manifests in lots of ways. And one of those could be suicidal thoughts. It could be thoughts that life is too much. And if you're living in that silence and isolation by yourself, it can take you to very dark and scary places.

On the shame around suicide

Smith: [The term] "committed suicide" is like a crime. Suicide is not a crime. It's an act of desperation. It's an act of running out of steam and hope. "HOPE" is an acronym that we use for "Hold On, Pain Ends." But if I don't know that the pain is going to end, if I think whether I am a young Black boy or an older Black man, that there's no way out except death to bring relief and release, the truth of the matter is that's a prison of a different kind, and so the shame is so misdirected.

On skepticism in the Black community about therapy

Smith: When I think of the disservice that that [skepticism] has perpetuated in men and particularly Black men, that "I don't want anybody to get in my head," "I don't want anyone in my business," "I don't want anyone messing with my mind." "I don't need any of that because I've got this." So all of those messages are conditioned responses to trauma and to dis- and mis-information. If you understood that you were whole and whole people need other people who are safe to explore their internal worlds, you wouldn't need the defense that you don't want anyone getting close. ...

So when you talk about stigma for therapy — that therapy is for white people, for rich people, for sick people — not only is that not true, therapy ... at its best, it's an opportunity to be in a safe space and [to] overhear the conversation that you've been having with yourself all of your life, but it's never been safe to listen.

On the trauma of living in a racist society

Smith: If you go into a store and someone is following you around simply because of the melanin in your skin, that is a traumatic moment. It's a traumatic event.

If ... a Black boy ends up being chased or shot and killed, too often, this is about: How is it that Black boys are often seen as scary and dangerous, even when they are 6 or 7 or 10? The experience that the white world has of them is their skin color and their gender, [which], put together, creates a level of fear. So that person who I'm describing, who is pathologized and demonized, can ingest that as if those lies are true and then never expose and be treated for what it has cost them to be Black and male in America.

On needing to go deep within himself

Vance: There's a mathematical formula for as high as you want a building to go, you have to go a certain amount of feet deep. And if you want to later on try to add to the height, you cannot do it. You have to tear that building down and go deeper into the ground. So if you want to go higher, you must go deeper. And I want to go higher. And it's going to cost me something. Everything that's worth doing costs you something. And just because it's hard work doesn't mean there's something wrong. It just means it does work. You got to go through it.

Sam Briger and Thea Chaloner produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Carmel Wroth adapted it for the web.

Copyright 2023 Fresh Air. To see more, visit Fresh Air.

Tonya Mosley
Tonya Mosley is a correspondent and former host of Here & Now, the midday radio show co-produced by NPR and WBUR. She's also the host of the award-winning podcast Truth Be Told and a regular contributing interviewer for Fresh Air with Terry Gross.