The Cost of Carrying Everyone: What the Strong Black Woman Schema Does to a Body

She's the dependable one. The one who remembers everyone's birthdays and doctor’s appointments. She works all day, checks on her parents, helps her children with homework, comforts her friends, and somehow still manages to smile when people ask how she's doing. People admire her. Little do they know she's also the woman who is quietly unraveling.

Sound familiar?

Black women are a double minority, marginalized by race and gender. This puts Black women at a greater risk from suffering from post-traumatic stress disorder (PTSD) (Castelin & White, 2022). For generations, Black women have been praised for being strong. We are strong enough to endure racism. Strong enough to survive sexism. Strong enough to hold families together while the world threatens to pull them apart. We are strong because what other choice do we have?

Our strength was, and still is, a survival mechanism and coping strategy (Anyiwo et al., 2022). Our identity became so wrapped up in our strength that we don’t even know ourselves outside of this superhuman strength we feel obligated to embody. This the Strong Black Woman Schema (SBWS), a sociocultural framework that encourages Black women to appear strong, resilient, suppress emotions, resist vulnerability, and prioritize caregiving at the expense of sacrificing self (Anyiwo et al, 2022). At first glance, these traits seem admirable. Who wouldn't want to be resilient? But what happens when strength isn't a choice anymore? What happens when your body never gets permission to rest?

The body keeps score. We’ve all heard this phrase before, but what does it really mean? And what does it mean for Black women facing the realities of the SBWS?

When we're under stress, our nervous system shifts into survival mode, the sympathetic nervous system activity increases, cortisol and adrenaline rise, heart rate increases, and blood pressure climbs (Lovallo, 2016).  This response is adaptive in short bursts. It is the body’s physiological response to danger and is necessary to keep us alive, hence the name “survival mode.” But It is not meant to last long term. Yet many Black women live in a constant state of chronic vigilance. From financial responsibilities, to microaggressions in the workplace, to caring for aging parents while still maintaining the household, Black women carry a lot. The body interprets all of this as stress. And eventually, stress impacts physiology.

Chronic stress exposure among Black women is linked to higher rates of hypertension, cardiovascular disease, sleep disturbances, anxiety, depression, and chronic pain conditions (Woods-Giscombe, 2010). This process is known as "weathering"— the idea that repeated exposure to social and environmental stressors accelerates biological aging (Geronimus et al., 2006). Simply put, the body ages under pressure. Immune systems weaken under stress. The burden of stress is far more than emotional. It's real, and it is measurable.

I would be remiss if I failed to acknowledge the invisible illnesses that modern medicine struggles to explain like Fibromyalgia, chronic fatigue, migraines and autoimmune diseases. They present as persistent pain with no obvious cause. But the nervous system does not separate emotional stress from physical stress (Lovallo, 2016). It responds to both. A body that spends years in fight-or-flight may eventually forget how to feel safe resulting in muscles spasms, loss of sleep, or increased inflammation. Pain pathways become sensitized. The body adapts to danger even when danger is no longer present (Lovallo, 2016).

Many Black women are left asking: "Why am I exhausted all the time? Why do I hurt everywhere? Why can't I get some sleep?!"

Society taught us that being strong was badge of honor, but no one taught us that survival has physical and mental side effects. The cruel irony is that the women most praised for their strength are often given the least permission to be human.

We are expected to care for everyone else. To endure. To persevere. To smile and not complain. To pray harder and push through. Rarely are we encouraged to ask, “Who takes care of me? What do I need? What would happen if I stopped carrying everything?”

Now, don’t get me wrong… strength is crucial to our existence. It can be beautiful. Strength built communities and preserved our culture. Strength got us here! But strength should be a resource, not a prison. Black women deserve softness without guilt. We deserve to rest without explanation. We must learn to build and enforce boundaries without apology. We deserve healthcare providers who listen to us the first time. And most importantly, we deserve the freedom to be fully human and not endlessly resilient.

We must stop wearing our pain and stress like a badge of honor. There is no reward for the most burnt out woman. Healing is creating a life where survival isn't your primary identity. And maybe that's the next evolution of strength. I recognize that this behavior is learned and passed down from generation to generation. It is remnants from our enslaved ancestors embedded in our DNA. But we must unlearn to be incessantly strong. Our health depends on it.

~ Tasiri

Tasiri is an independent health equity advocate and PhD student in Mind-Body Medicine. She writes about the intersection of health, policy, healing, and culture at TasiriSoul.

References

Anyiwo, N., Stanton, A. G., Avery, L. R., Bernard, D. L., Abrams, J. A., & Golden, A. (2022). Becoming strong: Sociocultural experiences, mental health, & Black girls’ strong Black woman schema endorsement. Journal of Research on Adolescence, 32(1), 89–98. https://doi.org/10.1111/jora.12707

Castelin, S., & White, G. (2022). “I’m a Strong Independent Black Woman”: The strong Black woman schema and mental health in college-aged Black women. Psychology of Women Quarterly, 46(2), 196–208. https://doi.org/10.1177/03616843211067501

Geronimus, A. T., Hicken, M., Keene, D., & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among Blacks and Whites in the United States. American Journal of Public Health, 96(5), 826-833.

Lovallo, W. R. (2016). Stress and health: Biological and psychological interactions (3rd ed.). SAGE Publications. https://sk.sagepub.com/book/mono/stress-and-health-3e/toc

Woods-Giscombé, C. L. (2010). Superwoman schema: African American women’s views on stress, strength, and health. Qualitative Health Research, 20(5), 668–683. https://doi.org/10.1177/1049732310361892