Testimonies and Healing: Anti-oppressive Research with Black Women and the Implications for Compassionate Ethical Care

People start to heal the moment they feel heard.

—Cheryl Richardson

Qualitative interviewing requires that the researcher create a context in which participants can feel heard and share stories that have historically gone misrepresented and even been silenced.¹ For qualitative researchers who employ an anti-oppressive, antiracist lens of inquiry, the interview provides a potentially liberatory process for members of marginalized communities to illuminate the injustices they have experienced. Scholars have also provided evidence that the research interview endeavor can be even therapeutic for people who are able to deconstruct and reconstruct the societal perceptions and values they attach to their own lived experiences.² In particular, qualitative inquiry has illuminated how marginalized people such as female sex workers, survivors of trauma, and individuals engaged in drug use have found the process of telling their story to be both health promoting and beneficial for raising awareness about the needs of their marginalized communities.³

Facilitating people’s storytelling process is therefore significant for critically engaged investigators, as they have both a chance and an obligation to create inclusive spaces for those who navigate systemic oppressions of criminalization and institutional and societal stigmas. Undergirded by both my clinical practice and research experiences, this commentary will reflect on the ways in which Black women’s experiences with criminalization and stigma shape their research engagement. Moreover, this reflection piece advocates for building more compassionate, antiracist spaces within bioethics and behavioral science research, promoting healing for those who navigate systemic oppressions of stigmatization.

Formerly Incarcerated Black Women, Stigma, and Research Vulnerability

Formerly incarcerated Black women fall at the intersection of many communities that navigate stigmatization. Experiences of survival sex, substance use, incarceration, and impaired ability to take care of children carry significant marks of devaluation or societal stigma.⁴ For formerly incarcerated Black women, their experiences with stigma—that is, discrediting marks that are attached to one or more of an individual’s identities and cause them to question their sense of belonging and reduce them to a tainted being⁵—also make them vulnerable participants in research. Stigma itself has been associated with research ethics-specific concerns, as participants report perceptions of coercion and emotional distress and shame within the research process.⁶ Given Black women’s intersectional, or overlapping, experiences of system-level oppression and societal stigma, it becomes critical to explore how they engage in the qualitative inquiry process. Moreover, it is critical to explore strategies for critical community-engaged researchers to explicitly employ decolonizing and antiracist research practices throughout the life of the inquiry process.⁷

Traditional scholarship has often dissociated intersectionality from a transformative and interactive praxis by condensing it to a theoretical analysis of identity processes.⁸ In this essay, I seek to center the process of research meaning making as both interactional and intersectionally experienced by participants and investigators in ways that promote anti-oppressive critical inquiry. I bring to bear decades of research, community organizing, and direct-practice experiences partnering with justice-involved communities to this current reflective process. I also write from the perspective of a Black, cisgender woman from a modest economic background situated within predominantly White institutions of education as both a contributor to and a facilitator of change. Attuned to my own intersectional identities and reflexive process, I explore how Black women’s experiences of intersectional stigma shape how they engage in research and share their experiences navigating reentry after incarceration and substance use.

Naming, Reframing, and Reclaiming

From my previous work exploring this topic,⁹ I have walked away with three critical understandings of how the qualitative research process can function for Black women with intersecting experiences of marginalization.

First, the interview process can serve as a context for naming one’s intersectional¹⁰ experiences of stigma, as these overlapping devalued statuses reinforce oppression and pose barriers to women’s ability to heal from trauma and substance use. Throughout my research investigation, participants discussed the importance and value of being able to talk about their multilayered experiences with incarceration and substance use in research contexts that were nonclinical settings.¹¹ Following imprisonment, people must still interface with various surveillance systems (for example, mental health facilities or community corrections programs such as parole and substance-use treatment) in which they are either mandated or expected to tell their stories while in fear of being labeled, punished, or diagnosed.¹² The qualitative interview space can serve as an alternative context in which formerly incarcerated women tell their stories without the fear of institutional harm and criminalization.

Through the naming endeavors of participants in my research, another process emerged that they discussed within the interview spaces. Many women reflected on how hearing their stories led them to reframe the meaning attached to their past in ways that cultivated greater clarity and understanding.¹³ Sharing experiences of navigating stigma allowed them to reflect on their strategies of resilience in ways that strengthened their personal recovery journey and healing.¹⁴ This finding contrasts with previous accounts that conceptualize interviewing as a type of excavation¹⁵ as opposed to an (unintentionally) health-promoting intervention.

Indeed, women expressed that they viewed the research process as a rich relational exchange—a place where they felt respected and heard. They also reframed the meanings attached to their criminalized experiences with substance use and incarceration. It was this burgeoning storytelling process, where women found healing, that led many to then reflectively reclaim their stories in efforts to channel the harms they experienced from stigma—for not just their own healing but also for that of others. Black, formerly incarcerated women conveyed that they viewed the sharing within the interview process as amplifying their desire to promote change in the lives of others who are at risk of facing similar harms.¹⁶ In fact, women expressed that they saw their experiences of facing devaluation and stigma as being a part of a ministry to be channeled into testimony, a tool to advocate for and reach others.¹⁷

Empowering Women, Building Trust, and Sharing Vulnerability

Considering the legacy of research misconduct as well as the multisystem barriers that justice-involved women navigate, a significant role for the qualitative researcher who seeks to understand the experiences of communities that face societal marginalization, stigma, and oppression is to facilitate storytelling in anti-oppressive and compassionate ways. Thus, first, researchers must actively engage in building relational trust. This can be demonstrated through communicating words of affirmation as women share their stories of trauma and resiliency. In my previous studies, participants expressed that they viewed the researcher’s permission-seeking process throughout the interview as building relational trust. Study respondents reported that, when they perceive the interviewer as actively checking in to make sure they are comfortable answering questions, they feel empowered and cared for.¹⁸ Moreover, this kind of attuned interaction with participants gives them the context to intentionally name their trauma—specifically stigmatization—and be heard. While a participant’s experiences of trauma can impede the qualitative inquiry process, the researcher’s work in creating research spaces to discuss and validate these stories can build a relational sense of safety and deepen disclosure.¹⁹ The researcher’s role as validating participants’ storytelling process is critical when participants are sharing highly sensitive stories of stigma, structural violence, and harm. Indeed, entering the meaning-making world of others requires compassion and empathy. As Kathleen Gilbert explains, “It is not the avoidance of emotions that necessarily provides for high quality research. Rather, it is the use of our emotions that benefits the research process.”²⁰

Lastly, the process by which researchers share their own stories with participants about how they came to do the research and community work they are engaged can also be a significant step toward advancing antiracist compassionate research. The process of giving up one’s story is often seen as a way of promoting equity, as the researcher then too becomes vulnerable.²¹ Moreover, this research sharing process signifies a commitment to engaging in the instrumental work to promote relational security for participants in community-engaged inquiry. Fundamentally, it’s by foregrounding a framework of social justice and ethical care that we advance research knowledge that more intentionally disrupts systemic sources of racial and social injustice.²² It’s within this very intentional process—of creating reflexive and compassionate research spaces where Black women are heard—that healing emerges.

Broader Implications for Health Research and Clinical Practice

Emerging scholarship investigating the experiences of women of color participating in clinical health trials, as well as reproductive and sexual health research, has found that the researcher-participant relationship can have critical implications for advancing health equity. According to study participants, factors that promoted research engagement included perceptions of researchers as trustworthy and community-based collaborative partnerships with the targeted population.²³ While anticipatory concerns of racialized medical mistrust were expressed, the prospect of promoting community health and justice as well as the personal benefit of better health motivated women to engage in research. These research efforts suggest the importance of using compassionate ethical care to address health disparities within diverse communities.

While this essay explores ways in which qualitative inquiry can be health promoting, research endeavors have often been experiences of significant devaluation and stigmatization for marginalized communities that already experience myriad forms of violence and criminalization within the larger society. There is significant evidence that historic incidences of research racism and maltreatment inflicted upon women, particularly marginalized women of color, continue to shape engagement in research.²⁴ Emerging critical scholarship also suggests that Black women face structural barriers and silencing from various social service institutions that provide care, such as community mental health clinics and substance-use and child-welfare services.²⁵ These systemic harms in health practice not only create formidable barriers to clinical care but also elevate the call for advancing compassionate ethical care in antiracist research that seeks to illuminate these lived experiences.

The call for greater ethical care and reflexivity in research practices can have implications for health care practitioners and social workers alike. In efforts to address and mitigate risks, some health service organizations serving communities with already stigmatized experiences of mental health or substance use illnesses have become principally focused on the surveillance of clients in ways that reinforce harm and stigmatization and impede their well-being.²⁶ Service mechanisms focused on monitoring and control devalue and delegitimize the need for therapeutic alliances that can ameliorate that impacts of systemic oppressions on patient well-being.²⁷ Advancing research endeavors in which marginalized communities can tell their stories of societal and multisystemic harm further promotes health care practices embedded in social justice and ethics. Moreover, such research endeavors center client agency and compassionate care by considering the implications of privilege, oppression, and power on therapeutic practice and practitioner-client relationships.²⁸