July is Bebe Moore Campbell National Minority Mental Health Awareness Month.
At 36, Chajuana Mayes had reached her limit.
She had relocated to a new state with her daughters and new husband, and was struggling to balance the expectations of being a mother and wife while holding down two jobs and taking care of the house. She also grappled with guilt — she’d moved her daughters away from their fathers and worried about how they were coping.
Mayes said she began overeating and drinking to manage stress, leading to excessive weight gain, other physical health issues and exhaustion.
“Every day I got up, I looked in the mirror, cried and told myself, “This can't be my life. This can't be just it,’” she said. “I was creating so much unnecessary suffering because I believed that I had to be everything to everybody once I became a wife and a mom.”
While Mayes’ story is common for many women in midlife or approaching that stage, her physical and emotional exhaustion had an additional layer. From the examples set by the women in her family and cultural representations of Black women in media, there was an unspoken understanding that her efforts were expected of a strong Black woman in America.
Cheryl L. Woods Giscombé, Ph.D., RN,, a professor at the University of North Carolina at Chapel Hill, developed the often-used framework for the Strong Black Woman (SBW) schema, noting the Black women she studied characterized the “superwoman” role into five main ideas: the obligation to manifest strength, the obligation to help others, the obligation to suppress emotions, the pressure to show resistance to being vulnerable or dependent, and the need to demonstrate a determination to succeed despite limited resources.
The duality of the Strong Black Woman schema
There’s often a paradox within the SBW schema. In some cases, it can encourage a sense of positive self-worth and pride. A study in the Annals of the New York Academy of Sciences found that even when Black women felt they had to project strength and resilience in adverse conditions, the schema offered a protective impact from negative health effects of chronic racial discrimination. However, the more detrimental aspects of the SBW schema can compromise Black women’s physical and mental health and well-being.
Taisha Caldwell-Harvey, Ph.D., a licensed psychologist and founder of therapy practice The Black Girl Doctor, regularly works with women managing the duality of the SBW schema.
“In practice, that looks like a woman who is the emotional, financial and spiritual backbone for everyone around her but has no socially acceptable space to be soft, tired, sick or in need herself,” Caldwell-Harvey said. “At the same time, it’s important to say: For many of us, this isn’t just a behavior pattern, it’s an identity. In my work with Black women, I name it as both cultural pride and survival strategy. I also invite us to look honestly at what it costs.”
In conversations with patients, Caldwell-Harvey said she sees three manifestations of the negative side of the SBW schema, all of which impact Black women’s physical and mental health.
Hyper‑independence and overwork can lead to “Black women feeling compelled to carry everything alone, to work ‘twice as hard’ at home and at work and still never feel ‘enough,’” she said.
There’s emotional suppression, which involves “a difficulty naming sadness, fear or trauma because ‘I’m supposed to be strong,’ which delays help‑seeking until crisis.” Then there are physical and maternal health risks of “pushing through pain, minimizing symptoms and being dismissed by healthcare providers who assume Black women can tolerate more, contributing to dangerous gaps in treatment and Black maternal morbidity and mortality.”
Data from the 2023 KFF Survey on Racism, Discrimination and Health: Experiences and Impacts Across Racial and Ethnic Groups illustrates some of those potential connections.
Among Black adults, women were more likely to say they were treated unfairly by a healthcare provider because of their racial or ethnic background (21% to 13%). Black adults said they were more likely to have difficulty finding a provider who could understand their background and experiences than white adults (46% to 38%), and 24% of Black adults reported negative experiences with providers that included assuming something about their lives without asking, blaming them for a health issue, refusing to prescribe pain medications or ignoring direct requests and questions.
Vanessa Anyanso, Ph.D., who got her doctorate in counseling psychology at the University of Minnesota, studied the positive and negative mental health outcomes for Black women related to the SBW schema for her dissertation. As a descendant of Nigerian immigrants, Anyanso also wanted to look at the experiences of Black women with more recent immigration family histories and found they had a similar concept of the SBW schema within contexts familiar to their cultures.
“Everyone had such a complex relationship with the SBW schema,” Anyanso said about the women in her study. “They talked of being high achieving as a positive, and something that motivated them to be successful. A lot of women took pride in being able to care for their family and broader community, and being a leader. They saw being resilient as a positive thing, as an understanding they could overcome and do whatever they needed to do.”
At the same time, the respondents talked about the mental and physical toll of living up to expectations inherent in the SBW trope.
“They talk about it being like a mask … something they have to wear and the pressure of living up to that being exhausting,” she said. “There’s a feeling of having to bottle up emotions and suppress needs because they need to finish whatever big project they have to do or to care for others.”
Making the SBW schema work for you
Seeking culturally competent mental health counseling can also help Black women working to address their relationship with the SBW schema. In her practice, Caldwell-Harvey said she doesn’t tell Black women to simply “stop being a Strong Black Woman,” but teaches them to treat it as an option, not a mandate.
“I’ll say, ‘Let’s talk about this Strong Black Woman thing,’” she said. “You are allowed to pick it up when you need it and set it down when you don’t. We get very concrete about what ‘setting it down’ looks like: asking for help, saying no, delegating, resting without guilt or letting someone else be the dependable one for a change.”
When Mayes recognized her physical and mental health would only get worse if she kept pushing herself beyond her limits, she was ready to make a change. She started with smaller steps after her own breaking point, like saying “no” more often at home and thinking about ways her family members could help around the house. She carved out time for self-care, which she said made her a more empowered and healthier wife, mother and employee.
Mayes, now 47, channeled her energy into starting a health and wellness coaching business, with the mindset of helping herself and others create personal change.
“I’m no longer in a space where I live my life on autopilot based on a belief system that isn't even mine,” Mayes said. “My life now is all about what serves me best, even if someone else disagrees with my decisions. This allows me to be truly me and live a life I enjoy.”
Caldwell-Harvey sees a generational shift in how Black women are approaching the SBW schema. While older generations might identify more strongly with the idea, she said more younger millennials and Gen Z women see the schema as a burden and more actively reject it altogether.
“That tells me the culture is ready to honor what this archetype gave us and to imagine more humane ways of being Black and woman,” she said. “You can be strong, soft, held, angry, joyful, exhausted or deeply in need. All of those are legitimate ways to be a Black woman.”
