Recovering while Black

Race, belonging and the Black body in substance use recovery spaces  

Black people in treatment can sit in the same group and receive the same services while carrying a reality no one else in the room is equipped to acknowledge. image credit: Shutterstock

When I think about the places where I learned to recover, I remember the feeling of being watched. 

Not because someone was always looking directly at me, but because being Black in those spaces meant I was rarely allowed to forget I was Black because I was in isolation as one of one, or one of few. I entered treatment because I needed somewhere to heal. Instead, I found myself navigating a familiar set of questions: Was I safe here? Did I belong here? Would anyone understand what I was carrying into the room with me?

Isolated inside rehab

When I entered residential treatment, there were four Black women in the facility, including me. None of the clinicians or aides were Black. The only Black people I regularly encountered were dining staff members and the two other Black women receiving treatment alongside me. I was in a predominantly white recovery environment, in a predominantly white geographical area; it was impossible to ignore.

At times that isolation was quiet but sometimes it was explicit.

I overheard white women describing Black women as “loud,” “ghetto,” “trashy,” and “nasty.” When I reported what I had heard, the response was not to address the racism I had experienced but to punish me for recording what was said and violating a no-cell phone rule.

It was in that moment I realized how unsafe I was in that environment. It stayed with me because of what it communicated: racism was treated as peripheral while punishing me was actionable.

During the same residential stay, a white male client repeatedly used the n-word toward older Black men. He wasn’t removed and there was no meaningful response that I could see. On the other end of the campus, the two other Black women who had entered treatment with me seemed to face repeated efforts to push them out — efforts that eventually worked, leaving me in true isolation as the only Black woman left.

Isolated beyond rehab

My isolation didn’t end when I moved into sober living. There were only two Black women in the facility: another woman and me. I remember how different it felt when we were alone together. Our shoulders could drop, the mask could fall, and we could breathe. But at least once a week during mandatory house meetings, when we were surrounded by everyone else, we were visible and invisible at the same time.

That contradiction is difficult to explain unless you’ve experienced it. You can be hyper-visible as the only — or one of the only — Black people in a room while also feeling unseen in the ways that actually matter. People can see your body, the skin you exist in, without understanding the reality attached to living in it.

The counseled becomes the counselor; isolation persists

Years later, I returned to school to pursue a master’s degree in clinical mental health counseling. I decided to complete my clinical residency at a substance use treatment center. This time, I was on the other side of the therapeutic relationship.

Perhaps in naivety, I expected that perspective to feel different. In some ways, it did. I had more knowledge, more language, and more authority than I had possessed as a client. But I also began recognizing dynamics I had experienced as a client playing out in the lives of Black people seeking treatment — clients directly under my care.

I found myself having conversations with Black clients about staying vigilant and looking out for one another because of racism in the surrounding community. These were conversations my white clients did not have to carry as part of their treatment; racism wasn’t a burden they had to carry alongside addiction and whatever legal matters may be haunting them.

For Black clients, recovery and race could not always be separated neatly and put away for another time. Sometimes, they ran together in tandem, one directly affecting the other.

One Black client I worked with experienced racism in their workplace and was deeply traumatized by it. Their struggles with recovery were intertwined with what had happened to them. Growing up in a predominantly Black neighborhood and school, they hadn’t experienced living in a predominantly white, small Southern town. It was a culture shock, to say the least.

Disturbing but not shocking, a white female therapist told her she was using racism as an excuse not to get better. Those words negatively impacted the client, and shortly after, they left treatment.

That sentence crystallized something I had been trying to understand for years:

What happens when a client’s response to racism is treated as a barrier to recovery rather than a response to harm?

Substance use treatment asks people to examine how trauma, relationships, environments, and experiences have shaped their behavior. But what happens when one of those experiences is racism, and the treatment environment itself does not have the cultural framework to recognize it?

Representation matters, but representation alone is not enough. Having Black clinicians in a treatment facility does not automatically make that facility culturally responsive, and having a diverse client population does not mean clients experience belonging.

The difference between access and belonging

A person can have access to treatment while still feeling isolated within it. They can sit in the same group, attend the same sessions, follow the same rules, and receive the same services while carrying a reality that no one else in the room is equipped or willing to acknowledge.

For me, that has been one of the most complicated parts of recovering while Black and later becoming a counselor-in-training.

I learned firsthand what it meant to enter a space designed for healing and still have to monitor my surroundings. Later, I watched Black clients carry that same vigilance into treatment. I watched the line between a person’s response to racial harm and a perceived failure to “make progress” become dangerously easy to erase.

Recovery cannot require Black people to pretend racism stops at the treatment center door. Healing requires room for the whole person, including the parts of us shaped by family, community, trauma, culture, and the realities of living in a racialized society. Sometimes what looks like resistance, anger, mistrust, or difficulty engaging may have a history that deserves to be understood before it’s labeled as “treatment resistance.”

I think about those two Black women in residential treatment who eventually left. I think about the woman in sober living who understood, without needing an explanation, why it felt different when the two of us were alone. I think about the Black clients I later encountered as a clinician-in-training who were trying to recover while also navigating racism outside and inside the spaces they were supposed to heal.

All of that brings me back to the same question:

How do you tell someone they are safe enough to heal when they still have to remain vigilant enough to survive?

The goal should be larger than getting Black people into treatment. The goal should be creating treatment spaces where Black people can finally exhale once they get there.