Black Lives Matter in Therapy Too
Therapists, some questions to ponder:
*If you knew a client was wearing a ‘persona’ or ‘coping mode’ during a session, would you mention it?
*If you knew they were uncomfortable mentioning a challenge - would you create a safe space to help them discuss it?
*If you were aware that they lived in fear & experienced different forms of racism - would you discuss it?
*If you knew that a client felt they did not belong, would you discuss it?
Hmm…
Let me guess, you would. You would because you know how such experiences can affect one’s view of the world, their daily functioning and psychological wellbeing, their self-esteem, their connection to others, and more. Thus, being the center of our treatment.
Black Lives Movement
In one of the last chapters of an insightful self-help book called, ‘The Unapologetic Guide to Black Mental Health’, it said the following (Walker, 2020):
“You may have to see a white therapist. In a perfect world and if you prefer one, you will find a black therapist. Because therapy relationships are so important, you may feel that you can only trust and be comfortable with a Black therapist. This feeling is absolutely understandable. You would not want to subject yourself to yet another ‘space’ where you have to pretend to not be you, avoid your African American vernacular to speak standard English or even worse, have your therapist act like she doesn’t see you as Black.”
The Black Lives Movement has become louder over the last couple of years. To me, as a Caucasian woman... being, ‘see our struggles, see our pain, see our suffering, see our injustice’. In other words, see the various challenging experiences that black people are enduring, all other the world, in different but similar ways.
White Therapist Doubt
While the Black Lives Movement was on the news and social media daily, I was seeing my clients, and one day, met my first black client. I had seen clients from various ethnicities and races over the last few years but had never worked with a black client. Luckily, I have now worked with multiple. No one had taught me how to make a black client feel safe or seen -fully- in a session, though. When asking other mental health professionals, all said not to address race, not to differentiate, not to put focus on it. Wasn’t that the point of the Black Lives Movement, though?
If you were fortunate like me - culture, ethnicities, and international psychology were taught at university. We are taught to incorporate someone’s culture into their treatment and through which the lens we see their symptoms.
Skin color was not addressed.
I panicked. How do I support black lives in therapy?! I see your struggles - how do I tell my client? Do I wait for them to mention it? An-elephant-in-the-room.
Opening the discussion…
Following their suffering online and my gut feeling– I decided to incorporate the movement into the session. I did this with all of my future black clients in the intake or second session.
“How does it feel to have a white therapist as a black person?”
Or
“Do you feel comfortable sharing your experiences as a black woman with me?”
Or
“I’m white in a white-dominated world - can you tell me how being black in such a world is for you?”
Or
“Do you have any concerns seeing a white therapist?”
I encourage white (and other) therapists to question whether they should address race - in a way they are comfortable with- to their clients. Why? Two words, RACIAL TRAUMA.
Addressing this opens the discussion and shows our clients that we know it is important. Moreover, we see them, their pain, their struggles, and the differences in their experiences within this world. Being white in this world & being black in this world…is different.
Racial Trauma
Racial stress impacts clients differently than other stressors. Sometimes, black individuals internalize beliefs through direct & indirect messages fed by this unfortunate ‘white-dominated world’.
Racism is experienced all of the time. This has psychological consequences.
Here are some examples of observed trauma responses in black clients.
Of course, this does not apply to everyone!
Explore how it is for YOUR client.
1. Black clients feel unsafe in outside environments. Some clients report being in a hypervigilant state most of the time when they are outside, in fear that something bad will happen to them. As a result, trying to seem as ‘small’, friendly, least threatening as possible (for example, reducing the volume of their voice, not wearing big or loose clothing such as hoodies, minor movements or hand gestures, avoiding eye contact with those walking by, etc). Also, wearing clothes that don’t show their body shape to avoid comments by strangers (such as about their possible curvy figure).
There are many crimes against black individuals who have not committed crimes while they were merely walking or playing on the street. They are often accused of crimes for being at the ‘wrong place at the wrong time’.
Hypervigilance is a trauma response as a reaction to such events (even through exposure by media or story telling) of racism.
2. Having a ‘white’ self. For example, changing their voice to sound ‘softer’ (black people are often told they are aggressive, intimidating, or threatening if they speak in different tones). White people are usually not told such things when they are passionate or change their tone of voice.
Also, articulating their words in a certain way (black people are often told, through indirect and direct ways, that they are less smart, including due to their manner of speaking – such as different words used in their cultures or having different accents). For example, black individuals with an African accent have often been told that they sound uneducated.
Other coping behaviors…
Perfectionism. Some clients believe they need to be perfect (academically or at work) to be perceived as the same level as their peers from other ethnicities or races.
‘If we are not perfect, we will be seen as stupid, unworthy, uneducated, less-than.’
Beliefs stemming from racist past events they have endured or through generational trauma. Behind every coping strategy is a belief that…indeed…I might be, that. This leads to Imposter Syndrome (feeling like a fraud), beliefs of defectiveness, and other challenges.
Also, perfectionism in how they may present themselves. In addition to manners of speaking, being perfect with their appearance… clothes, make up, nails, and more. While I’ve worked with obvious stains on my shoes or messy hair from cycling to work in The Netherlands, individuals falling under this category most likely would not be found looking as such out-doors or at appointments.
Otherwise,
Some individuals do not cope with overcompensating behaviors but rather, the opposite, surrendering to what is perceived to be how others view them. This corresponds with ‘labeling theory’, we become what we are told that we are, or rather, we act how others (society) expect us to.
Emotional Inhibition & Deprivation & Shame:
In addition to these examples, there is a notion in society that black individuals are ‘strong’ and can hold a lot of strength or pain, pressuring black people to adhere to that stereotype of holding in (suppressing) their pain.
Feeling emotions is often considered to be ‘white’ or ‘weak’ in black communities. Feeling anxious or depressed almost does not exist. It is not accepted. As a result, black clients are often given messages to suppress and ignore their emotional difficulties.
They are called words such as ‘Bounty’ or ‘Oreo’ = black on the outside, white on the inside.
As a result, they may experience a lot of shame related to their suffering.
There is a very present stigma attached to mental health within the black community. Mental health is not often something that is acknowledged or addressed, leading to greater trauma and psychological distress for individuals suffering. In addition, high suicide rates amongst black boys & men (despite this being a ‘sin’ in many religious communities).
Hence, it’s extremely difficult for black individuals to seek therapy, trust the safety and effectiveness of therapy, additionally, with a therapist that is not black.
Last thoughts,
Discussing race can be uncomfortable and difficult… however, to quote an Afro-Caribbean acquaintance of mine, “If you have a black client and don’t address their race, you’re having a conversation, not therapy.”
This article is not to convince anyone of anything but to shed awareness on another perspective. If you’re a black client seeking therapy, we see you, we hope that if your therapist doesn’t address race but it’s something that you’d like to address, that you’re comfortable attempting to tell your therapist this. You deserve a therapist who sees you the way that you want and deserve to be seen. Fully.