Talking about racism in therapy

The course I hated most in grad school was taught by a professor who said, “If your clients talk about the outside circumstances that keep them down and make their lives horrible, about how they’re so hard done by, they can’t ever take responsibility for their own lives.”  It was supposed to be a course on marriage and family therapy, which is a topic I love a lot on its own; but most of what I learned was about the use of institutional power, from a rich moderate liberal white guy who thought that talking about inequality of any kind was actively harmful to therapy.

I try to remember him even now because he was respected in his field and by his colleagues.  He’d run programs in schools and military bases, taught therapists-to-be, received all the marks of approval from his profession, and thought that if a therapist let their client talk about experiencing racism or sexism, they were sabotaging the therapy.  I try to remember him because I have to remember that when I meet a new client, that client has no outside indicators that I’m not exactly like him.

Meeting Black clients was always a little awkward at my first practicum, because I had to use a colleague’s office and couldn’t change any of the decor.  The office’s owner was, like me, a White woman, and not too visually distinct from me at a distance.  She’d done charitable work in Africa–I don’t know where, because the piece of paper behind her computer literally just commemorated her work at “The Orphanage in Africa”.  There were photos of her and her son standing posed with groups of Africans, with African children, with a Maasai man in traditional dress.  There was all the evidence of a White Saviour Complex in action.  Yes, there are ways to be a White North American in a helping profession in Africa and not commit the standard racist follies, but, well–one of the first of them would be not to proudly display it in terms of helping “The Orphanage in Africa”.

“Uh,” more than one Black client said, looking nervously around the room.  “Are those yours?”

“No,” I reassured them, and their shoulders went down a notch.

I was literally just finding my feet as a counsellor, and I devoted a lot of time trying to figure out just how to establish a relationship and get the work going.  My discoveries that year were all pretty elementary, but I think at the same time the simple things are the essential ones.  And one of them that I learned was: Open the door to conversations about race.

I learned it from a young Black woman who saw me because she had issues with self-confidence.  She could close or open her presentation to the world like a lightswitch; when she was “off” she was quiet, watchful, and self-contained, and when she was “on” she was gregarious, witty, insightful, and caring.  And I remember this session–It started off with her musing that she felt awkward in social situations, that she just felt out of place, like there was something “wrong” with her.  As we talked I drew out examples, and one was about her friends calling her “Sassy” as a nickname, labelling any time she was humourous or talkative as “sassy”.  It grated on her, made her feel self-conscious, too loud and outspoken.  “And they never call anyone else that,” she complained.  “Just me.”

My ears metaphorically pricked.  I’d been reading the work of Black feminists and womanists like Renee Martin and Latoya Peterson, and I knew that the Sassy Black Girl was a common racist trope, that Black women are often characterized as loud, disrespectful, angry, and unfeminine, compared to the cultural ideal of a small, quiet, deferential, perfectly feminine White woman.  It’s an entire system of belief that hurts and limits everyone in it.

So I knew that was a thing–and I also knew that we were in an area where the population was maybe 2% Black, on a good year, so the odds were that the friends who were calling my client “Sassy” were probably White or Asian.But what struck me as odd was that when we talked, she assiduously avoided using the words “race” or “Black”, and examined the entire scenario in light of her specific appearance and actions.  “Maybe I’m too loud.  I know that when I get excited I sometimes talk too much.  I think maybe that’s part of it.”

Finally I ventured, as part of an empathic reflection, “It sounds discouraging, to have your friends making these remarks that make you feel self-conscious, and honestly… sound kind of racist.”  I stumbled over the last half, with all of the awkwardness of a White person who’d been raised to think it’s rude to mention race, and was afraid of how it would go over.

She froze for a moment, and then said, “Yeah.  It is racist.”  Then she dropped her head into her hands, dancing in her chair with frustration.  “It is so racist!  They don’t even mean to be, but oh my god!  I can’t believe how racist it is!  It’s all these little things that you can’t even point out when they happen and it is so aggravating!”

She knew it was racist.  My observation was no great insight for her into the functioning of society and the history of the term “sassy”.  She’d lived racism, learned about how to deal with it from her family, and learned academic terms like “microaggression” before I ever saw her.  What I did–what my remark showed her–was that it was okay to talk about racism in the therapy space.  Until then, I’d been potentially just like my professor: there was always a risk that if she tried to bring it up, I would shut her down and invalidate her experiences.  Race had been an invisible factor she was trying to do the therapy work without: she was literally willing to pick herself to pieces, searching for the flaw that explained why she’d been singled out for teasing, than break the unspoken rule that talking about race (with a White person, at least) was inappropriate.

What that moment taught me was that I had to noticeably hold the door open to conversations about inequality.  There is a lot that subjugated groups now about their experience that they likewise know isn’t safe to talk about with people who have privilege over them, whether the power differential is sex, race, disability, or anything else.  In therapy, clients fear that relationship-shattering moment when their therapist–someone who has so far been a warm and supportive figure–strikes out at them from a place of privilege to enforce social norms.  If I say, “Oh, let’s not make this a race issue, not every white person is racist,” I’m proving that I, at least, am a white woman it’s not safe to talk race with.And often when I opened the door, the immediate and enthusiastic response was the equivalent to, “I’m allowed to talk about racism? OH MY GOD LET ME TELL YOU ABOUT THE RACISM I’VE SEEN.”

For the next fifteen minutes, she threw herself into telling stories, becoming both animated and thoughtful.  All she seemed to want me to do was to witness, nod, show that I understood.  She worked her way from the racism she experienced at school and the loneliness of so often being the only Black person in the room, to her somewhat fragile connection to her identity as a Black woman.  Being able to contextualize her friends’ remarks instead of accepting them as objective fact helped her purge a kind of poison of the soul.  She remembered the resilience she’d been taught as a child by her relatives, who’d tried to prepare her for a racist society.  I watched her shoulders rise as she recited, “Be proud of yourself no matter what.”  Her face glowed when she talked about spending time with Caribbean people, even ones she wasn’t related to, because with them she never felt self-conscious about being too loud or too outspoken.  If anything, she felt too quiet and withdrawn, because she had been so conditioned by White society.  From out of her own memory, she pulled a way to tell her friends to quit it with “Sassy” while maintaining the friendship, and a plan to reconnect with her culture locally with a Caribbean festival being held later in the month.

Talking about race didn’t just mean that she saw that her friends were doing something wrong and should stop.  What it did was connect her to a wealth of knowledge and community that had already encountered this problem and knew how to deal with it.  It gave her self-confidence and the memory of being fiercely loved.  She remembered that society’s standards for behaviour, and for women, are artificial and broken; they have served to subjugate women and people of colour by punishing deviance.  Instead, she believed, we should have the right to break those rules and push forward to a society where people are treated equally instead of having their behaviour dictated by stereotypes.

Talking about race gave her power.  It gave her the ability to change her circumstances for the better.

That sure sounds therapeutic to me.


3 thoughts on “Talking about racism in therapy

  1. The funny thing being I totally know where the prof probably got that line from an actual useful theraputic perspective, since As You Know Bob the preponderance of people I’ve had to deal with in my life whose external locus of control really did function as “everything is someone else’s fault and so I’m the victim and don’t have to/am helpless to change and also never the one I’m the wrong and any time I have difficulty it’s me being attacked”.

    I mean, we know someone with that attitude who just left a trail of stinking wreckage for us to deal with, you know?

    Figuring out where that’s different from “this client deals with real hard shit and it needs to be acknowledged and dealt with” (race stuff especially, class stuff, sexism stuff, cissexist stuff, disability stuff) is a necessary skill. I’m not surprised that education focused on wealthy cissexual heterosexual white people that’s mostly about (let’s be honest) that same population lacks it, though.

    (I mean your story is a classic example of Not That At All. Obviously.)

    Which sucks. Also omg that office. D:

  2. “What that moment taught me was that I had to noticeably hold the door open to conversations about inequality.There is a lot that subjugated groups [k]now about their experience that they likewise know isn’t safe to talk about with people who have privilege over them, whether the power differential is sex, race, disability, or anything else. In therapy, clients fear that relationship-shattering moment when their therapist–someone who has so far been a warm and supportive figure–strikes out at them from a place of privilege to enforce social norms.”

    YES. This. and also:

    “But a therapist’s got to decide if their loyalty is to their client or the power structure.”

    Valuable realizations.

  3. Can this be required reading for every health care professional, ever?

    And “A therapist’s got to decide if their loyalty is to their client or the power structure” really succinctly and beautifully puts into words why I’ve had a powerful, visceral reaction of “I DO NOT LIKE YOU I DO NOT WANT TO WORK WITH YOU I DO NOT WANT YOU IN MY PROFESSION GIVE ME YOUR WHITE COAT AND STEP AWAY FROM MY PATIENT” to certain physicians I’ve encountered in my training, usually specialists or sub-specialists consulting on complicated, hospitalized patients we shared who were usually of color, usually poor, and usually had mental health issues, and they were only interested in dismissing my patients because they were of color, poor, or had mental health issues–in reinforcing the narrative about Those Lazy, Irresponsible People Who Need To Get A Job And Accept Responsibility. They acted totally differently toward white, middle-class, neurotypical patients. They chose the power structure in a really serious way and called it “clinical judgement”.

    And dude.


    IN CAPS.

    …And then people wonder why I want to have a full-spectrum practice, even though I know it means I will have to do everything, know everything, work long hours, earn less money, and not have a community of physicians supporting me. I believe it is beyond important for patients to have someone solidly in their corner when it comes to their health–people are smart, they know when they’re being dismissed, they know when they can’t trust someone, and being defensive and nervous and feeling ignored and dismissed and alone does not lead to healthy people.

    I’m learning that I cannot count on many or even most of my colleagues to be in my patients’ corner, and then they lie about it and say they’re “exercising clinical judgement”, and in no way do I want to associate with them or the medicine they claim to practice, so…I’m going to have a full-spectrum practice in the middle of nowhere and be solidly in my patients’ corner and be very careful and selective in who I refer to.

    Will you move to the community I practice in? Some of my patients will inevitably need a good therapist. 🙂

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