Therapy News

During my first internship, I worked on a hospital unit with patients who were going through difficult health challenges, many were elderly, many poor, most were people of color or immigrants from other countries. Sometimes I’d encounter people, my role to provide bedside emotional support and group support, who’d make offensive comments. I heard older white folks who’ve watched San Francisco change a lot in the 40, 50, 60 plus years they’ve lived here, make racist comments sometimes. And in that context I felt frozen. I thought a) it’s not your job to call them out, it’s your job to provide emotional support and b) that old adage that you can’t teach an old dog new tricks. I was particularly confused about how to handle this if the patient had dementia. I can’t say I walked away knowing how to deal with this effectively or in a way that felt good to me.

Now, in private practice, with a client base of mostly white men and women in their 20’s and 30’s, stuff still comes up. And I still struggle to discern what my role is as a therapist in those moments. Also, what’s my role as a human being? Ultimately, I decided that my role as a therapist is both to support the individual and to support a greater good. These are inseparable to me. Partly because racism and other kinds of oppression are also harmful to the oppressor. So by not pointing out problematic thinking on the part of my client in regards to their blind spots when it comes to race and privilege, I’m not supporting their healing and growth. 

So here’s how a few simple approaches to therapy, that you probably already consider in your work, can incorporate anti-racism:

Meeting the client where they’re at.

At the most basic, Rogerian level, this is a great starting point for therapy. We have to try to understand our clients as they are and meet them there. So when this comes to racism and/or white privilege, this means taking the time to put their current attitudes about race into perspective for yourself. I have to say, this is a huge challenge for me sometimes. I can feel impatient. But out in the world, I think that’s ok - I can be frustrated, impatient, and very direct. As a therapist, I think it’s wise to feel it out a little bit first. Because a lot of the most effective change around this stuff is slow, and requires someone willing to be patient and understanding while a person’s views begin to shift. 

Balancing challenge with support and validation.

Therapy is really about creating enough safety and enough of a healthy attachment that our edges can be pushed. I need a lot of love and validation from my therapist so when she challenges me, I can take in her feedback. Loving, validating, and meeting our clients where they’re at doesn’t mean colluding with their harmful belief systems. You can expect to witness in your clients the various defenses and reactions that come from white fragility when faced with their own privilege and racism. 

You can support them by normalizing those reactions and putting them into context. Because I’m white, I might say “growing up white and not being exposed to much else, I know when I began seeing how deep racism really does still run in this country — and that it’s even inside of me — was a horrible shock. I didn’t want to see it and sometimes I’d try to push it away. This is a really understandable reaction.” 

You can challenge them by also asking them to stay engaged and asking them to listen to what people of color are saying about their experience. 

You can support them by reminding them that while we’re all responsible for helping to rectify the gross inequities in this country, owning that responsibility doesn’t mean hating yourself or believing you’re bad. 

You can challenge them by pointing out when their assumptions about other people are informed by racism and/or privilege.

Unpacking unconscious and/or irrational beliefs.

A lot of undoing racism is changing habit of thought. Every therapy modality has their own language for this. If I’m thinking more psychodynamically, I’m curious about unearthing what kind of deeply buried unconscious material is at play when a client is displaying their racism. I think this gets even more fascinating if we think of a social or collective unconscious and the impact that colonialism, slavery, etc. have had on all of our psyches for generations. This can be useful to talk about.

If I’m thinking more cognitively, racist beliefs are habits of thought handed down through the culture at large. We have to first help our clients identify the beliefs and then find ways to reframe those thoughts and challenge those beliefs over and over.

Like most things in therapy, it helps to continually redirect our clients away from specific content and onto their feelings. From there, we can help them uncover the deeper vulnerabilities and fears they’re defending against with their racism in order to develop new narratives. And most importantly, make space to process what it’s like for your clients to get called out.