Using the R-word in Therapy: Race

Dr. Anica Camela Mulzac
October 2022

I am a Black woman. That statement may not seem revolutionary, but for many therapists choosing to think of themselves as a racial being in the context of a therapeutic setting this declaration can very well feel revolutionary. As therapists we often, and rightly so, get so focused on creating a safe, healthy space for our clients to bring and explore their full sense of self and life experiences in therapy, that we can fail to consider how our own racial identities and experiences may impact how we show up and engage with our clients. Whether one identifies as a person of color or not, living in a racialized society requires us all, therapists and clients alike, to continually wrestle with and seek to unhook from the noxious influences of bias and prejudice that surrounds us. As a result, failing to broach the topic of race in therapy can leave us unwittingly susceptible to the larger negative social forces that may undermine our effectiveness, client experience, and clinical outcomes.

When asked, many therapists report infrequently initiating conversations on race and racial experiences in therapy with their clients of color, and even less so with their white clients (Drustrup, 2021). Instead, it can be common practice to defer to their clients, particularly BIPOC individuals, to raise the topic altogether. As a result, they may falsely conclude that a client’s silence on the topic is evidence of their wish to not engage on the matter. Choosing to refrain from therapist-led exchanges on race in session may strike as benign on the surface, with some argument that the therapist is being client centered in letting the client take point on what is discussed. While most will agree that client centered treatment is the gold standard, this practice in no way precludes therapists from highlighting matters in treatment that impact client health and functioning. In fact, one could argue that failing to do so may be a dereliction of duty. Countless research studies and anecdotal reports have long demonstrated the direct link between mental and physical health conditions and experiences of racial discrimination and prejudice (Drustrup, 2021; Sue, Alsaidi, Awad, Glaeser, Calle, & Mendez (2019).

The decision to adopt a hands-off approach to racial dialogue may instead be steeped in therapists’ own countertransference—feelings of insecurity, fear, anxiety, past experiences, etc. As a result, taking the time to explore what may be underlying one’s own reluctance to address clients’ racial identity and experiences in treatment may be highly invaluable. Your comfort in raising the topic of race in the therapy room may very well be indicative of your willingness to discuss the matter outside of the therapy room. Renowned psychologist and expert on the topic of race relations, Dr. Derald Wing Sue, uses the term “race talk” to describe “A dialogue or conversation that involves topics of race, racism, “whiteness” and white privilege.” (Sue, 2015) Among the reasons he cites for individuals’ wariness in engaging in race talk in interracial settings is that such exchanges can “arouse intense emotions such as dread and anxiety (for whites) and anger and frustration (for people of color) that disrupt communication and behaviors.” (Sue, 2015)

I truly believe that the person with the most power in the room has the most responsibility to address the hard/awkward thing in the room. Therapists typically hold inherent power in a therapeutic relationship and as such the ultimate responsibility for initiating race talk rests with them, not necessarily the client. This then begs the question: How can therapists increase their readiness to discuss race in therapy?

Consider the following suggestions:

Self-awareness: Take the time to reflect on your own racial/ethnic identity and explore the ways this identity has shaped your values, worldview, experiences, and therapeutic framework. Uncover and identify your own biases and prejudices, and process how they show up in your life. Feel free to do the above in the safety of your own therapy, with close friends and/or family, by journaling, etc.

Listen well: Be attentive to the ways others you encounter discuss race, and the experiences they share on the matter. This practice may help expand your understanding of the varied lived experiences of others, deepen your empathy, and increase your insight into the unique stressors and challenges others may face due to their racial identity.

When tempted to avoid…don’t: While it can feel safer to steer clear of dialoguing about race, repeatedly doing so may hurt rather than help your openness and willingness to navigate the rocky terrain of race talks. Lean into the discomfort, seeing it as a sign that you are engaged rather than a sign that something is wrong.

Practice humility: Acknowledge your ignorance, to yourself and others, as well as your commitment to remedying it. Take active steps to expand your knowledge and understanding of the historical and present-day manifestations of the systems of racial injustice and inequity—read books, listen to podcasts, watch documentaries, participate in workshops/trainings, attend professional/educational conferences, etc.

None of us have all the answers, but a commitment to being teachable and a willingness to take long, honest looks at ourselves gets us on the path to lifelong learning, and closer to correcting many social ills. Rather than simply seeking to “do no harm,” let us also seek to “do the most good.” Tackling the topic of race head on is certainly one way of achieving that goal.

****To listen to the Resilience Lab October 2022 playlist built with this article’s theme in mind, click here.

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