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It can be hard to believe that racism is committed by therapists who may consider themselves to be fairly progressive and egalitarian. After all, most of us go into helping professions because we care about people. Unfortunately, even the most well-intentioned clinician can fall prey to a sort of subtle racism called a microaggression (Sue et al., 2007).
A microaggression is a brief, everyday exchange that sends devaluing and potentially harmful messages to a person simply because that person belongs to a minority group. Microaggressions are often unconsciously delivered in the form of verbal slights or subtle dismissive behaviors. I wrote previously about some of the more egregious types of microaggressions that may be delivered by therapists lacking multicultural education (How Therapists Drive Away Minority Clients). But there are many forms of microaggressions that slip through because they are statements that may seem positive at face value. As a Black woman myself, I am often on the receiving end of these types of remarks. Although I know my friends and fellow psychologist colleagues mean well, the comments make me bristle inside.
Examples of microaggessions by therapists
The following are statements made by therapists, harvested from various sources (Constantine, 2007; Sue et al., 2007), as well as statements I have heard made by other mental health professionals. Such remarks are often meant to be supportive, and I explain why a person of color might find each of these troublesome.
“You speak good English. Where are you from?” (to a non-White client with no accent). This backhanded compliment sends the message that the client is not a real American. Asian Americans and Latino Americans are often assumed to be foreign-born, making such clients feel as if they are aliens in their own homeland. It may also communicate a belief that people from the client’s group typically lack proper education, refuse to assimilate, or are in the US illegally.
“As a gay person, I know just what it’s like to be discriminated against because of race.” The therapist is engaging in over-identification, denying or minimizing his own potential bias because of assumed similarity. The therapist is saying, “Your racial oppression is no different than my form oppression, and therefore I can’t be a racist because I’m like you.” First of all, being gay is not the same as being Black (or Hispanic, or Asian American); both may be difficult but not necessarily in the same way. Furthermore, anyone can be a racist, even a sexual minority, even someone who is in fact an ethnic or racial minority. No one is immune to the negative social messages (pathological stereotypes) that disproportionately denigrate people of color. The therapist’s statement actually proves that the therapist has no clue what it’s like to be a racial minority.
“I’m sure you can cope with this problem as a strong Black woman.” Although potentially flattering, this form of idealization overestimates desirable qualities and underestimates limitations. A Black woman may be left feeling that she now has to live up the therapist’s expectations to be strong, and therefore cannot be free to share her weaknesses and vulnerabilities. In fact, the strong black woman archetype keeps many of us working multiple jobs, overcommitted to family responsibilities, and constantly in motion, resulting in problems like high blood pressure, binge eating disorder, and absolutely no time for ourselves. And when we have no time for ourselves, therapy is the first thing to go.
“It might be okay for some people to cope by drinking because of their cultural norms.” This statement shows a perplexing acceptance of problematic behaviors based on pathological stereotypes about certain minority groups. The client may be seeking help for an alcohol problem and the therapist is not doing the client any favors by communicating approval of the behavior for any reason.
“Let’s hope you weren’t treated that way due to racism. What are some other possible explanations?” This dismissal fails to acknowledge the reality of racial discrimination as a problem in our society. It tells the client that discussion of racism will not be heard, and racism is not a valid explanation for mistreatment. It may also communicate that racist behaviors from others are the fault of the client (blames the victim), not the person who perpetrated the act.
“I don’t usually do this, but I can waive your fees if you can’t afford to pay for counseling.” This is an example of dysfunctional helping, which is patronizing to the client. It sends the message that the therapist believes the client and all members of his/her ethnoracial group are poor and in need of handouts. Certainly there are cases where a fee reduction is helpful or even essential, but this should be based on income and need not race, otherwise it is inappropriate.
Why do therapists say these things?
The often unconscious nature of microaggressions creates a major challenge to most White therapists who think that they are fair and unbiased (Sue et al., 2007), although people of any ethnic or racial group can make these mistakes. Mental health professionals tend believe they are knowledgeable about psychological issues, making them less likely to realize when these acts have occurred in their sessions.
In other words, given that is it not currently fashionable to be a racist, and most therapists genuinely want to help their clients, they may not be open to the possibility that they have in fact propagated racism. This defensive posture prevents learning and change, only ensuring that the microaggression will be repeated sometime in the future.
Most people of color have heard these types of microaggressions many times and may be willing to give their therapists an occasional “pass,” realizing that the therapist means well, despite the blunder. However, such statements communicate to clients that they are not understood and their experience as a person of color will not be addressed in a useful way. Minority clients may prematurely terminate therapy or simply decide to share only limited information with their therapists.
What can therapists do to keep from making these sorts of mistakes? That will be the topic of my next article. Also see my post on how to become multicultural.
Dr. Williams teaches and lectures on multicultural issues. She also offers a webinar for therapists on microaggressions and understanding and connecting with African American clients (3-6 CEUs).
Have you experienced a microaggression from a well-meaning therapist? I’d love to hear about your experience. Please be sensitive and respectful.
References
Chou, T., Asnaani, A., & Hofmann, S. G. (2012). Perception of racial discrimination and psychopathology across three U.S. ethnic minority groups. Cultural Diversity and Ethnic Minority Psychology, 18(1), 74-81.
Constantine, M.G. (2007). Racial Microaggressions Against African American Clients in Cross-Racial Counseling Relationships. Journal of Counseling Psychology, 54, (1), 1–16.
Sue, D. W., et al. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271-286.
Terwilliger, J. M., Bach, N., Bryan, C., & Williams, M. T. (2013). Multicultural versus Colorblind Ideology: Implications for Mental Health and Counseling. In Psychology of Counseling, A. Di Fabio, ed., Nova Science Publishers. ISBN-13: 978-1-62618-410-7.
