What is race or culturally-based therapy and does it have legitimacy?
The question in my mind whilst I was training to be a therapist was whether I was a black woman training to be a therapist or a woman training to be a black therapist. This question has remained largely unanswered, mainly due to not being able to separate my race, culture and experience from my training as a therapist.
The impact of the training I undertook, meant that I had to hold my breath and make my peace with theories that were particularly Eurocentric and held what I took to be the high ground on the make-up of families, how children should be raised and what damage would ensue if the prescribed way was not experienced. I found it difficult and sometimes impossible not to feel that my own cultural and racial experience was being judged as inferior to what was being presented as the acceptable norm. However, I did get help and guidance along the way from the tutors who were of colour who had undergone the training and my white therapist who I can only describe as an ally. The overwhelming guidance and encouragement I received was not to give in and to stay the course when I found the training experience too difficult to navigate.
I could go into depth about my frustrations during this period. The main incident that has stayed with me was when one tutor gave me excellent marks and feedback for an assignment and another on the same assignment, questioned my ability to write English. I challenged the comments, and I was told that I had received good marks so why focus on the negative comments? For me, the issue was why one tutor would say I could not write in English, which is my mother tongue and another tutor provided me with the feedback of 'well written'. At the time of my training, I was a Manager responsible for a team of over 15 people, writing reports, developing training programmes and drafting policy/strategies.
As part of my training, I needed a placement in a counselling organisation, I applied for 52 placements with only 2 replies. The first reply was an apology, they had just taken an intern and were happy to consider me in 12 months. The other was an interview which proceeded well until the panel said, "Our clients may expect that their therapist is white and middle class, how would you deal with this?" At that moment, I could not say whatever nonsense I was expected to spout to show my gratitude for the opportunity, but instead, I replied "Your clients will be in for a shock as I am not white". I was given feedback that the interview went well but the service was not in a position to offer me the support I would need.
What enraged me most was that during the 4 years of my training, the seminar on diversity and race was always presented the same week as an assignment deadline. The cohort was always asked if they wanted to spend the whole session on diversity or if would they like to spend some of the time talking about what is needed for the impending assignment. Needless to say, the assignment was always the chosen option. On another course I encountered the argument that race and culture were just another difference, so why talk about this specifically when we can simply talk about the effects of being different or in the therapeutic vernacular being "other"?
It is too painful to talk about race or cultural differences within the training environment, and therefore it means that it is a "no-go area" for the therapy room. Therapists are not trained to sit with a client who requires racial or cultural understanding. Therapist of colour are often silenced and made to feel apologetic if they want to bring race into their practice.
I would argue that therapeutic empathy and positive regard for a client cannot be achieved whilst ignoring the client's race and culture. Some clients will seek out therapists who are outside their culture because they fear cultural judgment. This is not a reason or excuse to not train therapists to provide culturally sensitive and appropriate therapeutic experiences for their clients as needed.
How can race and culture be addressed in the therapy room? The training of therapists needs to change so that there is an open discussion on these topics at all levels of the training offer, Additionally, as a psychodynamic trained therapist, a review, research and updating of theories and understanding of basic principles through an intercultural lens is undertaken.
During the Black Lives Matter moment, clients began seeking therapists of colour with whom they could talk about their experiences, however many of those therapists were not able to respond as they had their own experiences of trauma in this area. It was a mess, however, perhaps it has brought about a more healthy landscape where race and culture can be thought about, discussed and voiced without needing to be apologetic or hide under the umbrella of diversity. In Britain in 2024, there is a need to address the trauma clients have experienced as a consequence of institutionalised racism, generational colonial trauma, internalised race-related shame, dealing with micro-aggression and the experience of intersectionality.
So yes I do think that there is a need for race and culturally-based therapy, and it is most definitely a legitimate area for concern, I would love to hear your thoughts on your experiences in this area or your reaction to my musings on this topic.
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