When the Therapist Turns Out to be Human

• A Therapist Looks Inward
• The Importance of Community for Black Female Therapists
• My Boundaries Come First
• The Power of Genuine and Affirming Intersectional Identities
• A Most Challenging Clinical Experience

A Therapist Looks Inward

This year has been one that has proven challenging career-wise and personally. While these challenges have offered opportunities for growth, reflection, and introspective experiences, they have arrived at a point in my career as a therapist I had never anticipated. This has been the place where I have questioned my professional identity to the point that it affected my competence and well-being.

A large part of my therapeutic identity resides at the intersection of my race and gender. With much pride, I relish identifying as a Black female therapist because it gives me a unique lens of empathy, therapeutic alliance, co-regulation, and strength in my approach to psychotherapy. So, when that identity became weaponized against me in the therapy room, I wondered how that would influence my trajectory as that Black female therapist providing mental health services to clients of intersectional identities.

If They Knew I Was Black Beforehand, Would They Want Me as their Therapist? 

Racial encounter experiences with clients often stick out in my mind and linger, leading me to wonder how many uncomfortable clinical experiences fellow Black female therapists have had like mine. Having a name that one may consider “white-passing” with a “different accent,” I often found my racial and ethnic identity a point of curiosity for new clients, particularly White clients. A few showed overt shock on their faces when they saw I was Black. Over a period, however, I have arrived at the more useful question, “If they knew I was Black beforehand, would they still have moved forward with having me as their therapist?”

A supervisor at that time called on me and a colleague with whom I had recently seen a new family for an initial co-therapy session. She told us that the parent of the identified child client expressed her desire to change therapists along with accompanying discomfort — without apparent or stated reason. My supervisor immediately expressed support for us knowing that race had to do with the parent’s choice. The atmosphere of the room was filled with laughter to “ease” the intensity of the discussion; however, at the same time, that faux lightness felt belittling to me and my own personal and professional struggles as a Black woman.

Following that early encounter with the parent of the “distressed” child, many similar experiences have occurred. These included clients requesting to change therapists due to me being “direct,” “challenging,” “a woman,” and many other reasons that had racial overtones which could easily be missed due to the ease with which these issues could be missed.

These common microaggressions directed at me as the therapist can and often have been difficult for me, as I suspect they can be for fellow clinicians in similar circumstances. I have always considered my primary role to be one of providing a brave space for clients to work towards a better and more improved mental health trajectory — while considering, when necessary, our racial differences.

I recall a former White client whom I had been seeing for a year expressing to me her desire to change therapists because my accent was not “American enough” for her. This came after a year into our work, which I thought was going well. I quickly — perhaps too much so — expressed that while I was American-born, I had not been raised in the US.

I wondered what being American enough really meant, knowing once again I was experiencing racial discrimination and prejudice. Experiences like these have often traveled alongside me. These particular clients are blind spots, as I attempt to re-focus, or perhaps shift the focus to the basic, familiar, and comfortable principles of therapy, at the clinical expense of dealing with the racial issues head-on, in –the moment.

The Importance of Community for Black Female Therapists

My road to growth, acceptance of vulnerability, and wisdom as a mental health professional has been paved by the nurturing, direct, and protective guidance of other Black women. Through their lessons and guidance, I have come to appreciate the importance of community for Black female therapists.

When I think of community, I think of phrases like safety, transparency, guidance, mutuality of goals, productivity, culture, support, open-mindedness, and encouragement. If any of these notions are also useful to other Black female therapists, then more communities need to be established for therapists with marginalized intersectional identities.

Psychologist Ariane Thomas has highlighted the importance of community for her professional growth as a private practitioner and educator. She stated, “My career started with Black women taking care of me and mentoring me into the roles that would distinguish my career as a private practitioner and educator. Two incredibly important Black women ushered and mentored me into those roles, and I will be forever grateful to them both. I have found that in both roles, I've come to the point in my career when I'm able to pay it forward. I take great pride in my ability to support and mentor young Black women entering the field both as an educator and as a clinician.”

Thomas expressed the importance of paying it forward for other generations of therapists like me and Aisha Popoola, who shared her views with me on the pressure on Black female therapists to present as role models. She said, “Being a minority in the field, I often feel the pressure to serve as a role model for aspiring Black mental health professionals, and I also want to be the best at my job in order to prove my competence as a therapist.”  

The complexity of how Black female therapists show up in the therapy room is further proof of the importance of community for Black female clinicians. Having this sense of community as a clinician is particularly important in validating the core shared, and often very challenging, experience of navigating the professional demands of the work world.

Clinician and now clinical educator, Laura Dupiton, has often raised awareness of the impact of professional growth not taught in graduate school. She said, “none of my diversity courses gave me a blueprint for holding space for someone who questioned my humanity. Learning how to hold space and boundaries that protected my personhood was pivotal to my work.”

My Boundaries Come First

Author therapist Nedra Tawab described boundaries as “expectations and needs that help you stay mentally and emotionally well.” Establishing professional boundaries as a therapist is hard enough, let alone as a Black female therapist. I have often been faced with personal and societal expectations to be cooperative, pleasant, and easily available to my clients. However, when my boundaries have been violated, and I have asserted their importance by setting limits with clients around what I will and will not accept, strong, and often negative reactions ensue.

Such was the case with a recent therapeutic encounter I had with a White client that centered around microaggression. When setting the boundaries and expressing expectations that my client respects my racial identity by bringing awareness to the insensitive and prejudiced remarks she made, I was initially met with resistance and the expectation to appease her. I felt it necessary in that moment to provide unsolicited, and more than likely unwanted racial psychoeducation.

Laura Dupiton referenced the stereotype of “The Mammy Myth,” which portrays the Black woman as subservient and happy to first meet the needs of her superiors. Laura stated, “As a supervisor and professor, being in a position of power challenged me in new ways. I was surprised to be met with entitlement, an expectation for me to be lenient and nurturing despite unethical behavior or not meeting basic expectations. I was expected to play the role and stereotype of the Mammy. This process unlocked more of a need for me to create new boundaries and expectations for myself as a leader.”  

The importance of setting a tone from the beginning of treatment as well as in work environments is expected for the Black female professional. Clinician Aisha Popoola explains, “I have learned that from the outset that setting clear and transparent boundaries with clients regarding session times, communication channels, and the scope of therapeutic involvement is always helpful. And consistently upholding these boundaries can help maintain a professional and structured therapeutic relationship.” With such stereotypes as the Mammy Myth, setting boundaries has often proven to be difficult in my experiences as a Black female therapist

The Power of Genuine and Affirming Intersectional Identities

When I asked how each of these women would describe their Black woman experience as therapists, I was met with colorful descriptions, such as a learning experience that comes with navigating stereotypes and biases, microaggressions and racial stress, trust and rapport, representation, and role modeling, and balancing professional and personal identities. Other descriptions have included “paradoxically sacred, powerful, heartbreaking, and terrifying,” and “a charmed experience that is different now than it was then.”

In my experience, some factors that contribute to this “paradoxically sacred, powerful and terrifying” experience, come from the interactions that occur between intersectional identities of me, the therapist, and those of my clients. A complicated example would be a BIPOC cis female, disabled, Christian therapist from a high socio-economic background, working with a White, non-binary, Seventh-day Adventist client from a low socio-economic background.

Ariane Thomas shares the power of genuine and affirming encounters of intersectional identities in the therapy room as she stated, “I think race, gender, and all our intersectional identities if incorporated genuinely and with affirmation into our work, can only enhance the relationships we have with clients. It is also essential that we work to find power within all their identities. I cannot imagine expecting a client to bring about change in their lives if I believe their race and gender render them basically powerless”.

She further states, “What has surprised me most that I was not taught, but that I now teach, is that in the process of engaging with a client in a way that celebrates and affirms all the identities we bring to a relationship, I learn and grow as well. I believe that in the protected space we create in a therapeutic relationship, it is important to value those aspects of our identities as strengths and sources of power”.

What Thomas highlights here is the need to recognize humanity even in professional relationships like that between the therapist and client. It is important that Black female therapists as well as others with intersectional identities be given the same respect as that which is afforded their clients. I have personally experienced collective growth between my clients and me in the therapy room which has led to a stronger therapeutic alliance and productive clinical work. 

A Most Challenging Clinical Experience

More recently, I suffered from a therapeutic experience I believe to be common among the Black woman’s struggles at work and in career-driven environments: downplaying her value to make others comfortable, proving her competence and ability to navigate explicit racist or sexist encounters.

Following this experience, I began struggling with self-doubt, motivation, imposter syndrome, and my commitment to being the best culturally sensitive and competent therapist I could be. I quickly realized that well beyond being a clinician, I was human, which led me down the path of exploring how race, racism, and discrimination happen to the therapist in the therapy room. Through that experience and that of other respected Black female therapists, I examined the importance of community, boundaries, and the impact genuine and affirming intersectional identities play in the Black female therapist’s experience.  

As I sat during my session with my long-term client with whom I had built a strong therapeutic alliance, I experienced a chilling feeling; one I liken to feeling “small.” I sat and listened as my client recounted the difficulties and challenges of being a White woman from a middle-class family with nothing more than an undergraduate degree. She made comparisons between herself and other White colleagues whom she described as more privileged; hence, why she was more deserving of financial and professional promotions than other colleagues, including the Black ones. Additionally, she expressed feeling tired of jobs that required her to serve racially marginalized communities and stated that she has given back as much as she could.

I sat in disbelief at what I was hearing, recounting the recent incidents I had with this client where my boundaries as a Black therapist were not respected. I noticed that it became difficult for me to engage in further conversation with this client about the presenting issues that brought her to therapy as my own ruminations and feelings of just experiencing racial prejudice and ignorance came to the surface. I thought it was fortunate for this client, with whom I had a longstanding relationship, to be able to raise this racially charged topic, and in doing so, bring to their awareness the bias and ignorance in their remarks. I soon learned that I was wrong!

I took what I thought was a golden opportunity with her to say, “I am currently struggling to be present in session with you as your therapist because I could not move past some of the offensive statements that were previously said about your Black colleagues. As a Black woman who happens to be your therapist, I must bring that up with you as it is currently clouding my judgment and making it difficult to be professional.” In all honesty, I felt small, shocked, hurt, and responsible for what was happening. While trying to hold my tears and hide my fear, my immediate thought was to put my client’s needs first despite her negative reaction to me pointing out what was going on.

This client went on to respond defensively and immediately dismissed and minimized my feelings as she expressed, not understanding why I would feel triggered by the statements she made about deserving more professional benefits than her Black co-workers. She consistently put the responsibility on me to explain to her why my feelings and experiences of her racial ignorance were valid. The more I felt spoken down to, the more fear I experienced. As I tried to make sense of the interaction while remaining professional, I began experiencing physical symptoms like a headache, tightness in my chest, chills, and stutters.

I expressed to her that I needed time to process what I was experiencing with her, as it would be unfair as her therapist to carry on our work in light of this therapeutic rupture. And this rupture, I believed, was directly due to her failure to recognize and take ownership for making remarks that were racially ignorant and biased — and that hurt me deeply. The conversation became slightly heated as she persistently asked me to tell her that she was not a racist and often made apparent attempts to induce guilt because I “[was] the ‘therapist’ in the situation.” I recall stating that despite being a therapist, I was also a human being with real marginalized experiences that often led me to feel unsafe, and that I was experiencing those feelings in session with her.

I had to make the difficult decision to terminate my relationship with her, but not before and without seeking comfort and encouragement from amazing Black female supervisors who validated my experiences of guilt, responsibility, emotional dysregulation, and anxiety.

Some other experiences I had following this incident were a lot of doubt in my competency as a professional, hyper vigilance with other White clients, low mood, lack of motivation to be diligent in my work, and struggles with controlling emotional responses. Overall, as difficult as this experience was, it led me to a reflective season that birthed “the human therapist.”

After much-needed supervision, time, and education, this client and I were able to mutually terminate our professional relationship. In addition, she seemed able, or at least willing, to take accountability, which highlighted the growth she experienced in our work. It helped teach me the importance of forgiveness — even during racial encounters — and reiterated that in therapy with her, it was not about being right or wrong, but on making intentional spaces to learn from one another to be better humans.  

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