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What We Might Be Missing – Listening for Racial Stress in Session

19 Comments

There may be times when a client comes into a session with a specific story about racism that they experienced, and they want to talk about it.

But according to Usha Tummala-Narra, PhD, a client’s experience of racial stress will usually come up much more subtly – and it could be easy to miss if we aren’t listening carefully.

In the video below, Usha will share a case of a woman whose presenting problem did not initially seem to be connected to racism, and yet it turned out to be a critical part of her story. I’ll let Usha take it from here.

 

 

Click here for full transcript
Dr. Tummala-Narra: There’s a client whom I’ve worked with who came in and her presenting issue was to deal with some anxiety that she had in a relationship with her boyfriend. She is an immigrant and she grew up in the United States most of her life, she’s Black (Afro-Caribbean), and she was describing her relationship with her boyfriend, who’s white. She couldn’t figure out why she couldn’t deepen her sense of intimacy with him, even though she felt as though she was in love with this person and that he loved her. She couldn’t quite figure out why she couldn’t settle into the relationship. So, a couple of months into talking about the relationship and her family of origin, and just the course of their relational history, just in passing, she told me that the first time that she and her boyfriend met, that he told her that he never thought that he would be attracted to a girl from the Caribbean and specifically referring to a girl with darker skin. She continued to sort of move on in the conversation to something else, and at that moment, I heard something that seemed to be important. I didn’t quite know what that was but I stopped her and I said, “Well, what did you feel when he said that to you?” She said, “Well, at first, it didn’t really bother me, I didn’t take it personally,” but over the course of the conversation with her, it became more and more apparent that, in fact, there was something about that, unconsciously, that she worried about. It raised for her an anxiety of whether or not her boyfriend could really understand her experience as a Black woman. She wondered if he could really understand her own fears of whether he would find her attractive in a few months, in a few years, and whether she was being compared to a different standard of beauty. This issue of race and racism that manifested in the relationship in that moment with her boyfriend was connected to previous experiences and ongoing experiences of racism that she has faced and continues to face. The two really were, in the conscious level, seen as separate. They existed in separate universes, but unconsciously, they were very much a part of the same problem. Had we not explored that further in the therapy, then I could have very well attributed her concerns and presenting issues to a fear of intimacy. I could have connected that back to her family of origin, perhaps, or other things in her life, rather than really trying to see that there was a deeper source that was connected to a social problem which impacted her everyday of her life.

 

What are your biggest takeaways from Usha’s case study? Please let us know by leaving a comment below.

 
You can acquire skills for working with racial stress in our course, The Trauma of Racism: Expert Strategies to Help Clients Heal, where you will hear from 19 experts in the field of multicultural psychology.

If you found this helpful, here are a few more resources you might be interested in:

When Racism Triggers Emotional Reactivity

Working with the Trauma of Racism

Moving from Cultural Competence to Antiracism

 

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Related Posts: Antiracism, Anxiety, Relationships, Shame

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19 Comments

  1. Cynthia Lackner, Psychotherapy, Denver, CO, USA says

    I am a psychotherapist and I have recently started working with a patient who suffers with Post Traumatic Slave Disorder. Even though my patient is a black male and I am a white, Jewish, woman, I am finding ways to help him heal his multi-generational pain. I find this work fascinating and I am learning as much from him, as I hope he is learning from me.

    Reply
  2. Roz Dunn, Health Education, CA says

    racial divide is an illusion based on rhetoric in the absolute sense.
    A colleague of mine: she is black, I am Caucasian , when in group process work, heard my personal story of abuse, neglect,, which to her almost identically mirrored her own, she admitted that she thought white people were somehow exempt from such horrors. It was a moment of deep healing for her, I am happy to say. I’m glad it helped. We may not all have had slavery in our ancestry in the same way, but we have all been enslaved in a lot of different ways. Authentic and empathic listening is the key

    Reply
  3. Jo Oppenheimer, Psychotherapy, USA says

    The importance of truly listening to the client. Listening with Jung’s 3rd ear. Usha caught and did not let the connection slide because she truly listened.

    Reply
    • Heather Clay, Social Work, NZ says

      Yes this is correct and therefore she did very well to highlight the issues and explore further.

      Reply
  4. Eva E, Other, So Cali, CA, USA says

    Female bodies are heavily objectified to begin with whether in sex industry or in beauty and fashion. One may not be consciously aware, but products are developed for white people – choices of colors to the very designs and functions of products are specific to white bodies/facial structures. These are subliminal, but if your body type belongs to an ethnic group, it is felt everyday conscious or not. I think that’s what’s coming to the surface. At least that’s how I saw it.

    Reply
  5. Judith Schachter, Psychology, CA says

    There are always multiple determinants to a symptom/reaction…in the case discussed…it is unlikely to be one source though it fine the hidden source was uncovered

    Reply
  6. L R, Coach, NC, USA says

    not necessarily true, kim. as a Black woman born in America, early on in my healing journey, I encountered an exceptional white healer who without me even asking , voluntarily did a healing on me for low self-esteem and negative effects of slavery that could have been operating. prior to that I was unaware that I perhaps even needed to do any healing for the effects of Slavery. Even with current events, I would not be prejudiced in my selection of a therapist but I definitely would screen them first to see if I felt confident that they were a match for me & could help me with my desired issue (s).

    Reply
  7. L R, Coach, NC, USA says

    another toxic example of benign neglect. she definitely attracted the perfect therapist for her to truly find healing in that situation and thank God it was not you. The guy is a blatant colorist and racist.

    Reply
  8. Cindy Ames, Counseling, MELBOURNE BEACH, FL, USA says

    As a therapist, we deal with many issues that we have not personally experienced…and yet we can be highly effective and impacting as we ourselves can also be impacted in amazing ways to do better and be better. I disagree with therapists suddenly becoming hunters of racism without more research and backing about client outcomes. People come to us hurting for numerous reasons and we need to walk with them to find health without an agenda. We don’t do this with religion, politics, etc. (I will definitely seek my own help first to address racism or oppression before doing this with a client.) Racism and oppression is terribly hurtful for everyone involved physically and mentally. When it comes up or appears to be an issue, it should be processed and explored to find health and healing. As with any issue, if I am not the proper person or expert, I will refer out for their best interest. I wish all of us the best to do no harm to our clients while assisting us all to find unity in this world.

    Reply
    • charles saunders, Other, USA says

      Excellent response

      Reply
    • Wendy Johnson, Another Field, MT, USA says

      Well said, I second that.

      Reply
  9. Wendy Johnson, Another Field, USA says

    Simply a comment about many different points of view and opinion posted herein.

    Reply
  10. Rebecca Davenport, Social Work, Austin , TX, USA says

    Kim,

    Who are you refering to ‘would be afraid to go to you’. Or, are you simply reiterating that no white bodied therapist could be helpful to any person of color?

    I worry that this idea is a sweeping generalization of the type that is the prejudice we are looking to heal.

    Do you imagine a therapist with a black body could be helpful to a client with a white body?

    I appreciate the conversation. I am taking notes and look forward to more learning, dialogue and civil debate in service of awareness, reperation, and constructive connection.

    Reply
    • Kim says

      Rebecca–I was referring to the original poster, Laura. I’m sorry if my words came off as strong. I’ve had horrible experiences with white therapists, and white women in general. It could be that they didn’t know how to be with a black immigrant woman with a family history of anxiety and depression. I had therapists who made the situation worse. I needed someone to hear and understand but instead I got people who I felt could not see or hear me. I suspect that they were uncomfortable. A lot of my trauma was around my mistreatment by white folks.

      Reply
  11. Cleo Miller, Psychotherapy, CA says

    I am a Caribbean-Canadian; I must say some excellent points, but I have to agree with Kim. I can remember a time when I was experiencing systemic racism in the workplace, prior to opening up my own practice. I went to see a therapist and unfortunately there was no Black Therapist where I was living so I chose a white therapist who had lived and worked in a metropolitan city having experience with working with diverse groups of people. It was a mistake, she could not understand the depth of what I was feeling, yes she empathized and encouraged me to use my voice, but she could not relate, so the sessions were not helpful. Based on my experience, a black therapist who isn’t afraid to challenge, empower, and break down barriers, would be the best fit to address racialized trauma.

    Reply
  12. Kay Mawalom, Psychotherapy, USA says

    Laura, describing a racial preference isn’t like describing a preference for a car. Further, someone who upholds white supremacy in subtle ways shouldn’t lead us to wonder if they should diagnosed with Aspergers. What you are doing here is denying, minimizing and invalidating centuries of suffering Black bodies hold. Focus less on the White man. Focus on the Black woman. She’s the client. For once, see if you can not center whiteness. At a minimum, please ensure you don’t see Black patients if this is how you’d respond to their experience. Comments like this cause irreparable harm.

    Reply
    • Kim says

      Thank you. You said it better than I could.

      Reply
  13. Rhonda Gaines, Social Work, MD, USA says

    Let me first say that I appreciate the spirit of what is being conveyed. However, as a descendant of persons subjected to American slavery, my takeaway may be different than the norm.
    As a descendant and clinician i see many things through a new lense. Where is our voice in this “new American awareness”? Throughout history someone other than us has creates the dialogue and thus defines how we interpret our experiences.
    For me, authentic Anti-racism is more than awareness or even inclusion. In a time such as this, it is passing the mic, having a seat, and taking notes.
    Again, it is not my aim to discount Usha’s revelation nor your intention. I have been trying to conceptualize what’s whirling in my mind but, unfortunately, the big picture eludes me. Suffice it to say, all areas of American life are founded on the pathological construct of white supremacy.
    What is the goal of Anti-racism? Is this the ideal of the moment?
    Is the behavioral health community ready or for that matter interested in efficacy? Systemic change? Humility?
    Who among my esteemed colleagues is willing to experience the prolonged discomfort of confronting the privelege bestowed as a result of, not just expertise, but the profound benefit/privelege of an arbitrary and and man made construct.
    I implore all of you, let true healing, reckoning, and reparations begin with us.

    Reply
  14. Judy Hanazawa, Counseling, CA says

    This is good work to be able to work with clients who experience the variety of ways racism manifests. So good she listened closely and followed up with her client about her memory about her boyfriend’s comment about being attracted to a black woman. I am also thinking that given the therapist was also a person of colour, did that provide more possibility she could better sense the impact of this incident ? I believe there needs to be more practice development in providing appropriate ways to support clients who are dealing with racism, have trauma based on being racialized, are addressing historic racism injustices upon family, community, as well as being affected today given how society is more closely examining, reacting to, with many protesting the destructiveness of systemic racism and its manifestations within institutions such as law enforcement, etc.

    Reply

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