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In recent weeks, people across the United States and worldwide have been deeply affected by the continued violence and racial injustice against Black Americans. Some people are awakening for the first time to the persistent and pervasive nature of racial injustice and police violence toward Black people. The recent murders of George Floyd in Minneapolis, Breonna Taylor in her Louisville, Ky. home, and Ahmaud Arbery while out for a jog in South Georgia have ignited a renewed sense of anguish and outrage. Amid the resulting nationwide protests and calls for transformative change, the country is now facing a broader reckoning around systemic racism, privilege, and police brutality.
Most of us were already feeling heightened emotions in the context of an unprecedented pandemic that has added layers of sadness, tension, and uncertainty about how to participate in the movement against racial injustice. Many of our clients are experiencing an accumulation of traumas and grappling with understanding the layers of their emotions. They’re also looking to you, their mental health care providers, for support in finding the most effective ways forward. What follows is some guidance for you to support clients who are bringing these issues to sessions, as well as how to take care of yourself during this difficult time.
Recognize who is most affected
It’s important to understand that Black, Indigenous, and People of Color (BIPOC) are much more likely to experience distress in response to the race-related news of the past few weeks. On top of having to deal with the harmful physical and mental health consequences of racism every day, police killings like that of George Floyd are potent reminders of the real dangers Black and brown people face in seemingly mundane situations such as interacting with a police officer, going for a run in their neighborhood, or shopping in a department store.
It is traumatizing for anyone to witness the brutal and inhumane murders of Black and brown people that have become more widely disseminated via news outlets and social media. However, the impact of these events on people of color is far broader and deeper than simply being upset, horrified, or angry. Black people especially face regular and jarring reminders that tragic incidents like the killings of George Floyd or Breonna Taylor could happen to them or their loved ones, too. They are more aware than their white counterparts that little has changed despite years of activism and advocacy, along with lip service from politicians and corporations about diversity and justice. Black communities have the lived experience of decades and centuries of racial injustice.
Supporting clients of color
Clients of color may or may not want to discuss these issues with you. Avoid pushing clients on this topic, even if you suspect it’s on their mind. If a client does broach these issues, you may want to ask them what would be most helpful–whether it’s listening, validating, or something else. Be careful about offering interventions such as identifying thinking traps or promoting acceptance–this could be received as invalidating, especially if you have a different racial or cultural background from your client. Instead, try to learn about your client’s unique perspective and experience—not so they can educate you about racism, but to help them feel as seen and understood as possible.
Consider how your client’s unique background informs their lived experience in society. This includes recognizing the intersectionality of different parts of their identity (including race, gender, sexuality, and ability) and compounded experiences of discrimination. It’s understandable to be concerned for your clients, but it’s also important to hold them as resilient rather than fragilizing them.
If you are white and trying to support clients of color around issues of racism and systemic injustice, it can be tough to know what to say. The reality is that you lack the lived experience to fully understand what they’re going through. Bringing a sense of humility and compassion to these conversations is important. Sometimes just acknowledging that as a white person, you know you cannot fully understand their experience can help build alliance and trust. If you don’t know what to say, you can try something like, “I don’t have the words to do this justice, but I want you to know I’m here to support you however I can.” If you feel unequipped to discuss these issues, now more than ever, it’s crucial to educate yourself about racism and privilege. Our list of recommended online resources is a good place to start.
Supporting white clients
Your white clients may express a mix of grief, anger, guilt, or confusion about what’s happening right now. It’s important to respond to these emotions with compassion, just as you would for any other emotions. One potential source of distress for white clients may be a feeling of powerlessness or helplessness in the face of events they find morally reprehensible. If your client holds values around equality or racial justice, exploring how they can act on these may be the most helpful way to respond. Strong emotions usually indicate that something is aligned with or opposed to our values. Inaction in the face of injustice may be a primary source of suffering for clients who care about these issues.
In other words, the best thing for some clients may be to find ways to take actions that align with their values. You can help clients identify a range of potentially appropriate actions such as educating themselves or others about systemic racism and inequality, speaking out against racism, supporting organizations or activists, or engaging in community service. It’s easy to stay stuck in a place of fear and paralyzation—not knowing where to start or what to say— that can prevent clients from living their values. This may feel similar to other areas of stuckness clients commonly encounter, such as pursuing meaningful relationships or taking risks at work, and some of the same motivation and willingness strategies will likely help here as well.
Making space for differing points of view
Clients may present opinions or perspectives that differ from your own or even that you find offensive. Encouraging your clients to seek out more education or consider alternative perspectives is always a good idea. If your client says something you feel is harmful to a marginalized group, you can ask them to try to put themself in the shoes of someone from that group and feel what it would be like to receive that comment. Other forms of perspective-taking, such as asking your client to try to take the perspective of a compassionate third party, are also valuable tools. At the same time, it’s not your responsibility to rehabilitate a client with racist views or educate someone who’s not interested in expanding their perspective.
It’s also essential not to assume that all people of color will share similar viewpoints or frames of reference for considering these issues. Remember that people have complex, multidimensional cultural identities and life experiences. The way we talk about racism in the U.S. is rooted in our society’s white power structure, so people who have lived in or are from other countries may see things from a different vantage point. It’s always valuable to look for how your client’s perspective makes sense in the context of their personal history and to search for common humanity when you encounter new points of view.
Know that if you ever feel attacked or belittled by a client, there’s no need to be subjected to abuse. It’s okay to say you feel uncomfortable with how they’re addressing you or end the session if needed.
Taking care of yourself
Remember to take care of yourself during this difficult time. Keep in mind that the same type of self-compassion and self-care guidance you’d offer to your clients applies to you, too. That includes honoring your emotions, responding to yourself with kindness, giving yourself permission to prioritize self-care, and connecting with others for support. Review these recommendations for a refresher on self-care amid the coronavirus pandemic and other stressful times.
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Resources for clients
Scaffolded anti-racist resource guide
The death of George Floyd in context
George Floyd. Ahmaud Arbery. Breonna Taylor. What do we tell our children?
75 things white people can do for racial justice
Resources for providers
Exposing our blindspots: How to tackle unconscious bias as a therapist
Addressing client’s prejudices
When therapists face discrimination
Racial microaggressions in everyday life
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DISCLAIMER
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
ABOUT THE AUTHORS
Shane O’Neil-Hart, LCSW, is the Senior Clinical Manager of the Mental Health Coaching Program Lyra Health and an expert in Acceptance and Commitment Therapy (ACT). He serves as the Vice President of the San Francisco Bay Area chapter of the Association for Contextual Behavioral Science (ACBS), and provides psychotherapy, supervision, and training in ACT.
Nazneen Bahrassa, PhD, is a clinical manager for the Blended Care Therapy Program at Lyra Health. Her clinical specialties include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), and evidence-based treatments for PTSD. She also has extensive experience in women’s health and trauma, diagnostic assessment, and risk assessment and intervention.
