Thema Bryant, PhD

Thema Bryant, PhD, is a psychologist, researcher, and professor at Pepperdine University.

She is one of the foremost experts on the impact of culture on trauma — especially in areas of race, gender, and religion. Through a mixture of cognitive-behavioral therapy and artistic expression, Thema helps clients develop a sense of safety, empowerment, and emotional healing.

She has written several books, including Thriving in the Wake of Trauma: A Multicultural Guide^[1] and Tweets for the Soul: When Life Falls Apart.^[2]

From her research and experience in clinical practice, here’s what she has to share . . .

What to Know When Working with Clients of Color

While you may be well-versed in how to work with different chronic types of stress, working with racial stress and trauma requires a specialized approach.

You see, the repeated stress and trauma that so many communities of color face comes from a systemic level. Meaning – at least in the United States – our society is structured in a way that places these communities at a disadvantage and leads to disparities between racial groups.

But unfortunately, much of our standard research, interventions, and training on racism and trauma have been lacking.

“One of the problems or critiques I have of our literature is, often research with racism puts the word ‘perceived’ in front of it. We don’t usually say ‘perceived’ sexual harassment, right? Or, ‘perceived’ bullying. We just call it bullying.”

– Thema Bryant, PhD, NEXT Level Practitioner Program

Seeing how much work needs to be done in this regard, Thema has committed herself to making mental health services more racially informed and inclusive.

Here are a few points she emphasizes can help with this:

• Understand that access to healthcare is often limited in communities of color – Not only that, but due to the historical mistreatment of people of color at the hands of scientists and health practitioners, these communities are also often less likely to reach out for help and more likely to terminate treatment prematurely. So, say a client comes in, and their mental health situation seems severe. Instead of wondering, “Why didn’t they get help sooner?” we want to be mindful of some of the barriers they may have faced in seeking treatment.
• Recognize our blind spots and implicit biases – While we may not make overtly racist comments, we all hold some unconscious biases about race that nevertheless drive our behavior. For example, these might show up in the form of microaggressions. So unless we make a point to reflect on the stereotypes we may hold, we’re at risk of acting from them and harming clients.

Anti-Racist Strategies for Treating Racial Trauma

To make our clinical practice safer and better in service for people of color, Thema says it’s not enough to simply not be racist. We also need to be actively anti-racist.

So here are a few changes that Thema says can go a long way in making your services more accessible to people of color:

• Change how you advertise – In your values statements and areas of expertise (as applicable), indicate that you work from an anti-racist framework and that you are tuned in to issues of oppression. At the same time . . .
• Build rapport, but understand that this takes time – Building a relationship takes time with any client. But when cultural differences and racial power dynamics are involved, developing this rapport can require and especially great amount of care. Understand that we can’t earn the trust of clients of color through just expressing a commitment to anti-racism – we need to actually embody this value through our actions.
• Ask about racism during the intake process – Much of our training has taught us to ask about topics like family of origin, sexual history, and substance abuse during intake. But rarely are we ever instructed to ask about race and racism. This might be in part due to the misconception that, if something is important, the client will bring it up. It might also stem from the idea that as clinicians, we should stay neutral with clients. But here’s the thing: Like politics and religion, race is still somewhat of a taboo subject. But in taking a “colorblind” approach, we ignore many important racial and cultural experiences that may have shaped a client and contributed to their presenting problems. So while doing so can be difficult, it’s crucial that we explicitly convey to clients of color, yes – it’s safe to talk about race in a session.
• Avoid pathologizing trauma responses to racism – Research shows that when Black clients present the same symptoms as white clients, clinicians will often give the more severe diagnosis to the person of color, while the white client gets the milder diagnosis.^[3] Why might this be? Well, if we don’t consider how racism and socioeconomic hardship might be shaping a client of color’s behavior, we might be more inclined to write them off as having conditions like oppositional defiant disorder or borderline personality disorder. This is why Thema says, even if a client’s reaction seems unwarranted, it’s important not to take such a response personally. Rather, we should examine the environmental factors that might be shaping this person’s behavior and recognize that their defensiveness, angry outburst, or accusatory tone might be a survival strategy. As Thema puts it, “that’s not resistance, that’s vigilance.”

“Survivors show up in different ways, and some of the ways that we present can be off-putting to people.”

– Thema Bryant, PhD, Practical Strategies for Working with Deep-Seated Resentment

Rethinking Conventional Approaches to Mental Health Treatment

Lately, there has been increased discussion about several flaws in the way we currently go about mental health treatment.

As we mentioned earlier, the scientific and healthcare fields have a history of mistreating people of color. Not only that, but many of the therapies to come out of these fields weren’t created with people of color in mind.

While Thema recognizes the benefits of these approaches and often incorporates them in her work, she also makes a point to highlight their shortcomings.

Take cognitive behavioral therapy, for example . . .

CBT is all about having clients challenge their thoughts. But according to Thema, for certain clients, this guidance might do more harm than good.

Here’s what she means by that . . .

“Usually in cognitive therapy, when we want to help people shift and we tell them, ‘Look at the evidence. Challenge the evidence.’ Well, what happens when the evidence is, all these people agreed that I am not important? That’s my evidence. So, it’s event after event after event that is speaking of my insignificance.”

– Thema Bryant, PhD, Advanced Master Program on the Treatment of Trauma

Consider survivors of human sex trafficking. What does it mean to ask these clients to “challenge the evidence” when the majority of their life experiences tell them they’re not worthy of basic human dignity?

The same applies to working with racial trauma.

Say a client has a persistent suspicion of being followed in a grocery store. To some, this may seem like an irrational fear. But for many people of color, this is a very real concern. Not only that, but it’s also essential that people of color trust these perceptions of danger. They’re necessary to keep themselves safe from racist – and potentially life-threatening – confrontations.

Likewise, think about if a client of color comes in expressing the sentiment that they’ve “never fit in.” It might be natural to doubt that this person has never felt a sense of belonging.

But for people of color, such ostracization is often not simply just “perceived.” Sometimes, a client may have numerous experiences being the only person of color in the room. Or, they may have memories of white parents telling their white children, “Don’t play with the Black girl on the playground.”

As Thema puts it,

“When we think about clients not feeling like they belong, we can get really focused on it being their perception, which we often clinically interpret as a misperception, which is based on our assumption that everyone belongs and it must be their trauma, their history, their insecurity that is blocking them from seeing the truth. And when we operate from that vantage point, often we have missed the reality that there are many people who have lived with individual and systemic rejection, who are routinely isolated and devalued.”

– Thema Bryant, PhD, NEXT Level Practitioner Program

This is why, in her treatment approach, Thema goes beyond our well-known, conventional therapies – and she incorporates some more innovative, non-traditional methods . . .

The Benefits of Expressive Arts Therapy (And How to Incorporate It Into Your Practice)

For many clients, expressive arts therapy is an approach that better resonates with them compared to more standard treatments.

Not only that, but many also double as somatic therapies that can target trauma healing from a bottom-up approach.

An artist herself, Thema makes extensive use of the expressive arts in her therapeutic approach. And there are a wide variety of creative approaches you can draw from, including:

• Theater & role play – Like Bessel van der Kolk, MD, Thema appreciates the power of theater and role play in helping clients heal from trauma. These activities can help clients embody a new sense of being and reimagine how they would have liked the past to happen.
• Music & dance – These activities can help clients connect with the present and get “in-sync” with one another.
• Writing & poetry – Creative expression through word can be powerful tool to reduce symptoms of PTSD.
• Religious & spiritual practices – In Western psychology, religiosity as a therapeutic tool has been neglected compared to in the Eastern world, despite preliminary evidence that spirituality could help in easing symptoms of mental distress. In fact, on average, mental health professionals are less religious than the general public.^[4] Not only that, but on average, people of color endorse a higher level of spirituality and religiosity compared to white folk.^[5] Here’s why this matters: For many people, the way they find meaning is through their faith. So, exploring religiosity with your client – and potentially making it a central part of their therapeutic approach – can often help. But just like with race, if we never ask about the role of spirituality in a client’s life, we may be missing a crucial piece in how they understand and navigate the world. So to do so, we want to inquire with humility and respect. For instance, imagine a client says they understand the religious meaning behind the fatal car accident their daughter was in. Instead of saying, “You don’t know that for sure,” Thema suggests that you might respond, “I never thought about it as meaning that,” “Have you heard any other interpretations?” or, “What else have you heard people saying?”

No matter what approach you might use, Thema encourages practitioners to explore novel treatments, educate ourselves on the topic of racial stress and trauma, and commit to making our clinical practices more anti-racist.

References

1. Thriving in the Wake of Trauma: A Multicultural Guide by Thema Bryant
2. Tweets for the Soul: When Life Falls Apart by Thema Bryant
3. Racial disparities in psychotic disorder diagnosis – World Journal of Psychiatry
4. Religiosity and Spirituality Among Psychologists – APA
5. Religious Landscape Study: Racial and ethnic composition – Pew Research Center