We’ve been trained to stay neutral in sessions with clients. But is this always possible, or even desirable?
Well, Miguel Gallardo, PsyD had a case in which a client made racist comments.
So then the question becomes, how do you handle this while still maintaining the therapeutic alliance?
Find out in the video below. He’ll also share a little about liberation psychology (a key part of his intervention) and get into when self-disclosure can be a powerful tool in a session.
Click here for full transcript
What are your biggest takeaways from the video? Please share with the community by leaving a comment below.
If you found this helpful, here are a few more resources you might be interested in:
How to Address Blindspots and Racial Bias in a Session
When Racism Triggers Emotional Reactivity
Working with the Trauma of Racism
The thing is a truly racist person would still not take in what you said because their just plain racist and people that are like that usually don’t change and have the same mindset for a long time so I don’t think he was racist I just think that black women was not his preference and I can understand that because I am a black women myself and I prefer to have a white therapist it’s just my preference
Thank you for this insight and guidance regarding an important topic. I had a recent situation with a client where I used a similar approach (although had many conflicting thoughts and emotions afterwards) to address the way the client talked about his wife as “the wife” and how his use of colloquialism may not in fact be in line with his own values. I reflected my thoughts and emotions regarding the term as an educated female. I asked the client to imagine how his wife as a highly educated and successful women in business who emigrated from Poland, or his mother an educator who raised her three children and sent them all to college following the early unexpected loss of their father, how would they view his use of that terminology. It went well however I experienced internal conflict until watching this post.
This is a great approach! I definitely agree with the need to give the client a chance to take the alternative viewpoint of putting himself in the shoes of the minority and express how he feels in that position.
I get that if the therapist practices and shows true emotional honesty it gives the client a base to follow and a person to emulate.
Is it racism or is it more racial prejudice ?
I appreciated the topic. I agree wholeheartedly that bringing my Self to the therapy deepens the relationship and allows the opportunity to address the minefields of unconscious biases. The grey areas of how and when will always be clouded by my own blind spots, and I thank you for the encouragement to keep risking.
Thank you for sharing this clip. I find the idea of being in the room totally disengaged with what is the social political context of the surrounding environment a dis-service to the patients and to ourselves. I am always glad to learn of professionals, like Dr. Gallardo that, with their approach are making our profession and the treatment we offer more relevant to the days we are living in, bringing forward tools to impact the patient and positively contribute to social change.
We weigh people according to the stereotypes and prejudices we have grown up with and continue to apply those yardstick routinely without much reflection. In therapy, trust,and conviction in his competence and a non-judgmental attitude are important.
Self-disclosure, as and when necessary, does facilitate the dynamic exchange between the therapist and the client; how much and with whom is a matter to be decided with prudence, caution and some reserve.
Identification with the client, empathy, unconditional regard, collaboration notwithstanding, will be incomplete and the distinct relationship has to continue throughout the sessions.
The sense of the ‘other’ will somehow estrange the alliance that is being built up, the relief is in the termination. Prejudice is contextualized in all transactions. Only sincerity, transparency and genuineness and beneficence will help overcome the blocks. In the eyes of the client, the therapist is being weighed throughout and maybe found wanting…
i totally agree sometimes self disclosure can help when working with clients, because they then see that it is human to feel something or that self realisation suddenly dawns on them and then this can move the sessions forward
well…..i had to look up “liberation psychology”….i’ve heard of “liberation theology” only. being the information addict that i am, now i have to learn all about it. his acknowledgement and acceptance that bias …just is……consciousness and self awareness of your own bias’s are key….nope…no such thing as a blank slate..;-)
i totally appreciated his willingness to meet a client from a place of truth and authenticity….not so much lost in theory…in my experience self disclosure can move therapy forward significantly….heart to heart pretty much always works 😉
I am a Latino counselor, one issue confronted for me is that many clients are coming with the expectation that as Latina I can support their beliefs, feelings and thoughts related to sense of anger, sadness or anxiety when become to discrimination. I manifested that I understand how they feel, but I bring a reminder in how the topic was affecting the nervous system. After they track the sensation they were able to observe how their window of tolerance was extremely tiny. Many reported that this self-awareness stopped them from escalation of anger, less reactivity to other race, or including more capacity for tolerance, they also created a therapeutic plan to avoid triggers. Some of them found memories related to past trauma where their parents lack of tolerance, compassion for them or others, many also talked about being raise in painful views of life. They started to realize that many of those views obeys to parental care and culture.
Equanimity and peace were found at the end of the session. Clients are appreciating my reminder that we have to focus in our body self-regulation, building capacity in the window of tolerance.
Self-disclosure wasn’t necessary, opening this topic was therapeutically helpful, tracking the body brought them to the power of self- discernment and they told me they want to decrease risk for activation when they deal with other racial groups.
Thanks to Phd. Peter Levine for such a nice way to assist my clients with understanding of what is happening on their body – magical.
I love what you’re doing, Ilse – thank you for sharing it. I think sometimes this sort of work can be accused of allowing injustice to continue, but I think it doesn’t need to be either/or – we can support clients to find their power and increase their capacity to manage such difficulties AND support a fight back against systemic oppression.
In my training, self-disclosure only functions for the benefit of the client.
If I judge that someone’s perspective on race needs to be addressed – what other areas are then subject to confrontation based on my own values? Misogynist religious beliefs?
The phrase “Gross generalization”…pretty in-your-face confrontation. I felt very uncomfortable with these words. They are judgmental and critical.
I wonder what would have happened if he had said, “You seem uncomfortable with black women as caretakers. Tell me more about that….”
” Sounds like you have had uncomfortable interactions with Black people. Has that affected how you see them?”
“What do you wish these women understood about your past experiences with Black people?”
“Have you ever experienced that yourself – that someone feels uncomfortable with you or doesn’t want you around because of being Latino?”
That would invite exploration and self-awareness rather than confront and shame with words like “gross”
Thoughtful and helpful suggestions, Julia.
Thank you.
I had the same response to “gross generalization” as judging language and love your alternative approach. It keeps the dialog about process rather than person in a way that speaks to the systemic nature of racism and racialization.
I think the biggest take away is the sharing of the therapist’s reaction to what the client was saying and helping the client process it or reframe it was very helpful. I really liked what he said about bias and that there is no blank slate. I think that is a very important statement because our minds are geared to discriminate and to lump things into certain categories. We discriminate in every choice we make based on our likes and dislikes or our fears and insecurities, or for multiple other reasons. We have to see each others as humans not as a color.
Very good! Thank you.
When I did home & community based medical case management in the rural south, my case load was brain & spinal cord injured patients, many of whom had to have home health aides for personal care. I encountered the racism of my patients against their African American home health aides like Dr. Miguel Gallardo describes. I had a strong, positive professional relationship with most of my clients that I could leverage. The first time they used a racist word or made such reference in front of me, I politely but clearly spoke up and let them know that while I respected their right to their own beliefs and values, that I was not comfortable with the kind of words and statements they felt free to express in front of me because we shared the cultural background of being white and southern. I asked them not to use those kinds of words or statements when I was in their home doing my work as their case manager, which involved overseeing and troubleshooting any issues the patient or their family had with their home health-aides. It is professionally important and ethical to speak up as necessary without attacking the patient’s value system. We cannot be complicit by our silence.
Bravo! Thank you for taking that stand. I’ve worked as a nurse for 40 years and I’ve seen a lot of racism in healthcare that I haven’t known how to speak up about. Thank you for sharing this example.
I’ve had similar situations as an in-home therapist with clients who have health conditions. One thing I’ve shared with them is Chimamanda Ngozi Adichie’ TED talk, “The Danger of a Single Story,” which speaks to how as a result of our enculturation processes we form our internal perceptions of “other” in a way that narrowly defines them based upon stereotypes.
Elizabeth, thank you for suggesting that TED Talk. Chimamanda Ngozi Adichie’s, “The Danger of a Single Story.”
Wow! Her story and examples say so much that theories don’t get to.
There are more issues at play here. The therapist needs to be cognizant of ableism dynamics here as well. There is a lot of shame and loss of control in this client’s situation which should be explored, which may be fueling his racist comments (not that that’s ok, but people are never at their best when going through a shame and loss of control storm). Afterward addressing this, it is appropriate to discuss his racist comments in light of societal prejudice. Once he feels understood you can explore his racism in that context. There is a lot of rich material here you dont want to shut down.
Authenticity regarding how a client may be interpreted is helpful to the client . It is not a criticism of the person but it is important to be honest and help the client’s own self- awareness of how they may be interpreted by others. Well said in this talk…If I were seeing a therapist-, I would like this honest approach- a therapist who is caring enough to be open and help my awareness. ( I am now retired from my private practice:-))
Excellent. Thank you.
I appreciate that Dr. Gallardo put the patient’s comments in a larger political context as opposed to delving into “psychological” explanation for his views.
As a psychologist I found the therapist handling of the racist comment to be positive and informative without being rejecting the client. He handled it well.
The Black Lives Matter issue and recent protests have introduced some less than understanding comments from a client or two in the rural mostly white area we live in. I felt I needed to comment, without negativity, how this misses the point of generational and societal racism. As a dark haired easily tanning person, I used a personal example to illustrate subtle forms of racism that exist in a blond world.
Thank you so very much for sharing your approach and perspective. This is very helpful.
I don’t know if this comes into play, but sometimes people prefer health care providers who have cultural competency. For example, some Japanese patients prefer to see my doctor because she’s fluent in Japanese and understands the culture. I can understand wanting to be able to speak to a health care provider in the language you speak bc it is a very personal experience and having an interpreter at an appointment can be awkward. Is that racist when the Japanese patients ask to see a doctor who speaks Japanese? People feel more comfortable with providers who are more culturally competent to treat them. I’m wondering if there was more of a fear they didn’t understand his culture vs racism? I’d be curious to know more.
This didn’t happen in a therapy session, but in a social setting at breakfast with 4 graduates of my professional certification program. One of them (a white man born and raised in south Texas, where we were at the time) started to tell a clearly racist joke about 2 little black girls. I interrupted him and said, “You know, when you tell jokes like that I worry for my 4 black grandsons. One of them came here to visit M (who was sitting at the table) and hang out with her son of the same age. Before flying here he called to ask me if he’d be safe in Texas. He knew that a black man had been dragged to his death in the streets of Texas around that time. It broke my heart that he had to ask me that question. I told him the truth. If you stay with M and her son and are out in public with them, you will be OK.” It made a real impact on this individual who, I knew, had great respect for me. I was his teacher and he admired me and my methods and books. He taught my methods and helped lots of people. I knew he would never hurt me on purpose. By letting him know that his racist behavior – which, I believe, was unconscious and culturally determined on his part – could indirectly hurt me and my family, I got the message across to him.
I had a “woke” moment that changed my understanding. A nice white lady (I’m white) volunteered at my grandson’s elementary school. She was so pleasant and fun and friendly. I knew she had children in the school, but I did not know them. During that year, a young African American man was shot and killed by the Oakland Police outside a store. At first, they said he had a gun, later if was found he was unarmed and shot in the back. It was sad and shocking, but didn’t hit me as hard until I found out the young man was the son of my friend at the school. Her husband was African American. The young man’s sister attended the same school as my precious grandson. It could have been my grandson, had he been Black.
This didn’t happen in a therapy session, but in a social setting at breakfast with 4 graduates of my professional certification program. One of them (a white man born and raised in south Texas, where we were at the time) started to tell a clearly racist joke about 2 little black girls. I interrupted him and said, “You know, when you tell jokes like that I worry for my 4 black grandsons. One of them came here to visit M (who was sitting at the table) and hang out with her son of the same age. Before flying here he called to ask me if he’d be safe in Texas. He knew that a black man had been dragged to his death in the streets of Texas around that time. It book my heart that he had to ask me that question. I told him the truth. If you stay with M and her son and are out in public with them, you will be OK.” It made a real impact on this individual who, I knew, had great respect for me. I was his teacher and he admired me and my methods and books. He taught my methods and helped lots of people. I knew he would never hurt me on purpose. By letting him know that his racist behavior – which, I believe, was unconscious and culturally determined on his part – could indirectly hurt me and y family, I got the message across to him.
I’d also appreciate more of this. An area I see as lacking is perspectives from POC therapists in working with white clients.
I recently shared my reaction to comments being made by a patient who I just discovered had been essentially radicalized by White Supremacist online groups. I gave it careful consideration but decided that my most therapeutic intervention was to openly express the impact of his racist statements. It’s a work in progress. I also did some online searches to see the kind of rabbit holes he had been down. It’s deeply disturbing. I think we all need to be aware of the risks to impressionable patients, from a number of online hate groups/conspiracy theorists and extremists.
What’s missing here is the focusing on the intersubjectivity of the patient – the idea of liberation psychology is not present here – exploring the feelings not the cognitive presentation is critical what feelings do the African American caregivers bring up – is there shame does the patient feel shame if he is not cared for my someone of his own culture is he betraying his own culture or his father or mother – is he scared what is the fear about is his own culture or he being diminished if he accepts caring from another culture this is an intimate job – the therapists reactions are narcissistic to imposed here within the deeper layers present or really getting to the core of what the shame and fear are of needing to reject these particular are givers opportunities missed in so many ways – neutrality is not possible correct but a therapists views when key areas a overlooked is not relevant – sorry don’t buy this or the word liberation in fact it’s a form of construction treatment and shuts down the patients ability to access her deeper levels of unconscious shame about why he has such a strong reaction to these cAregivers –
There are more issues at play here. The therapist needs to be cognizant of ableism dynamics here as well. There is a lot of shame and loss of control in this client’s situation which should be explored, which may be fueling his racist comments (not that that’s ok, but people are never at their best when going through a shame and loss of control storm). Afterward addressing this, it is appropriate to discuss his racist comments in light of societal prejudice. Once he feels understood you can explore his racism in that context. There is a lot of rich material here you dont want to shut down.
Katrina, I’m with you. This does seem like a very cognitive approach of trying to get the client to see your/another perspective without getting to the core of the client’s own issues. I don’t disagree that we can share our response, but trying to rationalize with the clients without a deeper inquiry into their feelings and experiences underneath their beliefs misses their pain entirely.
Well summed up Robyn, and glad you pointed out the importance of the feelings involved rather than intellect only.
i would also add a somatic approach as to where in the body this might be presenting in the felt sense to further help the client get in touch with and track old patterns frozen and release perhaps .
Yet it not to be forced onto him just because we think it is the best technique/belief.
I’m not particularly fond of the term “liberation” in this context either – don’t know what it is supposed to mean. What I feel is important here is the specific nature of the “racism” expressed – I didn’t pick that up in the presentation and I think that makes a big difference. If I had a patient use the n-word, for example, I think I would need to say something about my reaction to that. It would trigger in me a negative feeling toward the patient that could easily interfere with the work. But I could say, “let’s use a different word. Now tell me…”
However, something more subtle that SEEMS racist to me, is probably better explored for its meaning to the patient, lest I miss the point. So if my patient says, “I don’t like having black women take care of me”, I need to acknowledge that I don’t really know what that means. “Tell me what that’s like for you” and so on, as others have suggested.
More of these please
Therapists aren’t blank slates and teaching them to be is a disservice to them and their clients
Thanks for sharing this clip
more along the same line would be welcome
I myself have always said, “No thing is bias free”….who we are and where we come from as well as what we have been thru has an effect on how we see things, how we work, and communicate….
Addressing blatantly by sharing your own human reaction and exploring with them where their concepts may have developed is a good starting point.
It is helpful to hear that underserved populations attacking other underserved only perpetuates the difficulties …
Very helpful
Brilliant way to handle this problem. Hopefully the client is open to receive the information and open enough to look at themselves in the equation. In a movie sometime ago it said fear was the mind killer. The fear that individuals feel now is palpable d…once trust is established, hopefully the client can be open enough to hear the message. Dr. M. Force
As a “Black” therapist I believe its about time to talk about racism; but I would like to flip the coin and share a story with you. I used to work in a mental health agency, mainstream mostly whites. I was given a file to make contact with a white family; the intake worker overheard me speaking with one of the parents and recognized the names. She rushed into my office and asked me to put the parent on hold. The intake worker stated, the family specifically asked not to work with a Black therapist. The file was assigned to me because of my expertise in the area of the family presentation, which included two children. I spoke with my supervisor, and told her I will proceed to make the appointment. I went back to the phone, explained who I was, and why the file was assigned to me. The parent(mom) stated it was her husband’s request. Anyhow, I asked for a meeting and the entire family came in, including their two children who were the clients. After introduction, I hit it off with the children, they were ages 6 and 8 years old. I spoke with both parents separately, and explained the reason why the file was assigned to me; and about my understanding of their distaste for working with a Black therapist. I asked for three sessions and promised to transfer the file, if within that time I wasn’t able to get to the root of the problem. They agreed; to make a long story short the case was cracked open in 3 session. The family, especially the father, felt ashamed. I further helped the father worked though his hate and biases, and impressed on him, that his children will grow up and may live in a big city with many different nationalities, and they need to know how to co-exist instead of hating.
Thank you for sharing this experience!! So often supervisors choose not to disclose with workers about clients with racial biases. It’s past due for this to change!
This is such a powerful testimony of how therapeutic use of self works to resolve conflicts and bring about change, Cleo. Thanks for sharing your experience with us! We all need to hear about others’ successes that happen because of being proactive.
Thank you for this great example of working through a challenging situation. This is really encouraging to hear. It sounds like you displayed talent and understanding- two important components for any therapist to use.
As a domestic violence survivor, who was badly abused by a man, I do not feel as if I can let my guard down with a male therapist. I also had a very abusive male boss. Because a lot of the issues I’m going to therapy for involve abuse at the hands of men in power, yes I have chosen to work with a female therapist. I’m not sexist. Sometimes, there is a non-discriminatory reason for a client to have preferences of who they work with.
I too survived domestic violence by men. For me, receiving compassion from a male therapist was very healing. Even though I am still recovering from trauma, I am now in a relationship with a man who is kind and caring. I still have fears but I don’t fear my partner.
Thank you for your testimony of courage to trust again a partner who by his example has shown that there is something good still in this world. Wishing you more success in your journey.
This leaves me with so many questions.
Early in my career I had a mentor who referred to uncomfortable moments in the therapeutic setting as “grist for the mill”. Self-disclosure can be powerful; transference is also powerful.
Can I hold a patient with compassion even when he presents something abhorrent to me?
I found this incredibly helpful! Thank you!
I am a non-coloured person … non-white people say stuff about non-coloured people these days, and stuff about our ancestors, that is negative and stereotyping and makes out like non-coloured people were and still are horrible people who should be made to pay for the crimes of their ancestors … there are courses run by non-white people in Universities that teach people to dislike non-coloured people for no more reason than the fact that they are descended from non-coloured people who did things that the non-coloured people who are living today say they should not have done … not all non-white people are mean to non-coloured people but there seems to be more and more of it and it seems to be getting taught in schools as part of history lessons, and literature lessons, and every other lesson … maybe if we stopped thinking about what colour people aren’t then maybe we can appreciate them for what sort of people they are … the content of their character instead of the colour of their skin I think a wise man once said
I do need to acknowledge as a white person, that I have privileges born out of systems and structures developed on superiority and inferiority. We do have to acknowledge our history and the abhorrent actions, so we can ensure we as whita people are not complicit in this happening again. So we take action to make sure it does not. If the human race is seen as 1 body, and a limb of the body is suffering, we don’t say bad limb, our whole body rushes to heal and support the suffering limb. Our black brothers and sisters are suffering, in turn I want to stop that suffering. I want this whole body to heal. And so we inform, educate bring in to our clients awareness that which is experienced out of lack of awareness.
I think curiosity is key, but I like the suggestion that you and he have been on the receiving end of racism, too— how does that feel? What do you remember? So far, racism as I have met it in practice, seems to be transgenerational— a client may be responding to something that happened to an ancestor a few generations back. They have made an identification with that ancestor’s experience. I think it is often a mindset that is handed down in families. Not to defend racism in any way, but by exploring the client’s legacy, the stories they grew up with, we may begin to understand. But of course, help your client think about how it would feel to receive racist treatment, too.
We all have something in common that is
we are all different to each other
and he spoke very clearly in that way.its about losing the fear of the difference and appreciate the difference without dominating and suppressing what is in ourself and others.as a therapist it needs my openness and willingness to sometimes share my difference from the client and where we can meet in that ie gender. ..race.. social class..
Excellent and timely summary of being congruent in the counselling room. And also sensitive. I particularly like theintevention ‘People might look at you and I that way.’ I remember discussing in sueprvision whether or not it was appopraite to disclose myself as Jewish when a client said he’d hired a Jewish solicitor, adding with a nod to the expense ;And youknwo what they are like.’
I am so encouraged by this. I hope that this form of liberation psychology will eventually include sexism, so that a therapist who hears offensive remarks about African American women will also be aware of the sexism that is at play, that that therapist, male or female, will have the wherewithal to address sex-based bigotry as well.
It is so encouraging that the world is finally having a very public conversation about radicalized oppression. I dream of a day when the next death of an American woman by her murderous spouse is met with the same outrage as the death of a black American man at the hands of murderous police officers.
Thank you for your good work.
Here, here! So much sexism and gender bias, including by therapists.
Yes, exactly. We need discussion about how divisiveness and oppression are so subtle in today’s world that we buy into it without realizing what is happening. Pointing out that everyone has prejudiced thinking based on our uniqueness and then explaining the necessity of being as aware of those prejudices as possible is the teaching.
Very well put. Thank you
I also believe self disclosure can be therapeutic always keeping in mind the way you share yourself and the purpose for sharing. Can what you share be helpful to the client?
Thank you for sharing this. I have had experiences in the past where I haven’t challenged racist comments from a client when they have been subtle and covert.
I have been thinking about this with the growth of the Black Lives Matter movement over the last month and the need to make that shift when this happens down track!!
Very constructive way of responding , which also gives the recipient a greater chance of coming to empathize and understand the people he(or she) is criticizing. Thanks!
That’s all good if you are a minority group member, but if you are White then a intervention that is this direct might not be effective and do harm for the alliance and even solidify racist views given therapists are seen as authority. Much shame and defensiveness might arise. I do hope you asked how your self disclosure was experienced for him. I would love to hear alternative suggestions as it pains me to hear these kinds of remarks. My best strategy is to be clear I am not racist before my client states their views as to be a positive role model. If others have suggestions for those of us who are White/appear White that would be helpful as it’s difficult to navigate this issue effectively.
Thank you,
Dana Wagner, PsyD CADC SamaraCare Naperville, IL
I gained so much from the book “How to be an Antiracist” by Ibram X. Kendi. He also had YouTube videos.
I agree with others who have said that this is a difficult area to navigate It’s a therapist is white. I also think that then the conversation becomes something different than perhaps the client wanted. At the same time if I hear racist comments in my office I become very uncomfortable and that becomes a distraction from the therapy. I feel that this is a very appropriate topic for further training. Many years ago I put up a post about this in a group on LinkedIn, the question of how does one respond as a therapist when a client makes a racist or ethnic slur. The discussion went on for months with many and varied opinions on the subject.
I found this video really interesting. I had a client who suffered from domestic violence. However, she was completely unaware of the impact this DV had on her current mental health state. Thus, for her having her partner back was going to solve her current distress. Therefore, this was her initial goal to come to therapy. I had to disclose my perception and disagreement towards domestic violence as way to try to make my client understand the gravity and impact of DV on her distress.
It would be interesting to explore what underlying fears or resentments he might have of Black American women , that drive those racist thoughts and feelings. It could even be deep seeded values and beliefs that developed early in his childhood.
thanks
Vinesh
Or, maybe, these views come from a world where anti-blackness is the norm.
Anti-blackness is the norm in the US world
But surely that would open up a completely separate topic with the client than his presenting condition! An intelligent discussion like this one can be enough to bring awareness to racist thought patterns.?
I think so. Talking about it and using words like “colorism” or “gross generalization” can lead to some distress tolerance in clients who needs to learn to cope and regulate their emotions alsol. It would bring them to the separeate and open up discussion into the present and no longer angered by their past..