“I’m so glad my parents are dead,” he casually offered, as if telling me the day’s weather forecast or some similarly innocuous and inconsequential news. Raising more than a little bit of concern in my mind that was already reeling with possibilities, all of them quite dark, I decided to sit back, breathe, and let him lead the conversation. This, despite bursting with questions, centering mostly on the possible ill fate of this new patient’s deceased parents. “All things considered,” he said, without discernible affect, “I’m glad it’s over… I’m glad they’re dead, and I’m not afraid or ashamed to say it.” This is the kind of stuff that patients save for the doorknob experience; you know, that profound, therapy-altering utterance the otherwise reticent, resistant, or un-ready patient leaves you with on their way out of session, leaving you wondering if they will return to complete the story. However, this was clearly not one of those mysterious or seductive therapeutic mic drops designed to keep me wondering what would come next, nor was it a planned device strategically designed to keep me at therapeutic bay. This was an opening to, or perhaps an invitation from this 60-something man, who seemed to have his act together—except, of course, for this most disturbing utterance. So I wondered silently, at least for now, “How and when did his parents die, why was he glad they were dead, what role if any, did he play in their deaths, and why did he so quickly and emphatically share that relief over their deaths with me, a stranger?” Murder, suicide, murder-suicide, euthanasia? Was he the culprit, the victim? The greatest challenge for me in the moment was trying to quiet my mind and let him share his story, which I was sure was going to be a whopper. Surprisingly, he went on to talk not about his parents, but about the pandemic, which he said initially “hadn’t really hit me in any significant way.“ He was a late-career professional with a few stable income streams that allowed him to work remotely. He said he and his family were healthy, and that he had not taken any hit in income or status. He seemed content in the telling, but considering the opening salvo about his parents, I felt the need to dig a little further. Anxiety, perhaps, or maybe a masked depression because, after all, this pandemic infects everyone at one point or another, in one way or another; perhaps not physically, but emotionally. As his story unfolded, and however much I tried to ferret out this man’s hidden symptomatology, I was left with a nagging question of “Why is he here?” As the session ended, I was left with more questions than answers, which is probably a good thing because it left me in a state of curiosity, looking forward to the next visit when more would hopefully be revealed about this man who clearly was carrying a great burden with him. But in what form and to what extent was he burdened? That was the $64,000 question. The next session came, and as it began, I broke with my own personal and professional protocol by deciding to lead the session with a question. I asked him what he meant when he said that he was relieved that both his parents were dead. He seemed to look past me, fell into his chair as if a great weight were pulling him backwards, and then released what seemed to be a years-long held breath. His parents, as it turned out, had died of natural causes four and eight years ago; first his father and then his mother. He spoke with neither sadness nor regret, spending little time relaying the details of their passings. As much as I wanted to ask him, I refrained. It seemed that his relief came from the fact that his parents, who lived to 97 and 98 respectively, had passed well before the COVID pandemic, not only freeing him of the burden of their care during its clutches, but also without concern of having to do so during this period of quarantine and forced isolation. He recalled how important it was for him to be at their sides during their final descents, and how grateful he was to have been there with and for them to usher them out of their lives with the same constant and gentle compassion with which they had ushered him into his. He had become painfully aware of how families had not only been ravaged by the deaths of loved ones during the COVID pandemic, but tortured by their inability to visit family members in hospitals, convalescent homes, and hospices. Unlike his own parents, these people were dying in the care of strangers. While these events deepened the relief he expressed when we first met, his life had recently been upended when he and his wife took over the care of her 91-year-old parents, who now resided at two different extended-care facilities; neither of which allowed visitors. Unlike his own parents for whom he and his wife had cared up to their deaths, his in-laws might very well spend their last months or years in the care of strangers—isolated from family. The relief he felt at the passing of his parents, and the gratitude he harbored over being able to care directly for them, was slowly being eclipsed by profound sadness, anger, impotence and fear. That is why he came to see me, and it now made perfect sense. He hadn’t come to share his relief, but to express a deep guilt over abandoning his in-laws, even though that abandonment was compelled by circumstances beyond his control. When possible, phone calls, the occasional Skype, and window visits dulled the pain, but could not replace the care and comfort that comes with holding hands, hugging, caressing, bedsides visits, and vigils. His forced inability to attend directly to his in-laws had also rekindled the fears of mortality that he thought he had buried along with his parents. His personal narrative around dying while he was caring for them was one of hope, because he envisioned that like them, he would pass in the arms of loved ones. Now, that narrative had shifted, and death seemed to be a dark and lonely place, and the path towards it frightening. And that was where our therapeutic journey would begin.
Don?t Worry, Be Happy!
When we feel down and out, we may hear someone say—we may even use it ourselves in our personal or clinical lives—“Don?t worry, be happy!"
But we still feel miserable. And so may those to whom we direct it.
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Perhaps we, as either friends, family members, or clinicians have also said these words to someone. We just wanted to cheer them up, to give them hope that everything is going to be fine. Or, just because we didn?t know what else to say.
These words are also repeated in the famous song by Bobby McFerrin, which he quoted from the Indian mystic Meher Baba: “In every life, we have some trouble. When you worry, you make it double.” And then he repeats it again and again: “Don?t worry, be happy!"
It?s as if in repeating this Mantra, again and again, it will finally sink in.
But does it? Will anxious people stop worrying just because someone tells them to? Will sad people become happy just because they are told to? Really?
Similar well-meaning words of advice are readily available. They tell us to get busy, to get a dog, to do exercise, not to be alone, not to think about it anymore, to rely on God?s mercy, or just to drink a glass of water. When that doesn?t help, they try to make us feel better by telling us that many others are much worse off than us and that we should know better than feeling sorry for ourselves.
But the words don?t sink in. We still worry. And we still do not feel happy. In the face of trauma and loss, people tell one another all these things. But for the person listening, it?s all very frustrating to hear, especially when we are tormented by terror and feel that the end of the world is coming.
Even though there is no comfort in these recommendations, the chorus line is repeated again and again: “Don?t worry, be happy!"
As if anxiety and happiness was a choice. Some say that if we only stop thinking about it, it will get better. But whatever is bothering us is always on our minds. Oh, I wish they could at least remain silent. It?s almost like hearing “May the Force be with you!” (from the film Star Wars). When the Force has disappeared, however, we need something else.
But what?
If we or our clients have had a bad experience, should we/they not be upset?
If we survived a war, a famine, or a pandemic, should we not worry and be sad? To trauma survivors, most well-meaning advice doesn?t make much difference. Nothing anyone says can undo what was done. Coming from those who have not “been there” and not “seen that,” the words become nonsense rhetoric.
When emotions are the main thing that troubles us and/or our clients, we/they need to find a way to express it. If they have built up for a long time and are threatening to suffocate us, we need to find a way to let them out. We need to be permitted to feel what we feel, think what we like, and be who we are for as long a time as needed. Rather than getting advice, people need to feel understood, supported, validated. But there are no magic formulas that can promise us that if we only do this or that, everything will be just fine.
A few years ago, I participated in a seminar on trauma therapy in Jerusalem with some “experts” in the field who tried to summarize what we had learned about the best clinical practices for trauma survivors. We presented different kinds of “evidence-based” therapies, abbreviated with popular acronyms including EMDR, CBT, ACT, PE, NLP, PD and PMT, and explained how they worked in neuroscientific terms.
At one point, Leah Balint (a child survivor of the Holocaust) voiced her own understanding of the subject. She shared the story of a fellow survivor who was weeping heavily after recalling the loss of her parents during the war. Leah suggested that the woman take a hot shower with a lot of body lotion. Leah ensured us that it had been immediately effective.
We clinicians first smiled at one another and teasingly called this the “Leah Lotion remedy” because, after all, it can?t be so simple. Later, however, I reflected that there was a profound message to her story.
It?s of course impossible to come to terms with things that are lost forever. So, what else can we do, except to take a shower, literally and/or figuratively, and go on with our lives? It may even be another way of saying “Don?t worry, be happy!,” without actually using those words.
When nothing will ever be the same again, life still goes on. It will be an incomprehensible journey. It?s sometimes short, sometimes long, sometimes a lifetime—and then we may suddenly find ourselves “on the other side” without really understanding how we got there.
It will include many hot showers.
With time, the words of Meher Baba may become our own inner voice. We and our clients may suddenly stop worrying about the future, think less about the past, and even start to enjoy a hot shower in the present.
Beverly Greene on Race, Racism and Psychotherapy
Race, Racism, and Privilege
Lawrence Rubin: At this particularly charged moment in the history of race relations in our country, what is the primary message you want to share with psychotherapists, particularly white psychotherapists working with clients of color?
Beverly Greene: I think one of the charged characteristics of this particular time, and thereʼs a corollary to this in our history, the Civil Rights Movement and the marches during the Civil Rights Movement, is the way technology affects a movement.At that time, it was television. Many people across the country probably didnʼt believe that black people were being brutalized just because they were trying to register to vote until it was in everybodyʼs living room on television and being beamed all over the world. This beacon of democracy, the United States, held a group of its own citizens hostage in terms of civil liberties that are presumably granted to everyone. So I think it pushed some legislation along because it was an embarrassment to the government. It also became undeniable when it became visible over over and over again to people sitting at home in the middle of Paducah or wherever, who were not surrounded by that kind of activity, or hadnʼt previously had contact with black people.
And weʼre in that moment now, in terms of cell phones. Suddenly, if you step outside your house, YOUR privacy is gone. Everybody has a camera, and all these things are recorded. I think the sort of synergistic effect of all these killings and the power of George Floydʼs murder has resulted in an unambiguous, unassailable level of evidence that says, this is a serious problem, and this is real.
One of the challenges that people of color often face is that when they talk about their encounters with racism, theyʼre not believed, or itʼs minimized, even in therapy
One of the challenges that people of color often face is that when they talk about their encounters with racism, theyʼre not believed, or itʼs minimized, even in therapy. Therapists may want to explore all the other things that could have been going on in addition to, rather than race, which may seem so completely foreign in the life of a white therapist. In actuality, racism is an everyday occurrence for a black person or another person of color. The existence of racism is a real social phenomenon and not just something black people make up to make white people feel guilty or uncomfortable.
It is something that is connected to real challenges and obstacles that people of color must negotiate both practically and psychologically. In order to fully understand their patients of color, therapists need to appreciate that racism, as a form of social inequity, may be an unrelenting challenge to that client.
LR: What personal barriers might stand in the way of a white therapist fully grasping the reality of living as a black person in a racist society?
BG: Well, I think that we live in a society that is, in some ways, dominated by race, but also surrounded by a denial of that fact. I still see discussions on news programs in which leaders of various parties and contingencies are asked, “Do you think there is systemic racism in policing? In criminal justice?” Well, if anybodyʼs still asking that question, hello, where have you been?
LR: Theyʼre not getting it.
BG: I think the simple answer is that many people donʼt want to get it because it makes them feel uncomfortable, and this includes therapists. I donʼt know that all institutions do an equally good job at training prospective therapists to have that conversation. It can be highly variable. Even though race is a clear and evident social phenomenon in this country and has been for 400 years, there is a mutual denial of it, and so there is a pressure to not talk about it. Itʼs a difficult dialogue. Itʼs not something people have learned to have conversations about. If anything, itʼs something about which conversations are avoided. And so,
in therapy, many therapists donʼt know how to have that conversation, and are not comfortable with the notion; what if they say something that may be racist?
in therapy, many therapists donʼt know how to have that conversation, and are not comfortable with the notion; what if they say something that may be racist?
LR: Or offensive.
BG: Yes, but those are things therapists need to be addressing in their own professional development. If youʼre not having that conversation, why arenʼt you? What does it mean to the therapist to have that conversation? What if you do say the wrong thing? I mean, as therapists, sometimes we donʼt always get it right. So, what does that mean to the therapist? Itʼs about looking at, as you would many other issues, why would the therapist need to avoid that? Why might the patient have reluctance raising it? Patients may expect that theyʼre going to be told, “Itʼs you. There must have been something else going on. You must have done something wrong because people donʼt behave that irrationally.”Therapists must be able to confront their own reluctance or unwillingness to engage with a patient of color who has had experiences that are very different from their own.
LR: Why is race that much more of a challenging issue than some other ones like sexuality, gender, or religion? They are all important.
BG: I think that for many therapists, discussing matters of sexuality is fraught with challenges as well, but therapy is a place where we discuss difficult things. I mean, we discuss things that one would think are much more emotionally laden than race. Perhaps therapists are afraid of finding something in themselves that they donʼt want to see. Racism, despite its ubiquity, along with racist beliefs and practices, is not something people want to cop to. Even people who in fact are, will say no, theyʼre not racists, they just believe in white supremacy, or that theyʼre some other thing, but no one wants to be considered racist. For the most part, thatʼs not something you want to be. Thatʼs not a positive thing. Thatʼs not a neutral thing. And so, if people are afraid that it may be in them and itʼs going to slip out, what does that make them? Psychoanalyst Kirkland Vaughans observes that race has the capacity to evoke so much anxiety that it blocks the capacity to think. If the therapist is blocked in this way, a productive exploration cannot take place.But again, exploring difficult material like race is part of the work of being a therapist; you do so as you would any other tender or charged issue. We are obliged to ask, what is there that we fear finding in ourselves that is triggered by what the patient is raising? We are responsible for putting our own needs or distress on hold and exploring that which is in the patientʼs interest, regardless of how it makes us feel in the moment. We must ask ourselves, what is there that youʼre afraid of finding in yourself that may be raised by a patient? And some of that gets back to the practice issue. Typically, there isnʼt enough practice in having that conversation.
LR: You have quoted Cornel West who says, among other things, that “The challenge of being elite is to avoid the practice of elitism.” This seems to be related to what youʼre saying now because for a therapist, especially a white therapist, to acknowledge that they are an elite just by virtue of the color of their skin may be very, very difficult and uncomfortable for them; so much so that they avoid the conversations completely, and in turn, minimize their black clientʼs experience.
BG: Well, he was using the terms “elite” and “elitism.” One could say that
no matter what color you are, if youʼre a therapist, youʼve benefited from a level of education and opportunity that probably puts you in a group of, you know, maybe less than 10% of the general population
no matter what color you are, if youʼre a therapist, youʼve benefited from a level of education and opportunity that probably puts you in a group of, you know, maybe less than 10% of the general population. And that is a kind of eliteness, because youʼve had access to things that many people donʼt have access to, some being knowledge, but also just the ability to access certain institutions and the resources of those institutions.
I think heʼs talking about acknowledging having a certain level of privilege, which is the ease of access that one did not deserve, that one acquired by simply having a characteristic that the world values for probably the wrong reasons, but which just makes life easier. I donʼt think that most, not just white therapists, but that most white people donʼt walk around thinking about being white and what thatʼs apt to trigger in someone, and what they may need to do to manage that.
In contrast, people of color have developed an anticipatory intelligence, they are socialized to develop a kind of anticipatory intelligence around being very aware that they are people of color—which may exist at various levels of consciousness. For some people, it may operate on an unconscious level, while for others, itʼs the very conscious and deliberate practice of considering what their skin color is going to evoke when they walk into a room or when theyʼre interacting with white people. What is it your race is going to evoke in someone? What will you have to manage in response to that which gets evoked?
Thatʼs what having “the talk” is about among black families. Itʼs understanding what your children evoke in a police officer that their white counterpart does not evoke. Black children are often socialized around the notion of, “Youʼre as good as anybody, but you canʼt get away with what white kids can get away with, so remember that. If you do something, itʼs going to be seen and judged differently, and the punishment may be much harsher.”
All that highlights the difference between being privileged and not.
If youʼre privileged around something, you donʼt have to think about it
If youʼre privileged around something, you donʼt have to think about it. You donʼt have to think about how thatʼs going to negatively affect something youʼre about to do, or how it could get you hurt, or how itʼs going to transform an understanding of how youʼre responding to something. For example, during the initial COVID crisis back in March, I remember seeing some articles in response to the requirement to start wearing masks. What happens if you are a black person wearing a mask and you go into a store, or youʼre out in the street? How are you going to be perceived? Might you be perceived as suspicious? Might you be perceived as a criminal? Something that in a pandemic is a perfectly appropriate thing to do, may be seen differently if that mask is on a white face or a black face.
Hated, Unsafe, Unprotected
LR: I went into a gas station wearing a mask in a very white North Carolina town a few weeks ago, and the white guy behind the counter raised his hands in mock surrender and said, “Donʼt shoot.” I know he was being facetious, but maybe not. It went right through me in a way that I couldnʼt even comprehend. I knew it was a joke, but there was this bizarre presumption that because I had the mask, I was up to no good. So, I imagine that if I was a black man walking into that same gas station in that same town, I might have carried the additional burden of fear. Thatʼs the closest Iʼve come to being identified in that way.
BG: To being niggerized?
LR: Please say more.
BG: One could say, based on Cornel Westʼs use of that term and definition, that you were niggerized in that moment. You can take a mask off, but you canʼt take your skin off, and skin color for black folks leads to the presumption that youʼre up to no good all the time. You never have the benefit of the doubt. Your skin color says to them, “This is somebody whoʼs up to no good.” So you get followed around stores, or you get treated differently if youʼre asking to see certain merchandise.I think itʼs important to be aware of the intersections of class and other identities around race,
and how it can transform that experience, but the notion that social class and having money means people no longer experience racism is nonsense. Nobody knows how much money you have when you walk into a situation. The first thing they see is your color, and a range of judgments are made about that which supersede other considerations, and which can trigger behavior that you then have to manage, you know, whether you have other resources.
and how it can transform that experience, but the notion that social class and having money means people no longer experience racism is nonsense. Nobody knows how much money you have when you walk into a situation. The first thing they see is your color, and a range of judgments are made about that which supersede other considerations, and which can trigger behavior that you then have to manage, you know, whether you have other resources.
LR: So, what would a white therapist experience working with a black client who has been niggerized have to be aware of and look for, so they can respect and address it?
BG: First, let me explain what I think West meant when he coined that term. He first used that term in the aftermath of the 9/11 attacks, and the way the country was reeling in shock; feeling frightened, taken off balance, feeling unsafe. He said, “America has been niggerized.” Because
to be niggerized is to be hated, to be unsafe and unprotected
to be niggerized is to be hated, to be unsafe and unprotected. But thatʼs the status under which black people have lived in America for 400 years. And suddenly, America was made to feel hated, unsafe, and unprotected. He suggested that America could learn something from black Americans about how you manage being hated, unsafe, and unprotected. Because that is a part of the socialization of black folk, and thatʼs what black families do with their children. Theyʼre teaching them, “Thereʼs this thing youʼre going to have to manage.” Every black parent knows that they cannot protect their child from it, but they teach them how to recognize it, how to manage it, when you do something, when you donʼt, what you can do, and all those things.
But black Americans have survived. I often look at the ways that black people are vulnerable to less than optimal health and mental health outcomes, and I think itʼs important to flip that question and ask, “Why isnʼt that more so?” Because if you look at the kinds of challenges that black Americans face, many of them are the same that were faced in the past. Why are they not more damaged or riddled with problems?
In ʼ68, not long before his murder, Martin Luther King gave the keynote address at the annual meeting of the American Psychological Association, and everything he talked about in that keynote speech in terms of things that we needed to address at that time, a series of social problems, could have been written two weeks ago. On the surface, there is a great deal that has changed, but systemically, many of those things have not changed.
LR: So, when a black client comes into the office of a white therapist, they may carry with them a history of feeling hated, unsafe, and unprotected. Are they at further risk by a white therapist of being pathologized for those very characteristics that are part of having been niggerized?
BG: Well, yeah. Iʼve heard therapists in training incorrectly presume a level of paranoia on the part of the patient, a black patient, who was responding to what it is like to walk around as a black man, in ways that the therapist was clueless about. They werenʼt paranoid, they were appropriately vigilant. There is a difference between fearing something that isnʼt there and being appropriately vigilant about something thatʼs real, that you have to manage, and that your patient has had experience having to manage.I think itʼs also important to not disregard indications of potential pathology, because you donʼt help patients by doing that either. But you also have to look at every patient in terms of the nature of the social milieu that they walk around in. What happens when they walk around your neighborhood, as opposed to when you walk around your neighborhood? Thatʼs something that should be understood before the patient walks through the door.
You donʼt assume that whoever walks into your office is you or a reincarnation of your experiences
You donʼt assume that whoever walks into your office is you or a reincarnation of your experiences.
But when we view a patient, a posture of ignorance is where you should be. You donʼt know this person. You have everything to learn, and the more you assume you know about them or the more you assume you know about their experience, the fewer questions youʼre going to ask. And the questions you ask people are, I think, what is most important in therapy, not the answers that you come up with for them.
Presumptions and Pitfalls
LR: Is that what you refer to as the clinical pitfalls of assuming homogeneity among black clients?
BG: Well, thereʼs an assumption you make about a person when you say they are “overly suspicious.” Compared to what and whom? If you live in a country that is as racist as this one, how much suspicion is warranted? For a therapist to make uninformed assumptions about that, I think, is already an error. It depends on that personʼs life. What is that personʼs milieu like? What is their history? And, in some ways, what is their parentsʼ history? If youʼre dealing with someone whose parents have had really traumatic experiences around racial discrimination, around police brutality, or other kinds of things, we know damn well thatʼs going to affect parenting. So how did it affect the parenting of your patient? What kinds of things or strategies have they internalized that may be useful or may be less useful?Black patients address a real phenomenon in racism. But like any other thing that people address in therapy, some forms of solutions that theyʼve derived can be useful; some may not be. And so thatʼs kind of what youʼre looking at. And good racial socialization in families addresses that. Youʼre helping kids figure out, well, in Situation A, what do you do if that happens? How do you have a template for figuring out when you say something and when you donʼt? What does it mean if you let it go? What is it going to mean if you say something? Who are you saying it to? Does this person, if theyʼre made uncomfortable by your challenging them, do they have the power to hurt you? If itʼs a police officer, they do, so you donʼt challenge them. You become obsequious and compliant.
Thatʼs just one example. But thatʼs what “the talk” is about. Itʼs like in this situation, you may be in the right, but this person has the power to hurt you and, as weʼve seen in the legacy of this country, take your life and get away with it. And I hear that in conversation weʼre having in our family with my fatherʼs great-grandson, that my grandmother had with him. So, even in terms of the post-traumatic stress model of understanding racism, itʼs not post.
Racism is an ongoing stressor and potential trauma for people
Racism is an ongoing stressor and potential trauma for people. Itʼs not like a discrete entity or experience, and now itʼs over, and youʼre not going to have that again. Itʼs part of a way of life. Managing it is part of a way of life.
LR: We started this piece of the conversation around white therapistsʼ assuming a certain level of paranoia in a black client if theyʼre not aware that itʼs frightening and life-threatening to live as a black person in our society. Might a white therapist make similar presumptions around depression or trauma?
BG: Well, you know, I think some of the questions youʼre asking are relevant in terms of what good therapy is, and what is sort of symptom-focused….
LR: Diagnostic?
BG: Reductionist, lazy kind of therapy. I donʼt treat depression. I treat a person who is depressed. And that means learning everything about that person to understand what this means in that personʼs life. Because what it may mean in another patientʼs life may be completely different.
What does it mean to be depressed? When I see black women, for example, who often feel like they have to be ubiquitously strong all the time for everybody—well, you know, if thatʼs kind of their model of what they need to be, then it becomes important to address their depression in that context in order to understand what that means in terms of that personʼs inability to function in their milieu. Itʼs not just, “Okay, youʼre depressed, hereʼs the prescription.”In therapy, Iʼm trying to understand that personʼs experience of the world. What is it like for them to navigate the world every day? To get up, to do whatever it is they have to do, the challenges they face. What do they have to do to negotiate those challenges? To what extent is the external world helpful and supportive? To what extent is it part of the problem? To what extent are familial and community relationships helpful and supportive? To what extent are they part of the problem?
What does it mean to be depressed? When I see black women, for example, who often feel like they have to be ubiquitously strong all the time for everybody—well, you know, if thatʼs kind of their model of what they need to be, then it becomes important to address their depression in that context in order to understand what that means in terms of that personʼs inability to function in their milieu. Itʼs not just, “Okay, youʼre depressed, hereʼs the prescription.”In therapy, Iʼm trying to understand that personʼs experience of the world. What is it like for them to navigate the world every day? To get up, to do whatever it is they have to do, the challenges they face. What do they have to do to negotiate those challenges? To what extent is the external world helpful and supportive? To what extent is it part of the problem? To what extent are familial and community relationships helpful and supportive? To what extent are they part of the problem?
I guess one of the earliest things that I learned in psychology courses, probably before I necessarily thought I wanted to become a psychologist, was that you donʼt analyze behavior outside of understanding its context. Behavior is contextual. And the notion that this thing is a thing thatʼs located in the person and itʼs their defect, I think is the hallmark of what is problematic in what has been the history of institutional mental health.
We problematize the person and fail to try to understand how this person is interacting with the social world at many different levels. And sometimes, what people of color are doing is trying to cope with social pathology. Theyʼre not pathological. Theyʼre trying to cope with pathological situations in which they may have an inadequate range of resources. And so their solutions are not optimal. Or they may be trying to cope with social racism or something in a workplace and have a certain amount of baggage that theyʼve accumulated from a family where they didnʼt really get helpful instruction around how to manage these things and how to recognize them, or they have been complicated by family pathology or dysfunction.
All these things are going on, and they go on differently for every individual. Even when people belong to the same racial group, pretty much any black person I see, I assume theyʼve been confronted with racism at some point. It doesnʼt mean that I know anything about how they experience it, what they attribute it to, how they understand it, what they think theyʼre supposed to do about it; all those things are different for every individual.
Thereʼs no cookie-cutter kind of assumption that you can make that says, “Okay, now I know about that.” You must ask patients about their experiences in that way. Even if youʼre not a white therapist, it is important to ask patients if they think you can understand what the world is like for them? And if they think you can, why do they think you can? And if they think you canʼt, why do they think you canʼt? And itʼs not for the purpose of convincing them that you can because there are going to be things that you wonʼt understand because nobody understands anyone perfectly. But it helps to say, “What is the world like for you? What would having my understanding of that look like? What are the things you think I wouldnʼt understand, and why is that?”
Because the assumption is that a black therapist will ipso facto understand. Well,
if youʼre a black therapist, you understand racism, because youʼve seen it. That doesnʼt mean it gets experienced in the same way in the patient
if youʼre a black therapist, you understand racism, because youʼve seen it. That doesnʼt mean it gets experienced in the same way in the patient. And youʼre trying to understand the patientʼs experience, you do not impose your idea of their experience onto a patient.
LR: So, a black therapist may misread a black client, just as a white therapist may misread a black client, out of failure of curiosity, out of failure of empathy, out of their own internalized messages of racism. It cuts across races.
BG: Yeah. Or a black therapistʼs own internalized sense of what one is supposed to do when one encounters racism. That may range for some people from nothing and just keep moving along to the other extreme, which may be, “Well, you have to confront it every single time.” There is no one size fits all solution to addressing social inequity when you encounter it. It always is situational. It always depends on who you are, what your resources are, what youʼre up against. And at some point, do you want to do this?Itʼs like, okay, how much do you have to do today? Do you want to exert the time and energy on responding to this thing? Because at some point, in any patientʼs life or in any therapeutic moment, you make decisions about what youʼre going to respond to and what youʼre not. This is where location and context are important for someone, letʼs say, who was living or working in a really racist environment. If a person feels compelled to respond directly to every single racist thing that happens in their life, itʼs exhausting. And whatʼs going to be accomplished?
But then, the therapist needs to understand also, what does it mean to that person if theyʼre not responding? Why do they think theyʼre supposed to respond to every single thing? Again, the sense of, well, what do people think theyʼre supposed to do, and why do they think that? Where did they learn that? And if they learned it from family members, you know, was there a discrepancy between what family members told them theyʼre supposed to do and what they saw family members doing? That sort of “Do as I say and not as I do,” as we all know, doesnʼt work so well because kids see what you do before they understand anything you say.
A Way of Knowing
LR: Where do you fall on this so-called debate over whether a white therapist should bring up the issue of race with their black client?
BG: I never get why thereʼs a debate. The question is how you explore it. Because if you were seeing a transgender client, why wouldnʼt you ask any questions about that? Wouldnʼt you think that has some relevance to this personʼs experience? We ask LGBTQ clients about when they first experienced their sexual orientation, what they think it meant. We ask about coming out stories and the like. But
we make the assumptions about race that because people are born black, theyʼre born with a black identity, when in reality, theyʼre born with a black demographic
we make the assumptions about race that because people are born black, theyʼre born with a black identity, when in reality, theyʼre born with a black demographic. Theyʼre not born with a black identity. Identity takes time to develop and does so in interaction with the environment.
I think itʼs appropriate to ask questions like, “What was your earliest experience knowing you were a black person? When did you understand what that meant, and was there a connection between the two? Or do you ever remember not knowing? How old were you? What was the situation? What was the experience? What was the experience that you connected that gave race meaning? This thing, being black, means something. Itʼs connected with, among other things, subordinate social status. That means there are limitations on you in some way. How did you find out? Were you able to talk to anybody in the family about it? What did they tell you? What had their experiences been like? What was the most transformative experience youʼve ever had around race or racial inequity? What encounter really sticks out in your mind in terms of when you were growing up?”
When youʼre taking a personʼs history, itʼs important to be asking questions about family and who the family was, where the family came from, what their experiences were like. I am still an old school therapist who believes you want to understand something about somebodyʼs history and their family before you jump in talking about symptoms and what youʼre going to do ostensibly to address the “problem.” Part of it is understanding the history of the problem. Itʼs understanding the history of the person and how thatʼs related to this thing that theyʼre bringing in as the problem. What, if any, are the connections there? What was the most recent experience or encounter with racism? What was it like for them?
You had asked earlier whether the therapist should raise the issue of race when the patient walks in the door the first time you start talking about it. Well, you donʼt do that with a lot of things that you think are important to raise in therapy. You look for natural openings to do that. Itʼs reasonable to ask those kinds of questions when youʼre doing a history. The notion of whatʼs it like working with a white therapist? Thatʼs not the first question Iʼd ask someone. That may or may not be the issue for them. So you ask a broader question first about being understood. “What things do you think Iʼll understand? What things do you think I wonʼt understand? Would you be willing to tell me at times that you think I donʼt understand, or I donʼt get it?”
The patient may say something about race, and if they do, you can follow that up. And if they donʼt, there may be other opportunities to raise it around the general issue of difference. But I think an important thing is that often
when black people have been asked questions about race and racism by a white person, not just in therapy, but in their life experience, they never know if that person really wants to know the answer, because sometimes the answer is not pretty
when black people have been asked questions about race and racism by a white person, not just in therapy, but in their life experience, they never know if that person really wants to know the answer, because sometimes the answer is not pretty.
If what that person wants is for the black person to say something that makes them feel better about who they are, then if they talk about how painful it is, and it makes them uncomfortable, are they then going to want to argue with you about, “Well, but itʼs really not that…”; are they going to get angry with you? We are often asked this question, but people really donʼt want to hear the answer. Not the truth, anyway. Because the truth is often painful, and it may evoke feelings of guilt or shame. And when people feel guilt or shame, they seek to do what they need to do to get rid of that as quickly as possible. In a therapist, thatʼs dangerous. When these feelings of guilt or shame get evoked in a therapist, it is their job to understand why thatʼs happening. If the white therapist is feeling uncomfortable, they need to figure out why; and not with the patient, but in their own therapy, supervision, consultation, or in other ways.
LR: I was going to ask you about racial countertransference and transference, but as you speak, I realize that whether it is about race, the therapistʼs own discomfort or unresolved issues must be addressed—period.
BG: What youʼre saying is, one of the things you donʼt get to be if youʼre a therapist is lacking in self-awareness. And that kind of goes with the job. If youʼre not willing to do that, then probably another line of work is more suitable for you. Our obligation is to understand how weʼre being affected by the process, what thatʼs evoking in us and why, and to be aware of those things and not just act on them. It involves the capacity for self-reflection and restraint. You donʼt just act on your feelings, but you have to be able to recognize them.Therapy is a complex process. Youʼre monitoring whatʼs going on between, but you also have to monitor whatʼs going on within and have some sense of what can get evoked in you and why it gets evoked, and in this case, it is about race and racism. How much of whatʼs going on is really about a response to the patient or how the patient evoked something in you that you struggle with?
What is often surprising to me is when I started my career, it was around having this discussion. And now, you know, 30 years later, itʼs sort of like weʼre still debating talking about race in therapy? Really? How do you not? It also, by the way, presumes that white patients donʼt have feelings about race. When you ask “What do we do with black patients?” thatʼs important, but I
donʼt think you can assume that white patients donʼt have feelings of all sorts about race, many of which the therapist may not share and may not like
donʼt think you can assume that white patients donʼt have feelings of all sorts about race, many of which the therapist may not share and may not like.
Fishing with a Net
LR: So we canʼt presume that a black patient does have feelings about racism, and we canʼt presume a white client doesnʼt. Just like we canʼt presume a straight person doesnʼt have feelings about homosexuality and vice versa. Itʼs about good solid curiosity, appreciation for context and good tracking, the same basic skills that go into any type of therapy.On a related note, Monica McGoldrick recently interviewed Elaine Pinderhughes, a prominent black social worker, on the intergenerational legacy of slavery. Iʼm wondering whether and how this should be a part of the conversation with black clients.
BG: Well, youʼre talking about history. What is the nature of this patientʼs history? Who is their family? Where did their family come from? Where did people grow up? Something I learned from Nancy Boyd Franklin is that “Who raised you?” may be a more relevant question than “Who are your parents?” “Who did you go to when you were in trouble?” That gets at something more basic than who you were biologically connected to, which is important, but it may not have the kernel of emotional significance for everyone in the same way.Any patient that I see, Iʼm thinking, who was their family? Who were their parents? What kind of struggles did those people have raising them? Did they have enough or sufficient resources? Did they get, when they were growing up, some sense of how to help that patient understand who they are as a black person and what racism looks like; how you determine when itʼs racism as opposed to when itʼs something else? How deeply were they loved and cared for, and by whom…
Again, what do you do in response to encounters with racism? When do you respond? How do you respond? How do you figure all of that out? Well, how those parents were raised and what they experienced is going to affect that. How their parents were raised and where, and what kinds of choices they had or didnʼt have, is going to affect your client as well.
All of that is part of the transgenerational process of racial socialization. But it also includes other kinds of socialization within a family. Were people struggling to barely make ends meet? Because the more tangible tasks a family has to do to have basic resources, the less time and emotional wherewithal parents may have to look at the picture of, “Well, was your teacher mean because youʼre black?” They may respond poorly by dismissing their childʼs concerns, e.g., “I donʼt know. Just ignore it. Go watch TV. Go do whatever.”
So all those things matter. The history of the patientʼs relationships with their parents and other significant figures. Were those generally positive and beneficial connections? Were they fraught with conflict? All those things are part of the picture, and so I would think you donʼt have to ask about slavery.
LR: Itʼll come up.
BG: Yeah, youʼre asking about a familyʼs history, so you will get something that will lead you to ask other questions, or youʼll have the question answered. But you donʼt start there because not every black personʼs family goes back to slaves.
LR: I wonder if white therapists can fumble over their lack of racial awareness by presuming the inevitable presence of niggerization, by presuming slavery, by presuming transgenerational trauma; and in doing so, stack the interview with such racially charged questions that it becomes assaultive and oppressive to the black clients rather than illuminating, safe, and engaging?
BG: Thatʼs why Iʼm saying
you ask about history, not about slavery
you ask about history, not about slavery. Whatʼs your familyʼs history? Of any patient. Because often if you donʼt ask a question you donʼt get an answer, but ask a question, and you get information that you hadnʼt expected to get. At least thatʼs often been my experience. My assumption about what the answer would have been is not what it was. Even with patients who have specifically asked for a black therapist, I ask them why that was important. The reasons that I thought might be? That has never been so.
Once I start exploring that, I learn that sometimes itʼs not really about race per se, thatʼs not where itʼs at. That thing about blackness means something different to different people. It means something different to those who felt theyʼd be better understood. Once weʼre exploring the why, often the why doesnʼt necessarily mean the client feels better understood. The therapist may mistakenly presume that because they and the patient share a skin color that they also share a narrative around blackness. While all black folks share aspects of history and treatment, every personʼs individual narrative is unique. As a therapist, it is the patientʼs unique narrative that you seek to understand.
LR: So a black client might presume a certain level of safety with a black therapist that is as unwarranted, perhaps, as a feeling of unsafety they feel about a white therapist. Itʼs what the black client brings in that the therapist must be curious about, rather than just accept.
BG: You canʼt assume that you know anything. Be curious. I know when patients have asked for a black therapist, thatʼs the route that got them to me. And so I know that was a request, and I can ask about that. But again, it goes back to that question of “Do you think I can understand what the world is like for you? And in what ways, what kinds of things will I understand? What kinds of things wonʼt I understand?”Youʼre getting at whatʼs most important to the patient in terms of how they need to be understood. For some patients, it may not be their blackness that their concerns about being misunderstood are organized around. It could be their sexual orientation. It could be their class background and the way it intersects with their blackness. So you donʼt assume. You ask a question. Itʼs kind of like youʼre fishing. If you just want one fish, you use a line and a pole. If youʼre fishing and you donʼt know what youʼre going to get, but you want to get as much as possible, you use a net, and then youʼll get something. And what you get may then tell you what other kinds of questions you need to ask.
Working with the Family
LR: In working with black families, especially those with young children, how would a white therapist help that family to have “the talk” when the caretakers may not be willing, ready, or able to have that talk?
BG: You start with broader questions. I would ask parents about their relationship with their kids and what they want to see for their children. What are their fears for their kids? What are their concerns about their growing up? What are the things that they think are really important for them to know? How do they communicate that? Have they talked about that? Sometimes parents think they are communicating something to their kids that is not so clear, and sometimes itʼs their discomfort around not knowing how to do it.You can ask, “Do you think your parents had those concerns for you? How did they communicate them with you? Was that helpful? Would you choose to do that in the same way? Or would you think, ʼI need to do this differentlyʼ?” Because everybody has feelings about things their parents did when they were raised that they thought were helpful, or things they thought were less helpful and they thought something else would be more helpful. So you can get at it in that way.
In working with black parents, you do start getting their fears for their kids around race and whatʼs going to happen to them
In working with black parents, you do start getting their fears for their kids around race and whatʼs going to happen to them. For some parents, you may hear, “Well, I donʼt want them ever to use race as an excuse for not being successful.” Thatʼs valid. How might that happen? Letʼs look at that. How might that happen? How would we tell the difference between when itʼs them or when itʼs somebody or something else? Is there a sense of how to do that? How do they do it when theyʼre in the workplace or whatever?
And sometimes what you may hear from some people is their defensive way of managing racism, which is to be in denial about a certain level of it. Well, what is that? Itʼs a defense. So you try to understand what the defense is protecting them from, although in some cases, itʼs fairly obvious. Is it control? If you allow that thereʼs this thing out there that can have such a powerful effect on oneʼs life that you canʼt control, do you assume more responsibility for what happens to you than is necessarily yours because that feels better than acknowledging there are these places where you really donʼt have control? And that depends on who the individual is and what makes them feel more vulnerable. Because we know that certainly in some people who are traumatized or abused, early on in treatment, their understanding is often, “Well, I permitted that to happen. I brought it on myself.” There is a way that they take inappropriate levels of responsibility for something that happened to them. Because that may feel safer than the feeling that you were helpless and you could not have stopped it. But in fact, it highlights a way in which youʼre vulnerable in the world that for some people may be less tolerable than saying, “I was responsible for this bad thing that happened to me.” At least that gives a person a feeling of agency.
LR: You have written about narrative development among black children on their road to becoming adults. What are the therapeutic tasks for helping black families raise their children?
BG: Well, you have to understand how the parents have done that, and what they learned from their own parents about doing that. Did they get the message that this is a crazy world, and sometimes we have to negotiate things that are unfair? But in those moments, we canʼt change that. So the question is, what we do that leaves us with as much agency as possible while also keeping us safe? “Is this a situation that you can leave? Whatʼs the price of leaving? Is this a place that is hostile, but youʼre stuck there? Then how do you figure out how to manage that hostility so that you donʼt internalize it and minimize the injurious effects of it?” And anywhere in between.
LR: And thatʼs a privilege of being a white parent—never having to have those conversations with their kids. Never having to prepare their children to live in a hostile world.
BG: Thatʼs one of the privileges, yes. I read someplace in the family therapy literature that
one of the challenges for black families is to raise their children to live among white people without becoming white people
one of the challenges for black families is to raise their children to live among white people without becoming white people. That theirs is not a dominant cultural narrative, and how to hold both of those narratives in your head but understand and appreciate the difference and hold your own narrative in as high esteem as possible. We know that people who belong to marginalized groups often can see the center and the dominant group more clearly than it sees itself, because itʼs at the center of itself. Itʼs like you donʼt have to think about whiteness if it doesnʼt get in the way for you.
People are more aware of the identities that are apt to cause problems for them when they interact with broader society. Itʼs not unlike the way sexual minority individuals—although they donʼt have the benefit of getting that socialization from their families—understand how to be in a world that has a different narrative than their own. It is about being able to hold on to your own narrative, see the flaws in the dominant cultural narrative, understand when and how to challenge it, and when not to.
But therapists can help black parents who, if they can express trepidation or apprehension or concern about having “the talk,” can have it in therapy with that parent. “What would you want your child to know? What would you say to them? What is it that makes you apprehensive? What is it that somehow you think youʼre not going to get right? What would getting it right look like?”
You can roleplay in those situations. I have a colleague who was working with an adolescent black male and his grandmother. The teen was getting his driverʼs permit, and, of course, she was apprehensive about that but couldnʼt quite articulate that it was about more than just driving. Her unspoken message was that “You can get into an accident if youʼre driving.” It was about now heʼs in the crosshairs of the police. Heʼs out there exposed to danger in a different kind of way.
LR: Vulnerable.
BG: Yes. Some of the challenges for black families are heightened during adolescence, when there is a natural move towards autonomy in children.
Some families, in this instance black families, may appear to be overly protective or intrusive during these periods because theyʼre scared for their children
Some families, in this instance black families, may appear to be overly protective or intrusive during these periods because theyʼre scared for their children. There are realistic dangers out there for their children around which the parent may have apprehensions and fears due to lack of preparation.
That tendency to be seen as overprotective, to be interfering with a normal developmental move towards autonomy, has to be understood in terms of each individual family. For some families, there may be overprotectiveness that has other kinds of dynamics attached to it, but one of the things that happens in black families is that their fears are realistic. There are realistic things that happen to your kids if theyʼre out there driving that have to do with police brutality, that sometimes I donʼt think some white therapists recognize. Having an appropriate level of concern for your children but allowing them age-appropriate autonomy is a difficult balance to strike under normal circumstances. And for black parents, it can be particularly fraught, because there are other dangers out there that are real for black kids because they are seen as older than their chronological age, more aggressive, and possessing other kinds of negative traits that put them at risk.
This colleague of mine asked this grandmother what she was afraid of. I think in this instance she was talking about him getting his driverʼs permit. As the therapist asked what was going on and what were her concerns, the grandmother started to weep and said, “The police.” The therapist then said, “Have you had that talk with him about how to conduct himself when he encounters the police? This is likely to happen. This is something that happens to young black men. It may be that heʼs stopped unfairly…” and she said no. She just didnʼt even know how to approach that. The therapist said, “We can talk about it here. Would you like to have that talk with him here?” So thatʼs also another thing that therapists can do.
LR: So a white therapist might falsely interpret a black parentʼs efforts to protect their children as stymieing their autonomy, and that would not be a sensitive way to make that interpretation.
BG: No, nor is it an accurate interpretation. Itʼs not motivated by an attempt to stymie autonomy. Itʼs motivated by, for some parents that Iʼve worked with, an abrupt realization that when a child is a certain age, itʼs like, “Oh, this is what you look like out in the world, and this is whatʼs going to be made of that, and people are going to try to hurt you.” Particularly as boys move from childhood to adolescence and start looking more like young men than boys. But even as boys, black boys are adultified. In much of the research,
black children tend to be seen as more sexually precocious, aggressive, and older than their chronological age and less worthy of protection
black children tend to be seen as more sexually precocious, aggressive, and older than their chronological age and less worthy of protection.
Training Better Therapists
LR: What must clinical educators of all races do to better prepare therapists to work with black clients…to be better therapists?
BG: I often say to my students that the very thing required of us to reach a high educational/professional status is the same thing that undermines being a good therapist. To get into a clinical Ph.D. program in psychology requires demonstrating how much you know and how smart you are. But in therapy, youʼre not so smart. The patientʼs the one who has all the information about who they are. You donʼt. And
the more you can tolerate your own ignorance, the better the therapist youʼll actually be
the more you can tolerate your own ignorance, the better the therapist youʼll actually be, because youʼll ask questions as part of that process to help give your patient an organized way of understanding things and problem-solving so that they begin to ask themselves those questions.
As therapists, we have to be comfortable not having the answers, not needing to be right. Sometimes weʼll get it wrong. Part of what weʼre also modeling for patients is humility. That none of us gets it right all the time and that they donʼt have to either. There can be self-forgiveness for making mistakes. Thatʼs part of being human. That doesnʼt mean you can just do sloppy half-assed therapy and say, “Oh well, I made a mistake. Thatʼs okay.” We have a certain responsibility to our patients. But the sense that we should have the answers? Well, we donʼt have the answers.
Thriving Through Adversity
LR: It seems that traditional western medicalized psychotherapy is an oppressive ideology, or an oppressive regime designed to subordinate marginalized people.
BG: Historically, if you think about sexual minority group members and African Americans, three of the major institutions in our society have been used to maintain their subordination and to maintain the domination of the groups that are dominant. Thatʼs religion, law, and medicine. In religion, if youʼre deemed a sinner, youʼre regarded as defective or deficient, and itʼs okay for people to ill-treat you. If a person is legally deemed a criminal, then things can be done to that person that canʼt otherwise be done in a civilized society. And medically, when the person is deemed ill, they are pathologized. The illness is in this person rather than in the interaction between the person and society. Often, it is not that the patient is pathological, but theyʼre in an environment thatʼs pathological, and they donʼt always have the resources that they need to fulfill social contracts. By not fulfilling those contracts, then theyʼre seen as defective or pathological in some way.In the history of mental health, those two groups (sexual minorities and African Americans) have been subordinated through each of these dominant institutions. And if you look at immigrants and the history of psychological testing, there is sufficient evidence that they, too, have been marginalized as being intellectually sub-standard. Letʼs not talk about restricted educational opportunities or any of those things. Letʼs just pathologize the person. Itʼs a way of avoiding looking at systemic inequity. Itʼs rather saying, “This person is the problem,” or “The problem is in them.”
LR: It seems that psychotherapyʼs salvation lies in postmodern approaches, narrative approaches, that allow for a real hearing of the clientʼs narrative, the clientʼs history, and how they interact within the contexts of their lives, rather than a top-down reductionistic way of pigeonholing people.
BG: These groups of subordinated people have had to come up with solutions to problems that are very real and make us wonder, “Why isnʼt it much worse than this?” Because
if you look at all the systemic assaults that have taken place on African Americans from the inception of slavery, there was never a respect for the integrity of the African American family
if you look at all the systemic assaults that have taken place on African Americans from the inception of slavery, there was never a respect for the integrity of the African American family. Social policy has been organized around the kinds of practices that are destructive to black families. And so, if you look at slave families, you are compelled to ask, how did they manage to survive in situations in which their children were literally taken and sold, never to be seen again? Well, somehow informal adoption became this thing that black families did to claim children beyond biological ties and protect their groupsʼ children from this practice.
In slavery, the children on the plantation found parents among other slaves whose children had been given away. There have always been these kinds of adaptive mechanisms within African Americans that have never received much attention, that Robert Hill and Nancy Boyd Franklin later studied. Despite all the destruction, they wondered, how was it that African Americans in many cases not only survived but thrived?
I donʼt mean that they were unaffected by the destructive aspects of racism, but despite that, they thrived. Despite prohibitions against learning, people were determined to learn how to read. They were determined that their children would get an education. Why do we see that? That points to understanding the strengths of people as well as understanding their vulnerabilities. Thatʼs important and other groups can learn from it.
LR: Especially white therapists working with black clients.
BG: We can learn something from black clients about how to negotiate hostile environments. Successful black people have negotiated hostile environments. Theyʼve had to get to where they are, for the most part. And so, in terms of mental health as an institution, we might want to understand something about how survivors and thrivers in marginalized groups manage to do that and what the constituents of that were to help other people who have not.
Despite all the assaults, African Americans are not inevitable psychological cripples
Despite all the assaults, African Americans are not inevitable psychological cripples. The question then is, well, why is that? Given everything, why wouldnʼt they be? Why wouldnʼt people have just given up? Why did slaves have hope, for Godʼs sake? What was there to be hopeful about? Certainly there were some who did give up, but for the most part, weʼre all here because mostly they didnʼt. But why didnʼt they? There was no sign that there was any reason to be hopeful.
I think another important piece is, given what weʼre seeing in terms of this movement against police brutality, therapists need to understand this is not new for black folks. This is a long continuation of something, and the constant exposure to this may impact black clients differently than white clients for whom itʼs like, really? This really happens?
Black folks have been living with this interminably. For us, this keeps happening. This is kind of a pile-on, and it might help people to better understand that thereʼs perhaps a different response taking place among black people. This isnʼt new. So why is it that this has come up before, itʼs been discussed before, and itʼs dropped?
And is that going to happen again? Are those new-found coalitions really going to hold when the people who join us in those coalitions become niggerized, when they begin to be treated, you know, in destructive ways, as we are often used to being treated? When they begin to be negated in ways that weʼre used to being negated. Are those coalitions going to hold? Because we know what to expect. We know how bad it can get. People who are just joining these coalitions may not fully appreciate that. Is that clear?
LR: Depending on their history. Depending on how they were raised. Depending on their personal experiences. Yes, it is. Am I hearing you?
BG: This is something black families prepare their children for. This isnʼt new. So, what are the implications of that? Again, when the stress trauma isnʼt post, but itʼs ongoing.
LR: Ongoing. Continual. As we close, I am wondering if I did a good enough job of listening to you? Not as a black woman, not as a psychologist, just as a person in conversation.
BG: Yeah. Do you doubt that you did? Are you feeling reasonably satisfied?
LR: I am. This is so much bigger than I could have imagined. I mean, I havenʼt been a recipient of racism, and I see whatʼs going on, and I want this to be an important conversation, and I want the therapists to really get these messages, so I guess Iʼm carrying the burden, not for white therapists per se, but for therapists in general who arenʼt aware yet. I came into this interview with the greatest sense of burden on my shoulders.
BG: When you say youʼve never experienced racism, youʼve never experienced anti-Semitism?
LR: Perhaps I have somehow skirted it. Maybe one or two comments somewhere. People have told Jew jokes to me. And Iʼve sort of laughed them off or corrected them.
BG: Did you think they were funny?
LR: No.
BG: Then youʼve experienced a microaggression of anti-Semitism. Did you feel you could say, “Thatʼs not funny, and Iʼd rather you didnʼt tell me those kinds of jokes”?
LR: Yes.
BG: Did you feel you could say that?
LR: I did. Because itʼs usually some white person, whom I disregarded because of their ignorance, and I did feel powerful enough to say that. So, I havenʼt felt that I didnʼt have the right to say that.
BG: Well, but that was nevertheless a form of microaggression. That person was in the wrong. But if you were the dominated one, you would have to not say anything because their dominance in some way would be likely to prevail. Theyʼre small examples, but nonetheless, that is a form of anti-Semitism.
LR: Yes. So I have.
BG: And what made it OK for someone to think it was OK to say that to you…?
The Ask: Engaging Fellow Therapists of Color During Turbulent Times
The week after George Floyd?s death was significant for me both personally and professionally. Personally, as an African-American father and husband, I wrestled with the potential implications of this and other recent events on me personally, my family, and my community at large. Professionally, as a marriage and family therapist, I prepared myself to be ready to provide emotional support to all my clients, knowing that they differ in their variety of cultural experiences. Interestingly, while I was prepared to support my clients in their various responses, I was not prepared to have to provide emotional support for my professional colleagues as well.
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For some of my fellow helping professionals of color, this event was just the latest of many similar social injustices, leading them to wrestle not only with determining how they should respond, but also how much emotional energy they would allow it to have in their lives — believing that it likely wouldn?t be the last such event they would experience. And for other colleagues, while they were aware that they lived in an imperfect world with an imperfect history, this event made the inequalities between their life experiences and that of many others — with whom they differ culturally — more real and personally impacting than it had ever been before. In response to this new-to-them revelation, and with a genuine desire to not let that feeling fade away without making a mark on their lives in some positive way, a trend began — a trend that I call “The Ask.”
“The Ask” refers to the trend that I, and many other professionals of color, experienced after the death of George Floyd, where typical casual greetings were replaced by emotion-filled questions such as, “So, how are you doing?” — except with much more meaning that it previously held.
Asking how someone is doing is a common question among professional colleagues, as it is in nonprofessional life. It is generally a casual greeting, a courteous gesture of respect, and an acknowledgement of the therapist as a person, without an actual expectation of a long discourse in response. This is evident when someone says to their colleague in passing, “Hey, how are you doing?” only to be caught off guard when the colleague stops and offers a long personal answer to the question. The unexpectedness of the response reveals the reality that the original question was intended to be more of a casual greeting than a genuine invitation to share. Interestingly, while mental health professionals are often very good at cultivating vulnerability with their clients, we rarely do the same with our colleagues.
Despite the genuineness of the invitation, therapists of color do not always feel they have the luxury to casually accept the invitation to share vulnerably. This is not due to a desire for secrecy, judgment, or to convey a colleague?s unworthiness to know; but rather because doing so comes with risks that the therapist may or not be willing to take. As such, when it comes to asking therapists of color to share how they are doing as it relates to their personal and emotional struggles influenced by the impact of social injustices on their personal cultural experiences, it is beneficial to consider a few of the risks they might feel in responding to “The Ask.” Here are just a few of those risks, to get you started.
Risk of Polarization: Accepting the invitation to vulnerably share emotional cultural struggles (including past experiences and fears for the future) risks shifting the rapport between colleagues. Oftentimes, prior to “The Ask,” the therapist of color had the luxury of cultivating genuine neutral support from their colleague, regardless of whether the colleagues shared the same cultural experiences or values. They could practice managing their emotional struggles privately and strategically sharing about their own experiences only when doing so was beneficial for risk-free clinical consultation, understanding, and growth. However, if the therapist of color shares that they personally struggle with an experience or value the colleague has contrasting values and beliefs about, it may negatively influence future conversations. And depending on the colleague?s response, both therapists may walk away from the conversation with changed beliefs about and comfortability with each other. For some, this would be considered acceptable and beneficial, as it helps colleagues present their authentic true selves to professional relationships. However, for others, they would prefer the choice of when to take that risk, rather than having the risk thrust upon them.
Risk of Vulnerability: “The Ask” is often a request for someone to be vulnerable in a way that they have not previously been with the person who is asking. It is asking someone to trust that the answer can be received well and will not be used against them. And while it can be easy to take a lack of automatic trust personally, the reason for the caution often precedes the request. Often, previous experiences of vulnerability being rejected, minimized, or abused makes a genuine “Ask” a riskier request than it was intended to be.
Risk of Traumatization: “The Ask” indirectly invites the therapist of color to reexperience something potentially traumatic (whether directly or indirectly). While this may genuinely assist in helping the colleague increase their cultural understanding, the question arises as to whether it was worth the cost to the therapist of color. And while some reasonably conclude that this risk is acceptable because they are asking a mental health professional who is trained to effectively manage these potentially emotionally traumatic experiences, this conclusion minimizes the significant toll such a reexperiencing of trauma takes on mental health professionals who, while trained, are real people with real feelings.
In light of these risks and in order to provide a few helpful considerations regarding how a genuinely interested colleague can show care for therapists of color as individuals, while also seeking to learn from their cultural experiences, I offer the following.
Accept the Unavoidability of Risk. Doing so reduces judgment, shame, and blame in the event of an undesirable outcome such as unintentionally offending the person being asked and straining future professional interactions. While accepting that risks are unavoidable, efforts should be made to show a desire to reduce these risks and potential negative impacts as much as reasonably possible. Sometimes a brief disclaimer before “The Ask” that conveys value and reassures of positive intentions can significantly reduce unspoken tensions. For example, “I know it might be a lot to ask, but it?s not too uncomfortable, can I ask you something about your experiences?”
Ask Humbly. Asking with a sense of respect and value, rather than entitlement, sets a good foundation for the possibility that you can be trusted with the answer. Humility conveys both confidence as well as respect, making it clear that you know that what you are asking for is a vulnerable, voluntary gift the therapist of color can choose to or not to offer.
Accept & Validate Caution. Remember that present caution often has a past origin (that precedes “The Ask”), so instead of interpreting their caution as a personal sign of disrespect, consider what possible experiences they may have had prior to your encounter that may be making it difficult for them to return your genuine inquiry with unfiltered vulnerability. It?s even possible that they may have had a bad experience with someone similar to you in some way, making it unclear whether or not you will behave similarly or whether you will pleasantly surprise them.
Appreciate the Gift. If a professional is willing to share vulnerably despite these and many other personal or professional risks, then show your appreciation for that generous gift by expressing that appreciation verbally. Show that it was worth the risk by putting something you learned into action and sharing such with them. You can also show your appreciation for this gift of risk by not asking for too much too frequently — going back to the well too often can lead to feelings of being taken for granted. If it is unclear how often is too often, or what degree of appreciation is most applicable, initiate a verbal or behavioral offer in which you are comfortable, and follow their lead based on their response.
After spending several therapy sessions navigating “The Ask” with my clients, primarily focused on identifying and meeting their needs and desires for personal growth and understanding rather than my own, I experienced “The Ask” coming from a colleague whom I trusted professionally, but with whom I had not yet been personally vulnerable. Because of a combination of my previously cultivated respect for them professionally and the respectful care exuded by their request, I chose to take the risk and share of my efforts to balance personal and professional cultural experiences during these turbulent times. Although inwardly cautious, I was hopeful that it would be received well. Although the genuine verbal appreciation that I received in response was reassuring, what made the risk most worth it was the acknowledgment that the experiences I shared helped enhance their personal and professional understanding — potentially even helping them to understand experiences their current clients had been sharing about more thoroughly. Knowing that a personal risk could positively impact not only another professional, but also countless clients whom I may never be in a position to support directly, not only helped make that a positive experience, but also increased the likelihood that I might take that risk again in the future.
***
In life, both personally and professionally, some things can only be learned through experience, whereas other things we must learn by asking about others? experiences. I encourage you to acknowledge and accept the risks and implications of “The Ask,” including the emotional and relational implications of your genuine curiosity and desire for personal and professional growth. Offer nonjudgmental support if “The Ask” is declined. And express your genuine appreciation for whatever response your colleagues are willing to provide.
Helping Domestic Abuse Victims During Quarantine
In a time when most Americans have been asked to stay home in an attempt to control the spread of the novel coronavirus, many domestic abuse victims are finding themselves trapped with their emotional, sexual, financial or physical abusers. Distance is the primary strategy for many victims of domestic violence. For them, shelter-at-home means no shelter at all. They cannot leave home to go to jobs, to work out at gyms, visit friends or family, attend regular therapy sessions or join support groups.
During this pandemic, most therapists are adjusting to online therapy and all the challenges it presents. Many client populations lend themselves well to telehealth options. One that doesn’t is victims who are stuck at home in abusive relationships. Confidentiality and privacy are challenging when someone lives with an abuser. But services for those stuck at home in volatile environments are essential. Finding a private place at home or in their car to participate in online therapy is only one of the many difficulties in providing help to those isolated with their abusers.
Clinical Challenges in Domestic Violence
As a therapist, one of the most challenging populations for me to work with has been victims of domestic violence. I still remember the client I treated in a psychiatric hospital 37 years ago. She’d agreed to inpatient treatment for her depression and severe PTSD and to an escape plan, only to leave the hospital AMA and be picked up curbside by her abuser.
I was young and idealistic. I could not understand how this was possible after all our work together.
I now know that domestic abuse is an extremely complicated dynamic. One complication is that those close to a victim, as well as the victim themselves, often minimize the abuse and blame the victim for what is happening. Their friends and family are unlikely to know the extent of the abuse, and the few who may are so tired of hearing the same old story that they begin to blame the victim for not leaving. “If you’re not going to do anything about it, quit talking about it,” I often hear victims report their friends and family having said to them. This only adds to the guilt and feelings of worthlessness. Victims then feel more alone and emotionally dependent on their abuser. Worse still, it can lead to a victim’s not talking about the abuse all together.
Another challenging aspect of domestic violence is that the abuser often holds a past mistake or shortcoming over the victim’s head. This past error or genetic weakness (i.e., “Your family is full of deadbeats”) is often embarrassing and leads the victim to doubt their own worthiness. Often, an abuser will convince a victim that no one else will ever love them and life with the abuser, however painful, is as good as the victim can hope for or deserves. If the victim feels guilty or indebted, escape is even more unlikely.
Many abuse victims have been raised in abusive childhood homes where belonging, food, clothing and shelter were inextricably interwoven with emotional, verbal, sexual and physical abuse. Many of these childhood norms and assumptions retreat to the unconscious. They may never have been revisited, questioned or replaced with more healthy internal models of "family.” If an abuse victim was told repeatedly throughout their childhood, “I do this because I love you,” the confusion of that message may not even be in their awareness. Part of effective therapy with abuse victims is examining these toxic, yet impactful, childhood messages.
Victims of abuse who have children at home are truly in a double bind. Staying in the volatile environment is damaging to children, but leaving often presents even scarier situations. If they leave and divorce, the odds are, with a couple parenting classes, an anger management course, a few monitored visitations and an expensive attorney, their children will be spending half the time with the abuser without supervision. Just the thought of their children being unprotected with an abusive parent can keep many victims immobilized. Supportive education and legal representation can help mitigate some of these terrifying possibilities.
Another disturbed and disturbing aspect of these toxic relationships that keeps friends and sometimes therapists and law enforcement from intervening is that after a well-intentioned person assists the victim in getting away, the recently escaped is highly likely to return to the abuser. After this occurs, both the victim and the abuser turn on the helper as a way of re-establishing the bond in the abusive relationship. This can leave those who have sacrificed time, emotions and finances feeling used and resentful. Many friends and family members of abuse victims distance themselves from the person who needs them most, because they are just exhausted and discouraged.
It is important that as therapists, we try to remember that the victim is not staying in the relationship because they like the abuse. They are staying in the relationship for the upside (extended family, the “honeymoon” phase after a fight, the generosity, the flattery, the social community, the hope of a better future and stability for the kids), not for the downside. Many abuse victims are enticed by the kindness shown them after an abusive episode. They believe if the abuser can be nice for a short period, it may be in them to really change and show long-term kindness in the relationship. “Victims often believe they can influence the abuser into this state of kindness permanently”. They hope that if they accommodate enough, provide adequate logic, apologize sufficiently, and anticipate the wants and needs of the abuser, then they will be able to have the emotional safety and generosity they have only experienced periodically. In chasing this idealized fantasy, victims find themselves trying to take responsibility for the actions and emotions of their abusers.
Assisting a client in learning that they can survive, even thrive, without the upside of the abusive relationship will go further than continuously trying to get them to view the painful aspects of their circumstances. They are aware of the pain in the relationship. What they need to know is they can create or replace the good parts of the relationship.
Therapists who are working with abuse victims must focus first on immediate safety. This is not always easy to determine, as abuse victims often know the keywords that would trigger a mandated report. At times, I have called colleagues or even the attorneys through my professional organizations and professional liability company to ask questions about what is reportable and what would be breaking client privilege. These parameters are different in each state, and it is important to stay current with reporting laws. If I must make a report, I always tell a client that I am going to, why I must, and what they might expect from social service and law enforcement.
If the victim is not in immediate danger and nothing has recently happened that a therapist needs to report, the therapeutic focus then needs to be on increasing self-confidence and self-trust and creating a plan of safety for the victim.
While developing self-confidence, a sense of efficacy and self-worth are important parts of treatment, these may take time. “One way for a victim to work on these is to establish relationships with other survivors”. This may include reading others’ stories online or in books, feeling a sense of community by following social media dedicated to domestic violence, or joining web-based support groups for domestic abuse victims. Knowing that they are not alone and that others have found ways out are essential parts of treatment for victims. Reading that others have found ways of forgiving themselves for things that were held over their heads, or have learned that they are not worthless even though their heritage or pasts were not perfect, are emotional doors to freedom.
While building a support system and gathering other victims’ success stories, a therapist can help a victim develop practical plans. Strategizing is an important aspect of leaving, but also of staying safe before they leave. Plans can cover emergency shelter, food, money, and safety for themselves and their children.
Pandemic-Related Challenges
While providing treatment to victims of domestic violence is always challenging, the current pandemic exacerbates treatment issues. Not only are victims trapped in a confined space with their abusers, but financial issues, job loss, social isolation, loss of access to outlets like sports or hobbies, and an unpredictable future can increase the acting out behavior of an abuser who already does not possess good strategies for coping with stress. When important aspects of life are actually out of control, people who blame others for their emotions and behaviors are less equipped to problem-solve in healthy ways. Abusers who feel this loss of control may actually become more volatile and hostile.
“Victims also have fewer options during this pandemic”. They have fewer job choices, fewer treatment options and more financial and social restrictions. They may fear that domestic violence calls will not be a priority for law enforcement and the courts will not issue restraining orders. The choices for alternative residences with children may seem impossible. With so much uncertainty and schools and businesses closed to in-person contact, victims may feel hopeless to change their unsafe situations.
A client whom I am treating during this pandemic (details have been changed) must meet for our video therapy sessions locked in his car to keep his partner from listening through a closed door in the house. He and his partner have been together for five years. When my client’s partner found out the venue and caterer would not refund the money for their upcoming wedding after shelter-in-place orders made the event impossible, the partner became enraged, broke valuables in their home and threatened their dog. The partner blamed my client for the financial hit and took his anger and feelings of loss of control out on my client. My client was raised in a household where he was beaten and eventually thrown out due to his sexual orientation. His fears of abandonment and history of violence added to his tolerance of his current abusive situation. My client quit his job six months ago to help his partner start a new business, a business that is not viable in the current climate. He has tried to leave several times; after the most recent time, his partner promised to change and proposed marriage. Now with no job, all finances gone, isolation from friends, and a family that offers no safe haven, my client feels trapped and hopeless.
The following list contains strategies I use when working with domestic violence victims during the COVID-19 crisis.
Therapeutic Planning
I have found the following to be highly effective when planning with my clients impacted by domestic violence.
1. Seek shelter with someone else. “If possible and safe, find an excuse to stay with another close family member or friend”. Maybe they need help working from home or with their children or pets. Maybe the neighbor’s dog needs to go for a walk. Maybe your kids need a playdate with another child. Maybe you need to take food to someone who cannot cook for themselves. Find a reason to get out, at least for a while.
2. Stay prepared. Hide an extra car key, jacket, credit card and walking shoes. Keep your phone charged. If things escalate, you need a way to leave. Planning is essential because when you are under pressure with adrenaline pumping through your brain, you may not be able to think as clearly.
3. Avoid escalating things with your abuser. Many arguments escalate faster (and may become violent more quickly) when you try to explain yourself. Let your abuser believe false things about you, i.e., “You always…,” “You never…,” “You think that…,” “You didn’t keep your word about…,” “I always give you…” “I do everything for you, you don’t…,” etc. Let them view you incorrectly, at least for the time you are stuck at home. Note: If your abuser has ever been violent, or you think they may become violent, this is not a suggestion to allow or put up with harm. If you are in danger, leave the situation and/or seek help from someone you trust as soon as you judge it safe to do so.
4. Don’t try to resolve this fight. Remember that this won’t be your last fight. Often abusers rope victims into arguments threatening that “this is your last chance, or…” You will most likely have this argument again. If they threaten to leave or divorce, remember they will probably say it again in the future. This will not be the last argument. Allow the tension to not be resolved. Do not chase them to “understand” you or your perspective.
5. Reach out to people you can trust. Tell people who care about you. This is the time to reach out to those who love you. “If you don’t have trusted friends or family, call the National Domestic Violence Hotline” at 1-800-799-7233. If your abuser forbids you to continue therapy with your current provider, there are other therapists offering phone or video sessions during this crisis. Some counselors are even offering discounted therapy sessions during the pandemic. If for any reason you can’t continue therapy with your current provider, search for a trustworthy therapist here. If you feel suicidal or have thoughts of hurting yourself, call the National Suicide Prevention Lifeline at 800-273-8255, call 911, or go to a local emergency department for help.
6. Practice self-care. Take care of your emotions. Switch activities up if your abuser clamps down on one or two. Exercise, listen to music, play video games, go for walks/bike rides, garden, do creative projects, or join online groups. Your feelings are legitimate. You are not overreacting. Pour your emotions into a healthy activity.
7. Avoid being trapped. Try not to be stuck in a car with your abuser. Try to avoid confined places where you cannot leave. Make excuses to get away or take separate cars. Call 911 if you feel in danger.
8. Don’t let your abuser pull you back into an argument. When you stop responding in an argument, don’t get pulled back in by “See, you don’t care, you’re just walking away,” “There you go giving up on us,” “Come back here, I’m not done talking to you,” or “See, you’re not interested in resolving this!” Walk away anyway. Don’t explain why. Remember that you can tell your therapist about this in your next session. You don’t have to process it with your abuser.
9. Remember the abuse is not your fault. Remember that “an abuser isn’t abusive because they don’t understand you or the facts, they are abusive because of who they are”. And no matter what you do or don’t do, say or don’t say, you can’t change them. This is extremely difficult; it may seem like you caused their anger and are responsible for it, but you didn’t and you aren’t.
10. Get help if you feel threatened. Go to a neighbor’s home or call 911 if you feel threatened. There are many domestic violence safe houses that can pick you up and keep you safe from your abuser and help you with legal issues like restraining orders. Many have accommodations for children as well.
***
Let your clients know they deserve to be compassionate to themselves even if they feel they are not making progress fast enough. Remind them that they did not cause anyone to treat them in an abusive way. They are never to blame for someone else’s behavior. They deserve respect, no matter how they have reacted in the past. As their counselor, you can model this and help build their sense of self-worth in therapy.
As a therapist, you have a unique role. In that role, you may be able to demonstrate compassion and kindness the victim has never experienced before. Even if you feel disappointed that the victim has once again returned to their abuser, demonstrate that you believe they will eventually leave and that you are there to support them on their journey. Don’t be discouraged. The seeds you plant may grow to fruition long after your client has discontinued therapy with you.
Questioning the “Ditch the Desk” Theory of Therapy
A fellow therapist and I were leaving the local massive business furniture outlet and headed toward my new private practice office with a brand spanking new desk stuffed into the trunk of his trusty 1976 Buick Regal. The desk was sitting on its side, protruding from the trunk and looking like a chimney or perhaps a missile without fins. It might have looked a bit odd, but this mode of transportation was going to save a starving new private practitioner (that would be me) a hefty delivery charge.
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This was the easy part. Getting it up several flights of winding stairs ourselves was going to be the real challenge, and to this day, I still have an almost imperceptible spot on one of my fingers briefly smashed in the process to remind me of that glorious event.
As we drove to my new office, he explained that having a large, expensive-looking desk made a therapist appear successful and this would work to my advantage as a placebo, giving clients more confidence in my ability to help. However, while attempting to navigate the Buick with no view out the rear window, my colleague gave me a stern warning, that a desk was merely intended to make the office look stylish, since it played no part in the treatment process.
Now, don’t get me wrong! I was well-aware of his statement that the desk plays no part whatsoever in the treatment process. That fact had been drilled into my head by every professor whose course I had ever taken.
We were taught in no uncertain terms that when you are doing therapy with a client, you are face-to-face, with no desk in the middle. You have a chair, as does the client. However, sitting behind a desk makes you look like some big expert. Not good. Sitting behind a desk contributes to the imbalance of power already inherent in the therapeutic relationship. Here again, not desirable. It makes the helper look more important. You are perceived as being better or special. The explanation we were given depended on the professor, but the bottom line was always the same: get the darn desk out of the helping equation — and get it out now!
If your office has a desk at all, sit beside it or use it as window dressing. But whatever you do, do not sit behind it.
It was quite easy for me to acquiesce, since I had previously done home-based treatment for many years, where the closest thing to a desk was a client’s kitchen table or workbench cluttered with an endless array of flat-head screwdrivers in the garage.
Then came the dawn. One fine day when I was ready to begin a therapy session, my client remarked, “Look, I know this sounds stupid, or maybe a bit old fashioned, but I like it better when you sit behind the desk.”
Rather than hiding behind my notes from grad school or reflecting the statement back, I merely moved behind the desk for old school therapy, and everything seemed to go well.
Since that time, this has occurred maybe 20 or so times over the years. That is not a lot; however, it is certainly enough to take it seriously. Although this request is not the rule, it is in the realm of possibilities.
Looking back, my graduate faculty got it right maybe 95% of the time, but there are clients who do not fit the model. In those instances, although they may be statistically rare, I would say pull up a chair behind the desk rather than trying to pay homage to a mentor from the past textbook author you admired.
One day, when I was recounting my ditch-the-desk experiences with a physician, he noted that it made a lot of sense. He reminded me that for many years, physicians wore lab coats. Then there was a period when the profession thought it would be better to dress in street clothes. Physicians traded in their traditional medical threads for suit coats, sports shirts, silk ties and scarfs, blazers, and, on occasion, yoga pants.
According to the physician I was conversing with, some, though certainly not all patients insisted upon seeing a physician who looked… well… like a physician rather than a dignitary attending a high-ticket fund raiser or somebody gearing up for a sweaty jog in the neighborhood.
Like the counseling client who wants to see you sitting behind the desk, a cadre of patients came forward and said they felt more comfortable having a doctor who dressed like a doctor, complete with a stethoscope and a name tag. Thus, in many instances the doctor’s outfit of yesteryear, like vinyl in the music industry, is making a comeback.
Could conducting therapy from behind the therapy desk be the next big thing? Frankly, I rather doubt it, but it could be worth its weight in gold for helping a select group of clients.
***
Postscript: Dr. Rosenthal’s new book is the Human Services Dictionary
Lesson Not Learned
In 1968, an elementary school teacher named Jane Elliott decided to teach her young students an important lesson: discrimination is arbitrary and hurtful. For those who have not heard of her work or seen the video, she divided the children into groups of blue-eyed and brown-eyed children, each group taking turns experiencing what it was like to be ostracized due to an inherited characteristic. Lesson learned. Of course, it is unconscionable that any group of people should be judged superior or inferior based upon any aspect of their appearance, but we humans have no shortage of ways to diminish our fellow citizens.
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The scourge called racism has been dominating the news for weeks now, but never has its impact been far from the consciousness of our fellow citizens of color. And I have little doubt that many therapists are bearing witness to countless tales of shame, disrespect, violence, and fear. Each heartfelt and troubling story is an opportunity for us to gain a deeper understanding of the burden and cost of racism as it is experienced by our clients, day after day, year after year, generation after generation. Important conversations are also happening in these clients’ homes, between spouses, siblings, parents and children. And while many of these conversations likely share similarities, each will be as unique as the DNA of its speakers. I got a glimpse into the power and pathos of such talks during my most recent sessions with my client, “Ed”.
Ed describes himself as a mixed-race child; his mother is black and his father is white. His parents divorced when he was nine years old, and while the children continued to have visits with their father, the mother was the primary caregiver. Both Ed and his sister identify as black. Our last few sessions delved into recent conversations he’d had with his father, children, and sister — raw, bold, and honest communions.
During Ed’s last talk with his father, he was horrified to hear him utter some racist comments. As the father of two self-identified black children, Ed couldn’t fathom how his father could hold any racist views. The father’s response was that throughout the years, he had had “numerous run-ins or altercations with black folks which left a bad taste in his mouth.” This is a perfect example of the danger of generalizing from a few examples to prove the theory. After speaking at great length with Ed about this, the father conceded the cognitive dissonance of his views, but maintained that they were his views nevertheless. Although Ed loves his father, he no longer feels as close to him.
“Very Waspy-looking — pale skin, straight, light blond hair, blue eyes,” was Ed’s description of his wife. Their children, 11 and 13, more closely resemble their mother than their father, and Ed believes “they’ll easily pass for white.” Sitting around the dinner table one evening, he asked the kids what they would say or do if they were socializing with a group of people who were disparaging people of color. Would they speak up and say they were offended because they were mixed-race, or would they laugh it off, as my client said he had done in his youth, to avoid conflict? Had they ever witnessed discrimination in school? Ed realized this was the first time the whole family had sat together to discuss racism and how it might impact each of them. He and his wife now plan to revisit this topic on a regular basis.
Another important talk was the one Ed with his sister, who is married to a dark-skinned black man. Their three sons are as dark-skinned as their father. His sister shared her fears with him, fears echoed by many other parents of black sons both privately and publicly. Will they have the same opportunities as Ed’s “white” children? Will they be subjected to police brutality? Will they be disrespected, spit upon, diminished as people? While this was not a new conversation between the two of them, they both admitted this one had a more urgent tone to it.
Sitting with Ed during these last few sessions, listening to him speak about the different ways discrimination has shaped him and his family, I wished I had thought to bring up the subject of race in our earlier sessions. When I asked myself why I hadn’t, I didn’t like the answer. I was uncomfortable. What if Ed felt my words of support weren’t authentic? What if he realized my knowledge about black culture was lacking? What if I inadvertently said something he construed as racist? Racism appalls me, enrages me, but here I was shying away from broaching this difficult but important subject with the very client who would have benefited from these talks. And all because of a bunch of “what ifs?” I thought about the countless times I would point out to my clients that “what ifs?” keep us from challenging ourselves by confining us within very narrow boundaries, shutting out much of life — both its beauty and ugliness. Now my own “what ifs” were keeping me from fully connecting with my client because I was reluctant to sit with discomfort. But I have vowed to break free of these self-limiting boundaries so that I can more fully support all my clients, especially my clients of color.
As Ed and his sister acknowledged, crushing racism is indeed urgent. Whether insidiously or blatantly, its loathsome tenets debase societies. Perhaps it’s time we brought Jane Elliott’s video out of storage, to be viewed far and wide. Because unlike Jane Elliott’s students, we have yet to learn her lesson that any form of discrimination destroys the soul.
Psychotherapy with Coronavirus: A Novel Experience
A Very Strange Referral
When I first met Corona (“©”) in my psychotherapeutic practice early in 2020, I was struck by a contradictory impression. On the one hand, he was almost invisible, with a timid appearance. He was so small that I seemingly had to look at him through a transmission electron microscope. On the other, he had an impressive, crown-like outer shell. It resembled a round naval contact mine with spikes that could explode if one bumped into them. But ©, a master of disguise and transformation, was trying to evade any scrutiny. It was only when he presented himself as the silent killer responsible for the COVID-19 pandemic that he evoked my curiosity.
Despite being retired for years, I decided to accept © for immediate treatment. It was not an easy decision. In the past, I had worked with clients for whom I felt some amount of sympathy and whom I wanted to help. Now I was faced with an adversary I might ultimately want to eradicate.
When © entered my office, I immediately felt nausea and had difficulty breathing. I didn’t make much of it until I gradually became aware of the various symptoms he caused me — fatigue, sore throat, dry cough, and fever. These were not the common countertransference responses all therapists have with their patients. They were warning signs that I might need to develop a deeper appreciation and understanding of who he actually was. Being suspicious of his motivation for coming to therapy in the first place, I decided to keep some distance from him to safeguard my own health, both physical and emotional.
It turned out that people keeping a distance from him was his main “presenting problem.” As a result, he felt chronically lonesome. “Everyone relates to me as if I were some kind of pest,” © said, “as if I have no birthright.” Sobbing heavily, he added, “Nobody has ever told me they love me.”
Not being in close contact with others also made him feel detached from himself. He said that as long as he could remember, he had searched for his real identity and for his genuine “self.” There was no “core” within him, no nucleus that gave him a sense of grounding. He was merely a string of RNA with 29 proteins that had to hijack living cells to replicate. “Sometimes, I even doubt if I am alive at all,” he said. “I feel so empty by myself and thrive only when I can merge with another person’s cells through my spike protein. That is when I obtain some sense of self-actualization. At that moment, I get a kick out of causing a kind of blast in myself and the other person.” It took some time before I understood he was talking about the cytokine storm when the immune system starts to attack its own cells and tissues rather than just fighting off the virus. “Every time this happens, I feel euphoric and am willing to do anything to feel it again.”
The Assessment Phase
Before starting treatment, I sent © for a few confirmatory medical tests to assess his physical functioning. First, he underwent a basic medical examination with the PCR test which confirmed he was indeed made up of the SARS-CoV-2 virus. Then I conducted a psychosocial evaluation to learn more about his childhood history, recent life experiences, and family background.
“© told me he was a child of the animal kingdom. His ancestors had lived a comfortable life within bats and other creatures for centuries”. “When stray dogs had bats for lunch, we lived in them for a while. Then, some hungry dudes made raw hamburgers of the dogs and consumed them with sauce,” he said. “We suddenly found ourselves within the cells of human beings. It took some time for us to adapt to these new surroundings, because they were very different from what we had been used to. The bodies of human beings were so much more vulnerable to illnesses, especially in their respiratory systems. I wish we had stayed within animals, because we had a good life there.”
© was the heir of a long lineage of imperial families who each had a history of causing pandemics. “Some of my predecessors from the SARS and MERS families have told me all about you people long before I came here,” he said in a scratchy voice. “I am a descendant of these prominent protein lines and carry their legacy with pride.” Clearly, there was more than just a slight hint of narcissism at work.
To learn more about his unconscious, I tried a few projective tests. When asked to make up stories about the ambiguous pictures in the T.A.T. test, © expressed considerable emotional agony. An unlucky serial killer being hunted by crooked police in white uniforms evoked anger and fear. A wonderful world without human beings was presented as “heaven on earth.” The common themes typically displayed some kind of paranoid fantasies.
Next, I administered a Rorschach test, which © seemed to enjoy tremendously, as if identifying with and recognizing each picture. Watching the inkblots, he often responded with loud laughs. He saw a lot of animals, but also many details of inner organs. In Card 8, he was visibly thrilled when he recognized some bats. They were at the center of his most burning desires. Overall, his responses revealed a complex personality structure with a multitude of internal conflicts.
Much of ©’s psychopathology was exposed during these intake sessions, and it helped me to suggest a tentative diagnosis. Being a virus, he was addicted to spreading his vibes around, contaminating as many people as possible. “Besides his psychopathic and sociopathic behavior, he was also suffering from a severe narcissistic personality disorder”. To emphasize his superiority over others, he had taken the name “Corona,” which means “crown” and implies sovereignty. He even liked to label himself as © so that he could not be illegally reproduced in any form. Apparently, © had an inflated sense of his own importance, a deep need for admiration, and a lack of empathy for others. All these traits created troubled relationships. In short, he was a genuine example of an insidious egotistical parasite, someone who clings to another for personal gain without giving anything in return.
In addition to these personality characteristics, © had higher than normal intelligence. He was so clever that he had been able to outsmart the most known drugs and vaccines. He presented a completely new kind of psychopathology that nobody had previously encountered. What was most obvious was that he appeared to be more contagious and more deadly than others of his kind. © had already infected millions, and he had killed hundreds of thousands. The consequence of his activities had also caused catastrophic worldwide economic damage.
Researchers from all over the world were searching for ways to crush ©. They sought to understand how to block his proteins from trapping, overpowering and invading the cellular machinery of human beings. Hundreds of experimental antiviral drugs and vaccine candidates were investigated. These would either prevent © from entering a cell or stop the human immune system from going wild when © was inside. Alternatively, doctors would take the blood from recuperated survivors and give it to those who were ill to utilize the antibodies that had developed.
On a molecular level, some of the researchers targeted one of ©’s most precious spike protein receptors — the ACE-2 — but with little success. Epidemiologists had no clue as to when (or if) societies could reach sufficient population immunity to prevent further spread of the pandemic.
Being invisible evidently gave © an upper hand, and he succeeded in escaping being caught. As a result, there was an overwhelming sense of powerlessness among governments worldwide. “I was well aware of the urgent need to find better ways to cope with the threat he posed”.
Treatment Options
I contemplated what to do with ©. Exceptional measures were called for. Should I commit him to a closed ward and isolate him? Should I refer him to a medical specialist? Should I let him out among the people? Would I be able to cure him of his ailment with my psychotherapeutic arsenal? Would psychological techniques help him in his struggle? Did I want to help him? Or, as things developed, would I rather prefer to destroy him?
Despite all efforts to eliminate ©, nobody had sat down to listen carefully to what he had to say. Nobody had tried to understand with an open mind what he was actually up to. That is what I wanted to do.
I had misgivings from the very beginning. I thought an individual approach would perhaps be insufficient in dealing with a global problem that demanded a worldwide concerted struggle. Even if I succeeded in curing ©, contamination would continue to be spread by his offspring.
©, the silent serial killer I was reading about in the media, was now in my clinic, and I felt something needed to be done. My hope was that if I could understand him better, I could perhaps help to end his lethal mission. If I could let him feel what he did to others, he might be able to gain some insight and change his ways.
Alternatively, I wanted to find the best plan to wipe him out.
Therapeutic Process
Even though I tried to establish a therapeutic alliance with ©, the sessions remained scary. When getting close to him, I was afraid he might infect me, and it was hard to build a sense of trust between us. Concurrently, I felt sad for the people who were dying and for their loved ones who could not be with them when they passed away. Being empathic with © was especially difficult when I imagined an apocalyptic world without a future.
Numerous unanswered questions about him remained: How exactly did he infect people and how long did it take for him to do it? Why was he affecting various people in distinctive ways? Was it possible to become immune to him? Did he have a conscious or an unconscious agenda? These questions crossed my mind as I started to meet regularly with him.
Working with clients to help them develop a relationship of mutuality was something I had done before. If I could help them differentiate and integrate their self- and object-representations, their self-confidence would increase. However, I was not sure I wanted © to become more self-assured. Who knows what he could turn into at the end of such a process? The last thing I wanted to do was to help © strengthen his self-esteem and to “find himself” within a relationship of “unconditional positive regard.” I felt it was more important to promote some amount of reality-testing in him. I therefore decided to focus on his identity by asking him, “Who do you think you are?”
Every time I asked © that question, he had a different answer. One day, he said, “I am the Angel of Death to some. To others, I just come and visit with a breeze. Most children don’t sit still long enough for me to get under their skin.”
Another day he bragged, “I am Corona! Nobody knew my name only a few months ago. Now, I am world-famous, and everybody knows me. I am a celebrity, with pictures shown on all TV-stations, and everybody talks about me. Is there someone more recognized than I at the moment? Should I not be proud of my achievements?” He had been quite offended when they called him a “normal flu” at the start of the pandemic. ““There is nothing ‘normal’ about me,” he said”. “I am more contagious and much more dangerous than the unsophisticated viral mutations people are vaccinated against every year.” I looked at him with bewilderment but had to agree.
That made him continue with renewed enthusiasm, and he exclaimed, “You still relate to me as if I was a person, like your next-door neighbor. You cannot accept the fact that I am something else. I am not a human being! I am much smaller than you and much less sophisticated in terms of my genetic setup. That doesn’t mean I am less intelligent than you, however. You still can’t stand this fact. With all your 20,000 genes or more, and your big brains, you are still incapable of realizing the fact that I am more powerful than you. It blows your mind that I can kill you with a simple burp!” He was truly frightening in his sense of omnipotence and clearly was off the charts when it came to lethality.
Enraged, I repeated the same question again with a fiercer tone. “Who do you think you are? What gives you the right to spread your poison around and harm people? You are just a dangerous, cruel organism, for God’s sake! What gives you the right to play God? You can’t do that! Don’t you have any sense of compassion?” He looked at me as if he was unable to understand what I was talking about.
It became more obvious to both of us that I now related to him more as a foe than a friend. But as I looked for the best strategy to get rid of him, it struck me that his existence was ultimately based on a very basic (and eternal) question of survival, adaptation, and evolution that had always found a battlefield within biochemistry. And it was now materializing in my treatment room. I had read somewhere that parasites are intrinsic to biological evolution and that they drive its complexity at multiple levels. All living things are trying to survive and multiply either through fight or through cooperation, and they change a little during this process. Taking this aspect into consideration made me a little more accepting of him.
“As I had now expressed some of my anger, it became easier for me to continue to stay in contact with ©”. The next time I asked him, “Who do you think you are?” it was in a more friendly voice, and he became willing to open up more.
“I do not think who I am. I just exist. I am a chemical structure with a set of proteins that perform specific functions. It is not something I decide to do, and neither is it something I have any conscious control over. In fact, I am not sure if I am conscious of anything at all. Consciousness is a privilege for humans and not for viral beings like me. You know you exist, while we just exist. At the end of the day, that’s why I came to you for treatment. I also want to think and know I have a self. I get so tired of just floating around and multiplying.”
To my surprise, © turned his head towards me and added an important piece of information. “Look at me, doctor…” I looked at © and saw that he was choked up with emotion. “Self-replication is a central part of being me. I am, after all, just a virus.”
That was a smart thing to acknowledge, I thought, for such a primitive molecular creature. He began to recognize he felt bound by his body and had no conscience, no free will, and no self-control. Self-replication was apparently an expression of his libido, his fundamental life instinct. Gaining a sense of self in the form of an inner nucleus would perhaps help him to better control his previously destructive behavior.
It seemed as if we were making some progress in the therapeutic process.
In the Here and Now
From this point on, my respect for © gradually grew. Discovering new parts of his personality also helped me ask © more frankly about his motives for killing so many people. He assured me, “I don’t kill the people who die. I just enter their organs to multiply. When that happens, some of them can’t tolerate it. They can’t breathe and their lungs stop functioning. Or their cardiovascular systems go caput and they develop blood clots. It is just a sad result of my being there. But it’s not my original purpose.
“What I want is simply to multiply; to stay ‘virulent,’ and to be able to co-create. When people get too sick and especially when they die, I cannot use them anymore, and I die with them. That is who I am. I have to find a suitable balance between the infection I spread and the damage I cause to the body I enter. It’s an ongoing process I am still working on.”
My tentative diagnosis of © as a psychopathic killer was obviously incorrect. As therapy progressed, I gained more of his trust. He started sharing some of the techniques he used to spread himself around the globe. “People are so easily infected, you can’t believe it! If I leave a small trace of myself on a doorknob for example, and someone touches it and also touches his mouth, I will be able to get in through the respiratory tract and start my journey to the lungs. It’s so easy!” He was clearly pleased with himself. Then he added, “You should try it once yourself! You will be surprised at how easy it is.”
I had never thought about contagion in this way.
He continued, “What makes infecting more difficult, however, is with people who are too scared. People who have OCD, for example, are really difficult to infect. They clean everything they touch all the time, “and often I am washed away with soap or some ugly disinfectant spray! That’s very cruel! Don’t you think so?””
I understood that contagion for © was equal to ego-building. He was literally strengthening his sense of self whenever he succeeded in multiplying. And in each such multiplication, he was trying to imitate and learn from the host cell, and to change his ways accordingly. I wondered if this was also happening during our sessions but didn’t want to ask him directly. I was afraid of discovering that he was already floating around inside the cells of my body.
Instead, I asked © to describe how he was entering the cells of another body to perform his multiplication strategy. “You must understand,” he said, “I am just an assembly of malicious nucleic acids that infiltrates and burglarizes cells. I am therefore on a constant search for unsuspecting people with immune systems that are unable to detect me. I first disguise myself – into ®, so the watch dogs can’t notice me. That is not so difficult, because they are naïve and usually have no memory of having seen someone like me before. So, I am just let in without any problems.
“Inside the cells, I must prevent being discovered by all kinds of informants who are constantly looking for foreigners like me. But every time I enter a new cell, I am most terrified of the executioners in white T-shirts who want to get rid of me,” he howled. But then he added with an innocent grin, “When I manage to bribe them and encourage them to join me in my revolution, all hell breaks out.”
Envisaging the havoc © wrought inside cells made me feel uncomfortable. But my curiosity grew from his apparent understanding of what was happening in the immune system of human beings, and how to manipulate its white blood cells. I wondered if he was also aware of what was happening in the world. Had he noticed the chaos his pandemic rampage had done to the human population?
His answer to this question surprised me more than anything he had previously shared. © looked at me with distrust, as if he were unsure of how much to reveal. Hesitantly, he said, “While you are looking at me with your fancy electron microscope, you don’t realize I am also looking at you with my own viral magnifying glass.”
A Sudden Role Reversal
Taken aback, I asked him disbelievingly, “So what do you see in your magnifying glass?”
“I see you are scared of me and you try to keep a safe distance from me,” he replied.
Somewhat embarrassed, I nodded and asked in as casual a way as I could, “And…?”
““I see the chaos I have created in your world — the social distancing, the lockdowns, and the panic all around”…I see how you struggle with existential dilemmas, with protecting your health, or saving the economy.”
He smiled at me briefly, and added in a stammering, low voice, “Well, what I see… what I also see when I look at you human beings…” He closed his eyes and opened them slowly as if trying to recollect something. “I see what you are doing. I see what you do all the time, even when you try to hide behind your silly face masks. I see what you are doing with everything around you, with nature, with the planet, with the earth. I see how you contaminate the air we breathe and poison the water we drink. I see how you destroy nature at a faster pace than it can restore itself. I see how you burglarize its resources, and how you fail to give it back.”
I kept silent, waiting for him to continue.
“I also see how you spread your kind all over at the expense of others — the mass extinction of other creatures, all the mammals, the birds, the reptiles, and the fish that have been killed by you people.” He paused again and whispered with his eyes closed as if he doubted I would understand what he talked about, “You assume supremacy over all kinds of biological organisms you relocate and annihilate.”
Then he added, with a more accusing tone, “Who do you think you are?” referring to humankind in general. “What do you think you are doing to the Earth where we all live?”
With those words, he suddenly disappeared in a droplet carried away by the wind. I was left not only with a loss of smell but also with a new awareness. By trying to answer his question, “Who do we think we are?” “I realized human beings are not so different from the Coronavirus. We are only considerably more destructive”. I wonder if the present pandemic will become a “corrective emotional experience” for those who survive it.
Race, Racism and Therapy: Don’t Expect to Get Comfortable
In this video interview, Professor of Counseling, Darrick Tovar-Murray, PhD, discusses the turbulent issues of race and racism, and his thoughts on building allies and developing the multicultural competence that's necessary for working in our diverse world.
Don’t Shoot the Messenger
My patient is angry and ashamed. Another fight with her boyfriend, another book thrown across the room. When the feeling rises up this strongly, she finds it almost impossible not to strike out in action. She does feel better for a moment afterward, until the wave of shame comes over her. She feels trapped, stuck; action and inaction both seem intolerable. “I have to make the feeling go away.”
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My patient and I are doing therapy using the “TEAM” model, developed by David Burns. TEAM is an acronym that stands for T = Testing, E = Empathy, A = Analysis of Resistance, and M = Methods. “Analysis of Resistance,” also called “Agenda Setting,” lets us turn on its head our attitude about painful emotion: instead of seeing negative feelings as the problem, a sign of pathology or disorder, we can reflect on what is positive and important about them. As painful as they are to experience, our anger, guilt, shame, fear and sadness serve as critical signals and motivators, and reflect our deepest held values for ourselves and the world. Something remarkable happens when we shift our attention to notice this.
My patient and I are exploring a moment in time when she’d become so furious with her boyfriend that she felt an urge to destroy something. They’d been arguing over his not wanting to vacation with her family, and he had just said to her, “Don’t be so dramatic, you need to get ahold of yourself.” Feelings of shame and rage tumbled over each other inside her. She was filled with an urge to hurl the book at him, at the lamp next to the sofa, through the glass of the window. How could such a violent feeling possibly be a good thing? She takes some time with me to recall exactly how she was feeling.
She spoke slowly as she covered the painful terrain, alternating between glancing up at me and covering her eyes with her hands. “I was already hurt and angry that he wouldn’t spend time with my family, and then I felt like I was being condemned for being upset and hurt.” She paused, silent, and shaking. “I felt dismissed, wiped away, worthless.” She looked up at me, her face tight. “And then came rage, and that damn book, and yet and yet another round of shame, rage and shame, over and over.” Her shoulders sagged and she started to cry, shaking her head, “I just want to make the whole mess of feelings go away.”
In TEAM therapy, the analysis of resistance includes “the Magic Button question,” designed to help us see what is positive about our feelings.
“Yeah, I can see why you’d want to zap away those feelings. I’m wondering if we could do a little thought experiment. Let’s imagine you have a magic button, right here on the table next to you, and if you push that button, all of those negative feelings, the rage, and shame and hurt and feelings of worthlessness would be wiped away, with no effort at all. Would you push that button?”
“Of course! In a heartbeat!”
“That makes so much sense to me; but let’s be clear — we’d be saying you’d feel zero of any of these feelings, even though your boyfriend had just made that cutting comment; you wouldn’t react negatively at all. Is that what you’d want?”
She looked at me with a wan smile, “Okay, I guess I see your point, I don't want to be a robot.”
“Yeah, right. I’m actually thinking that your anger, your hurt, your shame — even that feeling of worthlessness — are important and actually positive. Let’s take the hurt and anger, for example. What is positive about those feelings?”
“Huh. I don’t know. I mean, what he said was actually kind of a dick thing to say.”
“I agree — it was kind of insulting, and then dismissive. Would it make sense to feel hurt and angry if someone close to you spoke to you that way?”
“I guess, yeah. I mean, I’d want to stand up for myself.”
“Yeah, like if someone stepped on our toe, you’d want to have awareness of pain?”
“Right, that makes sense, but I’m not sure I’d want to feel so much rage and shame that I felt like hurting him.”
“Probably not — we’ll get to that in a second, but let’s focus on what’s important and positive about your feelings. What does it say about you that you’d get angry if someone isn’t treating you well?”
“Well, that I care about myself.”
“Right, exactly! Can we start writing these down?”
Together, the two of us started to note down what was positive about her negative feelings — that her anger served as a signal that her boyfriend has crossed a boundary and said something hurtful to her, that she cared about herself and doesn’t want to be a doormat.
“But what about that shame feeling and feeling worthless — how can those possibly be good?” she asks me.
“Excellent question — can you think of anything?”
“Well, I guess it shows I’m not shameless,” she says dryly.
We both laugh.
“Ha ha! Yes, right — and what does that mean, to be shameless?”
“Well, someone who is shameless really doesn’t care about their behavior. I felt ashamed because I had lost control, and I wanted to hurt my boyfriend. You know, he can be a dickhead sometimes, but I actually do love him, and I really don't want to hurt him. I don't want to hurt anybody.”
“So, the fact that you felt shame means you cared about your behavior and your impact on others?”
“It was hard to see at that moment, but yeah, I suppose so. I mean, I didn’t throw the book at him, or even at that damn lamp. I just threw it at the wall, away from him.” She put her hand to her forehead and looked up at me sheepishly. “It made a mark on the wall. Actually, it made the third mark on that part of the wall. I guess that’s my book throwing place.”
“Oy!” I commiserate.
“Well, if we get this figured out and I stop throwing books, I can always repaint it,” she smiles. “No, but seriously, I think I’m getting the point here. My anger signaled that he said something hurtful, and then my shame let me know that my anger had gotten out of control and I was in danger of doing something I’d regret. And it’s funny, when I think of my feelings in that way, as carrying an important signal, or a message, I don’t feel as upset.”
“So, you don’t want to shoot the messenger?” I ask.
“Or I should at least read the message first!” she replies, “In a funny way, perhaps one reason I got so upset is because I had stopped listening to what my feelings were trying to tell me, so they had to get really loud for me to hear them. Maybe if I read the message, the messenger won’t become such a beast. How about if I worry less about the messenger, and start listening to the message?”