Racial Responsive Therapy & Supervision

We’ve all become aware of the harms that toxic positivity can do in our relationships and workplace settings, but what kind of harm can a culture of kindness cause? 

What a strange question coming from a therapist. I mean, aren’t we supposed to be the bastions of kindness in our profession? Isn’t warmth, validation, and compassion the most basic skills we should have as mental health providers? 

Kindness is an important value sewn into the fields where we offer professional care. Working in healthcare and education settings, I’ve been acutely aware of how central kindness is to doing our work well, both on an individual direct-care level and working in teams. In fact, sometimes teams’ collaboration and support is what keeps professionals coming back day in and day out to the work. 

Furthermore, there is plenty of research that demonstrates positive working relationships, kindness, support, and trust helps us be more productive, assists us in creative problem-solving and enhances our team cohesion.

As I crawl closer week by week into my third Labor & Delivery experience, I pray that I will be met with kindness in my obstetric care.  The kindness I will be afforded by my providers helps make the extremely vulnerable experience doable, human, and grounded.  I even realize how sensitive I am to the kindness (or unkindness) happening amongst the team of providers, and how when I notice disagreements or tension it actually feels threatening to the patience I will need and sound decision-making I hope I will receive. 

Kindness, like most concepts, reflects our social, historical and political contexts.  What is defined as kind is a reflection of our culture, our power dynamics, and unfortunately the tools of oppressive systems at play. In the space of race and racism, the culture of kindness comes at a cost.  When I’ve entered into organizations and institutions as a racial justice trainer I’m acutely aware when I as a white woman am about to cross the kindness line. 

I can literally feel it – my heart starts to pound, heat starts to rise in my cheeks. It’s like my body is telling me “what you are about to say will be threatening to the kindness homeostasis of this group of people.”

The intersection of race and gender is especially important in the culture of kindness for professionals who provide care. Fields in which predominantly white women work – let me be clear: not necessarily lead but work-  tend to prioritize kindness. But, hey doesn’t that make sense? We are talking about mental health therapists, teachers, “auxiliary” therapeutic and medical services (dietitians, occupational therapists, speech language pathologists, etc.). Isn’t kindness foundational to the work?

Girls who demonstrate kindness are highly reinforced by adults.  I mean, this kind of reinforcement likely happens as early as toddlerhood and most certainly preschool. Upholding a culture of kindness is often met in juxtaposition when girls and women use behaviors that reflect unkindness.  For example, girls that don’t honor the kindness, sensitivity or consideration rules are sometimes flagged and don’t even get me started on labeling mean girl behavior in preschool. 

Kindness and unkindness is deeply rooted in the history of white women holding the moral and spiritual responsibility of raising children. In Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, Dorothy Roberts gives us historical context, “…the image of the True Woman was delicate, refined and chaste. Although she was considered physically and intellectually inferior to men, she was morally superior to them.” which struck me as a convenient tool for gender oppression.  If one was expected to demonstrate, teach, and uphold morality, then in turn we would be bound to show our morality fully and without exception. Of course, this would leave us as women either: 1) unable to be human and demonstrate moral ambivalence or, 2) deficient in morality (a.k.a. a mean girl). 

But how do white women use kindness used as a gatekeeper against racial justice?

Well we tend to forget or disregard who kindness serves best.  My heart pounds when I’m about to be unkind to a group of predominantly white women, fearing that by suggesting some of their words may indicate racist perspectives I am being unkind.  But, of course like many tools of white superiority, this is quite twisted. The racist perspectives themselves are the true origin of unkindness and I am bringing that to light. My fear of being unkind in itself can be seen as an act of unkindness. 

The culture of kindness in predominantly white-women employed fields comes at a cost to racial justice because white supremacy is busy controlling the definition of kindness and exactly who should be prioritized in delivering its resources. 

So what do we do in fields where kindness feels like the lifeblood of the work? 

We re-define kindness and honor its true complexity. 

I was once speaking to another mom talking about struggling with my own self-compassion and self-care in one of the hundreds of areas we struggle with as mothers.  She said, “well isn’t this what you help your clients with?” I sort of said something like “Aw shucks, you got me” in the moment, but later I realized that I don’t really see my work like that at all as a therapist. The more I do the work, the more I realize I actively usher people towards talking about the most difficult experiences in their lives and feeling the most difficult feelings they’ve ever felt. Doesn’t sound particularly kind, at least in the way I’ve been socialized anyway. 

The real kindness comes with finding my clients where they are at in darkness and fear and walking with them a step further, and then a step further through grief. 

The group and institutional dynamics that protect white supremacy are really effective barriers to these kinds of conversations about race and racism in organization. We need to be mindful when the culture of kindness (or politeness) deters us from: 1) talking about race, 2) addressing racist perspectives, and 3) prioritizing compassion for white people’s experiences of tolerating their own moral failure (or their ancestors). And then we need to ask: who do we prioritize who receives our kindness resources?

How can you start to redefine kindness in your organization? 

I found guidance in Kindness, a poem written by Naomi Shihab Nye. 

Before you know kindness as the deepest thing inside,

you must know sorrow as the other deepest thing.

You must wake up with sorrow.

You must speak to it till your voice

catches the thread of all sorrows

and you see the size of the cloth.

To read the full poem – https://poets.org/poem/kindness

Racial identity development is a rich psychological process in which I can totally nerd out on and completely get lost in the weeds. Or, at least I can lose my audience.

I am grateful for the feedback I received once, “You say racial identity development a lot. Those words together don’t mean anything to me and I feel bored when you say them.”

In research it is incredibly useful to define concepts, especially in the social sciences where so much information is socially and culturally constructed.  In life it’s also really helpful to define concepts in order for people to be on the same page, to capture a moment or a phenomena or bring to the surface a social script that feels invisible (i.e., White fragility, weaponized incompetence, invisible labor, etc). Then in academia, we get lost in all kinds of fun arguments about what words mean and how they philosophically differ from each other, and which theorist got it right and which researcher has the most expertise and the best methods, and even sometimes, what or who is the most socially just. Oh, how we find competition everywhere. 

But, I especially care about defining racial identity and specifically racial identity development (RID) theory in a way that is accessible to professionals who care about building strong relationships with the people they serve. 

So then, what is racial identity?

Racial identity development theories (especially ones created by Dr. Janet Helms) focus on the psychological experience of race and racial identity. 

Our psychology on race includes our thoughts, attitudes, emotions, and behaviors about:

1. our worldview on race in general
2. our own race
3. the dynamics interplay between #1 and #2. 

The development of racial identity refers to a nonlinear emotional and knowledge-gaining process of understanding ourselves.  A part of gaining an understanding of ourselves is learning how our society has used race to effectively maintain power to a certain group of people based on a set of physical characteristics (i.e., phenotype). Of note, there is no biological basis for how we define race.  Race is a social construct defined by those in power, which evolves and shifts over history to keep up with values, technology, and patterns of human life. 

Now, how can professionals benefit from knowing about racial identity? 

Oh, let me count the ways. (See, I can go nerdy quite fast). 

First, many White people struggle to understand they even have a psychology on their own race. We are currently socialized to reduce a rich psychological experience into two categories (i.e., racist or not racist) and even those two concepts are flat. When we start to understand the dimensions and developmental process of understanding our racial identity, we will likely also start to see race differently within our society. In other words, our worldview on race in general will change. The dynamic interplay between our worldview and our identity is a little chicken-egg, thus there is no “perfect” or right order between advancing learning of self vs how race is used in our world.

Second, we are conditioned to avoid our psychological experience of race which interferes with our ability to 1) take perspective of and 2) empathize with people of Color.  Our relationships with people of Color in work (and our whole lives) suffer when it is clear we struggle to do both. In addition, learning about racial identity tends to shift our understanding or rather helps us tolerate the intense negative feelings of cracking our delusion about the existence of racial privilege. 

When we avoid thinking about our racial identity and the global historical use of race, can’t take perspective of or empathize with people of Color and also ask them to teach us about our privilege, oh no we are in trouble.

Professionals need to understand they have a racial identity and that psychology on race comes to play at work, even in a mostly White or even all White context. Learning about (and growing) racial identity is not just about a few moments of standing up when something goes wrong (but please do that). It is about how our psychological experience of race is walking around with us all the time and how helpful it is to build a practice of noticing, engaging, reflecting, and establishing new behaviors on race in order to be more racially responsive. 

I find theories and models on race are essential for addressing racism.  Race and racism has been constructed in one of the most complex, adaptive, and powerful tools of oppression. I struggle to understand racial interpersonal and system dynamics without a theoretical model to capture as much of the slippery, evasive, decontextualized weapons of racial injustice. In other words, the structure of theoretical models help organize, understand and target possible interventions to address racism, especially on an interpersonal level. 

When we don’t use a theoretical model to address the deep problems of racism, we are left with superficial solutions. People often look for a simple list of Do’s and Don’ts to follow when it comes to race, or rather how not to appear racist. In relationships, especially in one-to-one interactions it’s hard (maybe impossible) to actually follow specific rules and authentically connect. If it is one thing we understand as humans, it’s how off-putting following a script can feel in interactions (sales conversations really come to mind here).

One reason sales conversations really feel sucky is that they are scripted and follow a set of rules. These rules are an effort to shape conversations so that sales people remain as in control as possible and motivate action. All of this causes us to feel disconnected from the actual person we are talking to.  I think of times when I actually needed to buy something and the interpersonal exchange with the sales person was so annoying that I walked away to avoid continuing the conversation.

On an institutional level, it might be easier to look like we are addressing equity and inclusion by following a set of Do’s and Don’ts. But in interpersonal interactions, those attempts to appear committed to anti-racism fall short. Furthermore, if you try to follow Do’s and Don’ts when it comes to conversations you are probably trying to hide your own anxiety about talking about race. You might be resisting facing the deeper understanding of race and your racial identity. 

So, how can you approach conversations on race in a more prepared & thoughtful way?

Here are some suggestions that can happen before you are in a conversation about race:

1. Read & watch content that teaches about race and racism
   • ADD to your reading on race and racism with written, audio or video journal (I know, video journaling sounds a bit mortifying, but it is actually a powerful reflection tool.) 
   • Note – how do you feel in your body? What do you notice about your thoughts?
   • Try to have a few conversations about that specific content with another person in your life

1. Seek specific racial education on the thing you would like a script for. (i.e., if you are a therapist and want to talk about race with your clients of Color – seek out articles and books that address this topic)
   • Repeat the steps above 
2. Keep repeating these steps as you continue to approach racial issues that give you anxiety to discuss

As always, feel free to reach out to me for a consultation if you are interested in doing more focused work to increase your racial identity and racial responsiveness.

So, what is this term racial responsiveness anyways?

Unfortunately, we know a lot what racial responsiveness is NOT — at least in research.

Like most issues, we are better at defining problems better than solutions. Understanding problem in-depth (especially something as complex and illusive as racism) is a good way to target problems and tailor solutions for change.

But, people (especially White people) tend to struggle with tolerating the stress of learning about problematic racial dynamics without learning about solutions. (It’s a bit of a bind)

So, I’m here to say that racially responsiveness does exist, it is not an anomaly or out of your reach in the work you do. There are solutions. But, you can’t skip the part where you don’t learn about racially un-responsiveness. We must learn to tolerate understanding the problems at hand.

Being racially unresponsiveness in people-centered work can include behavior that:

• Ignores or invalidates race and racial dynamics
• Shares racist ideas or remains silent in the face of racism
• Punishes racial identity development/growth of those who hold less power than you
• Tone-polices or jargon-policies communication on race
• Encourages people with less power than you to teach you about privilege
• Justifies maintaining power of White people

Of course, this list is not exhaustive, it will continue to shape and shift with time and across different environments.

So what are the solutions to these problems? There must be many and varied, we don’t just need a toolbox, we need a whole workshop. Racism is a poisonous tool of oppression that has affected all parts of our working society. We must understand what damage has been done in any given area in order to thoughtfully bring it back to health.

As people-centered professionals, who you are is a huge part of what you bring to your role. Your racial identity is no different.

Many professionals I work with understand that their race matters, but they often hit major roadblocks towards learning more about their race or “doing better” when it comes to racism. We must work to grow our racial identity in order to:

• Stop ignoring race and racial dynamics
• Understand how some of the things we say or think are indeed racist
• Advocate for racial justice
• Know what to say when others are verbalizing racism
• Examine our processes in which we hire and promote White people
• Learn about our privilege. Even better, learn our emotional reactions to privilege and how they get in the way of anti-racism
• Get social support and learn how to self-nurture your own emotions in response to learning about race and racism

Again, not exhaustive. But, hopefully more hopeful.

If you are interested in working with me to increase your racial responsiveness or would like me to consult with your organization, please email me to set up a time to talk.

Across my years of studying race and culture in academic and psychological spaces, I have learned that: 1) words matter and 2) words will change. How we talk about social identities will change over time. We need to redefine and evolve our language to fit the changes we want to see in the world as well as address and label the current problems that we are seeing. 

When I encounter the term cultural humility when training providers, I always pause for a moment. I’m worried I’m going to waste everyone’s time & attention getting stuck in arguing the semantics of language rather than actually help people make changes that will improve their care and their self-knowledge. 

I was in graduate school when the concept of cultural humility was beginning to become popular. We were shifting from the term multiculturally competent towards cultural humility (removing the addressing the unnecessary need to prove plurality in “multi” and challenging the impossibility of “competence” when it comes to understanding culture). I expect the terms will continue to evolve to how we address equity and social oppression in healthcare (and beyond). 

But, I do keep getting stuck on humility. I realize the true definition of cultural humility is powerful and much more complicated than at first glance.  Cultural humility is a term developed by Dr. Melanie Tervalon and Dr. Jann Murray-Garcia, derived from their experiences working in the medical field.

The term refers to a committed practice of learning and self-examination in order to address privilege, power, and oppressive dynamics evident in provider-patient relationships. Practicing cultural humility across your years as a practitioner is a worthy endeavor, and much more challenging as it sounds.

So, why do I still get tripped up? 

One of the first definitions of humility that comes up in a web search is “having a low or modest view of oneself” which I think can be a bit dangerous in the space of culture and race and the way that Whiteness works. 

One of my biggest concerns with White healthcare providers (and many other professionals) is that they 1) may not understand they too have a race and 2) tend to not take responsibility of their power and privilege in their encounters with clients/patients. We need to understand what it means to have this area in our life so underdeveloped (especially in our professional roles) and how to grow our racial identity. 

Sometimes I feel as though the term humility is ripe for Whiteness to devour.  I worry “humility” justifies White providers remaining passive, asking clients/patients to teach us about their culture, or worse, asking clients/patients to teach us about our own privilege and power. 

Of course, the true concept of cultural humility does not support White professionals to remain passive in the process of self-reflection and the development of critical consciousness. And possibly, Whiteness will always find a way to hide the privilege and power dynamics no matter the terms we use. 

But, what terms would I want to add into the mix? 

Maybe privilege-responsible? Power-accountable? Actively reflecting on privilege and power into healthcare encounters?

Nope, still working on it.  Of course, I like the term racially responsive quite a lot. 

My goal for White healthcare providers would be to notice your yearning to rest in the space the term humility seems to offer.

What can we do to take the passivity out of humility?

How can we take our power and privilege seriously in the context of providing quality care?

How does burnout impact racial responsiveness for White healthcare & mental health providers?

In other words, how does burnout influence how you behave around race as a White provider?

The image that comes to mind for me is showing up for trainings on race with exhausted and over-scheduled providers (i.e., getting knocks on the door to respond to patients’ needs). Although most participants shared their appreciation for the material, I wonder how they will continue the learning that we started that day

The commitment to racial equity for most participants feels real, and so does the commitment to their patient care, and maybe even intellectually the commitment to their own self-care. Yes, burnt out White providers de-prioritizing their racial identity development is a privilege and a self-sustaining mechanism of oppression in healthcare.

I remember as an early doctoral trainee talking to other clinicians who graduated from my program about oppressive dynamics I was witnessing and I remember so vividly them saying, “Sometimes I don’t even see it any more, it’s just the water I swim in.”

Now that it’s been years since I was a trainee (and been through several bouts of clinical burnout myself), in hindsight I underestimated how many of my supervisors (there were many) were burnt out and overwhelmed.

How do we address the way clinical burnout impairs White racial identity development so that providers can become more racially responsive in their care?

What can providers do on an individual level to understand their relationship between burnout and doing better with race, privilege and power?

What can systems & organizations do to address clinical burnout, racial non-responsiveness, & the relationship between the two?