Ironies: Antiracist therapy's neglect of minorities
What happens if therapists protect paranoia in populations of color?
It’s a good thing that I am better at psychotherapy than I was at my first job. When I got flustered and made mistakes, the manager would tell me, “think things through.” Easier said than done when one is overwhelmed with anxiety. The same applies to even seasoned therapists who are desperate to mitigate the shame of contributing to a racist system. Psychotherapists generally possess a high level of agreeableness and pride themselves on being excellent validators, so when anxious benevolence and political pressure overwhelm rational thinking, it can compromise accurate assessment of a client’s mental health.
Part of my graduate training included reading Critical Theories. Although I applied myself to finding something of value in the readings, the importance placed on it outweighed the benefits. Still, after George Floyd was killed by those who swore to protect, the term “antiracist therapy” trended hard among those who swore to do no harm. It was then that I first inquired into what antiracist therapy actually means.
There are two reasons why I cannot find the manual on antiracist therapy that I first encountered in my search:
Nowadays it is looking for a needle in a needle stack.
I didn’t know I would be writing about this and at the time it didn’t seem worth keeping.
Truthfully, the antiracist manual was a disappointment. I was preparing for something polemic or something groundbreaking. I was disappointed and perplexed because it was neither. It looked exactly like cultural competency manuals except for two additions:
some somber warnings about microaggressions.
a rule to never attribute a person of color’s complaint about racism to paranoia.
When I took the rule at face value, it seemed a bit gratuitous, heavy-handed and careless, but hardly significant. Then I pictured putting it into practice with my own clients (particularly those least privileged), and I was shocked at how damaging this antiracist rule is if taken seriously.
The implied message…
for therapists - ‘Socially conscientious therapists will overlook choice symptoms of mental disturbance depending on race or when it comes to race’
for clients - ‘Diagnosing paranoia invalidates my experience.’
In application…
If a White client presents with paranoia, the antiracist therapist can provide treatment accordingly (or affirm it if the client is preoccupied over their implicit biases.)
If a non-White client presents with paranoid thoughts and behaviors, the antiracist therapist should leave it untreated.
Providing disparate treatment on the basis of race qualifies as discrimination. Providing disparate treatment on the basis of race that harms minorities is nothing short of racist oppression.
Paranoia about racism and experiencing actual racism are not mutually exclusive. And there’s more than enough real acts of racism in the world, so what makes it necessary to encourage paranoia about racism? Why is paranoia encouraged in the underprivileged? Do clinicians even answer to a non-clinical, political authority? Is neglecting and enabling someone’s mental suffering on the basis of their race ethical? Or does it privilege the comfort of the therapist above the mental health needs of clients of color? Should mental illnesses be left untreated if a client is a person of color and especially if that person is Black?
Furthermore, what makes paranoia sacred to Antiracism? Racism is a reality whether or not someone is paranoid, so why does the critical social justice movement discourage accurate diagnosis of paranoia? Does Antiracism rely on paranoia and persecutory delusions to sustain belief in claims that racism is everywhere… except where it’s exploited?
If this was just one example of how antiracism can be counter-therapeutic, I wouldn’t even bother with critiquing it because we’re all fallible even when we mean well. But over time I have found many more such examples. The disservice antiracist therapy does to minorities should be a concern to anyone who sincerely cares about racial justice. I strongly encourage anyone exploring psychotherapy as a service or entering the profession to distinguish between the performance of antiracism and its realistic implications.
I urge those in my profession who feel pressured to be good Antiracists to seriously consider what the vow to ‘Do no harm’ means and remember that it was intended to protect the clients first.
Update: After I published this I learned of yet another recent case of police brutality against a disabled Black man. So I think it’s time to write on a related topic that I’ve been sitting on for a while - Psychopathic Rescuers in the Helping Professions. Stay tuned.