I have been asked to reflect on what ‘Anti-racist clinical practice’ would look like. I guess my answer is that I am not really sure because serious anti-racist work has nothing to do with clinical practice. Racism is a power arrangement. It is about systemic oppression and institutional arrangements. It is not about individual cases. It is not about pathology.
The work of undoing racism is about organizing for social change and social justice. This is always a collective effort that takes place in communities and hopefully across countries.Clinicians work in their offices with individual cases, or possibly with small groups. This is not organizing, although it can be good work. People who have been tormented by living in oppressive, racist environments can find some insight or some clarity about their situations while working with a clinician who has some understanding of racism, how it is constructed and how it is maintained. However, they can find no relief from the ravages of racism by working clinically. When they leave the therapist’s office, they still return to a world in which racism is a daily reality.
So what would be the major difference between a therapist with an understanding of racism and a therapist without such an understanding. Probably a therapist with an understanding of racism could be somewhat helpful in clarifying what aspects of a persons’ current dilemma were caused by intrapsychic confusion and what aspects were caused by living in an oppressive racist environment. I say that such a therapist could be somewhat helpful because I am not always sure that it is easy to untangle these two arenas. We can internalize many aspects of oppressive environments and they can then become part of our intrapsychic confusion. Nonetheless, a therapist with strong training in undoing racism might help with this kind of sorting out. None of this however, is about undoing racism, because that is not a clinical issue. It is also not really anti-racist therapy because it is not doing anything against racism. It is just clarifying and identifying some of what people of color have to deal with.
The real contribution that a therapist can make is probably by acknowledging the serious limitations that therapy can play in social justice work. We are reminded of this by Ignacio Martin-Baro who says: “The emphasis on individualism reinforces existing social structures because it reduces all structural problems to personal problems. The burden is then on each individual to change themselves rather than to change their community or society.” In a similar vein he observes: “We must stop presenting the pathology of persons as if it were removed from history and society. We must stop presenting behavioral disorders as if they play themselves out purely on the individual plane.” (both quotes from Writings for a Liberation Psychology.)
Recently at my agency an African American mother presented her 19 year old son for treatment. He had been stopped by a local police officer for ‘walking while black’ on the streets of a nearby village. He had responded with great anger and in ways that worried his mother. The intake worker, a white Jewish woman with years of undoing racism training, met with the young man and listened to his story. She verbalized sadly that as a young black man he was indeed a target for law enforcement; that racism is serious and ever-present in our country; that his anger was overwhelming him; that it was vital that we all be working to change this system. And she also understood that his life could be in danger unless he found some ways to monitor his anger when confronted by authorities. She found nothing pathological in his response. She also knew he could not and should not stop being angry. She suggested that he meet with one of our counselors, a male of Haitian descent, so that they could share strategies for dealing with racism. The young man’s eyes filled with tears as his reality was affirmed. Is this therapy or survival training? And did this work need to be done with a trained social worker or could it have been done with a trained organizer. In either case, it will do nothing to undo racism.
That is why I get concerned when people start talking about anti-racist clinical practice.I am not sure what it is. So, I think as clinicians we need to be very careful to separate our good clinical work from our anti-racist organizing. And we should stay clear that the focus on individual cases diverts our attention away from the real problems, and drains our energies away from the real solutions.
Clinicians who really are invested in undoing racism will likely begin to spend much more time out of their offices. They will be meeting with community groups, they will be challenging unjust laws, protesting, and working to elect lawmakers who care about justice. And clinicians who are really serious about undoing racism will not be talking about personal stories but about collective experiences.
So while I am happy that more clinicians are understanding something about white privilege and systemic racism, this is not the work that gives me hope for the future. I say this as a reputable and well regarded clinician. But it is only when I leave my office that I know that I am joining the serious efforts to undo racism.
I, too, have been thinking a lot about what it means to be a clinician who works from an anti-racist frame.
I think that anti-racist practice of any sort has a both/and relationship to anti-racist organizing; it is not an either/or proposition. Most of us involved in anti-racist organizing have other jobs. Since my other job is to work as a clinical social worker, my interest is in ensuring that I perform this job from an anti-racist framework. From that perspective, I think it is just as important to be an anti-racist shoe salesperson, or an anti-racist stock broker... you get the picture. Racism is an institutional power arrangement, but those institutions are supported by people. If those people don't push for change, or adapt to change as it is introduced to them from the top, then change wont' happen or won't be sustained. Anti-racism cannot take hold unless some critical mass of people understand it, demand it, and work for it, but for most this needs to happen in the context of their day to day lives and jobs.
For social workers, anti-racist clincial practice needs to be defined as such because it is different from just plain good practice. As we understand institutions to be inherently racist, we must also understand that the institutions that taught us, employ us, regulate us, and support the development of the theories that inform our work must also be inherently racist. If we do not take the time and care to look at the unconscious ways in which our practice is reflecting the racism in our culture, then we do harm where we could have done good. This is as true for our white clients as it is for our clients who are people of color. Anti-racist clinical practice is different than cultural competency. It involves socioeducation of the client, teaching a way to understand the power inequities in our culture and helping the client to resist racism - whether they are the recipients of race bias, or those who are pulled into the role of oppressor. For some, often people of color, their undertanding is already informed by life experience and their resistance ethics are strong. They may just need validation and support. For others, often white clients, their understanding is fragile and their way of participating in racism unconscious and dissonant. They need help in understanding how their life troubles connect to their social context so that they can liberate themselves and live with more conscious awareness. Some of them may even become anti-racist organizers, but at the very least we can hope they will become anti-racist in whatever they do in their lives.
Far from detracting from my energy for organzing, feeling anti-racism alive in my clincial work energizes me to move forward -- and out of the office. I hope others are inspired to do the same.
Lisa Blitz
__________________
Anonymous
Date:
RE: What is Anti-racist Clinical Practice?revisited
I have been asked to reflect on what ‘Anti-racist clinical practice’ would look like. I guess my answer is that I am not really sure because serious anti-racist work has nothing to do with clinical practice. Racism is a power arrangement. It is about systemic oppression and institutional arrangements. It is not about individual cases. It is not about pathology.
The work of undoing racism is about organizing for social change and social justice. This is always a collective effort that takes place in communities and hopefully across countries.Clinicians work in their offices with individual cases, or possibly with small groups. This is not organizing, although it can be good work. People who have been tormented by living in oppressive, racist environments can find some insight or some clarity about their situations while working with a clinician who has some understanding of racism, how it is constructed and how it is maintained. However, they can find no relief from the ravages of racism by working clinically. When they leave the therapist’s office, they still return to a world in which racism is a daily reality.
So what would be the major difference between a therapist with an understanding of racism and a therapist without such an understanding. Probably a therapist with an understanding of racism could be somewhat helpful in clarifying what aspects of a persons’ current dilemma were caused by intrapsychic confusion and what aspects were caused by living in an oppressive racist environment. I say that such a therapist could be somewhat helpful because I am not always sure that it is easy to untangle these two arenas. We can internalize many aspects of oppressive environments and they can then become part of our intrapsychic confusion. Nonetheless, a therapist with strong training in undoing racism might help with this kind of sorting out. None of this however, is about undoing racism, because that is not a clinical issue. It is also not really anti-racist therapy because it is not doing anything against racism. It is just clarifying and identifying some of what people of color have to deal with.
The real contribution that a therapist can make is probably by acknowledging the serious limitations that therapy can play in social justice work. We are reminded of this by Ignacio Martin-Baro who says: “The emphasis on individualism reinforces existing social structures because it reduces all structural problems to personal problems. The burden is then on each individual to change themselves rather than to change their community or society.” In a similar vein he observes: “We must stop presenting the pathology of persons as if it were removed from history and society. We must stop presenting behavioral disorders as if they play themselves out purely on the individual plane.” (both quotes from Writings for a Liberation Psychology.)
Recently at my agency an African American mother presented her 19 year old son for treatment. He had been stopped by a local police officer for ‘walking while black’ on the streets of a nearby village. He had responded with great anger and in ways that worried his mother. The intake worker, a white Jewish woman with years of undoing racism training, met with the young man and listened to his story. She verbalized sadly that as a young black man he was indeed a target for law enforcement; that racism is serious and ever-present in our country; that his anger was overwhelming him; that it was vital that we all be working to change this system. And she also understood that his life could be in danger unless he found some ways to monitor his anger when confronted by authorities. She found nothing pathological in his response. She also knew he could not and should not stop being angry. She suggested that he meet with one of our counselors, a male of Haitian descent, so that they could share strategies for dealing with racism. The young man’s eyes filled with tears as his reality was affirmed. Is this therapy or survival training? And did this work need to be done with a trained social worker or could it have been done with a trained organizer. In either case, it will do nothing to undo racism.
That is why I get concerned when people start talking about anti-racist clinical practice.I am not sure what it is. So, I think as clinicians we need to be very careful to separate our good clinical work from our anti-racist organizing.
Why is all of this important you might ask. Isn’t this just a matter of language?
There are a growing number of social workers who believe that as a profession, Social W ork could do much more to undo racism. Over the years, our historical roots in work for social change have been weakened by many factors: our reliance on government grants, the need for agencies to become 501 c 3 organziations,the prestige and economic lure of clinical practise, the ensuing necessity to focus on credentialling ourselves so we could get insurance reimbursement. All of these factors have diverted many of us away from social justice work and anti-racist organizing.
The Anti-Racist Alliance (see www.antiracistalliance.com) has been working to transform social work education- to infuse our professional curriculums with an anti-racist analysis, and to inform social work students about the basics of anti-racist organizing. With this background, we can more readily participate in work around the country to create a fair and just society.
Naturally, we believe that this kind of education can certainly inform a more enlightened approach to psychotherapy. But the struggle to undo racism can not be productively fought in the offices of individual clinical social workers, no matter how well they understand racism. So a focus on ‘anti-racist’ clinical practise, or the creation of an anti-racist clinical specialty would drain important resources away from the need to create a new social work movement. This movement will educate social workers to challenge whole systems and to change whole institutions. To do this, we need the talent, creativity and resolve of great numbers of social workers including those of us who are clinicians. So we must continue to do good and informed work with our clients. But we should not confuse this very important work with participating in a social justice movement to undo racism.
Clinicians who really are invested in undoing racism will likely begin to spend more time out of their offices. We may be trying to change the way our agencies provide services. Or we may be going to community meetings, challenging unjust laws, protesting, or working to elect lawmakers who care about justice. And clinicians who want to join the movement will think and talk a lot about collective experiences, in addition to individual cases.
So while I am happy that more clinicians are understanding something about white privilege and systemic racism, this is not the work that gives me hope for the future. I say this as a reputable and well regarded clinician. But it is mostly when I leave my office that I know that I am joining the efforts to undo racism.
Regarding the notion that racism is a form of mental illness: I continue to think we need to be so careful about using the language of mental illness to talk about these issues. It may take us down difficult and unforseen paths. After all, if we accept that racism was 'done' for political ,imperialisitic, power driven reasons and was supported by religious and cultural biases than we understand we need to change thoughts and attitudes in order to 'undo' what was done. When we talk about mental illness, we are talking about individuals, about treatment etc. it is a big difference. Gail Golden
