Power, Privilege, and Therapy

Why therapists must be allies and advocates for clients of different races, religions, sexual orientations, sizes, ethnicity, genders, and any other point of diversity.

I wrote this post after an incredibly fulfilling discussion among colleagues about power and privilege in the therapy room.  A colleague bravely disclosed that she feels that she should bring up the different racial backgrounds between her and a client of several months.  The client is Latina and the therapist is white.  The therapist feels at times that she is missing some of who the client is because she's a "white lady" talking to a person of color and that the client could be holding back parts of herself in therapy because race has not been addressed.  Some felt that she should wait for the appropriate time to bring it up and some said that she should bring it up as soon as possible.

We arrived at the conclusion that as a therapist, we are put in a position of power from the beginning of every session.  We automatically sit in the chair with privilege as we delineate the "rules" of therapy, collect payment from clients, and are the ones to say when time is up.  When the therapist is in the position of power as the therapist and is in a position of power and privilege in society, it is doubly important to bring up issues of difference in the room so that the client can be free to explore, tell the truth, and be him/herself.

Here is how it could play out.  A white, female therapist sees a  black woman who comes to therapy every week.  The client talks about work stress and her family life but feels she must leave out any mention of racism at work or family dynamics that are central to her culture because the therapist may reject her thinking.  One day, the therapist brings up their difference; "you are black, and I am white.  What's it like to talk to a white person about this?"  It may be an uncomfortable moment for one or both of the two women, but now, the topic of race is on the table.  Perhaps the client can label racism at work or explain family dynamics within her home and the black community once the issue is opened by the person who is seemingly in power.

When we hold power over our clients, we limit them from being able to have power in their own lives.  Clients should feel empowered in session, even if not in society, to talk about issues of race, gender, sexuality, religion, language, or any other topic of dis-empowerment in their lives.  The key to making this happen as a helping professional is a) recognizing your own privilege, and b) bringing up the difference between yourself and the client in session any time it could affect the therapy.

Our privileges can be things that are not conscious in our minds, like money, having a healthy marriage, having children, dressing nicely, speaking a certain way, being educated, feeling confident, being physically fit... it doesn't take a white, straight, male to trigger feelings of inadequacy, privilege, and power in a client.

Here's the really important part for clinicians and what I learned from the wisdom of the group; waiting until it's "comfortable" to talk about issues of diversity is a privilege as well.  When I say that, I mean that when we think to ourselves, 'gosh, it's just not the right time,' or 'that would make things really awkward right now, I'd better wait,' the person who is on the other side deals with that discomfort every day, everywhere he or she goes, and with everyone he or she meets.  If you are gay, you don't have the privilege of avoiding the topic of being gay.  Straight people, however, do have the privilege of avoiding the topic of being straight because it's "the norm" in our society.  (I put "the norm" in quotations because it is a terrible social construct that I do not wish to reinforce but is a more than prevalent thought, conscious and unconscious, so prevalent that we cannot ignore it if we are to disassemble it.)

Take your own difference and use it to have empathy for others.