If your instinct is to go against your prior training or common wisdom, you’re probably on the right track.
Since around about 2004-ish, I have participated in hundreds of hours of group therapy, both as a patient and as a trainee in conference settings. I’ve been in long-term therapy groups, over many years, as well as in groups that lasted only three hours. I’ve been in small process groups and in large groups of 100+ people.
I’ve been in groups led by men, by women, and by a team of both.
I’ve also led hundreds of hours of groups and workshops myself, and with co-therapists.
I’ve read Yalom’s entire group therapy bible, and watched his training videos. I’ve even read his fiction account of group therapy, The Shopenhauer Cure.
When it comes to group therapy, I’m a believer, and I’ve been around.
I will note that in my hundreds of hours of group therapy, I have only been in one group led by a Black therapist. It was in 2018, in a group that lasted 9 hours over two days and was part of a conference with a theme focused on cultural competence and spirituality. It was the first and only training group in my many hours of group therapy focused on addressing culture competence in group therapy and where race came up as an issue within the small process group.
Since then, the pace around training therapists to address race in group therapy (and therapy in general) has picked up, thank goodness, with specific training in clinical approaches and scenarios lagging behind more generalized training.
I offer the following based on my experiences in a variety of groups where race was either, not addressed, or mishandled in a way that likely a) caused harm to BIPOC members of the group and/or white people attempting to be anti-racist in their thinking and behavior and/or b) did nothing to capitalize on the unique potential of group therapy to teach, model and provide space for people to practice functioning socially in an anti-racist and more just way than the general society does.
Group therapy is uniquely positioned as a vehicle to model, teach, instill, and grow pro-social, positive, anti-racist, more just interpersonal relationships between people and within groups and communities. If we, as white group therapists, are not thinking seriously about how to utilize this potential in our groups, whether they be all-white or mixed race, we are failing our patients and our patients’ families and communities, trickling out eventually to society as a whole.
I have witnessed, firsthand, in the groups I run, the power of group therapy to help people better examine and to even change attitudes around racism, fatphobia and diet culture, sexism and gender norms, and heteronormativity and to do it while maintaining and improving their relationships with the people representing the marginalized groups affected by these harmful attitudes and norms.
But these moments and shifts require group facilitation that takes into account the shifts in power dynamics and perspectives, as well as the self-reflection around one’s own racism or other -isms, necessary to hold, contain, and foster difficult, painful dialogue. Most importantly, it requires letting go of many therapeutic norms that inadvertently lead to a lack of safety for marginalized people in groups and/or maintain the values of White supremacy that stifle and shut down such work and can, in the short and long-run, do harm to individuals with in the group as well as the group as a whole.
Here is a non-exhaustive list of things I have learned and observed that may serve us well as white therapists who wish to lead groups that reflect the values of social justice, anti-racism, and, above all, do not perpetuate white supremacist power dynamics.
Do not always follow the tears. Especially if they are white tears.
As a therapist, we are trained to look for and to address tears. This is no different, and perhaps is often more magnified, in group therapy.
However, in instances where a BIPOC person in a group is attempting to address a wound or harm inflicted by a white person who has said or done something racist, the tears that will appear first will often be the tears of the white person being confronted rather than the Black person who has been harmed.
Robin Diangelo covers this phenomenon extensively in her book, White Fragility, and offers a compelling example of how this may play out in a group setting, albeit not a therapy group. She writes of a situation in which a white woman was given feedback on how something she had said had negatively impacted people of color in the room and the white woman fled the meeting. In response:
These coworkers were sincere in their fear that the young woman might actually die as a result of the feedback. Of course, when news of the woman’s potentially fatal condition reached the rest of the participant group, all attention was immediately focused back onto her and away from engagement with the impact she had had on the people of color.”¹
One can easily imagine then a situation in which a therapist, trained to empathize with pain and tears, could easily be diverted to play into this harmful dynamic and to immediately turn and care for the white person receiving the feedback, leaving the BIPOC person who had raised it in the dust. And if you’re not sure, I can promise you, it happens. I have watched it over, and over, and over. With many, many, well-meaning, liberal, white people playing into it with no conscious idea of what they were doing.
We need to stop.
And to stop, we will have to carefully examine our own training, to understand that it is useful much of the time, but not all of the time, and that much of it was created by white men in a white world, and be prepared to abandon it. What abandoning it will look like will often feel callous or insensitive or unprofessional. The important thing to ask yourself next is: Callous to who? Insensitive to who? How do I define professional?
Because what you need to do next is to ignore whoever is crying, unless it is the BIPOC person, and keep the focus of the group entirely on the wound the BIPOC encountered and how that person is responding and reacting to the tears of the white person who they confronted. Before anything else happens in the group, the BIPOC individual should be cared for, supported, and tended to and only then should the group move forward.
Next, the group’s responses and feedback should also be focused on the tears — not on soothing them or caring for them— but in offering their own internal responses to them.
“I feel torn about what to do. Sally is crying but Jeff deserves to be heard.”
“I am annoyed that Sally is crying. It feels overdramatic.”
“I would be crying too if someone said that to me.”
“It’s hard for me to not take care of Sally right now.”
“I’m mad at Therapist for not allowing us to care for Sally right now.”
Fine. All of it is fine. Because the group is now reflecting on its response to having racism addressed and its own internalized white supremacy instead of rushing to cancel out the BIPOC person’s feedback and caretake white supremacy itself.
Support — do not pathologize — healthy or appropriate anger towards oppressive, harmful, racist, homophobic, sexist, or ableist behavior, ideas, or language.
As group therapists, we may have many responses to aggression or even strong assertive behavior in a group, particularly when it makes other group members (or us) uncomfortable.
We may be tempted to question it’s origin — What was that about? Did Sara remind you of someone from your past?
We may be tempted to ask for the feeling under the aggression — hurt or disappointment.
We may ask the group to focus on their reactions to the aggression or strong statement as a way of examining its impact on relationships
Fine. Do what you do.
However, when the aggression or forceful language is coming in defense of or ally-ship with someone in a marginalized group, whether that person is present or not, or against an oppressive idea, policy, language, etc., we may need to adjust our response to ensure that we are not subtly or overtly signalling to the person in question and/or the entire group that standing up for others or for justice in unequal settings is problematic or, even worse, a sign of psychopathology.
(And have I seen this happen? Yes, yes I have.)
At times, we may even need to commend or open space for the group to commend, such acts or ideas or language from another group member, so that a culture of the group is one that normalizes and validates standing up for others, keeping harmful and degrading language or ideas (even subtly harmful ones) out of the space, and examining and noticing and addressing micro-aggressions or other race-based harms.
Examining how someone presents ideas or feelings is fine, and typical work in group therapy. However, when such an interaction is around defense of an oppressed person or group, that work should be conserved for later, when the positive good of the stance has been absorbed, and, ideally, when the person who raised it asks to do such work, i.e. “I would like to figure out how to come across more gently when I address racism at work so that people will hear me better.”
DiAngelo offers a good take on this in her book, noting:
To let go of the messenger and focus on the message is an advanced skill and is especially difficult to practice if someone comes at us with a self-righteous tone. If kindness gets us there faster, I am for it. But I do not require anything from someone giving me feedback before I can engage with that feedback. Part of my processing of that feedback will be to separate it from its delivery and ascertain the central point and its contribution to my growth. Many of us are not there yet, but this is what we need to work toward.”²
Indeed, as group therapists, we are in an excellent position to foster such skill building if we handle these moments and opportunities appropriately, which will require divesting, at times, from our usual approaches and techniques.
Invoke the concept of shame sparingly and carefully.
Oh, my, this one gives me a headache. No one loves to throw the accusation of shame around more than a white therapist in a conversation about race.
“You shamed him!”
“You shamed me!”
“That was shaming!”
If you are about to say this in your role as a psychotherapist, or even as a person, ever, just please stop. Take a breath. Ask yourself, before you speak: Really?
First, let’s look at a definition of shaming, which is commonly accepted.
Shaming is an attempt to make another person feel ashamed. Shaming targets who a person is, not what they do. Telling a child they are bad is an act of shaming. Shaming also sometimes appeals to religious or social norms. Publicly airing a person’s misdeeds is usually an attempt to shame them. Guilting, by contrast, focuses on a single act. A parent attempting to guilt their child might lecture the child about how hurt they are by a child’s life.³
This is, in most clinical settings, how shame and guilt are explained to patients. And yet, therapists magically forget this definition when they are in any situation where race is at hand.
Diangelo explains this on two fronts: 1) the extent to which white people become inarticulate and almost stupid when race comes up⁴ and 2) the extent to which white people will go to defend against race being addressed or pointed out.
She writes, “While the capacity for white people to sustain challenges to our racial positions is limited — and, in this way, fragile — the effects of our responses are not fragile at all; they are quite powerful because they take advantage of historical and institutional power and control. We wield this power and control in whatever way is most useful in the moment to protect our positions.”⁵
In the professional world of the therapist, there are few things more damning than being told that you are shaming. It is the endeavor of any therapist to be the exact opposite of shaming — empathic, connected, loving, supportive, and accepting. Therefore, it is a brilliant wielding of the institutional power Diangelo speaks of for therapists in settings with other therapists, which is where therapists are trained, to call it “shaming” whenever any sort of racism or other oppressive behavior is named or identified.
In fact, anytime I have heard racism or other oppressive language or acts being addressed by someone, they may be naming something that would cause guilt, i.e. based on a specific act, and remediable, but rarely, if ever, is it genuinely shaming, i.e. “You are a bad racist person to the core!”
Whenever shame comes up anywhere near topics of race or other -isms, my ears prick up and I become immediately suspicious, and I think this is a habit that would serve all therapists well, whether we are leading a therapy group or we are in a training session with colleagues. What I often like to say is, “Just because you feel ashamed (and really what you probably feel is guilt), that does not mean that anyone shamed you.” In a therapy or other setting, I might then follow this up with, “Would you mind sharing what you feel ashamed about?” as a means of keeping the topic on the racial issue at hand, rather than diverting from it. This may take some skill in keeping the person focused on their own shame, rather than on a critique of the speaker, but is well worth following through with. And, of course, the goal is not to leave anyone in their shame, but to provide psycho-education or reframing so that they can internalize the feedback they received within a culture of white supremacy, depersonalize it, learn from it, and move on.
In any group setting, we need to be at the ready and willing to head off these attempts to shut down conversations, feedback and attempt to remedy injustices or inequities, by defending against this trope, which comes up over and over again if you listen for it. I have yet to hear it be used accurately and fairly, and never have I heard it used in a way that still facilitated the ongoing discussion of the original complaint. It is always used to shut down and divert from that complaint, hence preserving white supremacist norms.
Remember that the political is personal and, at times, it belongs in group therapy.
As group therapist, we love to be “in the room.” “Let’s bring it back in the room,” we say. “I feel like we’re outside the room.”
Great, good for us. This is great and serves such a purpose in so many ways. Most of the time.
The problem is when this leads us also to say, “We don’t do politics in group” or “That’s outside the room, let’s not talk about it here,” when a BIPOC (or even white) person brings up the death of George Floyd or their fears about an upcoming election.
Yes, at times talking about current events or the daily news can be a defense and a way of avoiding doing one’s therapy work, but not all the time. And by immediately and carelessly shutting down such topics without discrimination or consideration of their meaning to the person raising them or their relevance to and within the relationships within the group, or we impose hard and fast rules with no nuance, we act as agents determining what is and isn’t important, and we send the signal that race or the outside world doesn’t impact us and isn’t relevant emotionally. And we know, that, of course, the more marginalized statuses you hold, the greater the emotional relevance and impact the outside world has on you.
Dr. Howard Stevenson has done extensive research and training on racial stress, and has found that…“men and women who experience racism have a host of health risks, from high blood pressure to breast cancer to lower life expectancy. These risks seem to be related to chronic stress that disrupts sleep habits over time.”⁶ At a workshop of his that I attended, I believe that he said that black children in America will experience a loss of one hour of sleep a night over their lifetime due to racial stress.
My colleague, Hayden Dawes, LCSW, LCAS, writes in his widely circulated essay, An Invitation to White Therapists:
I can confidently attest that we, as therapists, are failing to create space for Black and Brown people and the totality of their lived experiences…In our treatment team meetings and case consultations, we choose not to consider how the chief complaint of our patients of color (for example, anxiety or depression) intersects with their racial identity. We fail to recognize how the structural pillars of American society continue to press their knees on the necks of Black and Brown people. …Our supposedly “objective” tools and practice models are not value-neutral; they are not anti-racist. Rather, they uphold false narratives and contribute to the dehumanization of a suffering people.⁷
Race in America is a matter of physical and psychological health. Cultural, social, family, and community manifestations of racism on our patient’s lives belong in their treatment, including in group therapy.
As group therapists, I would advocate that we should take a page from the experts working to help kids develop healthy racial attitudes when they’re young, all of whom advocate encouraging kids to talk about race⁸, rather than what we used to do, which was go, “Shhhhhh, don’t ask about that!” when a child would ask why someone’s skin color was different than theirs. We need to be welcoming, inviting and encouraging of discussions about race or other forms of oppression, and often these will start by bringing the political or cultural outside inside to the therapy group.
Dawes elaborates, writing:
Have you seen how you cannot hold my big feelings, neglecting me as I work to contain painful visceral discharge after being racially profiled? In those moments, your lack of action becomes another retraumatizing vehicle failing to undo the pervasive messages that say Black and Brown people are subhuman — less than dogs. Would you neglect to ask about sexual trauma if you had not experienced it yourself? Your immobilization also causes you to forget your clinical skills. You fail to check in with your clients of color regularly about racism. Yet without your invitation to name and express their pain, these clients suppress deeply held emotions in a room in which they ought to feel at their most free. You do not shy away from other forms of suffering. You ask your client if they are suicidal; you check in about their phobias and compulsions; you fill out mindfulness worksheets as you have been trained to do.⁹
Be skeptical and curious about unconscious or conscious attempts to move a conversation away from the content of race or a racial wound that has been inflicted.
We are so good at this when race isn’t involved. Let any patient try to divert a topic away from something difficult or emotional and we are right there, “Hold on, what happened there? Can we come back to…?”
But when it’s race, off it glides away, into the ether.
I was once in a workshop with therapist colleagues who I like and respect very much. It was a workshop focused on diversity and race in therapy. We were put into a small group to discuss a specific topic, and the all-white therapist group stayed very on task, until something uncomfortable around our own racism came up. At that point, the group devolved into small talk. I was a more junior member of the group and found it difficult to do so, and it took some psyching myself up, but I eventually pointed this out — that we were doing exactly what the workshop was focusing on: moving away from an uncomfortable discussion. A group member offered a hypothesis as to why we did this, giving a story of how he had bought a book about black history but it kept sitting on his shelf and he never read it. When I asked why, he replied frankly, “I didn’t need to.” The rest of us nodded knowingly.
He was right. We don’t need to.
We, as white therapists, can be quite comfortable in our therapy chairs in our therapy groups without ever discussing race. At worst, we may lose a patient or two of color, but we can, quite frankly, get by just fine never asking a group to look at its own racism or challenging white supremacist ideas, which is, quite frankly, very hard work.
But if we are interested in being genuinely good at our work, at doing what is at the foundation of it: promoting mental health, symptom improvement, and improved relationships, we need to do the hard work. And this means not letting these topics or issues, whether they present in group as large and booming or extremely subtle, go by. And that we need to not only keep the topics and issues themselves in the room, but also encourage our groups to look at why it almost floated past, why the group allowed it to, as that is where the work of examining one’s own biases and racism will be done.
Do not ask BIPOC people to represent their race, and support them if they refuse to.
I taught a master’s level social work class in Diversity in a Multicultural Society a few years ago. I, of course, often ran it largely like a process group, because that is what I know how to do. In one class session, racism was the topic of the readings and discussion, and members of the class would turn to the BIPOC class members and ask them to verify or validate things in the readings or that I was saying. A Black woman in the class was asked a specific question about her lived experience and paused in a way that raised my antenna. “You don’t have to answer if you don’t want,” I said. She responded that, no, she didn’t want to. I accepted her answer and moved to a discussion with the white students who had asked of how it felt to be told, “No,” by this woman. That discussion was powerful and important for the entire class, illuminating and making available to be questioned in a way that no reading or film could have the white students’ internalized expectations of having any of their wishes fulfilled by Black people and to have that dynamic turned on its head.
It was critical that I, as the group leader/teacher, take on the role of supporting the Black woman unequivocally in her decision to not share, or none of that work could have been done. Had I been ambivalent or raised issues of class participation or left it open, i.e. “What does the class think about that?” the same work would not have ensued. Instead, there would have been much intellectual philosophizing about how things should go, and racism out there, instead of real emotional work being done by the people in here on themselves and each other.
As a group therapist, or leader of any type of group, it is crucial to remember the truth of oppressive dynamics, said so well by Desmond Tutu: “If you are neutral in situations of injustice, you have chosen the side of the oppressor. If an elephant has its foot on the tail of a mouse, and you say that you are neutral, the mouse will not appreciate your neutrality.”
Relatedly, DiAngelo writes, “White fragility functions as a form of bullying; I am going to make it so miserable for you to confront me — no matter how diplomatically you try to do so — that you will simply back off, give up, and never raise the issue again. White fragility keeps people of color in line and “in their place.” In this way, it is a powerful form of white racial control. Social power is not fixed; it is constantly challenged and needs to be maintained.”⁹
As a group therapist, can you imagine being okay with any intervention or knowing that you were facilitating a group in which any patient gave up and never raised an issue again? That entire idea is contrary to what group therapy is designed to do for people, which is stand in and own their truths and their self in relationship to others. No group therapist worth his or her salt would be okay with working in a way that facilitated a culture in which what Diangelo describes exists, and, yet, I bet if one were to interview BIOPIC patients in mixed groups run by white therapists, many would report this existing.
Unless the therapist is actively working to ensure that it doesn’t.
Because what Diangelo is describing is our cultural norm. To think our groups are immune from it is hubris and folly.
And to be clear, I am certainly not perfect any of this. I am still learning. I still screw up. I miss things. I don’t see things. I still have trouble knowing how or when or if to bring in racism with white patients, when it’s not necessarily coming up organically, even when I can see that it’s relevant, or even when a white patient may make a semi-racial slight. I back down, I get nervous. It is hard, at times, for me to know how to proceed.
Shortly after teaching one of my Diversity classes, a Black woman I had brought in as a guest speaker one day observed in our debrief of how the class went that I had identified a Black, female student as angry, when she had not seemed angry to her, subtly letting me know I was falling into the trap of the angry Black woman trope.
Without someone there constantly to point these things out, I am, of course, missing things.
And I am learning. I am working on it. I am aware of where I am failing or out of my depth and I am attempting regularly to do better, even when it’s clumsy or I’m scared about how it will go. I take feedback when my white biases show and my white supremacy thinking takes hold, because of course it does, and even though it’s hard, I let it in and I let it change me. I read different writers and thinkers geared towards helping me see and identify white supremacist thinking and ideas in myself. I lean into bringing race into my work in therapy, even when I’m nervous and I don’t quite know where it’s going to lead or if I’m going to end up looking like an idiot, a racist, or both.
As group therapists, it is not enough to conduct our work as usual, as we have been doing it for years, and in ways most likely developed by primarily white therapists or academics who were working within all-white groups. If we want for our groups to truly reflect the ethos of social justice, equality, equity, and fairness that our Codes of Ethics espouse, we will have to work at it, to actively work counter to the cultural norms of white supremacy as it shows up in us, in our patients, and in our groups and communities.
And there is great potential if we do. Dawes outlines the potential of therapists to impact social attitudes and social change:
The stigma surrounding mental health is wearing thin. As the mistrust in our institutions expands from the government to churches to mass media, more and more people are turning to therapy for help and solace. As such, we therapists stand to be primary influencers of American culture. This responsibility must not be taken lightly. In this spirit, by being alive at this time in history, we are invited to create a more anti-racist and socially just space for all of our clients.¹¹
The potential and opportunity Dawes outlines is expanded exponentially through group work, where the opportunities and risks for racial wounds and dynamics are also most likely to present themselves with the complexity with which they show up in the greater society. We have then, not only an opportunity but also a responsibility to learn to directly address these matters effectively and compassionately, and to be doing the work of healing racial trauma rather than inadvertently perpetuating it.
Footnotes:
- Dianglelo, R. (2018). White fragility: Why it’s so hard for white people to talk about racism. Beacon Press: Boston. p. 111.
- Diangelo, R. (2018). White fragility: Why it’s so hard for white people to talk about racism. Beacon Press: Boston. p. 128.
- Good Therapy. (Sept 27 2019). Shame. GoodTherapy.org. Last accessed February 11, 2021: https://www.goodtherapy.org/learn-about-therapy/issues/shame
- Dianglelo, R. (2018). White fragility: Why it’s so hard for white people to talk about racism. Beacon Press: Boston. p. 110.
- Dianglelo, R. (2018). White fragility: Why it’s so hard for white people to talk about racism. Beacon Press: Boston. p. 112.
- Rosati, J. (April 14 2016). “Facing the moment: Professor Howard Stevenson on managing racial conflict through racial literacy.” The Penn CSE Magazine. Last accessed February 11, 2021: https://www.gse.upenn.edu/news/facing-moment-professor-howard-stevenson-managing-racial-conflict-through-racial-literacy
- Dawes, H.C. (June 1 2020). An invitation to white therapists. Elemental. Last accessed February 15, 2021: https://elemental.medium.com/an-invitation-to-white-therapists-a04cc93b1917
- EmbraceRace. “10 tips for teaching and talking to kids about race.” Last accessed February 11, 2021: https://www.embracerace.org/resources/teaching-and-talking-to-kids
- Dawes, H.C. (June 1 2020). An invitation to white therapists. Elemental. Last accessed February 15, 2021: https://elemental.medium.com/an-invitation-to-white-therapists-a04cc93b1917
- Dianglelo, R. (2018). White fragility: Why it’s so hard for white people to talk about racism. Beacon Press: Boston. p. 112.
- Dawes, H.C. (June 1 2020). An invitation to white therapists. Elemental. Last accessed February 15, 2021: https://elemental.medium.com/an-invitation-to-white-therapists-a04cc93b1917