Conference: Black Trauma in the Therapy Room

BME Voices Talk Mental Health Trauma Conference 2020

This Saturday I attended Trauma Conference 2020 – Black Trauma: When it presents in the therapy room. This excellent online event was put on by BME Voices Talk Mental Health.

The speakers were Dr Dwight Turner (psychotherapist, academic, and forthcoming author), Dr Keren Yeboah (psychologist and author of the study ‘Power and the ‘hidden self’: reimagining the therapeutic use of power in work with Black people diagnosed with psychosis’), Ebinehita Iyere (youth practitioner working with young people affected by the youth justice system), Sharon Frazer-Carroll (occupational therapist, organisational expert and founder of Time To Talk Black), and Dr Isha Mckenzie-Mavinga (psychotherapist, academic, and author).

A note on trauma

Trauma is a spectrum, not a binary. Despite the best efforts of many, society as a whole is only just beginning to comprehend the multifarious nature of trauma, what trauma means for people individually and collectively, and the different ways it can manifest. Many now accept that you don’t have to be a combat veteran, refugee, or incest survivor to be traumatised and to experience PTSD or CPTSD, and that trauma in your ancestry is likely to manifest in the present.

It’s also more understood that ‘minor’ daily incidents, known as microaggressions, can cumulatively cause a high level of distress in a person. And that ongoing fear of threat can cause as much harm as an actual incident. But some, especially those with power, may find it harder to accept that certain populations experience this more than others. The challenge comes when these same people realise that it is they themselves who are causing the harm. Without deep reflection, it is hard to own our acts and do the work.

The multiple impacts of systemic inequality

At the conference every speaker, in different ways, outlined the systemic construct of Whiteness and Blackness (the racial complex that binds us) and its impact, through racism, on Black lives. We heard about trauma responses to racism and the impact on mental and physical health, including internalised racism (or our ‘internalised supremacist’), and how quickly you lose touch with your humanity when you are forced to adapt to a culture that someone else has created.

Gaslighting and double standards

We heard about the harms done by the White-constructed mental health system to Black patients with psychosis, (for example being criminalised on entering the mental health system, and having anger mislabelled as a pathology) and the constant location of issues solely within the Black community, and the minimisation of the racism that creates this.

Ancestral trauma held in the unconscious

We had an interactive discussion about whether Black trauma exists, and whether therapists should undertake specific training about it. We were reminded that in 2020 the (White) world is waking up to a reality that many have already lived with for a long time, and that White therapists need to do more self-reflection and investigation. The silence of early lockdown ’emphasised the noise in peoples’ heads’ – the ancestral trauma, bursting to speak, that is so often buried in the unconscious.

Examining racism in supervision and training

We heard about the process of unmasking racism in clinical supervision, and the reminder that Black therapists are impacted by racial trauma while also hearing about it, and yet sometimes feel unable to name racism to a White supervisor. And when a Black student is expected to educate the rest of the students in the room, and do the labour of caretaking White fragility, (and keep their own feelings in check to protect others as well as themselves within a White system), they cannot give time to their own development.

The whiteness of the therapy world

Self-care

For the last hour of the conference, the primary theme in the panel discussion was self-care. When Black therapists speak about interaction with White colleagues, the word ‘exhaustion’ quickly comes up. There will be times when Black therapists cannot be with White friends and colleagues, because of this exhaustion, rage, and hurt. White people cannot expect to be rescued from this – ‘It’s not about you’. One speaker spoke of ‘trying not to be drawn into other peoples’ awakenings.’ Another quoted: ‘Just because we are in the same storm, does not mean that we are in the same boat.’ White therapists are advised to read, especially outside therapy subjects, and process shame and guilt by finding a place where it’s okay to talk.

Challenging course leaders

How do Black trainees stand up and challenge their course leaders? One speaker sent their comments to all their leaders and fellow students, and spoke out on social media, adding: ‘Get your message right and don’t endanger yourself.’ It is important to create Black spaces if there were none previously. But ‘realise you can’t do it all.’

Beyond eurocentric trainings

In the Q&A, someone asked: ‘Where are the Black and Asian modalities?’ The response came: ‘Here we are!’ The teachers, supervisors, and learnings are already here! They need to be listened to, and training organisations need their wisdom and experience in order to build equality-based and culturally competent trainings from the ground up. There are plenty of people and organisations out there who can help: Kaemotherapy, Race Reflections, Me & White Supremacy, Radical Therapist Network, Resmaa Menakem, and others can all contribute to new forms of training that prove the organisations truly value every student equally.

When I attended the inaugural BME Voices Talk Mental Health conference back in October 2018, I was surprised to see so few other White therapists there, perhaps 10% of the delegates. This was an indication of the work we have to do to make counselling and psychotherapy truly reflective of all populations, in respect of both therapists and clients. However, after the events of 2020, and the increasing profile of Black Lives Matter, I suspect this year the numbers were greater.

There is a long way to go

Every speaker had something positive to say about how we might go forward. But it was also clear that, in many ways, things have barely changed in 30 years. There are of course many individuals of all backgrounds desiring change in the mental health system and psychotherapy – but the process is slow. And, unfortunately, it is not clear that organisations are truly listening. One major piece of evidence of this is the ScopEd project, a proposed framework for a hierarchical classification of therapists, and promotion of particular member organisations. ScopEd was not mentioned at the conference (as I recall), but I feel it fits strongly with the theme.

A missed opportunity

This is not the post to go into detail about this, but I will describe it in brief. There was an opportunity for some real systemic thinking to address the huge missing pieces currently within mainstream therapy trainings, (race, racism and White supremacy being one of the most significant, but not the only one). Instead a top-down medical and analytic model is being proposed, and many counsellors may be put out of business by being deemed incapable of taking paid work. This hierarchical structure does nothing to address racism, misogyny, homophobia, biphobia, transphobia, classism or ableism, and does not seem to address systemic factors at all, even though they affect all of us every single day, therapist or client. It also doesn’t address the access issues that prevent so many people (particularly Black, and working class) from training as therapists in the first place. While I would agree that training standards do need to be addressed, it is the counsellors who are bearing the brunt of this project, rather than the training organisations who trained them.

In his book How to be an antiracist, Ibram X Kendi states, over and over again, that it is racist policies that need to change, and that only working towards anti-racist policy will have meaningful impact. Sadly it feels as if this is being played out, however unintentionally, in the counselling world. Of course, good intentions mean nothing without deep reflection on the impacts of our actions.

I am very grateful to all the conference speakers for sharing so much, and to Helen George, founder of BME Voices Talk Mental Health, and co-host Leoni Cachia. I’m looking foward to the next one already.