As far-right and anti-immigration influences take hold across the globe, people of colour are often struggling to know where they might feel safe. Encountering occasional racism has been a fact of life for people of colour in most countries in the west. Emboldened by the far-right movements, racist voices are now becoming louder and moving into the mainstream.
One of the emergent themes within the therapy room has involved a resurgence of racial trauma, especially for those who have previously experienced significant such harm.
Every migrant or person of colour has a different relationship with race and the culture around them, but certain themes predominate when navigating life as a cultural minority, including seemingly innocuous “othering” (“oh, how is your English so good?”), unspoken discrimination in employment, stereotypical beliefs (all south Asians are truck drivers), deliberate ignorance, scapegoating (house prices are rising because of immigrants) and outright hatred (“go back to where you came from”). Many people of colour have also experienced frank and outright abuse and violence because of racism.
Aisha* was one of these people. She is a young woman of Pakistani origin and had been seeing me for therapy to manage some difficulties with her family. Aisha said she had also experienced an assault in adolescence by Caucasian peers from school, and believed that this was racially charged, though the school denied this at the time. She had initially started seeing a psychoanalytic practitioner but stopped seeing them when they tried to interpret her reaction to a racist comment by her manager as a transference reaction deriving from childhood. Her experiences with therapy had been mixed and she struggled with the quick injunction to “put up boundaries” she had received from Caucasian therapists, with limited recognition of the cultural context she resided in. While therapists from any background can work very successfully with people of colour, it does require a level of sensitivity, willingness to learn, and to incorporate an understanding of structural issues such as colonialism and discrimination into therapy.
Within the context of increasing anti-migrant and anti-Muslim rhetoric, Aisha found that she was hyper-vigilant and anxious about the possibility of another assault. She said she had nightmares about the attack and was starting to perceive danger in her daily life. She worked as a nurse and was subject to a lot of racism from clients, and much subtler racism from colleagues and management. She said her typical manner of smiling and ignoring it was becoming difficult to continue. She found herself so angry that she was clenching her teeth at night and was diagnosed with temporomandibular joint disorder (TMJ).
My first therapy task was to understand her culture instead of making assumptions. I also needed to reflect the reality of what Aisha had experienced and to sit with her in her distress, instead of moving into a glib intervention such as reframing her thinking. Exploring the disempowerment and fear she felt and normalising this in the context of the changes in the world was important, before we could move into more active interventions.
I noticed that Aisha’s threat perception was heightened, which is a typical response for those who have experienced trauma. I had to walk a fine line of helping her to see this without dismissing her understandable fear. We worked on some basic psychological techniques such as controlling what you can and letting go of the rest, but I made a point, as I do for all my clients experiencing structural harms, that describing the technique in this way might feel like slapping a Band-Aid on a broken leg. We utilised eye movement desensitisation and reprocessing (EMDR), a trauma treatment to reduce her anxiety about the assault, and additionally worked on some basic lifestyle interventions to ensure she had the building blocks of mental health in place.
Learning to respond assertively to racist comments and behaviour was also an essential part of our work, and Aisha identified that racism from colleagues was much worse than racism from patients – though the latter was more overt. We worked on building some interpersonal effectiveness skills and rehearsing self-talk to support Aisha with combating these difficulties.
While therapy was a tiny part of the puzzle, feeling understood and supported in her experience of disempowerment was important to Aisha. She was able to externalise the racism and see it as a reflection of the people engaging in this behaviour, rather than as a personal failing. She acknowledged that this was sadly the reality of life for many migrants, but she now felt more empowered to make changes for herself and for other people of colour in her workplace.
*All clients are fictional amalgams
• Dr Ahona Guha is a clinical and forensic psychologist, trauma expert and author from Melbourne. She is the author of Reclaim: Understanding complex trauma and those who abuse, and Life skills for a broken world
• In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978. In the UK, the charity Mind is available on 0300 123 3393 and Childline on 0800 1111. In the US, call or text Mental Health America at 988 or chat 988lifeline.org
