Should My Therapist Look Like Me? →

I am on multiple therapist listserves where we look for referrals to connect therapists to clients. Often the request will include demographics of the sought-after therapist: woman of color, female identified, queer person of color, latino male therapist, older, trans or gender non-conforming therapist, etc. Occasionally on these listserves, therapists bring up the idea that these specific requests are unnecessary, that a good therapeutic relationship can be built regardless of difference.

This, of course, is true. The therapeutic relationship can be empathetic and deep even if the client and the therapist do not have similar life experiences. Also, just because someone looks like you obviously doesn’t mean that their life is, or has been, like yours.

However, when it comes to being understood, people who are from “marginalized populations” - people who are non-white, non-heterosexual, gender non-conforming, non-monogamous - understandably seek out therapists who either similarly identify with, or specialize in working with these populations. No matter how much work a therapist has done, a client may not feel safe in the room with someone who has not had firsthand experience of the discrimination that they face every day. The therapist may represent and benefit from the system that is directly oppressing the client. And for some clients, the amount of work they have to put in to feel a sense of trust is just not worth it or possible. Here is a really great article by Stephen W. Thrasher about why having a queer, black therapist is so important for him https://www.them.us/story/why-i-see-a-black-queer-therapist. 

Given that the majority of Marriage and Family Therapists in California are white and are women, (https://www.camft.org/images/PDFs/articles/mariam/2015_demographic_survey.pdf),  it can be difficult to find a therapist who shares your racial or ethnic identity, sexual orientation, or gender identity, especially in less populated areas. So, what is there to do?

• Look for diverse images on a therapist’s website - if your potential new therapist has pictures representing many people, it’s usually a good sign that they are thinking about people with backgrounds different from their own. 
• Look for inclusive language in the way they describe either the clients they work with, or their own philosophy.
• Ask for recommendations from people you know. This is one of the best ways to find a therapist you like.
• Look for organizations such as the National Queer and Trans Therapists Network (NQTTN) https://www.nqttcn.com, or use search terms such as “therapists of color”, “queer therapists” or “trans-affirming therapists”, etc. in your specific area., etc. 
• In the Bay Area there is a Therapists of Color Directory http://www.therapistsofcolor.org/directory.html, Gaylesta, Therapists for Gender and Sexual Diversity https://directory.gaylesta.org, Bay Area Open Minds, Psychotherapists Affirming Sexual and Gender Diversity https://bayareaopenminds.org and many more organizations that are aware of the need for a diversity of options for people seeking therapy that works for their specific needs..

When is difference in a therapy relationship not working?

If you as a client have to explain your experience in a way that you wouldn’t have to if your therapist were from your community, then there may be a problem. A therapist is ethically obliged to either educate themselves or refer out if they feel that something is outside of their expertise. If a therapist shows a lack of understanding of how race and racism impact you, for example, that is problematic. If a therapist asks you to explain something, you should not feel like you are educating them on something you think they should already know. That is not your job in therapy.

You as a client might not need your therapist to have experienced oppression in the same way that you have, but if your therapist challenges your experience or point of view, or doesn’t acknowledge your experience in a way that lets you know you have been understood, or hasn’t taken the time to understand oppression in the United States, then these factors could negatively affect the therapeutic relationship.

If your therapist doesn’t know, for instance, some popular culture references you make in session, the therapist can do some research on their own time. Your therapist’s knowledge - or lack of knowledge - of the reference may be important to you. It may help put you at ease, feel seen and understood. Or it may not be important to you. You will know.

Trust Yourself

Seeing a new therapist can be an awkward experience. You are there to share your struggles and often things that you don’t share with others in your life, and your therapist is a stranger to you. It may take a number of sessions to really feel comfortable with your therapist. 

It’s also a good idea to directly ask a potential therapist about their work with other people like you.  You will get a sense right away based on how they answer, and how the answer feels to you.

But sometimes we know right away if it’s not a good fit. If you know it’s not a good fit, you are not obligated to continue with that therapist. It is totally fine to let the therapist know it’s not working for you and you are continuing your search for a therapist. 

Feel What You Feel

Have you ever had the experience of feeling something under your skin or in your emotional background that is rumbling or seems a bit uneasy, but you don’t want to look at it, and instead you find yourself eating more chocolate than usual, or binge-watching shows on Netflix, or constantly checking your social media? 

We all spend a certain amount of energy in avoidance behaviors - specifically trying to avoid feeling some of our emotions. Avoidance is an amazing human ability and is necessary for us to function in the world. If you feel angry about something at home, it is not helpful if you are raging while at work. If you are experiencing sorrow, sometimes you have to push through the desire to lie down and weep because you have to take care of things in your daily life. Avoidance of emotions can be adaptive and is necessary.

However, many of us spend a great amount of energy unnecessarily avoiding emotions, primarily because we are afraid to feel what we feel. Often, our fear of our emotions is greater than the reality of feeling them. Sorrow, as an example, can be scary to think about. We may avoid sorrow fearing that we will fall into a dreary abyss and never reemerge. Sorrow is heavy and can color the way we view the world. But usually if we allow ourselves our sorrow, it will move through us in a matter of time - sometimes hours or days. True, we won’t be bright and cheery, but it is possible to feel sorrow and still show up for your life. 

Emotions are ever changing, always moving. If an emotion is stuck, there may be something going wrong, a way in which it is being held onto. Sometimes the act of avoiding an emotion causes it to hang on much longer than it would otherwise, gnawing at us until we finally give it space. We often act out more when we are denying ourselves an emotion - we will suddenly say something mean to someone close to us, or engage in behaviors including eating or drinking that make us feel worse. While avoidance behaviors can be necessary, it is important to allow yourself some time - even if it’s just a few minutes - to feel what you are feeling. It’s also important to allow space for expression - maybe crying, punching pillows, writing in a journal, or addressing a situation that needs resolution. Pretending the feeling isn’t there doesn’t make it go away.

There are times when emotions are truly too overwhelming to handle on your own. This could be the case with trauma, in which the anxiety, fear and despair seem to be too much. Grief is another emotion that takes a much longer time to work through, with time being one of the greatest healing factors. Our culture does not allow much time for grieving so often people feel pressured to get over it, rather than move through it - a process which is slow and contains so much emotion. Therapy is a great place to explore overwhelming emotions. With a good therapist, you can go into a rough emotion in the presence of someone who will help you touch the depths and help you to leave the room resourced - something that can be tricky to do on your own.

Whatever it is, if you find yourself in avoidance behaviors, check in with yourself. What are you feeling? What are you avoiding? Try to make space for yourself to just feel what you feel.