How To Talk About Race With Your Therapist: Navigating The Conversation Honestly

Note: The following post contains subject matter regarding suicide and race. If you or someone you know is at risk, contact The National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Help is available 24 hours, seven days a week.

Though discussions about race are becoming more frequent, broaching the topic in therapy can feel like navigating uncharted territory for some. This may require a measure of vulnerability and trust that some people feel uncomfortable with.

However, as we manage the complexities of racial dynamics and social justice, it becomes increasingly prudent to bring these conversations into the therapeutic realm. The therapist's office should be a space for introspection and healing. As such, individuals should be able to feel comfortable discussing race with their therapist within any context they need to if they so wish. 

In this post, we'll discuss the significance of addressing race in the therapeutic setting, how to discuss race with your therapist, and what to look for when choosing a culturally competent therapist.

Note: Clients should have control over what they would and would not like to discuss in therapy. You should never feel pressured or coerced into talking about complex, potentially sensitive topics like race, gender identity, and sexual orientation. It's important for your therapist to respect your boundaries and comfort level when talking about any issue, including race. 

You should be able to talk about race with your therapist

Find a compassionate therapist you can trust

Racism and mental health

Research repeatedly shows that racism can have a severely negative impact on an individual's mental health, and statistics on mental health and racism are telling: 

• In 2020, suicide was the third leading cause of death among African Americans ages 15-24.
• Native and Indigenous American adults have the highest reported rate of mental illnesses of any single race-identifying group.
• The risk for mental health problems in Hispanic children and adolescents is significant and higher than their white counterparts in many cases. 
• Suicide was a leading cause of death for Asian American adolescents and young adults in 2017.

The impact of racism on an individual's well-being is complex and multifaceted. Ways in which racism can affect mental health include, but aren't limited to:

Trauma and stress

Experiencing racism, whether it's in the form of discrimination, racial microaggressions, or overt acts of racism, can lead to chronic stress and trauma. Constant exposure to discriminatory behaviors can activate the body's stress response, leading to various mental health issues.

Depression and anxiety

The persistent experience of discrimination and racism can contribute to feelings of marginalization, alienation, hopelessness, and helplessness— all significant risk factors for depression and anxiety.

Self-esteem and identity

Racism can challenge one's sense of identity, belonging, and self-worth. Individuals who face discrimination may internalize negative stereotypes, leading to a negative impact on their self-esteem, self-image, and mental health.

Interpersonal relationships

Racism can strain interpersonal relationships, both within one's community and with individuals from other racial or ethnic backgrounds. This social isolation can contribute to feelings of loneliness and exacerbate mental health issues.

Intergenerational trauma

Racism can have a cumulative effect across generations, affecting families and communities. The transmission of stress and trauma from one generation to the next can create a cycle of mental health challenges.

Institutional racism

Systemic or industrial racism, where policies and practices disadvantage certain racial or ethnic groups, can significantly contribute to feelings of powerlessness and frustration, impacting mental health on both an individual and societal level. 

Physical health consequences

The bi-directional relationship between our mental and physical health is widely accepted by experts in the mental health field. A growing body of research is exploring how chronic stress resulting from racism can impact an individual's physical as well as mental health. Findings indicate that racism can have a variety of physical health consequences, including, but not limited to, increased risk of cardiovascular problems, immune system suppression, and organ and tissue damage. 

The impact of racism on mental health is not uniform, and individuals may respond differently based on various factors such as resilience, support systems, and coping mechanisms. Addressing racism at both individual and systemic levels is crucial for promoting mental health and well-being for everyone.

How to talk about race with your therapist

Talking to your therapist about race is an essential and valid conversation to have, as it can profoundly impact your mental health and well-being. Here are some tips on how to approach this conversation:

Recognize the importance to your mental health

Begin by acknowledging the significance of discussing race in the therapeutic relationship. For most, racial identity, experiences, and the societal context in which one lives can influence mental health in various ways.

Express your comfort level and concerns

Share your comfort level with discussing race and let your therapist know if you feel uneasy or hesitant about the topic. Open communication about your comfort level lets your therapist know where you stand on the issue so they might better gauge how to approach the discussion. If you have specific racial or ethnic concerns, share them too. This could include experiences of discrimination, microaggressions, or challenges related to your identity. Being specific can help your therapist better support you.

Provide context and explore personal impact

If you feel comfortable doing so, offer context about your racial and cultural background and any specific experiences that may be relevant. This could include topics like systemic racism, racial trauma, or current events that are affecting you emotionally. Discuss your experiences and how broader societal issues and events related to race may impact your mental health. This can help your therapist understand your perspective and tailor their approach accordingly. 

Ask about their approach and discuss cultural competence

Inquire about your therapist's approach to discussing race in therapy and talk about your expectations regarding your therapist's cultural competence. Ask about their own experiences working with clients from diverse backgrounds, whether they engage in ongoing education about race, and what steps they take to ensure they treat their clients equally.

Ask about what challenges they may have experienced when working with clients of your race or cross-cultural clients in general and how they incorporate cultural sensitivity into their practice to promote their clients' well-being. This can give you a feel for how they might approach the issues that may come up in your therapy sessions. 

Potential difficulty communicating about race isn't confined to brown clients and white therapists or any other kind of racial difference. For example, an individual may have concerns about their own role in systemic racism or how such prejudices against others have shaped their worldview. 

Regardless, the therapeutic relationship is a collaboration. Finding a therapist who communicates openly is critical to a successful therapy process. If your own therapist is not responsive or if you feel uncomfortable, it may be helpful to address this concern directly or consider seeking support from a therapist with more experience in addressing racial and cultural issues.

Remember that you are within your rights to screen therapists for as long as necessary to find the right fit. When interviewing therapists, ask for a short preliminary conversation via video chat or over the phone to get an idea of who they are and if you'll be comfortable working with them. 

Online therapy for topics about race

Uncertainty over how your therapist will respond to your experiences with racism or how it could potentially affect your therapeutic relationship can create barriers to healthy, honest communication. If this is a concern for you, it's essential to find the right therapist with a background in serving diverse communities. 

With the rise of online therapy, finding a therapist that fits those needs is easier than ever. Online platforms like BetterHelp match clients with licensed, experienced therapists from various backgrounds and specialties. 

BetterHelp is also a helpful choice for people experiencing various barriers to treatment.  For example:

• Responsibilities at work or home that make it difficult to schedule and attend appointments. 
• Accessibility issues or difficulty commuting to and from appointments. 
• Discomfort with divulging deeply personal information face-to-face or encountering others in an office setting. 
• Financial concerns.

Unlike conventional therapy, online therapy allows you to speak with your therapist from anywhere with a reliable internet connection on your schedule via video chat, online messaging, or by phone. 

Online therapy is discrete, and often more affordable than traditional therapy without insurance. A large body of research also indicates that virtual therapy is as effective as conventional therapy for treating a wide variety of mental health issues associated with racism and discrimination, such as anxiety, depression, PTSD, and substance use disorders. 

Takeaway

Whether you're experiencing racial tension and discrimination from others, conflicted about your feelings on race, or distressed about how your own may impact your relationships, discussing race with your therapist can be a transformative journey, shedding light on the intersections of identity, experiences, and the pursuit of mental well-being. If issues of race and discrimination are affecting your mental health, reach out to a BetterHelp therapist and take the first step toward healing.