Racial Trauma in Therapy: A Roadmap for White Therapists
Dr. Martha S. Rinehart, PhD, LMFT, is a staff therapist at Council for Relationships who helps individuals and couples navigate identity, relationships, and life transitions. In this blog on racial trauma in therapy, she reflects on what it can mean for white therapists to do more responsible, culturally responsive work with clients of color. Drawing from her training, her ongoing learning, and the writing of leaders like Dr. Kenneth Hardy, Eddie S. Glaude Jr., Resmaa Menakem, and James Baldwin, she offers a practical roadmap for building trust, naming race directly and reducing the risk of harm in therapy.
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Racial Trauma in Therapy: Cultural competence isn’t a finish line
When I was training to become a marriage and family therapist, I took several cultural competency classes meant to prepare me to work with clients from marginalized communities and cultures different from my own. I am a white woman and I bring my own social location and cultural assumptions into the therapy room. The classes highlighted what we don’t know and why we must never assume that what is normal for us is normal for everyone, everywhere.
When I finished my training and prepared to begin my work as a therapist, I felt a little scared. I knew “cultural competence” is not a realistic finish line, and that this line of work requires ongoing learning and humility. I also believed it was inappropriate for therapists to ask clients for help. That felt unfair, and I agree with that. Most frightening, I was told that culturally inappropriate therapy could cause real harm.
Racial Trauma in Therapy: Why race must be addressed directly in therapy
“Today’s therapist must be willing, positioned, and poised to address matters of race in therapy in ways that are thoughtful, responsive, and shaped to address the ever-widening issues of racial trauma,” explained Dr. Kenneth Hardy. “To engage clients of color in therapy without, at the very least, some cursory knowledge of racial trauma and an accompanying skillset to address it borders on racial malpractice.”
So how do we proceed? Slowly, with patience, and with a steady effort to improve and refine understanding. I began to tear down the learned and inherited stereotypes I carried about what it means to be a person of color in America, and to examine how whiteness shapes what I have been taught to treat as ‘neutral’ or ‘standard’ in therapy.
The authors I have found most helpful are Hardy, Eddie S. Glaude Jr., Resmaa Menakem, and James Baldwin. Their work pushed me to do the work myself — to stop “quaking,” or as Glaude shares, “looking for someone else to be my leader.” On reflection, there are a few things I try to keep top of mind when working with clients of color.
Racial Trauma in Therapy: A roadmap for working with clients of color with humility and care
These ideas are not a checklist and they are not a substitute for lived experience. Still, they offer a practical starting point for white therapists who want to show up with greater humility, care, and accountability. I return to them when I feel uncertain, and I use them to stay focused on building trust and reducing the risk of harm.
Be humble
Menakem, in My Grandmother’s Hands, writes that “Your white body was not something you chose…Simply because you have a white body, you automatically benefit from white-body supremacy, whether you want to or not. … Your whiteness is considered the norm, and the standard against which all skin colors — and all other human beings — are compared. That alone provides you with a big advantage…You need to be aware of what those privileges are and how they function. You need to not take those privileges for granted as your birthright. You were granted those privileges, but you did not earn them. Great harm was done to other human beings to secure those privileges for you, and for others with white skin.”
In practice, humility includes expecting feedback without defensiveness, taking responsibility for missteps, and continuing to learn without placing the burden on clients of color.
Name race early and set accountability
Hardy goes so far as to offer white therapists a short speech to share before beginning therapy with clients of color: “As a white therapist, I am devoting more time and space in my work to having real conversations about race, and yet there is always a part of me that is sitting with a little bit of fear and anxiety about saying the wrong thing. I won’t let it stop me, and I want you to know I will be holding myself accountable; however, if by chance I miss something, I hope you will let me know how you have been impacted.”
It can also help to name what accountability and repair will look like in practice, so clients of color do not have to carry the burden of managing it. For example, “If I say something that doesn’t land well, I will name it, apologize, and take it to consultation. You’re not responsible for educating me. We can decide together what repair looks like.”
Make no assumptions
Don’t assume one client is like another. Don’t assume all marginalized clients share certain characteristics. Look for both the expected and the unexpected. Glaude, in We Are the Leaders We Have Been Looking For, writes, “Slavery’s afterlife and that of Jim Crow … frame how we might imagine ourselves in relation to a society saturated with assumptions about who we are and what we are capable of — assumptions that some would argue make the entire way of life in the West possible. In this light, the business of living requires coming to terms with the dead — precisely because their ghosts continually haunt us.” So listen for the voices of those ghosts to help light the way.
Also, avoid assuming race is the only salient identity in the room. Many clients of color are navigating racism alongside other identities (gender, sexuality, disability, immigration statues, religion, and class) that intersect and compound risk, safety, power, and access.
Start with one simple question
In Racial Trauma: Clinical Strategies and Techniques for Healing Invisible Wounds, Hardy asks, “How does your racial identity shape how you look at the world, and how do you believe it impacts how you are perceived?”
If helpful, you can add choice and pacing: “We can talk about this now, later, or not at all. I want you to have control over the pace”.
Actively listen to the response
Once the question is on the table, remain quiet as long as you can and practice active listening. Per Menakem, “Being an active listener involves not interrupting, not making judgments; not asking questions other than to make sure you understand; not giving advice or offering explanations; and no jumping in with a story of your own.”
As much as you can, don’t jump in with a bunch of questions, even if they are appropriate biopsychosocial or medical history questions. There will be time for all of that. Otherwise, there is no reason to expect a client of color to trust you enough to answer questions honestly. Further, this approach allows the client to center their story in their own way, rather than trying to fit it into the questions we provide.
Go slowly to build trust
Trust builds slowly, so therapy should proceed slowly to allow that trust to develop. In addition, Hardy reminds us that “the invisible wounds of oppression often remain invisible to both those who suffer from them as well as those who are responsible for inflicting them.” Proceeding slowly grants respect and space for someone to reveal themself in their own time and manner.
This matters because, “Finding ways to make peace with humiliation is integral to the experiences of the racially oppressed. In many ways, humiliation and devaluation are at the core of virtually all the defining experiences of people of color, the poor and other oppressed and marginalized people.”
Grant clients the gift of moving at the pace that feels safe for sharing their stories. “The therapist’s drive to fix a specific presenting problem should not overshadow the client’s need for the space to process their being, to promote a type of spiritual liberation, and to sit quietly and perhaps comfortable with themselves and the complexity of their conditions while the therapist bears witness. This type of process is so vitally important because many people of color, despite the enormity and prevalence of racial trauma in their lives, have very few sacred places where dedicated time and space are granted for the sole purpose of metabolizing the emotional strains and stresses of racial trauma.”
One caution: “Go slowly” should not mean avoiding race, postponing repair, or minimizing harm. It should mean pacing with the client while staying willing to name what is happening.
Expect racial trauma to show up
“The trauma held in Black bodies shows up as a wide array of physical problems and dysfunctional behaviors — all of which are common symptoms of persistent and pervasive stress.” Menakem also urges us to remember, “Trauma is never a personal failure, nor the result of someone’s weakness, nor a limitation, nor a defect. It is a normal reaction to abnormal conditions and circumstances.”
It can also help to avoid pathologizing coping strategies. Many survival responses are adaptive to chronic stressors, even when they carry costs over time.
Don’t neglect sociocultural context
Hardy argues that a key missing component of many models of therapy involves neglecting context. Hardy writes, “A neglect of context … is the failure to seriously consider the relationship between human suffering and the sociocultural context in which it is often embedded, permeates most traditional models of therapy.”
To deny that race is an issue for clients of color becomes a grave disservice. “Doing intensive and transformative clinical work with racial trauma requires a major shift in how the process of therapy is approached, structured, and executed.” The work requires therapists to:
- Adopt a racial lens
- Become racially lingual by developing a proficiency to effectively engage in conversations about race
- Develop a good working understanding of the invisible wounds of racial trauma
- Engage in critical racially based self-of-the-therapist work
- Actively redesign the therapeutic space to accommodate a greater tension between being and doing in the execution of therapy
Strengthen six relational factors for race work
Hardy identifies six “critical relational factors that therapists must master to enhance their ability to effectively integrate and navigate racial issues in therapy. These relational factors represent metaphorical muscles that must be exercised and developed; otherwise they atrophy and serve as a major clinical impediment to working with racially traumatized clients.” The six “muscles” are:
- Intensity
- Intimacy
- Transparency
- Authenticity
- Congruency
- Complexity
As these muscles develop, our ability to have difficult conversations grows more sustainable. Over time, the hope becomes alignment between thinking, words and behavior, so clients of color can feel that we are trustworthy and worthy of their trust as they tell their stories.
Ask one more question, even when it’s uncomfortable
For white therapists, the first muscle (intensity) may be particularly challenging. It requires letting go of white fragility so we can push past our own boundaries in service of our clients. Menakem writes: “White fragility screams this message to people of all colors: Whenever a white body feels unsafe or uncomfortable, it’s everyone’s job to soothe it down ASAP. If they don’t, a dark body may need to get broken. This message gets broadcast twenty-four/seven to (and through) millions of white bodies. But it’s a flat-out lie.”
This work is not for the faint of heart. It requires stepping out of comfort zones. Specifically, Hardy calls for asking one more question: “It is imperative to have an unrelenting and resounding commitment to asking one more racially based question than one is comfortable asking or making one more statement than one is comfortable making. … In cross-racial conversations, both in and out of therapy, intensity is often difficult to achieve for two principal interrelated reasons: 1) whites tend to conflate ‘comfort’ and ‘safety’; and 2) people of color withhold the expression of deeply seated authentic feelings that add intensity to a conversation for fear of reprisal by whites.”
Hardy also explains that “More than anything, culture creates a sense of belonging — and belonging makes our bodies feel safe. This is why culture matters to us so deeply. We humans want to belong. We experience belonging — or the lack of it — in our bodies. We experience it deeply. When we belong, we feel that our life has some value and meaning.”
Racial Trauma in Therapy: Belonging is the goal
And isn’t that really what we are trying to do here — provide a pathway for clients to find belonging, and to feel that their lives have value and meaning?
I think so.
Racial Trauma in Therapy: About Dr. Martha S. Rinehart and more from Council for Relationships
Racial trauma in therapy can feel difficult to name, but the right support and the right therapeutic relationship can make a meaningful difference. Below, readers can learn more about Dr. Martha S. Rinehart and explore additional ways Council for Relationships can support them or someone they care about.
Dr. Martha S. Rinehart is a CFR Staff Therapist who sees clients online across Pennsylvania and New Jersey.
Racial Trauma in Therapy: About the author
Dr. Martha S. Rinehart, PhD, LMFT, s a Staff Therapist at Council for Relationships. She works with individuals and couples and supports clients navigating identity, relationships, and life transitions. Her approach centers curiosity, care, and building a trusting therapeutic relationship. Interested in working with a Council for Relationships therapist like Dr. Rinehart? Request an appointment through our therapist-matching service.
More from CFR
Council for Relationships (CFR) has provided expert therapy, clinical training, and research since 1932. With a team of expert therapists and psychiatrists, CFR offers individual, couples, and family therapy across the greater Philadelphia region and online. If racial trauma in therapy feels relevant to your life, you do not have to navigate it alone. To get started, get matched with a Council for Relationships therapist or psychiatrist. You can also sign up for CFR’s newsletters for mental health resources and updates, and explore more blog content for practical guidance and support.
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