Why I'll Be Choosing My Next Therapist by Race

“Black people don’t do therapy; we go to church” is a statement I’d heard countless times in my community. We didn’t discuss mental health so much in my family either. And when the concept of therapy did come up, it was doubly dismissed as a privilege purely for the rich, and something only white folks did. But after I suffered from insomnia and anxiety for more than five years, my friends started suggesting I find a therapist. It never crossed my mind that racial dynamics would play a part in this treatment—but then they did.

I am a black gay woman in an interracial relationship. I have survived sexual assault. Knowing I wouldn't want to explore this with a man, I looked for a female therapist and by chance ended up with a woman of color. Our shared experiences as marginalized people made me feel safe, understood, and validated. She understood how the subtle nuances of my oppression impact all aspects of my life, including my mental health. She understood racial income disparities (the Economic Policy Institute reported in 2017 that black women would have to work seven additional months to make as much as white men do in a year, for example), and she took that into account when suggesting coping mechanisms (holistic treatments, classes, and even medication can be expensive and out of reach). Her language was inclusive, empathetic, and intersectional, and it helped me immensely.

A few years later, my partner and I moved to her hometown of Atlanta. Having to live in a state where the majority of the people voted for Donald Trump—who emboldens racists with his dog-whistle rhetoric and whose policies further marginalize people of color—heightened my anxiety. Georgia also doesn’t have legal protections for LGBTQ residents in the workplace, and “religious freedom” legislation essentially creates loopholes for this kind discrimination. Simply existing in this place, at this time, was triggering, and I needed to resume therapy.

I ended up in the office of a white woman, and at first this seemed fine. We talked through some recurring issues with my sexual assault. She offered helpful techniques for insomnia. She was warm and engaging.

But our sessions took a weird turn when some of my anxiety about my income and struggle with friends and family intersected with racial oppression and microaggressions. I didn’t think she understood my anxiety surrounding the underrepresentation of people of color in journalism. She believed if I just applied myself more, I would have a successful career. I was dismissed when I insisted that there were systemic problems at play.

And when I told her that I decided to distance myself from people who supported Trump, whether they were family or not, she seemed to wear her disappointment plainly. “You actually cut people out of your life? Don’t you think that was rash?” she asked. “Aren’t you putting politics over friendships?”

Politics is never just politics when you’re part of a marginalized community. “Political decisions impact my life every single day,” I explained, spelling out how inflammatory comments about people of color, women, and immigrants are harmful to me. That may not have been my friends’ or family members’ intention when they cast their votes, but that was the impact. I don’t think she got it.

I’m not suggesting that white therapists are unfit for the job, nor denying that plenty of people are treated by therapists of different races and genders all of the time—often to great results. And to anyone who thinks they need some help but live in a place where finding a practitioner with a similar background is impossible, please get whatever help you can. My wife and I had a perfectly positive experience in premarital counseling with a white therapist who was supportive and took care to recognize her privilege often. But in my one-on-one therapy, things were not going that way.

It had started to feel like my trauma was being minimized rather than held and acknowledged the way it had been with my first therapist, back in New York. It’s no wonder black Americans seek mental health services at only one half the rate of white Americans. And yet the Department of Health and Human Services found African Americans are 20 percent more likely to report having mental illnesses like depression and PTSD.

That black people continue to stifle these struggles is one more painful piece of the legacy of slavery. For generations strength meant survival; illness of any kind meant weakness (and danger), and God was the only therapy you’d need—and, it’s worth saying, the only kind you could attempt to access. The stigma around mental illness in the black community persists today, according to the National Alliance on Mental Health. And so any conversations surrounding the wellness of marginalized people simply must include the impact of oppression, of social systems that harm them, and of white supremacy. Any therapist I see needs to have a basic understanding of my experiences as a black woman in a country that has historically oppressed people like me. Of course that impacts my mental state. How could it not?

After a few days of reflecting on that session, I started to doubt myself. Maybe I was overreacting or misinterpreting her. I reached out to a friend who had been down this road before. “The race of my therapist wasn’t an issue until he didn’t understand the complexities of raising black children in this country,” my friend, who is black, told me.

Her voice changed and she started to tear up, remembering her therapist’s inability to grasp her deepest fears. “He actually told me that if I just teach my boys to comply with the police, they should be fine. He said things only go bad when people run or resist arrest.” My friend told me she never went back to that therapist again; she now sees one who is black.

“You’re building a relationship with your therapist, and that can’t be done if they’re questioning your race-based trauma,” she explained to me, as I struggled over the question of whether it was right, or OK, for me to choose someone new based on their race. She helped me understand that, in fact, that’s exactly what I need to do.

My therapist doesn’t always have to agree with my choices (or even my characterization of Donald Trump and his supporters), but it is not negotiable that she believe in the validity of my experiences. When someone you’ve entrusted with your care dismisses your experience or even refuses to acknowledge the presence of racism, it only sharpens the pain of your trauma. When they empathize, it can open the door for healing—before either of you speaks a word.

Jacy Topps is a writer based in an Atlanta and New York City. Her work has appeared in Slate, Vice, and Huffington Post.