Couples therapy seems to be a middle-class, White person construct. There are a lot of reasons for this that we’ll discuss at various points on the blog, including financial and geographical. (Most private practitioners, for example, have offices in middle/upper-middle class communities with a lower concentration of racial diversity.) Nevertheless, for whatever reasons, therapy, especially couples counseling, seems to be utilized less frequently by African Americans.
Dr. Clifford Broman, a professor of sociology at Michigan State, recently evaluated racial demographic data of therapy participants in his article, “Race Differences in the Receipt of Mental Health Services in Young Adults,” published in a 2012 edition of the journal Psychological Services. Broman created a longitudinal project in which teenagers were asked to assess their therapeutic experiences over a seven year period (1994-2001). Almost 5,000 young adults participated in the project, which involved reflecting on the process of therapy through a Likert scale format in 3 periods (1994, 1998, and 2001). 55% of participants were White, and 20% were Black. He discovered that Blacks with prior therapeutic experience were less likely to currently seek services, whereas other racial groups maintained an interest of pursuing counseling. He also discovered that Blacks with higher education were less likely to receive services than those with lower education; the opposite was true for other racial groups. Perhaps education symbolizes a victory over systemic injustice, a representation of strength and “overcoming the odds”, and the acknowledgement of an educated Black person that therapy is needed implies that reverting to a place of weakness and subjugation.
In couples counseling, one of my goals is to develop intimacy through the witnessing of vulnerable parts, under the principle that “if my partner will accept my weakest, most needy parts, he/she will be more willing to accept all of me.” This principle counters our natural survival strategies, which rely on variations of physical and emotional strength. Dr. Phillip Goff, as we discussed in previous blog posts, suggests that Black youth are more likely to be perceived by peers and authorities as aggressive, angry, and more culpable. This social perception reduces the possibility that others see Black people (and that Black people perceive themselves) as innocent, empathetic, and child-like, and transforms into adult identity and couple formation.
How can we get Black couples to buy into vulnerability models of couples therapy if they’ve had to/been forced to see themselves strictly through labels of “strength”? I wanted to use this blog post to make five suggestions, with the help of research established by Georgia State’s Dr. Makungu Akinyela, who writes about couples therapy with African American couples in the book Re-Visioning Family Therapy: Race, Culture, and Gender in Clinical Practice.
1) We must ask couples about racism as part of our assessment. Dr. Ken Hardy, one of the editors of “Re-Visioning Family Therapy”, encourages therapists to connect with systemic injustice by asking “What happened to you?” When did each person experience racism for the first time? What has racism prevented you from achieving your goals? Ask these questions in the context of the couple rather than the individual, and learn about how these messages of racism affect couple interactions.
2) Cultural competency needs to come from an African-Centered model. Dr. Akinyela explains that cultural competency is often strictly evaluated in relationship to Western culture. When I ask about racism, there’s always the shadow of the dominant discourse of White culture: how do your experiences fail to fit into the mores and norms of Caucasian families? While these questions are important, Akinyela encourages therapists to ask about the influences of African culture: its practices, ethics, and interpretations of mental health.
3) We must focus on the process of storytelling. Akinyela writes that African cultures center around musicality and oral narratives, as opposed to Caucasian cultures, in which stories are written and read. He encourages therapists to ask questions about the metaphors that these couples produce (Akinyela reminds us that metaphors drive African storytelling) and the rhythm and timbre of conversations.
4) Assess for the importance of spirituality. Akinyela writes, “We understand spirituality as that experience of connectedness and relationship that is expressed in the customs, rituals, music, and traditions of Black people. Spirituality is also understood and expressed as an honoring of elders and ancestors and a respect for the collective history and past of descendants of Africans enslaved in America” (p. 358).
5) Identify working models of strength and vulnerability for both partners. One of the challenges with always being strong is that others aren’t allowed to help. It may be scary for partners to accept the influence of the other, particularly if doing so also increases the risk of irrational culpability (such as the treatment of Black youth as adults.) When do we expect the other person to be strong, and how can we revel together in the sharing of narratives that disprove the racial legacies of powerlessness? But also, when are we allowed to ask for and receive help from the other, and what emotional process coincides with asking for help?