discrimination

There is no racism in clinical psychology: Personal reflections from another Black trainee.

This article asks whether the majority ethnic group may have a tendency to dismiss experiences of racism. Considering my lived experience, I reflect on some processes which may become engaged when racism is evoked and propose some potential implications for clinical psychology.

Subjective realities and embodied experiences

When individuals speak about their experiences of racism, they are often challenged about their interpretations and encouraged to consider more ‘objective’ reasons which may account for the behaviours or words that caused offense or hurt. Invariably, as there are multiple ways to interpret events, particularly in the realm of human interactions, experiences of prejudice and of discrimination can easily be discounted. Such dynamics are well documented and I, like other Black and minority ethnic (BME) trainees have encountered them in Training. Navigating a racist society may equip individuals from racialized minorities with the ability to recognize subtle pre-verbal and para-verbal cues of racism.

This embodied apprehension of prejudice may be the result of inner adaptations to the external reality of racism yet, it can easily be dismissed as it may not lead us to easily verbalise our experiences. There have been repeated calls for increased cultural competence within clinical psychology but, trainees continue to be socialised into rhetorics of social and power awareness. Diversity indeed commonly features within our professional discourse. A ‘better than’ position may be adopted whereby racism and discrimination become minimised and eventually envisaged as being ‘out there’ rather than ‘in here’. Being able to remain oblivious to the experiences of those who are racially subjugated and deny responsibility for racism may be the hallmarks of White privilege.

Expectedly, following experiences of racism from a supervisor, I painfully reflected upon my experience before alleging that the supervisor was prejudiced and racially offensive. When my concerns were raised, they were instantly discounted. I was interrupted in my account then coached into considering other possible motives for the conduct. The differential treatment and offending words did not provide ‘evidence’ of discriminatory intentions. Nevertheless, when the same supervisor questioned areas of my competence and intelligence without evidence, an epistemological shift occurred so that the supervisor’s perspective and judgement alone became sufficiently evidential. Meeting a positivist threshold was no longer necessary.

Managing cognitive dissonance

It is well documented that people tend to use prior beliefs to interpret personal experiences. This is the essence of Cognitive Dissonance Theory. Festinger (1957) posited that powerful motives to maintain cognitive consistency often give rise to irrational or unhelpful behaviours and that when excessive dissonance is produced intellectual defences can be triggered. Such defences may manifest in the refusal to accept the discomforting information, or in unduly questioning its validity. Refusing to consider the possibility that racial prejudice may indeed have been involved within the supervisory relationship, may help protect the safety of existing assumptions and truths whilst unabling a reflexive consideration of privilege. More disturbing perhaps, may be the implications that the purported competence/intelligence deficiencies seem to have been accepted in the absence of supporting evidence. Cognitive Dissonance Theory would posit that prior beliefs or worldviews were therefore not disturbed in this instance.

The denial of racism

Behaviours displaying overt prejudice are now relatively rare. They have been replaced by more covert forms of racism. Such behaviours although more subtle have been posited to betray deeply rooted prejudices. When BME trainees have spoken about their experiences of training, experiences of both overt and covert racism have been documented. The latter may be met with more scepticism however, when potentially painful and/or anxiety provoking information is instantly rejected, one may suspect that some level of denial may be at play. Denying racism may indeed serve multiple functions. Institutionally, and it may help avoid liability for potentially unlawful acts. Socially, it may be part of a strategy of positive in-group presentation and demonstrate adherence to social norms and values. Moreover, such self-presentation, may also serve to defend the in-group as a whole or its dominant discourse.

Thus, the failure to fully hear, document and investigate race related concerns may be interpreted as reiteration of the professional consensus and public discourse: ‘there is no racism in clinical psychology’ or ‘we are not racists’. This social denial has been theorised to also fulfil an individual defence. ‘She is not racist’ may therefore mean ‘I am not racist’ whereby staff rather than empathising with the trainee’s distraught come to identify with the supervisor accused of racism. This interaction between the institutional, social, and individual may make accusations of racism highly discomforting. Possibly more so than the potentially discriminatory acts complained of. To discharge such discomfort; counter-accusations are usually made e.g. ‘playing the race card’, ‘having a chip on the shoulder’, ‘being paranoid’, ‘being oversensitive’ or indeed ‘jumping to conclusions’.

Individual and/or institutional racism?

In the mist of scepticism and cognitive ‘reframing’ attempts, my distress became invisible. I was left with little support. Engaging with the pain might have shifted ‘the gaze’. Perhaps I was being punished unconsciously. Trainees, who challenge racism may be at risk of being ostracised, dismissed or penalised. The McPherson enquiry uncovered institutional racism within the police force which it defined as:

‘The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racial stereotyping’. (McPherson, 1999, 6.34)

Although this definition is not without problems, it does offer a framework to reflect on how systemic and unintentional discrimination may become manifest within institutions. The independent enquiry into the death of David Bennett found institutional racism within the psychiatric system, including persisting race inequalities, the widespread use of stereotypes and of particular relevance here, failures to take allegations of racism seriously. Its recommendations led to the ‘Delivering Race Equality in Mental Health’ programme. The action plan came to an end in 2010 thus; race inequalities may have fallen down the political agenda. However, they remain. In this context of suffering and alienation, BME service users’ experiences of racism continue to receive little empirical and clinical attention. Perhaps parallels may be drawn.

Final Reflections

Although multiple versions of events and reality can and do co-exist, the most privileged amongst us may have vested interests in maintaining oppressive biases which locate truth where power is and assure that only those with power can define reality. The inter-connection between agency and systemic structures may mean trainees from racialized minorities are at risk of being silenced and dismissed in their experiences. It was to help ensure that they have a voice that I created ‘The Minorities in clinical psychology Training Group’. Indeed, in the context of continuing challenges in recruiting a more representative workforce and enduring difficulties in adequately serving BME communities; a failure to pay close attention to such voices may not only deprive the profession of opportunities to better understand and meet the needs of service users from traditionally marginalised groups, it may leave clinical psychology vulnerable to accusations of institutional racism.

Thank you for reading. If you have found this article helpful or interesting, please share it with others.

Want to learn more?

Please see…

Adetimole, F., Afuape, T., & Vara, V. (2005). The impact of racism on the experience of training on a clinical psychology course: Reflections from three Black trainees. Clinical Psychology Forum, 48, 11-15. 6.

Care Quality Commission and National Mental Health Development Unit (2010). ‘Count Me In 2009 – Results of the 2009 national census of inpatients and patients on supervised community treatment in mental health and learning disability services in England and Wales’. Care Quality Commission: London.

Constantine, M. G., & Sue, D. W. (2007). Perceptions of Racial Micro aggressions among Black Supervisees in Cross-Racial Dyads. Journal of Counselling Psychology, 54(2), 142-153.

Department of Health (2005). Delivering Race Equality in Mental Health Care, Department of Health: London.

Fanon, F. (1967). Black Skin, White Masks. London: Pluto Press.

Festinger, L. (1957). A Theory of Cognitive Dissonance. Stanford, CA: Stanford University Press.

Hardy, K, V. (2001). Family therapy: Exploring the fields past, present and possible futures. Adelaide: Dulwich Centre Publication.

Hook, D. (2006). ‘Pre-discursive’ racism. Journal of Community and Applied Social Psychology. 16, 207-232.

Patel, N., Bennett, E., Dennis, M., Dosanjh, N., Mahtani, A., Miller, A., et al. (2000). Clinical Psychology, Race and Culture: A Resource Pack for Trainers. Leicester: BPS Books.

Patel, N. (2004). Difference and Power in Supervision: The case of culture and racism. In Fleming, I. & Steen, L. (Eds.), Supervision and Clinical Psychology: Theory, Practice and Perspectives. Hove: Brunner-Routledge.

Macpherson, W. (1999). The Stephen Lawrence Inquiry: report of an inquiry by Sir William Macpherson of Cluny. London. Home Office Cm 4262-I.

NSCSHA (2003). Independent Inquiry into the death of David Bennett. An Independent Inquiry set up under HSG (94)27. Norfolk, Suffolk and Cambridgeshire Strategic Health Authority: Cambridge.

Tan, R., & Campion, G. (2007). Losing yourself in the moment: The socialisation process of clinical psychology training. Clinical Psychology Forum (180), 13-16.

Van Dijk, T. A. (1992). Elite Discourse and Racism. Discourse and Society 3(1): 87-118.

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Service Users’ Voices: Yvonne Stewart-Williams.

I will not attempt to provide any analysis but let the power of the narrative and Yvonne Steward-Williams’s lived experience speak.

In this short video (courtesy of Time To Change – http://www.timetochange.org.uk) Yvonne speaks of her experience of stigma and discrimination upon experiencing mental health distress.

Yvonne is a Lesbian Single mother of a beloved fourteen year old biological heterosexual male child born via artificial insemination. She has a twenty year Mental Health diagnosis of Schizo-Affective Disorder and was diagnosed with Erotomania – ‘Love Addiction’ four years ago. Yvonne has been in full time paid employment with her present employer ; a London based Homelessness Charity with specialism in Mental Health & Well-being for approximately seven years. She works there as a Complex Needs & Mental Health Support Worker. In addition, Yvonne is studying a OU – Open University part-time degree in Combined Social Science with Sociology & Social Policy. Yvonne is also :

· A Schizophrenia Commissioner

· An Aspiring Conservative Councillor-she stood at the 2010 Local Election

· A Stonewall Ambassador

· A Mental Health & Gay Rights Campaigner & Activist

· A Time to Change Ambassador

· A British Quaker

· A Woman Freemason

· A Published author :

Stewart-Williams, Y. (2010). Altered Perceptions: An 18 Month Diary, One Day At A Time, In The Life Of A Mental Health Service User. Butler, London.

Altered Perception is an eighteen month daily journey from an acute psychiatric hospital admission prior to Yvonne’s 2009 acute psychiatric admission via HMP Holloway Women’s Prison. This diary explores her lesbian sexuality; the parenting role of James, her young biological son in looked after foster care, and the support she provided to a loved one battling with prostate cancer. In this diary Yvonne reveals that for her it is not so much whether mental illness can be cured, but what one does in life in between each acute psychiatric episode. A kind of walking between the raindrops, until the getting wet experience

For further information on Yvonne :

http://www.time-to-change.org.uk/blog/368

https://www.blogger.com/profile/07790789766835253289

Yvonne is on Twitter (@Yvonne_S_W)

‘Why does it always have to be about race’?: Blocks to meaningful dialogues on race and racism (Part 1)

Talking about race

I like to think about race. I like to write about race. I like to talk about race. I find the subject matter fascinating.  I make absolutely no apologies for this. Critically, for me, like for many others from racialized groups, thinking, writing and talking about race is making sense of the world and processing difficult experiences. I accept that there are many Black people and other individuals from the racialized minorities who may not see race and racism as salient features in their lives and that of course, Black people do have other issues, joys, concerns and fears that are unrelated to racism, I hope no one would doubt that. Nevertheless, people find intellectual and personal fulfilment in various pursuits and passions. As a Black woman with Black parents and Black children, race and racism have shaped much of my existence hence, I believe I have become quite adept at identifying racism for what it is (to me, at least) and I have lost my inhibitions about naming it a long time ago. This may not make me a very popular person is some circles.

Whilst it is not always about race and racism, I do find the range of defences the subject matter attracts even more gripping and see no shame or
pathology in my choice of subject matter and passion. I have written a bit about my position and epistemology in a previous post (to access it, click here). Thinking and writing about race/racism isn’t exactly a walk in the park for those who experience race discrimination and other forms of race related violence on a regular basis, but, by far the most challenging is to talk about racism ,or more precisely, to create a dialogue on racism.   I have spent much of my career and personal life encouraging discussions and dialogue on these subjects but continue to find that similar processes often become engaged when attempts at broaching the subjects are made.  Contrary to what many may assume, I have not found that the blocks to such conversations are dependent upon intellectual ability, levels of education or even psychological and social ‘mindedness’. In the current post I aim to identify the three most common barriers I have come across in my attempts to make space for racism in discussions.

1. Cognitive dissonance: It can’t be that bad…

Cognitive Dissonance theory propose that people tend to interpret personal experience in a way that does not disturb prior beliefs. According to the theory we hold various cognitions about the world and about ourselves; when new information clashes with the latter, a discrepancy is evoked resulting in a state of tension: cognitive dissonance. As the experience of dissonance creates discomfort, we are motivated to reduce or eliminate it to achieve consonance or harmony. When excessive dissonance is produced, intellectual defences may be triggered to restore cognitive consonance. If people are socialised to believe firmly in meritocracy and in the accessibility of justice and fair treatment for all, there is little wonder accepting the prevalence of structural racism would cause much dissonance. Moreover, people, by and large, like to think of themselves as good and many aspire to be ‘colour blind’ and ‘liberal’. Indeed, individuals from dominant groups probably more often than others, are projected images of themselves as benevolent, fair and ‘reasonable’, such expectations of course clash with the possibility of being capable of committing discriminatory and racist acts.

2.  Undue focus on the individual intention: We/I don’t mean it.

Following from the above point, many have noted that when racism is evoked, those with race related privileges often focus on intentions in the belief that the absence of discriminatory or racist intent diminishes responsibility.  A cognitively focused perspective. Undue focus on intention may be one of the manifestation of race related privilege and social power. People at the receiving end of racism, unsurprisingly, often emphasize consequences- an affective standpoint. Those differing frames of reference may problematize meaningful dialogue on racism.  However, it is important to bear the law in mind.  The Equality Act (2010) defines harassment as ‘unwanted conduct’ related to a protected characteristic, that has the purpose or effect of violating other individuals’ dignity or creating an intimidating or hostile, degrading, humiliating or offensive environment for them.  When it comes to racial harassment, Impact is clearly embedded within the law. Further, there is no legal justification for acts of direct race discrimination.  In other words, it can still be racism even if racist intentions are absent.

3. Misplaced guilt? Or, feeling responsible for the ‘sins’ of our forefathers.

I used to find responses based on such beliefs quite perplexing until I realised how pervasive and strongly they can be held. Guilt may well be a by-product of any race/racism centred discussions for many.  Guilt can be unhelpful and disabling because it often inhibits reasoning and encourages defensiveness rather than connection and reflection particularly if it cannot be contained. There is absolutely no rational reason for anyone to feel guilty over what their ancestors, great grandparents or even parents did in relation to racism, slavery and/or colonisation years if not centuries ago (no one chooses his/her lineage). Nevertheless, it may be legitimate to experience guilt for one’s failure to challenge racism and race related privileges that result in the perpetuatation of racial oppression which of course was started by long dead and buried forefathers. Emphasizing our distance from our ancestors’ actions can serve to distract from responsibilities we might personally hold for present actions or omissions and their associated feelings and emotions. The task then appears to be, for many, to transcend feelings of guilt (and at times, shame) and accept some personal and collective responsibility for making on-going race privileges visible today.

I hope this initial list will generate some input from others who may have got stuck in race discussions.  I’d love to hear what additional barriers/blocks people have encountered as naturally there are many others, some seemingly more elaborated and complex. I will aim to focus on these in the second part of this article and then suggest a few ideas to facilitate dialogues.

What are your thoughts?

To access the Equality Act (click here).

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