Saying yes to the therapist.
Finding a therapist is sometimes like finding a soulmate; you want someone who meets your criterion, and sometimes you wonder what exactly that means. Does the culture of your therapist matter, or do you just go based on vibes?
Getting out there is not always easy. It took you many inner tribulations and nudges from friends and family to finally see someone. You browse several profiles, trying to figure out which person would be the right fit for you. As you try to make sense of them, you wonder how well you know yourself. An answer you’d only know once you’ve sat across from them. They see you unravel your most vulnerable self; see them parse each word you speak. You gauge how intimate you can be in the first meeting. You try to cover the awkward pauses; sometimes, you let them take the lead. And when you wrap things up, they look at their watch and ask if you’d like to do this again. And in that moment, you wonder, “Should I say yes to this therapist?”
In many ways, finding a therapist is like finding your partner. For some, it's a match at first sight; for some, it's a quest till they find the perfect one. Some feel that shared culture makes the relationship more compatible; while others think that shared interests build the bond. Either way, sitting close to a stranger and letting them peel into your most vulnerable inner self is not easy.
Identity is at the core of therapy. Our culture, race, gender, sexuality, and values shape how we perceive ourselves and the world. Each person has different lived experiences and hence different worldviews. These worldviews and lived vocabularies dictate how the therapist-client relationship would be. Homage to Netlix’s Indian matchmaking, we all know how important it is to have a criteria list when you are looking for your special someone and where to compromise if not all the criteria are met. Similarly, it is essential to have some notions about what you are looking for in a therapist and which criteria are nonnegotiable to you. What is less talked about is that if you feel not all your criteria are met after sessions, it's completely okay to break up and move on to the next; no hard feelings there!
Identity in Therapy
Having a therapist from the same cultural background is a set criterion for many people from minority groups. The demographic of therapists is, however, very skewed.
“I am seeing a White female therapist, and it's going well. But sometimes I do wonder if it would have been better if I had someone from my culture who would easily understand stuff like how important it is for me to have my family on board with all my decisions, as in my culture, we do care a lot about what family members and elders think,” said Skyler Pak, an Asian American student who is pursuing her bachelor’s degree in Communications, Philosophy, Politics, and Economics at USC Annenberg. Pak is the President of the Annenberg Cross-Cultural Student Association, a group that gives students from diverse cultural backgrounds a platform.
“I am ethnically Chinese, and I absolutely do not want a Chinese therapist! Asserted Yolanda Wan, a Digital Social Media graduate student who will soon pursue her Ph.D. in Communications at USC Annenberg. “I am seeing a White female therapist who speaks to me using Taylor Swift references, and I love that! Sometimes, I confuse her as my friend, but I know I shouldn’t mix that up.” Wan was born in China but moved to the US when she was a year old. When she was 12, her family had to move back to China again for six years. Wan describes these as some of the worst years of her life. “I still have PTSD because of that. I was bullied there, and I couldn't assimilate into that culture. When I moved to the USA, I felt like I belonged there. I see myself as 50% Chinese and 50% American. At times I feel I don’t relate to my friends from China. My American therapist sees my American side and understands my problem because of this mixed identity.”
Inclusivity in Therapy
It is essential for psychologists and all healthcare practitioners to practice cultural competency and humility. The proportion of BIPOC healthcare providers to BIPOC clients is skewed. Thus, psychologists must be aware of and responsive to patients’ cultural perspectives and backgrounds, especially in a multicultural country like the USA. The intersection of patient-centered care and cultural competency birth an environment where the client feels understood and respected.
Having said that, there is no linear approach toward cultural sensitivity. “If I say something like, oh, this approach works for Chinese populations, and this one works for Black populations, then that is stereotyping in itself! So, culture is definitely a tricky territory to tread on” said Umadevi Ramesh, an Indian Clinical Psychology Doctoral student at the University of San Francisco. Umadevi works as a Psychology trainee with primarily African American female populations at Alameda Health System in Oakland. She left India in 2017 for her undergrad in Psychology, where she was the only person of color in her cohort. Although her post-doctoral program is pretty diverse, she is the only international student in her program.
She often wonders how her classroom teachings would translate if she decided to return to India and work there. Many approaches, for instance, Cognitive Behavioral Therapy, are very emotional and feeling-centric. How these feelings are manifested across cultures is very different. “There is no defined vocabulary for English words like hate, guilt, and shame in my mother tongue Malayalam. So, it's also important to see how words and emotions are perceived in the other person’s culture. For instance, I have a client who is deeply spiritual and religious. So her self-care exercises look like attending church events, preaching, and leading prayers. I consciously tried to decolonize the idea of self-care cause not anyone can go on a spa trip with friends for fun. It's all about connecting with your core values.”
Umadevi herself was on a quest to find a good therapist to keep her mental health in check. She went to see a male therapist but instantly knew that it was not a good fit for her. She has now found a POC female therapist and has been making progress with her. Her being a woman helps, as the conversations around things like sex and intimacy are more comfortable than what would have been with a male. After her degree, Umadevi wants to work with ethnic minority populations in the USA.
Finding a Community
Social media plays an important role in creating a sense of community among people going through mental health issues, affirming them that they are not alone in this struggle. From people venting online to therapists explaining symptoms of anxiety while shimmying to “Baby calm down,” therapy has become a genre on apps like Instagram and TikTok. Many mental health practitioners also start forums on Facebook, Twitter, and Reddit to raise awareness and build communities.
A lot of students find mental health communities and college clubs very helpful, as they are accessible, and give them a sense of community. One such club is The Happy Hour, started by Sophia Zaman at USC, which provides a safe space for students to talk about mental health and well-being. Zaman started this club after receiving the Kaleigh Finnie Memorial Scholarship at USC Annenberg. “I am a first-generation college student. My mother immigrated from war-torn Iraq. I am fortunate that my mother talked about her own trauma and mental health issues with us and normalized such conversations. Mental health is still stigmatized in a lot of Arab countries.” The Happy Hour has always had an inclusive approach and hosts speakers that talk about diverse issues, from LBTQIA care to body positivity, so that all groups feel seen. This way, many students find people to who they can relate to in their mental health journey.
While talking about her own therapy experience, Zaman said that the cultural background of the therapist does not matter to her. “Since my high school years, I have had the same therapist. She specializes in panic and anxiety disorders. I don’t think a therapist needs to have the same lived experiences as you to be able to understand you. I like having an outsider’s perspective. Plus, they (therapists) are professionally trained. Having said that, I soon will be parting ways with my therapist as we have outgrown each other. It’s been years now, and I don’t think I am the same person I was in my high school years. So now I feel like seeing someone who would see me from a different lens.”
Negotiations and communication in therapy are very important to solidify the bond. No one teaches us how to break up with a therapist (or with anyone), but it is important to take a stand and portray what you feel in that relationship. “I remember this one time my therapist had canceled a few of my appointments, and that really pissed me off as I was going through something at that time. In the next session, when my therapist apologized, I did not say the customary ‘don’t worry, it’s alright’ but expressed how upset I felt and moved on with the session. In one of the following sessions, my therapist recalled that incident and said she was proud of me for being assertive and conveying what I felt. So don’t ever feel bad communicating in your therapist-client relationship” said Pak.
Creating your criterion
There is no one universal parameter to assess which therapist is right for you. While Pak contemplated finding a therapist from her culture, Wan was adamant about finding one that was not from her background. It is important to know what your criterion looks like, and it is okay to bid adieu when those are not met. Some criterion that people listed while finding that ideal therapist were -
● Qualifications - Ensure the therapist is specialized or has experience of working with your mental health issues.
● Access - If you are a college student, try asking your Student Wellness Centers for services that are covered in your insurance. Even college health clubs have resources or referrals you can access easily. Psychology Today’s Find a Therapist is also a renowned tool that you can scan for find therapies that take your insurance. The portal has filters you can apply, related to race, age, gender, insurance, specialization, location, etc, to find your ideal fit. It also has a profile section where you can read about your therapist before meeting with them.
● Identity - During the sessions, try discerning if the therapist acknowledges your worldviews, differences and identity. Try asking yourself how important it is for you to have a therapist who has the same lived experiences as yours.
● Communication - If you have any concerns or feedback about your therapist, do not hesitate to communicate them to your therapist. Communication makes the therapeutic alliance stronger.
● The Breakup - Thankfully, therapist breakups don’t need to be that fussy and complicated. No matter how good they are, you wouldn’t stick with your heart surgeon if it's your liver that has an ailment, right? Similarly, it is completely okay to part ways if you feel your therapist is no longer equipped to deal with your problems.
There is plenty of fish in the sea. So take a dive and find your “the one” or multiple “the ones” who can make your mental health journey more meaningful. As seen above, for some, having a therapist from their cultural backgrounds made them feel seen, while for some, them being a Swiftie did the trick! That’s the beauty of therapy. It is one of the most personal experiences, so don’t feel bad if your journey does not emulate someone else’s. You are unique, and so will be your platonic trysts with your therapists.
