Session 250: The Dynamics of Black Women Working With Black Women Therapists

Session 250: The Dynamics of Black Women Working With Black Women Therapists

Dr. Joy: Hey, y'all! Thanks so much for joining me for Session 250 of the Therapy for Black Girls podcast. We'll get right into the episode after a word from our sponsors.

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Dr. Joy: If you've been contemplating working with a therapist, you may have found yourself wondering if working with another black woman is the best choice for you. There are many, many reasons why this is a great choice but there is also a level of vulnerability in working with another sister that catches many by surprise. In this week's episode, I'm joined again by my friends and colleagues, Dr. Beckwith and Dr. Ayanna Abrams, both psychologists in Atlanta, to dig a little deeper into the dynamic that can occur when black women work with black women therapists. We discussed some of the joys and challenges of working with black women therapists, we shared some of our own experiences of working with our own black women therapists, and discussed how you can advocate for yourself to ensure you're getting what you need out of therapy. If something resonates with you while enjoying our conversation, please share it with us on social media using the hashtag #TBGinSession or join us over in the Sister Circle to talk more in depth about the episode. You can join us at Community.TherapyForBlackGirls.com. Here's our conversation.

Dr. Joy: I am so thankful for both of you joining me for another (what I am sure will be) exciting conversation. Thank you so much for joining me again.

Dr. Beckwith & Dr. Ayanna: Happy to be here. Yay, thanks for having us.

Dr. Joy: I wanted to have you all here today to chat about like some of the dynamics that actually happen in therapy. Because I think we talk a lot about the importance of fit between a client and a therapist but I don't know that we always talk about like what that means and how that actually plays out in the room. I'd love to hear from you both, if you could just start by talking about why does the fit with your therapist matter so much.

Dr. Beckwith: I think there's something so special and remarkable about being seen and being understood outside of your group chat, where the things that you don't say are even heard. And so I think that's part of why fit really, really matters. Even if we don't have a necessarily shared experience, I think as being a black woman with a black therapist, there's something about not needing to come into the therapy session and justify or defend my perspective on my experience. I think that's what the fit does for me. It's like I feel like from the moment that I'm in that room (doesn't have to be a shared experience or a lived experience) there's something about feeling that I belong and that this person understands me and understands my perspective without having to justify it or defend it.

Dr. Ayanna: I agree that the fit piece comes in with that explanation piece and how much of myself do I need to explain. And here I’m like how explicit, not as if your therapist has to get to know you and my particular unique experiences with things. But what’s really important for me, even seeking my own personal therapy, is that somebody understood where I was at that time. And I was on postdoc and I was about to sit for licensure, so somebody who could understand that process that I was embarking on without me having to kind of explain, the way in which I do to everyone else in my life, was really important for me. So now there's more room for me to talk about my unique experience of this experience that she could already understand.

And I think that's what's really helpful, whether it be about the kind of exact thing or about cultural experiences–around norms or about where you might have grown up. Things like that can be really helpful so that you can actually more so focus on your unique experience of that larger thing. Not saying that they did have to have this exact shared experience, but they can kind of grab some things and also help you contextualize things without me having to do such, such deep explanation that I think black women have to do with so many other areas of our lives.

Dr. Beckwith: You're so right, Dr. A. I think it allows us to just be. And I feel like sitting across from my therapist, there's a comfort in knowing that her lens and her perspective of kind of what I'm going through is not solely fueled or informed by, let’s say, like social media or reality TV or just a book. And all of those things are helpful in their own right or whatever, it's something about knowing that you're not seeing me through those lenses or through those sources of information solely. Your right. So I'm coming here and I get to put it all out there. And it may have taken me a while to get there, so I don't want to spend all of my time trying to catch you up to speed about what my experience is like.

Dr. Joy: You know, but even with all of those things–and you're right, I agree with both of you on everything that you've shared. But even with all of those things, we also know that it is sometimes hard to share what you need to share in therapy and so I think that there are some particular things that happen with black women clients seeing black women therapists. Generally, I think it may be hard to open up to a therapist, but I do think that there are some things that happen with black women clients and black women therapists that add an additional nuance to that experience. Can you say a little bit about that? Or in your own experience, because we're also all black therapists with our own black therapists. And I do want to talk a little bit about that too later, but we'll put a pin in that. But are there things that have come up in your own experiences or in experiences with your clients that you feel like, okay, there's something happening here that I think is particular to the dynamic of us both being black women?

Dr. Ayanna: I think language is a huge thing. Even just the way in which black women might talk about things and like the storytelling piece of it. Something that I notice often and that I also practice is that we talk about building rapport, what it means to make sure that you listen to a client, but I find that particularly important with black women. The narrative experience. That I'm not coming in from jump telling you that this is this, this is your diagnosis, this is what needs to be done next. Versus “I'm gonna let you talk for a bit.” Because I also understand, culturally and contextually, that you having this space to talk is really important for you so I can kind of engage in a little bit more kind of observing of that, versus kind of coming in with the clinical pieces. That is something that I notice as this nuanced practice. Like I'm gonna let this ride for a little bit in this way because it's important for you to be able to share these things with me.

But also the language piece. Any kind of euphemisms–that's a whole other conversation. But euphemisms that many black women use. Not all, because we are not a monolith, I understand that, but those things do come up the safer you can feel in a space. I will notice that black women clients, not as a means of like testing me, but they will offer some of those things. And me being able to either understand it already or me being able to kind of go with it without like doing all this nitpicking around how they are saying things, has also felt really important for me in my personal experience but also what I notice in work with black women. Like letting you tell the story in your own words. Not in my clinical words, but in your own words, whatever those may be.

Dr. Beckwith: I like that, Doctor A. I think for me, I think the decision for me to go to therapy and to go to therapy... First of all, Dr. A, do we all start therapy on postdoc? Because that was my first...

Dr. Joy: There's something there, in and of itself, right?

Dr. Beckwith: I was like, yes, that's exactly when I started. I can speak to it from the decision to go to therapy and to go to therapy with a black woman therapist was also what brought me great discomfort. We all know the stigma that's attached to going to therapy. Putting that aside, what I was doing (of course still having that) was like, okay, we're going to therapy, we're going to share this side of us. It's being able to unpack fully in front of another black woman. When typically, what do we do? We talk about often being the strong black woman and we hold everything together so well and we support each other so well. And here I am now sitting in front of this person who's doing a beautiful job of holding space for me, and I'm having to not hold it together. Which is what I want, you know, the decision brings the discomfort. I'm having to speak my truth and do it with your hands shaking in a way.

I think that's what it was. It's like, man, I keep it together... That's not really true, I don't keep it together in front of my girlfriends because you guys are my real girlfriends. You know, we keep it together often. We know that we carry a lot, we know that we wear multiple hats, and so we see our sisters doing the thing and we're like “go ahead, girl.” I had to kind of make that switch and say this is the space where you don't have to hold it together. To allow yourself to be vulnerable in front of another black woman. I think that was the part that was really challenging and I don't know if I would have felt like, oh, let me pour this all out in front of someone else. But I think for me I'm realizing like here you are, this is your sister. There is this power differential of course, but being able to say and share truly what my experience in this world is. As we're talking about it feels good to be seen, it's like, mm hmm, she's really going to see you. And I don't know how often we let people outside of our girlfriend group see us in the way that I still allow this person to see me.

Dr. Ayanna: What that also just made me think of is that the relationships that black women as clients can have with black women therapists is also really connected to what kinds of relationships do you already have with black women. I had already had experiences where I trusted black women to hold space for me. But if I hadn't had that experience, I can imagine that this might also be a harder thing to do and it might bring in a lot more anxiety or kind of shame or like concern to be able to offer that kind of vulnerability. But because I had experiences with black women mentors and because I had some experiences with black women professors, that was also helpful for me to see her in a certain light. Saying like, oh, okay, I know that it's possible that you can do this.

And I will also... Again, in terms of my particular relation with my therapist, my referral was from my black woman mentor so that also created a lot of safety for me to go to her. Because I'm just like, okay, she's known me in this way, she knows a lot of what I need and kind of what I've been experiencing and she trusts her. So that also helped me build up that trust beforehand. And it didn't make it easy. It was that because she was also a black woman psychologist, I can't say to you that I'm struggling with these things. You are in the position that I'm about to be in. And that also, we had to have a whole many, many dialogues about that because I wasn't in the field yet as an independent professional. But I think it was also really helpful for me to have a black woman psychologist on the other side of that for me to help me through that process and to help break down some of those things that I was coming up against. With even talking to her about it.

Dr. Beckwith: I like exactly what you’ve said with speaking about it from the perspective of being the client with a black woman therapist but also thinking about being the therapist and having other black women in front of us. And you hit it. Creating a space where it's like, no, this is a safe space, I am a black woman who you can trust. When I say there is no judgment, there is no judgment in this space. And you're right. when I've seen there be great challenges, sometimes it's often from those who don't have that experience outside of the therapeutic room. Or having been betrayed by other black women or not feeling that they can trust other black women or not having this strong sister circle of black women where they do feel safe, they feel seen, they feel that they could be open and vulnerable. So now what I'm doing is working against that, too–to be that space and to create that space–and it may take a little bit of time because of that. So it’s more than just build a rapport; we're working against kind of these years of evidence they may have. Is this really a safe space? Can I really trust this black woman? And that takes time.

Dr. Joy: Something you said, Dr. Joy, earlier, and that you kind of furthered, Dr. A, is this idea of the strong black woman. And how even unconsciously we bring this into the therapist office. I've had the experience of clients telling me that it has been difficult. Black women clients telling me that it does feel difficult to sometimes unravel in front of me because I may look like I have it all together. Now, we know that we are all just holding our threads together the best way we know how... Barely, right. But to your earlier point, Dr. Joy, I do think that there is a way that we relate to each other just as black women in the world that is like, “okay sis, I see you.” Because we know like the rest of the world can be really rough.

And I think when you come into therapy, it can be difficult to kind of move out of that space. And as the client, to kind of like allow yourself to unravel in front of this other person who maybe does look like they have it together. I mean, your therapist should not be spilling all of their junk in your session and so there's some of it that, you know. Of course, it's not about us and so you don't know everything that we may be struggling with, but I do think that that makes it difficult sometimes for black women to do the deep digging that is necessary. And I'd love to hear from you, Dr. A, because I know you talk a lot about black women's vulnerability and I think that this is so, so important (we know) in the therapy space.

Dr. Ayanna: Yeah. And I think that that is... Even as you were just speaking of, there are things that I can remember that my therapist (and we've been working together for 10 years), that she has said that I'm almost certain that if I had a therapist of a different race or gender, I would not have heard in the same way. When she talks about things like, hey, what's going on? What's making it hard to open up? Just kind of simple questions like that, I know that I would have a different response if say a white woman asked me. Like what do you think is getting in the way of us being able to stay on this topic today? I'd have a whole different reaction versus like, “okay, you know why I don’t wanna talk about this.” There's a way in which we can say some things. And again, she can move with it and with some of the contextualizing of it.

The vulnerability piece, I will say in the beginning was hard. I had this paradox of already feeling safe because there was a referral, I felt safe in the referral, I felt safe in what I knew of her training, I felt safe in kind of all these different ways. I had referred to her before, like all this kind of stuff, right. But at the same time, for me, it was like, man, you are moving me through things that I assume you don't go through because you've done this so much better than me. Because you've now got this office space, you’ve got an assistant, you’ve got all these things that are set up.

And I think, particularly given where I was in my career and seeing her that made me more vulnerable. I don't think I'd have those same responses or reactions now that made it a little bit more difficult to talk to her about anxiety about the exam and anxiety about... Mind you, I had no clue. I don't know if she passed on the first, second, third. I don’t know anything of her and this licensure exam. I don't know anything about any of her process, I don't know what she experienced in graduate school, I don't know any of those things. But the fact that she could name that those might be things that I might be experiencing without her having to say “I had these things happen” was really important for me. And her willingness to go really slow with me.

I think oftentimes what comes up is, because we are mental health professionals, people might also expect us to show up in a certain way in the world and in therapy. And what she often does–she still says this to us–is like, hey, you are not a therapist here, you're not a psychologist here. I understand that you are, but you are not that here, and like let's slow down in that space. That took me a little bit a while to actually practice. I'd heard her say it time and time again. And I'd say, yeah, this is going on but I understand that, clinically, this is what's going on with them so I actually have more empathy for them. And she'd be like not in here. Like that is not what we are doing. “That is not your role in here.” And those were the things that were really helpful for me to understand, oh, that's what she means by the stripping of the cape and the vulnerability and the honesty that I thought that I was giving in here, but I'm actually not really giving in here. And like I said, just the slowness of that.

It doesn't mean that it doesn't get kicked up every now and then when something else comes up and I feel more vulnerable, but now that we've been working together for so long, it's easier for us to kind of get into the kind of underbelly of things than it was maybe in the first two years of our work. But I had to really challenge myself in a lot of ways to say, hey, why aren't you doing this in a different way? Like all these things that you say to your clients, why are you putting up this barrier? Like why aren't you doing your homework? Like why aren't you doing all of these things to allow you to really slow down and be in that space? And then be able to have those kinds of conversations with her. But, you know, I gave a little bit of a run. It wasn't easy. It wasn’t easy for me to get there.

Again, that is what is the most helpful in terms of this therapeutic relationship. How honest can you be? How untethered do you allow yourself to look in session? Am I still trying to like conceal my tears? Am I still trying to “zip this up” because I’ve got a patient next? All those kinds of things that we've really been able to work on so that I can learn that it's okay for me to be vulnerable too. I deserve the same things that I also offer to clients.

Dr. Beckwith: Absolutely. I had to learn that. That it is okay, just like you're saying, for her to hold space like we often hold space. And that we are worthy and deserving of being held just like we hold others. Of course, all the holding. Holding inside of our work and then the holding personally in our various relationships and friendships. And so allowing the space to be what it's supposed to be. And I think one of the beautiful things about having her as our therapist is having someone who isn't timid, who isn't shy, and who can challenge you in a way that we need to be challenged.

Dr. A, you hit the nail on the head when you said, had I received some of these messages that I received from someone else, I probably would have sat back and be like “you don't know my life and you don't know my experience, how dare you ask me that?” Like I would have received that in a number of different ways. But being able to be like, actually, you do know my life, I've shared a lot of it with you. And actually, you do know my experience. And so being forced to kind of sit in it because it took away some of those excuses as well. But I love the way that “no, I'm not backing down from you,” from one black woman to another. It's like, no, we're gonna sit in this. What's the reason for that?

I don't remember the question or what I was doing, but I remember the moment where I was like, oh, yeah, she’s not gonna let me, you know... There was something that I said and I gave like all of these other explanations for it. Then I kind of felt bad, like am I excusing my black experience? But I remember her saying something to me–I wonder if you're doing that because traditionally, you've always had to work hard as a black woman. I was prepping for something, I had put in all of these hours or whatever. And it's like you know you’re only really getting paid for one hour, right, but you’ve put in like three hours for this talk or whatever. And I had all these excuses in terms of why I did it and I remember her bringing me back to like who I am, and for her to be able to say that to me. And I was like, you know what, okay, you're right. It ain’t all this other stuff. You’re right. Okay. Touché. Like how much more time have we got because it's starting to feel really warm in here!

Dr. Ayanna: We at the 45 or an hour?

Dr. Beckwith: This is a good place to stop and pick up next week!

Dr. Joy: Right, “let us wrap this up!” More from my conversation with Dr. Abrams and Dr. Beckwith after the break.

[BREAK]

Dr. Joy: You both have made these comments around like many of us want to go to a therapist to feel seen. Like we want to have this place that we don't have this extra judgment and there is no other context besides what we share in these 45 to 50 minutes. But there is something very intimidating and uncomfortable, I think, when you really are seen. And I do think that that is a particular gift that many black women do have, is like the seeing. Like we really can see what you are leaving out and so I think that that is what makes people uncomfortable sometimes. But that really is the work of therapy, is for you to get to a place where you really can allow me to say like, okay, I see what you're doing here and let's look at where else this might be playing out in your life and how it's impacting you.

Dr. Beckwith: Absolutely.

Dr. Ayanna: I think that's something that my therapist has also offered me in such a really beautiful and like nuanced way. Not penalizing me for the strong black woman trope, not pathologizing it, because she gets it and she gets why it's problematic to also pathologize it. But really helping me with the discernment of “you’re gonna need some of that.” We're not gonna get rid of it. In this here world, you’re gonna need some of that, but let's help you actually better decide when it's effective to use that versus the ways in which it's actually getting in the way. We need some of that to continue to protect ourselves, to continue to rally around ourselves, to continue to resource ourselves. But her helping me understand when I'm crossing the threshold. And oftentimes, she could see that before I can see it, but not making me feel guilt or shame or like you should know better or your ancestors did all this work so that you could just rest. Why aren't you sleeping this week? And like she doesn't do it in that way but that's why I said that she has helped me learn the dance of when I need some parts of that and when I don’t. And I have a hard time believing that other therapists will be able to offer that kind of beautiful nuance and that kind of dance around it.

Dr. Beckwith: Yeah, having someone that helps us to restructure and reshape it in a way that still honors the experience. Yeah, absolutely. Like you said, we need some of it. We don't want to get rid of it. But knowing like, okay, you're doing the most right now. And being able to kind of hold me in that and it's like, okay, you're right. As opposed to having to push back against that.

Dr. Joy: The other side of I think what we're talking about. I have also heard... complaints may not be the best word, but I have also heard commentary from black women clients who have had an experience with a black woman therapist and they felt it was too girlfriend like. It kind of feels like, okay, this maybe doesn't feel as challenging. Of course, we don't know particular experiences. But what do you think may be happening in those situations where it does feel therapeutic but it doesn't really feel different than talking to my girlfriends?

Dr. Ayanna: One, I always wonder like the training piece. I think there’s a whole other piece around that but I think that is the countertransference that we recognize.

Dr. Joy: Can you back up and explain countertransference to us? What does that mean?

Dr. Beckwith: It's almost like over-relating, over-connecting in a way that is outside of the therapeutic framework.

Dr. Ayanna: It doesn't hold the same boundaries of the therapeutic relationship where I am your therapist, I am not your friend. We do not text, we do not socialize. I do not share a lot about myself with you. I can share some things in terms of what's appropriate self-disclosure, but I think that's where the line tips as a therapist, depending on your relationships with black women.

And I think the other piece that can sometimes come up is that because you want this to be such an open space, sometimes we take it too far. Because we want this to be so safe and so comfortable and we know that it was hard for you to make it in here, we know it's hard for you to be vulnerable, I think sometimes we overcorrect by making it a bit too social in the room. And now the clients are also getting a bit more savvy with like, no, no, no, that's not what they say you're supposed to be talking to me about. I think clients are more aware of it but I think that sometimes that can be the therapist attempting to... Not take responsibility for it, but to overcorrect for the difficulties maybe in intimacy or vulnerability or openness. By trying to make this not too safe, but not too easy... I don't have the right word.

Dr. Joy: Super cool... Because the power differential is real, right? Like there is a power differential that exists between client and therapist.

Dr. Ayanna: Mm hmm.

Dr. Beckwith: You're talking about it, Dr. A, I think it's that fine line. You're trying to make it comfortable but still keep the power differential. We know how tough it is. It’s like when we say we don't understand; we overstand. It's like we know how difficult it was for you to perhaps get here, we know how uncomfortable it is to be across from us in this situation, and we want you to feel comfortable. But you're right, that's perhaps where the training comes into play. How do I still make you feel comfortable? How do we have a strong rapport where you do feel seen, you do feel understood, but you don't feel like we're having a fireside chat every time? Also knowing too that we know it's easy to talk about certain things and so it's like we also do what's comfortable. It's easy sometimes to have these conversations, to laugh and chat this way, which basically help us (in terms of a coping mechanism) avoiding it instead of shining the light on what we need to shine the light on.

So some of those conversations are in fact perhaps even the therapist kind of sensing the discomfort of the client, or the client going towards this small chat because of the discomfort of it. So we're trying to make you comfortable, we want you to be comfortable, and then some of these things that we're talking about (that we have not talked about with so many others) is uncomfortable. I think it's all of that and us overcorrecting for a lot of things. But I think that's where our ethics and our training come into play. And it's like, you know what, no. You know, I'm here for you, I have you, I got you. And you don't have to text me tonight. And I'm not going to eat while I'm talking to you. I honor you and I respect you and your time and the energy that you're putting into this space and this experience.

Dr. Joy: Anything you’d add there, Dr. A?

Dr. Ayanna: I think the ways in which I see that come up the most is keeping clients on track in the therapeutic relationship. And that piece about sharing of ourselves in ways in which ideally, we're using self-disclosure only as needed, and that is to build rapport and to deepen safety. But because it can be so easy to get into that girl talk where we're just chatting about our different experiences, I think some therapists might begin oversharing about their personal experience. In an effort to align, in an effort to say you are not alone in this, I don't want you to feel isolated in this. Even me in this power differential, I also experience these same things in the world. Maybe in terms of racism or misogynoir or dating issues, things like that.

But that's where the ethics come in to kind of ground like, hey, what is it that you're trying to help them experience? And is this the only way to help them experience that? Like what's coming up for you where you want to be so attuned to them? Where is your skillset to actually hold that frame? And oftentimes, if those two things are problematic, we're going to see this kind of blurred line in there. Unfortunately, most clients don't recognize that because they don't understand the frame of therapy if you really haven't set it, so they're not getting their needs met. It feels like another kind of girl chat that might have a little bit more structure around in terms of when they can talk. But I'm also noticing that more in terms of social media connections and what does it mean if you are following a therapist? And what does it mean if the therapist might also be following you or like sharing things and all that kind of stuff?

I think it still is extremely important to set the frame and say, yes, while this is this kind of space for you, I actually want to support you in building relationships with other women. Let's actually focus on that so that it doesn't have to be me in here. “But I've noticed that when we talk about some things, we don't get to this part of it. Do you have people who you can talk to about those things outside?” Like that's a way to kind of bring it back out of the therapy. “I notice we bring up a lot of this or this or this–do you ever talk to anybody about dating outside of here?” To also help them see that they can create spaces like that. But we might have to do a little bit more work to find it because depending on the client and where they're located, what their experiences have been, I might be the only black woman who they are talking to about any of this stuff. So do I find myself feeling responsible for giving them all these things versus actually helping them build up some social skills and kind of expand their circle to kind of get that need met?

Dr. Joy: Mm hmm. I feel like y'all are preaching because what both of you are talking about is really the self-awareness we need to have as therapists to know when our own stuff is coming up. And so we all go through however many years of training that we go through, but after training, it's still important for us to be engaged in like some kind of supervision or some kind of peer supervision and additional continuing education. Because we don't stop being human after training and so the countertransference that you were talking about, like that stuff comes up. And it's not necessarily a bad thing; it's how you use it and what you do with it that makes the difference. If you have this countertransference come up where you are reacting to a client as if they're like your little sister, it's not a bad thing that it happened but it is a question for like, okay, what's going on with me that I am now not in the role of the therapist but now I'm seeing myself more in like a sisterly kind of relationship? And what kinds of areas in my own life do I need to address?

And so the addressing it outside of the therapy room happens in peer supervision or paid supervision or group supervision. And so I think that's something else that maybe clients don't know, is that that is a lot of what we're doing outside of therapy, too. Like engaging in consultation with our colleagues around like, hey, this thing happened for me and I really need some insight. What do you think? Can you give me some insight about what may be happening with this client?

Dr. Ayanna: And I think what that also just made me think of is, not only can that countertransference show up in more of this kind of girlfriend, girl chat way. Sometimes that countertransference can show up in terms of an increased sense of like responsibility for our clients. Like, man, you are so important. I know like what is going on is so important. So I might find myself doing more, I might find myself feeling more responsible for what's going on for you, I might find myself feeling more in distress that things are not changing for you. That you are in so much pain, that you have not gotten out of this abusive relationship, that you have not gotten out of this job. So that's why really paying attention to what is coming up for you and that self-awareness is really important. It's not only the positive kind of soft way; it can really, really hinder the work if you find yourself doing too much and trying to get them to do too much so that you feel better. So that you feel like you helped them, so you feel like you've saved this black woman. I think that's something that black women therapists really, really need to keep an eye on.

Dr. Beckwith: It's the self-awareness part, whether we're getting that in our consultation groups or supervision groups and also in our own therapy work, like you said, Dr. A. Because we may miss it. It's like what is this? It’s like you’re overly caring for this person or you're doing a lot of extra work for this person or you're really feeling a huge sense of responsibility for this person. It’s like what is it with you where you feel that this is your role? Are you seeing all of your “little sisters”? And what is it about you? How did we get in this situation? And being self-aware, knowing what your strengths and weaknesses are.

Dr. A, you mentioned something earlier when you said we're in this social media age where someone may follow you on Instagram or follow you on Facebook or something like that, and it's like knowing what your boundaries are. If in fact I'm overly connected to you, and is that preventing us from being able to do some of this deeper work in therapy? Because now we're talking about whatever we saw on social media or what you saw me post. And so really being self-aware, really knowing what your strengths and weaknesses are, and then having other spaces where we can talk about how these things are impacting us. Outside of the continuous education, outside of, oh, I'm a therapist in private practice.

Dr. Joy: More from my conversation with Dr. Abrams and Dr. Beckwith after the break.

[BREAK]

Dr. Joy: What would you share with clients when some of these maybe awkward things come up? You know, like if I have to maybe have a difficult conversation with my therapist because I do feel like this feels like too much of a girlfriend chat. Or maybe my therapist like fell asleep during session, or I feel like they acted inappropriately. (Not unethically, because I feel like that's a different conversation.) But just something that like maybe you found offensive or you feel like, oh, that feels weird for a therapist to be doing. Like what kinds of suggestions do you have for people listening who may need to have a difficult conversation with their therapist? And why maybe is it important to even have the conversation?

Dr. Beckwith: I think anything that gets in the way or that you feel may be getting in the way of getting what it is that you need. You're coming here for a particular reason, you're coming here to do the work and I think anything that gets in the way of you doing the work warrants a conversation. It's an investment of your time, it's an investment of your resources. And so I think, however you have to do it, what I've encouraged some people to do sometimes is if it's tough to kind of bring it up in that moment to even send a message and say, “Hey, I'd like to talk with you next session.” So then you're prepping yourself and you're not backing out of it in the moment. You're prepping yourself and also prepping the therapist. I’d like to talk to you next session about some of the work that we're doing and our goals, our progress. Are we in alignment with the framework that we have set forth? Do you still have the same goals in mind for me? And being able to share in that space. And I want to make sure that my anxiety or my trauma is still the forefront.

And you can even own your part of it. It’s like I feel so comfortable with you. I feel that I can come in and I can talk to you about these various things, but I want to make sure that I don't get off track with doing the work for something else. And allowing your therapist to hold space and to show you a positive experience if you are not getting what you want or what you feel that you are coming there for. Allowing her to correct the experience because sometimes it's like we don't know; you're getting something. And allowing us to correct that experience.

But I like being able to know ahead of time if you don't feel comfortable in the moment, so you can let them know via message that you'd like to talk about this. And it holds you accountable so you cannot back away when you get in that session. It's like, yeah, I got your email. It sounds like you really want to talk about your goals and revisit where we are in terms of our plan and our work together. But knowing that you're worth that. You don't have to endure something if you don't feel that you're getting what it is that you want and you need. But also knowing that we want you to get what it is that you came there for. You know, you're not hurting anyone's feelings, no one's disappointed. It's like we want you to get what you came for.

Dr. Ayanna: I'm so glad that you asked this question because what I've been seeing... This has been actually why I'm just seeing a bigger influx of this. That somebody will say something like I'm having this issue with a therapist and I need some support, and they'll say leave them. Don't go back, ghost them. They don't need to do anything. Don't tell them nothing. Find you a new therapist. Get back on the directory. And I'm just like these are things you can have a conversation about. Why are we just ghosting therapists? Like what are we doing? What are we doing here? So I'm glad that you're having a conversation about like what language can we use to maybe better get our needs met and that we still use that as data to see if this is a good working relationship.

I think there are a few different ways to do that. I think one, there's a way in which you can offer feedback on what you are experiencing and ask that to be different. And two, I think you can ask for what you want to experience instead. If I might notice that a therapist is eating in session, so I might feel really uncomfortable asking you not to eat. But like, hey, is there a different time that we can meet, like after breakfast or like after something like that? So there's sometimes a way in which you can say and it really focuses what you want to experience instead, if it feels less comfortable kind of saying like “I don't want you to do this thing.”

I think another way, as Dr. Joy had shared, is being able to say, hey, I'd like to have this experience and sometimes I get a little bit distracted when I notice you eating in session. So that's a way to clue into them that, oh, that's having an impact on me. Which is not you telling them “you shouldn't be eating, I’ve checked with therapists and that's against the ethics code and you can't be doing that in here.” But just it affects me in this way when I notice this. Or when you're driving and moving around, I find myself getting distracted by what I'm seeing behind the screen if you're driving during our sessions–can we either have sessions at a different time?

That's very different than sometimes we can feel anxiety provoking is asking somebody to not do a thing and that's a whole other assertiveness training. But really attuning to what's happening for you when those things are happening. And ideally, your therapist would be listening to you. Something it's getting in the way of them being able to focus, them being able to get vulnerable, them being able to stay there. And ideally that could give the therapist some feedback about what they can be doing differently.

I think you had mentioned some like sleep. A therapist falling asleep is... it doesn’t work. That's just not gonna work. That is something that you can also say like, hey, I've noticed that this has happened the last few sessions. That you have fallen asleep like midway through. Like you fall asleep by the end of sessions and that begins making me feel “blank, blank, blank, blank, blank.” Is this a good time for us to still meet because I’ve noticed that you are falling asleep? Like really looking at the behavior versus going into that's unethical, that's this, that's this. But this behavior leaves me feeling this and I don't want to have that experience–can we do something different? And I think you can work yourself up to that.

And I also think, as Dr. Joy said, that being able to put that out there maybe in email or something like that in between the session, can allow that to come up the next week and then you can help prepare yourself for having that conversation. But it doesn't mean that you're silent about it. And it doesn't mean that now you're reactively avoiding the therapy by not going or by doing all this stuff instead, versus letting them know. Which I think is also a good general practice. Letting them know that something is happening that's getting in the way of the relationship. They might not know. I don't know how they wouldn't know about sleep and stuff, but like they might not.

We don't know what's going on with that and you might get a lot more information about sometimes what is going on with the therapist if they're not in tune enough to really realize that this is having an impact on your care. But I think things like that schedule, lateness, like things like that. Like, hey, I've noticed that we have sessions at this time but you tend to come 20 minutes and that really bumps me up against the end of this and like I got something to do next. Can we make sure to meet at 11:00 so that I can get to my next thing? Because it really like gets in the way when we have to rush at the end of session.

Dr. Beckwith: And, Dr. A, I think it goes back to what we were talking about earlier too with the fit. Are you advocating for what you need? And by you sharing what does and does not work for you, it also allows you to see if this is a good fit for you in terms of their response. If you're defensive about, oh girl, I was only eating because of X, Y and Z. Or “I know.” You know, it allows them to correct the behavior, allows you to endure the discomfort of kind of standing up and advocating for yourself and here's this person who is working with you.

But also, if you don't get the response that you want, you don't have to ghost. There are so many other ways. You don't have to ghost, so you don't have to go in the ethics board or whatever. It's like you really can say this is not a good fit because you didn't feel heard, you didn't feel understood. And Dr. A, you also mentioned that it allows you to get more information. “I thought this was the only time that worked for you at 11 o'clock and so I was running over.” It just allows for both people to see each other and to understand each other and to see if we're still a good fit for each other.

And there's something really beautiful about, wow, I communicated my needs and this shift was made and look at us. Because we don't have to run and we don't want to run from every situation that does not feel like a good fit for us or does not feel like we are getting our needs met because we did not communicate what those needs are. And I get it. There are certain things where we feel like you're falling asleep, I don't know why I have to tell you that that's not good. But there's something about saying I don't know if the five o'clock time is really late if it's at the end of your day. I do notice that you seem a little bit fatigued and is it possible that we can move to another time?

Dr. Ayanna: That's a nice way–I noticed that you seemed a little fatigued at the end of your day.

Dr. Joy: Yeah, and I like the way that you both phrase that. Because I do think that there is a fine line of the client doing some caretaking in some ways by having to say like, hey, I notice you look a little fatigued. And so I think it is important to be careful and to know that as the client, like you're not responsible for reminding your therapist to take care of themselves or to do what they need to do so that they can be present. But I do think the way that you've talked about it in terms of like advocating for your own needs. Like I notice that I get distracted. It really is a great practice in letting people know what you need and like what kinds of things will help you do the work you need to do.

Dr. Beckwith: Yeah, absolutely. And I don't have to like scream it from the mountaintops. I can just really clearly say like, hey, I need to be able to finish by this time and I know that we kind of start sometimes a little bit late. Being able to advocate, I think it strengthens that muscle. It strengthens that muscle so then you're moving from situation to situation and you're advocating for what you need. And getting your needs met.

Dr. Joy: Yeah, yeah.

Dr. Ayanna: And I'd also recommend saying it sooner than later. Don't wait four times, don't wait five times. Because now you are past the disappointment or confusion; now you're resenting that this is happening now. It's affecting you even kind of starting kind of what you're thinking about before you go into session, because this is on your mind that long. This is also a practice of assertiveness. You can say things soon so that you two can navigate the relationship and it gives them a better chance of meeting your needs sooner.

Dr. Beckwith: Before you start building a narrative that is not the accurate one. We start to think like, oh, this means such and such and such and such because you're eating or because you're late or because you're driving. And it's like let's not do that. Let's not build a narrative that doesn't sit well with you, that makes you feel worse than you already feel. Allow them to correct the behavior as soon as you start experiencing something that doesn't work for you.

Dr. Joy: Such beautiful sentiments. I feel like we could definitely go longer on this conversation. There's so much to chat about, but of course we don't have all day! Please share with us where we can stay connected with both of you, if you’d love to share your website as well as any social media handles you'd like to share.

Dr. Ayanna: Sure. My website is www.AscensionBehavioralHealth.com. And as I always say, I run my mouth the most on Instagram, that is @Dr_Ayanna_A.

Dr. Beckwith: And then my Instagram is at @AskDrJoy. And my website, which is under construction but coming, is www.DrJoyBeckwith.com. So it's coming.

Dr. Joy: Perfect. We will be sure to include all of that in the show notes. Thank you both so much.

I'm so glad Dr. Beckwith and Dr. Abrams were able to share their expertise with us today. To learn more about them and their work, be sure to visit the show notes at TherapyForBlackGirls.com/ session250. And be sure to text two of your girls and ask them to check out the episode right now. If you're looking for a therapist in your area, be sure to check out our therapist directory at TherapyForBlackGirls.com/directory.

And if you want to continue digging into this topic or just be in community with other sisters, come on over and join us in the Sister Circle. It's our cozy corner of the internet designed just for black women. You can join us at Community.TherapyForBlackGirls.com. This episode was produced by Fredia Lucas and Ellice Ellis, and editing was done by Dennison Bradford. Thank y’all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care.