Microaggression in the Therapy Room

What are microaggressions? 

Microaggressions are comments and situations where people's biases against marginalized groups surface in a way that leaves the person on the receiving end feeling confused, uncomfortable, or insulted. 

Psychologist Derald W. Sue has written two books addressing cultural competencies and with that, microggression. Sue defines the term: "The everyday slights, indignities, put downs and insults that people of color, women, LGBT populations or those who are marginalized experiences in their day-to-day interactions with people."

Microaggressions can oftentimes be more injurious than acts of racism because they are more likely to appear to be a compliment or a joke, and come from people we know: our friends, colleagues, and even our in-laws, professors, doctors, and even our therapists. 

"A lot of people hear 'microaggressions' and they think, 'Oh, it’s just the little things that hurt people’s feelings,'" said Roberto Montenegro, a chief fellow in child and adolescent psychiatry at Seattle Children's Hospital. He studies the biological effects of discrimination. "It isn’t about having your feelings hurt. It’s about how being repeatedly dismissed and alienated and insulted and invalidated reinforces the differences in power and privilege, and how this perpetuates racism and discrimination." (Dastagir, 2018) 

Here are some examples of microgressions fromBuzzFeed, and a 2014 campaign called “I Too Am Harvard.” 

Microaggressions and the Therapeutic Relationship

The delivery of microaggressions may be communicated both unconsciously and unintentionally--this implicity can also be found in the therapy room. In Sue’s textbook, written with David Sue, entitledCounseling the Culturally Diverse: Theory and Practice,they report thatminority clients are 50 percent more likely to end therapy after just one session with the clinician for reasons like the lack of cultural competency and exchanges in microagressions. Though no therapeutic relationship is immune to microagressions, the clinician, who is already in a position of power, can take it upon themselves to develop multicultural sensitive approach within the interactions and thought processes. This can be achieved through a life-long practice and awareness; as well as a willingness to look at one's own biases.(Owen, Tao, Imel, Wampold, & Rodolfa, 2014) 

Thomas E. Schacht from East Tennessee State University College of Medicine writes, “Each member of a therapeutic dyad acts and reacts, remembers and constructs, projects and internalizes, in a complex, cyclical, and recursive interpersonal and psychodynamic dance that defies simple reductive description or ascription of  responsibility to one actor.” (Schacht, 2008)

Coming to therapy and opening up to a stranger is a significant hurdle individuals take in their healing journey. Yer the interactions from one session can then deter them for good. This is reason for therapists to (if not from personal experience, or self-exploration) make the effort to stay educated on issues and sentiments regarding cultural diversity. 

Doctor Anatasia Kim, PhD, is an associate professor at The Wright Institute in Berkeley, California writes, “As much as we want to protect the therapeutic relationship, we can’t pretend that we therapists aren’t shaped by our own cultural identities, just like our clients are, and that this doesn’t affect what happens in the therapy room. After all, if we uttered something our clients perceived as offensive, wouldn’t we want them to speak up? In today’s sociopolitical climate, it’s hard to avoid these discussions in any relationship.” (Kim, 2019) 

Is the fear of microagression keeping you from therapy?