Client Initiated Microaggressions

My client never told me that he did not want me to be his therapist – but I felt it. As I recognized the slight condescension in his voice, my heart rate increased instantly, my muscles tensed, my voice began to tremble, and I noticeably stumbled on my own words. After we hung up the phone, I took a few deep breaths and moved on with my day. I did not tell my supervisors or colleagues about what happened. After all, maybe it was all in my head. Maybe I am just too sensitive because of endless experiences where I encountered dismissive, insulting, and demeaning reactions when a person first heard me talk.

Intersection of Marginalized Identities and the Therapist Identity

People who experience ambiguous, discriminatory, and stigma-based incidents related to aspects of their social identities face confusion in discerning what happened. Therapists who hold historically marginalized social identities have unique experiences. We are faced with questions such as:

• How do I piece together the complexity of caring for my client while also acknowledging the impact negative interactions have on members of historically oppressed communities that I feel a sense of belonging to?
• Which identities do I feel protective of?
• Who else do I feel compelled to protect…my family…friends…community…historical ancestors?

As counseling psychologists and counseling psychology students, our identities come with us everywhere we go. They come with us to our training programs, classrooms, supervision – they even come with us to therapy.

Silence perpetuates oppression so let’s do something radical: let’s talk about client-initiated microaggressions.

What Is a Microaggression and What Is Its Impact?

Microaggressions are defined as covert, brief, and subtle expressions of stigma-based prejudice and discrimination against members of marginalized minority groups. Recent national data on the demographics of the US psychology workforce indicate a large increase in women, racial ethnic minorities, and people with disabilities entering the field as mental health service providers.

Our field as a whole has accepted that the experiences of marginalization are detrimental to mental health and overall well-being. Just as it is imperative to recognize the impact of microaggressions on our clients, it is also important to recognize the impact of microaggressions on therapists.

I am currently collecting data on client-initiated microaggressions and I have been startled to discover how little research has been conducted on the phenomenon. Results from studies of microaggressions suggest that people who are microaggressed spend time struggling to interpret and discern what just took place. This may also apply to therapists who experience client-initiated microaggressions. The one thing that therapists can easily identify is how they felt (ex.: confusion, disorientation, physiological activation, etc.), but the tricky thing about microaggressions is their ambiguity and how to make sense of what happened.

How can supervisors and training programs foster the development of therapists who hold marginalized identities while also creating space at the table for the complexity of their experiences? Just like the many other spaces in life, the therapy room is no exception – the therapeutic space is another space that people with marginalized identities also need to learn how to navigate.

What Can We Do?

So what can we do when we, our supervisees, or colleagues experience a microaggression? Here are some recommendations:

1. Don’t dismiss it. People who hold marginalized identities often have microaggressions dismissed and de-validated by the majority. 
2. Normalize it. People who hold marginalized identities often feel like their emotional reactions are out of place.
3. Validate it. Strive to provide a corrective emotional experience that evokes clarity and visibility of the experience of struggle.
4. Help them demystify their experience. This event is likely one of many experiences of marginalization interwoven into their story of growth and evolution which is occurring inside and outside of the therapeutic space.
5. Initiate programmatic change. In order to ultimately provide a suitable and empowering training experience to therapists who hold minoritized identities, programs need to open the dialogue to include the experiences of those who have been historically marginalized within our field.
6. Support research. We need more research to better understand how to attend to the unique needs of therapists that have experienced client-initiated microaggressions.

The Bottom Line

Therapists who experience microaggressions like the one I outlined earlier may feel alone in their experience. The responsibility of client confidentiality may also exacerbate feelings of isolation. Therefore, supervisors and other people who are working directly with clinicians/therapists must provide a safe space to validate and process the experience. Let’s not leave our therapists alone with the isolating emotional burden of making sense of the microaggression they experienced.

Yifat Gohar Levenstein, B.A. (she/her/hers) is a PhD student in the Counseling Psychology program at the University of Utah. Her research interests include multicultural counseling, access to mental health, experiences of individuals who hold marginalized identity, and research that promotes social justice within different systems.