Microaggressions — those subtle messages that demean, insult and invalidate a person — are routine occurrences for many diverse groups. Harvard University psychiatrist Chester M. Pierce coined the term microaggression in his 1970s study of racism in the media. Derald Wing Sue and David Sue extended the definition, adding brief, everyday exchanges that send denigrating messages to a target group.
Microaggressions can be communicated verbally or nonverbally, intentionally or unintentionally. Because the counseling relationship is a snapshot of our racial realities, microaggressions can also occur within the counseling relationship. Microaggressions 
committed in the counseling setting can result in clients being misunderstood or misdiagnosed and receiving ineffective treatment — thus having their needs go unfulfilled.
In the course I teach on social and cultural diversity issues in counseling, I began using one of the activities from Sue and Sue’s text Counseling the Culturally Diverse: Theory and Practice. This involved having students identify microaggressions in the media and present their analysis. The assignment’s impact was so powerful that students were still discussing it after the semester had concluded.
I decided to repeat the activity over subsequent semesters but added assignment directives such as reenacting a counseling session in which a microaggression was committed during the course of the session. I also asked students to write or videotape narratives of their experiences being the recipient of, or committing, a microaggression in real time. They identified the type and theme of the microaggression, the related dilemma and how they felt about the experience. The students also pointed out what they might do differently if they encountered a microaggressive event in the future.
The microaggression assignment proved to be a revelation for the students, educating them on the daily prevalence of these subtle and overt messages that offend and invalidate the recipients.
Types, themes and dilemmas
There are three subtypes of microaggressions: microassaults, microinsults and microinvalidations. Microassaults are deliberate verbal or nonverbal attacks intended to express discrimination. Microinsults are rude, unintentional actions or comments that demean a person’s race/ethnicity, gender, sexual orientation, age, ability or religious identity. Microinvalidations are comments or behaviors that discount, question or diminish the thoughts, feelings or worldview/reality of the recipient.
Sue and Sue developed 16 distinct categories of microaggression themes and designated the implicit message that each conveyed, including second-class citizen, traditional gender role prejudice and stereotyping, criminality/assumption of criminal status and pathologizing cultural values/communication styles.
Sue and Sue also developed four psychological dilemmas to demonstrate how microaggressions affect the recipient. The first dilemma, the “clash of sociodemographic realities,” demonstrates the conflicting realities of Whites who deny being racist and minorities who believe that Whites are racist and enjoy their position of power and superiority. The second dilemma, “invisibility of unintentional expression of bias,” describes how a person can inflict a microaggression and be oblivious to its impact on the recipient.
The third dilemma, “perceived minimal harm of microaggressions,” refers to the perpetrator’s reaction to being confronted with the microaggression. This person perceives the communication as innocent, thinks the recipient is being “too sensitive” and believes the recipient should “get over it.”
Finally, the “Catch-22 of responding to microaggressions” involves the action/reaction of the recipient of the microaggression. The recipient of the microaggression may question the situation: Did that really happen? Can I prove that happened? Should I say anything? Will anything happen if I respond? The recipient considers whether his or her actions will be negatively interpreted or stereotyped (for example, being viewed as the “angry Black man”). Self-questioning can be exhausting and can take an emotional and physical toll on the individual. However, by not addressing the microaggression, the recipient carries the weight of the experience on his or her shoulders, which also contributes to mental health complications.
Student personal narratives
What follows are some of my students’ accounts of microaggressive events. The students were either the recipient of a microaggression or had committed a microaggression against another person. Although the students gave their permission for their experiences to be included in this article, only their initials are being used.
****
L.G. is an African American female who experienced a microinsult with the theme of assumption of criminality. This illustrates the Catch-22 dilemma of responding to a microaggression.
“I was insulted while shopping at a department store. I was not particularly dressed for shopping. I was going to purchase an outfit to wear for an evening event taking place that night. I found several items that I needed to try on, so I asked for the young lady that normally assists me. I was told it was her off day. I was also told I could carry only a limited number of items into the fitting room. I have shopped in this store since they opened and had never been told that before.
“I picked out approximately 25 items to try on. I took four or five items into the fitting room at a time. When I finished with the first set of items, I then asked her to bring the next set of items that she was holding at the register for me until I completed trying on all the items that I had selected. This took about 90 minutes. I knew she was working on commission and she could have taken care of others. I let her ring all those items up and just before giving her my credit card, I informed her that I would come back to the store when the other sales clerk would be there to make my purchases.
“I did get angry, but I’ve learned not to be the victim but to be the victor. I refused to let her have that much power over me. I possessed the power. This could have had a negative effect on me, but I am confident in who I am at all times. I demand to be treated with dignity and respect, especially when your income depends on me spending my money at your store.”
****
R.C. is an African American female who experienced a microassault with the theme of second-class citizen. She also demonstrates the Catch-22 dilemma of responding to a microaggression.
“I am a patient care technician at [a hospital in central Alabama]. I assist the nurses, handle vital signs, draw blood, give baths, help patients, etc. One night while at work, I was asked to handle a patient’s bloodwork. I gathered everything I needed and went into my patient’s room to draw his blood.
“The patient was a White middle-aged male. When I entered his room, I told him what I had come to do, and his exact words were, ‘Get this nigger bitch out of my room now!’
“I could not believe what he had said to me. My first reaction was to remain calm and proceed to do my job, but in my head I wanted to choke him. After I attempted to continue my work, he got louder, saying, ‘Get this bitch out of my room.’
“One of the White male nurses heard all of the fuss and came in. The patient continued to scream as I stayed quiet and drew his blood. When I finished, the nurse said, ‘See, she’s good at her job. She got it on her first stick.’
“To me, when the patient saw the White male nurse being respectful and nice toward me, he calmed down. I guess the patient needed to see how another White person treated me? I did let the patient know that it wasn’t nice to be so disrespectful to another human, and when he asked could I hand him something, I simply reminded him that I was a ‘nigger bitch’ and closed his door.
“So many different thoughts ran through my head when this happened to me. I didn’t know if I should’ve walked out of the room, cursed him out, stuck him on purpose or ignored him. I decided to take the high road and ignore him. I completed my task in a hurry, but before I left the room, I reminded the patient of what he had said to me. I believe I did the responsible thing to ignore him because I know that I’m not a ‘nigger bitch.’ I will never forget this day.”
****
J.B. is a White female who experienced a microinsult and microinvalidation with the theme of traditional gender role prejudicing and stereotyping. Her reflection illustrates the dilemma of the invisibility of unintentional expressions of bias.
“Serving as an officer in the United States Army was an honor and one of the highlights of my life. During my service, I certainly experienced a lot of sexism as a female in a traditionally male occupation. For instance, I was constantly being asked if I was a nurse. In the early days of women serving in the military, most were nurses, so I was often assumed to be a nurse. What I did not expect was to experience sexism regarding my status as a military veteran.
“I am a disabled veteran. After visiting my doctor at the local VA [Department of Veterans Affairs] clinic, I had to get a same-day prescription from one of two local pharmacies. I went to the closer of the two and presented my prescription to the male pharmacy technician. He asked, ‘Does he need it today?’
“I said, ‘I need it today.’ He replied, ‘Well, there is no way you can get it before 11:30 tomorrow.’
“I just took the script back and went to the second pharmacy on the list. In the second pharmacy, the female pharmacy technician did not ask me if ‘he’ needed it filled that day.
“In retrospect, I do not think that I would have handled the situation any differently. I did not feel like confronting the man about his microaggression. I might have written a letter to the pharmacy explaining that assumptions such as the one this man made were often harmful to others. In short, the man’s assumption ‘added insult to injury.’ I have learned to ‘pick my battles’ as I have gotten older, and the most important thing in this situation was my getting my medication to stop the pain I was in at the time.”
****
L.T. is an African American female who has a disability. She experienced a microinsult and microinvalidation with the theme of assumption of abnormality/brokenness. She illustrates the dilemma of the invisibility of unintentional expressions of bias.
“Here’s an experience I had with someone because of my disability. Having a disability, I have had people who see me in public and assume that I am mentally slow based on my physical appearance. One time when I was an undergraduate and at the beauty shop getting my hair done, this woman was also there getting her hair done. I was talking to my stylist, and the woman said something to me. When she spoke to me, she would get in my face and talk like I had a problem with my hearing.
“People think that just because my body is different, that means I’m also different mentally. I have had someone ask me if I have MS [multiple sclerosis] because my body shakes. I have heard people say, ‘Aww, look at her,’ like they feel sorry for me, and I just want to say, ‘If you only knew me.’”
****
A.B. is a White female who committed a microinsult against her friend. The theme was ascription to intelligence, and the dilemma represented is unintentional bias of a microaggression.
“I have a best friend who is Hispanic. She is taking this English class. In order for her to advance to the next level of English, she has to pass the Compass test. So she was venting to me about it, and she was nervous because she doesn’t know English as well as other students in her class. She knows it’s important to pass this class in order to make it to the next level.
“I told her, ‘It’s OK because you’re Hispanic anyway.’ In the moment, I didn’t realize that there is a hidden message in that. Her response to me was, ‘What do you mean by that?’
“I told her I didn’t mean it the way it came out. She told me she felt like I was saying that Hispanics are not capable of being good at English. I explained to her that I knew she struggled because she isn’t good at English. I helped her in English and told her I knew she was going to pass this test. She said, ‘I understand, and I know you meant that.’
“She was very forgiving, and she did not stay mad at me. I told her I was sorry, very sorry. Even talking about it now, I feel bad. All I could do was apologize. I am still uncomfortable about what I did. The experience made me feel bad, and I still feel bad. I am much more aware of these things, and I will try not to do that anymore.”
The impact of microaggressions on diverse populations
The use of microaggressions on individuals from diverse backgrounds can have a negative impact on recipients. Psychological and physical problems can result from microaggressions. According to Sue and Sue, minority clients are 50 percent more likely to prematurely terminate counseling after their initial meeting with a counselor or other mental health practitioner. In part for that reason, it is important that counselors understand the physical and psychological impact of committing a microaggression during session.
Because they feel that their White counterparts may dismiss or invalidate their experiences with racism and oppression, many people of color refrain from discussing race with them. Counselors can better empathize with clients who have experienced microaggressions when they go through their own personal examination and understanding of the debilitating effects of microaggressions. Counselors can also acknowledge the microaggressive events that their clients present with in session and assist them in developing strategies to challenge and mitigate the effects of microaggressions. Counselors can empower these clients by addressing microaggressions, advocating for clients and establishing strategies to combat microaggressions in the clients’ workplaces, academic institutions and social environments.
Conclusion
With an increasingly diverse population in the United States, microaggressions are becoming an everyday occurrence for many clients. Cultural awareness and introspection are two tools that can help counselors become cognizant of microaggressions and address slights that may occur in the counseling relationship.
It takes a lot for clients to seek counseling services and disclose their personal problems to us. We, in turn, must make the effort to be educated regarding cultural diversity and not simply pay lip service to cultural competency requirements. It is important that we build awareness about the detrimental effects of bias toward marginalized groups, play a vital role in validating clients’ experiences of microaggressive events, refrain from minimizing their accounts of microaggressive experiences and perceptions of reality, and refrain from becoming defensive when our clients point out that we have committed microaggressions.
****
Priscilla G. Wilson, a licensed professional counselor and national certified counselor, is an assistant professor in the College of Education and Professional Studies at Jacksonville State University in Alabama. Contact her at pgwilson@jsu.edu.
Letters to the editor: ct@counseling.org