Monthly Archives: May 2021

Listening to voices of color in the LGBTQ+ community

By Laurie Meyers May 26, 2021

It has been 52 years since the Stonewall uprising — a multiday protest that began when police raided the Stonewall Inn, a gay bar located in Greenwich Village in New York City, in the early hours of June 28, 1969, and began arresting patrons and employees. The bar was a haven for the LGBTQ+ community, and the raid — purportedly for liquor license violations — was one more in a pattern of police harassment of queer and transgender establishments. 

Many in the LGBTQ+ community credit Marsha P. Johnson, a Black transgender woman and frequent patron, with throwing the first brick that sparked the uprising. However, in interviews in the 1970s, Johnson said she didn’t arrive until the clash was underway. Other stories had Sylvia Rivera, a Black and Latina transgender woman, throwing the first Molotov cocktail. Rivera later said she was in the crowd throwing coins before the cocktails began flying. LGBTQ+ historian Charles Kaiser believes that Stormé DeLarverie, a Black biracial lesbian and drag king, sparked the resistance by throwing the first punch. 

People may not agree on how the uprising began, but one thing is clear: Trans and queer women of color were at the forefront of the gay liberation movement that emerged from Stonewall. Johnson and Rivera also helped found the group STAR (Street Transvestite Action Revolutionaries), which offered housing to homeless and transgender youth. 

Their contributions to the LGBTQ+ communities are starting to be recognized. The East River State Park in Brooklyn was renamed Marsha P. Johnson State Park, and in 2019, New York City announced plans to build monuments to honor Johnson and Rivera. They will be the first permanent monuments of transgender women in the state of New York. The monuments are also part of the city’s effort to address the gender gap in public art. 

But the gap stretches beyond gender. Over time, the contributions of Johnson, Rivera, DeLarverie and many other queer and trans people from Black, Indigenous and people of color (BIPOC) communities have been overshadowed by white narratives and priorities. In the eyes of many, the face of the LGBTQ+ community is still too often exclusively that of white, gay, cisgender men. 

Often, nonwhite queer and trans people do not feel included — or necessarily even safe — within the larger LGBTQ+ community. As in other spaces in a system built on white supremacy, racism is all too prevalent. People who are part of communities across the BIPOC spectrum also face increased oppression and unique challenges because of the intersection of their cultural and LGBTQ+ identities. Although the term BIPOC is meant to be inclusive, sometimes it can be used as a catchall term that — intentionally or not — erases individual communities. What follows are professional insights from seven Black, Latinx, Indigenous and Asian counselors on how racism and oppression affect clients who identify as both ethnic/racial minorities and LGBTQ+.

Creating safe, inclusive spaces

Historically, white people have been the ones to decide where or how people of color fit into their world, observes Adrienne Erby, an assistant professor of counselor education at Ohio University. Her research focuses on intersectionality and racial, cultural and LGBTQ+ issues.

In a wider society that consistently looks to white, cisgender men to lead, LGBTQ+ communities can replicate that same dynamic, Erby says. White, gay, cisgender men may not lead all aspects of the LGBTQ+ movement, but they  have become the face — and the voice — of it, she notes.

“Who gets to have a voice? Who sets the agenda for activism?” Erby asks. Navigating racism and genderism — particularly among Black transgender women — increases the risk of experiencing violence or being killed, she explains. Constantly questioning one’s safety creates different priorities — such as sheer survival, notes Erby, an American Counseling Association member. For BIPOC queer, trans and nonbinary individuals, the interaction of racism and genderism affects even the most basic things, such as the ability to find and keep employment, health care and safe housing.

Trans activists note that the addition of transphobia on top of racism compounds the problems with employment and housing. Transgender women often have no place to go when they need shelter or are in danger because most homeless and domestic violence shelters do not accept trans individuals. 

Disrupted education is also a major issue for LGBTQ+ individuals who are BIPOC. Trans and nonbinary adolescents — particularly those of color — frequently drop out of school to escape race- and gender-based bullying by peers and even teachers, in addition to being pushed out of school through disciplinary measures that disproportionately affect BIPOC students, Erby says. 

Counselors can be crucial advocates by challenging policy and procedure and function as “safe adults” for these students, she emphasizes. At the same time, Erby cautions counselors to resist the desire to “reframe” legitimate issues such as racism, heterosexism, genderism and transprejudice. Rather than helping, these approaches serve as barriers to open communication, especially among queer, trans and nonbinary people of color. BIPOC are more likely to respond to honesty and authenticity, she says. 

“In our homes, most of us have learned to read very quickly if a person is someone [we] can talk to,” Erby says. “Instead of expecting people to come out to us, we need to show that we can be invited in.” Inviting someone in — putting the power with the student or client to share what they choose — is essential to building trust, she stresses.

Counselors are often trained to assess through questions that are information driven rather than narrative driven. “We ask for the information that we need to have, which is not a bad thing — it’s essential — but we also need to be asking broader questions,” Erby says. So, instead of just confirming that a client is living with their family, for example, counselors should invite clients to tell them more about their families, she advises. 

Erby recommends that counselors get a sense of who clients are not just in the moment, but in their lives outside of counseling. Who are their family members? Where did they grow up? What is their relationship to a faith community? “It’s important that we talk about the things that shaped [clients], like family, school, race, faith, spiritual belief and how [they] identify,” she says.

“We [also] have to broach the issues of race, culture and gender from the start and throughout our relationship,” she asserts. “I always make sure to mention race, gender, affectional and spiritual identity. These are things that people may not bring up themselves.”

Pushing past a white-centric narrative

Tameeka Hunter, an assistant professor of counselor education and supervision at the University of Arkansas, believes one of the most consequential elements in understanding and centering the diverse stories of the LGBTQ+ population is to stop using white experiences as a benchmark. For example, coming out of the closet is a white, patriarchal construct, she explains. Western (white) culture is an individualistic one that places more emphasis on individual desires and independence than on collectivist or relational cultures. However, as Hunter points out, most of the cultures across the BIPOC spectrum are relational, so the community is a core part of the person’s identity.

“Coming out is not possible for everyone,” says Hunter, an ACA member whose research focuses on marginalized populations, including LGBTQ+ and disability populations. “It may not be safe to do so. ‘Coming out’ may cause significant losses.”

For example, Black culture is a relational culture that honors its elders, and the community’s support is an essential tool in surviving racism, Hunter says. Coming out may jeopardize the person’s place in the community and threaten their source of social and financial support and safety, she notes. 

Part of being an LGBTQ+ affirming counselor requires examining one’s own biases about issues such as gender, affectional identity and race, and understanding the complexity of being at an intersection, says Hunter, who is a diversity speaker and researcher. 

In addition to making sure their intake forms are inclusive, including categories for racial, affectional and gender identity and pronouns, counselors need to let clients know that they’re open to talking about religion and spirituality, because as Hunter points out, that can be a central part of many Black people’s lives. And if an LGBTQ+ client’s family believes that being a sexual minority is sinful, it could create serious identity issues for them. Letting clients know that they can safely talk about religion/spirituality in session “creates a space for them to tell you, ‘I’m in conflict with my family’ or ‘I might believe that my sexuality is a sin or an abomination,’” she explains.

In situations in which clients are struggling with being gay and fear that their family will reject them, counselors should assess the client’s support system, Hunter says. Is there anyone they can talk to in the family? If not, counselors can help clients expand the way they think about support. For example, LGBTQ+ people frequently have “found” families — nonbiological kinships that provide a supportive environment. Hunter helps clients find supportive networks by asking them about places or people who bring them a sense of peace or joy. They can also choose to whom they want to disclose their LGBTQ+ identity. That may mean being open with some family members but not with others, she adds. 

“People of color who are also LGBTQ+ have a tendency to find community with those who share [their] sexual identity, racial identity or another marginalized identity,” she says. “That’s a way to hold on to … culture. Part of finding community is holding on to the validity of our experiences.”

People with multiple marginalized identities are constantly forced into presenting little bite-sized pieces of themselves. Being among like-minded people is a way of finding relief from the strain of holding back so much of one’s self, she says.

But Hunter also cautions that it’s all too easy for counselors to indulge in what she calls “disparity porn” — stereotypical narratives such as being Black makes someone more prone to substance abuse or that Black families are typically less accepting of LGBTQ+ family members or are more homophobic. “While it is important to acknowledge health and other systemic disparities so that we can educate future counselors and support clients contending with those concerns, many times we disproportionately attend to those disparities,” she says. “Disparities and systemic oppression are important topics, but there needs to be balance in how often these topics are covered.” 

Hunter recommends that counselors also focus on positive affirming concepts such as resilience. “We can celebrate those who are thriving in the community by illuminating their stories,” she says.

Hunter concludes by emphasizing our shared humanity: “I strongly believe that our liberation is bound together — all marginalization from systemic suppression is bound together — even if we do not share the same marginalized identity.” In other words, she thinks that when the most stigmatized among us — such as Black transgender women — are free, then we all, as a society, will be free.

Unfracturing identity

When people engage with the LGBTQ+ community, there is often an initial feeling on the part of those who have been marginalized that this part of their identity has finally been validated, and they feel safe, says Misty Ginicola, a licensed professional counselor (LPC) who specializes in counseling LGBTQ+ individuals. Often, however, those who are Black, Latinx, Asian, Indigenous or other people of color “soon learn that [they] are not completely safe,” she says.

Colonization and the oppressive system it established is everywhere, Ginicola notes, so racism and misogyny are also entrenched in the LGBTQ+ community. “It hurts worse when it comes from a space where you think you are safe,” she observes.

Mirroring may be a developmental psychology concept applied primarily to children, but Ginicola, a professor in the clinical mental health counseling program at Southern Connecticut University, thinks that adults instinctively do it too. “We look for people who mirror and validate [us],” she says. “For those of us who have different marginalized identities, we never get a true mirror. … No matter what — I think I can speak personally from this angle — there won’t be a community where you have all of your marginalized identities [mirrored].” 

It’s not just that no one community can encompass every aspect of a person; it’s that when it comes to marginalized identities, there will always be environments that are not only unwelcoming but also hostile, explains Ginicola, an ACA member and co-editor of the ACA-published book Affirmative Counseling With LGBTQI+ People. For safety — and many other reasons — it may be necessary to suppress parts of one’s identity, which may cause a person’s identity to fracture, she says.

To remain whole, the person must cultivate a home and community within themselves, Ginicola notes. Her goal is for clients to be able to say, “If I don’t feel welcome somewhere, I’m not going to go there. I won’t fracture to fit in anymore.” But getting to a point where the client can say that requires examining all of their identities, Ginicola says. 

She helps clients explore the boxes they are trying to fit into by asking them, “What is it that you think people expect you to be? Do you want to be that?” For example, Ginicola has a client who is queer and grew up in a rigid evangelical family. Because the client still has inner critical voices connected to his strict religious upbringing, she works with the client to explore where those voices come from and whether those voices reflect his value system or someone else’s. Counselors have to look at all of those areas that have shaped the client’s identity, even if it makes them uncomfortable, she says. 

“Colonizing beliefs and the value system that we have in place as a culture is a lose-lose for most people — even for people who do seemingly fit,” she says. “We all walk around fractured in some way, whether it’s about your physical experience [or] mental health diagnosis. We’ve been taught to pull those things inward in order to fit in.” 

“I think the other thing we have to tackle as individuals and as a society is binary thinking,” Ginicola adds. “Everything [is] black and white, good and bad. Our society has not prepared us to have complex emotions.” 

Navigating intersections 

An element of cultural misappropriation exists among the white LGBTQ+ community, says Christian Chan, an assistant professor in the counseling and educational development department at the University of North Carolina-Greensboro. One sentiment he often hears from clients who have at least one marginalized identity is that “I’m absolved from being microaggressive. I’m absolved from acknowledging that these other forces are at play. I can’t be racist.” But people with marginalized identities can still act in racially aggressive ways, he says.

In some ways, white LGBTQ+ individuals are established as the “norm and ideal,”  notes Chan, an ACA member whose research focuses on intersectionality, social justice and the LGBTQ+ population. Their white privilege helps mitigate some of the oppression they face, despite being queer or trans. 

Chan also points out that those from BIPOC communities often grow up in collectivist cultures. In Black, Latinx, Indigenous, Asian and other communities of color, there is a sense of kinship and sharing that helps them bear the weight of hatred and injustice, which is always present but has been particularly visible over the past year, he says. But if identifying as LGBTQ+ makes a person unwelcome in their culture or family and their race/culture is not widely accepted in the queer and trans community, where do they turn? What happens when they are disowned not only from their family but also from their culture? Chan says the sense of isolation that can occur from being physically in a community but not feeling a part of it can be profound. “It’s a dance of hypervisibility and invisibility,” he says. 

Race also intersects with genderism and heterosexist norms, Chan points out. Queer men have internalized many of the stereotypes of masculinity prevalent in straight culture. They not only view being “too feminine” as taboo, but also often have an ideal of hypermasculinity, he says.

Stereotyping and fetishization of BIPOC bodies are widespread in clubs and on dating apps, Chan continues. For example, on heterosexual dating apps, Asian men are often perceived as less masculine because of prevailing stereotypes in queer culture, he says. In contrast, Black gay men are fetishized because they are often perceived as hypermasculine. Blatant racist comments are also common on dating apps, he adds.

It is important for counselors not only to acknowledge that a client’s LGBTQ+ and BIPOC identities are connected but also to understand how the client navigates these overlapping forms of oppression, Chan stresses. He advises counselors against assuming that the reason a client is in their office is related to their racial, affectional or gender identity. But he also urges counselors to let clients know that they are in a safe space where they can talk about all of their experiences because internalized oppression is negatively linked to mental and physical well-being. Chan notes that affirming intersections can actually buffer negative encounters and reduce distress. Counselors can help clients see that there is strength in navigating their intersections because it can build resilience and even be lifesaving, he says.

Becoming an accomplice

“One of my favorite sex educators, Ericka Hart, will frequently note that queerness does not absolve racism,” says Alandria Mustafa, an LPC at Sula Counseling in Goose Creek, South Carolina. “White LGBTQ+ folks perform Blackness, especially Black femininity, through a variety of mannerisms and the use of AAVE [African American Vernacular English] and slang terms that were born and bred in the Black queer community, while also invalidating and gaslighting queer and trans Black people, who are attempting to name and seek acknowledgment for harm done within the community.” 

“White LGBTQ+ people tend to believe that because they are also queer, they have a comparable oppressive experience to queer and trans Black people,” continues Mustafa (pronouns they/them/their). “This couldn’t be further from the truth, but attempts to explain and explore how this is false assumption are usually complicated by white fragility.” 

Mustafa stresses that white LGBTQ+ people need to listen to queer and trans Black people when they say that anti-Black attitudes are harming them, and they need to do the work of unlearning anti-Blackness. “Queer and trans Black people would best benefit from mutual aid and true accomplices, not just allies. Accomplices are willing to leverage resources and power in pursuit of true equity and accountability,” they add.

When working with clients who have been rejected by their communities of origin because they identify as members of the LGBTQ+ community, Mustafa encourages them to acknowledge the lack of acceptance as an internalization of white supremacy in individual Black communities. 

“The idea that we are disposable is a direct result of being disposed of over many, many years,” Mustafa explains. “This conversation usually supports the externalization of transphobia and queerphobia, so we can recognize that rejection is a product of generational and ancestral trauma.”

Mustafa also encourages clients to challenge their definition of family and the belief that families must be biological. “Queer and trans BIPOC have always been intentional and thoughtful around creating family dynamics amongst one another as a means to keep each other safe and provide support,” they say. “So, I typically invite the development of chosen family and social support systems as safe familial dynamics that can always be created and nurtured outside of those we share a genetic makeup with.”

Racism within the LGBTQ+ community also leads to extreme marginalization of transgender (particularly Black transgender women) and nonbinary people, who are at the greatest risk of violence and murder, Mustafa says. 

“It’s important to acknowledge that this [marginalization] is due to transphobia and anti-Blackness, both of which are a result of white supremacist rhetoric and the harmful nature of the gender binary,” Mustafa emphasizes. They point out that “trans and nonbinary folks are also less likely to engage in support services — whether this be mental/emotional health services or physical and reproductive health services — and are least likely to access a variety of community programs.” The reason for not accessing these services does not stem from a lack of desire or willingness, Mustafa says. It comes from “a variety of systemic barriers that make it incredibly challenging to access care that is safe.”

Mustafa suggests the following ways that counselors can support transgender and nonbinary people:

  • Offer some pro bono or sliding scale services to ensure that transgender and nonbinary people have access to mental health care. 
  • Do not charge for documentation that is required for transgender people to pursue affirming medical care. 
  • Vet providers who claim to provide gender-affirming medical care before referring clients to them. “We are responsible to our clients, and even more so to our clients who are trans, to ensure that the referrals we use are practicing affirming care and are not likely to cause harm to our clients,” Mustafa stresses.
  • Include gender-neutral language on websites, intake documents and signage in the office (on bathroom doors, for example).
  • Continue to learn and self-critique one’s perceptions about gender and sexual identity. Mustafa adds that counselors should challenge how they perceive gender in their personal lives as well. Counselors cannot say that they believe in affirming gender diversity and gender expansiveness in the therapeutic space and then present with rigidity and a lack of flexibility in the personal space, they say.
  • Advocate for clients. “The personal is political,” Mustafa says. “Trans folks of color are highly politicized, solely based on their intersecting identities.” It is virtually impossible to properly and wholeheartedly serve a population at the intersection of a variety of marginalized identities while also claiming neutrality about legislation and policies that cause harm, they point out. Mustafa stresses that counselors cannot stand by while working with a population of people who cannot access proper medical care because of anti-trans legislation and policies or who are murdered and discarded for simply existing.

Being LGBTQ+ and Latinx

One of Roberto L. Abreu’s principal areas of research is with the parents and families of Latinx queer and trans people. What he has found in his research challenges the belief and stereotype that Latinx families are not accepting of their LGBTQ+ family members. The families whose stories he highlights in his research are interpreting Latinx cultural norms in ways that are affirming of their LGBTQ+ children.

“Like in other collectivist cultures, there is a strong emphasis on community and family among Latinx people,” says Abreu, an assistant professor of counseling psychology and director of the Collective Healing and Empowering Voices through Research and Engagement (¡Chévere!) lab at the University of Florida. “Family is central to everything. The idea is that it doesn’t matter what happens; family comes before anything else,” he says. 

Gender norms are also important in Latinx culture, Abreu notes. Specifically, mothers or those in motherly roles are seen as the keepers of the culture. The mothers he spoke to often reported that one of the reasons they accept their LGBTQ+ child is because it’s their duty as a mother, which includes being self-sacrificing and putting the well-being of their children above all. 

Abreu points out that even Latino male gender norms, which are often described in terms of rigid views of masculinity, has layers. Part of Latino male gender norms involves keeping one’s word, being emotionally in touch with one’s family and setting a good example for the family unit — all characteristics associated with caballerismo (the idea of a man as the family provider who respects and cares for his family). For example, some of the fathers Abreu has spoken to describe working on their own feelings and emotions regarding their LGBTQ+ child and coming to a place of acceptance to ensure that their other children and family members also accept the LGBTQ+ child. 

“Latinx culture also places a heavy emphasis on the idea that everyone should be afforded dignity,” Abreu says. He has found that parents of LGBTQ+ children often interpret this as their child’s right to love whomever they wish.

Abreu also studies issues faced by Latinx transgender people and says access to health care is a challenge for this population. “The barriers go beyond simply getting to the doctor’s office. Not having forms in their native language and [experiencing] negative interactions with office staff are just two examples of the types of discrimination and hostile environments that Latinx transgender people face before they even see the doctor,” Abreu says. 

“Health care providers also frequently attribute everything to the patient’s identity as transgender,” Abreu notes. For example, a person might come in with a cold and be asked intrusive questions about being transgender. “Medical staff also tend to hyperfocus on parts of the trans women’s identities, such as making assumptions about what they do for a living,” he says.  

When Abreu asked study members what services they most needed, they named trans-specific health care sources, financial resources, spaces for transgender homeless people, addiction care, and help for the undocumented such as legal and documentation expertise. Abreu also believes there should be a center that offers education for family members to understand what being LGBTQ+ means. And all of these resources need to be offered in Spanish, he adds.

Acknowledging and advocating for BIPOC LGBTQ+ clients

“It is imperative to understand not only LGBTQ+ experiences, but [also] how that intersects with race/ethnicity,” says Tamekia Bell, an assistant professor at Governors State University in Illinois. “We are not monolithic individuals; we have multiple identities. However, sometimes we struggle or ignore the multiple identities that people have.” 

“I do believe some people of color may feel shut out by the larger LGBTQ+ community,” Bell continues. “BIPOC LGBTQ+ individuals need the community to not only speak out against hatred around LGBTQ+ issues, but [also] systemic racism and dismantling white supremacy. Again, the focus needs to center on all members of the community, not just the privileged ones.”

Bell, an ACA member whose research interests include multicultural competency surrounding individuals with disabilities and LGBTQ+ individuals, cautions counselors that not all individuals who identify as LGBTQ+ have the same experiences. “It is important for counselors to have our clients guide us in that discussion and not assume [that] because they identified as BIPOC and LGBTQ+, they will have struggles with who they are,” she says.

Society as a whole sends constant and consistent messages to BIPOC LGBTQ+ individuals that they are not valuable, notes Bell, chair of the Society for Sexual, Affectional, Intersex and Gender Expansive Identities’ Queer & Trans People of Color Committee. It is society that needs to change, she stresses, yet BIPOC LGBTQ+ individuals are expected to adjust to the society they live in. “This is where our work outside the therapeutic spaces is so crucial,” she emphasizes. “We can provide tools, resources and support for our clients, but ultimately, they go back into the world that tells them they are unworthy. In order to truly help our clients, we have to work to dismantle the systems that make our clients feel undervalued and unworthy.”

Bell advises counselors to seek out resources and readings to help them learn how to provide ethical and culturally competent care to BIPOC LGBTQ+ individuals. By doing their own work, counselors avoid placing the burden on BIPOC LGBTQ+ counselors, clients and community members. “The work is not always easy, and I sometimes find myself saying or doing the wrong thing,” Bell admits. “In those instances, I acknowledge my ignorance, apologize for my transgression and commit myself to continuing to do better in the future.” 

When working with LGBTQ+ individuals, Bell acknowledges her privileges and asks that they call her out if she says or does something offensive or inappropriate. “Because I know and understand my worldview is different, I am more intentional,” she says. “I do not mind the work because I want to live in a world, and have future generations live in a world, where they are honored and valued for who they are and being their authentic selves.”

Daniel Samray/Shutterstock.com

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Laurie Meyers is a senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Voice of Experience: The power of a moment

By Gregory K. Moffatt May 19, 2021

He wasn’t a counselor, and I wasn’t seeking any interventions, but a single powerful moment with a mentor changed my life. His name was Mr. Rouse, my sixth-grade teacher. He had been teaching at my tiny little schoolhouse for only a couple of years. My elementary school was a brick and stone structure that was built in the 1890s and had served our rural community for decades. Nearly every student walked to school or rode a bicycle, so only two or three buses lined the curb in front of the building each day. Almost nobody rode to school in a parent’s car.

Mr. Rouse had been my older sister’s teacher during his first year at our school, and he most definitely made a splash. He was one of only three male teachers in the building. That was unusual enough, but he was anything but traditional. Bearded and rough in his demeanor, he never wore a tie — this at a time when even students sometimes wore ties and dress shirts. He would teach in the United States for however long it took him to earn enough money to go overseas, and then he was gone again to teach in some remote village halfway around the world.

I don’t know how he picked our little village for one of his money-raising sabbaticals from overseas work, but I’m glad he did. I will mark my sixth decade of life this summer, and yet his face and voice are still clear in my mind.

I was a mediocre student who never took my studies seriously. Even though I was an avid reader very early in life, I liked playing baseball, riding bikes and climbing trees far more than schoolwork, and each school day was a countdown until I was free to get on my bike and head home. Equally significant, I never thought I was very smart. Nobody ever gave me any clear reason to think otherwise until Mr. Rouse.

One of his routines was a weekly spelling test composed of 10 words. Any and all students who got 90% or higher on every test throughout the year were invited to a local restaurant with him to celebrate in May. My sister made that goal and got her picture in the local paper with her fellow classmates and Mr. Rouse at the restaurant celebration.

I stayed in the game until just after Christmas break when I missed two words on a weekly test. My score of 80 meant I was out. It didn’t really surprise me that I hadn’t made it, but I was disappointed. Mr. Rouse came to my desk sometime that day and sat in the seat beside me, his huge body squeezed into the ancient drop-down desk — the kind with the inkwell in the upper corner. We went over my spelling words, and the mistake I had made was a simple one.

“Greg, you are too smart to make a mistake like that. You could have finished the year,” he said matter-of-factly. I could see that he believed I was smart and that he believed in me. I never wanted to disappoint him again.

Many years later, after a rough freshman year in college, I thought of Mr. Rouse as I worked to salvage my GPA. I also thought of him when I applied to graduate school and yet again when I applied to my doctoral program. As some of my classmates withdrew from our Ph.D. program, I remembered his words, “You could have finished,” and I pushed through.

I’m so grateful for Mr. Rouse, but he also taught me something very therapeutic. I don’t remember anything else from that sixth-grade year or about him. I moved on to junior high the following year, and Mr. Rouse moved on to his next adventure the year after that. I never saw him again, but the power of that one moment — just seconds in my long life in a sixth-grade classroom — influenced me forever. I suspect that if I had ever gotten the chance later in life to ask Mr. Rouse whether he did that on purpose, he would probably have said no. He was just a good teacher doing his job, but it was a powerful moment that he took advantage of, and we can’t always plan those times.

So now I think of him every time a client comes through my office door. I have my agenda and activities ready to go, but it may be just one serendipitous moment — maybe even a moment I don’t recognize at the time — that changes them forever.

Raymond Fisher/Shutterstock.com

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Investigating the impact of barbershops on African American males’ mental health

By Marcie Watkins, Jetaun Bailey and Bryan Gere May 13, 2021

Ralph Ellison, a famous African American novelist, literary critic and scholar, completed a series of essays in Shadow and Act that depicted the many social differences shaping Black and white America. He held the African American barbershop in high regard, proclaiming its significance as an institution as higher than secondary education for the African American male because it was a place of self-expression.

In Shadow and Act, Ellison writes, “There is no place like a Negro barbershop for hearing what Negroes really think. There is more unselfconscious affirmation to be found here on a Saturday than you can find in a Negro college in a month, or so it seems to me.”

This quote from Ellison reveals the historical impact that African American barbershops have had on the African American community in addressing a broad range of issues. It also reveals a foundational support for the therapeutic practices that take place in these barbershops.

During the time Ellison was writing the essays that would make up Shadow and Act, the nation was navigating uncharted waters, with many individuals, especially African Americans, demanding equal rights. Although there were many pressing issues, inequalities in relation to employment and education were considered foremost. African American males were greatly affected by discriminatory practices.

Today, unfortunately, some of these same inequalities still exist, despite major progress being achieved. A considerable body of research shows that the emotional impact of inequality can cause issues such as mild, moderate or severe depression, anxiety and other health-related issues, including high blood pressure, in connection with life stressors such as employment and finances. Although barbers are not typically formally trained to address psychological issues, African American barbershops do provide an avenue for individuals to express and address problems affecting their lives.

Researchers have identified several factors as being responsible for the emergence of the barbershop as the epicenter for African American mental health discourse. These factors include historical and cultural mistrust of health care professionals among the African American community and the low number of mental health professionals of color. Specifically, help-seeking behavior among African Americans has been conditioned by a distrust of formal health institutions and a leaning toward faith-based interventions.

The 2013 article “African American men and women’s attitude toward mental illness, perceptions of stigma, and preferred coping behaviors” by Earlise Ward et al. attributed mental health stigma to increased rates of suicide in African American males, as well as problems with education, marital life, employment and overall quality of life. According to Felecia Wilkins’ 2019 article “Communicating mental illness in the Black American community,” fewer African American males tend to seek out mental health services to address their problems. It is possible, however, that African American men receive mental health services via alternative nonformal and nonmedical institutions such as the African American barbershop.

The nonjudgmental, discursive, yet intimate environment within barbershops engenders individuals to seek them out not only to socialize, but also to obtain and share information, including their personal concerns or challenges, from and with others. African American men with diverse challenges who need input and support to address their needs or to improve their personal well-being may thus consider the barbershop a viable platform for receiving solution-focused counsel and information.

African American barbers: Confidants and counselors

Many African American barbers have unique relationships with their clients, serving as confidants and informal counselors. The significance of this relationship has been captured over the years in several literary works and movies. For instance, in the 1988 movie Coming to America, we see comedic yet intense scenes between the African American barber and his customers regarding relationship advice. In the 2002 movie Barbershop, Eddie (played by Cedric the Entertainer) expounds on the historical roles the African American barber has occupied, including counselor, fashion expert and style coach.

Many might question why barbers are accorded such prominence within the African American community, and especially by African American men. As Erica Taylor explains in “Little Known Black History Fact: History of the Black Barbershop” on blackamericaweb.com, being a barber was the first notable position for newly freed African American males. Taylor further notes that sustainable financial security and professional integrity came along with the profession. Thus, it is likely that many African American men viewed the role of barbers as notable, even if wealthy white customers regarded the job as unskilled.

Historically, the African American community has looked at business ownership, and particularly barbershop ownership, as a symbol of prosperity. In a 1989 article titled “Black-owned businesses in the South, 1790-1880,” Loren Schweninger highlighted the barbering career of John Carruthers Stanly. Stanly, an emancipated slave, became one of North Carolina’s wealthiest businessmen. While in slavery, he owned a barbershop, and by the time he was freed by his owners, he had gained a favorable reputation due to his business skills. A related story found in the Colorado Virtual Library highlights the achievement of another businessman, Barney Ford, who started out as a barbershop owner and eventually became a hotelier and real estate magnate. Collectively, these cases and several others highlight the regard with which the African American community holds barbershops and their operators. African American barbers are viewed as respectable individuals who can be entrusted with the innermost feelings and emotions of members of the community, especially African American men.

In a 2010 Counseling Today article titled “Men welcome here,” Lynne Shallcross wrote that the barber’s chair is more welcoming and less fearful for most men than the therapist’s couch. Perhaps African American men have understood and internalized this notion and feel compelled to highlight the platform of African American barbers and their barbershops as environments that are nonintrusive and welcoming.

A 2019 article, “Lined up: Evolution of the Black barber shop,” captures the perspectives of African American barbers on the pivotal role played by barbers in both the economic and cultural development of African American communities from Buffalo, New York, to Riverside, California. These perspectives capture the display of emotional vulnerability by clients to their barbers. One of the barbers acknowledged the therapeutic practices that go on in the barbershop and his role as an informal therapist. This means that becoming a good barber inevitably requires one to be a good counselor or confidant because many individuals who present for haircuts also use the opportunity to discuss their personal problems, including challenges with mental health.

African American men and mental health issues

In the 2011 article “Use of professional and informal support by Black men with mental disorders,” Amanda Toler Woodward and colleagues reported that African American men are less likely to seek mental health services. At the same time, African American men have more life stressors that cause psychological distress than do other racial groups, according to an article written by K.O. Conner and colleagues in Aging and Mental Health. Specifically, African American men are more likely to be unemployed for longer periods and more likely to be exposed to violence, harassment and discrimination within their communities. Worse still, according to Conner and colleagues, African American men are more likely to be stigmatized due to mental health issues.

James Price and Jagdish Khubchandani, in an article titled “The changing characteristics of African-American adolescent suicides, 2001-2017,” reported an alarming rise in suicide among young African American men. According to the authors, the rate of African American male suicide increased 60% from 2001 to 2017, with young African American males more likely to die by suicide by using firearm (52%) or hanging/suffocating themselves (34%). Conner and colleagues stated that African American men continue to battle insurmountable odds related to unemployment, police brutality and other stressors that lead to increased emotional and psychological distress.

Research shows that within the African American community, mental health issues are rarely discussed, and especially related to how they impact individuals, groups, families and the community. Typically, African American men are socialized to handle difficulties or problems by themselves or with close friends and family members, not with the help of outsiders such as professional mental health service providers.

Programs such as the Confess Project understand the community’s influence in addressing issues related to mental health and overall well-being. Thus, the Confess Project created a solution to bridge the gap concerning the provision of mental health services by exploring the possibility of educating African American barbers. This relates back to Ellison’s position that the knowledge-based institution of the African American barbershop may stand above other institutions in addressing the mental health issues of African American males.

SFBT and the African American barber

The Confess Project Barber Coalition program seemingly utilizes a form of solution-focused brief therapy (SFBT), recognizing the barbers’ coaching abilities and assisting them to encourage African American males to speak about emotional health. Coaching, as defined by the website SkillsYouNeed, involves improving one’s agility, both mental and physical, by remaining in the present instead of the past or future. As noted by F.P. Bannink in a 2007 article, SFBT focuses on the fact that people’s ideas of the nature of their problems, competences and possible solutions are construed in daily life in communication with others. Daily life communication is a form of staying in the present, which is often observed in barbershops.

In a 2014 article, James Lightfoot noted that much of the strength of SFBT involves freeing the process from focusing too deeply on the problem and allowing more attention to be given to the solution and the future instead of the past. Unlike traditional therapy, which might keep clients stuck in their past by rehearsing traumatic experiences, SFBT assists clients in positively looking toward the future to change their behavior.

Developed by Steven de Shazer and Insoo Kim Berg as a short-term intervention, SFBT focuses on problem identification and motivation, the miracle problem, possibility, hope, scaling/goal formation, exceptions, coping, confidence/strength and feedback. The core functioning therefore shifts the focus from mental illness to mental health and changes the role of the counselor from an active role to that of a facilitator or coach, according to Bannink. The seeming intention of the Confess Project is to promote mental health instead of mental illness in the African American community by way of African American barbershops.

Ellison’s quote ended with an understanding that African American barbershops provide an opportunity for self-expression. This has some connection to the “miracle question” proposed in SFBT, which allows clients to describe what they want out of therapy as a method of self-expression. Ellison and de Shazer thus subtly concede that the interactions in the barbershop and those that occur in SFBT are both modes of treatment that encourage and nurture forms of self-expression and emotional connection.

As a counselor and mental health advocate, I (Marcie Watkins) understand the mental health value of the barbershop in the African American community. My husband, Brandon, was a barber during the early stages of our marriage. I believe that he later selected a career in the counseling/human services field based on his experiences as a barber. My husband would often share that the barbershop was a place of community and weekly refuge for African American men. A sense of pride was established as a man with minimal budgetary resources could come to the barbershop for a haircut, therapy, relaxation and socialization — all in one package deal.

My husband stated that “to choose a barber to cut your hair and pay him your hard-earned money was a true sign of trust. If a man can trust you to cut his hair, he will trust you with every secret and problem, just as you would a therapist.” As such, the qualities of a therapist and a barber in the African American community are synonymous. Barbers hear about major life events because getting a haircut precedes weddings, funerals and any other special activity for which one needs “a fresh cut.” As such, my husband also stated, “When a man trusts you to make him look his best, he will trust you to tell you anything. That trust would also be transferred to his son and grandsons for many generations.”

As a mental health advocate, I forged partnerships with Jetaun Bailey and Bryan Gere, both of whom were professions at a historical Black university near my hometown, in educating African Americans on the importance of seeking and receiving mental health. During a conversation about mental health, Ellison’s quote was introduced, which led to a lengthy discussion among us. During our discussion, we shared experiences of observing dynamic exchanges in African American barbershops in which the owners/barbers seemingly served as facilitators/coaches and several patrons took on the role of group members. We also noted that the exchanges at times became heated. However, we noticed that the barber exuded characteristics similar to those of a group facilitator or coach — like those of an SFBT counselor — in controlling the conversations and making sure that everyone had a voice.

We also collectively agreed that a spirt of “call and response” had been infused in the exchanges between the patrons and the owners/barbers. Call and response is rooted in African American culture. This form of expression is interwoven in African American music, religious gatherings and public conversations. For example, a patron might use a solution-focused technique by asking a miracle question. The question might be “Man, what would you do if you had a million dollars?” A response might be “Get out of debt.” Thereafter, a call might be made by a patron or patrons: “Can I get an Amen?” As such, that patron is calling everyone to respond in unified agreement over the answer of “getting out of debt.”

The expression-type groups of author, educator and counselor Samuel Gladding, a past president of the American Counseling Association, can be closely aligned with call and response. Gladding recommends expression-type groups — such as those involving creative arts, music and literature —as ideal in reaching the African American population. These groups might mirror the outlets of how call and response is delivered. Gladding notes that commonly shared positive values among African Americans include creative expression.

It appears through our observation that with this call and response, the barbershop patrons remain in the present while being coached or guided by the barber, which is the core of the counseling relationship in SFBT. This discussion led to development of a presentation during Black History Month in spring 2019 at a historically Black university in Alabama. The presentation was titled “Investigating the Impact of Barbershops on African American Males’ Mental Health: Are Barbers Untrained Solution-Focused Counselors?”

Group Presentation

Approximately 75 participants, mostly students and some faculty and staff, attended our presentation that sparked much dialogue and generated some potential recommendations in getting African American men to seek formal counseling from more traditional avenues. Students were encouraged to interject throughout the presentation (like the call-and-response traditional method in the African American community) rather than waiting until the end. Therefore, if a student felt the need the comment, they were encouraged to raise their hands and wait for the presenter to acknowledge them to speak.

Based on feedback received from the participants, we cannot conclusively state that African American barbers possess innate characteristics that mirror those of SFBT counselors. Considering the responses received, it seems that African American barbers feature characteristics similar to those of client-centered counselors, because they are actively involved in the sharing process of the discussion, such as sharing their own personal struggles. Participants believed that this client-centered approach on the part of African American barbers was developed through years of listening and engaging with different people.

On the other hand, the participants felt that barbershop patrons generally possess the characteristics of solution-focused clients because they come to the barbershop knowing what they would like to express and discuss. This suggests that patrons are taking on the role of “expert” because they are able to open dialogue without any hesitation and anticipate a positive outcome. This might hint that SFBT could serve as an effective “gateway” therapy method for African American men. This approach could likely give them a sense of authority over their problems, thus leading them to explore more therapeutic approaches if their problems require deeper self-assessment.

Several of the students and a few of the staff members had once worked as trained and untrained barbers to support themselves while pursuing their education. They collectively agreed that the barbershop serves as a “one-stop” location for various businesses within the African American communities. In these barbershops, patrons can find flyers, brochures and pamphlets on everything from soul food restaurants to personal trainers. As such, one student stated, “So why not mental health?” He went on to suggest that grants could potentially be written by local and state agencies to conduct mental health presentations in barbershops periodically. He pointed out that impromptu presentations are routinely conducted in barbershops, such as someone promoting a hair show or concert.

Recommendations and conclusion

It is implied that African American men use supportive services in the community more than professional help for coping with life stressors. This method of support is not necessarily recognized through mainstream research, but it is acknowledged through other avenues, such as Ralph Ellison’s quote, as a place of self-expression. Although it does not replace professional counseling, the barbershop could be a window of opportunity for increasing mental health treatment for deeper psychological issues. As the literature reports, programs such as the Confess Project are successful in providing education to barbers to recognize mental health issues. Other mental health agencies could follow suit in reaching this population or simply networking with this organization. Mental health agencies that link with African American barbers will further promote and reshape their scope within the African American community because it will allow them to evolve from givers of advice to advocates in the mental health community.

It is assumed that some community support is instrumental in aiding mental health, and perhaps the African American barbershop should be further recognized as one of those support systems. By educating African American men through their most prized institution, the barbershop, perhaps mental health providers will be able to reach an upcoming generation that is suffering in silence.

A worthwhile goal would be to decrease/eliminate mental health stigma in the African American community by evolving the barber’s role as an advocate for change, because the legacy of the African American barbershop is deeply rooted. It was one of the few initial professions that gave African slaves and freed men financial stability, pride, voice and respectability, and it gave others a chance for self-expression. Moving forward, the institution can be used as a catalyst for change. This change can come in the form of stressing mental health instead of identifying mental illnesses.

Although SFBT could not be directly linked to the characteristics of an African American barber or its patrons as experts, the theory does promote mental health instead of mental illness. Mental health embodies our emotional, psychological and social connections, thus giving everyone a voice of self-expression instead of hiding behind the curtains of shame or stigma associated with mental illnesses.

 

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Marcie Watkins is an associate licensed professional counselor, a doctoral student and co-owner of Solutions4Success. Contact Marcie at Solutions4success@att.net.

Jetaun Bailey is a licensed professional counselor, certified school counselor and evaluator. Contact Jetaun at BaileyJetaun@hotmail.com.

Bryan Gere is an assistant professor at the University of Maryland Eastern Shore and a certified rehabilitation counselor. Contact Bryan at Bryangere23@gmail.com.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Working with clients who are angry at God

By LaVerne Hanes Collins May 11, 2021

What, exactly, are we to expect from God? What is God’s role in the human experience? What’s a counselor to do when a client is angry at God?  

In 2020, 48% of Americans surveyed by Gallup said that religion was “very important” in their life, and an additional 25% said that religion was “fairly important.” Only 27% said that religion was “not very important” in their life. 

Among the 73% who answered that religion was very important or fairly important to them, there are undoubtedly a variety of beliefs about what a person should expect, or not expect, from God. Those deeply personal expectations can be dynamic as they are shaped throughout the life span, evolving and changing over time. 

As a licensed clinical mental health counselor trained in Christian thought and faith-based counseling approaches, I’m used to my clients coming to my office with a range of definitions for faith, religion and spirituality. They come with varied beliefs and assumptions about God. These have typically been shaped by family tradition, religious institutions, influential friends and thought leaders, their own singular experiences and interpretations, or by any combination of these factors.  

I recognized early in my career that people sometimes become angry at God when there is a discrepancy between their expectations and their experiences. I was already an ordained minister when I went into counseling, but I knew that I needed more training to be effective with faith-based concerns. So, after receiving my master’s degree in community counseling, I earned a doctorate in Christian counseling so that I could help people work through issues of faith and spirituality. 

Clients usually come to me because of something painful and unexpected: any kind of loss; a misfortune; an untimely death; a miscarriage; a broken marriage; a sick child; an economic or job-related crisis; an abuse, assault or robbery; a health crisis; an injustice; a natural disaster; or any other traumatic event you can imagine. Clients suddenly feel that their situation — or even their life — bears the imprint of a rubber stamp: “Goodness Denied!” It brings about an unnerving discrepancy between the individual’s expectation of a loving God and their lived reality. 

Why it’s hard to talk about anger at God

When a person experiences a crisis or traumatic event, the initial feelings — sadness, anger, disappointment, fear — are typically about the event itself. Other powerful emotions often reflect existential questions about God’s role in their situation. Was God present (abandonment)? Why was this allowed to happen (confusion)? Then there are questions about their own feelings. Is it OK to be mad at God? Are they allowed to feel this way?

Depending upon a person’s beliefs, the thought of being angry at God, an all-powerful transcendent being, can seem rather taboo. The very mention of God suggests authority — an ultimate moral authority. So, to be angry at God can seem irreverent or sacrilegious. It may be an anger that is easy to feel but terrifying to verbalize.

Clients with a spiritual or religious worldview may come to therapy afraid of being judged for those beliefs in the same way that they fear being judged by factors such as race/ethnicity, economic status or sexual orientation. It is a sensitive area because spiritual or religious values reflect the principles upon which a person makes decisions that govern their life. Those values reflect a moral compass that provides direction for one’s views, perceptions and choices. Counselors are bound by our professional codes of ethics to respect the diversity of religious and spiritual positions held by clients. We are to regard those spiritual beliefs as elements of cultural diversity, requiring a commitment to cultural awareness and sensitivity in our counseling work.  

The painful questions

When crisis strikes, a person may tend to question God’s goodness. “God is good. What happened to me is not.” Did God cause the crisis? Why didn’t God prevent it? Why is God always loving to everyone but me?  

A 2010 Baylor University Religion Survey project suggested that a person’s expectations of God are determined by their answers to two questions. First, is God involved or uninvolved in human affairs? Second, is God benevolent and merciful toward humanity, or is God judgmental and critical toward humanity? The model that came out of this study suggested that the aspect of religion that is most relevant to a person’s mental health is the nature of their relationship with God. It’s a matter of how people see God relating to them.

Baylor University’s Paul Froese and Christopher Bader described this in their 2010 book, America’s Four Gods: What We Say About God — And What That Says About Us. They asserted that regardless of our religious tradition (or lack thereof), Americans worship four distinct types of God. First, nearly all Americans believe that God is loving. But there are significant differences in the way people view God’s involvement and God’s judgment in the world. The study said that some Americans (31%) believe in an authoritative God who is more engaged and more judgmental. Others (24%) believe in a benevolent God who is more engaged and less judgmental. There are also those (16%) who believe in a critical God who is less engaged and more judgmental. The last group represents people (24%) who believe in a distant God who is less engaged and less judgmental. 

The Baylor model has provided me with a useful paradigm for case conceptualization. When I see clients who are angry at God, it is typically because of a discrepancy between their experience and their expectation. The characteristics that they ascribe to God no longer make sense. On the other hand, when their situation is consistent with the extent to which they believe God engages and judges the world, there is less tendency for cognitive discrepancy and anger at God. 

In therapy, I give the client space to vent their anger. The way the client explains why they’re angry at God provides insight about which profile they ascribe to God. That profile essentially forms the underlying beliefs that get explored in cognitive behavior therapy (CBT).  

When the person’s complaint against God stems from something that God failed to do or failed to provide, it suggests that the person expects God to be involved in and benevolent toward the situation. They may be angry at God for neglecting to provide protection from a tragedy, for denying something that they expected to receive or for failing to heal a disease. This is inconsistent with their expectation of a benevolent God who is kind, merciful, compassionate and protective. A major cognitive discrepancy then exists.

Although people generally perceive God to be loving, some clients may question why God seems to not dole out punishment or judgment for wrongdoing. These clients may describe dismay because they expected some execution of justice, yet it seems that God is allowing someone to “get away with” something. This departs from their expectation of an authoritative God who is engaged and who also judges and punishes sin without delay. “Why did God not bring that party to justice? Why was I unjustly denied while someone else was unjustly allowed?” they ask.

Clients who believe in a distant God will see God as being uninvolved with today’s world. They may believe that God created the world through a kind of cosmic force, but they see God as now being removed from that world and simply observing from afar. For them, God set the world in motion but has remained unknowable and perhaps even mysterious. This belief suggests that God may not be paying much attention to mere mortals. When tragedy comes — to good people or to evil people — there are absolutely no answers from God. God exists, but not for the sake of involvement. 

Clients who see themselves as having created their problems may expect to go through life hopelessly. They often believe that a critical God allows punitive misfortune and is not engaged in the business of bettering human conditions for those who have morally failed. This leads to low expectations about improvement in their situation. 

So, while religious activities such as prayer and regular attendance at services have been the traditional measures of religiosity in Western culture, Froese and Bader suggest that those behaviors have little effect on someone’s reported mental health. The study found that people who believe their troubles are the result of God exacting judgment because of sin have higher levels of anxiety, paranoia and compulsion than those who believe in a caring, engaged God who will help them cope with life’s challenges.

When counselors understand a client’s image of God, they have an opportunity to explore and invite reflection upon that person’s internal beliefs and thoughts. That can be helpful to counselors in health care and disaster response because many painful issues give rise to the question of “Why me?” The most effective way of answering that question is from within that person’s view of or belief in God, not by trying to change that person’s belief (unless the person is ready to challenge their own belief system).  

A cognitive behavioral response

CBT involves the exploration of underlying beliefs that form the foundation of a person’s thoughts, feelings and subsequent actions. The Baylor study’s typologies of God in America offer four different cognitive beliefs that clients may subscribe to. Cognitive discrepancy is present when two cognitions are experienced as conflicting. One example comes from a client who said, “God is good and brings good things to our lives, but what happened in my life is not good.” Another client grieving a series of miscarriages said, “The womb is for giving life; my womb only gives death.” These statements reflect emotionally painful discrepancies between these clients’ expectations and their experiences. 

People will naturally seek information that is congruent with their beliefs. However, when their emotional pain becomes too great, they will also try to engage in dissonance reduction by avoiding information that is incongruent with the belief they want to hold on to. When they cannot find a way to retain the belief, they may abandon their faith completely. 

An alternative approach: Creation-Fall-Redemption

In my practice, clients who come from Judeo-Christian traditions have found the following reframe particularly helpful for taking God out of the four boxes. In this way of looking at problems, clients can consider and develop a theology of suffering that normalizes their pain and gives them an alternative lens for their situation.  

Creation: The sacred texts of Judaism and Christianity begin with the story of how God created the earth, everything in it, and humanity. At each stage of Creation, God paused and said it was good. God gave permissions and parameters to the man (Adam) and woman (Eve). As long as they followed God’s plan, life was blissful. They were warned, however, that operating outside of God’s permissions and healthy parameters would start a cascade of difficulties throughout the whole earth and throughout all generations. This disobedience would add the knowledge of evil to the good things they already knew and disrupt the harmony of the entire creation. 

The Fall: The second stage in the human experience was an unfortunate one, as Adam and Eve both went beyond the limitations that had been set. This is commonly referred to as “the Fall” (of humanity). Artists often portray this event as the eating of an apple, but that seems to just be artistic interpretation. The important thing to realize is that the consequences of this event introduced into the world three sources of problems: moral evil, natural evil and human limitation.

Each of these represents a different source of pain that all of humanity is unfortunately destined to experience because of the introduction of evil into the world. Moral evil includes all of the selfish human choices that bring harm to others or to our world: violence, greed, assaults, etc. Natural evil includes those things that bring destruction and devastation beyond our control: health issues such as sickness, disease, infertility and miscarriages, and atmospheric conditions such as destructive weather, earthquakes, pestilence and accidents. The third category, human limitation, includes restrictions on our capabilities, which we call weaknesses, and our now-limited life spans, which we call death. 

Clients benefit from being able to categorize their problems. They long to know how to interpret them, and often, God has seemed like the only one to blame. Instead, clients can choose at least one of these three categories for every problem known to humanity. If they subscribe to a Judeo-Christian belief system, they find the answer in the very beginning of the history of humanity, in the context of a faith that they already believe in. 

Redemption: Can something good come out of this? Is there any comfort to be found in this pain? If the effects of the Fall cannot be immediately reversed, where is hope? For clients looking for an answer within the Judeo-Christian tradition, redemption is found in one’s faith — in the belief that God will not leave the world forever in the condition that sin left it in through the Fall. 

There are different symbols for redemption that depend on the faith belief system of the client. I often ask clients what redemption means for them in the context of their faith. Some find comfort in knowing that God’s love is available to them no matter how painful their situation and that God is lovingly walking beside them through the worst of times. Others may speak of present opportunities to turn their painful experience into something positive by helping others. Many Christians will speak of Jesus’ resurrection. Still others describe a sense of eternal justice that is yet to be understood here on earth. 

In this way, God is seen as being with them in their pain but not as the cause of their pain. The key point is that clients examine their discrepant beliefs and find a way to reframe their tragedy or pain into beliefs that empower them with resilience. With that, they can more easily resolve the cognitive discrepancy without letting go of the faith that they hold dear.

The cognitive behavioral inquiry

The process of exploring which of the four God types the person subscribes to and then introducing a Creation-Fall-Redemption alternative involves a basic cognitive behavioral approach. Here are some key talking points for the cognitive behavioral process.

Identification of beliefs

  • Identify the spoken and unspoken beliefs about life, suffering, God, people, etc.
  • Explore where those beliefs came from.  
  • Discuss the expectations that are held in those beliefs.

Thought reconciliation

  • Identify the client’s thoughts about this particular situation.  
  • Explore any incongruence, inconsistencies or dissonance between beliefs and thoughts.
  • Identify the form of evil in the client’s situation: moral evil, natural evil or human limitation.

Emotion management

  • Name the emotions. (What’s the individual’s history with that emotion?)
  • Determine if there is a need for forgiveness of self or others. If so, ask the client to choose whether they’d like to act upon that.

Behavioral adjustments

  • Encourage the client to determine how to use the anger or other emotions constructively.

Sample questions for cognitive behavioral processing

Socratic questioning is a valuable tool in CBT. This method is especially useful with the sensitive issues of spirituality and religion because counselors must approach this topic without judgment about the client’s beliefs or values. The best questions are open-ended, focused, concise and neutral. Questions such as these can be used at any appropriate point in the process described above.

  • What would change for you if you could see God being as angry about this injustice as you are?
  • How would it be for you if you knew God was as saddened by your loss as you are?
  • What would you like the fruit of your pain to be?
  • What if you didn’t need to figure out how you’re supposed to feel or supposed to act?
  • What if your situation is a result of a fallen world rather than a fallen God?

Diagnosis and treatment planning

What about a billable diagnosis? What about measurable treatment goals? Counselors often avoid religious and spiritual discussions in therapy because they need a billable clinical diagnosis for third-party payers. Rarely, however, does a client initially state their presenting concern as anger at God. That’s mainly because it feels taboo and unacceptable to be angry at a Supreme Being. Clients do present with symptoms of depressive disorders, generalized anxiety disorder, adjustment disorder and trauma-related disorders. The billable diagnosis is there. 

Specific and measurable goals are found in reducing the frequency and severity of the diagnostic symptoms associated with the disorders. This might include a specific reduction in the number of days when particular symptoms cause clinically significant distress or impairment in functioning. It might include a specific reduction in undesirable self-medicating behaviors each week or a reported improvement in problematic sleep patterns. As the person resolves the religious- or spiritually related anger, issues such as these will often improve. The success in this kind of goal setting is in getting a baseline severity measure and then measuring symptom improvement over time. 

Issues of abuse are a clear exception to this CBT approach. When a client’s history involves any form of victimization such as spiritual manipulation or sexual abuse, the counselor must exercise extreme caution. In these cases, trauma-informed care and trauma-specific interventions are more appropriate than CBT interventions. 

Summary

Clients of deep spiritual and religious faith may come to counseling at a major life crossroads. The perception of God denying goodness can lead to a real crisis of faith. The tendency to typecast God into one of four frameworks leaves people struggling to make sense of a situation that creates a discrepancy between their expectations and their experience. As counselors respond in ways that help clients clarify their theology of suffering, we can also help them cope effectively with present and future problems.

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LaVerne Hanes Collins is a licensed clinical mental health counselor, licensed professional counselor and national certified counselor. She is the owner of New Seasons Counseling, Training and Consulting LLC, where she develops in-person and virtual continuing education (CE) training for licensed counselors on issues of race, faith, culture and trauma. Her web-based CE training on CBT for clients who are angry at God is available at: http://bit.ly/3tqfMGu. Contact her at DrCollins@NewSeasons.training.

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

The unique challenges that face immigrant clients from Africa

By Stephen Kiuri Gitonga May 10, 2021

Immigrants to the United States have one goal in common: to attain the American dream. For many, this dream means leading a life with fewer struggles than they experienced in their countries of origin. Africa is the second-largest continent in the world, stretching from Senegal to Somali (west to east) and Tunisia to South Africa (north to south). It has 54 countries and a population of approximately 1.3 billion people. There are about 3,000 African tribes, each of which speaks its own language or dialect.

The most widely spoken languages in Africa include English, Arabic, Swahili, French, Portuguese, Akan, Hausa, Zulu, Amharic and Oromo. It can be easy for counselors in the United States to assume that one Black client is like the other Black client, when in fact one might have been born and brought up in the U.S. and the other might be a first-generation immigrant from Africa. Such an assumption would be disadvantageous to clients from Africa because their varied and diverse experiences would be ignored. If these experiences contribute to the client’s presenting problem and yet are disregarded or overlooked by the counselor, then treatment of the presenting problem would be challenging or even elusive. 

It is important for counselors to take stock of the unique challenges that afflict immigrants from Africa and could complicate their lives in the United States. Mental health counselors are encouraged to pay special attention when working with this population to address the presenting mental health problems and other issues unique to these clients that, if left unaddressed, could have a negative impact on their well-being.

Culture shock

Relocating from Africa to the United States is likely to be a culture shock for the immigrant client. In fact, many immigrants from Africa experience culture shock even before they travel to their new country. 

The process of securing a visa to travel to the U.S. is a daunting experience that takes months — and sometimes years — to complete. Applicants physically go to the U.S. Embassy offices in their countries or regions to attend interviews and complete official paperwork related to their travel. At these offices, they are likely to see armed white police officers in full gear, complete with duty belts, guns, sunglasses and other items dangling from the belts. Applicants may feel intimidated by the sight of these officers, having previously been accustomed to seeing Black police officers carrying gear that is less threatening. 

The interview determining potential receipt of a travel visa can go either way, and applicants are aware that if they are denied, they will not necessarily learn why they were not issued visas. Issuance of a visa is the prerogative of the immigration office. There is no provision for explanations in cases of denial, although candidates can submit new applications for consideration in the future. 

Once African immigrants actually travel to the U.S., they are likely to experience culture shock in multiple ways. Depending on such factors as their previous experience with international travel, their country of origin and the port of entry to the U.S., new immigrants may be shocked by the size of the cities, highways, forests, rivers and lakes, and the sheer amount of food that gets served on a plate. They also observe that cars generally carry fewer occupants than they are used to and that there are more people driving up and down the streets than people walking or using public transportation. Immigrants from Africa also quickly realize that they are a minority race in the United States — a stark contrast to their majority status in their country of origin.

Another cultural experience that may be shocking for the new immigrant from Africa is the sole use of English to communicate. Code-switching, which is common among people who are bilingual, is not possible when English is the only language in use. Other things they learn or observe include the high cost of living, differences in dressing, the prevalence of low-context interpersonal interactions, driving on the right side of the road, a love for sports that are unique to Americans, people who are homeless, panhandlers on the streets, and the menace of opioids, to name but a few. 

The COVID-19 pandemic has introduced another complication to the cultural experiences of immigrants from Africa. In line with their social nature, these individuals support one another whenever a member falls sick by visiting and helping with child care, cooking and other household chores. COVID-19 safety guidelines do not allow people to congregate, especially around someone diagnosed with the disease. While the COVID-19 pandemic was peaking, it was common for people to be buried in communal graves. From an African context, it is uncommon for a person to die and for the bereaved family to be unable to complete all the rituals associated with funerals. It may take time for immigrants from Africa to come to terms with these tragic experiences.

Past and present trauma

Depending on their country of origin, some immigrants from Africa may have preexisting posttraumatic stress disorder or other disorders that have gone untreated from such events as war, physical abuse, sexual abuse, accidents, displacement, political violence, intertribal clashes or terrorism. There is ongoing instability in such countries as Somalia, South Sudan, Chad, Ethiopia, the Democratic Republic of Congo, Libya and the Central African Republic, with many casualties every year. In Nigeria, there is ongoing violence instigated by the terrorist organization Boko Haram. 

Survivors of these instabilities may end up immigrating to the U.S. as refugees or enter the country under another status. Their traumatic experiences in their countries of origin, compounded by new traumatic experiences in the new country to which they have immigrated, can be challenging to treat. Many of these individuals may be unaware that they even have a treatable condition. 

Loneliness

Research points to the seriousness of loneliness to one’s mental health. People immigrating to the U.S. may suffer prolonged periods of loneliness before they form meaningful relationships within their host communities. Loneliness can be compounded by cases of rejection, discrimination, isolation, stereotyping, microaggression and so on in their new communities.

They are often unable to communicate on a regular basis with family members back in their country of origin because communication by mail can take a long time and international phone calls are expensive. Loneliness, coupled with other problems, can lead to depression or degenerate to suicidal ideation for this population. 

Language

Only a small minority of immigrants from Africa report English to be their first language. Most of them have learned other languages before English. Student immigrants from non-English-speaking countries encounter fewer problems because they are usually enrolled in English classes during the first semester of their respective programs. Others who were fluent in English in their country of origin are often surprised at how different American English is from other English dialects and accents. 

Fluency in language is important for self-expression and self-esteem. Immigrants who struggle with the English language might have a harder time adjusting to their new life in the U.S. Another disappointment they typically experience is inability to code-switch — i.e., switch from one language to another — like they were used to doing before their relocation. This is because most of the members of the majority culture with whom they now interact speak only in English. 

New identities

Immigrants from Africa are faced with changing their identities in multiple ways upon arrival in the U.S. For example, in their country of origin, there may have been certain activities and roles such as child care, cooking, driving, mowing the lawn, financial management and so on that were classified by gender. In the U.S., these responsibilities are more commonly shared between men and women. 

If African immigrants were wealthy back in their home country, they likely had employed the services of a live-in houseworker to help with such chores as child care, cleaning, laundry and cooking. These chores must now be shared between the couple irrespective of their gender. Assignment of these responsibilities is often a major source of discord among couples who have emigrated from Africa. That is because in many cultures in Africa, it is the responsibility of the woman to cook, clean, do laundry and take care of the children, irrespective of her other daily roles and responsibilities. Once the couple has immigrated to the U.S., it is often difficult for their families back in their country of origin to understand this new setup of shared responsibility. Families in the country of origin will often comment that the immigrants have lost their cultural identity.

Loss

Immigrants from Africa experience multiple losses as they settle in their new country. Examples of losses include identity, wealth, social status, family bonds, language, cultural traditions, freedom, innocence, traditional food, life goals, favorable climate and familiarity. Depending on the impact of these and other losses, immigrants from Africa may need mental health help to cope. 

It has been particularly challenging for African immigrants during the COVID-19 pandemic to deal with the resultant losses. They are used to living a social life in which they congregate for no apparent reason. During the pandemic, they have largely lost this aspect of their culture because of restrictions on in-person socializing. Likewise, when fellow community members are hospitalized, they cannot be visited. When people die from COVID-19, there is added pain due to restrictions on viewing the deceased or completing traditional funeral rites. Additionally, at the height of the pandemic, people who died from COVID-19 were buried in mass graves, while others were cremated. These are not common practices among many cultures from Africa.

Family relationships

There is a common tradition in Africa alluding to the fact that it takes a village to raise a child. Extended family members, relatives and neighbors are all expected to be involved in the well-being and development of growing children. Immigrant couples do not typically have the luxury of the village caring for their children in the U.S., whose dominant culture is individualistic rather than collectivistic. If these parents are busy at work, college or with other commitments, they take their children to day care for a fee because they are no longer surrounded by close family members or friends who would have cared for their children. This can become a major source of family relationship problems for immigrants from Africa, particularly when these fathers must change their traditional attitudes and beliefs to share responsibility for child care. 

Parenting is another source of strained relationships among African immigrant families. This is in part because the village is now absent, and the couple is left to care for their children with little outside help. In addition, parenting styles in the U.S. are different from parenting styles in Africa. African parents’ cultural practice of disciplining a child may be construed as child physical abuse in the U.S., potentially landing these parents in trouble with the law.

In Africa, the cost of raising a child is low in comparison with the U.S. For this reason, immigrant couples may decide to have fewer children or not have children at all. There are also differences between the first generation and second generation of immigrants from Africa. Second-generation children have greater exposure to the mainstream majority culture and are more likely to be influenced by it. Attempts by the parents to teach the second generation the value of maintaining their culture is often met with resistance, and this can strain family relationships.    

The American dream

The common belief among aspiring immigrants from Africa is that the American dream is easily attainable. Some interpret the dream to be good education, wealth, good health, affordable health insurance and stable income. 

While some immigrants do attain the American dream, others struggle. For the latter, the lack of attainment may become a source of self-pity, shame and guilt, particularly because their family back in their country of origin may not understand that not everyone in the U.S. is wealthy. Some begin to question why they immigrated and may consider immigrating back to their countries of origin. Problems could then arise if communication within the family is not effective.

Racism

The Black Lives Matter movement has unearthed social ills that have plagued the United States for many years. As a marginalized population, immigrants from Africa may be the targets and victims of discrimination, racism, bigotry, hatred, microaggression and other social ills often propagated by institutions that are supposed to protect them. 

Now that these ills have been widely exposed, there is a possibility that they will become added sources of anxiety and associated mental health issues. Questions may arise for these immigrants regarding how safe it is to continue living in a country where they are openly not wanted. Family and friends in their country of origin may begin to have similar questions and feelings and urge them to return home.

Education

When immigrants from Africa enter the U.S. on an F-1 student visa, they are expected to maintain their student status and follow the strict guidelines from the U.S. Citizenship and Immigration Services until they complete their studies. Some of the stipulations include maintaining full-time student status by taking the required number of courses per semester and maintaining passing grades. They are not allowed to seek employment without authorization. Such authorization, when granted, permits them to work for 20 hours per week on campus. 

The cost of higher education for international students is high. Many students are not able to afford tuition to complete their studies and may end up dropping out of school. When that happens, they lose their student visa status and begin the cat-and-mouse game of evading U.S. Immigration and Customs Enforcement for violating their immigration status. 

Students who complete their studies are granted the opportunity to apply for a change of status to become U.S. permanent residents, especially if they have completed graduate studies in high-demand programs such as software engineering, nursing, medicine, computer science and so on. The process takes time, but it is the safer route that most students follow to ensure their continued stay in the country and their eventual attainment of the American dream. Before that happens, they live in constant fear of being deported.

Acculturation

Over time, continued interaction between immigrants from Africa and the majority population in the U.S. results in acculturation. Immigrants pick and choose aspects of the majority culture to adopt and aspects of their respective cultures to retain. In a symbiotic and ideal relationship, the majority culture picks aspects of the immigrant population to adopt as well. It is important that counselors working with immigrant clients from Africa encourage them to maintain aspects of their culture that are meaningful to them, lest they lose their identity completely.

Another source of family conflict may happen when children abandon some of their family’s cultural aspects in favor of aspects of the majority culture. This occurs during the preteen and adolescent years when they are developing their identities, often influenced by the majority culture. It becomes a problem if their parents are not in favor of the adopted tenets of the majority culture. 

Drug and alcohol use

Alcohol in most African contexts is used to serve social and traditional purposes. With the mainly communal lifestyles, people look out for one another to avert misuse in a “brother’s keeper” sort of way. But these close relationships are largely or completely absent in African immigrants’ new country of residence. Here, they do not have close friends or family members to keep an eye out for them or with whom they can share their problems. 

Without education and awareness of mental health counseling, some immigrants from Africa turn to self-medication with alcohol, drugs or both. Addiction is now a serious problem afflicting African immigrants, and it is good practice to assess for drug and alcohol use, even if this is not the presenting issue brought to counseling. Left unchecked, drug and alcohol dependence could easily degenerate into a generational problem that afflicts current and future generations.

Treatment guidance

Professional counselors should consider the following items when working with clients who are
African immigrants.

> Assessment: Effective treatment begins with a thorough assessment. In addition to the issues brought to counseling, it is important for mental health counselors to assess for other issues that are not so obvious. For immigrant clients from Africa, counseling may still be a new concept. They might not be comfortable sharing their problems with strangers. Hence the need for counselors to select assessment instruments and procedures that are less intrusive. 

> Rapport: Research points to the significance of developing therapeutic rapport with clients early in the counseling process. It is also necessary to maintain this relationship throughout the counseling process. It will likely require additional effort to build and maintain a trusting relationship when working with immigrant clients from Africa because counseling may be a new concept for them. In addition, it may be necessary to educate these clients on what mental health counseling is all about and their roles and responsibilities in the counseling process. 

> Cultural sensitivity: Mental health counselors are cultural beings, and they bring their culture to the counseling relationship. It is vital for counselors to be constantly aware of their culture, including the biases, beliefs and stereotypes that they hold about immigrant clients from Africa. It is also imperative that counselors refrain from imposing their culture on these clients. 

It is beneficial for counselors to learn about the unique culture of their immigrant clients from Africa by setting time aside for cultural immersion and attending ethnicity-specific cultural activities from time to time. They will then use ethnicity-specific and evidence-based interventions to work with these clients. 

> Self-care and wellness: Mental health counseling can drain our emotions and energy. Therefore, mental health counselors should engage in a self-care regimen, maintaining regular self-care activities and schedules, to reenergize. Likewise, it may be helpful to educate our clients who are immigrants from Africa on how to engage in self-care and identify wellness strategies for their improved mental health and enhanced overall health.

 

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Stephen Kiuri Gitonga is an assistant professor in the clinical mental health counseling program at Lock Haven University in Pennsylvania. He is a licensed clinical mental health counselor licensed to practice in Idaho, Kentucky, Utah and Pennsylvania. Contact him at skg200@lockhaven.edu.

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, visit ct.counseling.org/feedback.

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