The Psychology of Representation: Part 1

Written by Dr. Fabrice Lubin

I'm watching a YouTube video on "Mental Illness -- The Impact of discrimination." As each panelist recounts their struggles with cultural bias, oppression, and all the in-between, the counselor in me observes their nonverbal behaviors and the immediate physiological reactions: throat tightening, stutter in speech, and mild to moderate physical reliving of their trauma. In this interview, they present photos of each panelist as a child, subtly and powerfully capturing their curiosity, youthfulness, and family. The intentionality behind including these photos, along with their undeniably vulnerable discussion, articulates the journey it took for them to arrive here at this moment, not quite fully formed (for when are we ever?) and unbroken by the challenges they have overcome. I believe that the creators of the show knew the importance of personal history and representation. At the risk of projecting my feelings, they know their audience is starving for mirrors that appropriately reflect their experiences. Overall, the discussion reminds me of a remark I heard from a BIPOC mental health advocate: "When anyone comes into your office, you should always be personally curious about their journey. The person you see in front of you wasn't always professional, successful and complete." 

We need to understand that the leaders, mentors, and healers within our BIPOC community do not arrive with everything figured out. 

They come as they are.

Direct and authentic display of wounds, abuses, joy, resilience, and resistance matter to our human community. It deepens our understanding of what BIPOC and other marginalized people endure before their "arrival", whether it is in the media, the classroom, boardroom, or our healing spaces. When I interview BIPOC for counseling positions, I'm never surprised to hear the complexity of their narratives and the microaggressions they've endured. They will speak of feeling isolated in their classes. They will tell you of times when people inappropriately labeled them as exhibiting poor boundaries. They will emphatically share what it's like to carry the burden of racist perceptions that mark them as: lazy, argumentative, narcissistic, and unprofessional, to name a few. There are many more names, labels, and incidents, some of which I know directly through my own experiences. Inherently, these experiences pose a curious question: What exactly do we as BIPOC people do with our pain? Do we attempt to share, express, repress, convert, subvert, resist, desist, define, refine? More so, whatever the manifestation our struggles evolve into - for whose benefit does it serve? 

If we transform our pain into what appears to be good-natured, healed, and overcome, are we doing so to convince a white audience? Seeking this type of approval matters when you're in a field where white clinicians account for 86% of mental health professionals. To be sure, many group practices would love to expand their clinical base to include (QT) and BIPOC individuals. In my experience and from the stories I've heard while these mental health organizations may want the BIPOC body, they certainly do not wish to deal with the BIPOC mind, a consciousness that has been exposed to and endured direct/indirect hostility, systemic racism, and trauma. In mental health, the idealized clinical temperament is one of stoicism, neutrality, objectivity, and reserve. A failure to demonstrate these qualities can lead to significant misrepresentation, labeling, and significant emotional distress for white people. What do you do then, with all the messiness of being a marginalized body in a culture that oppresses you? What is the expected recourse when you see George Floyd, a man that might resemble men in your own family murdered by police? What does it mean to ruin the party?

As a graduate student, when I exhibited any emotion approaching anger, distress, or pain, I knew that I risked my mask from slipping. In 2007, during an interview for a practicum placement and training for a local Hospital in Chicago that served marginalized communities, a white supervisor implored if I had any questions. As someone interested in community engagements and initiatives, I asked how community interventions were possible when the city itself was aggressively cutting funds to service these areas. Their response was to barrage me for asking the question in the first place. Leading him to remark: "you're here to answer my questions, I'm not here to answer yours." 

I left the interview, sobbed on the EL, but the incident was not over yet. On the same day, this clinical supervisor would Google search my name, read my LiveJournal, and report me to my graduate school as he was "concerned about my behavior during the interview." He did not mention yelling at me during this interview, and he did not specify the tears that stained my face. When I explained my situation to the white representatives from my school, they excused his behavior by saying, “There's no way he could be racist; he supervised me." They told me that having a personal LiveJournal was problematic, that I shouldn't publicly display Bjork lyrics, and that there was “no place for poetry when you're a psychologist.”  

I completely disengaged from the majority of my graduate courses. My voice began to recede into the background of my classes. I refused to participate if it meant exposing myself to ridicule perceived or real. Later in 2008, my cousin was shot and murdered in the street. I subsequently abandoned work on my thesis, the interpretation of this act by faculty was taken as a failure on my part, not as someone who was in the stages of grief. Of course, it was my "fault" I never asked for assistance or expressed how painful this loss had been in my life. I never talked about not being able to sleep and struggling to write a eulogy while boarding an airplane for my home state. I never wanted them to think any less of me, so it was better if they didn't think of me at all.

Moments like these directly reinforced that I had to suppress my own emotions, experiences, and hurt. If, as a graduate student in a counseling program, I felt mislabeled, diagnosed, or punished for speaking out against oppression. Why would anyone from the BIPOC community willingly comply with other mental health professionals when they risk losing their kids, their jobs, or worse? More frightening still, as a perceived leader in the mental health field, who should I turn to for supervision, support, and care? Who would I work to serve as a model for appropriately "integrating" or "processing" my trauma? Especially when the impact of discrimination continues to bruise me and those in my community? Subsequently, I did attend therapy with white clinicians three in total at various times of my life. The number of times when issues of race, culture, or oppression were brought up by these educated, progressive, healing people? Zero.

Whenever I see a successful "integrated/processed" version of a BIPOC person, I am left to wonder about the journey and the feelings that are left out: the confusion, rage, internalized racism, depression, anxiety, and in some forms, passive suicidality. Only recently through shows like Insecure, I May Destroy You, Ramy, Pose, Little America, Random Acts of Flyness, and Atlanta are we beginning to see a more textured, complex, and varied QT (Queer, Trans) and BIPOC (Black, Indigenous, Person of Color) experiences. Within some circles, we turn toward anti-racism and the dismantling of white supremacy, but this task is left to the Black and Brown bodies to perform. So yes, we must sustain even more effort. I think we are expecting so much from identified Black leaders and only provide so little. Their mental health remains overlooked -- I wonder how much pain they have to juggle while simultaneously being perceived as the pioneers in overcoming the challenges inherent in our racist country. 

Access to mental healthcare has significant barriers, regardless of ethnicity, primarily due to financial and lack of insurance coverage. Still, according to a 2015 study by the American Psychiatric Association. 48% of identified white individuals with mental illness will receive mental healthcare compared with 31% for Black residents and even lower at 22% for those identified as Asian. Depending on your socioeconomic status, therapy is normalized considerably within a white American population. At the very least, mindfulness, yoga, acupuncture, and reiki have all become increasingly accessible and standard practices. They all have their models of what it means to observe feeling states of being, drawing awareness to your body, and taking on committed action to heal. ways to strengthen and elevate themselves, but because I would love to see the inherent complexity that exists to reach this pinnacle. Generally speaking, you can turn on any movie or show, read any book, consume any high art, and see the multidimensionality of the white persona presented. I am not saying in-depth exploration of feeling is the standard to which most people consume media. At the same time, some of the most-watched TV shows are The Sopranos, Breaking Bad, and Game of Thrones -- all of these shows depict white characters embodying various forms of complexity and struggle. 

As a result of significant socioeconomic disadvantage and a shortage of culturally representative clinicians, our BIPOC community severely lacks these types of interventions and healing. Without adequate cultural representation in mental health and beyond, there is insufficient modeling of how BIPOC individuals can remain vulnerable, engaged, and authentic. Even worse, does the "cure" we are looking for continue to appease or appeal to serve oppressive forces?

We need more transparency, creativity, and variation of what thriving mental health is specifically for someone identifying as BIPOC. The emphasis that an overwhelmingly white mental health community places on resilient, processed, or integrated individuals can feel removed or beyond marginalized communities' reach. On another level, there could be an outright distrust of "integration" itself because it's perceived as white-washed because white people have upheld these models for so long. 

No matter the theoretical orientation you have at its root, therapists are dealing with stories. How we write our notes, conduct intake, prescribe interventions...All of these are stories. We must demand from our professional community and those in power: how are you listening to these stories? How are you writing these stories? Are you leaving something or someone out? Are you reducing essential qualities of a personal and regulating them to insignificant or worse, pathologizing because of unfamiliarity and fear?

Lack of representation leaves holes in the narratives of our human consciousness, and as a result, the whole suffers.