How are Blackness and Whiteness Embodied in the Clinical Encounter?

24 February 2025

Here are notes summarizing my opening talk:

The therapeutic alliance between the therapist and the patient is an important process in making changes happen.

Norwegian statistics show that people with migrant backgrounds have experienced discrimination more than the rest of the population in 2021. 50% of people born in Norway with migrant parents and 40% of the migrants have experienced discrimination in contrast to 19% in the rest of the population.

Microaggressions are the everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, which communicate hostile, derogatory, or negative messages to target persons based solely upon their marginalized group membership. In many cases, these hidden messages may invalidate the group identity or experiential reality of target persons, demean them on a personal or group level, communicate that they are lesser human beings, suggest they do not belong with the majority group, threaten and intimidate, or relegate them to inferior status and treatment (Sue, 2021).

The negative messages can be expressed verbally or by behaviors or can be on a transmitted on systemic level (Sue, 2010)

Microaggression can reflect one’s understanding of superiority and beliefs about what is normal. These understandings can therefore affect the interactions with the other

There are three forms of microaggressions (Sue, et al, 2007)

Micro-assult

Micro-insult

Micro-invalidation

Those who are exposed to such actions are put in a difficult situation. One can sit with a strange and vague feelings of being attacked, which do not feel right. Should I act on these or not?

Over time, such experiences can become an emotional strain. This may be an ongoing process in a person’s life.

Although microaggressions may initially be felt to be nonsense and pointless, the victim exposed to them over time can became anxious, sad and subject to emotional pain.

Surveys show the 53 to 81% of people of color have experienced microaggression in therapy.

Some of the Pitfalls to Recognition of Micro-aggression in Therapy (Constantine, 2007):

• Color blindness: I don’t see you as colored and issues related to color are not addressed
• Over-identification: Knows what it means to be suppressed, as a woman “I know what you are going through”, thus the patient’s own experiences are not focused
• Insensitive treatment proposals: Collective vs. individual social approach
• Denial of own stereotypes and prejudices
• idealization e.g. you can endure a lot, you are a strong black woman
• Minimize questions related to ethnicity/race as immaterial to the treatment
• Attributes specific status, ex. you are articulate . . .…..
• Arrogant to the patient’s background
• dismissive by saying the patient is oversensitive when issues related microaggressions are brought up
• validates certain unwanted behavior as ok because the therapist believes it is common in the patient’s culture