Woke at the Door

Imagine for a moment that you, as I do, run a private psychotherapy practice. A colleague has referred a client, telling you little about them, and you are to meet for the first time.

When they^[1]The pronoun “they” is used here not to denote any deference to gender identity initiatives, but rather to allow the reader to imagine the client/patient as who or what they wish in the … Continue reading enter your office you observe them. Their manner of dress, posture and hand gestures, even scents.

But you merely observe, that’s how you’ve been trained as an analyst: observe.

The client speaks. After a few minutes, as if being prodded (was it something they said, a reference, a countertransference?) it now consciously occurs to you: they are black.

You perk up. You realize that because of their skin color the patient must have been, at one time or another, oppressed. You need to be consistently (even, if need be, ashamedly) mindful of that.

Or at least this is what you’ve been told in recent training workshops, performed in rooms full of people over the years where no one objected. Not once.

You listen to them in your usual attentive manner but indeed something’s now off. As a psychoanalyst you’ve spent years analyzing the unconscious, a highly perceptive and reverent process that requires many sessions with a patient before any meaningful interpretation can be made.

The unconscious and “unconscious bias”

But there’s a new unconscious in the room now, one you’re expected to immediately own and respond to: “unconscious bias.” You are, you’ve been told, especially with minorities, to couple this with your newfound awareness of the “systemic racism,” of which such clients have been victims.

And surely, you think, this patient, based on a culturally accepted skin diagnosis, has been a victim.

And then something happens, or doesn’t: The patient does not bring up race. Not in the first session and then not in the fifth. Twenty. Twenty five.

You keep waiting, often seeing things through a racial lens, just to be ready—to be sensitive to it, to have the so-called “uncomfortable conversation.” You even consider bringing it up yourself because, you think, they might not be bringing it up because they’re afraid and because you are upholding this very system that prevents them from being their true self. You, after all, are a living breathing manifestation of the racist patriarchy itself!

Over time, the only discomfort you feel is that you are betraying your ethical duty as a therapist. You are no longer listening, you’re merely gauging your race-o-meter. And in the process you’re failing your patient—failing, however ironically, to offer them fairness and non-discrimination.

You go back to your psychoanalytic training: observe. In psychoanalysis, bless it, you’re required to observe. Not just the patient but yourself, by way of the countertransference. This has always been a most sacred tool.

So, you observe and you listen. The patient goes deeper into their lives and you create a connective dyad. Over time it becomes the most loving and constructive relationship of their life.

Woke and suffering

I have worked in healing countless patients over the years, from a vast array of racial identities. Race gets addressed, and indeed I work to serve as a “container” for this part of the analysis. But race, even when discussing “identity issues,” has never been the central issue of my patients’ process of healing themselves. Not once. It’s apparent there are much more important issues for them.

For some it’s childhood trauma, including sexual abuse; for others, anxiety disorders, manic and major depressive episodes, PTSD, psychosis, social phobias, suicidality, divorce, infidelity, fears of abandonment.

What my practice has taught me in working with patients (from Bellevue Hospital to reduced-cost clinics to urban high schools to Beverly Hills) is that suffering is universal. (I’ve found race is not only often irrelevant to deep understanding of this suffering, it’s often an impediment to it, though I leave that value judgment up to each patient.)

To be clear: If a patient brings up race I will dutifully listen and listen with all of me to their perspective. I owe them that, and I honor that. But no matter the societal pressure I simply will not make it the centerpiece of my inquiry into who they are.

They deserve, and receive, so much more.