Race, Gender, Sexuality, Class, Religion and Politics Belong In Therapy

How and why should we talk about race, class, sexuality, gender, politics, religion, etc. in therapy? Should you bring these topics up in the first place? In my NYC therapy practice, the definitive answer is yes.

I find in my therapy practice that people come in with a specific topic of concern: anxiety, stress at work, wanting to leave a job, fear of flying, riding the subway, panic attacks, stress in their relationships, or a traumatic event.  All reasons to get “in the chair” so to speak.  

But we bring more with us than just the topics listed above, we also bring our cultural realities. Whether we like it or not, religion, gender, sex, politics, class and race accompany us all in the therapy room. We need to include it as a topic for discussion in therapy because, most likely, these topics and experiences play into the issues that the patients walk in with.

Political and Cultural Issues Give Therapy The Whole Picture

If we don’t talk about our race, class, gender, religion, sexuality, etc. then we lose a very valuable piece that defines who we are. We leave the whole picture out. We also lose the opportunity to be closer as people.

When I was in college, I worked for an organization that broke down our boxed-in thinking about race, religion, gender, sex and class. In the organization, we made space for teens in the Southern United States to look at their experiences and biases. It was life-changing and therapeutic for some of these folks.

It also created a community of teens who could now talk about their race, class, politics, religious process, gender, sex and sexuality. Eventually, the teens would come to hang out in our office to “help.” My boss never kicked them out because she was creating space in the world for them to talk about these issues and hang. She would work while they would talk and create community.  This community of people developed a place to sit and talk about anything from race to dating to worries about their place at school or at home to the racism they experienced daily and the ways in which they were biased.  It created a place where these topics could be processed, discussed, and grown.  

We Should Talk About Our Cultural Realities In Therapy

Ideally, a similar opening up can happen in the therapy room if we create space to talk about these issues. Each of us lives in our own cultural realities. Our exploration of these realities can help both the patient and me, as the therapist, dilute our assumptions, which can widen the therapeutic process.

If we, together, talk about what it was like to grow up as a first generation American, to be the only Black man in a work environment, to take in the current election culture and how it affects emotional health or the tension between a patient’s fluid understanding of gender and their parent’s relation to gender as binary, we can understand where they’re coming from. We can see what the patients have developed and where they want to go.

Perhaps sometimes, we don’t immediately understand the impact of these issues or how to bring them up–but we need to slow down and take a look.

Creating A Safe Space For Cultural And Political Realities

These issues are often touchy and challenging to talk about. How do we create a space in the therapy room where it’s ok to delve into these cultural realities? When you want to talk about these topics, it takes trust. We have to ask questions of each other and not assume experience.

I create a space for someone to let me into their world. I have respect for who they are and their experiences as we see how this affects their anxiety, trauma, work and family life. I do not claim to know what anyone’s life is like so I have to create a space for them to tell me and for us to expand past societal biases.

We start off with the basics: race, gender, ethnicity, class, sexuality, religion practice/background or atheism, and politics. Then, we delve further. Trust develops through the experience of listening, hearing and curiosity.

Acknowledging My Own Cultural Experience

Until we get to know someone’s cultural realities, we just make assumptions and that’s just not good therapy. These assumptions go both ways, which is why it’s important for me to acknowledge my own cultural realities as a therapist. I’m a white, Southern woman who grew up in the Bible belt. That’s key. It may not need to be a big issue, but it seems essential to allow space for this too.

I’m curious about investigating the role I play in my culture and the different realities I live with. I do this by having conversations with people where they can help me help me understand the world and culture I operate in. I also keep it at the forefront of my mind so I don’t forget.

Therapy Looks At The Bigger Picture

When we talk about race, politics, gender, class, sexuality, and religion in therapy, we can create a larger context to work with and do bigger therapy. It can help us understand–and address–how cultural realities can impact anxiety, depression, loneliness and sadness, trauma and development.  Like the teen organization I worked with in the South, we can create a meaningful community in the therapy room in which we discuss our cultural realities and experiences.