In May 2020, early in the covid-19 pandemic, Eleanor Gil-Kashiwabara, PsyD, was in the process of building a private practice and consulting business focusing on culturally informed care for clients who are Black, Indigenous, and people of color (BIPOC). Then George Floyd was murdered, and she was suddenly fielding numerous calls from social service agencies that were already overwhelmed by the pandemic and needed her help in addressing issues of racism.
“Many of these organizations were [theoretically] interested in this work before,” she said, “but now they were prioritizing it.”
As a result, Gil-Kashiwabara, who is Latinx, pivoted from developing her private practice to spending much of her time consulting with agencies on how to improve their cultural climates—everything from supporting organizational leaders in understanding how their policies might be contributing to racism to helping organizations find more culturally appropriate ways to serve their clients.
Gil-Kashiwabara is one of many BIPOC clinicians for whom the pandemic and social unrest have offered new opportunities to bring racial and cultural awareness to their work. She and others are moving beyond Western forms of therapy and conceptualization to incorporate a larger understanding of systemic inequities and their impact on people individually, collectively, structurally, and multigenerationally. Because such information is lacking in most graduate training or in evidence-based practices, many BIPOC clinicians are incorporating their lived experiences and emerging literature on racialized trauma to bring culturally competent care into their clinical practices.
Besides making culturally informed adjustments in private practice, relevant interventions include Indigenous modalities such as healing circles and storytelling; bodywork such as dance and “body positivity” (accepting and honoring your body as it is); spiritual practices and connecting with faith leaders; and psychosocial tools to challenge racism or implicit bias when they occur.
Collectively, such approaches lead to what some BIPOC psychologists call radical healing.
“Radical healing is where individuals rely on the cultural strengths of their particular communities to survive, to thrive, to exist,” said Helen Neville, PhD, a professor of educational psychology and African American studies at the University of Illinois at Urbana-Champaign who studies this concept. “It identifies each racial, ethnic, or cultural group with a series of cultural strengths that they can use to adapt and contribute to society.”
Here are some ways that BIPOC psychologists have been using these ideas in practice.
Healing through informed therapy
During the pandemic, Washington, D.C.–based clinical psychologist Jessica Smedley, PsyD, saw themes among her Black clients that weren’t too different from what psychologists were seeing in general—grief and burnout, relationship stressors, family stressors.
But her clients’ specific racial backgrounds gave extra dimension to their experiences, she said. For example, many were torn about whether to join last year’s protests against police brutality, fearing that they would contract the coronavirus.
“There was a lot of ambivalence, despair, grief, and anger [related to the murders of George Floyd, Breonna Taylor, and others],” she said. “But because of the pandemic, there were a lot of people who opted not to protest who normally would have, and that confounded stressors that were already there.”
Besides encouraging these clients to use self-care tools such as tapping into their faith beliefs and getting exercise, she urged them to identify creative ways to engage in social justice work including writing letters to lawmakers, making donations to relevant organizations, and helping elderly neighbors with groceries or rides.
“I shared that there are other ways that we can show up and support our community,” she said. “It helped people think outside the box.”
In her New York–based practice, clinical psychologist Carmen Inoa Vazquez, PhD, ABPP, noticed a rise during 2020 and into this year in feelings of shame among Latinx women about how their appearance and identity failed to meet White norms—in her assessment, a trauma reaction to disturbing external events.
“My Latinx clients had pretty much the same reaction—they felt all of their old body image and identity issues relating to previous struggles coming back,” she said. “It’s the feeling that no matter how hard you work or how much you try to fit in, you don’t.” For female immigrants, those feelings were compounded by trauma related to migration, including fleeing from oppression in their countries of origin, trying to survive in and adapt to a new culture, and feeling unsafe, she said.
To add to these issues, COVID-19 quarantining led to an exacerbation of relationship problems in many Latinx women who struggled with cultural and gender norms, Vazquez added. These included feeling pressured to be an uber-caregiver while working full time, and upholding marianismo, the gender role ideal that expects women to be nurturing, self-sacrificing, and patiently tolerant. These cultural presumptions were very difficult to attain during the pandemic and brought guilt and conflict to many households. Because many of Vazquez’s clients weren’t able or didn’t want to live up to those standards, gender tensions rose and domestic violence increased, leading some marriages to end in divorce, she said.
To help her clients work through these issues, Vazquez used a number of culturally informed methods, including “theory in the flesh,” first articulated by Chicana activist Cherríe L. Moraga in 1981. It emphasizes “accepting and loving yourself, your body, your skin color, as you are, not as defined by outside norms,” Vazquez explained.
She also encouraged clients to share their personal stories and histories in a narrative fashion, known as testimonio. In that context, she provided information on the individual historical contexts for these experiences in order to illuminate her clients’ stories. This type of work, she believes, can empower women psychologically because it encourages them to talk directly about their unique personal experiences in ways that incorporate sociological and psychological understandings of culture, migration, gender, and agency.
“Once you find your voice in this way, you have a personal understanding that goes in conjunction with sociopolitical and historical experiences of oppression and trauma,” Vazquez said.
Healing through groups
Other BIPOC psychologists used innovative group formats to facilitate expression and healing in the wake of COVID-19 and racial awareness protests.
At the beginning of the pandemic, for example, the Association of Black Psychologists Inc. (ABPsi) launched the Sawubona Healing Circles, virtual gatherings held in the United States and abroad that are grounded in African-centered values like trust, reciprocity, collectivism, and acknowledging the divine spirit in each of us, said ABPsi President Theopia Jackson, PhD. Sawubona is an ancient Zulu greeting that loosely translates as, “We see you”—meaning that one person sees the other both individually and with the collective spirit of their ancestors, she explained.
“We designed the circles as soon as we realized we were in COVID because we didn’t need to wait for statistics to tell us that our communities would be hit the hardest,” she said. “And we knew that if we helped to culturally ground our people, that they’d be in a better position to counter the systemic racism and racial trauma that they are exposed to,” whether from health disparities or from racist encounters with police or others.
Toward this end, participants were able to share stories, bear witness to the adverse impact of racial trauma, deepen their understanding of African wisdom, and promote individual and collective wellness and cultural coping strategies, Jackson said. Throughout the process, facilitators used African proverbs, culturally meaningful quotes, music, meditation, and other cultural tools, while inviting participants to recognize and express appreciation for their ancestors.
“The Sawubona Healing Circles are not therapy, yet they are therapeutic,” Jackson said.
In another effort, clinical psychologist Aakash Kishore, PhD, an LGBTQ+ veteran care coordinator at the VA Portland Health Care System in Portland, Oregon, ran support groups for LGBTQ+ veterans of color throughout the pandemic. A big theme, Kishore said, was loneliness.
“For some of these veterans, group was the only contact they had during COVID-19,” said Kishore, who uses they/them pronouns. “Many of these folks lost huge swaths of their community” during the AIDS crisis, “so to have survived means that many people who were their closest family died.”
The racial protests and heightened racial awareness also spurred Kishore’s clients to become more attuned to the internal effects of systemic racism, transphobia, and homophobia, they said, and to the ways that an inherently racist and largely cisnormative and heteronormative system presses them to tamp down their true selves, emotions, and bodily reactions.
To counter these reactions, Kishore encouraged clients to accept and value themselves as they are: “I try to create a little space for ‘I’m OK. I’m OK in my own body. What I’m feeling right now is right, is OK, it fits. I don’t have to get rid of it, I don’t have to change myself.’”
These group formats also highlighted the power of community, Kishore added. “Group members have been able to uplift each other and to find humor” even in painful life events such as being misgendered, Kishore said. “Knowing there is a place they can be fully seen supports resilience.”
Healing through faith communities
BIPOC psychologists have also connected with leaders and members of faith communities, helping them to incorporate mental health and social justice ideas during a stressful time. Congregants have suffered stress and trauma both from the pandemic and from social unrest, leading to expanded needs related to COVID-19 sickness, job loss and economic distress, trauma from racism, lack of child care, and more.
To help address these stressors, a number of Black psychologists, for example, have partnered with Black churches because of their important role in Black community life. Black Americans place strong trust in their pastors, and these churches have traditionally been champions of justice, liberation, and equity. Psychologists have run mental health workshops to help clergy and parishioners explore how the stress of racism and the pandemic might show up—for example as anger, exhaustion, or tearfulness—and to offer healthy coping strategies. Psychologists heading these workshops have also sought to destigmatize therapy by pointing out that mental health practitioners and clergy are working toward the same aim: to nurture people’s mental and spiritual well-being.
In one such effort, Smedley partnered with a pastor from her former home parish, the Friendship Missionary Baptist Church in Vallejo, California, to offer psychoeducational support related to the pandemic and racial protests during online Bible study groups and virtual worship services. While the pastor shared relevant biblical passages from a Black theological perspective, Smedley provided ideas on how parishioners could cope with painful feelings and reactions resulting from current and past traumas. During the Good Friday service, for example, she used text related to Christ’s suffering and crucifixion to highlight parallels to racial trauma and to discuss the importance of validating such trauma and connecting with supportive people as ways toward liberation. She also offered tips for psychological and spiritual coping, for seeking professional help, and for engaging in activities that help people feel liberated on a personal level.
Smedley also ran a virtual support group for Black clergy in Washington, D.C., part of her role as coleader of a D.C. Psychological Association COVID-19 task force during 2020. These faith leaders faced challenges including anxiety, depression, stress, and income loss, as well as difficulties in trying to preside virtually over a large number of COVID-related deaths coupled with profound COVID-related grief. In general, many pastors struggled with not being able to see parishioners in person, some of whom were not familiar with or did not have access to new technologies.
“Many of these leaders thrive and gain energy from being able to see their members,” Smedley said. “So not being able to show up at the home or the hospital during COVID-19 was really detrimental to their identity as pastors.”
The groups helped the ministers feel more connected to each other and get fresh ideas on supporting their congregations, she added. “It was an honor just to hold that space and say, ‘Hey, this is what you all are feeling, your feelings are normal, and here are some ways to cope.’”
Healing through organizations
BIPOC clinicians have also been working with organizations to improve their multicultural competence and address issues of racism during this stressful time. As Gil-Kashiwabara began working with social service agencies and schools, for example, she started to hear common themes and needs, specifically the need for education on the roots of discrimination and for guidance on culturally based solutions and interventions to address racism.
In San Diego, clinical psychologist Debra M. Kawahara, PhD, of Alliant International University, received calls from several companies requesting her help in supporting their Asian American and Pacific Islander (AAPI) employees in the wake of COVID-related anti-Asian rhetoric and subsequent hate crimes.
In small group discussions, Kawahara encouraged the employees to share their thoughts and feelings about what it felt like to be an AAPI person in the current climate, as well as in general. They talked about feeling invisible and wanting to be more fully seen and heard by others in and outside the workplace, being assailed by microaggressions and wondering how to respond, and facing safety concerns related to anti-Asian hate and violence. Having these conversations “really seemed to activate these employees to want to have more of a voice in their workplace,” Kawahara said.
These efforts were a start, but they underscored the need for much more work in the area, she said. Fostering a climate of diversity, equity, and inclusion “needs to be part of an organization’s strategic plan that includes goals as well as accountability outcomes related to their progress,” she said.
That goes for the country as a whole, Kawahara added. “It’s up to all of us to dismantle racism, the oppression, the discrimination that we see happening in our society,” she said.
