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Why We Need More Therapists of Color Transcript

PLEASE NOTE: This is a minimally-edited transcript that originates from a program that uses AI.

Anita Rao 0:01
I've been going to therapy consistently for about 12 years. And in that time, I've seen five different therapists. Each one supported me through a distinct season of my life, that transition to living on my own after college, a big move and career shift and a bad breakup. All of these therapists, including the one I see now are white women. While I've talked with all of them about my personal history and family dynamics, it's only my most recent therapist who's shown that she can help me dig into questions about my biracial and bicultural identity. When I was trying to plan my wedding and figure out how to balance my dad's wishes with my desires, she was the one who gave me tools to stand up for myself without ostracizing him. When I feel trapped in a certain way of doing things, she helps me figure out how to identify my own values without judging and shaming my family or my past self. As I've now learned, therapy that honors the both and of being a person of color in this country is the kind of mental health support that many of us need to thrive. This is Embodied our show exploring sex relationships and your health, I'm Anita Rao.

The vast majority of mental health workers in this country are white. And throughout history, the mental health field has centered the experiences, perspectives and cultural norms of white folks, as my own experience illuminates a therapist doesn't need to match your cultural identity to be a good fit. But the desire to find someone who understands the racial and cultural nuances and mental health has led more and more folks of color to seek out therapists who share a similar background and push the field at large to rethink diversity and mental health spaces. Someone who's advocated for more diverse approaches to wellness is therapist to Sahaj Kaur Kohli. She's the founder of Brown Girl therapy, a mental health community for children of immigrants, and the author of "But What Will People Say?" Sahaj, welcome to Embodied.

Sahaj Kaur Kohli 2:17
Thank you for having me.

Anita Rao 2:18
So you embody a lot of firsts in your family. You're the first to be born in the West, you're the first to seek therapy, what was your family culture around mental health growing up?

Sahaj Kaur Kohli 2:30
Well, as you said, I was the first in my family to be born in the West. And so I was being raised in a household, an Indian household with a different set of cultural values, norms and expectations than that of the culture, I was being socialized. And so a lot of the narratives of self care and wellness I was being taught weren't explicit. And in fact, when I think about it, they were actually not modeled either. My dad's main priority, and everything he did was to provide stability and security. So he was always working. And my mom's job was to provide for the maintenance of the household and our day to day needs. So she was always putting herself last. So when it comes to wellness narratives, it's not really something I ever talked about in my household, especially because the household was rooted in collectivist culture, which means that I was taught that the roles we play are often more important than taking care of ourselves as individuals. So I feel like that tension that I felt between taking care of myself, and it being selfish, and wanting to take care of myself, because it actually allowed me to play those roles better, was something that I've just struggled with for my whole life.

Anita Rao 3:35
That tension really came to the forefront for you. When you first approached your parents about getting more consistent help you were living at home, you were struggling with depression, and you approached her parents about wanting to go to therapy, tell me about that conversation, and what that continued to reveal to you about your family's mental health beliefs.

Sahaj Kaur Kohli 3:57
So I went through something traumatic in my early 20s. And I was living at home at the time. And that was really when I realized I needed professional help. And so I felt really scared to tell my parents because I was still, you know, dealing with the consequences of this traumatic experience. I was falling into a deep depression. And I remember telling my immigrant parents, you know, I think I need to talk to someone else. And they just couldn't wrap their heads around it for them. They felt like they failed me in some way. Because I was struggling for them. They felt like they should be the ones who can make things better for me. And I know now that that's because that's a belief that they've held about their job as parents, but it also really led to these painful and really difficult conversations that we had to have around mental health around wellness around the fact that they can't fix everything. You know, to be totally honest, it got worse before it got better. I didn't get the help that I needed right away because my parents didn't know how to support me in that. It took me getting emotional. and physical distance from my parents and from my parents house becoming financially independent before I was even able to get the help that I know I needed. And I think that now I can have conversations with my parents around mental health around wellness. But back then they just really didn't grasp that we would even think about talking to a stranger or talking to someone outside the family about our problems.

Anita Rao 5:24
You mentioned that process of moving away, and having the space and the resources to seek out therapy on your own for the first time, tell me about your search for a therapist and how much you were thinking about finding someone who would understand your cultural background, the beliefs, the context that you came from.

Sahaj Kaur Kohli 5:44
I didn't think about those things at all, when I was looking for a therapist back then I didn't have access to kind of the content and knowledge that we have now. And instead, back then I actually was just referred to my therapist by a friend's therapist. And that was it. So I didn't know to look for someone who might be able to integrate my cultural identity or understand my family dynamics. And instead, I just went with the first person I was referred to now she's also a white woman, she is from the Midwest, she was middle age. And she was really helpful for what I needed at the time, which was really healing from the traumatic experience that I experienced. But I worked with her for about four years. And towards the end of our time together, I started to realize that I was feeling a little uncomfortable in our sessions. And I didn't have the language I have now, which is I think that I was being judged a little bit about family dynamics and norms, I remember bringing up things about what my parents expected of me. And I remember feeling like it wasn't being validated or integrated into the room that maybe the cultural norms I was being raised with were different from what my therapist assumed. And so instead, I think my therapist was trying to help me, with my family dynamics, with healthy relationships with communication styles based on a Western metric of what those look like, rather than integrating my cultural norms. And eventually, I just decided that maybe it wasn't a fit anymore. Now, that's not to say I didn't get the help I needed. But I think now I know that I would want to work with someone who can actually integrate my cultural norms and values into our sessions and into our work together.

Anita Rao 7:17
Can you give me an example of what that disconnect looked like? Because I know there are folks who talk about, you know, very overt microaggressions they experience in therapy or, you know, racist things that therapist says, but some of the examples you give in the book are a little more nuanced, where, you know, there was a disconnect going on in your mind, but it may have not been obvious for your therapist, that what she was saying was not going to register with you.

Sahaj Kaur Kohli 7:41
Yeah, so I think for me, you know, the biggest example that comes to mind in my personal journey is that my parents were visiting New York, and they were expecting me to stay in the same hotel room as them because I was a single woman at the time I wasn't married. And for them, it was very normal in my family, and in my culture, to be sharing a hotel room, different beds, with your parents. And I remember telling my therapist at the time, you know, I don't want to do this. And I remember her response being, then why would you like it was almost like, she didn't understand that this would even be an option for me and my parents. And while I don't think that she meant it in a way that was supposed to be harmful to me, it did feel invalidating to me. And I think what was happening and the language I have now is that many therapists need to do the work themselves to understand their own biases and assumptions about wellness. If my therapist, for example, believes that there should be a certain amount of boundaries and child parent relationships, then it makes sense that she had the response she had to me when I was telling her that my parents wanted me to stay in the same hotel room as them. But for me, if I was working with a client like that, I might ask, Is that normal for you? And how do you feel about that? Is that something that you are comfortable with, rather than just assuming that it's not the right thing to do? And I think those are the smaller experiences that a lot of clients have, where maybe it just feels invalidating because the therapist isn't actually showing curiosity or interest in how the client feels about the experience. And instead, they are imposing their own standards of what it should look like onto their client.

Anita Rao 9:15
I'd love to talk about how therapists get training in understanding different cultural norms, you decided to go to grad school for clinical mental health counseling in 2019. And you quickly noticed some patterns in your education that reflected some of your own experience in therapy that a lot of courses centered this really individualistic view of wellness. Can you tell me more about some of the gaps that you saw?

Sahaj Kaur Kohli 9:40
Sure. So you know, just thinking about the history of wellness in the West, thinking about the history of some of these theories and techniques and tools that are used and are evidence based and researched. They are often founded by a norm for white people. And so if you think about these theorists and where they're coming from, they're taking their own cultural views, which are Eurocentric in nature rooted in individualism and Western. And now as we go through training clinicians are being trained from that lens, even though, of course, we are working with a diverse population who may not subscribe to those cultural norms. And so in my own training, I was seeing that present in every class I took, in fact, we only were expected and required to take one multicultural class through my entire three year training. And that's quite common in a lot of these mental health counseling, or training programs, that there's only one class that focuses on multiculturalism. And if you think about the disproportionate amount of white therapist in the West, that translates to the graduate programs. So there are a disproportionate number of white professors, I was lucky enough to have professors of color mentors of color in my program, because that was something I actually filtered for when I was choosing a program. And so that helped me be able to get access to people who looked like me or shared in different cultural norms and values, to be able to think about multiculturalism, expanding my perspective on some of the issues that we were learning. But, you know, I feel like it's a systemic structural issue that we have not integrated cultural nuances into our coursework and into our training. That's why it's really important that therapists and clinicians actually do the work to understand their own assumptions and biases, because we're not really being trained to do that, except on the very foundational surface level.

Anita Rao 11:37
So how do you actually do that work to better serve clients of color? Sahaj has a pretty straightforward answer to that question. And we're going to hear what that is after this break.

This is Embodied. I'm Anita Rao. As someone who's met and broken up with my fair share of therapists, I know the importance of having a provider who really gets you and a lot of time, that means they know how to ask questions about identity, and be open to learning about the cultural forces that shape your mental health. Cultural

Erinn Scott 12:15
Cultural competency, to me means seeing clients holistically, and understanding valuing, and integrating a person's social identity markers into the therapy work. It also means being aware of and challenging my own biases that I had, and assuring that I'm not projecting my values onto others. The number one way that I try to maintain cultural competency is to not assume and instead to ask my clients, how they identify what cultural factors are important to them, and also to give permission to let me know when I might have missed something.

Lisa R. Savage 12:57
I think it's really important for those of us who are mental health professionals, to remain open, non judgmental, and curious. If we can maintain those states of mind, it gives us a lot of information. We don't go into a situation with a person from a different culture, believing that we know it all, or that we know enough to understand that.

Melody Li 13:27
We need collective liberation, not the facade of cultural competence. The mental health field upholds whiteness as default, what we need instead of so called cultural competence, is the accountability by mental health professionals to reckon with the ways that we individually and as a feel, uphold white supremacy as systemic racism and to act to dismantle it.

Susan Chung 13:56
When I think about cultural constancy, I think about cultural humanity, because I think having the humility to try to understand other people's culture or try to own that you might not be able to understand other people's culture sometimes can be more important of, you know, actually knowing people's culture. You know, like being confident in other people's culture, and Santai I believe, you can never be completely culturally competent, but you can control to her documentary to understand others.

Anita Rao 14:36
Exploring how different cultural traditions and beliefs can be a part of mental health treatment is something Sahaj Kaur Kohli has integrated into her therapy practice. Sahaj is a therapist, the founder of Brown Girl therapy, and the author of "But What Will People Say?" So you've done a lot of work to bring more folks of color into mental health spaces drawn your own background of being a daughter of immigrants and a se Asian American. And there's a lot of interesting research about how Asian American folks access therapy that shows that they're like three times less likely to seek mental health services than white Americans. What are some of the challenges that you've noted that prevent people from seeking support?

Sahaj Kaur Kohli 15:17
I think there's a lot of cultural and familial stigma that still exists in these communities around, you know, narratives that kind of perpetuate these myths about seeking mental health care, like it makes you weak, or it makes you not enough, or makes you incapable, in some way. And I think if you add on top of that some of the cultural values like saving face, were in a lot of Asian American cultures and communities, we are expected to kind of put our family reputation first. So there are narratives around don't air, your dirty laundry, don't talk about your family, or your emotions, or anything that can be perceived as negative outside of the family. And that can often cause people to suffer in isolation. I see clients all the time, who, you know, understand that mental health care is important, but still struggle to believe that they deserve care, because oftentimes, they are coming from families and from elders and ancestors who have been through quote unquote, much worse. So they start to compare their struggles to those of their family members. Well, my family abroad doesn't have access to mental health care, so I shouldn't access it, or my grandparents, you know, lived through war and trauma, therefore, my problems aren't that bad. And they start to almost shame themselves out of even believing that they deserve access to care. And if someone were to even be able to get over those personal levels of stigma that they have internalized, then it comes to finding care that is culturally sensitive, that can speak to their struggles that can serve them in ways that feel really meaningful. And that's a whole nother barrier that I see in children of immigrants and Asian Americans who feel like Okay, I'm ready to seek out this care. But now, how do I find the care I deserve?

Anita Rao 17:03
There is a lack of diversity in the therapy field. And that means that as you said, many folks can't find a therapist with the same racial or ethnic background as them that that doesn't mean that they won't get good care. And I know that you take a lot of effort to make sure that clients who don't share your background feel seen and supported. What are some of the tools that you use to do that, to continue your own work to support them.

Sahaj Kaur Kohli 17:29
It's about having humility. And I think, for me, even if I have clients who come to me and say, you know, I really love the way that you talk about mental health, or I am also Indian American, I want to work with you, I will always say, that's great. And I want you to know that I'm always going to ask questions, I will never assume that your relationship with your culture is the same as mine, or that your goals are going to be the same as mine. And that is that is what I want therapists to take away from this conversation is that having humility, understanding that you don't know everything, that a person, an individual is an expert on their own life, on their own goals on their own relationship to their roots, and their cultural identity is how we can empower them to have agency but also how we can start to understand how we might be able to help them. So I never assumed that I know everything. And I think it's really important, you know, to ask questions, to be curious to integrate culture and family, I always ask my clients, you know, is there anything that I could be watching or reading to help me understand your experience or understand your culture or understand, you know, your country of origin. And I think that my clients really appreciate that, because they will sometimes give me like a short doc to watch or short story to read. And they'll say, you know, this is something that really speaks to my experience. And it helps us build a level of rapport. Because at the end of the day, the number one indicator of success in therapy is a client's comfort with the therapist. So you don't have to share an identity with a client, in order to be able to serve them. You just want them to feel comfortable enough, psychologically safe enough to be able to open up to you. And that's why curiosity is so important in this work.

Anita Rao 19:05
I want to talk about some of the particular work that you do in your therapy that you talk about in your book. But what will people say and as I was reading it, I was just really like, nodding so aggressively, to find myself in community with other folks who have had the experience in therapy around things like boundaries, something that we hear, Oh, this is so good for your mental health, like you need to learn how to set boundaries. But in my family culture boundaries is not a word that anyone knows it's not a word that would be really comfortably accepted. If I were to just say, Hey, I'm doing this because I'm setting a boundary. So I'd love to know how you think about boundary setting as a therapist who's aware that that might not work in some family cultures that are more hierarchical.

Sahaj Kaur Kohli 19:53
Western messaging around boundaries really doesn't apply to so many of us who come from collectivist cultures. So when I'm working with clients, you know, boundaries is one of the biggest, you know, themes and topics that come up in my work that and guilt, guilt, that maybe setting boundaries is bad guilts that they're not enough of their cultural identity, guilt that they're letting down their parents or their family in some way. But when we talk about boundaries, you know, I always have to broach and probe my clients to think about their relationship with that word, what is the messaging that they have internalized about setting boundaries? Right? It's often what we've been taught in western messaging around boundaries, which is just say, no, just cut out toxic people. And like you said, that doesn't speak to so many of us who actually value these relationships and want to retain and maintain these relationships. So how do we take care of ourselves while also maintaining these relationships and setting boundaries where we need to, often I will have clients pick another word. Sometimes I have clients use a word in a different language that speaks to them. Sometimes I've had clients say the word compromise feels better to them, right. So even just choosing a different word, and just forgoing the term boundary altogether, will sometimes help my clients explore the concept without using that word, because that word is so loaded to them. And when it comes to setting boundaries, right, one of the biggest things I see with people who come from collectivist cultures, is that we're less likely to set verbal boundaries. So what we do instead, and what I work with my clients on is how can you set behavioral boundaries. And that might look like you know, not picking up the phone when you're not ready to talk to someone going home. But going home for less time, or setting plans while you're at home. So you're not at home with your parents for as long as long as you would have been right. So thinking about things that you can do to help protect your mental health, that doesn't involve you having to verbally state that boundary with a loved one, because that's not going to be received the same way we talk about it in the Western world.

Anita Rao 21:52
One of those other tensions between the individual and the collective that I know has come up in my own therapy work. And I've talked with other friends who are children of immigrants or friends of color who feel like okay, even if I do this work, my parents aren't going to change. So how much is it really worth or what's the point are there reframes that you offer to folks who feel this way about seeking mental health support for themselves?

Sahaj Kaur Kohli 22:17
Absolutely, I get that question all the time. And when it comes to the question of, you know, my loved ones aren't going to do the work. So what's the point of me doing it, I like to tell people that we can leave bread crumbs for our loved ones. So when we do this work, when we learn tools, when we learn skills, we can start to model that behavior. And even more than that, we will learn how to show up differently in those relationships. And when we change, everything changes, when we make different decisions about how we respond or don't respond in a relationship, that other person will respond differently, when we can focus on ourselves and how we are enabling the dynamic, how we can show up differently skills we can put in place that can help us manage our own emotions during relationship conflict and tension. And I think that's really important for people to remember is that doing this work is for yourself. It's not for other people. And when you change the relationship changes,

Anita Rao 23:09
What are some of those bread crumbs that you've seen come to fruition in your own family dynamic with your mom or with your dad?

Sahaj Kaur Kohli 23:18
I think you know, it's been really interesting because looking back now I can see all of those breadcrumbs, but I didn't realize I was leaving them. So it took me going to therapy to even be able to work with my therapist to find ways to tell my parents I was in therapy. And you know, learning those communication skills helped me broach conversations with my parents that were more vulnerable and intimate, I was able to talk to my parents about my mental health. They didn't always agree or understand. But it allowed me to feel some agency over sharing this part of myself. And I think as the years went on, I was able to see that the communication skills and the regulation skills that I learned helped me broach my relationship with my parents differently. So with my dad, for example, I was I would always get really heated when we were in any type of conflict, I would get really defensive, I would get really upset. I would get really angry. I didn't know how to manage my emotions. But slowly I was able to realize that I could slow down, I could take pauses, I could ask for clarification, I could approach the conversation from a different perspective. And that allowed us to have different types of conversations. And even more just being in therapy and validating my own mental health struggles and emotional struggles. I have been able to give that back to my parents, I've been able to reflect back to them that they might be struggling that maybe the fact that their feet hurt so much is something that they're doing every day that is leading to levels of stress, that maybe because they have a headache, they're overworked. And I've been able to reflect that and validate their own mental health and emotional health and that's allowed me to feel a level of connection with them to be able to offer that to them.

Anita Rao 24:56
I want to zoom out a little bit and talk about your work. In the therapy field, and we've been mentioning, there's this really high demand for therapists of color because there aren't very many of them, they make up only about 40% of the workforce. So there's a really high burnout rate for a lot of therapists of color. What are some of the structural supports that you'd like to see to help folks stay in the field more sustainably?

Sahaj Kaur Kohli 25:22
Oh, I always laugh when I get this question because there are so many structural inequities when it comes to becoming a therapist. And it's something that I didn't realize until I went through the program myself. So, you know, many therapists who even make it through a master's program don't make it to the licensure stage. And that's because often there are requirements around unpaid internships, low paying jobs and salaries leading to debt and unlivable wages, even the amount of restrictions around hours and time requirements for getting, you know, the hours and supervision one needs to get to licensure, is inflexible and doesn't allow for our family struggles, family planning, right also often doesn't come with paid time off. And this can lead to burnout. So as you're saying, there are so many things that stop people from even finishing getting to licensure, even if they started. And I think that, you know, what I would like to see is that there are more scholarships and fellowships offered for especially bipoc People who want to become therapists. I think that that is really important, because I think, in general, right, if you are just a lay man, looking at the mental health field, you feel like it's not made for you, that is a near common narrative in communities of color, because we don't see ourselves represented. So a lot of people will then look to becoming a therapist and feel exactly the same way. Well, what's the point because I'm going to be trained in a certain way. So I would love to see there be more accessibility and funding for people to become therapists. I would love the course and curriculum to be more diverse to allow for cultural inclusivity. And sensitivity and integration into this work. And then even more systemically, right, like insurance rates are really low therapists don't get paid all that? Well. I would love to see more systemic changes in how therapists are valued and paid in this country.

Anita Rao 27:18
You do so many different things within the therapy world, you straddle a lot of different worlds, you are therapists, you see clients one on one, you create content online for Brown Girl therapy, you are an advice columnist at the Washington Post. And I know that in your past experiences, you've gotten advice, at least during school you did from a professor who said, Don't do any public facing work, like that's not what you're supposed to be doing. As a therapist, I'd love to know how you figure it out your own personal philosophy around straddling these various worlds in the mental health landscape.

Sahaj Kaur Kohli 27:55
You know, when my professor told me that in the beginning of graduate school, I remember feeling like I had to leave the field altogether. And I will say it was those very professors of color and mentors of color, who helped me find my path. And I think it was really important for me to have people who looked like be helped me figure out what integrity and ethics looked like in the work that I wanted to do. A lot of times, you know, we are told as clinicians to be a blank slate. And I don't think that that is a culturally apt way to look at being a therapist, I think connection is from showing up as a human right showing up as someone who is embodying all of their identities, cultural identities, racial identity, sexual gender identities, religious identity in the room with your clients. And I find that that's how I have gotten my clients is because I've been able to be so honest about my own experiences, about my own relationship with my identity. And I think it's really important for clinicians to understand that by being a blank slate, you're not leaving much to the client to feel comfortable with you. And knowing you, I have lots of clients who are Asian American who will come to me and say, I want to know a little bit more about you. And of course, we'll talk about why. But I think that they have that desire, because we come from cultures where being connected to people is so important. So being a blank slate just doesn't feel right to me. And I think, you know, I love being a therapist. I love the clinical work I do. But I've had to be very honest with myself, that it can't be the only thing I do because it is really exhausting. I find that balancing it with other forms of mental health work and advocacy really helps me prevent burnout, but feel like I am able to do this work in multiple different ways. That I'm not only just helping individuals on the micro scale, but I'm also helping in the macro scale of D stigmatizing mental health and creating accessibility in the field.

Anita Rao 29:47
I would love to end on a message that I've seen you share in multiple different ways and share often in the brown girl therapy community, which is that while you want folks to have resources to support their Mental health, you encourage people to seek out support, you also want people to know that they're not a project that needs to be worked on all of the time. And I want to hear how you've struck that balance in your own life.

Sahaj Kaur Kohli 30:14
It's really hard. You know, I have spent my whole life craving personal development content, I think we are all products of kind of a commodified wellness, you know, system in which we are told that there are things that we can always be doing to be better people have better lives have healthier relationships. And that's all great, right? I think that it's great that we have access to all of this content. I think it's great that we all do this work, I love doing this work, and you are allowed to just do you're allowed to play. And that is something that I have integrated into my own life is just leisure reading, right reading books that are romance and thrillers that I might forget in one week, but because I enjoy it, playing board games with my friends, right? I think so many of us get caught up in trying to prove or show what we're doing and having something to show for our time. But instead, I want to remind people to just enjoy how can you integrate joy into your life today? And that is a question I asked myself all the time. Because I also want to remind myself, I'm not only worthy by what I can do for other people or what I can produce, I'm worthy just by being a human being.

Anita Rao 31:22
Finding that balance between self care and self improvement is tricky. I know from all the years that I have been working on it. But as Sahaj mentioned, even starting that journey to find good mental health support can be challenging. Just ahead, we're going to meet someone who has made a career of figuring out how to meet people where they are, stay tuned.

This is Embodied. I'm Anita Rao. Therapists of color are no strangers to the barriers that prevent some of their clients from seeking mental health support, from cultural messages about therapy being just for white people to the realities of how difficult it can be to find a provider who understands their background. So anticipating those barriers and meeting clients where they are becomes a core part of many providers' work.

Erinn Scott 32:16
Ways that I seek to bring more people from marginalized backgrounds into the mental health space is to acknowledge the history of harm that has caused suspicion and distrust in the mental health field. As well as help clients find ways to uphold their cultural values. I talk to clients all the time about how they can both pray, and go to a therapist, that one action does not have to negate the other.

Lisa R. Savage 32:41
I got tired of my expertise being discounted. And so I've formed clinicians of color to elevate bipoc mental health professionals, they bridges the gaps or bipoc community members, but allow them to can walk put someone who was liked and I also am a strong proponent of taking mental health services to people so my private practice is centered on community based services.

Susan Chung 33:09
So being school I'll be attending their meeting or I be other space, you know, so to really kind of show my presence so I can get to know them. They know okay, I hear they can kind of talk to me, or in the community, you know, back then I will go to nearby maybe the senior center where the ISP mentor is already aware of a lot of Chinese immigrants senior will be when they feel that you're there for them. They're more willing to listen and to understand.

Melody Li 33:40
Collective liberation is central to our work at inclusive therapists and mental health liberation. We amplify the voices and expressions of neurodivergent and disabled communities of color. We're a movement creating change through decolonial education, collective care, and activism.

Anita Rao 34:04
One person who works to bring in more diverse clients to his practice and approaches therapy from a social justice framework is Jor-El Caraballo. He's a therapist and writer who authored the book, "Self-Care for Black Men." Hey Jor-El, welcome to Embodied.

Jor-El Caraballo 34:18
Thank you so much for having me.

Anita Rao 34:20
So you grew up in North Carolina, and I've heard you describe yourself as a highly sensitive child. Can you tell me a little bit more about the dynamics in your family growing up around talking about feelings and talking about mental health?

Jor-El Caraballo 34:35
Yeah, sure. So growing up in a small sort of rural town in North Carolina. It was interesting because of course, I was this dark skinned black boy who really felt big feelings as a young person and in my household and in my community, we weren't really talking a lot about feelings or emotions. hence, it's not to say we never did. But it certainly wasn't a normal topic of conversation. And so I think it was a bit difficult to figure out, how do I exist as I am naturally with all these feelings and learn to cope with them, when the environment wasn't sort of prising or encouraging sort of what I felt was happening for me naturally.

Anita Rao 35:23
So what did you know about therapy? And who provided it as a kid? Did you see any models around you have that kind of work?

Jor-El Caraballo 35:31
Not really. And I think that's in large part, what took me a bit longer to sort of appreciate anything about mental health and sort of the formal aspects. And I think that my only exposure to therapist was through the TV show Frasier. You know, it's still an Ironically, one of my favorite TV shows, you know, so obviously, you have these characters who are two white men, right. And so to me, sort of that understanding of psychology and analysis was very much a white thing. And those sentiments were echoed in, you know, my family and community. And there's also this strong culture of, you know, you don't talk about things outside of your family experience. But the reality was, a lot of us also weren't talking about them within the family. Right. And so, being able to see these examples sort of opened up the world for me a little bit, but I didn't see it as a viable vocation until, you know, I arrived into high school and was exposed to psychology more formally.

Anita Rao 36:39
Yeah, you have this college level psychology course and a teacher in there who really piqued your interest in therapy and in psychology as a field. I'm curious what in particular, made it seem like a profession, that would be a good fit for you for your personality for your interests?

Jor-El Caraballo 36:57
Yeah. I don't know. She'll listen to this. But I hope she's doing well, Mrs. Romek, you are great. You shout her out every time that I can. Because I think what was really striking for me at that point in my life was, I was sort of approaching this desire to embrace authenticity more, even though she was very different from me. She was, you know, zany, and interesting and a bit awkward. And I think what I saw in her was the possibility to be able to really be myself, and also do something that was a high value in my home was helping people and supporting people. And so psychology became this very clear pathway for me to utilize sort of like my natural skills and abilities, using my sensitivity, in the application of really helping people live the lives that they want to live.

Anita Rao 37:55
I want to talk about how you began to kind of find your way within this field through grad school. So you mentioned kind of growing up having most of these models that were really white therapists kind of white culture dominated representations, you went to a school that did integrate diversity more into the therapeutic curriculum, which is not always the case for therapy programs, we heard earlier from a hedge about how she had just one class that focused on multiculturalism. So talk to me about your training and how you feel like the principles around race and culture and inclusion were integrated into your training.

Jor-El Caraballo 38:34
You know, I attended undergraduate school at the University of North Carolina Wilmington, which is a predominantly white institution, and loved my experience there had a wonderful experience. But also it was sort of more of the same of that psychology as this. And it's only through this one lens that we can understand human behavior. And I think that that influenced how I arrived at Teachers College, and why I saw it as a really important option for me, because all of the material that I was exposed to about the program, said like multicultural, mental health, multicultural perspectives, was a thread that went through every course, we were talking about immigration status, we're talking about sexuality and gender identity, and how that influences all these wonderful theories of human behavior in psychology, and how we apply that to very real people in the real world.

Anita Rao 39:30
So you have been a practicing psychotherapist for about a decade and you've developed your own particular philosophy and approach to the work which you describe as grounded in social justice principles. And I'd love for you to help us understand what that means in particular for how you approach working with clients, one on one,

Jor-El Caraballo 39:48
Anyone who comes to work with us, we don't treat disorders we work with people and that means being able to explicitly discuss not only The history of things like racism or sexism in our world, and the impact on our mental health, but also what's happening now. Right, so being able to speak very plainly about the challenges of our socio political climate, being able to explore how you navigate capitalism, which is, you know, designed to get every drop of energy and productivity out of you, and how that's a challenge to your mental health. And so we were really focused on helping people have those conversations very openly, in the space of therapy, which I don't think has been the norm for a lot of folks.

Anita Rao 40:39
You also bring yourself into the therapy room in a more full way. And that's something that's a hedge also talked about is kind of figuring out her own philosophy around how much she discloses and how that might be different than what she was taught in her like ethics 101 class in grad school. So talk to me about your approach to disclosure and how you think about your the identity that you're bringing into the room with clients.

Jor-El Caraballo 41:03
Yeah, so despite, you know, my program, being, I guess, very like forward thinking, in some ways, when it came to self disclosure, I had the same experience in which, essentially, you know, most of our advisors were saying to us, like, Don't ever say anything about yourself in the space of therapy, which is also really interesting, right? Because there are things that we telegraph, no matter what. So, you know, I don't have to disclose my skin color to people, it's already in the room, right? There are some assumptions and ideas already formed, right, once we enter the space together. And so my approach and the approach that we take in our practice is saying, we show up as humans first, there are still professional boundaries, there's only so much we're going to share. But I think it's important to acknowledge it, for instance, in my work with black male clients, that I also walk in the world as a dark skinned black man. And so I do know what it's like to be existing in a public space where some people will look at me cautiously, right, and what that feels like in the detriment of that to my mental health. So we should be able to speak about that openly in the space of therapy. So people want to have support, and then figure out how can they navigate that, so that they can take the best care of themselves.

Anita Rao 42:30
You mentioned talking and working with black male clients, and I know that's a population, you're really passionate about reaching through your work. And you have thought a lot and read a lot about black masculinity and the pressures black men feel to be stoic and only show certain emotions. And I'm curious about maybe an example that you have of how you do that kind of work to open people up to a more varied emotional landscape in your work with other black men.

Jor-El Caraballo 43:01
I think first and foremost, my visibility as a provider is really important. And so in the things that I do outside of the therapy room, I'm trying to normalize men talking about emotions, and more emotions than just anger. Right. But I think within this session, a lot of the work that I do with black male clients is helping them understand that in order to take care of our mental health, we need a robust emotional vocabulary. And so figuring out how you differentiate between, okay, what's frustrating versus annoying, or irritability versus anger? What's the nuance there, in developing that language with people and helping educate them, so that, yeah, they can one understand themselves, and then feel really empowered to speak about their experiences, clearly to the people around them, so that they can have the kind of support they want. And they can have the relationships that they find fulfilling.

Anita Rao 44:03
I'd love for you to continue that thread with kind of helping me understand how you work with folks who are bringing these systemic issues into the therapy room with you, you gave an example and in a blog post that you wrote about someone that you were talking to in the wake of the killing of Ahmaud Arbery, who asked you can we heal if things like this are always going on? So how do you how do you handle that in the moment with clients who are opening up to you about recognizing these systemic forces, but also wanting to build resilience and to build tools for self healing?

Jor-El Caraballo 44:39
I think that so much of it starts with the actual acknowledgement of the breadth and depth of their experience and their response to it. Because I think that while we are so exposed to really harmful content, I don't think that we're actually having full conversations about what it's like to see that, right and giving people the space to talk about what it's actually like to experience that as indirect trauma, and then sort of figuring out for them as an individual. Okay, so now we know the state of the world, we know that this thing happens. We know that, in some ways, it's not going to stop anytime soon. So what are the ways that you as an individual can cope in your own day to day life? And then what are the communal and other structural things that might be helpful for you to undertake, so that you feel more empowered and in control of your experience and influencing change?

Anita Rao 45:40
I love that. And I love to know how you I mean, you do a lot of writing work, you do both interaction with people one on one, but you also create a lot of content for social media, you've created a series of meditations for folks to help guide kind of healing work, are there any particular ways that writing has helped you communicate different kinds of messages about mental health than what you're able to do in like a one on one session?

Jor-El Caraballo 46:06
I don't know if the messages necessarily are, are different. But I think what's really powerful about writing for me is, is that enables me to communicate those same messages with a much wider audience, for a myriad of reasons. Black people, people of color may not find themselves in therapy, whether it's, you know, because of the historical trauma in medicine for people of color, whether it's accessibility issues of cost, or insurance and time, off from work and other responsibilities. Right. All these are barriers to people. And so with writing, I like to think of it as an extension of my clinical work, and introducing people to these ideas, continuing to bolster their understanding of psychology, whether or not they're able to have a therapist of their own.

Anita Rao 46:56
We've been talking about your personal philosophy and approach to this work throughout this conversation. And I would love to end on a piece of your philosophy that I really loved reading about, which is that you like to use humor, and you like to bring popular culture where relevant into your therapeutic practice. So can you talk to me about how you think about humor as a tool for healing?

Jor-El Caraballo 47:22
I think a lot of what we're dealing with, especially now, in in our world, and in our culture, is so absurd. And so I think that it's important that we just allow space to acknowledge the absurdity. And how sometimes laughing about those things, can really provide a great sense of relief and catharsis, right? And so I take this approach of yes, sure, not everything is funny at every moment, but being able to access humor and laughter, and even joking, right in the space of therapy, really promotes that safety and promotes the space to continue the work. Right. If you feel safer to laugh, you feel like your therapist is an actual human being that lives in the world. What could the next part of that conversation then be like? How much more open? Are you willing to discuss something that's difficult, or find ways to explore ways to move forward in your life because you're having an experience that also feels human?

Anita Rao 48:23
Jor-El, I have so enjoyed learning about your philosophies and your approaches to this work. Thank you so much for the conversation.

Jor-El Caraballo 48:29
Thank you so much for having me.

Anita Rao 48:38
Embodied is a production of North Carolina Public Radio-WUNC, a listener-supported station. If you want to lend your support to this podcast, consider a contribution at wunc.org now., special thanks to Lisa R. Savage, Erinn Scott, Susan Chung, and Melody Li for contributing to this week's show. We appreciate you. This episode was produced by Kaia Findlay and edited by Amanda Magnus. Jenni Lawson is our technical director Quilla wrote for the sick. If you have thoughts after listening to this episode, we would love to hear them. Leave us a voice note in our virtual mailbox. SpeakPipe. You could also write us a review. Let us know why you listen to this show. Until next time, I'm Anita Rao, taking on the taboo with you.

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