Rhonda and I are proud to feature Audrey Kodye, a psychologist
with a private practice in Canada, and Sunny Choi, LCSW, who
specializes in the treatment of underserved populations in the San
Francisco Bay Area. In today’s podcast, these beloved TEAM-CBT
therapists bring us an important discussion on the impact of
racial, gender, religious and sexual bias, including tips on how to
incorporate relevant questions into our initial evaluations of all
new patients, as well as illuminating ideas on how to maximize
treatment effectiveness with TEAM-CBT.
Both Audrey, who was born in Mauritius, and Sunny, who was born
in Hong Kong, describe their experiences with bias and violence,
both when growing up, and as adults, and how these experiences
shaped core feelings of not being “good enough.”
Sunny explained that how he incorporated the negative messages
that were triggered by his traumatic experiences:
I grew up in a privileged family in Hong Kong, and was favored
as a male child. When we came to the United States, I was 12 years
old and undocumented. I got beaten up because I had slanted eyes,
and I was hated because I was gay. I worked super hard, getting a
degree in engineering from UCLA and a master's in management from
Stanford, and became successful, but got more and more depressed
due to my belief that I “wasn’t good enough.”
Now I work with marginalized populations, the poor, people of
color, LGBTQ, immigrants, and abused women.
Audrey said:
I’ve also felt like I wasn’t good
enough. . . . I’m a light-skinned black woman from Africa, from a
lower-class family in Mauritius. . . . My ancestors had to be very
resilient due to prejudice, and I’m very proud of them. I’ve also
struggled with social anxiety and depression due to the racial
trauma I’ve experienced.
Sunny and Audrey have both been
helped by TEAM-CBT, and feel it has a great dealt to offer and have
appreciated that diversity is celebrated in the personal work so
many people do in David and Jill’s Tuesday training group. They say
that “TEAM has helped us and our patients as well!.”
They gave some valuable tips on how to incorporate diversity
awareness in to treatment with TEAM, but the same tips would be
helpful to anyone interacting with a friend or colleague who may
have been the victim of abuse.
Sunny added:
“I got scared and anxious when
thinking about this topic prior to today’s podcast. What I’ve been
through has definitely shaped my behavior, my thinking, and my
feelings, and the hatred is still happening today.”
He tearfully described the experience of his cousin who has a
Chinese restaurant in Oakland, and someone threw a rock through the
window to act out on their hatred for Asian Americans.
Audre said:
"I also felt sad and anxious while
preparing for the podcast. It’s not easy to talk about racism and
discrimination, and I felt a lot of self-doubt about my own
experiences with racism and discrimination before the podcast,
because they have so often been invalidated. People get defensive
and are often incredulous. They don’t believe it. So you run into
conflict and opposition and defensiveness when you try to speak
out."
David agreed and emphasized how sensitive and defensive people
can be when our “blind spots” are confronted, especially when we’ve
been in a state of denial, thinking of ourselves as totally
innocent when we’re not!
They discussed three keys in thinking about racism and
discrimination:
Systemic racism: the Five Secrets of Effective Communication
can be helpful. For example, it is important to acknowledge the
anger your patients may feel because of the injustices they
experience.
Micro-aggression: These are subtle put-downs that may sound
like compliments, and might even be intended as such, but are
really hurtful. For example, when learning that Sunny is gay,
someone may say, “Well, Sunny, you certainly don’t act gay!” This
statement, which might sound innocent, actually implies that you’re
“less than” or “less of a man” if you’re gay!
Internalized oppression: This is when the person who is being
targeted turns against himself or herself, and internalizes the
message that “I’m not good enough,” or “I’m defective.”
David points out that this is similar to Freud’s model of
depression, which he thought of as “anger turned inwards.” Although
Aaron Beck railed against this construct, I have to admit that the
negative thoughts of people who are depressed nearly always do have
a hostile, bullying tone.
David also compares racial discrimination and hatred to the
three components of “Abuse Contract” he often explains in his work
with abuse victims. There are three parts to the contract:
I get to abuse you, physically, psychologically, sexually, or
financially for my please.
We have to keep it secret. If you ever tell on me, or even
imply that I’m doing something wrong, I’ll REALLY hurt you.
It’s all your fault. You’re the dirty bad one, and you deserve
what I’m doing to you. I’m a god who is superior and without
fault.
And in spite of the absurdity and cruelty of this “contract,”
human beings seem to have the capacity to buy into it, and this
includes children and adults as well.
Sunny also emphasized that Asians especially are told NOT to be
angry, and that’s why it can be so helpful to use the Five Secrets
with trauma patients as well as Positive Reframing to encourage
acceptance of anger and seeing that it can be entirely healthy and
justified.
Sunny and Audrey provided additional tips on working with
marginalized groups. The most important thing is to ask about
trauma and encourage the person to talk about it, as opposed to
keeping these experiences hidden, even in therapy. He They said that many
patients will open up immediately, and will often use the entire
therapy hour just venting. The experience of being heard and
supported can be deeply appreciated, and can also provide important
clues to the origins of the patient’s feelings of depression,
shame, and anxiety.
Simple, obvious questions are all that are needed, such as:
“Have you ever experienced racism, rape or sexual trauma, or
homophobia. Have you ever been bullied or beaten?
Sunny gave many additional examples of subtle racism when he
was working in Silicon Valley as a manager. But colleagues he
didn’t know often thought a person he was supervising was the
manager, and he was the person being supervised.
Audrey described similar experiences when people told her she
was super smart, and that was probably because she was
“mixed”--that is, not purely of African descent--or because she’d
worked “really hard,” implying others who belong to her ethnic
group do not. Again, an apparent compliment which is really a
subtle put-down.
Sunny tearfully described how he took years and years of voice
training, trying to change his accent to sound “less Chinese.” Now
he says, “I finally feel okay with who I am!”
Although, I think Rhonda and David might say, Audrey and Sunny,
we love you, and you’re way more than “okay” in our eyes. You’re
our teachers and you’re showing us the way, and making us aware of
our own many errors and biases, in a kindly and loving way. Thank
you!”
Thanks for listening today!
Rhonda, Sunny, Audrey, and David
About the Podcast
This podcast features David D. Burns MD, author of "Feeling Good, The New Mood Therapy," describing powerful new techniques to overcome depression and anxiety and develop greater joy and self-esteem. For therapists and the general public alike!