Focuses of therapy for Black women: Lack of validation, stigma, relationships, and more

A mental health professional’s ultimate mission is to help his or her clients live their very best lives—which takes patience, understanding, and support. What I mean to say is therapy is a safe place: you don’t have to worry about being judged or ridiculed—your only worry should be getting down to business. And how easy that would be if we were anything but human.

But we are human, and that means that you probably have your concerns and reservations about therapy. The most urgent being, what if it doesn’t work? Here’s my response to that: but what if it does? You’ll get the opportunity to address and work through whatever issues you have going on with a skilled professional. Which, if you’re a Black woman, might include a few particular focus areas. “Working with Black women, for me, is a different ballgame,” Dr. Donna Oriowo, licensed clinical social worker, says, before going on to identify the following focus areas of therapy for Black women:

1) Lack of validation.

The first focus area she discusses is a lack of validation many Black women suffer from: “Lack of validation of the intersectional experience of being both Black and female can lead a lot of Black women into therapy with low self-worth and/or an identity that is not entirely borne of what they actually want,” she explains. “Oftentimes, the way an Black woman may define herself is based on either an agreement of or in opposition to the status quo that has been predetermined based on Black stereotypical tropes.”

2) Stigma.

“There is a lot of stigma that Black women have to contend with,” Oriowo explains. “There is already the stigma that Black men and women don’t or shouldn’t go to therapy because it’s a ‘white thing,’ but additionally, there is the idea that Black women don’t have struggles with body image—related to body size and other physical characteristics, sexuality, or sex.”

3) Relationships.

Another common focus of discussion in therapy for Black women centers around relationships. “Concerns regarding relationships also come up a lot,” Oriowo says. “Some are concerned that they will not meet a quality Black man and remain single. Others are concerned that they may have settled into the wrong relationship, but fear leaving because of the erroneous idea that Black women don’t get married. And yet again, for others, low self-esteem can show up in relationships in ways of settling to ensure they don’t end up alone.”

4) Self-care.

And lastly, Oriowo says that she also often talks about the importance of self-care with her Black female clients, as they tend to prioritize others: “Sessions can also deal with the masks that Black women are often wearing, specifically the Superwoman mask. In being required to be everything to everyone, Black women are often not prioritizing themselves or their needs, which can lead to increases in anxiety, depression, and poor self-image.”

The above may be common focuses in therapy for Black women, but they’re also common issues among all women. The difference lies in the context, as explained by Mental Health Therapist Shemiah Derrick: “In general, the same issues that non-minority women seek therapy for are the same issues that Black women come to therapy. I think the difference lies in the context of those issues. Some of the most common reasons for therapy I see with my Black female clients are family of origin issues and challenges with career advancement and the presence of tokenism.

More and more Black women are realizing the presence and impact of generational trauma and how it impacts them as adults, partners in a relationship, wives, or mothers. They often still are treated differently and overlooked for advancement opportunities in many work environments despite their experience and education level. In many environments, some Black women are consistently the only Black man or woman or minority represented and are intentionally positioned in interactions or experiences based on ethnic characteristics over knowledge and capabilities.”

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