Claiming a Seat at the Table

Diana M Gonzales-Ricard, LCSW-R

In the final year of my doctorate in social work, as I think of all the trauma-informed interventions I have learned over the past two and a half years, one thing is quite evident: cultural humility and trauma-informed care are, far too often, buzz words that are not backed up by actual practice. This point was driven home for me during my first semester when I realized that we are still pathologized by Western culture. While we briefly explored interventions such as EMDR and TF-CBT, we spent an exhaustive amount of time on Polyvagal Theory. To be fair, we did discuss intergenerational trauma and intersectionality. However, while about 75% of my cohort is non-White, and other cohorts also reflect this, there were no non-White professors and no reference made to any trauma-informed theories addressing racial/cultural trauma. While one professor did have us use bell hooks in a class about trauma-informed teaching, one might go through the program believing that there have been no non-White theorists who have contributed a more diverse perspective on trauma and its treatment.

To make matters worse, I have heard things said by some professors and students to make me wonder what the experience would be like for a non-white client or patient working with them.

I am not one to believe that one can only find help in a therapist who is culturally similar. I have had several therapists in my life, and the most influential one was an elderly Jewish psychologist who helped me navigate away from publishing and into social work and even wrote a letter of recommendation for me to get into graduate school. He continued to see me, even after my insurance had stopped paying him and said nothing. When I confronted him after reading an EOB I had received, his response to me was “I thought your treatment was more important than my fee.” It is something I have never forgotten, and I have modeled in my own practice.

Perhaps it is because he was a New Yorker and lived in Greenwich Village, Dr Storozum had a natural cultural humility about him that made him curious to know more, rather than pathologizing what he did not understand.

That, unfortunately, is an experience I have heard from many individuals who have come to see me over the years. As they navigate the cultural stigma of seeking help from a professional, too often they are met with misunderstanding. How does one explain the deeply ingrained stoicism so inherent to most of us that makes us pick ourselves up and keep going, even when we are exhausted, because we have been taught that the world is not going to stop for us and there is no other choice? How does one explain the enmeshment with our families that would be labeled as codependency by Western culture… the enmeshment that makes it impossible to turn our backs on our families, no matter how much they are driving us crazy, but they remain the base of our identities? How can I explain to someone that, even if I cannot stand my sister, don’t they dare say anything negative about her and I’ll still have her back even after years of discord? I recall one Dominican patient of mine who had issues with her mother lamenting “I wish I could be like White people and just cut her off.”

These all lead to a complex experience that, if one does not understand, could easily be pathologized and labeled with various diagnoses from the DSM. And who decides what goes into the DSM?

Am I saying that we do not need help and there is no room for growth? Absolutely not. We do have our issues that we often do not address. It would just be nice to be able to find therapists who already understand the culture, who understands what is dysfunctional, even within cultural norms, and can serve without judgment.