When Blackness & Therapy Collide

First, welcome to my blog, Keep It Trill.

Trill is a wonderful urban compound slang word that means true and real, and my articles will attempt to be this in the best way I know how. I'll address a huge range of issues, many which touch upon how racism affects us as individuals, parents, a group, and a nation.

This being said, I have two adopted kids. My son, Xavier, is 19, and I'll be talking about him today, along with a former black adolescent client in my caseload, some of my former colleagues and the danger of cultural incompetence and/or racism in a therapeutic setting.

I have always chosen my son's therapists with great care. Working in the mental health field enabled me to know, or at least have an idea, who to avoid. During Xavier's childhood, he attended a short-term adoption group run by two young white social workers. They used art therapy as it's main tool. It was great and they were wonderful. The art was non-threatening and helped him connect with his feelings. He met other kids in the same or similar situation. It also allowed me to peek into his world on a different level.

He was also seen by a colleague of mine - a fine white male psychologist - for many years to address his ADHD, oppositional behavior, school struggles and adoption issues. This guy retired when my son was 16. It was just as well. Therapy stopped working well when he turned 14, and by 15, they weren't making any progress.

Xavier had become aggressive and extremely destructive at home. I'd give him a consequence for skipping school, or coming home too late, (sometimes drunk or high) and he'd give me a consequence of tearing up something in the house. He was quietly failing in school. He needed several hospitalizations for depression, mood swings, and horrible behavior. In addition to his ADHD, they labeled him Bipolar. At one three week in-patient hospital stay, a psychiatrist gave him six different medications which resulted in a painful and embarrassing episode of tardive dyskinesia a day after discharge and while on a school outing. I nearly died when I saw him in the ER, smacking his lips, his face frozen and his body jerking. They gave him a shot of something that relieved the symptoms.

I called his white hospital psychiatrist who had doubled the dosage of one of his six meds upon discharge as casual as an afterthought, maybe thinking this would keep my angry kid from returning. Dr. Wannabe Freud blew me off like my kid's medical crisis wasn't a big deal - and harshly told me not to ever call him on his cell phone before he hung up on me.


The arrogant bastard. I should have sued him and the hospital, but I was too overwhelmed. Sounds so lame now, but I think it's why hospitals and doctors don't get sued more often. As a caretaker of hostile and possibly mentally ill loved one, there's no energy left to fight a legal battle with hostile doctors, hospitals and lawyers. You just want your kid to get better, and all your emotional and psychological resources go into this.

I did research on the web. Against shitty medical advice, I took Xavier off all but three of the meds, then weaned him down to two. His mood stabilized - but he got fat, which is every teenager's nightmare. He said he didn't feel like himself, nor did he act like himself. He hated this and a year later, and at 16, refused to take meds. Instead he smoked more marijuana to chill out on bad days. I didn't like this mainly because of the legal repercussions and warned him until I was blue in the face, but I couldn't follow him around every time he walked out the door and he could care less about my taking away his PlayStation. In all honesty, the weed he smoked on the sly kept him calm. On the downside, his grades didn't improve and were the same - straight Ds and Es because he didn't give a damn about school.

As he aged, it became clearer that he wasn't bipolar. Xavier was suffering from Post Traumatic Stress Disorder (PTSD) from early foster home neglect and the pain from getting to know his birth family and their problems, and worrying that he could never be better than them. To do this would, in his confused adolescent mind, would be akin to being disloyal to his past.

I never thought my son, at 14, would get into drugs since he knew his birth family's history, but he did. He also took up a new hobby of chilling with the Bloods. This is a pic of him taken when he was 16 or 17.


Cute, huh? Yeah, for a rap album or art project. He was tired of being a victim, which he unconsciously, like many black children and teens, perceived himself to be. I think this comes from a combination of learning about slavery and oppression at too young an age, through Black History Month topics in 2nd, 3rd, and 4th grades. They see our people treated harshly in news stories, left to suffer during Hurricane Katrina, and listen to music that legitimately expresses anger and sorrow.

To avoid feeling like or being the victim, he flipped to the opposite side of the coin and became the aggressor, a la gangsta style. He loved looking and being tough, and is damn good at it, so good that he caused me untold misery during the middle part of his adolescent years.

A couple years ago, his appearance scared the hell out of a 50-something, very middle-class looking white woman therapist. He'd been court-ordered to return to therapy at a program where I had no control over who his therapist would be. I wasn't worried; a little over half of the therapists I've known, black, white or Hispanic, are competent, so I figured the odds were slightly better than 50% he'd be assigned a good one. Well, he wasn't.

I told him to dress nicer for the interview, but he's was a hard head. We argued in the parking lot for 20 minutes before I could even coax him in the building. Finally, we sat in the reception room and waited to meet his new therapist.

Man, the knee-jerk fear on her face as soon as she laid eyes on him is memorable. She didn't understand that he was fronting - the grill in his mouth, the braids in hair and his baggy urban wear was for show, and a clue into his determined search for an identity as a masculine black male. Like many black youths, he got his clues from gangsta videos.


On one level, he thought her reaction was hilarious (and in a way, I did too), but on another level, he was so offended by her fear that permeated the interview that he refused to return. I couldn't blame him.

As I black therapist who has worked in two mental health clinics staffed almost entirely by white therapists, I can honestly say that a couple of these women were very uncomfortable working with macho black male teens or men. The genuinely nice one who was friend could admit it this. She wasn't racist, she was just nervous due to her early childhood conditioning to fear men, and black males in particular. She struggled to overcome this for personal and professional reasons, and I admired her for this. The other woman was just plain contemptuous of blacks and closed out every black case she got as quickly as possible, going to the lengths of lying in her records that she couldn't get in touch with these families. When I'd get re-assigned these cases that came back in, I never had a problem.

There was also a white male therapist whose racism was revealed to me unexpectedly one day. At our agency, we occasionally provided urine testing for teens we did therapy with until the late 1990s. One day a teen in my caseload needed this; he'd been busted on a minor weed charge but recommended for therapy to deal with the trauma he experienced in his war-torn country of origin.


He was as tall and regal-looking as his ancestors, intelligent, and unlike my own son years later, dressed appropriately and had a pleasant demeanor when he had an appointment.

I walked around our office, which took up an entire floor, to find a male therapist who could watch my client pee in a cup. I approached the only guy in the office at the time. He was a generally very quiet white male therapist. He was doing absolutely nothing. I asked him to assist me. He looked up and down at my 6'4, jet black African adolescent client, smirked, and said, "Nuh-uh", then walked away without a care in the world - to do more of nothing.

This helping professional's body language and words were akin to a psychological drive-by. You could not only see the racism in his face, but hear it in his voice and feel it in your heart. The look on that kid's face was one of tremendous pain. He instantly knew what the real deal was. I turned to my client, who by then had covered his face with his hand. I apologized for this man's behavior by spitting out the words, "F him."

This 16 year old took a deep breath and nodded. As the say in AA and NA, Denial ain't a river in Egypt, and any therapist who denies blatant racism to their client is lying and tampering with their reality. For young blacks and males in particular, this generally leads them to having a deeper distrust of the system, or worse - becoming more dysfunctional as they turn to alcohol or drugs after one bad day after another, similar to the way adults might have a drink or two after a bad day at the office. At least they're getting paid and have good days at work. You don't get paid for putting up with racism and then dealing with the anger turned on itself in the black community.

But back to my own son. At 16, Xavier wanted a black male therapist. The guy had to be straight as well. He's not anti-gay, anti-woman or anti-white; he just wanted someone he could relate to. When he had been younger, he had seen my pain, coming home late from the office, and heard the tales of subtle, hard-to-prove racism that I was forced to endure and witnessed, all to keep my damn job and raise my family.

In hindsight, maybe when he showed up at that program, looking and acting like a hoodrat with attitude, he was testing the system to see if his new shrink could accept him - as he was expected to accept them.

After much searching, I found the needle in the haystack - a black male psychiatrist for my son who had an opening and accepted his insurance. The icing on the cake was that he is also a part-time minister.

Prior to meeting us, the doc took the time to listen to me on the phone (!) and describe his tough early years in foster care and how he'd lived a solid middle-class existence after coming to me - including a couple trips to Broadway plays and several to Disney World, but despite all this, had been raising hell since turning 13.

When the new psychiatrist met my son, he sized him up immediately, smiled at him warmly and said, "Yo, bro, I like your Teenage Mutant Ninja Turtle outfit."



My son laughed. He was at time in his life where he needed a black male role model who understood him. And thus, a decent therapeutic relationship was born.

~~~~~