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  • Writer's pictureDr. Lana Holmes

Therapy Along the Margins: A Personal Introduction

Therapy has been called an art, a science, and a healing practice. Fundamentally, it is a collaborative process (between the clinician and the person seeking treatment) to identify and work through the problems that interrupt adaptive functioning, within multiple areas of one's life (i.e., mental, emotional, behavioral, interpersonal, occupational, academic, etc.). To accomplish this, people coming into treatment must be understood for who they are. And yet for so many individuals (especially those within marginalized and oppressed communities), it can still be hard to find therapeutic spaces where they will be greeted with grace, compassion, and acceptance. Furthermore, it can be hard to find clinicians who come from their communities or have direct knowledge of their cultures/subcultures. That is why therapy must extend to people that often feel othered and worry about if they can be their true selves in the context of mental health treatment. The following blog article will explain why doing therapy along the margins is my passion and professional mission.

There are several reasons why diversity, inclusivity, and cultural competence are personal to me. First, I was born in Germany and come from an Air Force family. This afforded me the opportunity to be exposed to people from various cultures around the world. Moreover, it engendered a sense that the differences within humanity are what help us to thrive and progress as a whole. Secondly, from an early age, I was aware of three things related to my identity: I was Black, bisexual, and female. Like many children, I did not find anything wrong with who I was. However, I was also glaringly aware that these aspects of my personhood would subject me to discrimination, prejudice, hatred, and disenfranchisement. What saved me from being consumed by shame and internalized oppression was being surrounded by individuals (both loved ones and role models) who affirmed and valued me without caveats. One aphorism that I was raised with, sums up it quite well: “Even though there will be people who hate you for merely existing, that should not stop you from being who you are or doing what you want to do.” Finally, as I moved through adolescence, I found myself attracted to subcultures attached to literary (i.e., the Beat Generation) and musical (i.e., punk rock) movements that were predicated on personal and collective freedom, self-expression, authenticity, breaking conventions, and exploring new possibilities (within art, relationships, and life).

Alternatively, throughout my graduate/postdoctoral education and training, I found a set of contradictions with how the field of clinical psychology approached cultural competency and inclusivity. On the one hand, I was encountering clinicians, lectures, and journal articles espousing the importance of appreciating and understanding people, who are often sidelined by society. Furthermore, there was an emphasis on clinicians being aware of our own identities and biases, so as not to do harm or do a disservice to marginalized individuals seeking treatment.

Yet despite these efforts, I was still encountering people who described being insulted, misunderstood, or misdiagnosed by treatment providers due to being a person of color, a religious/spiritual minority, a member of the poly/bdsm/kink community, or a member of the LGBTQIA+ community. Also, some of these people expressed only feeling comfortable working with clinicians who were either fellow members of their communities or were allies.

Consequently, some of these folks were so discouraged by their negative experiences, that they either swore off mental health treatment entirely or it took many years to muster up the courage to return to therapy. And even then, rebuilding trust and opening up was difficult. This made me realize that to do my work, I needed to make sure to:

  • be empathic, by drawing upon my experiences as a member of several marginalized and oppressed groups;

  • be authentic, to model pride and validation in one’s identity;

  • listen, to co-facilitate healing that is tailored to each person, rather than forcing people to adhere to culturally myopic interventions that were designed by and for members of dominant cultural groups; and

  • have an interdisciplinary approach to cultural competency that involves directly working and building relationships with practitioners, educators, and members from various marginalized and oppressed communities.

Clinical work, including therapy, was designed to help and heal people. To that end, it is important that individuals that are othered, feel welcome to be their full selves without ridicule and prejudice. And to know that being different, is a strength, as opposed to a liability.

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