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Adapting counseling skills for multicultural and diverse clients

29/11/2021 Client: muhammad11 Deadline: 2 Day

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OBSTACLES TO CULTURAL COMPETENCE UNDERSTANDING RESISTANCE TO MULTICULTURAL TRAINING
Chapter Objectives

1. Acknowledge and understand personal resistance to multicultural training.

2. Identify how emotional reactions to topics of prejudice, discrimination, and oppression can act as obstacles to cultural competence.

3. Understand worldview differences between majority and socially devalued group members in this society.

4. Make sense of why majority group members often react differently from marginalized group members when issues of racism, sexism, or heterosexism are discussed.

5. Be cognizant of how worldviews may influence the ability to understand, empathize, and work effectively with diverse clients.

6. Realize that becoming an effective multicultural counselor is more than an intellectual exercise and is a lifelong journey.

Reading and digesting the content of this book may prove difficult and filled with powerful feelings for many of you. Students who have taken a course on multicultural counseling/therapy or multicultural mental health issues have almost universally felt both positive and negative feelings that affect their ability to learn about diversity issues. It is important not to allow those emotions to go unacknowledged, or to avoid exploring the psychological meanings they may have for you. As you begin your journey to becoming a culturally competent counselor/mental health professional, the road will be filled with obstacles to self-exploration, to understanding yourself as a racial/cultural being, and to understanding the worldview of those who differ from you in race, gender, ethnicity, sexual orientation, and other sociodemographic characteristics.

The subject matter in this book and course requires you to explore your biases and prejudices, a task that often evokes defensiveness and resistance. It is important to recognize personal resistance to the material, to explore its meanings, and to learn about yourself and others. Sometimes what is revealed about you may prove disturbing, but having the courage to continue is necessary to becoming a culturally competent counselor or therapist. This chapter is specifically written to help readers understand and overcome their emotive reactions to the substance of the text, and the course you are about to take. Let us begin by sharing reactions from four past students to reading Counseling the Culturally Diverse and discuss their meaning for the students, and the implications for mental health practice.

Reactions to Reading Counseling the Culturally Diverse

Reaction #1

1. White Female Student: “How dare you and your fellow caustic co-author express such vitriol against my people? You two are racists, but of a different color. . .I can't believe you two are counselors. Your book does nothing but to weaken our nationalism, our sense of unity and solidarity. If you don't like it here, leave my country. You are both spoiled hate-mongers who take advantage of our educational system by convincing others to use such a propagandistic book! Shame on you. Your book doesn't make me want to be more multicultural, but take ungrateful people like you and export them out of this great land of mine.” (Name withheld)

2. Analysis: This response reveals immense anger at the content of CCD, and especially at the authors, whom she labels “hate mongers” and “racists.” It is obvious that she feels the book is biased and propagandistic. The language of her words seems to indicate defensiveness on her part as she easily dismisses the material covered. More important, there is an implicit suggestion in the use of “people like you” and “land of mine” that conveys a perception that only certain groups can be considered “American” and others are “foreigners.” This is similar to statements often made to people of color: “If you don't like it here, go back to China, Africa or Latin America.” Likewise, the implication is that this land does not belong to persons of color who are U.S. Citizens, but only to White Americans.

Reaction #2

1. White Male Student: “I am a student in the field of Professional Counseling and feel compelled to write you because your text is required reading in our program. I am offended that you seem to think that the United States is the only perpetrator of prejudice and horrific acts. Excuse me sir, but racism and oppression are part of every society in the world ad infinitum, not just the United States. I do not appreciate reading biased material that does not take into account all forms of prejudice including those from minorities. You obviously have a bone to grind with White people. Minorities are equally racist. Why do you take such pleasure in attacking whites when we have done so much to help you people?” (Anonymous)

2. Analysis: Similar to the first response, the male student is also angry and offended about the content. There is a strong feeling of defensiveness, however, that emanates from his narrative. It appears he feels unjustly accused of being bigoted and that we are implying that only U.S. society and not others are racist. To make himself feel less guilty, he emphasizes that “every society” oppresses “minority” constituents and it is not Whites alone who are prejudiced. These are actually accurate statements, but they mask the defensiveness of the student, and have the goal of exonerating him and other Whites for being prejudiced. If he can get other groups to admit they too are racist, then he feels less guilt and responsibility for his own beliefs and actions.

Reaction #3

1. Latina Student: “I am currently embarking on the journey of becoming a Marriage and Family Therapist at a California State University. I just want to thank you for writing Counseling the Culturally Diverse. This book has spoken to me and given me so much knowledge that is beyond words to express. Finally, there is someone willing to tell it like it is. You have truly made an impact in my life because, being an ethnic minority, I could empathize with many of the concepts that were illustrated. Although some White classmates had difficulty with it, you truly validated much of my experiences. It reaffirmed how I see the world, and it felt good to know that I am not crazy! Once again thanks for writing the book.” (Name withheld)

2. Analysis: The reaction from the Latina student is diametrically opposite to that of her White counterparts. She reacts positively to the material, finds the content helpful in explaining her experiential reality, feels validated and reaffirmed, and realizes that she is “not crazy.” In other words, she finds the content of the book truthful and empathetic to her situation. The important question to ask is, “Why does she react so differently from the two White students?” After all, the content of the book remains the same, but the perceptions appear worlds apart.

Reaction #4

1. African American Male Student: “When I first took this course (multicultural counseling) I did not have much hope that it would be different from all the others in our program, White and Eurocentric. I felt it would be the typical cosmetic and superficial coverage of minority issues. Boy was I wrong. I like that you did not ‘tip toe' around the subject. Your book Counseling the Culturally Diverse was so forceful and honest that it made me feel liberated . . . I felt like I had a voice, and it allowed me to truly express my anger and frustration. Some of the white students were upset and I could see them squirming in their seats when the professor discussed the book. I felt like saying ‘good, it's about time Whites suffer like we have. I have no sympathy for you. It's about time they learned to listen.' Thank you, thank you, and thank you for having the courage to write such an honest book.” (Name withheld)

2. Analysis: Like the Latina student, the African American male finds the book compelling, honest, and truthful. He describes how it makes him feel liberated, provides him with a voice to describe his experiences, and taps into and allows him to express his anger and frustration, and he thanks the authors for writing CCD. He implies that most courses on multicultural psychology are taught from a EuroAmerican perspective, but the book content “tells it like it is.” Additionally, the student seems to take pleasure in observing the discomfort of White students, expresses little sympathy for their struggle in the class, and enjoys seeing them being placed on the defensive. (We will return to the meaning of this last point shortly.)

Reading Counseling the Culturally Diverse: Theory and Practice (CCD) is very likely to elicit strong emotions among readers. These four reactions, two by White students and two by readers of color, reveal the range of emotions and reactions likely to be expressed in classes that use the text. Over the last 35 years we have received literally hundreds of emails, letters, and phone calls from students, trainees, professors, and mental health professionals reacting strongly to the content and substance of CCD. Many of the readers praise the book for its honest portrayal of multicultural issues in mental health practice. Indeed, it has become the most widely used and cited text in multicultural psychology, considered a classic in the field (Ponterotto, Fingerhut, & McGuinness, 2013; Ponterotto & Sabnani, 1989), and now forms the knowledge base of licensing and certification exams for counseling and mental health professionals.

Despite the scholarly status that CCD has achieved, some readers (generally those from the majority group) find the substance of the book difficult to digest and have reacted very strongly to the content. According to instructors of multicultural counseling/therapy classes, the powerful feelings aroused in some students prevent them from being open to diversity issues, and from making classroom discussions on the topic a learning opportunity. Instead, conversations on diversity become “shouting matches” or become monologues rather than dialogues. These instructors indicate that the content of the book challenges many White students about their racial, gender, and sexual orientation realities, and that the book's writing style (passionate, direct, and hard-hitting) also arouses deep feelings of defensiveness, anger, anxiety, guilt, sadness, hopelessness, and a multitude of other strong emotions in many. Unless properly processed and understood, these emotions act as roadblocks to exploring issues of race, gender, and sexual orientation. Learning about multicultural psychology is much more than an intellectual exercise devoid of emotions.

It would be a mistake, however, to conclude from these examples that White students and students of color respond uniformly in one way. As we will explore in future chapters, many White students react positively to the book and some students of color report negative reactions. But, in general, there are major worldview differences and reactions to the material between the two groups. For example, many socially marginalized group members find solace in the book; they describe a deep sense of validation, release, elation, joy, and even feelings of liberation as they read the text. What accounts for these two very different reactions?

For practicing professionals and trainees in the helping professions, understanding the differing worldviews of our culturally diverse clients is tantamount to effective multicultural counseling. But understanding our own reactions to issues of diversity, multiculturalism, oppression, race, gender, and sexual orientation is equally important to our development as counselors/therapists (Todd & Abrams, 2011). As we will shortly see, that understanding can be quite anxiety provoking, especially when we are asked to confront our own biases, prejudices, and stereotypes. The old adage “counselor or therapist, know thyself” is the basic building block to cultural competence in the helping professions. Let us take a few moments here to dissect the reactions of the four readers in our opening narratives and attempt to make meaning of them. This is a task that we encourage you to personally take throughout your educational journey as well. Likewise, as a counselor or therapist working with culturally diverse clients, understanding differences in worldviews is an important first step to becoming culturally competent.

Emotional Self-Revelations and Fears: Majority Group Members

It is clear that the two White students are experiencing strong feelings to the content of CCD. As you will shortly see, the book's subject matter (a) deals with prejudice, bias, stereotyping, discrimination, and bigotry; (b) makes a strong case that counseling and psychotherapy may serve as instruments of cultural oppression rather than therapeutic liberation (Sue, 2015; Wendt, Gone, & Nagata, 2015); (c) indicates that well-intentioned mental health professionals are not immune from inheriting the racial and gender biases of the larger society; and (d) suggests therapists and trainees may be unconsciously biased toward clients from marginalized groups (Ratts & Pedersen, 2014).

Although supported by the research literature and by clinical observations and reports, these assertions can be quite disturbing to members of the majority group. If you are a majority group member and beginning the journey to cultural competence, it is possible that you may share similar reactions to those of the students. Both White students, for example, are reacting with anger and resentment; they believe that the authors are unjustly accusing U.S. Society and White Americans of racism, and claim the authors are themselves “racist” but of a different color. They have become defensive and are actively resisting and rejecting the content of the book. If these feelings persist throughout the course unabated, they will act as barriers to learning and further self-exploration. But what do these negative reactions mean to the students? Why are they so upset? Dr. Mark Kiselica (Sue & Sue, 2013, pp. 8–9), a White psychologist and now provost of a college in New York, writes about his own negative emotional reactions to reading the book during his graduate training. His personal and emotional reactions to the book provide us with some clues.

I was shaken to my core the first time I read Counseling the Culturally Different (now Counseling the Culturally Diverse). . . .At the time, I was a doctoral candidate at The Pennsylvania State University's counseling psychology program, and I had been reading Sue's book in preparation for my comprehensive examinations, which I was scheduled to take toward the end of the spring semester. . .

I wish I could tell you that I had acquired Sue's book because I was genuinely interested in learning about multicultural counseling. . .I am embarrassed to say, however, that that was not the case. I had purchased Sue's book purely out of necessity, figuring out that I had better read the book because I was likely to be asked a major question about cross-cultural counseling on the comps. During the early and middle 1980s, taking a course in multicultural counseling was not a requirement in many graduate counseling programs, including mine, and I had decided not to take my department's pertinent course as an elective. I saw myself as a culturally sensitive person, and I concluded that the course wouldn't have much to offer me. Nevertheless, I understood that. . .the professor, who taught the course, would likely submit a question to the pool of materials being used to construct the comps. So, I prudently went to the university bookstore and purchased a copy. . . .because that was the text. . . .used for his course.

I didn't get very far with my highlighting and note-taking before I started to react to Sue's book with great anger and disgust. Early on in the text, Sue blasted the mental health system for its historical mistreatment of people who were considered to be ethnic minorities in the United States. He especially took on White mental health professionals, charging them with a legacy of ethnocentric and racist beliefs and practices that had harmed people of color and made them leery of counselors, psychologists, and psychiatrists. It seemed that Sue didn't have a single good thing to say about White America. I was ticked off at him, and I resented that I had to read his book. However, I knew I had better complete his text and know the subject matter covered in it if I wanted to succeed on the examinations. So, out of necessity, I read on and struggled with the feelings that Sue's words stirred in me.

I was very upset as I read and reread Sue's book. I felt that Sue had an axe to grind with White America and that he was using his book to do so. I believed that his accusations were grossly exaggerated and, at least to some extent, unfair. And I felt defensive because I am White and my ancestors had not perpetrated any of the offenses against ethnic minorities that Sue had charged. I looked forward to the day when I would be relieved of him and his writings.

Becoming culturally competent in counseling/mental health practice demands that nested or embedded emotions associated with race, culture, gender, and other sociodemographic differences be openly experienced and discussed. It is these intense feelings that often block our ability to hear the voices of those most oppressed and disempowered (Sue, 2011). How we, as helping professionals, deal with these strong feelings can either enhance or impede a deeper understanding of ourselves as racial/cultural beings and our understanding of the worldviews of culturally diverse clients. Because Mark did not allow his defensiveness and anger to get the best of him, he was able to achieve insights into his own biases and false assumptions about people of color. The following passage reveals the internal struggle that he courageously fought and the disturbing realization of his own racism.

I tried to make sense of my emotions—to ascertain why I was drawn back to Sue's book again and again in spite of my initial rejection of it. I know it may sound crazy, but I read certain sections of Sue's book repeatedly and then reflected on what was happening inside of me. . . .I began to discover important lessons about myself, significant insights prompted by reading Sue's book that would shape the direction of my future. . . . I now realized that Sue was right! The system had been destructive toward people of color, and although my ancestors and I had not directly been a part of that oppressive system, I had unknowingly contributed to it. I began to think about how I had viewed people of color throughout my life, and I had to admit to myself that I had unconsciously bought into the racist stereotypes about African Americans and Latinos. Yes, I had laughed at and told racist jokes. Yes, I had used the “N” word when referring to African Americans. Yes, I had been a racist.

Sue's book forced me to remove my blinders. He helped me to see that I was both a product and an architect of a racist culture. Initially, I didn't want to admit this to myself. That is part of the reason I got so angry at Sue for his book. “His accusations don't apply to me!” was the predominant, initial thought that went through my mind. But Sue's words were too powerful to let me escape my denial of my racism. It was as though I was in a deep sleep and someone had dumped a bucket of ice-cold water onto me, shocking me into a state of sudden wakefulness: The sleep was the denial of my racism; the water was Sue's provocative words; and the wakefulness was the painful recognition that I was a racist. (Sue & Sue, 2013, pp. 9–10)

Years later, Mark Kiselica (1999) talks about his racial awakening and identifies some of the major fears many well-intentioned Whites struggle with as they begin studying racism, sexism, or heterosexism on a personal level. This passage, perhaps, identifies the major psychological obstacle that confronts many Whites as they process the content and meaning of the book.

You see, the subjects I [White psychologist] am about to discuss—ethnocentrism and racism, including my own racism—are topics that most Whites tend to avoid. We shy away from discussing these issues for many reasons: We are racked with guilt over the way people of color have been treated in our nation; we fear that we will be accused of mistreating others; we particularly fear being called the “R” word—racist—so we grow uneasy whenever issues of race emerge; and we tend to back away, change the subject, respond defensively, assert our innocence and our “color blindness,” denying that we could possibly be ethnocentric or racist.” (p. 14)

It is important to note Kiselica's open admission to racist thoughts, feelings, and behaviors. As a White psychologist, he offers insights into the reasons why many White trainees fear open dialogues on race; they may ultimately reveal unpleasant secrets about themselves. In his own racial/cultural awakening, he realizes that discussing race and racism is so difficult for many Whites because they are racked with guilt about how people of color have been treated in the United States and are fearful that they will be accused of being a racist and be blamed for the oppression of others. Maintaining one's innocence by rejecting and avoiding racial topics are major strategies used to hold on to one's self-image as a good, moral, and decent human being who is innocent of racial bias and discrimination.

Kiselica's reflection is a powerful statement that addresses a major question: Can anyone born and raised in our society not inherit the racial biases of our ancestors and institutions? When we pose this question to our students, surprisingly an overwhelming number say “no.” In other words, on an intellectual level they admit that people are products of their social conditioning and that escaping internalizing biases and prejudices is impossible. Yet when racial biases are discussed, these same students have great difficulty entertaining the notion that they have personally inherited racial biases and benefited from the oppression of others, because “racism resides in others, not me!”

Mark's honesty in confronting his own racism is refreshing, and his insights are invaluable to those who wish to become culturally competent counselors and allies in the struggle for equal rights (Chao, Wei, Spanierman, Longo, & Northart, 2015). He is a rarity in academic circles, even rarer because he was willing to put his words on paper for the whole world to read as a means to help others understand the meaning of racism on a human level. Mark's courageous and open exploration of his initial reactions to CCD indicates what we have come to learn is a common, intensely emotional experience from many readers. Because CCD deals openly, honestly, and passionately with issues of racism, sexism, and homophobia and challenges our belief that we are free of biases, it is likely to evoke defensiveness, resentment, and anger in readers. In Mark's case, he did not allow these reactions to sabotage his own self-exploration and journey to cultural competence. And we hope you will not allow your emotional “hot buttons” to deter you from your journey to cultural competence as well.

Emotional Invalidation versus Affirmation: For Marginalized Group Members

It is clear that the same subject matter in CCD often arouses a different emotional response from marginalized group members; for the two students of color, for example, they felt heard, liberated, and validated. They describe the book content as “honest” and “truthful,” indicating that their lived experiences were finally validated rather than silenced or ignored. One of the more interesting comments is made by the Latina student that “it felt good to know that I am not crazy.” What did she mean by that? Many people of color describe how their thoughts and feelings about race and racism are often ignored, dismissed, negated, or seen as having no basis in fact by majority group members. They are told that they are misreading things, overly sensitive, unduly suspicious or even paranoid when they bring up issues of bias and discrimination; in other words, they are “crazy” to think or feel that way.

As can be seen from the students of color, many marginalized group members react equally strongly as their White counterparts when issues of oppression are raised, especially when their stories of discrimination and pain are minimized or neglected. Their reality of racism, sexism, and homophobia, they contend, is relatively unknown or ignored by those in power because of the discomfort that pervades such topics. Worse yet, many well-intentioned majority persons seem disinclined to hear the personal stories of suffering, humiliation, and pain that accrue to persons of color and other marginalized groups in our society (Sue, 2015). The following quote gives some idea of what it is like for a Black man to live his life day in and day out in a society filled with both covert and overt racist acts that often are invisible to well-intentioned White Americans.

I don't think white people, generally, understand the full meaning of racist discriminatory behaviors directed toward Americans of African descent. They seem to see each act of discrimination or any act of violence as an “isolated” event. As a result, most white Americans cannot understand the strong reaction manifested by blacks when such events occur. . . .They forget that in most cases, we live lives of quiet desperation generated by a litany of daily large and small events that, whether or not by design, remind us of our “place” in American society. [Whites] ignore the personal context of the stimulus. That is, they deny the historical impact that a negative act may have on an individual. “Nigger” to a white may simply be an epithet that should be ignored. To most blacks, the term brings into sharp and current focus all kinds of acts of racism—murder, rape, torture, denial of constitutional rights, insults, limited opportunity structure, economic problems, unequal justice under the law and a myriad of. . .other racist and discriminatory acts that occur daily in the lives of most Americans of African descent. (Feagin & Sikes, 2002, pp. 23–24)

The lived experience of people of color is generally invisible to most White Americans, as this quotation portrays. As we will discuss in Chapter 6 , racial, gender, and sexual orientation microaggressions are experienced frequently by people of color, women, and LGBTQ persons in their day-to-day interactions with well-intentioned members of the dominant society (Velez, Moradi, & DeBlaere, 2015). Microaggressions are the everyday slights, put-downs, invalidations, and insults directed to socially devalued group members by well-intentioned people who are unaware that they have engaged in such biased and harmful behaviors. A lifetime of microaggressions can have a major harmful impact on the psychological well-being of victims. Note the following narrative provided by an African American man as he describes his day-to-day experiences with microaggressions that label him a dangerous person, a lesser human being, and a potential criminal.

It gets so tiring, you know. It sucks you dry. People don't trust you. From the moment I [African American male] wake up, I know stepping out the door, that it will be the same, day after day. The bus can be packed, but no one will sit next to you. . . I guess it may be a good thing because you always get more room, no one crowds you. You get served last . . . when they serve you, they have this phony smile and just want to get rid of you . . . you have to show more ID to cash a check, you turn on the TV and there you always see someone like you, being handcuffed and jailed. They look like you and sometimes you begin to think it is you! You are a plague! You try to hold it in, but sometimes you lose it. Explaining doesn't help. They don't want to hear. Even when they ask, “Why do you have a chip on your shoulder?” Shit . . . I just walk away now. It doesn't do any good explaining. (Sue, 2010, p. 87)

Here it is important to note the strong and powerful negative emotions and sense of hopelessness that pervades this narrative. The Black man expresses strong anger and resentment toward Whites for how he perceives they are treating him. His daily experiences of racial slights have made him believe that trying to explain to Whites Americans about these indignities would do little good. In fact, he expresses pessimism, rightly or wrongly, that Whites simply do not understand, and worse yet, they do not care to hear his thoughts and feelings about race and racism. He feels hopeless and frustrated about making White Americans understand, and states, “Shit . . . I just walk away now. It doesn't do any good explaining.” Although he does not directly mention it, one can surmise that he is also tired and drained at having to constantly deal with the never-ending onslaught of microaggressions. For some people of color, the sense of hopelessness can lead to simply giving up.

Dr. Le Ondra Clark, now an African American psychologist in California, describes her experiences of being one of the few Black students in a graduate program and the feeling of affirmation that flooded her when taking a multicultural counseling course and using CCD as the textbook.

I, a native of Southern California, arrived at the University of Wisconsin, Madison, and was eager to learn. I remember the harsh reality I experienced as I confronted the Midwest culture. I felt like I stood out, and I learned quickly that I did. As I walked around the campus and surrounding area, I remember counting on one hand the number of racial and ethnic minorities I saw. I was not completely surprised about this, as I had done some research and was aware that there would be a lack of racial and ethnic diversity on and around campus. However, I was baffled by the paucity of exposure that the 25 members of my master's cohort had to racial and ethnic minority individuals. I assumed that because I was traveling across the country to attend this top-ranked program focused on social justice, everyone else must have been as well. I was wrong.

The majority of my cohort was from the Midwest, and their experiences varied greatly from mine. For example, I remember sitting in my Theories of Counseling course during the first week of the semester. The instructor asked each of us to share about our first exposure to individuals who were racially and ethnically different from ourselves. I thought this was a strange question. . . .I was quite surprised as I listened to what my cohort members shared. I listened to several members share that their first exposure to someone different from them had not occurred until high school and, for some, college. When it came time for me to share, I remember stating that, as a racial and ethnic minority, I had never been in a situation where there was not some type of racial and ethnic diversity. Just sharing this made me feel distant from my cohort, as our different cultural experiences were now plainly highlighted. I remember thinking to myself, “Where am I?” For the first time in my life, I felt as if I was a foreigner, and I badly needed something or someone to relate to.

I did not begin to feel comfortable until I attended the Multicultural Counseling course later that week. Students were assigned a number of textbooks as part of this course, including CCD. . . . I never imagined a textbook would bring me so much comfort. I vividly remember reading each chapter and vigorously taking notes in the margins. I also remember the energy I felt as I wrote about my reactions to the readings each week. I felt like the book legitimized the experiences of racial and ethnic minorities and helped me understand what I was encountering in my Midwest surroundings. It became a platform from which I could explain my own experience as a racial and ethnic minority from Southern California who was transplanted to the Midwest. The personal stories, concepts, and theories illustrated in CCD resonated with me and ultimately helped me overcome my feelings of isolation. CCD provided me with the language to engage in intellectual discourse about race, ethnicity, social class, privilege, and disparities. I remember the awareness that swept over the class as we progressed through the textbook. . .I felt that they were beginning to view things through my cultural lens, and I through theirs. We were gaining greater understanding of how our differing cultural realities had shaped us and would impact the work we conducted as therapists. (Sue & Sue, 2013, pp. 17–18)

Le Ondra's story voices a continuing saga of how persons of color and many marginalized individuals must function in an ethnocentric society that unintentionally invalidates their experiences and enforces silence upon them. She talks about how the text provided a language for her to explain her experiences and how she resonated with its content and meaning. To her, the content of the book tapped into her experiential reality and expressed a worldview that is too often ignored or not even discussed in graduate-level programs. Le Ondra found comfort and solace in the book, and she has been fortunate in finding significant others in her life that have validated her thoughts, feelings, and aspirations and allowed her to pursue a social justice direction in counseling. As a person of color, Le Ondra has been able to overcome great odds and to obtain her doctorate in the field without losing her sense of integrity or racial/cultural identity.

A Word of Caution

There is a word of caution that needs to be directed toward students of marginalized groups as they read CCD and find it affirming and validating. In teaching the course, for example, we have often encountered students of color who become very contentious and highly outspoken toward White classmates. There are two dangers here that also reveal resistance from students of color to multicultural training. A good example is provided in the reaction of the African American student in the fourth scenario. First, it is clear that the student seems to take delight in seeing his White classmates “squirm” and be uncomfortable. In this respect, he may be taking out his own anger and frustration upon White classmates, and his concern has less to do with helping them understand than hurting them. It is important to express and understand one's anger (it can be healing), but becoming verbally abusive toward another is counterproductive to building rapport and mutual respect. As people of color, for example, we must realize that our enemies are not White Americans, but White supremacy! And, by extension, our enemy is not White Western society, but ethnocentrism.

Second, because the book discusses multicultural issues, some students of color come to believe that multicultural training is only for White students; the implicit assumption is that they know the material already and are the experts on the subject. Although there is some truth to this matter, such a perspective prevents self-exploration and constitutes a form of resistance. As will be seen in Chapter 3 , people of color, for example, are not immune from prejudice, bias, and discrimination. Further, such a belief prevents the exploration of interethnic/interracial misunderstandings and biases toward one another. Multicultural training is more than White–African American, White–Latino/a American, White–Asian American, White–Native American, and so on. It is also about African American–Asian American, Asian American–Native American, and Latino/a–Native American relationships; and it includes multiple combinations of other sociodemographic differences like gender, sexual orientation, disability, religious orientation, and so forth. Race, culture, ethnicity, gender, and sexual orientation/identity are about everyone; it is not just a “minority thing.”

Reflection and Discussion Questions

Look at the opening quotes by the four students, then answer these questions.

1. In what ways are the reactions of the White students different from those of students of color? Why do you think this is so?

2. Which of the four reactions can you relate to best? Which reaction can you empathize least with? Why?

3. As you continue reading the material in this text, you are likely to experience strong and powerful reactions and emotions. Being able to understand the meaning of your feelings is the first step to cultural competence. Ask yourself, why am I reacting this way? What does it say about my worldview, my experiential reality, and my ability to relate to people who differ from me in race, gender, and sexual orientation?

4. As a White counselor working with culturally diverse clients, would you be able to truly relate to the worldview being expressed by people of color?

5. As a counselor of color working with White clients, what challenges do you anticipate in the therapeutic relationship with them?

6. What do you think “understanding yourself as a racial/cultural being” means?

Recognizing and Understanding Resistance to Multicultural Training

As a counselor or therapist working with clients, you will often encounter psychological resistance or, more accurately, client behaviors that obstruct the therapeutic process or sabotage positive change (Ridley & Thompson, 1999). In therapy sessions, clients may change the topic when recalling unpleasant memories, externalize blame for their own failings, not acknowledge strong feelings of anger toward loved ones, or be chronically late for counseling appointments. All of these client behaviors are examples of resistance or avoidance of acknowledging and confronting unpleasant personal revelations. Oftentimes, these represent unconscious maneuvers to avoid fearful personal insights, to avoid personal responsibility, and to avoid painful feelings. In most cases, resistance masks deeper meanings outside the client's awareness; tardiness for appointments is unacknowledged anger toward therapists, and changing topics in a session is an unconscious deflection of attention away from frightening personal revelations. In many respects, multicultural training can be likened to “therapy” in that trainees are analogous to clients, and trainers are comparable to therapists helping clients with insights about themselves and others.

As we shall see in Chapter 2 , the goal of multicultural training is cultural competence. It requires trainees to become aware of their own worldviews, their assumptions of human behavior, their misinformation and lack of knowledge, and most importantly, their biases and prejudices. Sometimes this journey is a painful one, and trainees will resist moving forward. For trainers or instructors, the job is to help trainees in their self-exploration of themselves as racial/cultural beings, and the meaning it has for their future roles as multicultural counselors. For trainees, being able to recognize, understand, and overcome resistance to multicultural training is important in becoming a culturally competent counselor or therapist.

In the next few sections, we focus upon identifying how resistance manifests itself in training and propose reasons why many well-intentioned trainees find multicultural training disconcerting and difficult to undertake. By so doing, we are hopeful that trainees will attend to their own reactions when reading the text or when participating in classroom dialogues on the subject. Ask yourself the following questions as you continue reading in the next sections and throughout the book.

Reflection and Discussion Questions

1. What type of reactions or emotions am I feeling as I study the material on multicultural counseling? Am I feeling defensive, angry, anxious, guilty, or helpless? Where are these feelings coming from? Why am I feeling this way, and what does it possibly mean?

2. Does having a different point of view mean I am resisting the multicultural material? List all those reasons that support your stance. List all those reasons that do not support it.

3. How applicable are the resistances outlined in the following sections to me?

4. In what ways may these emotions affect my ability to understand the worldview of clients who differ from me, and how might that affect my work?

In work with resistance to diversity training, research reveals how it is likely to be manifested in three forms: cognitive resistance, emotional resistance, and behavioral resistance (Sue, 2015). Recognizing the manifestation and hidden meanings of resistance is one of the first priorities of multicultural training for both trainees and trainers. For trainees it is finding the courage to confront their own fears and apprehensions, to work through the powerful emotions they are likely to experience, to explore what these feelings mean for them as racial/cultural beings, to achieve new insights about themselves, and to develop multicultural skills and behaviors in their personal lives and as mental health professionals. For trainers it means understanding the nature of trainee resistance, creating a safe but challenging environment for self-exploration, and using intervention strategies that facilitate difficult dialogues on race, gender, sexual orientation, and other topics in the area of diversity.

Cognitive Resistance—Denial

To date, my biggest discovery is that I didn't really believe that people were being discriminated against because of their race. I could hear them say it, but in my head, I kept running a parallel reason from the White perspective. A Chinese lady says that her party had to wait longer while Whites kept getting seated in front of them. I say, other people had made reservations. A black man says that the receptionist was rude, and made him wait longer because he's Black. I say she had a bad day, and the person he was there to see was busy. A Puerto Rican couple says that the second they drove into Modesto. . .a cop started tailing them, and continued to do so until they reached their hotel, which they opted to drive right on by because they didn't feel safe. I say, there's nothing to be afraid of in Modesto. It's a nice little town. And surely the cop wasn't following you because you're Puerto Rican. I bet your hotel was on his way to the station. I know that for every story in which something bad happens to someone because of their race, I can counter it with a White interpretation. And while I was listening with a sympathetic ear, I silently continued to offer up alternative explanations, benign explanations that kept my world in equilibrium. (Rabow, Venieris & Dhillon, 2014, p. 189)

This student account reveals a pattern of entertaining alternative explanations to the stories told by persons of color about their experiences of prejudice and discrimination. Although the author describes “listening sympathetically,” it was clear that he or she silently did not believe that these were instances of racism; other more plausible and “benign” explanations could account for the events. This is not an atypical response for many White trainees when they listen to stories of discrimination from classmates of color (Young, 2003). Because of a strong belief that racism is a thing of the past, that we live in a post-racial society, and that equal access and opportunity are open to everyone, people of color are seen as exaggerating or misperceiving situations. When stories of prejudice and discrimination are told, it directly challenges these cherished beliefs. The student's quote indicates as much when he says that his “benign explanations” preserves his racial reality (“kept my world in equilibrium”).

The fact that the student chose not to voice his thoughts is actually an impediment to learning and understanding. In many classrooms, teachers have noted how silence is used by some White students to mask or conceal their true thoughts and feelings about multicultural issues (Sue, 2010; Sue, Torino, Capodilupo, Rivera, & Lin, 2010; van Dijk, 1992). Denial through disbelief, unwillingness to consider alternative scenarios, distortion, fabrication, and rationalizations are all mechanisms frequently used by some trainees during racial conversations to prevent them from thinking about or discussing topics of race and racism in an honest manner (Feagin, 2001; Sue, Rivera, Capodilupo, Lin, & Torino, 2010; van Dijk, 1992). In our teaching in multicultural classes, we have observed many types of denials that work against honest diversity discussions. There are denials that students are prejudiced, that racism still exists, that they are responsible for the oppression of others, that Whites occupy an advantaged and privileged position, that they hold power over people of color, and even denial that they are White (Feagin & Vera, 2002; McIntosh, 2002; Sue, 2010; Tatum, 1992; Todd & Abrams, 2011). This latter point (Whiteness and White privilege) is an especially “hot topic” that will be thoroughly discussed in Chapter 12 . As a trainee in this course, you will be presented with opportunities to discuss these topics in greater detail, and explore what these denials may mean about you and your classmates. We hope you will actively participate in such discussions, rather than passively dealing with the material.

Emotional Resistance

Emotional resistance is perhaps the major obstacle to multicultural understanding because it blocks a trainee's ability to acknowledge, understand, and make meaning out of strong and powerful feelings associated with multicultural or diversity topics. The manifestation and dynamics of emotional resistance are aptly described by Sara Winter (1977, p. 24), a White female psychologist. She also provides some insights as to why this occurs; it serves to protect people from having to examine their own prejudices and biases.

When someone pushes racism into my awareness, I feel guilty (that I could be doing so much more); angry (I don't like to feel like I'm wrong); defensive (I already have two Black friends. . .I worry more about racism than most whites do—isn't that enough); turned off (I have other priorities in my life with guilt about that thought); helpless (the problem is so big—what can I do?). I HATE TO FEEL THIS WAY. That is why I minimize race issues and let them fade from my awareness whenever possible.

The Meaning of Anxiety and Fear

Anxiety is the primary subjective emotion encountered by White trainees exposed to multicultural content and its implications. In one study, it was found that when racial dialogues occurred, nearly all students described fears of verbal participation because they could be misunderstood, or be perceived as racist (Sue et al., 2010). Others went further in describing having to confront the realization that they held stereotypes, biases, and prejudices toward people of color. This insight was very disturbing and anxiety-provoking to them because it directly challenged their self-image of themselves as good, moral, and decent human beings who did not discriminate. Facing this potential awareness creates high levels of anxiety, and often results in maneuvers among students to avoid confronting their meanings.

I have a fear of speaking as a member of the dominant group. . .My feelings of fear stem from not wanting to be labeled as being a racist. I think that fear also stems from the inner fear that I do not want to know what happens to people of color every day. I may not directly be a racist, but not reacting or speaking up to try to change things is a result of my guilt. . . .This is a frightening prospect because I do not want to see the possibility that I have been a racist. Awareness is scary. (Rabow et al., 2014, p. 192)

In the above quote, the student talks about “fear” being a powerful force in preventing him or her from wanting to learn about the plight of people of color. The strong emotions of guilt and fear, and possibly “being racist” are too frightening to consider. For many students, these feelings block them from exploring and attempting to understand the life experience of people of color. In one major study, for example, silence or not participating in diversity discussions, denials of personal and societal racism, or physically leaving the situation were notable avoidant ploys used by students. The apprehensions they felt affected them physically as well (Sue et al., 2010; Sue, Torino, et al., 2010). Some students described physiological reactions of anxiety like a pounding heart, dry mouth, tense muscles and perspiration. One student stated, “I tried hard to say something thoughtful and it's hard for me to say, and my heart was pounding when I said it.” Others described feeling intimidated in the discussions, stammering when trying to say something, being overly concerned about offending others, a strong sense of confusion as to what was going on, censoring thoughts or statements that could be misunderstood, reluctance in expressing their thoughts, being overwhelmed by the mix of emotions they felt, and the constriction they heard in their own voices.

These thoughts, feelings, and concerns blocked participants from fully participating in learning and discussing diversity issues because they became so concerned about themselves (turning inward) that they could not freely be open and listen to the messages being communicated by socially devalued group members. Indeed, their whole goal seemed to be to ward off the messages and meanings being communicated to them, which challenged their worldviews, and themselves as racial beings, and highlighted their potential roles as oppressors.

The Meaning of Defensiveness and Anger

Although defensiveness and anger are two different emotions, studies seem to indicate a high relationship between the two (Apfelbaum, Sommers, & Norton, 2008; Sue, Torino, et al., 2010; Zou & Dickter, 2013). One represents a protective stance and the other an attempt to strike back at the perpetrator (in many cases statements by people of color). In the opening quotes for this chapter, note that both White students became angry at the authors and accused them of being racist and propagandistic. In absorbing diversity content, many White students described feeling defensive (unfairly accused of being biased or racist, blamed for past racial injustices, and responsible for the current state of race relations). “I'm tired of hearing ‘White people this. . .White people that'. . .why are we always blamed for everything?”

When the text discusses bias and bigotry, or when classmates of color bring up the issue, for example, some White students seem to interpret these as a personal accusation, and rather than reach out to understand the content, respond in a defensive and protective posture. In many cases, even statements of racial facts and statistics, such as definitions of racism, disparities in income and education, segregation of neighborhoods, hate crime figures, and so forth, arouse defensiveness in many White students. Their defense response to a racial dialogue is seen as protection against (a) criticism (“You just don't get it!”), (b) revealing personal shortcomings (“You are racist!”), or (c) perceived threat to their self-image and egos (“I'm not a racist—I'm a good person.”). Because of this stance, we have observed that many White students who feel attacked may engage in behaviors or argumentative ploys that present denials and counterpoints because they view the racial dialogue as a win-lose proposition. Warding off the legitimacy of the points raised by people of color becomes the primary goal rather than listening and attempting to understand the material or point of view.

When White students feel wrongly accused, they may respond with anger and engage in a counterattack when a racial topic arises. It appears that anger stems from two sources: (a) feeling unfairly accused (defensiveness) and/or (b) being told the substance or stance they take is wrong. Many White students may feel offended and perceive the allegations as a provocation or an attack that requires retaliation. Anger may be aroused when students feel offended (“How dare you imply that about me?”) or wronged (“I am deeply hurt you see me that way”), or that their good standing is denied (“Don't associate me with racists!”). Unlike defensiveness, which defends one's own stance, anger turns its attention to attacking the threatening behavior of others. Given the choice of the fight-or-flight response, some White students make a choice to take verbal action in stopping the threatening accusations. The strategy used is to discredit the substance of an argument and/or to derogate the communicator, often through a personal attack (“he or she is just an angry Black man or woman”). In many respects, anger and defensiveness may become so aroused that one loses control of one's self-monitoring capacities and the ability to accurately assess the external environment. These latter two abilities are extremely important for effective multicultural counseling.

The Meaning of Guilt, Regret, and Remorse

When discussing diversity issues, many White trainees admit to feeling guilty, although most tend to say that they “are made to feel guilty” by people of color, especially when unjustly accused (Sue, 2003). This statement actually suggests a distancing strategy in localizing guilt as external to oneself rather than one rightfully residing and felt internally. Guilt as an emotion occurs when we believe we have violated an internal moral code, and have compromised our own standards of conduct. The question becomes, why should White trainees feel guilty when topics of race, racism, or Whiteness are discussed? If indeed they are not racist, not responsible for the racial sins of the past, and not responsible for current injustices, then neither would they feel guilt nor could they be made to feel guilty.

Some have coined the term “White guilt” to refer to the individual and collective feelings of culpability experienced by some Whites for the racist treatment of people of color, both historically and currently (Goodman, 2001; Spanierman, Todd, & Anderson, 2009; Tatum, 1992). In diversity discussions, many White trainees find guilt extremely uncomfortable because it means that they have violated a moral standard and are disinclined to acknowledge their violation. What is that moral standard? Being a good, moral, and decent human being who does not discriminate, being a nonracist, living a life that speaks to equality and justice, and being a humane person who treats everyone with respect and dignity are the positive standards that are being breached. Compromising these moral standards and beliefs and acting in ways that violate them bring on bad feelings of guilt and remorse.

Behavioral Resistance

All the white people I know deplore racism. We feel helpless about racial injustice in society, and we don't know what to do about the racism we sense in our own groups and lives. Persons of other races avoid our groups when they accurately sense the racism we don't see. . . . Few white people socialize or work politically with people of other races, even when our goals are the same. We don't want to be racist—so much of the time we go around trying not to be, by pretending we're not. Yet white supremacy is basic in American social and economic history, and this racist heritage has been internalized by American white people of all classes. We have all absorbed white racism; pretense and mystification only compound the problem. . . .We avoid black people because their presence brings painful questions to mind. Is it OK to talk about watermelon or mention “black coffee?” Should we use black slang and tell racial jokes? How about talking about our experiences in Harlem, or mentioning our black lovers? Should we conceal the fact that our mother still employs a black cleaning lady?. . .We're embarrassedly aware of trying to do our best, but to “act natural” at the same time. No wonder we're more comfortable in all-White situations where these dilemmas don't arise. (Winter, 1977, p. 1)

Although helplessness and hopelessness can rightly be classified as emotions, they also border on providing direct excuses for inaction. Students studying diversity topics often describe two emotions that vary from helplessness (feeling powerless) to hopelessness (despair) when diversity topics are discussed. These feelings are expressed in the quote above by the author when she realizes the vastness and magnitude of individual, institutional and societal racism; how they make themselves felt in all facets of human life; and how deeply racism is ingrained in the individual psyches of people and in the entire nation. Like many students who read CCD and take this course, the author's denial of her own biases has begun to crumble, and her self-awareness places her in a very uncomfortable position. Trainees who have come to recognize and own their biased beliefs and prejudices, their roles in perpetuating racism, the pain their obliviousness has inflicted on people of color, and their privileged and advantaged position in society may feel overwhelmed by the magnitude of the problem. This may cause paralysis or inaction. Taking steps to make the “invisible” visible and to eradicate bias and discrimination requires concrete action. As long as the person feels helpless and hopeless, inaction will result.

Although guilt continues over realizing their potential culpability over past deeds, it is compounded by the knowledge that continued inaction on their part allows for the perpetuation of racism in the self and others. Thus taking action is a means to alleviate feelings of guilt. The emotions of helplessness and hopelessness make themselves felt in two different arenas: one is internal (personal change) and the other is external (system change). In becoming aware of one's racial/cultural identity, for example, White students at this juncture of development may begin to ask two primary questions:

First is the question, “How does one change?” What needs to be changed? How does one become a nonracist or an unbiased person? How do I break the shackles of social conditioning that have taught me that some groups are more worthy than others, and that other groups are less worthy? Many trainees often make these comments: “I don't know where to begin.” “If I am not aware of my racism, how do I become aware of it?” “Tell me what I must do to rid myself of these prejudices.” “Should I attend more workshops?” “I feel so confused, helpless, impotent, and paralyzed.”

The second question is “What must I do to eradicate racism in the broader society?” While self-change requires becoming a nonracist person, societal change requires becoming an antiracist one. Impacting an ethnocentric mental health delivery system falls into this category. This role means becoming an advocate and actively intervening when injustice makes its presence felt at the individual level (for example, objecting to a racist joke or confronting friends, neighbors, or colleagues about their prejudices) and at the institutional level (for example, opposing biased mental health practices, supporting civil rights issues, making sure a multicultural curriculum is being taught in schools, or openly supporting social justice groups).

Helplessness that is felt by White students in diversity studies, unless adequately deconstructed as to what it means, can easily provide an excuse or rationalization for inaction. What good would it do? I'm only one person, how can I make any difference? The problem is so big, whatever I do will only be a drop in the bucket. Feeling helpless and hopeless are legitimate feelings unless used as an excuse to escape responsibility for taking any form of action. Helplessness is modifiable when these students are provided options and strategies that can be used to increase their awareness and personal growth, and when they are provided with the tools to dismantle racism in our society. Hopefully, this course and the readings will provide you with suggestions of where to begin, especially in mental health practice.

Hopelessness is a feeling of despair and of giving up, a self-belief that no action will matter and no solution will work. Helplessness and hopelessness associated with the need for change and action can be paralytic. The excuse for inaction, and thus the avoidance of racial exploration, does not necessarily reside simply in not knowing what to do, but in very basic fears eloquently expressed by Tatum (2002):

Fear is a powerful emotion, one that immobilizes, traps words in our throats, and stills our tongues. Like a deer on the highway, frozen in the panic induced by the lights of an oncoming car, when we are afraid it seems that we cannot think, we cannot speak, we cannot move. . . .What do we fear? Isolation from friends and family, ostracism for speaking of things that generate discomfort, rejection by those who may be offended by what we have to say, the loss of privilege or status for speaking in support of those who have been marginalized by society, physical harm caused by the irrational wrath of those who disagree with your stance? (pp. 115–116)

In other words, helplessness and hopelessness are emotions that can provide cover for not taking action. It allows many of us to not change for fear that our actions will result in the negative consequences expressed above. Becoming a multiculturally competent counselor or therapist requires change.

Cultural Competence and Emotions

There are many other powerful emotions often experienced by students during the journey to cultural competence. They include sadness, disappointment, humiliation, blame, invalidation, and so on. These feelings, along with those already discussed, can make their appearance in dialogues on multiculturalism or diversity. The unpleasantness of some emotions and their potentially disturbing meanings makes for avoidance of honest multicultural dialogues and hence a blockage of the learning process. Rather than seeing emotions as a hindrance and barrier to mutual understanding, and rather than shutting them down, allowing them to bubble to the surface actually frees the mind and body to achieve understanding and insight. The cathartic relationship between memories, fears, stereotypic images, and the emotional release of feelings is captured in this passage by Winter (1977, p. 28), who describes her own racial awakening:

Let me explain this healing process in more detail. We must unearth all the words and memories we generally try not to think about, but which are inside us all the time: “nigger,” “Uncle Tom,” “jungle bunny,” “Oreo”; lynching, cattle prods, castrations, rapists, “black pussy,” and black men with their huge penises, and hundreds more. (I shudder as I write.). We need to review three different kinds of material: (1) All our personal memories connected with blackness and black people including everything we can recall hearing or reading; (2) all the racist images and stereotypes we've ever heard, particularly the grossest and most hurtful ones; (3) any race-related things we ourselves said, did or omitted doing which we feel bad about today. . . Most whites begin with a good deal of amnesia. Eventually the memories crowd in, especially when several people pool recollections. Emotional release is a vital part of the process. Experiencing feelings seems to allow further recollections to come. I need persistent encouragement from my companions to continue.

We are aware that the content of this chapter has probably already pushed hot emotional buttons in many of you. For trainees in the dominant group, we ask the following questions: Are you willing to look at yourself, to examine your assumptions, your attitudes, your conscious and unconscious behaviors, the privileges you enjoy as a dominant group member, and how you may have unintentionally treated others in less than a respectful manner? For socially marginalized group members, we ask whether you are willing to confront your own biases and prejudices toward dominant group members, be honest in acknowledging your own biases toward other socially devalued group members, and work to build bridges of mutual understanding and respect for all groups.

Trainees who bravely undertake the journey to cultural competence eventually realize that change is a lifelong process, and that it does not simply occur in a workshop, classroom, or singular event. It is a monumental task, but the rewards are many when we are successful. A whole body of literature supports the belief that encountering diverse points of view, being able to engage in honest diversity conversations, and successfully acknowledging and integrating differing perspectives lead to an expansion of critical consciousness (Gurin, Dey, Hurtado, & Gurin, 2002; Jayakumar, 2008). On a cognitive level, many have observed that cross-racial interactions and dialogues, for example, are a necessity to increase racial literacy, expand the ability to critically analyze racial ideologies, and dispel stereotypes and misinformation about other groups (Bolgatz, 2005; Ford, 2012; Pollock, 2004; Stevens, Plaut, & Sanchez-Burks, 2008). On an emotional level, trainees of successful diversity training report less intimidation and fear of differences, an increased compassion for others, a broadening of their horizons, appreciation of people of all colors and cultures, and a greater sense of belonging and connectedness with all groups (APA Presidential Task Force, 2012; Bell, 2002; President's Initiative on Race, 1999; Sue, 2003).

In closing, we implore you not to allow your initial negative feelings to interfere with your ultimate aim of learning from this text as you journey toward cultural competence. Sad to say, this empathic ability is blocked when readers react with defensiveness and anger upon hearing the life stories of those most disempowered in our society. We have always believed that our worth as human beings is derived from the collective relationships we hold with all people; that we are people of emotions, intuitions, and spirituality; and that the lifeblood of people can be understood only through lived realities. Although we believe strongly in the value of science and the importance psychology places on empiricism, Counseling the Culturally Diverse is based on the premise that a profession that fails to recognize the heart and soul of the human condition is a discipline that is spiritually and emotionally bankrupt. As such, this book not only touches on the theory and practice of multicultural counseling and psychotherapy, but also reveals the hearts and souls of our diverse clienteles.

Implications for Clinical Practice

1. Listen and be open to stories of those most disempowered in this society. Counseling has always been about listening to our clients. Don't allow your emotional reactions to negate their voices because you become defensive.

2. Know that although you were not born wanting to be racist, sexist, or heterosexist, or to be prejudiced against any other group, your cultural conditioning has imbued certain biases and prejudices in you. No person or group is free from inheriting the biases of this society.

3. Understand and acknowledge your intense emotions and what they mean for you. CCD speaks about unfairness, racism, sexism, and prejudice, making some feel accused and blamed. The “isms” of our society are not pleasant topics, and we often feel unfairly accused.

4. It is important that helping professionals understand how they may still benefit from the past actions of their predecessors and continue to reap the benefits of the present social/educational arrangements.

5. Understand that multicultural training requires more than book learning. In your journey to cultural competence, it is necessary to supplement your intellectual development with experiential reality.

6. Don't be afraid to explore yourself as a racial/cultural being. An overwhelming number of mental health practitioners believe they are good, decent, and moral people. Because most of us would not intentionally discriminate, we often find great difficulty in realizing that our belief systems and actions may have oppressed others.

7. Open dialogue—to discuss and work through differences in thoughts, beliefs, and values—is crucial to becoming culturally competent. It is healthy when we are allowed to engage in free dialogue with one another. To a large extent, unspoken thoughts and feelings serve as barriers to open and honest dialogue about the pain of discrimination and how each and every one of us perpetuates bias through our silence or obliviousness.

8. Finally, continue to use these suggestions in reading throughout the text. What emotions or feelings are you experiencing? Where are they coming from? Are they blocking your understanding of the material? What do these reactions mean for you personally and as a helping professional?

Summary

Students who take a course on multicultural counseling and mental health issues have almost universally felt both positive and negative feelings that affect their ability to learn about diversity issues. Those from marginalized groups often feel validated by the content while majority group members often feel a range of emotions like defensiveness, anxiety, anger, and guilt. It is important not to allow these nested or embedded emotions to go unacknowledged, or to avoid exploring the psychological meanings they may have for trainees. The journey to becoming culturally competent therapists is filled with obstacles to self-exploration, to understanding oneself as a racial/cultural being, and to understanding the worldview of those who differ from others in terms of race, gender, ethnicity, sexual orientation and other sociodemographic dimensions. The subject matter in this book requires students to explore their biases and prejudices, a task that often evokes strong resistance from both majority and oppressed group members.

It is important to recognize personal resistance to the material, to explore its meaning, and to learn about yourself and others. Sometimes what is revealed about you may prove disturbing, but having the courage to continue is necessary to becoming a culturally competent counselor or therapist. Recognizing the manifestation and hidden meanings of resistance is one of the first priorities of multicultural training for both trainees and trainers. For trainees it is finding the courage to confront their own fears and apprehensions, to work through the powerful emotions they are likely to experience, to explore what these feelings mean for them as racial/cultural beings, to achieve new insights about themselves, and to develop multicultural skills and behaviors in their personal lives and as mental health professionals. For trainers it means understanding the nature of trainee resistance, creating a safe but challenging environment for self-exploration, and using intervention strategies that facilitate difficult dialogues on race, gender, sexual orientation, and other sociodemographic dimensions. This chapter is specifically written to help readers understand and overcome their emotive reactions to the substance of the text and the course they are about to take.

Glossary Terms

Antiracist

Behavioral resistance (to multicultural training)

Cognitive resistance (to multicultural training)

Cultural competence

Emotional affirmation

Emotional invalidation

Emotional resistance (to multicultural training)

Emotional self-revelation

Microaggressions

Multiculturalism

Nested/Embedded emotions

Nonracist

Self-reflection

Worldview

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27. Sue, D. W. (2015). Race talk and the conspiracy of silence. Understanding and facilitating difficult dialogues on race. Hoboken, NJ: Wiley.

28. Sue, D. W., & Sue, D. (2013). Counseling the culturally diverse: Theory and practice (6th ed.). Hoboken, NJ: Wiley.

29. Sue, D. W., Rivera, D. P., Capodilupo, C. M., Lin, A. I., & Torino, G. C. (2010). Racial dialogues and White trainee fears: Implications for education and training. Cultural Diversity and Ethnic Minority Psychology, 16, 206–214.

30. Sue, D. W., Torino, G. C., Capodilupo, C. M., Rivera, D. P., & Lin, A. I. (2010). How White faculty perceive and react to classroom dialogues on race: Implications for education and training. Counseling Psychologist, 37, 1090–1115.

31. Tatum, B. D. (1992). Talking about race, learning about racism: The application of racial identity development theory in the classroom. Harvard Educational Review, 62, 1–24.

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33. Todd, N. R., & Abrams, E. M. (2011). White dialectics: A new framework for theory, research and practice with White students. Counseling Psychologist, 39, 353–395.

34. van Dijk, T. A. (1992). Discourse and the denial of racism. Discourse and Society, 3, 87–118.

35. Velez, B. L., Moradi, B., & DeBlaere, G. (2015). Multiple oppressions and the mental health of sexual minority Latina/o individuals. Counseling Psychologist, 43, 7–38.

36. Wendt, D. C., Gone, J. P., & Nagata, D. K. (2015). Potentially harmful therapy and multicultural counseling: Bridging two disciplinary discourses. Counseling Psychologist, 43, 334–358.

37. Winter, S. (1977). Rooting out racism. Issues in Radical Therapy, 17, 24–30.

38. Young, G. (2003). Dealing with difficult classroom dialogues. In P. Bronstein & K. Quina (Eds.), Teaching gender and multicultural awareness (pp. 360–437). Washington, DC: American Psychological Association.

39. Zou, L. X., & Dickter, C. L. (2013). Perceptions of racial confrontation: The role of color blindness and comment ambiguity. Cultural Diversity and Ethnic Minority Psychology, 19, 92–96.

C:\Users\dglover\Documents\ch2.gif

THE SUPERORDINATE NATURE OF MULTICULTURAL COUNSELING AND THERAPY

Chapter Objectives

1. Compare and contrast similarities and differences between “traditional counseling/clinical practice” and culturally sensitive counseling.

2. Understand the Etic and Emic orientation to multicultural counseling.

3. Become cognizant of differences between counseling/clinical competence and multicultural counseling competence.

4. Identify Eurocentric assumptions inherent in our standards of clinical practice.

5. Discuss and understand the characteristics of the three levels of personal identity.

6. Develop awareness of possible differences in counseling culturally diverse clients who differ in race, gender, sexual orientation, and other group identities.

7. Provide examples of ways that other special populations may constitute a distinct cultural group.

8. Define multicultural counseling and therapy, cultural competence, and cultural humility.

9. Explain how cultural humility is different from cultural competence.

The following is the third counseling session between Dr. D. (a White counselor) and Gabriella, a 29-year-old single Latina, who was born and raised in Brazil but came to the United States when she was 10 years old.

Dr. D:

So how did it go last week with Russell (White boyfriend of 6 months).

Gabriella:

Okay, I guess (seems withdrawn and distracted).

Dr. D:

You don't sound too sure to me.

Gabriella:

What do you mean?

Dr. D:

Well, from the last session, I understood that you were going to talk to him [Russell] about your decision to live together, but that you wanted to clarify what moving into his apartment meant for him.

Gabriella:

I didn't get a chance to talk about it. I was going to bring it up, but I had another attack, so I didn't get a chance. It was awful (begins to fidget in the chair)! Why does this always happen to me?

Dr. D:

Tell me what happened.

Gabriella:

I don't know. I had a disagreement with him, a big stupid argument over Jennifer Lopez's song “Booty”.

Dr. D:

“Booty”?

Gabriella:

Yeah, he kept watching the video over and over on the computer. He loves the song, but I find it vulgar.

Dr. D:

Lots of songs press the limits of decency nowadays. . . .Tell me about the attack.

Gabriella:

I don't know what happened. I lost control and started screaming at him. I threw dishes at him and started to cry. I couldn't breathe. Then it got really bad, and I could feel the heat rise in my chest. I was scared to death. Everything felt unreal and I felt like fainting. My mother used to suffer from similar episodes of ataques. Have I become like her?. . . .God I hope not!

Dr. D:

Sounds like you had another panic attack. Did you try the relaxation exercises we practiced?

Gabriella:

No, how could I? I couldn't control myself. It was frightening. I started to cry and couldn't stop. Russell kept telling me to calm down. We finally made up and got it on.

Dr. D:

I'm glad things got smoothed over. But you always say that you have no control over your attacks. We've spent lots of time on learning how to manage your panic attacks by nipping them in the bud. . . before they get out of control. Maybe some medication might help.

Gabriella:

Yes, I know, but it doesn't seem to do any good. I just couldn't help it.

Dr. D:

Did you try?

Gabriella:

Do you think I enjoy the attacks (shouts)? How come I always feel worse when I come here? I feel blamed. . .Russell says I'm a typical emotional Latina. What am I to do? I come here to get help, and I just get no understanding (stated with much anger).

Dr. D:

You're angry at me because I don't seem to be supportive of your predicament, and you think I'm blaming you. But I wonder if you have ever asked yourself how you contribute to the situation as well. Do you think that fighting over a song is the real issue here?

Gabriella:

Maybe not, but I just don't feel like you understand.

Dr. D:

Understand what?

Gabriella:

Understand what it is like to be a Latina woman dealing with all those stereotypes. My parents don't want me living with Russell. . .they think he benefits from having sex with no commitment to marriage, and that I'm a fool. They think he is selfish and just wants a Latina. . . .like a fetish. . . .

Dr. D:

I think it's more important what you think and want for yourself, not what your parents would like you to do. Be your own person. And we've talked about cultural differences before, in the first session, remember? Cultural differences are important, but it's more important to recognize that we are all human beings. Granted, you and I are different from one another, but most people share many more similarities than differences.

Gabriella:

Yes, but can you really understand what's it like to be a Latina, the problems I deal with in my life? Aren't they important?

Dr. D:

Of course I can. And of course they [differences] are. . .but let me tell you, I've worked with many Latinos in my practice. When it comes right down to it, we are all the same under the skin.

Gabriella:

(period of silence)

Dr. D:

Now, let's go back and talk about your panic attacks and what you can do to prevent and reduce them.

Reflection and Discussion Questions

1. What are your thoughts and feelings about the counseling encounter between Dr. D. and Gabriella?

2. Do you think that Dr. D. demonstrated cultural awareness? Is this an example of “good counseling”? If not, why not?

3. When Gabriella described her episodes as ataques, do you know what is meant?

4. What are the potential counseling and cultural issues in this case?

5. Is it important for the counselor to know what the song “Booty” is about?

6. When the parents suggest that their daughter might be a “fetish,” what could they possibly mean? Is it important?

7. What images of Latinas exist in our society? How might they affect Gabriella's relationship with Russell?

8. If you were the counselor, how would you have handled the situation?

Culturally competent care has become a major force in the helping professions (American Psychological Association, 2003; Arredondo, Toporek, Brown, Jones, Locke, Sanchez, & Stadler, 1996; CACREP, 2015; Cornish, Schreier, Nadkarni, Metzger, & Rodolfa, 2010; D. W. Sue, Arredondo, & McDavis, 1992). The therapy session between Dr. D. and Gabriella illustrates the importance of cultural awareness and sensitivity in mental health practice. There is a marked worldview difference between that of the White therapist and the Latina client. In many cases, these differences reflect the therapist's (a) belief in the universality of the human condition, (b) belief that disorders are similar and cut across societies, (c) lack of knowledge of Latina/o culture, (d) task orientation, (e) failure to pick up clinical clues provided by the client, (f) not being aware of the influence of sociopolitical forces in the lives of marginalized group members, and (g) lack of openness to professional limitations. Let us briefly explore these factors in analyzing the previous transcript.

Culture-Universal (Etic) versus Culture-Specific (Emic) Formulations

First and foremost, it is important to note that Dr. D. is not a bad counselor per se, but like many helping professionals is culture-bound and adheres to EuroAmerican assumptions and values that encapsulate and prevent him from seeing beyond his Western therapeutic training (Comas-Diaz, 2010). One of the primary issues raised in this case relates to the etic (culturally universal) versus emic (culturally specific) perspectives in psychology and mental health. Dr. D. operates from the former position. His training has taught him that disorders such as panic attacks, depression, schizophrenia, and sociopathic behaviors appear in all cultures and societies; that minimal modification in their diagnosis and treatment is required; and that Western concepts of normality and abnormality can be considered universal and equally applicable across cultures (Arnett, 2009; Howard, 1992; Suzuki, Kugler, & Aguiar, 2005). Many multicultural psychologists, however, operate from an emic position and challenge these assumptions. In Gabriella's case, they argue that lifestyles, cultural values, and worldviews affect the expression and determination of behavior disorders (Ponterotto, Utsey, & Pedersen, 2006). They stress that all theories of human development arise within a cultural context and that using the EuroAmerican values of normality and abnormality may be culture-bound and biased (Locke & Bailey, 2014). From this case, we offer six tentative cultural/clinical observations that may help Dr. D. in his work with Gabriella.

Cultural Concepts of Distress

It is obvious that Dr. D. has concluded that Gabriella suffers from a panic disorder and that her attacks fulfill criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association, 2013). When Gabriella uses the term ataques to describe her emotional outbursts, episodes of crying, feeling faint, somatic symptoms (“heat rising in her chest”), feeling of depersonalization (unreal) and loss of control, a Western-trained counseling/mental health professional may very likely diagnose a panic attack. Is a panic attack diagnosis the same as ataques? Is it simply a Latin American translation of an anxiety disorder? We now recognize that ataque de nervios (“attack of the nerves”) is a cultural syndrome, occurs often in Latin American countries (in individuals of Latina/o descent), and is distinguishable from panic attacks (American Psychiatric Association, 2013). Cultural syndromes that do not share a one-to-one correspondence with psychiatric disorders in DSM-5 have been found in South Asia, Zimbabwe, Haiti, China, Mexico, Japan, and other places. Failure to consider the cultural context and manifestation of disorders often result in inaccurate diagnosis and inappropriate treatment (D. Sue, Sue, Sue, & Sue, 2016). Chapter 10 will discuss these cultural syndromes and treatments in greater detail.

Acknowledging Group Differences

Dr. D. seems to easily dismiss the importance of Gabriella's Latina/o culture as a possible barrier to their therapeutic work together. She wonders aloud, for example, whether he can understand her as a Latina (being a racial/cultural being), and the unique problems she faces as a person of color. Dr. D. attempts to reassure Gabriella that he can in several ways. He stresses (a) that people are more similar than different, (b) that we are all “human beings,” (c) that he has much experience in working with Latinos, and (d) that everyone is the “same under the skin.” Although there is much truth to these statements, he has unintentionally negated the racialized experiences of Gabriella, and the importance that she places on her racial/ethnic identity. In multicultural counseling, this response often creates an impasse to therapeutic relationships (Arredondo, Gallardo-Cooper, Delgado-Romero, & Zapata, 2014). Note the long period of silence by Gabriella, for example, after Dr. D's response. He apparently misinterprets the silence as agreement. We will return to this important point shortly.

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