Behavior Modification Experiments in Resisting White Supremacy in Clinical Practice – Comprehensive Study Notes

Context, Authorial Positionality, and Core Premise

Michael Boucher, a 52-year-old, white, heterosexual, cisgender male with economic privilege, practices at a Rochester (NY) health center that serves uninsured and under-insured individuals. He details his professional path to decenter whiteness in therapy, asserting that most current clinical models either marginally address or actively perpetuate racism, colonization, and white supremacy, thereby causing psychological, emotional, and physical harm to Clients of Color.

Illustrative Clinical Encounter: Ms. Pamela’s “Research”

Ms. Pamela, an African-American woman aged 60, observed Boucher in the waiting room for 6 months before agreeing to therapy, vigilantly assessing if he was “safe.” This vigilance highlights the everyday racialized risk management experienced by Clients of Color, contrasting sharply with the white privilege where white clients rarely need such precautions. Boucher’s emotional reaction, marked by tears, signified his honoring of her trust despite historical dangers and his recognition that any white–Client-of-Color encounter inherently risks reenacting colonization and enslavement dynamics.

The Ever-Present Risk of Racial Harm in Therapy

While power differentials are inherent in all therapeutic relationships, racialized power significantly amplifies the potential for harm. White clinicians frequently lack a “fundamental awareness” of systemic racial oppression, as noted by Erica Woodland in 2017.

The Whiteness of Clinical Training

Clinical training is largely characterized as learning “how to be a white clinician,” given that major theorists, textbooks, videos, and assumed clientele are overwhelmingly white. Eurocentric theories are often presented as universal, as highlighted by Clausen in 2015, and these diagnostic frameworks subsequently influence critical societal institutions like courts, prisons, schools, and medicine. Woodland further asserts that the mental-health system itself is “rooted in the degradation of indigenous people, Black people, women, queer people.”

Historical Functions of Psychology & Psychiatry

Historically, the fields of psychology and psychiatry have served colonialist agendas by legitimizing the existing racial status quo, a point made by Fanon in 1963. Hall & Malony demonstrated in 1983 that majority clinicians often pressured minority clients to adopt dominant values. Nicole Penak also critiques therapy offices as being “expressions” of capitalism, neoliberalism, and colonialism.

Essential Reflective Questions for White Clinicians

To detect and address white supremacy in practice, white clinicians must ask themselves critical questions: How would they detect white supremacy in their practice? What does modern colonialism look like? How do their methods inadvertently reinforce racial oppression? What histories and sources, particularly those centering marginalized voices, must they commit to studying?

“Telling the Truth” as First Step in Healing

Dr. Joy DeGruy’s Post-Traumatic Slave Syndrome trainings expose hidden racist medical history, and she posits that truth-telling is the essential foundation of health, as discussed on page 41. This process, while initially depressing, ultimately proves liberating by removing the need to defend a white-centric heritage.

Research Findings on White Clinician Self-Work (Baima & Sude, 2020)

Research by Baima and Sude in 2020 on white clinician self-work identifies three key findings: clinicians must learn the historical and contemporary implications of whiteness within society and the profession; they need to explore their personal oppressive tendencies, judgments of People of Color, and their own social location; and they must shift “self-of-the-therapist” work from focusing on personal victimization toward confronting their own perpetration, especially racial perpetration.

Persisting Through Confusion and Discomfort

Tre Johnson's 2020 observations suggest that white individuals often receive seemingly contradictory advice within racial justice discourse (e.g., step up / step back, read / act) but are ultimately tasked with “figure it out” themselves. Clausen emphasizes that while whites can easily disengage, authentic commitment requires sustained engagement.

Building Racial Literacy: Key Resources

Key resources for building racial literacy include books such as Robin DiAngelo’s White Fragility (2018) and What It Means to Be White (2012), works by Debby Irving (2014) and Tim Wise (2005), and the influential “Characteristics of White Supremacy Culture” by Jones & Okun (2001). Additional valuable insights come from Savage & Knight (2020) on what Black therapists want white colleagues to know, and Zencare’s 2020 “10 Ways White Therapists Can Address Racism.”

Concept of “Pre-Transference”

Lennox Thomas introduces the concept of “pre-transference,” positing that racism, projections, and prejudices exist prior to any therapeutic session, necessitating accountability dialogues among white individuals themselves. Janet Helms’s racial-identity-development model (2019) serves as a valuable tool for self-assessment and peer work in this context.

From Reading to Behavioral Modification

Tre Johnson critiques white liberals for merely “reading and talking” without commensurate action. In response, Zencare outlines 10 actionable practices for white therapists, including committing to ongoing readings and trainings, undertaking learning activities outside of session time, creating a personalized education plan, actively tracking and reducing microaggressions, validating racial trauma, and asking client-specific rather than stereotyped questions. Implicit in the article are further actions such as seeking supervision, explicitly naming whiteness in the therapeutic space, staying accountable, and knowing when to refer clients to other therapists.

Cultivating Curiosity & Humility in Sessions

Cultivating curiosity and humility in sessions involves always asking permission from clients, such as “May I ask more about that?”—a practice that serves as a micro-decolonizing act by respecting client boundaries. For example, discussing differences in depression with a Black client led to Boucher reading Terrie Williams’s Black Pain (2008), significantly deepening his understanding of the diverse expressions of depression.

Narrative Therapy & Appreciative Witnessing

In narrative therapy, the clinician adopts an “appreciative ally” stance, as described by Rice in 2015. However, without sufficient racial literacy, therapists risk failing to comprehend or validate clients’ performances of resistance. Mukungu Akinyela (2002) emphasizes that curiosity about these acts of resistance allows for the reclamation of dignity by the client.

Staying Present Under Racial Stress

In a case involving a client named “Larry” who stated, “All you white people are the same…,” the therapist's defensive offer to terminate the session exemplified white fragility; a preferred response would have been to acknowledge, apologize, and lean into the therapeutic relationship. A strong therapeutic alliance is a crucial predictor of positive outcomes, according to Norcross & Lambert (2018). Derald Wing Sue (2010) notes that microaggressions are inevitable and the responsibility lies with the therapist to repair them.

White-Body Supremacy & Somatic Work

Resmaa Menakem’s My Grandmother’s Hands (2017) introduces the concept of white-body supremacy, explaining that it constricts the affective range of white individuals, making reason or workshops alone insufficient for healing. Menakem argues that whites have historically “outsourced” their pain onto dark-skinned bodies (p. 211), and therefore, healing necessitates embodied practices to enable white clinicians to truly “feel” the realities of their clients.

Choosing a Side: Values vs. Alignment

The protest chant “Which side are you on?” resonates in the therapeutic context, prompting clinicians to consider their stance. Paul Kivel (2000) suggests that after naming one’s values, the next question must be “Who do you stand with?” Tre Johnson emphasizes that true justice requires actively dismantling oppressive systems within one’s jobs, networks, and families.

Decolonizing Therapy & Reclaiming Humanity

Jennifer Mullan advocates for integrating systemic oppression analysis into therapy, seeing it as essential for re-humanizing both therapists and clients. Lila Watson (2004) cautions that if white individuals join liberation efforts merely to help the oppressed, they “waste time”; instead, the mutual liberation of all involved must be the overarching goal.

Practical Integration & Ongoing Accountability

Practical integration and ongoing accountability in decolonizing therapy involve a commitment to continuous study of history told by marginalized voices, regular race-focused supervision and peer consultation, engaging in somatic practices to address white-body constriction, explicitly validating clients’ racialized experiences within sessions, and participating in public, organizational, and policy advocacy that aligns therapy with broader liberation movements.

Ethical, Philosophical, and Practical Implications

Ethically, white clinicians bear the responsibility to mitigate the potential for racial harm that is inherent in power differentials within therapy. Philosophically, the act of decentering whiteness fundamentally challenges the universalist claims that underpin much of Eurocentric psychology. Practically, this work demands concrete behavioral change, including developing personalized education plans, altering questioning styles, cultivating bodily awareness, and engaging in systemic activism; mere reading alone is insufficient.

Concluding Charge

The text concludes with a powerful charge, framing the effort as “a struggle for the souls of white folks, the soul of our profession, and the soul of this nation.” It asserts that sustained, embodied, and accountable action—rooted in truthful history, critical self-examination, and genuine solidarity—is the only viable path toward collective liberation and clinically safer, more just practice.