Black and White Thinking: Using CAT to think about Race in the Therapeutic Space

Brown, H. and Msebele, N., 2011. Black and White Thinking: Using CAT to think about Race in the Therapeutic Space. Reformulation, Winter, pp.58-62.


In this paper we explore how racial difference, that is being white as well as being black, taps into ingrained patterns of binary thinking that generate anxiety and give rise to painful projections. As Tony Ryle(2010 p6) reminded us, CAT theory reflects the notion that “social relationships are replicated within the structure of the self” and race is a therefore a critical fracture line that is continuously being reproduced.  White people in particular tend to draw a veil over race as if to disavow their part in the racial hierarchy that pertains in our society, and as a way of trying to manage the unhelpful meanings and associations they have absorbed as part of our/their enculturation (Ryde 2009 p22). Speaking openly about these issues might seem to cross a line that exists to keep things pleasant on the surface, but it is our view, paradoxically, that being explicit might help us to think in less “black and white” terms and to feel more confident about supporting black patients and black colleagues.  CAT provides useful tools for naming and understanding these dynamics.

Moreover there are professional and moral imperatives that suggest we should be making racial inequality more explicit as a priority in our work. Our profession is predominantly white and Msebele (2008) has shown that black psychotherapists continue to face cultural and economic barriers throughout their training and entry to the profession.  Altman (1995) states that a psychoanalysis that does not address these issues “makes a statement of indifference to social issues or of collusion with the established order” (1995 p75). Nor is it the case that racial tensions are lessening because, despite wishful thinking that “race” might be less of an issue in this post-Obama era, the reality is that racial violence, forced migration, extremes of wealth inequality, poverty and exploitation, remain at the heart of life for many black people across the globe.  Moreover, as Obama, wrote in his autobiography (2008 p195),  the stories told by black communities are not only those of poverty and dispossession but arise “out of a very particular experience of hate” which is rarely named in the therapy room or put onto the diagram, although it hints at a powerful and often disavowed reciprocal role.

White and Black as Reciprocal Roles

In 1964 Curry, a pioneering black psychoanalyst writing against the backdrop of the American civil rights movement, wrote a seminal paper on race within psychotherapy called “Myth, transference and the Black Psychotherapist” (Curry 1964a) in which he pointed to numerous examples of binary thinking in myth and archetype, hinting at the way black and white are tied together. He cited the  “frequent themes … that light and darkness, black and white are complementary and inseparably related in some type of dynamic tension or equilibrium (p548)”. To Black is accorded darkness, sleep, death the Devil and evil: White gets illumination, light and awareness but these cannot exist “without these complements” (Curry 1964a p548). This is underscored by the processes that define disadvantaged groups as “others” in relation to those with more power, categorizing them on the basis of a range of “differentnesses” (see Kareem and Littlewood 1992 p137). Curry had noted how magic was attributed to black people whereas white was related to the “orderly rational progression of life” (Curry 1964a p548;see also Ryde 2009 pp68-70) and that constructs were always defined in relation to their polarities with the result that

Black people are always conceived of in counterpoint, (especially to white upper class men) along a range of continua, including their supposed inferiority, badness, and emotional abandon (Curry 1964a p553).

He (op cit p 552) named this process as a set of “reciprocal responses to race”: in CAT we might also think of them as dilemmas or false opposites.

Writing almost thirty years later, Frankenberg also described the way that patterns of relating were hammered out interactively within the prevailing power structure. She described roles that were “co-constructed”, “complementary” and “binary” at a societal, as well as at an interpersonal, level (1997 p12). This suggests that White and Black might helpfully be thought of as an archetypal and/or institutionally embedded reciprocal role that is structurally maintained and re-produced in our social and economic relationships. As such it should be brought into the therapy room and named. Racism should be there on the diagram so that its part in the person’s mental life can be understood and challenged because to do otherwise colludes with the fiction that the forms of a person’s accommodation or resistance are somehow innate or uncalled for. Ryle (2010 p7) notes how “Social and historical influences form aspects of the self which feel innate or “given” …we should recognize and name them”.

Reciprocal role procedures, dilemmas, traps and snags, provide powerful explanations of the multiple injuries that this core superior/inferior structure inflicts as it becomes the blueprint for all reciprocations, whether complied with, or rebelled against. What is done by others, or through the injustices of the world, come to be repeated as self-talk and done again to the self; what is feared is readily seen in “others” and/or elicited from them; pervasive feelings of anger, envy or powerlessness may be so easily triggered that they arise on the slimmest pretext almost literally “out of nowhere”. Hence a person who has grown up breathing the poison of racism will always see it, be looking for it or fear it in new situations, sometimes to the extent of bringing it “on themselves” when others do not do it directly to them. Just as white people may come to believe, in a small corner of themselves, that they are superior, so black people may need to bat away numerous images and messages that they are lesser, or switch roles to establish hierarchies of their own, finding refuge in self-segregation (see Curry 1964b p135).  

Casting groups in the role of “other”

And because this is a two-sided process, race is not only a determinant of black people’s experience and emotional lives but of white, (Sandoval 1997 p98), fundamentally forging their expectations of the social world (Frankenberg 1993). Sandoval (1997 p102) made explicit how far the consciousness of dominating/advantaged, as well as dominated/disadvantaged peoples are shaped in, and by, unequal interactions. As a result, white people may take credit, for things that are the result of privilege rather than their own supposedly exceptional qualities, losing sight of the “other end of the stick” that allows them to stay in their advantaged position. At other times, they may feel doubly disappointed or grandiosely entitled if they are “knocked off their perch”. What these dynamics obscure is the fact that to be this  “somebody”, white people leave black people to occupy what Martin Luther King described as “a degenerating sense of ‘nobodiness’” (cited in Msebele 2007 p10) and that  this is clearly a reciprocal role.

But usually white people act as if they are operating outside and independently of “race”; Ryde (2009 p39) describes this as taking a “neutral” stance, as if they could “opt out” of having a racial identity at all, or in CAT terms disavow that they occupy, or have been the benefactors of, this hating/ oppressive end of the reciprocal role. This feigned neutrality is one of the clearest markers of dominance, in that it allows the privileged group to forget that their position has been forged in relation to the less advantaged “other”. For example several of our major cities and financial institutions continue to thrive on the founding wealth of slavery which has come down through, and capitalized generations to this day, but the source of this wealth is rarely acknowledged. Of course class and gender interplay with the way privilege operates but white people usually experience themselves as “normal” rather than privileged and are able to act as if everyone else differs from them and that they are the legitimate reference point  for, humanity as a whole,- “everyman” against which variation and inferiorities can be measured. Responding to a survey about Black writing in the 60’s, Curry suggested that;

“It is almost as if you cannot write about being black without doing it in terms of your relationship to Whitey,- and when it all goes down, Black-White may be that deeply related, for Whitey cannot define himself as being White without using the reference point of black” (cited in Keller 1969).

This dynamic can be seen in relation to other impositions of “otherness”, for example De-Beauvoir elaborated it in relation to women in her 1949 book entitled “The second sex” and disability theorists such as Oliver (1996) and Finkelstein (1997) have developed it in relation to disability. It is described as the “unmarked-dominant-posing-as-universal” position (Sandoval 1997 p102 after Barthes) and is the means whereby the definers get to consider their experiences as typical. So the reciprocal role is one of “normal” to “deviant, different or denigrated.”  In this way “whiteness [has become] integral to the standards by which identity, confidence, humanity, gender, knowledge and academic values are constructed” (Frankenberg 1997 p18) and in this way whiteness takes a dominant role in the therapy room without a word being spoken.

At a personal level a white therapist treating a black patient the “same” as a white patient runs the risk that they will fail to address their patient’s particular experience of racism and miss the layers of significance raised by their personal issues. For example, a black woman in her twenties brought to therapy a pervasive feeling of shame about her body and her family that could be traced back to a specific experience of abuse within her family, but it was overlaid by feelings she had of being dirty, shameful and sexualised as a black woman. Exploring the issues of sexual abuse outside this context seemed to confirm and not dispel painful, racist stereotypes that  she had internalised.   Saying nothing might seem “polite” and even safe, but it is rarely helpful because unless the issues can be acknowledged from an empowering standpoint, silence colludes with, rather than challenges, the status quo. Nevertheless it is this polite evasion that has become the norm in therapy and organizational life, although it runs counter to CAT’s commitment to naming things as a precursor to reflection and change.

The trap of “Not seeing” Race

Naming issues involves taking risks because talking about race as a white person is invariably complex (Fuertes et al 2001). Frankenberg (1993 p30) describes three different kinds of discourse,

  • an essentialist biologically based racist discourse: this is sometimes also referred to as scientific racism because it draws on a distorted version of Darwinism to imply  inferiority in Black races
  • a “colour –blind” or “power-evasive” approach that has taken root to allow a white person to “not see” race as a way of slightly defying, without ever really confronting, this underlying story and
  • a race-cognizant way of thinking and speaking,- one that acknowledges both historical and current abuses of power in relation to race in ways that are explicit and empowering.

There has been recent empirical evidence of the way the second, colour-blind “not-seeing” operates and is learned by white people who embrace it as a way of appearing to be non-racist. Apfelbaum, Sommers and Norton (2008) conducted a series of experiments using photo cards in which asking about race was an efficient way to complete the task but white people continually censored themselves from mentioning it. They were most likely to do so if their black co-participant did so first and this echoes our experience that it is left with the black person in a black-white dyad to raise the issue of race, whether they are the therapist or the patient. Further versions of this experiment were conducted with children showing this to be a strategy learned by the age of 10, by which time white children had internalised the prioritising of not seeing race over speaking positively or even neutrally about it.

There was another, covert, element to this experiment because not only did many white people skirt around the houses in trying to get the task done, those who did not explicitly bring up the issue of race were also assessed as less friendly when a video showing their non-verbal engagement with their black co-participants was assessed by an independent researcher. This was explained in terms of their using up so much cognitive processing in censoring themselves that they were unable to manage their non-verbal behaviour. Extrapolating from this to the realm of the therapy room means that paradoxically, those white therapists who are most highly motivated to appear unprejudiced to their black patients, might paradoxically end up seeming less caring and risk jeopardising their self management in the “therapist” role. This is a trap and the exit is to speak openly about race from an empowering perspective and not to expend energy in trying not to notice it.

Bringing these issues into Therapy and Supervision

In CAT we know that naming things is liberating but race is often treated as if it is unspeakable (Lago and Thompson 1997). A black colleague recounted a first session of therapy with a new white patient that consisted of fielding challenges to her competence, qualifications and credibility. In supervision the racist undertones of this dynamic were left unsaid and she took away a sense of failure and of not being quite as competent as her white colleagues, not one of validation that she had, of necessity, done more than they would ever have to do.

Conversely when white therapists are consulted by black patients it may be easy for them to remain aloof and “helpful” in ways that pathologise, rather than validate the many ways in which racism has impacted on their patient’s sense of themselves and their expectations of others. One young black woman, angry about the way her college had mishandled her application to medical school, felt let down by a counselor who saw this in terms of her oversensitivity rather than as the latest incident in a chain of administrative, racially motivated, indifference. This might seem a harsh judgment but indifference that delivers inequality, if unchecked does real and lasting damage. As Ryle (2010 p7) said, “we should ensure that, in reformulating our patients’ distresses, we attend to the ultimate as well as the intimate causes” (our emphasis).  Another patient was only able to open up to being the victim of frequent violence in her neighbourhood when the white therapist asked her specifically about her experiences of racism as a recent immigrant to the city: the patient had previously denied any difficulties in speaking to a white therapist as if naming this would break the alliance, but she then spoke movingly of her dilemma about whether to dress as her community wished at the expense of being exposed to such violence or to adopt a less visible “Western” styles of dress which made her feel safer but brought her into conflict with her own family. She said she felt “between the proverbial rock and a hard place”.

Racism may also lurk in the background when the therapist and patient are both white. It is unlikely to be named, as Ryde (2009 p45) remarks, because it would be well outside social norms to draw attention to whiteness in this context “as if I would infringe a social code of conduct that could show me up as naive or on a wrong–headed campaign”.  But white therapists may find themselves invited to collude with racist views or slurs on racial others. Taking the usual non-committal stance draws one in further and can lead to feeling uncomfortably complicit.  This leaves the therapist with a complex task of identifying, naming and seeking to challenge assumptions, while building an alliance that does not rest on a collusion against “others.”

Also both black and white therapists may find themselves addressing issues that arise out of mixed race relationships in which power imbalances on lines of age or gender may morph onto exaggerated versions of those that occur in mono-cultural relationships. Sometimes these relationships go with society’s grain of dominance and control, and involve exploitation or violence, for example people may buy (including by mail order) or exploit partners or use them as part of a strategy to gain immigration status. In other instances people may be seeking to go against the grain for example by forming mixed partnerships or adopting children across lines of race or culture, but founder against the rocks of resistance that they encounter in their own families and communities or because the other’s way of being in the world  fundamentally challenge beliefs they carry within themselves. 

Race-Cognizant Psychotherapy

There are no easy answers here, and Heron (2005) argued for complex self-awareness, as opposed to knee-jerk reactions or empty gestures. For a white person “admitting one’s privilege does not necessarily unsettle its operation” (p344) and may confer additional benefits which she names as “double comfort,- the comfort of demonstrating that one is critically aware, and the comfort of not needing to act to undo privilege”. The work of putting things right, is inevitably more complicated and tentative than simply paying lip-service to anti-racism. Ryde (2009 p50) describes a “white awareness” group in which participants moved through a cycle of denial, shame and guilt towards a more profound shift in beliefs and attitudes. Others may learn through political involvement or by opening up a collaborative exploration with their patients about the bits they are unsure of: it may be possible to “wonder” about the areas of another person’s culture that you do not understand, or to invite the patient to explore the voices of significant others in their lives.

So, as part of a race- cognizant commitment, white therapists working with black patients need to give clear signals that they are aware of, and can hear, reports of racism or abuse: it is not a diversion or distraction from the “real” therapeutic agenda, but a core part of it. Black patients may otherwise find themselves in a dilemma, holding back to maintain, or speaking out and risking a rupture of, the “nice” parts of the therapeutic relationship: in other words complying or getting angry in response to the therapist’s failure to see the real inequalities they have endured. Acknowledging the torment and turmoil of previous generations can add depth to the reformulation letter because, as Samuels remarks, “Individuals live not only their own individual lives but also the life of the times” (2001 p28) and it contextualizes current generational conflicts in values and beliefs.

In our own discussions, we came face to face with these dynamics, with numerous glitches and misunderstandings as we tried to reached for common ground in terms of our practice as psychotherapists. We share the view that empowering practice involves as a minimum, some signalling ahead to the patient that racism is not something that needs to be left outside the therapy room because each time a therapist (whether Black or White) fails to name it as a concrete reality in the person’s daily lived experience, they fail to make sense of their own positions,- of relative privilege or relative disadvantage, or to explore the expectations and feelings that go with these default settings.

That is why we argue for the acknowledgment of race and racism: even if it is done clumsily or tentatively, because to do so at least lays the groundwork for authenticity and demonstrates commitment to a more honest and respectful dialogue. We hope that the CAT community might take an increasingly visible stance alongside the many pioneers,- both practitioners and theorists, of intercultural psychotherapy and those from organizations working with minority communities in the UK, to open up reflective spaces within which racial inequality can be named as a site of mental distress and one that is exacerbated by its habitual shroud of uncomfortable silence.  As Ryle, so recently remarked “We should not join the sleepwalkers” especially when we have tools that so powerfully illuminate the ways in which racism operates.


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1.  This article has been condensed and adapted from a more detailed exploration of these issues published as Msebele, N. and Brown, H. (in press 2011) Racism in the consulting room: myth or reality? Psychoanalytic Review vol 98 accepted March 2010
2.  Hilary Brown is Professor of Social Care at Canterbury Christ Church University, Kent and a Cognitive Analytic Psychotherapist working in the Sussex Partnership NHS Trust UK and in private practice. Please direct correspondence about this paper to
3.  Naison Msebele is a clinical psychoanalytic psychotherapist registered with the UKCP and a member of the Universities Psychotherapy and Counselling Association and the Multi-Lingual Psychotherapy Centre ( MLPC) working in London
4.  Where specific cases are described details have been changed to maintain confidentiality and anonymity.


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Brown, H. and Msebele, N., 2011. Black and White Thinking: Using CAT to think about Race in the Therapeutic Space. Reformulation, Winter, pp.58-62.

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