On Racism in IAPT: Part 1

An introduction from NaG: In the wake of the murder of George Floyd and the Black Lives Matter protests it felt important for this blog to contribute a voice in support of Black Lives Matter. We know that race and racism are matters that affect every part of our working life but are too often not addressed directly. There was a dilemma though, I felt that the last thing we needed was another half-informed white voice giving an opinion on race; enter Sheeva Weil (she/they), my hero who has offered to write two posts about racism in IAPT. I can’t adequately express my gratitude. Sheeva is a Senior Psychological Wellbeing Practitioner and Wellbeing Lead and the co-founder of the Collective for Asian Psychological Therapists as well as being an activist and queer intersectional feminist. In her own words: ‘I take a keen interest into issues of human rights and social justice; my aim in this life is to change the world (no big deal). I also really love trashy TV shows and food.’ I’ll hand you over to Sheeva now, with thanks again for this powerful post.

It’s been over a month since George Floyd died. Since then, Black Lives Matter protests have ebbed and flowed. Some of us have posted, non-stop, to raise awareness about racism and anti-Blackness and slavery and Windrush and and and. Others of us have felt shocked to the core, donated a tenner and then retreated back to our comfort zones. Still others have rolled their eyes, condemned the “vandalism”, “looting” and “PC police” and ignored the uproar altogether. 

It was important to me to speak on this subject, and after conferring with NotaGuru, I was actually glad to have left some space between those most painful of events and the publishing of this article. Anti-racism is a process, and I am more than happy to remind people of the necessity to embark on this most arduous of journeys even and especially now that many of our Twitter and Instagram feeds have slowly started to turn away from BLM. 

We have split this article in half – this was not the original plan, but my call for personal anecdotes of racism within IAPT returned so many responses that we felt they must be given space. In order to address racism, we must acknowledge racism. Only once we have seen, heard, borne witness and accepted this oppression is deep-rooted in our services and community, can we consider how to move forward. 

Part two, to be published next week, will be a reflection on concrete actions we can take as APs, PWPs / LITs, CBT therapists / HITs and senior clinicians. We need to make IAPT services and Psychology as a whole more inclusive, not just in name but in practise. We’re not there yet, but I believe we can be.

Disclaimer: I am half-White, half-Asian. I am French, Dutch, Malaysian and Indian. I identify as a Brown woman. I do not speak for the Black community – I can only speak from my own experience. I hope not to offend, but expect that as everyone is a bit racist and by that definition so am I, it could happen anyway. I am open to being wrong, and welcome corrections from the Black community. I know NotaGuru would be more than happy to have others write on this topic, too. 

First, a story:

I started my IAPT journey in an inner-city London service. I was pleasantly surprised by the diversity in my team – there were several Asian therapists and a couple of Black therapists too. Of course, our admin team was almost exclusively Black and Asian and our management team was almost exclusively White; go figure.

Most importantly, my fellow LIT trainees were two women: one Asian and the other Black (both driven, compassionate, excellent clinicians). Just knowing that we had each others’ backs made us feel more comfortable to speak up about the ways in which IAPT systems and processes ran counter to our values, the issues we ran into when attempting to adapt therapies to the multi-cultural communities we worked with, and the inherent racism in the term “hard-to-reach population”. 

Saying that, there was someone else on our team who seemed less than keen to reflect on issues of diversity. At first, we thought Karen (not her real name, obviously) was just a little standoffish in general: she never said hello to us, nor did she seem keen to get to know us better. We figured, perhaps she was a little uncomfortable talking about race, especially given she was a White middle-class female like so many others in our field. Who knows, maybe she was put-off by the fact that us three trainees had grown so close so fast. Nothing to write home about. 

Then, new trainees started in our service: two White women this time. Karen was absolutely lovely to them. She offered to make them tea, gave them her revision notes, even asked them to lunch. That odd, on-edge feeling we had discussed feeling around her crystallised: maybe, just maybe, Karen was a little bit racist. 

All socials she organised were held in a local bar or involved eating meat – notwithstanding the fact that over half our team were vegan, vegetarian or ate halal. Several of us didn’t drink, either, and tended to avoid those team activities which involved drinking (e.g., all of them). When we organised sports-based socials, Karen didn’t attend. 

Karen once said to me, perhaps because she saw me as more White than Asian, that she’d read that White middle-class women are the most oppressed in Western society. Another time, she voiced her disbelief that our Black colleague had a blister on her foot: “Isn’t Black skin thicker than White skin?” On these and other occasions, our colleagues would laugh and someone would ever-so-gently explain the “misunderstanding”. It feels important to say: Karen was in her mid-20s and had grown up in London – no excuses when it comes to “ignorance”, in my eyes.

One day, as we sat together having lunch, a colleague told us he was feeling exhausted and demoralised, as a result of his work with a patient who faced deportation by the Home Office. We started discussing how dreadful it is that asylum seekers are asked to prove their trauma. Karen said, “Well, these people do try to take advantage of the benefits system. It’s only right that we should check they aren’t trying to lie their way in.” Then, “I don’t see why the big deal is. Why doesn’t this patient just go back to their country and lie about their sexuality? Then they won’t be at risk of harm.” 

You might be thinking – how could this woman feel comfortable voicing such abhorrent opinions in her office, around her colleagues, in an NHS hospital building? The author must be hamming it up to prove a point. I wish I were. 

I look back and wish I had had the clarity of mind to tell Karen exactly how wrong everything she had just said was. I wish I had felt the strength, the confidence, the… gumption to speak up, speak out, call her out on her blatant racism and unthinking cruelty. Instead, I made eye contact with my fellow trainees, walked out, and burst into angry tears. I felt heartbroken: was this the profession I had dedicated my life to; were these the people within it?

It gives me no pleasure to tell you that we did not report Karen to our management team. We didn’t lodge a complaint, we didn’t speak to our supervisors, we didn’t raise this issue higher. Why not? Perhaps we felt intimidated – Karen was well-liked by our majority-White senior team. We were three Black, Asian and mixed-ethnicity trainees – power dynamics cannot be ignored. Maybe we didn’t feel we had the clout, or we worried that we would be accused of lying, because we clearly weren’t particularly friendly with her. It’s true – we were afraid for our jobs, as we were in the process of applying for qualified posts. We also didn’t think anything would come of it: don’t you know how hard it is to fire someone from the NHS?

What saddens me more is that there were a number of more senior colleagues in that room. There were qualified LITs and HITs, White and BAME alike. Although I don’t know what they said to Karen on that occasion, I do know that no one ever reported her behaviour. Those reasons why my friends and I didn’t feel able to report… I do not feel as though they applied for our colleagues. What reasons, what excuses do they have? 

Why am I telling you this story? Honestly, it still festers in my heart of hearts. When I speak to those women I trained with, now close friends, we often reflect on this episode. It’s been years now, and we still wish we had taken action, in order to protect ourselves, our colleagues, and most of all our service-users and community. We feel we had responsibility, even as lowly trainees; and that we should have taken the risk, come what may. Rest assured: we have not made the same mistake since. Although we may not have always made friends, at least we can live with ourselves now. Karen did us a favour, I guess.

As uncomfortable as this is to write, and probably to read, I feel it is vital to talk about these incidents. We know racism exists in Psychology, and we conjecture that it might, maybe, perhaps exist in IAPT, but we often assume it is “unconscious bias”: the unwitting, ignorant and naive, well-meaning, even colour-blind. In my experience, and in the experience of likely every single Black, Asian or other ethnic minority IAPT staff member, not so. 

Please take some time to read and digest the anecdotes in this post, which are personal to their authors. They were sent to me directly, by text or by tweet; I have anonymised them myself. Although painful, I hope these will help those of you on the receiving end of racism and discrimination feel a little less alone. I have certainly felt a certain catharsis in putting these together. I cannot thank the authors enough for choosing to be vulnerable (which is the same as courageous, in my eyes).

For those of you who haven’t experienced anything like this, please believe us. If the urge to second-guess arises, please take a breath and consider where it came from. Perhaps you’ve never heard of anything like this: well, now you have. Please reflect on your privilege and consider what you would have done, had you been there – perhaps you were. And please, please do better. 

In the wake of George Floyd’s murder and the continual oppression of the Black community, we must lean into discomfort. This was never meant to be easy. Think of the pain our Black colleagues have endured – surely we can bear a little unease. Think about the toll that continual exposure to racism and discrimination takes. In order to do better for our profession and for those we profess to work for and alongside, we have to take a long hard look at ourselves. We must talk about our experiences, especially the difficult ones which make us feel gross and angry and sad. We should hold to account those we work with, who hold harmful beliefs and don’t want to let go of them. 

You probably work with a Karen, maybe even three. Karen might not be White – hell, you might be Karen. If you speak to your BAME colleagues, you might find out that your team is full of Karens, and that they tread lightly and fearfully every single day. Ask yourself: why is it that my BAME colleagues don’t get promoted at the same rate as my White colleagues? Why do they tend to leave my team sooner? Should I content myself with the reasons they gave in their exit interviews (“oh, the commute is tough…”)? Bearing in mind the microaggressions (or straight-up racism) they may have experienced, is it so inconceivable they would have decided to take their chances elsewhere?

Let me be clear: this is not about freedom of speech, nor is it about neutrality. Psychology is not, has never been and should never profess to be neutral. Our service-users often live at the mercy of inhumane governmental systems and policies – austerity has massively contributed to the rise in mental health issues, as has race-based trauma. Who among us hasn’t worked with an asylum seeker, staring into the paralysing maw of uncertainty, constantly confronted with the prospect of being deported back to war, violence, murder? Can you honestly say that the hostile environment has played no part in their mental torture? 

Ignoring these systemic, systematic oppressions does our profession and our service-users the greatest of disservices. We must also bear in mind the power that we as psychological therapists wield – those imbalances can only be harmful if we hold discriminatory beliefs (as most of us do) and do not recognise or challenge them. If nothing else, our NHS values of respect, compassion and inclusion should hold us to account. And for what it’s worth: freedom of speech is not freedom of consequence. 

A reminder that this is currently Part 1 of 2, Sheeva’s second post in one week is a fantastic practical resource that we hope will be useful for IAPT practitioners as well as anyone else who reads. If you have got more to add to this series please get in touch with me on Twitter @notapwpguru or using the contact form on this site and I’d be happy to talk to you about it.

Afterwards…

This is NotaGuru again. Sheeva’s fantastic post has been available for two days and has been viewed more than 1,800 times. People have continued to contact Sheeva to share their experience of racism and microaggressions in IAPT. We don’t want these stories to get lost; it takes a huge amount of courage to share these experiences when you don’t know how seriously you will be taken, if it’s just happened to you, or if speaking out will affect your career. We’ve decided to keep adding these stories to this post. Please, don’t skim past these, please read them carefully and think about what they mean.

6 thoughts on “On Racism in IAPT: Part 1

  1. Liking alcohol and meat and wanting to go places that have alcohol and meat rather than doing sports is not racist, it is just a cultural difference / preference. Everything else – bang out of order. Sorry you had to go through that.

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    1. enjoying alcohol or eating
      meat are certainly not in themselves scts of racism. However, choosing to host all work socials in locations which might distress or not cater fully to the majority of your colleagues is perhaps not demonstrating a good understanding of inclusion , care and flexibility of thought that one might expect to find at a senior team level. Not being able to see that so many others around you have differing needs or requirements to tour own may be a personal oversight or shortcoming but also, unfortunately can perpetuate and promote a feeling of exclusion, reduced value and not belonging in others

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      1. If a member of the team was a wheelchair user and every social was arranged at a non-accessible venue, would it be discrimination then? Just a thought.

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