In my counselling practice I see a lot of clients from cultures where there’s still a stigma linked to seeking mental and emotional health care. Interestingly, once these clients walk through my door, they leave their stigmas behind. They come willingly and motivated to change, accept the benefits of psychotherapy, are open and genuine in the session, and even acknowledge feeling better. But when they step out of my office, their cultural bias is back in place, denying the appreciation or even relevance of counselling therapy. The weekly visits to my office are part of a secret behavior, a secret still linked to shame and fear of society’s judgment. As far as the world is concerned, those hours in my office never happened.
When these clients step out of my office sometimes I see them veer towards the side exit, quickening their pace and looking down, avoiding any chance of bumping into anyone they know. Occasionally I take part in social justice work, and have perhaps crossed the strictly defined counsellor /client boundary by asking for support on social welfare or philanthropy projects. The culturally stigmatized clients respond in a curtly unhelpful fashion, not wanting to acknowledge any relationship with me outside of the session – even though they are back to their normal friendly selves in our next meeting. They may even decline claiming from insurance, to keep their secret safe. The bottom line however, is that they still keep coming back each week for a therapy that must be helping them, but they won’t admit it to the outside world.
On the other hand, I have clients who are referring their friends, family and co-workers to me, and even sometimes bringing a friend into the session as an intervention to elicit moral support. These clients have nothing to hide. How nice! But honestly, I see equal rates of therapeutic success in both culturally stigmatized and non-stigmatized clients. Yes, really! When there is a willingness and readiness to change together with a good therapist/ client alliance, stigma or not, therapy works.
*The views expressed by our authors are personal opinions and do not necessarily reflect the views of the CCPA