Insider, Outsider, Observer: Reflections of a Young Black Female Trainee on a Psychiatric Placement

Abstract

This paper explores the experience of a short-term psychiatric placement completed by a first-year Child and Adolescent Psychotherapist in training. Thought is given as to how three specific attributes of the trainee: being black, being female, and being a participant observer shaped the author's experience and the lessons learned. The theory of Internal Racism (Davids, 2011) is used to highlight how a racist structure in the mind acted to navigate and resolve anxiety before the placement began and during its course. Fanon's (1952Fanon's ( /2008) notion of 'the Black Problem' is also used to show how historical colonial patterns of relationship have been internalized into a social unconscious and so shaped the trainee's interactions with all individuals on the ward. Two examples are described to illustrate how exchanges with others can be influenced by race. These include 'the nod', a subtle form of recognition used amongst black people and 'racial codeswitching', adjusting one's self-presentation with the purpose of assimilation. Further thought is given to the practicalities of therapeutic treatment in contrast to medication.

Pathways to the therapist paragon: a decolonial grounded theory

“…The blank-slate therapeutic alliance says harm to the therapist does not matter; only harm to the client matters. This virtually ensures the therapy room will be a place where therapists with target ranks will need to code-switch, denying their own position in a system of unequal privilege and power in order to play their role ( Sithole, 2022 ). Therapists with agent ranks, on the other hand, benefit from the blank-slate therapeutic alliance, since it provides a built-in reason—avoiding client discomfort or harm—to maintain dysconsciousness and avoid addressing the harm all people experience in a system that maintains the privilege and power of some at the expense of others.…”