Working with Black LGBTQ+ Clients in America

I recently interviewed Verniece Green-Fulford, LMHC, a therapist at the Gay Therapy Center in New York about her experience working with Black LGBTQ+ clients. Here are some highlights of our conversation.

Adam Blum: What are some issues that your Black clients bring to therapy that are unique to their experience as Black people in America?

Verniece Green-Fulford: As a therapist I am privileged to hear the personal stories and the emotional impact of facing prejudice. Sometimes I am shocked that these experiences still exist today.

Just recently a pregnant Black female client told me about visiting the emergency room when her water broke. She was in great pain. The nurse took one look at her and said she was fine and that her water didn’t break. In health care Black women are often not seen as experiencing pain. It’s called the “superwoman syndrome.”

I grew up on Staten Island and I live there now. Every time I turn around it seems like someone is saying something racial. I get looks. Sometimes there is a feeling of ostracization. I never experienced this before. It changed during the Trump presidency. I am experiencing what my parents experienced many years ago but what I was spared from when I grew up.

Being LGBTQ adds another layer. I’ve had clients in rehab centers where they can’t thrive because they don’t have peers whom they identify with. They find that other participants are making untrue assumptions about them.

Adam: What are some of the psychological impacts of racism?

Verniece: There is an overall feeling of anxiety. There is the lingering question: Am I being judged? There is the fear that parents have for their children growing up today.

Depression is another common response. I have a client who gets depressed when he has to go out socially. He’s had close friends of mixed races his entire life. Now he finds he is not welcome in the home of his friends’ parents. It has changed the trajectory of the relationship.

Adam: What are some ways you help clients unpack the the impact of racism on their mental health?

Verniece: In therapy I help people to peel back the layers. We need to do this mindfully and carefully so that we don’t re-traumatize the client. When we hit a wall we take a break and do a body scan to recenter. We can learn to identify where in the body we feel the pain. This is a great way to calm down and regulate our emotions.

When we talk about racial trauma I aim to help clients feel whole when they leave the session. I invite them to leave the pain in the session room. We all need a place to put this stuff.

Adam: What are some ways clients can heal from the impact of racism?

Verniece: We do better when we build upon support networks, both remotely and in person. There are now so many wonderful BIPOC groups offering support. It’s healing to join a community that doesn’t bash but does talk about the injustices and how to advocate for what you need.

Adam: How do you support clients in their healing?

Verniece: I help clients see that there are three things that happen in life we have no control over. We are born, we go through changes of life every day, and we die. Anxiety is intolerance of uncertainty.

Many of us feel that we need control life and approach it with resistance. Resistance is ambivalence. When you are unsure of something and you find yourself having simultaneous feelings of love or hate for a situation, that’s ambivalence.

Part of this experience may come from the fact that you hate the idea of change. I help clients lean into change and learn to control only what you can. We ask: What can I do in order be a little more accepting of it?

Verniece: What gives you hope?

Adam: When I see clients come week after week, connecting to the work and to me I know they are hopeful about change.

These days, with everything that has been going on in the world, I feel like clients are more open to the process of therapy. They are here to do the work. And that makes me excited.


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