In This Issue

Microaggressions and their effects on the therapeutic process

Racial, gender, sexual orientation and other microaggressions have an unspoken and damaging effect on the therapeutic process

By Nathaniel Granger, PsyD

Solórzano, Ceja, & Yosso, (as cited in Granger, 2011), define microaggressions as brief, everyday exchanges that send denigrating messages to certain individuals because of their group membership (people of color, women, lesbian, gay, bisexual, or transgender (LGBTs)). The term was first coined by Pierce in 1970 in his work with Black Americans where he defined it as “subtle, stunning, often automatic, and nonverbal exchanges which are ‘put-downs’” (Pierce, Carew, Pierce-Gonzalez, & Willis, 1978, p. 66). They have also been described as “subtle insults (verbal, nonverbal, and/or visual) directed toward people of color, often automatically or unconsciously.”

Sue expounded on the definition as noted: Brief and commonplace daily verbal, behavioral, and environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial, gender, sexual orientation, and religious slights and insults to the target person or group, (Sue, 2010). Sue’s research related to the psychology of microaggressions indicates that White individuals are often unaware of the cumulative harm that people of color experience from being routinely subjected to various racial microaggressions.

Bonilla-Silva (as cited in Granger, 2011) defined subtle forms of racial bias, referred to as color-blind racism refer to the conception among White individuals that considerations of race are presently no longer relevant in people’s lives in the United States. Contemporary color-blind racism is expressed in everyday beliefs, attitudes, and behaviors that are considered acceptable, and even commendable, by White individuals who use them. Accordingly, such attitudes are so deeply embedded in societal values and practices that they lie outside the consciousness of many well-intentioned White people who may genuinely consider themselves to be nonracist (Sue, 2003).

According to Sue, microinvalidations, a type of microaggression, are characterized by communications or environmental cues that exclude, negate, or nullify the psychological thoughts, feelings, or experiential reality of certain groups, such as people of color, women, and LGBTs. In many ways, microinvalidations may potentially represent the most damaging form of microaggressions because they directly and insidiously deny the racial, gender, or sexual-orientation reality of these groups. According to Sue, the power to impose reality upon marginalized groups represents the ultimate form of oppression (Sue, 2010). Examples of microinvalidations can be heard in everyday statements such as low man on the totem pole.

The therapeutic relationship

The establishment of rapport is paramount to good therapy. In helping professions, this is referred to as the “therapeutic working alliance,” and most professionals agree that a successful outcome is related to the quality, nature, and strength of the therapeutic relationship. On a dynamic level, counseling and psychotherapy may be defined as a process of interpersonal interaction, communication, and influence between helping professionals and their clients. For effective therapy to occur, several conditions must be part of the process:

  • Communication must be clear, accurate, and appropriate,
  • The helping professional must establish credibility in the eyes of the client.

When microaggressions are unknowingly and inappropriately delivered by the helping professional, communication clarity and credibility suffer with the possibility of creating a rupture or impasse in the helping relationship.

When critical consciousness and awareness is lacking, when one is fearful about clarifying the meaning of tension-filled interactions, and when one actively avoids pursuing an understanding of these dynamics, the offenses remain invisible (Goodman, 1995) Indeed, avoidance of race topics has been likened to “a conspiracy of silence”. According to Sue, (as cited in Granger, 2011), making the invisible visible is the first step toward combating unconscious and unintentional racism, sexism, heterosexism, and other forms of bigotry festering under the sheath of microaggressions.

Examples of racial, gender and sexual orientation microagressions in therapeutic practice
  • Aliens in One’s Own Land
  • Ascription of Intelligence
  • Color Blindness
  • Criminality/Assumption of Criminal Status
  • Use of Sexist/Heterosexist Language
  • Denial of Individual Racism/Sexism/Heterosexism
  • Myth of Meritocracy
  • Pathologizing Cultural Values/Communication Styles
  • Second-Class Citizen
  • Culturally Insensitive/Antagonistic Treatment
  • Traditional Gender Role Prejudicing and Stereotyping
  • Sexual Objectification
  • Assumption of Abnormality

The way forward

Four objectives can be distilled from the definition that has relevance to combatting microaggressions:

  • Making the “invisible” visible
  • Establishing expertise and trust
  • Providing appropriate services to diverse populations
  • The old adage “physician [therapist], heal thyself” before healing others is all-important in having helping professionals become aware of their values, biases, and assumptions about human behavior.

Acquiring knowledge and understanding of the worldviews of diverse groups and clients are all important in providing culturally relevant services. Helping professionals must begin the process of developing culturally appropriate and effective intervention strategies in working with clients different from them. Additionally, helping professionals must develop skills that involve interventions aimed at organizational structures, policies, practices, and regulations within institutions, if they are to become culturally competent.

Principles to employ to lessen the effects of microaggressions in therapy

Principle One—Learn about people of color, women and LGBTs from sources within the group.
Principle Two—Learn from healthy and strong people of the group.
Principle Three—Learn from experiential reality.
Principle Four—Learn from constant vigilance of biases and fears.
Principle Five—Learn by being committed to personal action against racism, sexism and heterosexism.

As long as microaggressions remain hidden, invisible, unspoken and excused as innocent slights with minimal harm, individuals will continue to insult, demean, alienate, and oppress marginalized groups. In the realm of racial microaggressions, for example, studies indicate that racial microaggressions are often triggers to difficult dialogues on race in the classroom and the clinical setting, as well. Clients and therapists are confused and uncertain about what is transpiring, and both, therapists and clients are very “hung up” on clarifying these racial interactions for fear of appearing racist. It behooves professionals as well as laypersons alike to recognize and make every effort to ameliorate the effects of microaggression on the therapeutic process.


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Boykin, A.W., & Toms, F.D. (1985). Black child socialization: A cultural framework. In H.P. McAdoo & J.L. McAdoo (Eds.), Black children: Social, educational, and parental environments (pp. 33-51). Newbury Park, CA: Sage.

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Granger, N. (2011). Perceptions of racial microaggressions among African American males in higher education: A heuristic inquiry.

Sue, D.W. (2010). Microaggressions in everyday life: Race, gender, and sexual orientation. Hoboken, NJ: Wiley.

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