SA
Hi Priti! Can you describe how you’re feeling right now in five words?
P
I’m feeling excited, I’m feeling grateful, I’m feeling honoured, a little nervous and curious.
SA
I’m happy you’re excited, I’m excited as well. I was talking to my mother about this interview this morning and I was saying it’s going to be so interesting because I’m doing all the questioning today. Our roles are reversed!
I have been thinking a lot about what it means to be in therapy and receiving therapy that is culturally relative and sensitive and how significant it can be in someone’s journey and even though there are so many layers to seeking therapy itself, I personally have seen the benefits of digging deeper when it comes to finding a therapist who I feel like can relate to. I really felt like I found that when I started working with you.
How did you get into mental health? Was it something that was widely spoken about in your family?
P
Mental health was not widely spoken about in my family as I think a lot of people who grow up in non white cultures, I guess I’ll speak specifically to Indian culture, it is often considered shameful or inappropriate to share your life or your dirty laundry with someone else. I was fortunate enough to have a mother who is a medical doctor, and because of her profession she had some acceptance of it. It wasn’t something that was spoken about openly in my family and there was definitely some shame around it, especially from my dad. I’m trying to think back to when I even felt that mental health was important. Probably in high school and around adolescence because I was having a very hard time integrating. I was born and raised in the US and it was very difficult to assimilate, even though I was born here. There were two different languages being spoken in the house. High school was really hard because my friends were dating and I felt like I didn’t fit in. I didn’t feel like my parents understood the dating culture. I didn’t feel as attractive as the other girls around me, I didn’t have white skin or blue eyes or blonde hair. That’s when I started to struggle, as a teenager. I was suffering from depression, suffering from anxiety, suffering from feelings of not belonging. I didn’t have all the words for that at the time, only as I reflect back.
I saw my first therapist in college. That’s when it felt safe enough to go speak to someone without any criticism. I did see some counsellors in college, I don’t really remember the impact they had on me but it was a relief. I was sort of in and out of therapy in my twenties and then I had a pretty terrible break up in my late twenties and that really put me on the journey of therapy. I was living in Boston at the time and I saw a therapist, then I went to Law school and I didn’t stay with her. I then moved to New York and it was another time that I was struggling and I was seeing a coach. It became apparent between the two of us that I needed to see a therapist and I actually met my therapist who I stayed with for thirteen years. It was really meeting her and forming a very safe, comfortable bond with her. As I was trying to figure out what it was like to be a lawyer, I was really loving what I was learning about myself in therapy. I loved that I was changing and I loved the person I was becoming. I got more involved in the therapy process and became more curious about some of the psychological and human developmental concepts she would talk about, like attachment theory. I would just write pages and pages as I was trying to understand my younger self and older self. We would email, she was a very, very generous therapist. She really took me in. Through that I realized I wanted to do this work. I knew this was powerful and transformative and life changing. It felt like a gift to have a person like this on my side who became almost like a mother figure and took a lot of care to understand me.
I will say, interestingly enough, she’s white and she’s Jewish. We really didn’t talk about race until the last few years together – she recently retired. Now I’m thinking back to that and I haven’t put it all together but I think race wasn’t being talked about back then in the ways that we talk about it today. My journey went from being with her and then really getting into mental health. Then I made a transition, I went back to school to be trained as a psychotherapist/psychoanalyst. I wanted to be trained as a psychoanalyst in particular because I really loved the model of the mind and the unconscious, and the power of the patterns that are laid down through intergenerational experiences and attachments. And now psychoanalysis is so comprehensive, it’s not just Freudian thinking, it’s much bigger and it goes much deeper into the unconscious. That was really powerful when we started to work on things that I had been pushing down for many many years. Through us talking childhood came up, being Indian came up, having immigrant parents came up, the challenges came up, but we really didn’t get into the race piece as much until the later part of my journey with her. It was really her being so invested in me that helped me see that was the direction I wanted to go in.
To be honest with you, I think, ever since I was a young kid, I was always writing and journaling and wondering and interested in other people, why they were upset or suffering. And interested in my own suffering. Within me there was always a curiosity about psychology even though I didn’t study it formally until later on.
SA
She sounds like an amazing person.
P
She is, I miss her greatly. That was also a huge learning opportunity of saying bye to somebody without it being traumatic.
SA
I’m thinking about the way we ended our sessions as something that I’ve never experienced before. I’ve never had a therapist who was so thoughtful about concluding a relationship and I feel really grateful that I had that with you.
What you’re speaking to with your previous therapist is the safety and the security that she ensured you, and I know so many people who don’t feel safe with their therapists. Whenever I hear friends talk about uncomfortable therapy experiences I feel truly pained because I’ve never had to feel like I’m walking on eggshells when I’m speaking to my therapist. A friend of mine recently, who is of East Asian background, ended her relationship with her white therapist because she had to explain a lot of things to her and had to do a lot of work to make her therapist understand that they had different experiences.
So I think therapy is something that is intensely political. Especially if you are low income, if you’re racialized, if you’re queer, if you’re disabled, it can be very difficult to find a good therapist who is also effective at what they do. My first therapist in CBT was a white woman and I didn’t feel like I could relate to her when it came to race or my personal experience, but it was so beneficial in helping me understand the cognitive and scientific psychological aspect of my experience. After that, I realized that I personally needed to work with someone who could empathize more easily with my experience which is why I spent hours scouring the internet looking for you, and prior to you, looking for my previous therapist who was a Bangladeshi American woman. But that was only allowed because I have access to education, time and financial resources that allow me the space to spend time doing that work.
How beneficial do you think having a culturally relative therapist is? You’ve been working with someone from an entirely different culture and yet you yourself had so much to learn.
P
That’s a really interesting question. I continue to think about this deeply. I think I’m mixed on it. I think as a therapist it’s really important to honour and be respectful and meet the person where they’re at. I understand the cultural piece in many ways today seems to be much more important for clients who are seeking out therapy. I think again, if we’re thinking about the unconscious, there is something different about sitting in the room with someone who has the same skin color or has a skin color that is starkly different from the one that has been the oppressor or the one who has been unsafe. In a way, I think there is something really meaningful about it. I’ve thought about this through what I feel in my body when I enter spaces that are largely white versus a space that is mixed and I can feel my body change drastically. My shoulders are not as high, my heart is not pacing when I’m in a room full of people where the races are mixed. I’ve kind of learned over the last couple of years that the way I carry myself feels very different when the bodies are of different colors. I even think if a majority is not my background, say it is more of a Black or Latinx group of people, there’s still a safety that I feel with that group of people than when it’s primarily white. When I think of it from that model, I think color, ethnicity and race can make a difference because there’s something happening between the two people where there can be an immediate sense of “I know you, you know me, I don’t have to explain myself in a certain way.” I think that language can be clearly communicated when I work with patients that are not white. There’s just this natural communication of “I understand that you’re first generation so even though you’re Black or of a different culture than I am, we’ve had similar experiences.” There is something very profound about having a therapist that may understand your culture or have a journey around something that’s very similar between the two people.
At the same time, I think that, at the end of the day, the therapist who can make one feel the safest and can understand and empathize and take a lot of time to give the person that they’re working with a sense that they’re really trying to understand their history, who they are, their experiences, regardless of the skin color, that has to happen. Even your journey and my journey and someone elses journey is not the same. I understood many of the things that you were saying with some familiarity based on some cultural foundations, although, even you and I have a lot of differences. You grew up in Australia, I grew up in the US, your family comes from Sri Lanka, I come from another part of India. So there are so many layers and so many different parts that the therapist can’t assume. That’s what I think is the hazard. I think it’s a hazard that both the therapist and the patient can enter into if you’re culturally similar or if your ancestors come from the same country. As a therapist, even if you identify or understand ethnically and culturally a patient’s journey, you have to stay curious and separate your stuff from their stuff. You have to make sure that you’re asking detailed questions about life so that you’re not making assumptions because you can fall into that trap very easily.
SA
I’m just thinking about friendship groups in general. I have a few really good white friends who are like sisters and we really connect because we’ve done the work to get to know each other. And I think the same can be said when it comes to therapy. It’s not always about having similar cultural backgrounds but knowing how to excavate and hold space in a way that is thoughtful and mindful.
You brought something up just now about how you can feel it in your body when you are in spaces that are predominantly white as opposed to spaces that are predominantly non white. I was looking over a paper recently by the APA that came out in 2015 on diversity in the psychology industry and it says that in 2015 86% of the industry was white which, in America, is less diverse than the US population. What was it like for you to go into that workforce, other than being able to feel a stark difference in your body. Was it frustrating, was it challenging or exciting to be in that space – how was that for you?
P
That’s a good question. I was a lawyer before I ended up being a therapist and in law school, it was primarily white. I’ve lived in white spaces most of my life. Growing up in the time that I was growing up. I was in Jersey, and it’s not that Jersey wasn’t diverse. I actually was identifying this the other day – I ended up going to Catholic high school and it wasn’t religious based, it’s just that my parents thought the education was better than in public schools. So I actually had a diverse group of people around me and then I went to high school and it was primarily white. So my journey in white spaces started there. College was diverse but I ended up gravitating towards white spaces. I guess, to answer your question, fast forward to transitioning into a profession that is particularly, and I say this about psychoanalysis, that it is very white and Jewish. It was started by a white Jewish man, but Jews back then were considered the Othered race, so it’s an interesting history there. Freud was very much an outsider in the Austrian culture. He was a Jewish man who was born into a primarily Roman Catholic cultural environment. At that time Jews were considered lower class and he often felt ostracized in the medical community in which he was involved.
I went through training very disassociated. It would pop out. I often felt very angry in classes, I felt misunderstood, I felt as if I had to work harder than everybody else to prove myself. I also felt that being an Indian woman, I needed to fit the stereotype of quiet, hard working without posing any issues. And I did play that role throughout training and felt very jealous of my largely white class. There were only 12 of us but they were all white. Often I felt jealous that they could push back on the professors and they would speak up and get into arguments with administration because they felt things were unfair. I just kept quiet. It was dissociated on many levels because I didn’t know what was going on as to why I was feeling the ways that I was feeling. Now looking back, until I started talking about it therapy, and with a supervisor who was honing in on race with me and my experiences with work with my patients, did I start opening my mind to realize that I was holding on to a lot more than I even knew. That’s when I began to realize that, oh my body feels different. It was really one conference that I went to that was the first time that I was in a largely, predominantly mixed and heavily Black and Brown space, that I felt freedom. I was so excited, I was like, I look like these people and they speak my language. Something shifted. That’s when I realized that I had been hiding, and caving in and feeling small because I was terrified of just holding myself up and feeling like I had presence in a room full of white people. There was a sense of freedom and excitement, knowing and belonging. Belonging became the word that I kept using. I felt like I belonged, and I didn’t feel like I had to prove myself to belong. I’m actually starting to get a little emotional thinking about that, because that feeling of not belonging is just such a horrible thing to anyone to have to live through over and over again. I don’t want to make any assumptions but I do think that a lot of people who grow up in spaces where the people are predominantly white, or the culture is predominantly white, that sense of not belonging goes so deep. When you finally enter into a space where you fit, it feels magical. A sense of walking around like, I am allowed to be here and I don’t have to do anything different. That was a really powerful moment for me.
SA
It’s like the missing puzzle piece that you didn’t realize was missing and when you find it, everything falls together and makes sense.
P
Exactly. All of a sudden, those last few, critical pieces that were missing reminded me that I was a whole person here. That I didn’t have to be parts of myself.
SA
Right yeah. And being seen is so crucial to the ways that we belong. As I’m learning about somatics and the ways that we do physically cave in and make ourselves smaller when we feel invisible and also hyper visible. That is another scary thing that happens when we’re in unfamiliar spaces.
P
That’s a really good point – not just not being seen it’s also being hyper visible. I’ve often felt my body react to danger. Something in my body telling me this is dangerous when I’ve been hypervisible. Because then it feels as if you’re getting attention that doesn’t feel safe.
SA
Wow. Do you think that there needs to be more resources for people who are not part of the dominant culture when it comes to mental health?
P
I definitely think there needs to be not only resources but also accessibility – and oftentimes that is monetary for people who are underserved or marginalized. I don’t want to just make assumptions, but oftentimes it is money that becomes the problem or the issue when it comes to accessibility. I think that’s a complicated one. I don’t know if it’s talked about enough in the larger cultural contexts, but therapists often are trying to make a living and they’re not necessarily in a corporate structure. It’s such a mixed bag because the idea is to help and that mental health should be accessible and that people should be able to access therapists and that it should be affordable. But when you put insurance into the mix, and you put capitalism into the mix, and you put systems into the mix that we currently live in, it all ends up making it much harder for many of us to offer our services at a reduced rate. If you’re in insurance you barely get paid and you’re working very hard, those of us who really take our jobs seriously end up burning out. We are working all day long with people, and many of us work with trauma. It’s this balance that many of us are trying to offer. We want to do sliding scale and be reasonable but some of us live in very expensive cities and have families and have to contribute to family structures. It all really becomes a challenge in terms of figuring this all out. The simple answer is yes, and the obvious answer is definitely.
I think accessibility needs to be thought about in terms of how to structure mental health services so those of us who want to provide services in a much more accessible way are also being valued and we can survive monetarily and financially in the industry.
SA
I often think about how exhausting it must sometimes be to be a therapist. Just to be working with people who go through a whole range of different trauma and then have to consider the work that you have to do personally and independently. I do think that there needs to be more of a reciprocal structure. I really appreciated the way that we worked together where you were constantly checking in with me and asking, is this too much, how do you feel about paying this right now. There was so much flexibility and openness there that I feel can be so beneficial if it was widely integrated into the structure.
P
Yeah and you know, from time to time I was conflicted if I was charging too much, I knew you weren’t working and what your situation was. I can’t speak for all therapists but I can speak for my colleagues and friends and the people that I turn to, a lot of us think very deeply about this and care for the people that we work with to try and meet them the best we can. But it does get to a place where you need to make a decision, and I felt that you and I were at a comfortable enough space to have a conversation about it. It’s a fine line because you want to offer your services at reduced costs or for free but I think that can also end up becoming an issue, if the fee isn’t structured into the relationship. As I would sometimes tell you that I wanted you to value your work and yourself, I would tell you that you should get paid for your art and the work that you put in and the amount of effort – I think you got that, that it matters to be valued financially, to feel worthy. And to feel like you can use your money to not only pay your bills but to have time to enjoy things you want to enjoy. So that part of the treatment is so important and I think it does need to be set at a place where both people might need to stretch a little bit. The understanding is that therapy is supposed to be a place that helps you develop and grow into more of yourself so you can live the life you want to live. And money is part of that.
SA
I remember once when I was feeling financially insecure you were reminding me that the goal of therapy is to work together to release those insecurities, and the only way I can do that is to be consistent with the treatment. And I was like, oh yeah that makes sense, I shouldn’t feel guilty about spending x amount of money because it’s helping me. So thank you for that.
Before we come to an end, what are some things that are helping you feel grounded lately?
P
Self care is one of the things I have the hardest time doing, I’m still figuring it out. I love to cook, these days I’ve been gravitating back to some of the things my grandmother used to make for me as a child. I’ve recently asked my mom to help me with a samosa recipe.
Reading. I used to be an avid fiction reader. And these days, this kind of tells me how much I love what I do, I do often read for work. It’s still a sense of relaxation because it allows me to expand my mind and I’m always looking to grow, to understand my patients and new things I’m venturing into with them.
And walks. I really like taking walks and getting outside and being part of nature. It’s kind of challenging in New York City from time to time.
I miss travel, and being able to take myself away to different lands and cultures. But those are the things that I’ve been recently enjoying.
Priti Doshi’s mission as a therapist is to help people facilitate change in a direction that betters their lives by making it richer and fuller, and more open to possibilities that were once unavailable.
In her private practice, she provides psychodynamic psychotherapy that helps her clients examine conscious and unconscious patterns in life and styles of interacting with the world, while developing new insights into one’s self,working to change things that have become painful or stagnant.