Understanding Systemic Oppression in Therapeutic Settings and Its Impact on Healing

Therapy, Power, and the Weight of Systems

Therapy is often described as a safe haven — a place where you can finally exhale, where your story is supposed to be held without judgment. But for many of us, especially those living inside marginalized identities, that “safe” space doesn’t always feel safe. Therapy exists inside the same systems that shape the rest of the world. And when those systems are built on inequality, the same harm can quietly echo in the therapy room.

This post isn’t about discrediting therapy. It’s about naming what happens when systems of oppression — racism, ableism, classism, queerphobia, and more — seep into the space that’s supposed to be about healing.

Systemic Oppression Isn’t Separate from Therapy

Systemic oppression is not a theoretical idea. It’s history living in the present — in who gets believed, who gets labeled “difficult,” and who gets access to care in the first place. It shows up in the way therapists are trained, in the textbooks they read, in what they’re told is “normal.”

It’s not always loud or obvious. Sometimes it’s subtle — a facial expression, a pause, a question that doesn’t land right. Sometimes it’s a complete misreading of who we are because someone’s “neutral” lens was never neutral at all.

I’ve seen it. I’ve lived it. And I know I’m not the only one who has left a therapy session feeling smaller than when they walked in — not because of what they shared, but because of how it was received.

Cultural Competence Isn’t Optional

Cultural competence isn’t a box to check. It’s an ongoing responsibility. It means a therapist doesn’t just know that culture and identity shape someone’s story — they understand that ignoring it is harm.

When a therapist hasn’t done their own work, when they haven’t looked at how privilege and bias shape their perspective, it’s the client who pays the price.

I think about how many people have walked into therapy already carrying generations of trauma — Indigenous, Black, immigrant, queer — and then have to do the extra labor of explaining why certain things hurt. That’s not therapy. That’s survival.

Microaggressions Aren’t Micro

Microaggressions aren’t always the obvious comments or stereotypes people like to name in trainings. Sometimes they sound like “You’re safe here,” or “I want you to be honest,” or “This space is for you.”

But then their behavior doesn’t match their words. The moment you take the risk of being honest — when you name something that feels off, when you point out a contradiction — suddenly, the energy in the room shifts. You’re no longer seen as vulnerable or brave; you’re labeled disrespectful, defensive, or difficult.

That’s what a microaggression can look like in therapy. It’s not always about slurs or ignorance — sometimes it’s the way power gets protected. The way the therapist’s comfort becomes more important than your truth.

It’s saying all the right things about safety while doing everything that makes you feel unsafe. It’s the subtle withdrawal of warmth after you set a boundary. It’s the polite smile that turns sharp when you stop being compliant.

And that contradiction — that discrepancy between what’s said and what’s done — is what cuts the deepest. Because when the person who says “you’re safe here” ends up punishing you for speaking your truth, it confirms the fear many of us already carry that even in spaces meant for healing, safety is conditional.

And to be clear: microaggressions show up across all oppressed groups. They’re not limited to any one identity or community. They’re the quiet mechanisms of power that keep people small. I’m speaking from the lens I know — from what I’ve personally experienced — but these contradictions exist anywhere someone’s humanity is questioned for naming harm.

Therapists who truly want to hold safe space have to be willing to hear discomfort without defending themselves. Because if clients can’t safely say, “You hurt me,” then the space isn’t safe at all.

Intersectionality: The Layers That Shape Us

For some of us, oppression doesn’t come one layer at a time. It stacks — and those intersections create experiences that can’t be reduced to a single identity.

A Black trans woman in therapy isn’t just navigating sexism or racism or transphobia — she’s navigating all of them, all the time. A queer disabled person isn’t just managing internalized stigma; they’re surviving systems that were never built with them in mind.

Therapists who don’t consider intersectionality risk seeing only fragments of a person — and healing can’t happen in fragments.

The Mental Health Impact

Systemic oppression isn’t just an abstract issue — it’s a mental health crisis. Discrimination, poverty, exclusion — all of it leaves real scars. It shapes how safe we feel in our bodies, how we see ourselves, and whether we believe help is even possible.

And access to therapy itself is a privilege. The cost. The lack of therapists who get it. The fear of being pathologized for having trauma that society caused. It’s no wonder so many people stop trying.

What Real Change Looks Like

Therapists who want to do better can start by:

• Educating themselves — not through a one-time DEI training, but through continuous, humble learning.

• Reflecting on their biases — because bias doesn’t disappear by pretending it’s not there.

• Advocating for systemic change — not just in sessions, but in the field itself.

• Creating space for honest dialogue — where clients can talk about oppression without being dismissed as “angry” or “resistant.”

Empowerment and Accountability

Healing isn’t just about reducing symptoms; it’s about reclaiming power. For clients, that might mean realizing: “What happened to me wasn’t all my fault." For therapists, it means remembering that authority isn’t superiority — it’s responsibility.

Clients don’t need saviors. They need people who can sit with the weight of their reality without trying to sanitize it.

Community as Medicine

Sometimes the healing doesn’t happen in the therapy room — it happens in community. In spaces where people share stories that mirror our own. In movements that remind us we’re not broken; we’re reacting to a broken system.

Therapy can be part of the healing process, but it can’t be the only place healing happens. The community — the people — are where accountability and restoration begin.

Closing Thoughts

If therapy wants to call itself a place of healing, it has to be willing to look at the harm it also holds. Systemic oppression doesn’t disappear at the door of a therapist’s office. It just puts on quieter clothes.

Real healing happens when both therapist and client can see those systems clearly — and choose not to replicate them.

That’s what this is all about: Not tearing therapy down but rebuilding it into something that finally includes all of us.

Disclaimer:

These reflections come from personal experience and observation. They are not accusations — they are truths spoken in hopes of accountability and change. Therapy, like any system, must be examined if it wants to remain a space for healing. My intention is to challenge patterns that silence or harm marginalized clients, not to discourage people from seeking help.

A peaceful therapy room designed for comfort and healing