Internalized Racism: The Role of Mental Health and Psychotherapy

In the fields of mental health and psychotherapy, the concept of internalized racism[1] has long been a complex and often underexplored topic. While overt racism and systemic inequities are more widely discussed, internalized racism—a phenomenon in which individuals from marginalized racial groups absorb and accept racist beliefs about themselves—continues to play a significant role in mental health.[2] Mental health and psychotherapy, with their rich history of examining the mind’s relationship to the self, have both the responsibility and the tools to address this issue, yet often fall short. This article delves into the dynamics of internalized racism, the psychological and emotional damage it inflicts, and the critical, albeit underutilized, role that mental health and psychotherapy can play in dismantling it.

Understanding Internalized Racism
Internalized racism refers to the conscious and unconscious acceptance of a racial hierarchy in which one’s own racial group is placed in a lower or devalued position. It is the internalization of oppressive societal norms that devalue racial minorities, manifesting in self-doubt, shame, and even disdain toward one’s own racial identity.[3] Scholars like David R. Williams and Michelle Sternthal emphasize that internalized racism is a product of repeated exposure to societal stigma, discrimination, and marginalization, which can lead to adverse psychological outcomes, including depression and low self-esteem.

The psychological impact of internalized racism is profound.[4] It can erode a person’s sense of worth and belonging, lead to identity confusion, and cause emotional distress. Psychiatrist and psychoanalyst Frantz Fanon, in Black Skin, White Masks, argues that internalized racism distorts the psyche, creating a self-perception that mirrors the dehumanizing views imposed by the dominant culture. Fanon’s work highlights how the colonized mind comes to believe the negative stereotypes imposed upon it, leading to a profound alienation from one’s own racial identity.

Psychiatry’s Role in Addressing Internalized Racism
Psychiatry, as the medical field dedicated to diagnosing and treating mental illness, has a responsibility to address the mental health consequences of internalized racism. However, traditional psychiatric frameworks have often overlooked or inadequately addressed the cultural and social factors that contribute to internalized racism.[5] This omission not only leaves patients without the tools to understand the societal roots of their distress but also risks pathologizing individuals without addressing the underlying social determinants of their mental health issues.

A growing body of research suggests that exposure to racial discrimination and internalized racism can lead to a variety of mental health issues, including anxiety, depression, and substance use disorders.[6] In recognizing this, modern psychiatry must move beyond a purely biomedical model and incorporate cultural humility and trauma-informed care that takes into account the pervasive impact of racism. The inclusion of frameworks such as cultural psychiatry—where clinicians actively consider the cultural context of their patients—can provide the tools necessary to treat patients more holistically.

For instance, my colleague, Dr. Ruth Shim has emphasized the need for psychiatry to adopt more inclusive and culturally relevant practices that take the mental health impact of racism seriously. By acknowledging how racial trauma and internalized racism manifest in psychiatric symptoms, psychiatrists can better tailor treatment plans that address the root causes of mental health struggles in marginalized communities.

Psychotherapy and the Exploration of Internalized Racism
Psychotherapy, with its focus on the unconscious and the internal world, offers a unique vantage point for understanding how internalized racism operates on a deeper psychological level. Historically, psychotherapy has been critiqued for its Eurocentric bias and its relative inattention to race. However, contemporary psychoanalytic thinkers, particularly those engaged in relational psychotherapy, have begun to explore how racial identity and racism are deeply embedded in the unconscious.[7]

In her seminal work, “On the Matter of Whiteness,” psychoanalyst Dorothy Holmes discusses how psychotherapy must address the ways in which race and racism affect the psyche, both in terms of the therapist’s biases and the patient’s internalized racism. Holmes argues that psychoanalytic treatment must confront the ways in which patients of color have internalized societal racism and how this impacts their sense of self and relationships with others.

The therapeutic process, then, becomes a space where internalized racism can be examined, unpacked, and eventually deconstructed. Psychoanalysts like Neil Altman have called for an “anti-racist psychotherapy” that explicitly acknowledges the role of race in the therapeutic dyad and works to undo the internalized racism that patients of color often carry. By doing so, psychotherapy can provide a pathway to healing by helping individuals reclaim their racial identities in a society that often denigrates them.

The Need for an Integrated Approach
Addressing internalized racism requires an integrated approach that combines the strengths of mental health and psychotherapy.[8] Psychiatry’s medical model and focus on symptom alleviation, combined with psychotherapy’s deep exploration of the unconscious and identity, offer complementary tools to help individuals understand and dismantle the internalized racism they may carry.

Both fields must also embrace intersectionality, a concept coined by Kimberlé Crenshaw, which examines how overlapping identities (such as race, gender, and socioeconomic status) compound experiences of oppression. Understanding internalized racism through an intersectional lens allows for a more nuanced treatment approach, as individuals may internalize multiple forms of oppression simultaneously.

Conclusion
Internalized racism is a pervasive and destructive force that mental health and psychotherapy have historically neglected. Yet, both disciplines possess the tools to address it—psychiatry through culturally humble care and psychotherapy through deep exploration of unconscious biases and identity. By acknowledging the profound psychological impact of internalized racism, clinicians in both fields can work to empower individuals to reclaim their racial identities and challenge the societal norms that have caused them to internalize negative beliefs about themselves. In doing so, mental health and psychotherapy can become powerful agents of change, helping to dismantle the psychological chains of racism and promote healing and resilience.

[1] Bivens, Donna. “Internalized racism: A definition.” Boston: The Women’s Theological Center (1995).

[2] David, EJ Ramos, Tiera M. Schroeder, and Jessicaanne Fernandez. “Internalized racism: A systematic review of the psychological literature on racism’s most insidious consequence.” Journal of Social Issues 75.4 (2019): 1057-1086.

[3] Daniels, John. “Therapists, Minorities and Discrimination Based on Internalized Racism.” Reactions 180.22,457: 18-899.

[4] Willis, Henry A., et al. “The associations between internalized racism, racial identity, and psychological distress.” Emerging Adulthood 9.4 (2021): 384-400.

[5] Moise, Nathalie, and Sidney Hankerson. “Addressing structural racism and inequities in depression care.” JAMA psychiatry 78.10 (2021): 1061-1062.

[6] Juggins, Latoichia N. Racial Disparities: Factors Impacting Mental Health Treatment for African Americans. Capella University, 2019.

[7] Layton, Lynne. “Racial identities, racial enactments, and normative unconscious processes.” The Psychoanalytic Quarterly 75.1 (2006): 237-269.

[8] Carter, Robert T. The influence of race and racial identity in psychotherapy: Toward a racially inclusive model. Vol. 183. John Wiley & Sons, 1995.