Working with ambivalence: making psychotherapy more accessible to young black people
Black people's1 negative relationship with mental health services and lack of access to psychological therapies has been a serious problem in Britain for at least 25 years. Most of the literature and discourse about this problem has focused on factors such as racism and cultural insensitivity in mental health services. Whilst these factors are important, in this chapter I will suggest that black people's fear of mental health services also arises from intra-psychic con¯icts linked to fears of betraying their parents, family, culture and community. This perspective is based on the experience of developing a community based psychotherapy service for young black people and their parents. It arose out of a major theme in the work, which was that of experiencing a strong ambivalence from many black people towards mental health services in general, including psychotherapy. Initially this ambivalence was expected and seen as understandable given black people's negative experience of mental health services in particular and of racism in general in British society. However, over time and after much clinical work, this ambivalence came to be understood as a form of resistance to relinquishing familiar defences and a fear of betraying attachment ®gures, even though these caused pain and suffering.