by Afshan Mohamedali, Ph.D
My Observations of Working with Patients While Sporting a Hijab
Most therapists adhere to the “do not disclose rule” of therapy given that the therapeutic space exists for patients’ benefit. It’s possible patients know very little about their therapists from what they have directly shared and maybe more from what they’ve observed. Do they wear a wedding ring? Do they have photos in their office? Do they have a public or private education? Do they believe in God?
I’ve been wearing my religion on my head long before I became a therapist and so when I was first exposed to therapeutic work, the concept of a “blank slate” didn’t really speak to me. How could it? From the moment I meet patients in the waiting room, they already know something very personal about me.
Rather than pretend that my hijab doesn’t exist or let this now known piece of information about me go unsaid, I welcome patients to share their reactions as I would other feelings that naturally occur in the context of the therapeutic relationship. Some patients, while possibly curious, don’t usually articulate their curiosity about any part of me. Others do and I have navigated conversations about vacations, family, and weekends. A handful of these patients float questions about fasting during Ramadhan and observing a halal diet but I take note of those curious patients who ask about everything but my religious background.
It leads me to wonder what is going unsaid. What’s in the room but not being acknowledged? For me, the hijab is empowering but for some patients reacting to it, it can be silencing. Below are some of the observations I have made in working through patients’ hesitancies, curiosities, and assumptions that would otherwise hinder our work.
|“I shouldn’t talk about religion”|
Of course you should! If it’s on your mind as a thought, it’s already in the room and could benefit from being put into words. Religion is certainly a sensitive topic of discussion, much like politics, but it’s helpful to think about it as an opinion. In a healthy relationship, it’s important to value different perspectives, respect each other for each other’s differences, and come together despite them. Working through thoughts and feelings toward religion and spirituality can help you practice these skills, maintain a strong sense of self, and overcome a fear of offending another person.
|“She believes God is the answer”|
Not for everyone. I wouldn’t suggest the same coping skill to each patient and so I wouldn’t think that a belief in God is helpful to all. Just because it works for me does not mean, nor would I expect it, to work for you. That being said, I think it’s most helpful to use the therapeutic space to find what does. A belief in God certainly provides direction and answers but you can find that in morality, in the universe, and of course, in yourself. Most importantly, I won’t be offended at all that you have the opinion or even arrive at a conclusion that religion is not for you.
|“She won’t get me”|
I know that I look different than a lot of my patients and people often associate “different” with being misunderstood. I remind patients that therapy at the most basic level is two humans in a room having a conversation and, in any conversation, we share parts of ourselves so that someone else can understand us. Sharing your experiences with your therapist helps your therapist understand you so that you can understand yourself. Two people don’t have to have the exact experiences in order to “get each other.” I look to the concept of universal emotions here to bridge gaps in experiences: while I may not know from experience what causes you disappointment, I know what disappointment feels like and can channel these commonalities in helping you reflect and deepen your own understanding.
|“She totally gets it”|
Identifying as Muslim as well as Indian-American, I’m definitely a minority in multiple ways. With increasing numbers of ethnic minorities turning to psychotherapy for support, it’s more important than ever to be culturally sensitive but sometimes, both therapist and patients assume that simply having a minority status allows for experiences to go unsaid. You may find it easier to assume your therapist knows what you’re talking about or as a therapist, feel that you can skip the details and get to the work. But the only way you can be understood and be understanding is by working through the experiences that are still unique to you. Additionally, these struggles don’t occur in a vacuum; they are socially and interpersonally contextual. Exploring identity with a therapist affords the chance to establish a positive association to this concept and hopefully gain a corrective experience.
|“I’ll be okay if she’s okay”|
With changes in the social and political climate in the last few years, it’s not wrong to assume that minorities, including minority Muslims, face hardship. Sometimes patients have asked me about my experiences or at the end of our work, expressed having had concern for my own well-being. Other times, they avoided these topics fearing that I wouldn’t be able to help them if I myself were not okay. When these thoughts enter session, we can highlight how healthy their concerns are and remind ourselves of the goals of treatment.
|“I need to be okay for her to be okay”|
This assumption puts a lot of emphasis on you to speed up recovery before you are ready. It gives way to minimizing problems that might be related to the social or political climate and come to conclusions before fully resolving ambivalences. This likely happens in other relationships in which needs are downplayed or you deflect others from being there for you. In treatment, it is an opportunity to re-examine your patterns in relationships and find a balance between having needs met and maintaining sensitivity to others.
Whether you’re in treatment already or contemplating starting therapy in the near future, give yourself permission to be curious about your therapist. Your curiosity about your therapist is meaningful to who you are and expressing this can only help you work toward your own goals. Your therapist can handle it!
Koura, F. (2016). Hijab in the Western workplace: Exploring Islamic psychotherapeutic approaches to discrimination. Journal of Psychology and Behavioral Science, Vol. 4, No. 2, pp.80-88. Retrieved from http://jpbsnet.com/journals/jpbs/Vol_4_No_2_December_2016/7.pdf
Fraga, J. and Hendel, H.J. (2019). How to give your therapist feedback. The New York Times. Retrieved from https://www.nytimes.com/2019/08/01/well/mind/how-to-give-your-therapist-feedback.html