What it is:
Identity-related distress describes the mental, emotional and physical distress experienced by those who are members of minority or marginalized groups. Such minority identities can include visible or invisible identities, such as race, gender, sexuality, socioeconomic status, or ability. Stressors can include everything from experiencing hate crimes, abuse, discrimination, harassment, oppression, or disownment related to a minority identity, to more subtle or chronic forms of invalidation, micro-aggressions, non-representation, or stigma associated with an identity. Identity-related stressors can occur on a macro (society-based or policy-based), meso (community-based), or micro (individual-based) level.
While all people who hold a minority identity will face some level of invalidation, exclusion, or non-representation and be impacted by these stressors and injustices, the psychological term “identity-related distress” refers to distress that feels unmanageable, intolerable, or is keeping someone stuck. In particular, we assess for:
- An intensity of distress that mimics or causes mental health symptoms such as panic attacks, PTSD symptoms (e.g., flashbacks), depression, or suicidality.
- Attempts to cope that lead to difficulties with emotional dysregulation (e.g., impulsive behaviors when distressed) or emotional avoidance (e.g., isolation or shutting down when distressed).
- The distress negatively impacts functioning- including someone’s ability to form or maintain close relationships, maintain employment or schooling, or engage in activities that they enjoy.
- The distress results in an altered sense of self, including internalized stigma, self-hatred, or self-denial.
Identity-related distress is not a disorder, but rather a way to attempt to navigate a minority identity in the world. It can often present very similarly to trauma-related disorders, such as post-traumatic stress disorder (PTSD). As such, the goals of therapy for identity-related distress include understanding and processing emotions, finding effective coping skills, and strengthening your sense of self. Given that most people cannot entirely escape systems that deny, minimize, harm, or oppress them, treatment is geared more towards reducing suffering and increasing access to positive emotions while living within them.
Does This Sound Familiar?
- I don't know how to cope with the level of bias or oppression I experience.
- I don't want societal bias or oppression to take up every waking moment of my life.
- I want to find peace and happiness in spite of broken systems, but I have no idea how.
- I don't know how to disengage from watching or hearing news of others' identity-related oppression or harm.
- I need emotional support and skills as I navigate barriers to jobs, housing, or other opportunities due to my identity.
- I feel exhausted by the world and the way I am treated.
- I feel attacked, on edge, numb, or under threat as I move through my life.
- I have chronic bodily symptoms (stomachaches, headaches, etc) as a result of my overall distress.
- I am forced to be in environments, settings, or groups (family, work, etc) that make me feel uncomfortable in my identity or give me rejection/shame cues about my identity.
- I feel unhelpful levels of shame about who I am, how I look, or how others are perceiving and judging me.
- I have been and may continue to be a victim of racism and oppression and I want to better protect my mental health.
- I feel pressured to hide or minimize aspects of my identity for my own safety, but it feels either unmanageable or inconsistent with my values.
- I have experienced a hate crime, a verbal or physical attack, or other interpersonal harm because of my identity and this trauma is impacting my life.
Associated Concerns:
Individuals experiencing minority- or identity-related stress are at greater risk of a number of problematic symptoms and outcomes compared to non-marginalized individuals.
These include the likelihood of experiencing traumatic events and the development of PTSD, as well as the prevalence of a number of mental health disorders such as anxiety and depression.
Additionally, chronic identity-related stress has been linked to long-term health effects such as headaches, GI issues, sleep difficulties, appetite changes, poor concentration, decreased self-esteem, frequent shame experiences, and other factors that may decrease quality of life and ability to pursue goals and values.
How Identity-related Distress is Addressed at TAP:
The ways in which identity-related stress are addressed in treatment will vary from person to person. For some people, identity-related stress will be at the top of their list of concerns to address in treatment; for others, it will be an important part of their life, though potentially a lower priority for treatment. Moreover, some people may wish to discuss identity-related distress from more of an acceptance-based perspective (e.g., working on increasing self-compassion related to marginalized identity, understanding the impact of aversive institutional and systemic racism and homophobia, depathologizing the impact of identity-based trauma and stress), whereas others may wish to utilize a problem solving approach to coping with identity-related stress (e.g., managing difficult discussions across identity lines, coping with overt and covert microaggressions, coping with chronic stress symptoms). Others may wish to have open discussions of identity exploration, including topics such as processing values mismatch (religion and identity), addressing chronic shame, and values-based goal pursuit. These techniques and approaches can be integrated into any of our evidence-based therapies for other symptoms and diagnoses, or may be utilized as a standalone treatment for identity-related stress.
Therapists at TAP are comfortable initiating and participating in conversations about race, gender, and sexuality with their clients. We believe that acknowledgment, curiosity, validation, and respect for identity, as well as open dialogue regarding similarities and differences between the therapist and client, are important to facilitating a nuanced understanding of each individual’s experience of the world.
Specialty Services at TAP:
Identity and identity-stress affirming techniques and approaches can be integrated into any of our empirically supported therapies for other symptoms and diagnoses, or may be utilized as a standalone treatment for identity-related stress.