Therapy with Marginalized Couples

The problems many marginalized couples face in their relationships are often not about the relationship itself. They’re about surviving in a world that constantly threatens their dignity, safety, and right to exist as who they are. As therapists, our role is to help couples see that the “Tide of Torment” (as one client named it) from outside forces doesn’t stop at their front door. Systemic trauma seeps into the most intimate spaces of their lives, fueling habits of survival that, while protective, create distance and pain in relationships.

Once couples understand these dynamics, they can recognize that they’re not fighting each other. They’re fighting together against harmful systems. They can create islands of safety in their relationships, places where they can rest, be authentic, and experience intimacy. In my work with Solomon and Ayanna, I hoped to help them deepen their alliance and find respite.

Survival Habits

Solomon and Ayanna are a Black couple living in Seattle. They’re both of Nigerian descent—their parents migrated from Nigeria to the United States. The couple came to therapy because their relationship had become increasingly strained and distant.

Solomon described Ayanna as an “angry Black woman.” He found her to be temperamental, though he noted that she expressed her anger silently rather than openly. He complained: “She always looks like she wants to kill me, but when I ask her what the hell is wrong, she never wants to say. What am I supposed to do with that?” He no longer wished to speak with her on many matters, as he deemed conversations to be risky and unpredictable.

Ayanna, for her part, admitted that she often felt incredible rage that she struggled to manage. She recognized that something was wrong but couldn’t identify the source of her overwhelming anger. Both partners were confused and hurting, with Solomon feeling shut out and Ayanna feeling trapped by emotions she couldn’t control or explain.

Initially, I worked primarily with Ayanna to understand what was happening for her. I employed specific therapeutic interventions designed to create safety and facilitate healing. Questions therapists can keep in mind to guide explorations with marginalized clients include: During direct experiences of racism and/or homophobia, how do you keep yourself safe? When you expect to experience discrimination, marginalization, or prejudice, what are your typical responses? On a daily basis, how do you feel in your nervous system? How do you typically respond to these feelings? Which of these feelings and behaviors are connected to expectations or experiences of racism, homophobia, or transphobia? Have you seen any of these feelings or behaviors surface in your relationship with your partner(s)? Where do you think you typically exist on the window of possibilities (or the range allowing creativity and human potential)? Can you recount one or two actual incidents? Where do you think you typically exist on the window of possibilities? Has this impacted your relationship with your partner? If so, how? Has speaking about this now felt liberatory or oppressive?

These questions support clients in a deep process of pivoting (turning their attention inward and outward) and rumbling (excavating the roots of their experiences). Through this exploration, couples can begin to see how external systemic forces have infiltrated their most intimate spaces.

“Ayanna,” I began at the start of one of our sessions. “I want us to start looking at how you often feel in the world and how you survive. Is that okay with you? I know you mentioned the rage that feels hard to control, and I want to explore this with you. We want to see if it’s coming from something outside of you. Please let me know if this feels right.” This was an invitation for Ayanna to pivot and rumble, or turn her attention both inward to her inner experience and outward to the external systems affecting her.

“Sure,” Ayanna said. “All good.”

“On a daily basis, how do you feel in your body?” I asked. “And how do you typically respond to these feelings? Which of these feelings and responses are connected to expectations or experiences of racism?”

“Ha! Those are good questions. People are always saying or doing something stupid where I work.”

“At work? Can you say more?” I encouraged.

Ayanna grimaced.

“I work at an IT company and honestly, there are a bunch of White folks there who don’t always know how to act right. Like they would slip into some crap about immigrants, blaming immigrants for problems in this country. They think I can’t hear, but oh, I can hear them. I can hear them real good. I don’t say anything though. I shut my mouth, you know. It’s a bunch of White boys with God complexes. I shut my mouth and say nothing. I don’t know what they will do to me there.”

As she shared this, I recognized that two out of the four elements of relational privilege, or the social power that enables intimate connection, were being compromised here: protection and living your truth (the other two being social welcoming and belonging and self-worth). Ayanna cannot be her authentic self, and she does not feel safe in her work environment.

“That’s awful that they do this to you. I can see right now what this is doing to you!” I said, taking the relational risk to express how I feel with and for this client. This is the practice of intimacy—being present with clients’ pain—which helps to validate the trauma and let them know their disenfranchised pain is being seen. “This is not okay!”

“Tell them that!” Ayanna exclaimed.

“Indeed,” I said. “Ayanna, you mentioned that you say nothing a lot. When people say those xenophobic things, do you often keep quiet?”

“What else do you want me to do? Do you want me to say something?” she exclaimed. “Come on! Be real, Akilah!” Ayanna’s habit of survival is becoming apparent even during this session. I realize that it’s important for me to practice openness and not become defensive. There’s a power differential in the room, which is probably awakening this survival habit in Ayanna. I recognize that even my question could have been phrased differently in order to communicate better and validate it.

Family therapist and racial trauma expert Ken Hardy defines habits of survival as “rigidified, automatic, habitual responses that are driven by survival anxiety and the orientation toward survival.” Marginalized people often navigate day-to-day life by using these responses as protective mechanisms against ongoing systemic harm. When working with couples from marginalized communities, it’s essential to understand that these habits are not character flaws or relationship problems, they’re functions of the nervous system trying to enhance safety in largely unsafe environments.

In fact, these instrumental habits become necessary when our clients exist outside of their window of possibilities. For marginalized individuals facing ongoing discrimination, this window is often narrowed by the constant threat of harm from systems of oppression. The habits they develop to cope with these threats can inadvertently create barriers to intimacy in their relationships.

“I’m sorry, Ayanna, I could have shown up differently here,” I said. Even though it’s unclear if there’s been a rupture, a rupture makes sense when there’s a need to survive in a power dynamic. By acknowledging my misstep, I model accountability and show Ayanna that not all power differentials need to result in harm. This is the continued practice of openness and a willingness to repair. “Please know that I understand how that question might land for you. A bit more grace on my end should have been communicated. Is there anything you need from me here so that I can show up in a way that feels supportive?”

“I’m good. Do your thing!” It’s possible that she feels more comfortable, or the habit of survival (self-censorship) is manifesting again. I need to give her room and not dictate how she should respond to my power here.

“Saying nothing makes sense, to be honest. Some may call it a habit of survival. It may be your body’s way of keeping you safe in an unsafe environment.” Here, I’m encouraging the client to pivot, turn outward, and rumble. This is also a practice of epistemic embracing, or honoring her way of knowing and understanding the world. “Who knows what may happen to a young Black woman when she stands up to White men. That would scare the hell outta me!”

As practitioners, we ourselves must avoid pathologizing or vilifying our clients’ habits of survival and enact critical consciousness. Instead, we support them in understanding these patterns while facilitating insight into the ways these protective mechanisms, though adaptive in hostile environments, may create disconnection in their intimate relationships. In this moment, I’m being brave enough to practice critical consciousness myself so that I too can understand the value of this habit.

“Does that feel right to you?” I asked.

Ayanna begins to cry. “You can’t say anything. You can’t say anything.”

“Of course, you can’t say anything. It doesn’t feel safe and it isn’t safe. That is living in your body. Does it also feel that way with Solomon?

I’m inviting Ayanna to turn outward and inward simultaneously. This allows her the room to rumble and look at the relationship. I’m not sure if the two are connected. It’s not certain that the system is impacting the relationship. There can be many issues playing a role here, including Solomon’s own personality or even Ayanna’s family history. As such, there is a need to go slowly and check in with her. We are trying to generate an understanding together. There’s no rush.

“A lot of times,” she responds finally.

“Does Solomon remind you of these men at work?

“He isn’t like them,” she sobs. “He’s kind. He doesn’t say that crap. We both know what it feels like to be second-generation immigrants in this place, but . . . but . . . but everything just feels so hard since I started working at that godforsaken company. I wasn’t around that many White men before, to be honest.”

The link to the system is now apparent, so it is safer to explore this as a habit of survival that’s impacting the relationship. The rage Ayanna feels is not about Solomon. It’s about having to silence herself constantly at work. That suppressed rage has nowhere to go, and it spills over into her home life, the one place she should feel safe.

“How do you feel now as you’ve said that?”

“Confused, but that’s okay.”

“What thoughts, feelings, or sensations come up for you in your body?” I’m inviting body awareness: paying attention to visceral sensations, images, body-based impulses, meanings, affect, and sensation. “Are there any images you see? Is there anything you want to do?”

“I want to stand and stretch. I know that may sound weird.

“Let’s do it together then. Is that okay?”

Ayanna nods.

“How has this conversation felt? Does it feel more like a burden or is it freeing?”

“I feel lighter and sad, to be honest. It’s not like I can make all those White men disappear.”

The contradiction here is important to note. There’s a shift—she feels lighter—and she’s also seeing the reality of her situation. The systemic harm will not disappear simply because she understands it. But the understanding itself creates space for something new to emerge.

“That makes sense to me,” I affirm. “When you think about this moment, does it support or stifle your liberation?

“Well, I am stretching, so that’s your answer there, but I know we have more work to do.”

Systemic trauma creates barriers to intimacy. The rage Ayanna couldn’t express at work manifested as silent fury toward Solomon. He wasn’t the cause of her pain, but he became the recipient of the overflow of emotions she suppressed at her job. By helping Ayanna see this connection, we externalized the problem, validated her survival strategies, and opened new pathways for both healing and intimacy.

Adapted from Marginalized Couples in Therapy: Interventions for Healing from Systemic Trauma, Copyright © 2026 by Akilah Riley-Richardson. Used with permission from W. W. Norton & Company, Inc.