Traci Medeiros-Bagan, a marriage and family therapist in Southern California, wants us all to go to therapy. More specifically, she wants to create a world in which every individual has the access, agency, and knowledge to find a therapist that best fits their needs. Bitch spoke with Medeiros-Bagan about the importance of couples counseling, the dire need for more culturally competent therapists in the United States, and how the very idea of “sickness” has been weaponized against marginalized communities.
Tell us more about your work as a therapist. What are your areas of focus?
I mostly work with individuals, though I do see some couples, triads, and whatever incarnation folks are coming in with that need support. My caseload is pretty queer in gender, sexual orientation, and sometimes both. I [also work with] kink-identified folks, nonmonogamous folks, [and] some members of the adult-entertainment industry and sex-work community. Unfortunately, [sex workers] are not a huge part of my caseload, partly because [mental healthcare] is not very accessible.
You specialize in offering services to LGBTQ, nonmonogamous, and kink communities. Why is it important for therapists to provide culturally competent services, especially to these communities?
There’s been a long history of juxtaposing otherness with sickness or otherness with madness. So, [it’s necessary] to really be able to help folks name that because that might be part of what they’re unpacking when they come into therapy. That doesn’t mean that folks come in and say, “I want to work on anxiety,” and we only talk about their identities. It’s that balance of understanding that we are more than identities, but also those are big pieces of how we live. [It] should be bare minimum [for therapists] to be really competent and have done a little extra homework.
Vulnerable communities have been taught over time that we don’t deserve specialized care. We go in hoping someone will be friendly, tolerant, [and will] give us the care that we are supposed to be able to access. [Therapists] that don’t have those identities or aren’t competent in them don’t realize how much it takes for folks to get through the door to feel safe in established institutions of health. They don’t really understand that.
Culturally, we have some hang-ups about couples therapy, which is often viewed as a last-ditch effort to preserve an unhealthy relationship. Do you find that couples therapy has a lot of negative assumptions attached to it?
In general, individuals and couples tend to think, “How ‘sick’ do we have to be to come in and get support?” like there’s some sort of litmus test. (Of course, this differs by race and culture.) That definitely trickles down to couples, triads, and [any] kind of polycule format that is coming in to work on [specific aspects of their relationships]. They tend to come into therapy when something is hurt, broken, or needs a little support. That’s fine; therapy is certainly a place where I hope people find a soft place to land and to do some work. But [couples counseling] can also be a place [where] you can work on yourself.
Who do you think benefits from couples therapy? Is it useful for all kinds of relationships?
Absolutely. Couples counseling would be good for all couples. Actually, there’s a lot for folks to learn from queer couples, biracial couples, and couples in nonmonogamous and kink relationships. When we’re navigating [these types of] relationships, we can’t live on assumptions. We have to define [relationship roles] for ourselves. So, the majority culture could learn [from queer couples]. You can talk more. You can name things for yourself. You can make your own definitions.
It’s really important to have someone sit in front of you and tell you, “You exist. I see you, and I hear you. How can I help you?”
What would you say to someone considering therapy, whether as an individual or with partners, who is doubtful or feels that they’re not “sick enough” to warrant therapy?
I would [tell] folks that you don’t have to do that litmus test. That idea of sickness is something that’s been wielded against our vulnerable communities for a very long time. We get taught to go in to a doctor and have them tell us what to do or have them tell us what to take. Therapy isn’t really about sickness; it’s more about getting support [while] navigating your wellness and feeling empowered to do that or having the tools to do that.
If folks are feeling tentative when they start the process, I would encourage them to poke around. I know this is harder in certain areas, [but therapists are] working for you, so ask them questions. See if they’re going to be a good fit. Tell them that you’re having concerns. It’s their job to give you the sell on why [therapy] could be helpful to you and what they specifically could do for you. [Therapy] doesn’t have to center around sickness. If you have the access and the privilege, you can just do therapy for your own wellness.
What is one myth about therapy that you’d like to debunk?
Your therapist isn’t necessarily going to know more about you than you know about yourself. You’re the expert [about] yourself. [As marginalized people], our unique stories have been silenced. We haven’t had visibility. We’ve been held up to standards that don’t match our identities, and [we] have been told that we basically don’t exist. So, it’s really important to have someone sit in front of you and tell you, “You exist. I see you, and I hear you. How can I help you?”