Althea felt stigmatized by her abortion. She was sure everyone could see that she had had an abortion just by looking at her face. She often found herself wondering what her family and friends would think of her if they ever found out she had had an abortion. She was sure they would think she was less than human, a blight on society.
In the first few sessions it became clear that if Althea were in the same situation again, she'd make the same choice. She was seventeen and nearing the end of high school. She felt strongly that she didn't want the life her older sister had--a single mom struggling on welfare and frustrated by not being able to get a job that would let her support her son. Some of Althea's concern about what others would think came from her Christian upbringing, but for the most part her religious convictions were comforting and helpful to her at this time. She had prayed for forgiveness and felt it had been granted.
Why did she feel less than human? We spent some time exploring for other events in her life that might have made her feel this way, but she couldn't remember any specific incidents. Then she became very quiet and looked agonizingly uncomfortable. She began to cry and said, "It's being black." Then she cried for fifteen minutes. Her crying was alternately pitiful and full of rage.
She began to tell me about each moment of racism she had ever encountered. There were many; she had grown up in an integrated community and had been called names by a few of the kids there. She had a teacher who refused to acknowledge her writing talent but admired a less gifted white child. She grew up seeing few black faces on television, and those that were there were only comedians. She realized that the only two ways she ever felt were stigmatized or invisible.
Why hadn't Althea made this connection when we first explored other stigmatizing events in her life? To survive with some amount of self-esteem, she had repressed out of consciousness her knowledge of how bad it sometimes felt to be black in a white culture. Then it all erupted at once. Her sadness was for the hurts she had received just because she looked "different" to some of the kids in her neighborhood. The anger she felt was against the injustice of being judged for something she had no control over. In fact, she was proud of her African-American heritage. So these feelings of shame created even more shame for her.
It didn't take long for Althea to recognize that the feelings of stigma were not really how she felt about herself, but were "internalized" views of an often racist society. We worked together on this for a few months and then she felt solid enough in her battle against stigma to end therapy.