Lessons from Starting the First Psychodynamic Psychotherapy Group for Asian American and Pacific Islander Patients at McLean Hospital Amid Rising Anti-Asian Violence

In 2021, in the wake of rising anti-Asian violence in the United States and abroad, we piloted a group psychotherapy intervention for Asian American and Pacific Islander (AAPI) patients in the outpatient services department of McLean Hospital. The group, which lasted 12 weeks and took place virtually, included five group members and combined an interpersonal process group psychotherapy approach with the multicultural orientation framework. In this article, we discuss the intervention design as well as three key clinical vignettes from the group that challenged fundamental assumptions about ourselves as Asian American therapists and about the creation of a group that centers race, culture, and mental health. In particular, through discussion of the vignettes, we explore three scenarios that group therapists may face when facilitating similar multicultural groups: (1) drawing on notions of racial melancholia and racial dissociation, how to manage intragroup conflict between individuals with starkly different relationships to race and racial identity; (2) how to respond to intersectional microaggressions occurring between group members within a multicultural framework; and (3) where to draw the limits of psychodynamic approaches to psychotherapy in multicultural settings. Ultimately, we find that clinical encounters cannot be divorced from the histories and institutions that frame those encounters. Failure to recognize the impacts of such historical and institutional forces on clinical work risks perpetuating the inequities seen in mental health outcomes for AAPI individuals and communities.