Crissle’s Couch – Session 7 with Dr. Raquel Martin

Podcast: Crissle’s Couch
Host: CAKE MEDIA (Crissle)
Guest: Dr. Raquel Martin (Clinical Psychologist, Professor, Content Creator)
Date: December 23, 2025

Episode Overview

Session 7 marks a milestone for Crissle’s Couch, as Crissle welcomes her first clinician guest: Dr. Raquel Martin. The episode dives deep into the realities of mental health care—misdiagnosis, therapy terminations, professional ethics, cultural biases, and the unique hurdles Black clients face in therapeutic spaces. Through listener letters, the conversation balances tough truths, humor, and practical advice, giving listeners both affirmation and actionable guidance—making it feel like both a venting session and a masterclass in navigating mental health systems.

Key Discussion Points & Insights

1. Introducing Dr. Raquel Martin

[00:01–04:08]

• Crissle introduces Dr. Martin, outlining her credentials and digital impact on mental health education, especially her focus on anti-oppressive, culturally competent care.
• Dr. Martin discusses the weight of being a clinician:
  "We do a lot of fun stuff, but we ingest pain for a living…as soon as you were like, not gonna practice, I said, I know, that's right." ([01:51], Dr. Martin)
• Both discuss responsibility and the seriousness appropriate to clinical roles, likening this to making careful parenting choices.
• They affirm the right of individuals to choose how to live, pushing back on societal stigma against being child-free:
  "Let 2026 be the year that you guys stop with your... obsession with child free individuals. Y’all okay? What is going on?" ([03:20], Dr. Martin)

2. Listener Letter #1: Misdiagnosis and Navigating Therapist/Psychiatrist Disagreement

[04:08–15:11]

Letter from Doreen

A Black woman, 30, on therapy cycle, with new therapist suspecting ADHD while psychiatrist (in 30 mins) diagnoses bipolar II—Doreen is skeptical and distressed.

Dr. Martin’s Response & Insights

• Immediate concern at the rapid diagnosis:
  "A 30 minute evaluation is not the right amount of time to diagnose anyone." ([06:26], Dr. Martin)
• Advocates for letting her therapist talk to the psychiatrist before continuing care—continuity and collaborative care are crucial.
• Emphasizes trusting your gut and pushing back on hasty diagnosis, especially when prescribing serious medications:
  "They're not giving you Flintstone vitamins, you know what I'm saying? This is... serious medication." ([07:26], Dr. Martin)
• Discusses systemic issues—Black providers are underrepresented and overworked, which can lead to rushed, impersonal care.
• Highlights the importance of the clinician as the diagnostic tool, especially regarding cultural manifestations in Black clients:
  "The number of times I have changed my client's diagnosis...the only difference...I have the tools as someone who focuses on black health and well being..." ([10:14], Dr. Martin)

Memorable Exchange

• Crissle: "Now you’re trying to put me on drugs."
• Dr. Martin: "You don’t even know my middle name and you prescribing me lithium." ([10:02–10:06])

3. Mental Health Care & Insurance Industry Pressures

[12:53–16:27]

• Crissle shares her own experience with ADHD diagnosis; discusses how insurance turns diagnosis into a rushed, transactional process.
• Dr. Martin highlights perverse incentives and clawbacks, making diagnosis a benefit game for insurers, not for real care:
  "A lot of times individuals are like, they're trying to get rich... it's more unethical for me to say, hey, I'm not going to give you a diagnosis yet. Because, hey, we just met, right?" ([15:11], Dr. Martin)

4. Discussion: Diagnoses, the DSM, & Cultural Competency

[18:34–25:04]

• Crissle asks about trends to reclassify personality disorders under CPTSD; Dr. Martin pushes back, calling the DSM "trash":
  "The dsm, the book that we use to diagnose people is trash anyway. ...it's... culturally biased." ([19:06], Dr. Martin)
• Both agree: the treatment plan must fit the individual, not just the diagnosis.
• Dr. Martin underscores clinicians’ biases—most are white, affluent, and thus often unprepared for diverse client needs:
  "If you don't have a scholarship for, say, like a Psy D program, flat out the pocket is $200,000." ([13:14], Dr. Martin)
• Calls out the myth of “neutral therapists”:
  "I have no interest in being a neutral therapist... Therapy isn't neutral. Money is in neutral. Crime is an economic issue." ([22:58–23:19], Dr. Martin)
• Shares real stories of clinicians with shockingly low cultural competence—even in elite programs.

5. Listener Letter #2: “Too Self-Aware for Therapy?” and Therapy Termination

[29:39–49:58]

Letter from Sierra

A 17-year-old high school senior, previously discharged by her therapist for being “too self-aware”—now isolated, anxious about college, and fearful she’ll never find supportive care.

Dr. Martin’s Response & Guidance

• Flatly rejects the idea of being “too self-aware for therapy”:
  "There is no, like, one reason to start therapy. Therapy is not a reward for you being confused." ([30:17], Dr. Martin)
• Affirms everyone deserves support, encourages Sierra to use college resources early, and highlights benefits of groups.
• Explores “therapeutic alliance” as key, especially for young Black women—therapy is often the first place they’re truly heard and affirmed.
• Normalizes feelings of isolation and being “textbook”—the personal is common, not freakish.
• Calls out the therapist’s inappropriate, abrupt termination:
  "It’s super inappropriate... The clinician staying [she was] too aware [is] a limitation of their clinical education, not an issue with Sierra." ([46:38], Dr. Martin)
• Encourages clients to share prior negative experiences with new therapists for better care.

Notable Quote

"Self-awareness is not a barrier to treatment... It just means your treatment needs to work and look differently." ([41:47], Dr. Martin)

6. Listener Letter #3: Therapist’s Ethical Breach and Dual Relationships

[50:09–67:30]

Letter from Hakeem

A 38-year-old man whose therapist tried to play matchmaker between two clients, resulting in Hakeem being scammed and losing all trust in the process.

Dr. Martin’s Response & Ethics Lesson

• Immediate, unambiguous condemnation:
  "This is not a gray area. This is like a clear breach of ethical standards..." ([53:19], Dr. Martin)
• Outlines how to report a clinician for harm: find license, document everything, file with state board, and request confirmation.
• Explains why such a referral is dangerous: "What we state holds more weight. ...They involved you in something that shouldn't have occurred...."
• Urges Hakeem never to return to that therapist and not internalize the breach:
  "She doesn't deserve it, and she going to mess something else up. No, Hakeem, absolutely not." ([57:58], Dr. Martin)
• Offers resources for finding affirming therapists, and acknowledges how these experiences can turn people off the system:
  "Everyone can cause harm. Everyone can cause harm. ...This was a clear breach. Don't you dare go back. ...You are so much better than this." ([63:34], Dr. Martin)

Notable Quotes

• "Therapists literally have legal power over their clients. ...It is not a game." ([64:15], Crissle)
• "Therapists have to be so careful about what they say, because your words DO carry more weight than some other random person." ([65:10], Crissle)

7. Listener Letter #4: Gifting Therapy / Therapy as a Punishment or Gift

[72:05–88:28]

Letter from Andrew

Wonders if gifting therapy sessions to a partner or family is “rude,” especially after frustrations over his boyfriend’s mood, substance use, and emotional unavailability.

Dr. Martin’s Response

• Dissects the intent vs. impact:
  "It's not a gift you offer without consent… It seems like you're providing it in the realm of: 'You need therapy,' and there's shame involved in that."
• Urges Andrew to reconsider framing—therapy is not a punishment or conditional tool:
  "Shame and guilt have never propelled anyone into consistent or healthy healing." ([80:32], Dr. Martin)
• Recommends an approach rooted in care, autonomy, and humility: "I can't always provide you with the care you deserve; can we both work on this?"
• Suggests that Andrew reflect in his own therapy about his approach and motives.

Crissle on Intent vs. Impact

"This is exactly what we’re talking about. You have good intentions...but I got a checklist of all the ways you are messed up...that's why people are resistant." ([78:57], Crissle)

Notable Quotes & Moments

• On Mental Health System Shortcomings:
  "85% of therapists are white in this country...and even elitist. ...Who has the money to do that?" ([12:53–13:14], Dr. Martin)
• On the Importance of Cultural Competence:
  "If you’re going to work with diverse populations, you have to meet clients where they are. That is your job." ([22:11–22:42], Crissle)
• On Therapy Boundaries:
  "We are prohibited. It’s not a gray area. ...You don’t have to get licensed and pass the exam to know this." ([56:49–56:58], Dr. Martin)
• On Safe Relationships:
  "You have to give people a chance to hurt you, but also a chance to support you." ([86:21–86:29], Dr. Martin)

Timestamps for Key Segments

| Timestamp | Topic | |-----------|----------------------------------| | 00:01–04:08 | Introductions & Child-Free Stigma | | 04:08–15:11 | Listener #1: Misdiagnosis Dilemma | | 15:11–16:27 | Insurance/Diagnosis Pressures | | 18:34–25:04 | DSM, Diagnosis, & Culture | | 29:39–49:58 | Listener #2: Self-Awareness & Termination | | 50:09–67:30 | Listener #3: Therapist Breach/Ethics | | 72:05–88:28 | Listener #4: Gifting Therapy Etiquette |

Closing Remarks & Resources

• Dr. Martin provides information about her platforms, resources, and Black woman–centered mental health community: The Sanctuary ([89:44–91:30]).
• Final emphasis: Black mental health deserves affirming, specialized, community-based approaches—seek spaces that are truly for you.

Tone & Takeaways

Crissle and Dr. Martin blend humor, candor, and an unapologetically Black lens, rooting tough advice in immense caring. The episode empowers marginalized listeners to demand—and build—better mental health care, to trust their instincts, and to seek healing in community. Listeners walk away armed with strategies, validation, and the motivation to challenge broken systems, all while getting some good-natured “dragging” of trash therapists along the way.