Despite tremendous strides in educational and professional development, the black professional woman who seeks psychotherapy is often entrapped by a world view based on a very dissonant set of expectations. This world view is based on the belief that possibilities for acceptance on the basis of one's professional characteristics surpass possibilities for acceptance based on personal traits. Perceptions of professional competency contend with perceptions of personal incompetency. Severe motivational symptoms intensified by feelings of unworthiness, hopelessness, and despair exist in relation to this condition. Among its salient determinants are: (1) slavery, the perpetuation and internalization of myths, stereotypes, and other distortions, and (2) significant interpersonal losses. Training programs must strive to achieve a better integration of relevant knowledge, skills, and attitudes to enable psychotherapists to effectively meet the needs of this challenging client population. Additional psychotherapy research will be imperative to facilitate a better understanding of these dissonant expectations as well as other dysfunctional conditions that affect the black woman. (Author/PAS)