#and learning how psychiatry has been used as a tool of oppression | Explore Tumblr posts and blogs

your-dietician · 3 years ago

Text

Can Psychotherapy Promote Liberation? Addressing Power Dynamics in Clinical Practice

New Post has been published on https://depression-md.com/can-psychotherapy-promote-liberation-addressing-power-dynamics-in-clinical-practice/

Can Psychotherapy Promote Liberation? Addressing Power Dynamics in Clinical Practice

From a critical lens, there appear to be two overarching sentiments about talk therapy, or psychotherapy.

One view is that psychotherapy is irretrievably ensconced in the wider apparatus of medicalization and coercion that characterize psychiatric hegemony. From this lens, the risk of incurring harm in psychotherapy looms large. Because it cannot be disentangled from the medical model, psychotherapy, as an institution, may simply serve to enforce a status quo by locating problems squarely within individuals.

The other view is that psychotherapy offers a safer, med-free option to otherwise surface-level interventions that exclusively target symptom reduction. It not only is the more preferred mode of treatment by those seeking mental health services, but, through this view, psychotherapy offers restorative validation within a trusting, healing relationship.

Indeed, if psychotherapy is viewed as a healing relationship, rather than a curative treatment, then there may be a role for this empowering validation and solidarity in the project of rethinking social systems.

Inherent to both perspectives is this: psychotherapy can be powerful. Just as it risks transmitting harmful narratives about pain and distress, psychotherapy might also subvert these very harms in pursuit of genuine healing and transformation.

Rethinking Narratives

As a bi(racial/cultural) woman—White and Brown; American and Pakistani; and influenced by Christianity and Islam—confronting and rethinking oppressive narratives and systems to forge ways forward has become my modus operandi. Perhaps the biggest dichotomy I embody is derived from ancestral ties to colonizer and colonized.

At the age of 10, my family and I were first exposed to the mental health and legal system. At the time, I believed that psychologists were equipped with sophisticated tools to discover and expose the truth about a problem and then, make things right. Instead, I encountered an intimidating process of interrogation and assessment. I couldn’t make sense of how it was supposed to help.

The reports presented by mental health professionals seemed either abstruse or self-evident. The verdicts and recommended plans for my family were woefully impractical. We found ourselves forlorn and financially drained, none-the-wiser since having received individual diagnoses and psychological formulations.

“Depression.” This decontextualized label was provided to everyone in my family, among other diagnoses. It explained to us that our suffering was because of chemical imbalances in the brain.

It wasn’t until much later that I felt empowered enough to flip this interrogative, pathologizing stance and instead question the deficiencies and limitations that pervaded the systems and frameworks that purported to help.

Distress Through Different Lenses

“It’s all over but the heartache,” my father would say, after our extensive contact with the mental health and legal systems ceased. This experience of heartache could also be captured by the notion of a “sinking heart,” an English translation of an expression native to the Punjab region that straddles where Pakistan and India were parted.

Reflecting on it now, I feel fortunate to have been tacitly conjuring our own words and explanations, co-authoring stories that enabled me to creatively honor multiple meanings as true. These ideas of heartache offered much richer, embodied explanations outside of the confines of medical, psychological, or pathologizing lenses. And, eventually, they helped me to mend fractures across the binaries that seemed to constitute my experiences.

The mental health system had failed us. Providers and assessments seemed to completely overlook the context—the “what had happened.” Rather, we had been pulled out of context into what felt like mechanistic interactions and evaluations that revealed circular jargon. The jargon only seemed to obscure meaning. Instead of feeling that new ways forward had been presented, I felt further boxed into something that didn’t fit, incentivized to interrogate my feelings, change myself, and conceal what felt to be true and real.

“You’re doing the best you can in a really difficult situation.” This response was not what I had anticipated my therapist would say. I had expected her to suggest that I restructure my thoughts or perceive things differently. The “help” I had received so far seemed to orient me to a process of adjusting to disempowerment. And when someone offers you a ground to stand on, even if it is founded on the idea that you are the problem, you might just settle there, lest you go on feeling baseless. Her response in this moment mattered. She had heard and seen enough of what was happening that her response had the power to affect me.

What she said at that time wasn’t especially novel or poetic, but here is why it sparked a sense in me that things could be different: First, she named the context. She acknowledged that my personal experience and everything that was happening around me were connected.

She also provided fundamental validation that my experiences made sense within this context. On a much deeper level, her response signaled to me that perhaps she thought I was a good person and that disarmed me after having so long internalized that I was somehow wrong. It was a basic thing for her to say, but it required a degree of attunement, a keen sense of timing and delivery, and a strong relational foundation at a time when my ground felt like a giant fault line.

I envision an alternative scenario: perhaps I never got this message. What if I had foreclosed on the idea that the problem resided exclusively within me, that my heart ought to remain sunken as condemnation?

My mixed experiences with cultures of care prompted my interest in how they could respond to and address, rather than reproduce, the disordered conditions and structures that I, and many others, have internalized.

Cultures of Care in the Psy-Disciplines

This question of how relationships and change processes might serve to counter conditions of oppression and disempowerment steered my rethinking of mainstream mental health care. In the hopes of envisioning and implementing different responses to distress, I set my sights on becoming a psychologist.

My family couldn’t fully understand why I would pursue a doctorate in a field that seemed to profit from our pain. To me, it was an opportunity to study change processes with respect to how social and individual experiences are intimately connected—a chance to consider how things could be different.

I viewed psychology, psychiatry, and psychotherapy (i.e., the “psy-disciplines”) as powerful in that they produce and disseminate knowledge intended to define who or what is “healthy” or “normal.” These ideas make their way into everyday discourse. I felt it problematic that the psy-disciplines sometimes uncritically put forward these ideas, under the guise of scientific objectivity, without genuine acknowledgment of how this information was situated in cultural contexts and ideology. Unsurprisingly, I struggled to connect to the practices of my own field.

“Oppression is the root of all mental health disorders” a professor in my graduate studies declared. Counseling psychology seemed to be more attuned to the limitations and constraints of status quo psychology. They questioned psychology’s relationship to power, so I pivoted from clinical to counseling psychology.

Although I struggled to connect with practices in the field because they were largely oriented to delineate normal from abnormal thoughts, behaviors, and feelings, I found a lot of promise in theory—the feminist dictum that “the personal is political”; Foucauldian thought that examined power, knowledge, and madness; critical-community scholars who brought these ideas to bear; and humanistic-existential thought which held implications for psychotherapy process as well as historical ties to the anti-psychiatry movement. Decolonial scholars, such as Frantz Fanon, had never even been mentioned in my formal studies.

I found a like-minded community for the first time when I began my doctoral studies at the University of Massachusetts Boston and writing for Mad in America. There were so many studies and ways of thinking that had never been featured in my formal education or training but were brought to the fore in discussions with friends, mentors, and teams, including the Mad in America writing team. We were constantly coming upon scientific evidence that countered mainstream practices and frameworks in the mental health field.

A clearer picture was forming for me about the way contexts of distress were glossed over. Mainstream models did not account for the ways racism, poverty, and geopolitical factors were contouring individuals’ distress. Instead, the focus was exclusively on individuals’ biochemistries and genes, or even decontextualized intrapsychic factors, such as personality traits.

I had the chance to not only develop an in-depth view of how the current responses in the system were failing people, but also an understanding of how these systems colluded with guild interests and pharmaceutical ties—they were neoliberal and neocolonial by design.

It is not just about the medical model, but about how this model upholds a very specific view of distress that justifies the current standard of care. Locating disorder in individuals’ bodies depoliticizes distress. It absolves systems and unjust structures from the need to change and it protects the way things are.

I learned that decisions around treatment tend to be made to protect liability and prioritize what is good for the market, not necessarily what is best or most empowering with respect to health and wellness. Even a focus on health tends to be overtaken by a Western lens which valorizes neuroreductionism and biogenetic theories of causation without meaningfully engaging with philosophy and critical thought, such as the hard problem of consciousness. This lens overemphasizes individual agency and a culture of efficiency and solutions while misappropriating any model which challenges its core.

Yet, the psy-disciplines are continuously attaching their work to a social justice mission, conflating intervention with care, and access with equity. Uncritically exporting Western models builds upon legacies of colonization. In so doing, these mainstream approaches flatten resistance as it manifests in the individual, and pathologize diverse idioms of distress.

Time and time again, I covered research articles by scholars who declared the need for a paradigm shift in the field— Time to rethink diagnosis, time to develop new models for racial trauma, and time to utilize conceptual alternatives, such as the Power Threat Meaning Framework, that recognize the sociostructural and relational determinants of distress.

Psychotherapy: “Clinical Intervention is Cultural Prescription”

At the same time, I was about six years into training as a clinician. It became apparent to me that the macro issues in the field trickled into therapy and shaped the ways people understood themselves.

Sometimes, when I was first meeting a client, they would utter statements such as the following:

“My last therapist told me I had an anxious personality.”

“Something is wrong with the way that I think.”

“Maybe I was overreacting, but I felt like my therapist dismissed what I thought was real. I tend to catastrophize.”

I felt I was witnessing the psychologization of everyday life. The language they were using mimicked psychological theories that spotlighted individuals’ deficits.

Philosopher Michel Foucault famously described how control over discourse equates with control over how a person perceives and comes to experience both themselves and the world. Harmful social discourses and power dynamics could be transmitted and reinstalled in psychotherapy. Alternatively, perhaps they could be interrupted and subverted.

But I found that psychotherapy was hardly, if ever, being described as carrying the potential to trouble the status quo. Most often, it was rendered as treatment designed to reduce or eradicate symptoms. But this idea of psychotherapy as a drug did not match with the psychotherapy process research literature that emphasized client-therapist relationship, therapists’ empathy, contextualized understandings of distress, and clients’ resources as predictors of positive, desired change.

The research literature also appeared to flag the ways psychotherapy may be a site for reproducing harmful social power dynamics. For example, people marginalized in society were least likely to benefit and most likely to experience coercion, medicalization, and criminalization when accessing the mental health system. In psychotherapy, this looked like experiencing microaggressions, warranted distrust of clinicians, dropping out of therapy, and expressing greater dissatisfaction with psychotherapy services.

Psychotherapy process is guided by theoretical assumptions and psychological theory. The extent to which social and structural power dynamics have shaped knowledge in the discipline is the same extent to which psychotherapy might carry this forward.

Thus, psychotherapy risks becoming a site in which epistemological violence can occur. Epistemological violence involves utilizing explanations that problematize distress and dehumanize individuals when equally viable, alternative interpretations exist.

Decolonial and African studies scholars have similarly described power as the ability to define reality, especially the reality of what it means to be human, and convince the other that it is true, universal, or natural. If we recognize that psychotherapy is powerful, we must acknowledge, as clinical community scholar Joseph Gone put it, “clinical intervention is cultural prescription.”

Just as structural competency seemed key to subverting structural violence and conceptual competency to subverting epistemological violence, I wondered how these concepts apply to psychotherapy, if at all.

Can Psychotherapy Promote Liberation?

Once I became more familiar with the pitfalls of mainstream psychotherapy, I developed an interest in rethinking how the power of psychotherapy could be harnessed to trouble the status quo—to offer genuine healing and desired transformation.

To be clear, psychotherapy has been ill-equipped to attend to the sociopolitical determinants of individuals’ lives. It is not a stand-in for necessary material and structural change. Positioning individual-level interventions as the be-all-end-all misplaces disorder.

However, many people also opt into, or find themselves pushed into, psychotherapy services. The concept that relationships can be a place to explore and attend to, rather than “fix,” distress is hardly novel. Perhaps a psychotherapy that addresses individual pain and social change as interconnected—as mutually-informing processes—can offer an alternative to psychotherapy as an instrument intended to adjust individuals to an unjust social order. Perhaps relationships can be a space to cultivate and re-envision different ways.

Sankofa—“Alternatives” Have Always Existed

In a MIA interview with China Mills about coloniality and the Global Mental Health movement, she pointed out that “alternatives” have always existed. I thought of the Ghanaian concept of Sankofa, or, in English, “to go back and get it.” It represents returning to one’s roots, or reflecting on the past in order to move forward. I wondered about what different ways to do psychotherapy had been suppressed and denied.

When it came to challenging medicalization and the concept of the therapist as the expert, I set my sights on exploring Humanistic-Existential psychotherapy orientations because they were founded on respect for human dignity and the premise that each person is the expert of their experiences. When it came to recognizing the influence of social power and systems on individual wellbeing, I sought out the wisdom of Feminist-Multicultural psychotherapy theory.

I was interested in exploring the integration of Humanistic-Existential and Feminist-Multicultural orientations through a critical lens. Through this, I set out to move beyond deconstructing the harms of psychotherapy and calling our attention to these more marginalized approaches that may reveal an emancipatory potential.

Interviews with Eminent Humanistic-Existential and Feminist-Multicultural Psychotherapists

For my doctoral dissertation research, I interviewed 14 eminent psychotherapists who were distinguished in Humanistic-Existential (HE) practice, Feminist-Multicultural (FM) practice, or both. They had practiced for at least 15 years, written books, supervised training psychotherapists, held leadership roles, and taught courses in FM and HE approaches. About half of the participants had been featured in an expert video series to demonstrate clinical application of theory. Thirteen of the 14 participants gave me permission to disclose their identity.

I applied critical and constructivist approaches to analyzing what they shared with me about navigating power in psychotherapy. My dissertation chair, supervisor, and brilliant mentor, Heidi Levitt, is a leading scholar in qualitative inquiry in the field. She was my guide in this endeavor.

The content of the 14 interviews was the data. As a qualitative study, the findings were not intended to be generalized toward understanding a population. Rather, the interview data were in-depth, thorough descriptions meant to theoretically contribute to understanding ways to address power responsibly in psychotherapy.

In other words, the data are meant to capture a phenomenon, not reflect population statistics. I stopped collecting data when the addition of new findings no longer contributed unique ideas.

As I saw it, these findings could serve to repoliticize HE and FM theory and reclaim the aspects that may have been suppressed, diluted, and co-opted. I viewed it carrying the potential to contribute to a wider movement to fundamentally rethink psychological theory and its practical application.

With an enriched understanding of these perspectives, we may also be better positioned to recognize the pitfalls of their implementation. Scholars in psychology have long been exploring the fruitful compatibility between HE and FM approaches. Therefore, the interviews were also helpful in building a new, revitalized version of an emancipatory psychotherapy—to go back and get it.

Lessons Learned—Responsible Navigation of Power in Clinical Practice

Eminent FM and HE therapists believed that a genuine healing process was also a liberation process. FM therapist participants—including, but not limited to, Beverly Greene, Laura Brown, Judith Jordan, and Maureen Walker—underscored that psychotherapy ought to be a fundamentally decolonial process. Therefore, FM therapists used their power to empower clients by trusting clients’ assessments of themselves and supporting them to reclaim power that has been denied to them.

HE therapists—including Arthur Bohart, Leslie Greenberg, Jeanne Watson, Nathaniel Granger, and Kirk Schneider—emphasized that the client is the expert of their own experience and needs. HE therapists thus used their professional training to facilitate a process in which the client authentically and robustly participates and connects to their experience in the moment.

Liberation in this sense, entails the therapist ensuring that they do not impose hegemonic cultural values within psychotherapy. HE therapists supported clients to recognize and make meaning of their experiences and the ways parts of themselves may have been fragmented and disowned through harmful relationships with people and society.

The HE and FM therapists, as well as those who identified as both (e.g., Theopia Jackson, Lillian Comas-Díaz, Melba Vasquez, and Louis Hoffman), believed that empowerment was the goal of psychotherapy.

In a Western context, empowerment is sometimes construed to overemphasize the individual. A mind-over-matter attitude is encouraged, which supports the idea of a self-contained person who should simply seek to overcome their struggles, by “pulling themselves up by their bootstraps,” for example.

However, FM and HE therapists recognized that this overemphasis risked locating the problem in the person. They actively worked to challenge this existing approach which instead empowers a capitalist market and Western ways of thinking (e.g., Western dichotomies, rationalist philosophy) as superior.

FM and HE therapists sought to avoid imposing neoliberal capitalist or Western self-hood. This awareness of imposition meant that they diverged from the medical model. They refrained from labeling and categorizing clients. Empowerment, for them, meant that the goal was not exclusively focused on reducing or eradicating distress, but rather conceptualizing distress as meaningful or as resistance.

Therefore, these eminent therapists did not believe that empowerment entailed so-called “expert” prescriptions. A crucial part of empowerment was using their proximity to the field to demystify how systems worked (e.g., insurance, diagnosis requirements, session limits).

In viewing the client as the expert of their experience, therapists aimed to support clients’ creative capacities to interpret and make meaning of their life toward healing. They emphasized that they were not giving power to clients, rather, the clients are the ones who make therapy work for them.

The role of the client has historically been overlooked in therapy, argued the therapist participants. Yet, clients are the ones who apply and integrate what works into their lives—clients, actually, are interpreting the analyst.

Therefore, the psychotherapists I spoke with aimed to intimately recognize and center clients’ processes. They also viewed the psychotherapy relationship as a powerful site from which they endeavored to support clients’ harnessing of their (contextual, ancestral, etc.) resources and wisdom to arrive at new meanings and desired actions. Clients’ experiences and resources were viewed as ecological and relationally co-constructed. Thus, an empowering psychotherapy moved beyond self-improvement or harnessing resources contained within a disentangled self. The individuals’ process could reveal what is also required to transform social and contextual structures.

Some therapists emphasized that “critical consciousness” or “consciousness-raising” processes were integral to empowerment. Clients were supported to develop clarity about how relationships, systems, and social structures have influenced them. Clients’ inner power, therefore, was about a self-in-context. In addition to this, when clients could clarify the variables that constrained their thriving, they could feel empowered to reclaim their story and decide what, then, they wished to do, if anything.

Importantly, FM and HE therapists believed that therapists needed to understand power dynamics in order to navigate them responsibly. They must not simply absolve or deny that they are perceived as the “professional,” a person who has proximity to mainstream frameworks and influence within those systems. Moreover, therapists had to experientially explore their cultural power, conferred through their identities.

Philosophical and experiential training was emphasized as crucial to therapists’ honest reflections of themselves, their culture, and the mental health field. Adequate training in these areas could bolster a genuine humility to embrace different ways-of-knowing, particularly when it involves listening to expertise derived from lived experience.

Through these approaches, therapists in training are encouraged to understand what their positionality could symbolize to clients and what that could mean for their relationship. Further, they could consider their personal (and their field’s) vested interest or propensity toward promoting specific ideas about what is right, natural, or universal.

In session, responsible navigation of power is complex, FM and HE therapists described. It is tempting to believe that a therapist could simply tell someone how they have been disempowered or what they ought to do to resist oppression. But doing so presumes that the therapist knows best.

Distinguished therapist participants highlighted that empowerment is rarely brought about by the content of what therapists say, and more about their ability to meaningfully facilitate clients’ exploration and explication. Clients’ experiences tell the story.

Consciousness-raising is not the belief that somehow the therapist knows what the client ought to be aware of. Rather, it is the deep appreciation and respect that only the client can really know that. Yet, somewhere along their journey, their connection to this has been dispossessed and disempowered. The therapist is thus accompanying clients’ phenomenological exploration, or their exploration of their lived experience, toward reconnection and reclamation. A process to illuminate collective change.

Therefore, these distinguished therapists focused on developing skills to be responsive to clients—to hear clients as widely as possible. Responsiveness was developed through their self-reflection outside of therapy and then demonstrated through sophisticated skills such as radical empathy, keen perceptual awareness, timely and accurate reflections, and a critical awareness.

First and foremost, therapy was seen as a relationship. Therapists compromise the process if they choose to conceal their own authentic participation, for instance by hiding behind a façade of professionalism. In a culture governed by values of independence, neoliberalism, and hedonism, anchoring healing in relationship is countercultural. The process of therapy enacts a different way of doing and experiencing that is co-created and contains within it models of what can be transferred to other contexts.

As part of navigating power dynamics to accompany and support clients’ critical and experiential exploration, HE and FM therapists described that they: (1) structured shared power, co-participation, and provided robust informed consent at the outset of, and throughout, the psychotherapy process; (2) provided genuine validation to cultivate radical safety; (3) skillfully invited clients to engage their experience and reflected back clients’ meanings as they meant them; and, (4) utilized phenomenological exploration balanced with critical inquiry to allow for understanding experiences and constraints to clients’ thriving in order to potentially reveal novel possibilities.

Pitfalls, Institutional Constraints, and De-Politicization

HE and FM approaches both developed during the U.S. civil rights movement and converged in their focus on human dignity, resistance to oppression, and basic human rights for all people. In his book On Personal Power, Humanistic psychology leader Carl Rogers described the revolutionary potential of the person-centered approach.

Rogers aligned his work with radical Brazilian educator Paulo Freire, writing that, at the same time, but in different places, they had both put forward models of psychotherapy and education, respectively, that empowered people and challenged Western culture and institutions.

Although the liberatory roots of FM and HE therapy approaches have been recognized, the depoliticization of these therapies led to calls to revive a focus on power, particularly in feminist and multicultural scholarship or scholarship based on reconciling FM and HE theory.

An example of this depoliticization was described by HE therapist participants who explained how concepts of self-actualization had been misappropriated to overlook communal aspects. It has been applied as a goal to empower “selves,” in an egoistic or boundaried way. However, self-actualization ought to entail empowering exploration of lived experience that begets responsiveness to self and other in paralleling ways.

Empowerment was viewed as a ripple effect. Relational-cultural theorist Judith Jordan emphasized that the goal was to empower clients to empower others and so on. Ultimately, FM and HE therapists used their power to skillfully ally with clients’ exploration of lived experience. It was this exploration of clients’ lived experiences that was deemed key to informing self, other, and community liberation.

Similar to the misapplication of HE theory, FM clinical approaches had been taken up as reductive, check box understandings of identity that reinforced stereotypes without meaningfully addressing social power dynamics. FM therapist Beverly Greene described why institutions might be invested in sustaining social power dynamics, within psychotherapy and beyond, through proliferation of reductive approaches:

“[Psychologists] were part of an institution that was…invested in validating the social status quo. And basically, people in the discipline…who were very powerful…took social bigotry and wrapped it in psychological accoutrements….”

She continued:

“It’s incumbent upon people who are learning this discipline to think about what you’re being told. And who’s doing the telling?….There’s a proverb that says, ‘As long as the hunter writes history, the lion will never be the hero.’”

FM and HE therapists spoke to the ways they had experienced suppression and disenfranchisement within the field because their approach challenged mainstream mental health.

Hiring, promotion, and tenure processes as well as grants and research reviews were geared to support manualized therapies that converged with mainstream cultural values and aims. In the interviews, therapists described the activities they took up to resist mainstream approaches and establish solidarity.

If the field of psychotherapy were to take seriously FM and HE theory, they believed that it would challenge the very essence of the American Psychological Association. It would require a paradigm shift.

A Liberation Psychotherapy

From my findings, I was inspired to build upon liberatory models of psychotherapy. I developed a Liberation Psychotherapy model grounded in the merging of HE and FM theory that serves also to complement the work of Lillian Comas-Díaz, Janis Bohan, Glenda Russell, and other scholars who have long advocated for a shift in how psychotherapy is viewed and practiced.

I also drew from the broader context of Liberation Psychologies, derived from the work of Ignacio Martin-Baró and Latinx and indigenous community psychologies. The therapists I interviewed referenced concepts from liberation psychologies such as critical consciousness and psychosocial accompaniment. Liberation psychologies centralize examining power, privilege, and oppression to connect intrapsychic and sociopolitical phenomena.

The Liberation Psychotherapy model I have put forward clarifies how power dynamics can be responsibly navigated within psychotherapy and centers: (a) power in clients’ lived experiences; (b) interdependence and the power of relationship; (c) that expert power and cultural power dynamics are intersecting; (d) a critical-ecological framework; and (e) liberatory outcomes.

Power, ultimately, becomes a concept of focus that can be used to recognize the way social power dynamics can manifest within psychotherapy relationships and come to be transmitted through approaches, concepts, and frameworks.

I developed 12 principles of practice to articulate how a Liberation Psychotherapy model could differ from practice as usual. For example, these include guidance on how to anchor an exploratory, yet consciousness-raising, process that is culturally situated and honors what clients determine to be salient for them.

This Liberation Psychotherapy model further questions traditional symptom-based outcome assessment and encourages recognition of myriad diverse ways that people express empowerment within the psychotherapy process and in activities, such as, but not necessarily, activism, in the world.

This model is not only grounded in a project of reclaiming suppressed concepts from HE and FM theory, but rather centers liberation psychology concepts that fructify and clarify the merging of FM and HE approaches. Yet, centering exploration lived experiences as a process may reveal inroads to individual, interpersonal, and social transformation.

Genuine Embracement of a Different Way

I hope to further refine and develop this Liberation Psychotherapy model as I continue to engage in clinical practice and research. I have concerns about the way that this model could be co-opted, as many others have been, which would undermine an appreciation for what liberation means.

For this reason, I believe it is important to be clear about the inherent limitations of psychotherapy. As an institution itself, clinical practice must go above and beyond to address systemic oppression. Psychotherapy is a system of its own and it is one that is structured around an interpersonal frame and individual-level intervention. Therefore, it is especially susceptible to maintaining a focus on individuals and on what the individual, not the practice, might do differently. This removes not only the culpability of systems, including mental health ones, but encourages individuals to simply adapt to circumstances.

Inspired by the work of indigenous scholar, Jillian Fish, I have recently been building on some of the findings that came out of my research. An examination of power is one way to connect psychotherapy to wider social contexts. However, part of what this study enabled me to see more clearly was that social context is within the individual because context is what constitutes experience.

Jillian Fish has put forward a model that more succinctly captures this recursive relationship. She critiques the traditional ecological model in psychology, which places the person in the middle of concentric circles representing successively macro contexts.

An indigenous conceptualization inverts the traditional ecological model. It places social, relational, and temporal aspects, such as time and culture, within the person. I believe that for Liberation Psychotherapy to be genuinely embraced, this type of conceptualization in psychology and psychotherapy is crucial.

I often think of the saying “research is me-search.” My experiences in the world have been colored by social mores and relationships that cinched, flattened, and sought to eradicate what could exist in between binaries or outside of constraining frameworks.

From a psychoanalytic lens, trauma is described as that which a person cannot integrate and process—a wound. However, I felt that the things I struggled to integrate were the things about me that the world showed me it was not ready to process, integrate, or symbolize. It was not simply my own cognitive processing deficiency. Rather, my wound was like my own avenue to beholding a wider process of collective mutilation that has required us to forego different possible ways to live and to be.

Unsurprisingly, I developed an aversion to explanations about human experiences that stifle creativity, resistance, and the remarkable depth and breadth of human diversity. Therefore, my clinical and research work is geared around humility rather than an uncritical adoption of any singular solution that aims to be the only way. This project tells of how I attempted to go back and get it, resist reductive explanations, and merge together seemingly incompatible perspectives.

A liberation psychotherapy is not about uncovering who we truly are. It is an excavation into the ways our pain, hopes, tensions, and fantasies are reflective of all with which we are entwined, and then, using this to inform collective emancipation.

Source link

0 notes