#recently i've seen a trend. mostly on instagram. of peopel who identify as radical or lived experience therapists still not getting it

[trans-axolotl]

so im going into therapy (or social work, more broadly) as a profession (in school rn). i know that not everyone in anti psych would support that, understandably, and im not under an illusion that therapy isnt tied to the whole system and process. but i want to bring a liberationist, anti-racist, pro-mad, and abolitionist ideology to help who i can

do you have any suggested resources or reading recommendations or idk any insight on how to inform the way i go about juggling anti psychiatry in a profession that is considered going hand in hand with it?

Hi anon.

I think there can be ways that people working in the psych system can leverage power and resources in a way where they're acting in solidarity with psych survivors and mad people, but in reality, this very rarely happens, even among professionals who identify as radical or as having lived experience.

Fundamentally, the psychiatric system is one that perpetuates structural violence, and in smaller and larger ways, anyone who works within the system to legitimize it contributes to and is complicit in that violence. So I think that for anyone who is planning to work within the system, you need to be upfront with yourself that there is harm occurring and that isn't something you can just ignore or act like that's something you're separate from. Even if you're not working inpatient or facilitating forced drugging of someone, there's still a lot of ways that therapists can be complicit in psychiatric violence.

One of the most obvious ways is through mandatory reporting. I believe that in order to be an ethical therapist you must break the law--mandatory reporting is a dangerous way that mad people are surveilled by the state, and therapists must work to interrupt that and prevent it. There are a lot of therapists out there already talking about practical ways to avoid mandatory reporting and how to be upfront with clients about it, and I can link some of that at the end of this post. I won't say it's always easy, but we have an obligation to each other to do everything we can to stop psych incarceration from happening.

I think there's a lot of ways that even outpatient, therapists are asked to enable other forms of psychiatric violence. Even if in your practice, you're really focusing on liberation, respecting autonomy, etc, there are ways that other psych professionals might try to get you to help them perpetuate different forms of harm. And because of your degree and licensure, there's this power imbalance between you and your client that means you do have the power to enable these kinds of harms. The degree next to your name means that you will always be believed over your client and that is a lot of power to hold. If you're working with a client with an eating disorder and their dietitian gives an ultimatum that they have to be hospitalized or they're refusing to provide care, what do you do? If your client's psychiatrist is refusing to answer questions or let them switch to other types of medications, what do you do? If your client is involved in a court case and you're getting subpoenaed for their medical records, what do you do? If your MSW program requires you to do one of your internships in an inpatient program, how do you prevent that from happening? There are a lot more examples I can think of, but these are just a few things I wanted to highlight for ways that therapy is still entangled in the larger system.

Another thing that feels important to me is to make the distinction between being a "good therapist" and helping people, because I don't think those things are the same. I see a lot of "radical" therapists get fixated on this idea that they need figure out ways to make the psych system run smoother, to improve access, to overall make the psych system better, and that this is the only way to help people. It's really important to be able to separate those ideas. For me, psych abolition is a project of building up our capacity to care for each other while destroying the systems that currently enact violence on us, and reformist ideas about expanding psychiatric systems, increasing funding, and legitimize psychiatric authority gets in the way of actually transforming care. I think in order to help people, you need to commit to being a "bad therapist" in the eyes of a capitalist healthcare system.

One recommendation I have is to read Franco Basaglia's writing and learn about his approach of the democratic psychiatry movement. As a psychiatrist, he saw his role as a way to disrupt the system and deinstitutionalize. He has this quote where he talks about how they weren't focused on eliminating problems, but rather on how deinstitutionalization would create more chaos and new problems--and how that created so much possibility for transformation. I think he's proof that there are certainly ways that psych professionals can act as accomplices who actually are in solidarity with psych survivors, but it's rare.

Last point I have is that although you gain something from professional training and licensure, there's also a lot you lose. MSW programs often don't actually teach you the skills you want to learn about how to actually support people--there's a lot you're going to have to learn from continuing education credits. From my friends who have gotten their MSW, I've heard a lot of complaints about how surface level a lot of information is, and also about how a lot of the way that information is taught reinforces hierarchal ideas and doesn't respect patient autonomy. I'll also say that gaining licensure oftentimes creates barriers for radical action--I've seen so many therapists who then become so attached to holding onto and not losing that licensure that they weigh it above mad people's lives. I've heard so many therapists say "Oh I can't speak up against restraint because I'll lose my job/I can't ignore mandatory reporting because I'll lose my license/etc etc etc." And I think that can be a really damaging mindset that harms your potential to actually help people. There are several therapists I know who are in the process of intentional de-licensure because of this, but regardless if you pursue that path or not, this is a mindset you need to be on guard against.

All that being said, I think there is a need for more abolitionist therapists who are able to help support our communities, both in terms of creating that space for individual support and on a collective level. There are ways that you can leverage your access to resources and the way you're seen as legitimate in the system to help advocate for people, get them support, and interfere with psych violence. I have a therapist comrade who keeps working in inpatient psychiatry specifically so that they can continue to sneak in banned materials to the ward, prevent illegal restraints, be involved in court proceedings as an advocate, connect people to mad liberation resources, let psych patients use their phone, document psychiatric abuse with the plan to fairly soon release that information as a whistleblower, and more that I'm not going to talk about publicly. They still grapple with the fact that they are currently perpetuating harm at the same time, but to them, it's worth it to be able to sabotage things in that way. And I think that there are ways that you can take the information you learn in your program that is actually useful and find ways to bring that directly to your communities, and that there is good you can. I just think you have to be very intentional and aware of what it takes to actually do that, rather than just staying complacent with the label of being a "radical therapist" without doing anything to make that true.

For resources--here's my psych abolition drive with a lot of different zines, books, workbooks on different psych abolition topics. I really would recommend reading Psychiatry Inside Out by Franco Basaglia as an example of successful psychiatric resistance.

I would also suggest checking out Mutual Aid/Self Social therapy--the people who created this project are trusted comrades of mine, have both gotten their MSW or LMFT, and they have a lot of helpful insight into how to navigate things like avoiding mandatory reporting, de-licensure, etc. They have a discord server and also have regular online MAST meetings to train people on what MAST is and how to set up a MAST collective.

Genuinely wishing you the best of luck through school and appreciate that you're actively thinking about these things.