Therapy for Social Change Podcast

Last week I explained how treatments for mental health conditions rely on one of three particular definitions of the body that are circulating in the field right now. I noted that two definitions of these bodies, the “physiological body” and the “somatic body,” are “universal”: that is, physiology and soma are said to operate the same way, in all people. We rely on universality in medicine and mental health to help us identify illness or disorder, which is said to be an aberration from a universal norm.

I contrasted these two bodies with the “situated body." Today’s Action Snack asks you to see what happens to your thinking, your practice, or your understanding of yourself, if you put a mental health issue or diagnosis with which you are familiar within the context of the situated self. 

The understanding of what a body “is” and how it works shapes the interventions we are trained to use and how we think about psychological distress. There are at least three definitions of the body driving today’s mental health treatments, and these definitions are creating unofficial silos in the field, parceling out different understandings of embodiment and selfhood.

Many of the mainstream approaches to mental health treatment deny the specifics of the situated body and the ways our experience of embodiment, power, and oppression are present in our experiences of anxiety, or trauma, or depression. Most evidence-based practices are rooted in a universal definition of the body and thus presume that what anxiety “is” is stable and consistent across all people: that these terms are static—universal in the way they are understood, and uniform in the way they are experienced. But when we put the lens of the situated body over a term like anxiety, or trauma, or depression, these ideas become more complex, and we can ask what it might mean to include the situated body in all forms of mental health treatment. 

The way to make deep, lasting change is to be as boring as possible.

No flair. You sneak up on the change, like a cat stalking its prey. You tell no one you’re doing it. You waste no time asking others for their advice about your goal. You devote your planning and thinking not to the end result, but rather to the smallest possible action you can take. You make the first step so absurdly small, so trivial, that it’s laughable that you would call that a step towards change.

The goals we make as individuals feel tangible, even if they’re lofty. But when we consider our capacity and ability to contribute to change at the level of the social and political, suddenly our field of vision expands. What we are trying to change is larger and harder to break into small pieces.

What would it be like to think of activism as a kind of mycelium network, a super organism, matching in its structure the complexity and networked aspects of ideological constructions like patriarchy and white supremacy? How could a movement shift and adapt to current conditions, the way the ideologies of patriarchy and white supremacy constantly shape-shift to contain the political threats to their power? What if you saw yourself as a tiny, hairlike thread, one singular component of a vast web of change-making?

Then, what your current skills, interests, particular obsessions and talents—what you already have, who you already are—would be of vast importance to the networked whole.

If all you had to be was one tiny thread, what would you do?

Including an analysis of structural violence can help us to better understand and solve problems as challenging and complex as why it is that mass shooters are almost exclusively male. This post looks at a NYT article on how to predict a mass shooting, and overlays the experts' analysis with a structural lens.

I think of labor questions for therapists: Could much of the current, epidemic levels of depression and anxiety be caused by loss of meaning, overwork, lack of time to cook healthy food, lack of energy to really listen to the people who matter, because at the end of the day there’s nothing left to give? What would happen to our addiction rates if people didn’t feel compelled to numb themselves out at the end of the day, or before work started?

I think the Great Resignation, and the pandemic, raised these questions again, and the Amazon and Starbucks union drives are one answer, and the conversations about remote work are another answer, and the efforts to reduce student loan debt are yet another answer. These answers seem to me to fall more on the “bread” side of the house. So how do we get more roses?

I think therapists are being recruited to salve the wounds of labor. That somehow, we’re supposed to be the roses. I think the explosion of apps and services created by tech companies trying to turn therapy into a service that is an adjunct of HR departments is evidence of the evacuation of care at both the familial and the structural levels. It’s an open opportunity for corporations to monetize these needs by creating a kind of therapy that isn’t, actually, therapy, but instead something vaguely termed “support” that can happen at the other end of a text message, late in the night.

I’ve been thinking about harvest, in this late summer moment. How the natural world uses a strategy of abundance to ensure its continuity. A lot of what I write about in this newsletter is how ideas of scarcity, hierarchy, and dominance are impacting us, both individually and collectively. My goal is to make these ideas, and the structures that uphold them, visible. I want to talk with you about them, interrogate them, undermine them, transform them.

Harvest gives the lie to scarcity. The natural world thrives on interconnectedness and communication; it uses multiple strategies to ensure its ends are achieved. It is not inevitable that we will continue to dominate and oppress; that violence will continue to spill from generation to generation; that rights will continue to be stripped away; that the lights are going out. I know this because when I pay attention to the natural world, it schools me. And I know it because you are here, caring about these same ideas, doing all the things you do each week to help yourself and others thrive.

Photo by A Koolshooter on Pexels

The Climate Psychology Alliance of North America conducted a discussion between the U.S. environmentalist and author Bill McKibbon and the English psychoanalyst Sally Weintrobe about her recent book Psychological Roots of the Climate Crisis.

Weintrobe’s main argument is that the self is divided between a narcissistic aspect, which she names The Exception, and a reality-based, caring part of the self that is often able to contain the exceptional self.

The Exception has three illusory beliefs:

* I am entitled to see myself as ideal

* I am entitled to have whatever I want

* I am entitled to use omnipotent (magical) thinking to rid myself of any more unease about holding these beliefs

Weintrobe sees a link between the neoliberal politics ushered in by Reagan and Thatcher and The Exception: a kind of political enacting of the desires and illusory beliefs of The Exception, at the level of the political. There’s a feedback loop between a politics that tends to The Exception, and an increase in what she terms a politics of uncare. When The Exception becomes a national narrative of entitlement, threats to self and world such as climate change are avoided, denied, refused.

In the years since Regan and Thatcher, as politicians in the global north and multinational corporations continued to deny, delay, and disavow their culpability for the climate crisis, they soothed The Exception, not only at the level of the individual, but also at the political, delaying a reckoning with their politics’ true effects.

In our current moment, the bubble of denial that props up The Exception is breaking. And it is here that climate science finds itself in a paradoxical moment: reality is intruding on the consciousness of many who clung to denial. The impacts of global warming and population extinction can no longer be denied. The emergency is here. Climate scientists have won.

That victory, however, is now threatened by an under-anticipated secondary problem: whether the public can tolerate its exposure to reality, and the emotional impact of reckoning with the damage that has already been done. Climate reporters and scientists were, understandably, relentlessly focused on breaking down the counter arguments that sought to undermine the fact of climate change.

What was less thought through, however, was what would happen when the bubble broke. Suddenly, an enormous group of people in the global north have been plunged into awareness, terror, grief, and overwhelm. Frantic efforts to restore The Exception are still occurring, but the gig is up. The impacts of global warming on the global south have been occurring for decades, and those most vulnerable in the present have the fewest resources to maintain their survival.

The immensity of the challenge could be a siren song to return to denial, or a shock so immense as to induce mass paralysis. It is in this moment, when the political and collective rupture of denial is happening, that those of us who have the training to help ourselves and others stay “with” grief and rage have much to offer the movements working to eradicate environmental racism, ecological extinction, and the misallocation of resources across the globe. We can help people use their deep feelings as catalysts for engagement in collective action. And we can join with existing movements, helping those currently giving their all to sustain themselves, and to process their hope and grief.

You can watch the interview, here:

Some things I’ve been thinking about, after watching this interview:

How do patriarchy and white supremacy augment the Exception, for individuals who benefit from these structures?

How does the feminization of care impact the makeup of the climate movement, in terms of gender representation?

How can activists care for themselves, even as they are focusing their energy on building an effective movement? Should therapists become a secondary line of defense, backing up the activists with our knowledge of secondary trauma, emotion regulation, and the impact of structural violence and oppression on the self?

How do those who come from cultures that are non-individualist, or who are members of subcultural communities that prioritize care, view and understand the narcissistic elements of personality? Are there models of selfhood that do not conform to the Exception?

How might liberation psychology work in tandem with psychodynamic psychology to reinforce and increase the mass movement to overthrow Exceptional politics, introduce a politics of care, and combat ecological extinction?

Sources cited in the webinar, or by the authors cited in the webinar:

The Carbon Footprint Sham by Mark Kaufman

The Particular Psychology of Destroying a Planet by Bill McKibbon

Big Oil Coined “Carbon Footprints” to Blame Us For Their Greed. Let’s Keep Them On the Hook by Rebecca Solnit

Rhetoric and frame analysis of ExxonMobil’s climate change communications by Geoffrey Supran and Naomi Oreskes

Psychological Roots of the Climate Crisis by Sally Weintrobe

Talking about and paying attention to what it’s like to be in a body can be a way “in” to recognizing what shifts when the body is racialized. Because white people experience their bodies as at times “non-raced,” they can remain unconscious or oblivious of the ways their racialization is always present. How, then, does this dynamic impact the ways whiteness is suppressed in therapy sessions?

Photo by Mathias Reding on Pexels

So. This past week was one of those weeks where what I was going to talk to you about kept shifting under my feet. I started the week by working on a piece for you on boundaries.  

In the case of the boundaries post, I decided to look at what happens when we take a concept that’s pretty much taken for granted as a “good” therapy practice, and ask what happens to that concept when we move out of the zone of the individual, and overlay the lens of structural power. I thought it was going to be a fairly simple piece. I was going to ask us to notice that expanding the context in which a boundary is set can introduce new ways to understand and talk about boundaries with clients, and anticipate the impact of oppressive systems on clients’ attempts to set boundaries.

But writing the piece wasn’t simple. As soon as I put the interlocking structures of patriarchy and white supremacy “over” the generally received wisdom of what a good boundary looks like, I started seeing things, and asking questions. Most of my questions ended up showing me the field’s unacknowledged assumptions about what a boundary “is” and what it’s “for.”

One thing I noticed was that lots of the authors writing about boundaries used metaphors of land, property, rights, and ownership of the self to describe why a person might need or want a boundary, and why they should view setting a boundary as an act of healing or self love, even if the other party accused them of being aggressive or selfish.

So then I asked myself why the “self” that’s setting the boundary is conceived of as a form of property, and what that might mean, in the context of the U.S. history of who can and cannot own themselves, who is owned by another, who has 3/5ths of a self and whose self had the franchise and for how long.

Historically in the U.S., is it only the white self that has had enough “property in the self” to assert a boundary? Is that still true, in certain contexts? How do the conversations about property in the self and boundaries operate in the context of the overturning of Roe v. Wade?

It seemed like most of the writing on the self relied on a European concept of selfhood, steeped in concepts of land and property. It made me wonder what Indigenous models of the self look like, given the fact that Indigenous cultures have a completely different relationship to the earth than Europeans.

And what about communitarian cultures, which subordinate the needs of the individual to the community, or don’t even talk about selfhood on the level of the individual at all?

Another thing I noticed, as I reviewed the literature on boundaries, was that so much of the writing talked about how to “set” the boundary, but didn’t address the power relations between the two parties. Does that mean that the two people who are impacted by the boundary are thought to be equals? Or that the act of asserting the boundary eliminates power differentials? Are two parties ever equal, in their structural or institutional power?

And if they aren’t, why are we telling people they can assert a boundary and expect a positive outcome? Why are we assuming that you can protect yourself by setting a boundary, when in certain contexts, that act could result in institutional reprisal or interpersonal violence? What are our (“our,” being the “field’s”) assumptions about power, how it works, who has it, and what to do about it?

Boom. Game over. My head was buzzing. No way that piece was going to be ready for you in a few days.

I’m starting today’s post with my story for two reasons. First, because I want to say that I’m in here with all of you, struggling to figure out what it’s going to take to get the field of mental health, and therapy more specifically, to become accountable for its rootedness in white supremacy. I’m not outside this struggle, with answers to dole out every week. I’m in here with you, frustrated, overwhelmed, searching.

And my story about writing that boundary post, I’m sorry to say, is itself a reflection of how even as I’m working to identify and talk about white supremacy, my very approach to writing the post was an expression of whiteness.

I thought I could talk about a concept, put a lens on it, and start a discussion about how to “add in” patriarchy and white supremacy. I thought it was fairly simple to juxtapose what it means to talk about a boundary from the perspective of an individual and a structure. I thought I could do all that in a week.

And what happened instead was that as soon as I started introducing whiteness into the conversation about boundaries, the entire concept started to unravel, unwind. Within thirty minutes of reflection, I was asking myself if the idea of a boundary needed to be jettisoned, altogether.

I know very well that you can’t “add” a critique of white supremacy to an already-existing field and expect anything to change. But I thought I could retain the idea of a boundary and complicate it, by “adding in” a conversation about whiteness, patriarchy, and power.  

So I’m telling my story to say that this project of talking about patriarchy and white supremacy in the field of mental health is one in which I am going to be constantly working to inhabit a transformative consciousness, and repeatedly falling back into the assumptions and ideologies upon which the field is based.

I fell prey to whiteness in the way I approached the topic, in the speed at which I expected myself to move, in the frustration and brain fog I experienced, when I had to confront, again, the depth of the roots of whiteness in the practice of therapy. And in that moment of frustration, I thought I had nothing to offer you. If I didn’t have a complete and coherent way to talk about boundaries, what business did I have, trying to write these newsletters. And I don’t mean that in a drama queen kind of way. I mean, I really felt for a minute like I had nothing of value to say.

There’s that all-or-nothing thinking, and that idea that what white people have to offer is analysis, headiness, a totalizing framework of understanding. That my emotions were a consequence of my failure as a writer, rather than a reflection of what it feels like, in this moment, to want change to happen, to want pain and oppression to cease, and to know that real change is slow, inching, uncertain, unknown.

Two days after I hit the wall on the boundaries piece, I learned the Association of Social Work Boards (ASWB) finally responded to pressure and published the stats on their exam pass rates in this report. The results are horrifying and unsurprising.

It should be noted that the data ASWB chose to illustrate in their graphic was the eventual pass rate for the exam. Buried in the report was the first-time pass rate for the exam, which is worse. The Illinois chapter of the National Association of Social Workers noted, in their response to the report, that “the report mentions that first-time pass rates are better for determining bias; however, the information was written to highlight eventual pass rates, which skews the results.”

On Twitter, Isabel Vee posted a revised graphic, which crosses out the eventual pass rates and substitutes the actual first-time pass rates for the exam:

The response to this report on Twitter was explosive. Already today, Monday, the first business day after it was produced, there is movement energy to challenge the ASWB and the NASW to address the role of exams and licensure in the practice of therapy.

ASWB’s report includes a three-page “discussion” of their data. The discussion doesn’t name the institution’s, or the field’s, rootedness in whiteness, and the likelihood that the test questions are an expression of whiteness as a way of being.

It doesn’t acknowledge the longstanding arguments that the test is biased, and should be rewritten to include subject matter that is rooted in Afrocentric models of healing, Indigenous practices, and other healing modalities. It doesn’t explore what qualifies as “social work knowledge” or raise questions about how accreditation processes and quantitative research produce what counts as “knowledge” and “evidence,” or describe what knowledge is used as the source of the current exam questions.

I’m grateful to Alexandria L, who reposted on Twitter last week this important conversation about how the exam might be revised:

What ASWB does acknowledge is the impact of structural violence on the test takers themselves:

Census data have consistently shown that individuals from historically marginalized groups disproportionately experience socioeconomic hardship related to lower household income, higher poverty rates, inequities in educational resources and attainment, and lower rates of health coverage, wealth, and home ownership (Shrider et al., 2021). Accordingly, historically marginalized groups may be more likely to experience challenges in the period leading up to exam administration, including but not limited to access to comprehensive, accurate, and effective exam preparation resources; sufficient time or availability to prepare for taking an exam; and adequate financial resources to pay for the exam.

To read this text is to infer that the ASWB sees itself as outside of the effects of patriarchy and white supremacy, and the test takers themselves, as individuals, as inside these structures. It is the test takers, they say, who may be operating out of “stereotype threat,” being so anxious about proving themselves “exceptional” in the face of stereotypes about their racial or ethnic group, that they throw the test. It is those on the receiving end of racism and structural violence, this text notes, who are impacted by these systems. But those who are racialized as white, as the universal, invisible “norm” against which all others are racialized, are somehow outside these ideologies.

What ASWB is doing, in this paragraph, is displacing its responsibility to address its institutional expression of white supremacy, the structure, onto Black people, as individuals, who experience the impacts of both racism and white supremacy, as individuals and as a group.

Following this logic, it is Black people who “need resources” to fix this, not the institution that created the test, which is fundamentally flawed. White institutions can therefore look for “resources”—money, grants, mentors, etc.—to help those who can’t pass the test. They can continue to be the good guys, making up for inequality, and avoid having to engage in self-scrutiny or institutional transformation.

ASWB doesn’t acknowledge that to begin to address the legacy of white supremacy in the field, practice, and management of social work—and by extension other forms of therapy, case management, and social services—that every institution will need to become fluent in how to understand and combat white supremacy, the structure, rather than retaining a focus on racism, one engine of acts committed by individuals.

I fear ASWB is not only trying desperately to hold onto its institutional authority—and the money it makes off the test—but also going for the quick fix: the overlay, the frantic attempt to paper over its own expression of whiteness. I fear it is simply, in its current incarnation, unable to imagine a process of slow, determined, halting excavation of its epistemologies, its practices, and its assumptions about what professionalism “is” and what therapy “is.” I fear it is going to continue to avoid engaging in a process of deep self reflection and transformation that could serve not only the test, but the broader profession itself.

Pexels—August de Richelieu

This week's action snack asks you to verbally acknowledge a structure, such as patriarchy or white supremacy, as an ultimate source of violence.

If you look around, listen to podcasts, read the news, you’ll notice many conversations about racism and sexism, often dramatized by stories about individuals, such discussions about George Floyd and the cops, or Amber Heard and Johnny Depp and whose testimony was credible and why.

You’re less likely to encounter a complex discussion of what abolitionism really means, in practice, or why a lot of people want a transformative justice approach to addressing domestic and sexual violence.

In an individualist culture—where we are daily exposed to media, movies, advertisements, and other cultural products affirming that our future, our success, is within reach and a result of our own effort and grit—it’s disheartening to be told that our ability to make change in the world is constrained by structures that predated us, and identity positions we didn’t consent to inhabit.

It’s far easier to talk about individual acts of sexism and racism than to acknowledge the power of structures like patriarchy and white supremacy. And because acknowledging the force and impact of oppression flies in the face of individualism, conversations about structures can quickly turn away from the intended subject matter and become debates about “whether it’s even realistic” to enact systems change. 

You’re trying to talk about how it is that white supremacy functions, and how patriarchy is often implicated in how white supremacy categorizes and values different groups of people, and the person you’re addressing asks you if what you’re really saying is that white people are the root of injustice and do you really think all white people are the same? And . . . scene.

It’s easy to feel like the buzzkill at a party or, worse, to bear the brunt of institutional reprisal when we name entrenched systems of inequality and structural violence, instead of asking for a particular interpersonal dynamic to be adjudicated by the HR department. 

This week’s challenge is to engage someone in your life in a conversation about a structure, rather than an event, or an individual act, as a source of violence. Notice I said “source,” not “cause.” When we are talking about people, we can talk about cause and effect in a linear fashion. When we are talking about structures and systems, which operate in networks, we’re addressing root sources, not linear causality. Think about a spring or a well, out of which thousands of rivers flow.

Here’s an example. There’s been lots of conversation about the #MeToo movement being at a point of “overreach.” Some of the current criticisms—too many men are being accused; it’s like the Salem witch trials; not all men are bad; how are people supposed to have sex in this environment, etc. 

What’s happening in this conversation is that a focus on sexual violence has turned into a focus on individual men, and how many men out there are perpetrators of harassment and rape. The point of #MeToo is not to say that all men are rapists. The point of the movement is to transform the culture’s relationship to sexual violence so that it starts to see sexual violence as a set of behaviors that can be changed, or eliminated, rather than seen as “too big to solve.”

If we have a conversation about men as perpetrators and why men engage in sexual violence, we’ve lost the focus on the end game, which is to eliminate sexual violence. But if we start with patriarchy, the system responsible for the valuing of traits and behaviors that are coded masculine, and the devaluing of traits that are coded feminine, then we have a way of talking about the organization of the culture at large. When we talk about the kinds of masculinity that are valued in patriarchy, we see that patriarchy impacts everyone, including men, and that sexual violence is actually a logical outgrowth of patriarchy.

It’s important to remember that many of us benefit from and are oppressed by multiple structures at the same time. Please be patient with yourself if you are not used to naming structures. And please take this step in a context that can generate a conversation steeped in curiosity and engagement. The challenge here is to find words for something that is difficult to name and describe, and to receive interest and affirmation from others, when you do so.

If you recall the conversations I had with Claire about patriarchy in the last two posts, you’ll remember that we were investigating, noticing, questioning, in our discussions about how patriarchy was impacting us in the present, and how it functioned in the past. Our talks allowed us to collaborate, and in sharing our perceptions, to find more precise and powerful ways to talk about the structure that was impacting the two of us. And then Claire took our insights to Emily, so they could talk about the ways their conflict was an expression of their struggles with the patriarchal definition of “success.”

The purpose of this Action Snack is not to threaten your safety—either personally or structurally—or to generate conflict or dynamics of one-upmanship. The point is to notice how we forbid ourselves from naming root sources of violence, and as a consequence, have fewer strategies and resources available to us to fight back.

If you want to take this challenge up a rung, and you are in a position of power or authority in a group, organization, or institution, you may also want to look at the ways that organization or institution understands and explains the causes of violence that impact its members, or whether it addresses the impact of structures on its mission, vision, and values.

If you are in an environment where you are used to naming structures and participating in generative conversations about combatting structural violence, please share strategies in the comments about how you distinguish between individual acts of violence and structural oppression in conversation with others. What strategies have you and your communities used to protect individuals who name foundational structures as sources of oppression and the misuse of institutional power?

And if you are a mental health practitioner who wants to bring conversations about structural violence into your practice, but don’t quite feel comfortable with the language yet, this action snack is a perfect way to practice just naming and identifying how structures work with people in your life who are interested in these ideas.

I’d love to hear how this goes for you!