Social justice and psychotherapy

This section is for questions relating to therapy, assessment, formulation and other aspects of working with people in mental health services.

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Campion
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Re: Social justice and psychotherapy

Post by Campion » Wed Jul 15, 2020 12:35 pm

Why do I suddenly feel like John Sims character in Life on Mars?
(checks posting history)
Oh yeah... it has been a while.

Spatch wrote:
Sat Jul 11, 2020 5:44 pm
The other part is the interpretation of 'social justice', which is equally as varied as 'liberalism', and I am not going to answer on the behalf of Lancaster how they define it. I would even hazard that within the course team there is a myriad of conceptualisations of this, and probably the best thing you can do is ask someone on that team about this.

For me, social justice springs from post enlightenment values. It is John Rawls, Bertrand Russell and pretty much what any good clinical psychology supervisor will call 'reflective practice'. It is taking account of our biases, subtexts, being able to tolerate differences and ambiguity and build up empathy. Outside the most very simplistic, behaviourist therapeutic approaches it's hard to move away from that. Even the most right wing, neo-conservative psychologists will have been exposed to some of this and it will impact on their thinking.

Well, as you've so clearly elucidated old man, 'Social Justice' fails at the task of shared meaning; you've had to define what it means to you, as a basis on how to converse on the topic, and that points to the general problems with it as a concept.

It's a principle really, rather than a fleshed out philosophy. Part of the reason for this, is that we need the words to be agreeable in themselves, and when you flesh something out with a formal sense of meaning; there are so many different openings to attack it on a theoretical level that it threatens any idea that we might wish to maintain.

A lot of the problems for the idea come from relying too heavily on Rawls extremely flawed thinking; Rawls premiss is based on the idea that somehow society is a form of tabula rasa; a clay like substance that is infinitely malleable, so if we have a lot of square pegs, we can make them square holes. His first premiss therefore comes from a faulty thesis and; to borrow a common idea; that's problematic.

I'm not saying that we shouldn't try for more square holes; my argument is that making enough really might not be possible without destroying society and as far as I recall, Rawls never really accounts for this. This, to my mind, is why so many of the new activist base would be happy to see society destroyed and made anew in some grand utopia, not because Rawls never accounted for it; but that no-one can.
Spatch wrote:
Sat Jul 11, 2020 5:44 pm
However, lets go with it and say we work at level (d). We put your lady in touch with various culturally approrpiate support and activism groups, focus our work in therapy on raising their political awareness, educating them about their rights and autonomy and you start challenging the more damaging elements of their prevailing cultural context. A lot of that has to be individualistic, as you are working with a single person, not all of that group, and even if you are able to make a cultural level change, a lot of that quickly becomes personal.

It sounds to me like you are advocating 'the personal is political' here, which is nice, haven't seen that in a while... can you please explain to me how you see that working as a therapeutic tool when it was essentially designed as an ongoing political one in which you need to essentially hold on to that pain so as to increase its political value?

As an aside, it's good to see you fighting the fight again old boy. I do hope you have an argument for me; I'd hate to have dragged myself out of my many years of ethereal slumber to not be loudly and heartily debated.



Campion.
'Think how many blameless lives are brightened by the blazing indiscretions of other people.' - Saki.

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Re: Social justice and psychotherapy

Post by Spatch » Wed Jul 15, 2020 7:48 pm

Good to see you old timer. It's been too long.
It sounds to me like you are advocating 'the personal is political' here, which is nice, haven't seen that in a while... can you please explain to me how you see that working as a therapeutic tool when it was essentially designed as an ongoing political one in which you need to essentially hold on to that pain so as to increase its political value?
Not sure how that aphorism or position was initially designed, but I am not sure if I agree that one needs to hold onto ones pain in order to do anything. For me the overlap part of therapy is to explore someone's experience and how they make sense of this. Sometimes this involves questioning assumptions, social views and beliefs if they are no longer useful for that person (usually along the lines of Power/Meaning/Threat), which is where the issue of politics can come into it.

For instance, if someone feels they are a failure because they didn't score straight grade A's at A-level, and their parents approval is conditional upon this. There is a lot to unpack and explore, and some of this will stray into the realm of politics ("who defines who is a success or failure?" "Why is academic success more valued by some people than kindness?") or the philosophical ("is conditional love, actually love?", how can one construct oneself authentically?")

I am not sure what exactly it is you are objecting to, but would be curious to hear what is sticking with you. Also I am not sure that any form of clinical work that can be totally apolitical considering the underlying ethos of modern healthcare and the means by which it is provided.
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Campion
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Re: Social justice and psychotherapy

Post by Campion » Thu Jul 16, 2020 12:45 am

Spatch wrote:
Wed Jul 15, 2020 7:48 pm
Good to see you old timer. It's been too long.

It has indeed, but I do sleep a lot longer than I used to these days.


Spatch wrote:
Wed Jul 15, 2020 7:48 pm
Not sure how that aphorism or position was initially designed, but I am not sure if I agree that one needs to hold onto ones pain in order to do anything.

Holding on to the pain, or distress of something is an unfortunate side effect, at least, I would argue, of using personal experience as political action, if we agree with the Carol Hanisch proposition from the essay of the same name, 'the personal is political', much of what affects us in everyday life can be traced systemically back to the pressure of socio-political norms and their enforcement by what you and I would most likely identify as hegemony.

Given this, I would argue, the impetus is on us as individuals to use that knowledge, to use what affects us, as a form of crucible for political change. Whilst it's not always necessary to hold on to personal pain within this context; it's unlikely to help us form a consensus position if that pain or distress has been resolved elsewhere. Ergo, a need to hold on to pain, or distress to incentivise the formation of a collective understanding of the pain itself, to form a consensus for political action.

I'm not saying it isn't a valid political tool of course, I'm just curious as to whether it has any usefulness as a therapeutic one.

Spatch wrote:
Wed Jul 15, 2020 7:48 pm
I am not sure what exactly it is you are objecting to, but would be curious to hear what is sticking with you. Also I am not sure that any form of clinical work that can be totally apolitical considering the underlying ethos of modern healthcare and the means by which it is provided.

I would never argue that therapy should, or could be apolitical. I mean, hey. If you want me to argue that; I'll do my best, but I'm just not sure I can go there naturally. I'm also not objecting to anything, but it's me, so I understand why you'd think I was... I just saw what I thought was a suggestion of activism as a therapeutic tool and was genuinely interested in how you thought this might manifest itself?

Oh, and you brought up the name of one of my many 'he's who must not be named'. Honestly, you could have just said Marshall McLuhan, I'd have been back as quick.



Campion.
'Think how many blameless lives are brightened by the blazing indiscretions of other people.' - Saki.

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Re: Social justice and psychotherapy

Post by miriam » Thu Jul 16, 2020 2:29 am

Well said Lingua, AJ555 and Pooglet.
aufbau83 wrote:
Tue Jul 14, 2020 11:46 am
But I nonetheless stand by my argument about the importance of (what I understand to be) rational thought for (what I understand to be) recovery. To me, a salient point is that your experiences would have broken some people, perhaps even many or most people. Why did they not break you? Maybe good luck. Maybe you had excellent support. I want to suggest that it was, at least partly, your ability to think, to step back and reflect, to organize things and formulate plans for action, that helped you come out the other side and, ultimately, make it as a clinical psychologist with her own business, her own thriving forum and magazine. In fact, without these qualities, I don’t think you could’ve done what you’ve done. I’m not saying it’s a panacea – but even the refugee fleeing war and oppression who can think rationally is much better off than the one who can’t.
I'd say it was the fact I had supportive parents, who gave me the belief I am worthy of love and care, taught me to regulate my emotions and meant that my ability to problem-solve is maintained (to some degree at least) under stress. The fact I had friends who could support me emotionally and practically. The fact I had financial security and my past experiences gave me faith that I'd probably find another place to live, or could return to my parents' home. My positive experiences of health and social care, and my family's healthy diet and lifestyle, made me more optimistic about the health of my Dad and my premature daughters than many others may have been in my shoes.

Your individualism ignores the fact that we only get to use that intellectual facet of ourselves when we are safe, rested, warm, and our hunger and thirst is sufficiently sated, and we feel secure that our future basic needs will be met. That pre-frontal cortex you rely on for your rational thought model is switched off when we face threat, and many people face threat day in and day out. On top of that, we are social beings and responsive to those around us. Even our neurochemistry/anatomy is developed to match our environment and early experiences. This is known fact. To give one example by way of illustration: Babies exposed to domestic violence in utero or before 12 months of age have poorer attention and more aggressive play at age 6 and 8. It is a rational adaptive response to life experience that is not subject to reason or intellectual correction.
aufbau83 wrote:
Tue Jul 14, 2020 11:46 am
And what I’m ultimately saying is, this tendency can be encouraged, stimulated, even taught. I think it’s the key to recovery; I think it’s the most valuable contribution that a therapist can make; and I’d even argue that it’s the key to living in a civilized society.
I don't agree at all, on either account. I think really seeing and hearing people, recognising their individuality, and connecting with their experience is as close as I can get to naming an essential ingredient for therapy. Sure, we can talk about thoughts. Or we can talk about feelings. Or beliefs. Or relationships. Or the stories by which we understand our experiences. Or we can look at lifestyle, exercise, diet. Or identity. Or values. Or aspirations. But being rational isn't what is lacking in people who are distressed, or the panacea to help them recover.
aufbau83 wrote:
Tue Jul 14, 2020 11:46 am
Miriam, can I ask – and I hope I’m not simplifying your position here – given your skepticism about the centrality of rational thought to the “therapeutic endeavor”, are you also skeptical about the whole intellectual and therapeutic project of CBT? And of IAPT more generally?
I think CBT can be a really helpful tool for some people, if delivered in a way that is respectful of their individuality and experiences. I've seen CBT work for a whole range of people with milder difficulties that are less bound up in their history and context. I've also seen brilliant schema therapy and third wave CBT that deals with some of that history and context. I'm a big fan of some of the work being done with complex trauma, for example. I'm somewhat ambivalent about IAPT, as I think that it can have rather prescriptive and diagnosis-led pathways that offer very small and diluted doses of a single model of therapy to a much wider group than it was intended for. Which inevitably includes many who would benefit from more skilled, individualised and/or longer pieces of work, from services that have been cut away or have never truly met the level of need in the population. I also think that IAPT fits with what seems to be your mindset - that mental health difficulties are located within individuals who are faulty in some way and need to be fixed - and this stops people looking at the causes of distress that can actually be prevented or addressed in a much wider way than one individual at a time, or at the fact that any one of us could be sitting in the other chair if a few life events played out differently.
aufbau83 wrote:
Tue Jul 14, 2020 11:46 am
Is this why your left the NHS?
No. IAPT and the move towards cheaper staff doing more prescribed interventions had hardly touched children's services by the time I left. I had always worked in CAMHS where the work has always been much more systemic and creative. My particular niche was working with children who were in Care or adopted, where I was working with other organisations and supporting and training other professionals more than doing direct therapy. So none of that featured in my decision. In fact, until October 2008 I thought I'd be employed in the NHS my whole working life, like my Mum before me. I loved my colleagues and had quite a high level of autonomy, so I was able to design a lot of the pathways and shape my own role so I did a lot of things I enjoyed - like assessments, consultations, training and supervision. I felt I was paid pretty well too (on points that no longer exist within band 8C). Whilst I found the increasing marketplace mentality, recurrent organisational change, and attempts to meet an ever-increasing level of demand with ever decreasing resources, frustrating and disheartening, I was very much invested in trying to do the best with what we had.

However when another trust won a competitive tender for our service, and we were TUPEd over, the culture and management structure was very different. It didn't feel like they valued staff or the families referred to our service enough to put them at the centre of the design of the premises or pathways, and their focus seemed to be on fulfilling the minimum contract specifications as cheaply as possible. They were quite overt about stating senior psychologists were expensive and unnecessary, and remarkably unreasonable during my pregnancy and maternity leave. After a few very difficult conversations, I decided I wasn't enjoying it any more and (with the financial freedom of already doing regular court work that would sustain me financially) intended to take a career break from the NHS, so I went to speak to HR to get confirmation of the terms. During that meeting I mentioned some of the things I'd experienced and ended up with a redundancy offer and a gagging contract.

I've been doing my own thing ever since. I love the autonomy, creativity and flexibility that brings. My court work allowed me to build on my strengths in assessment and formulation in a context that allowed greater depth and informed critical decisions. But working outside the NHS also opened up greater scope to make a difference to vulnerable children and families at scale, through working with organisations and contributing to policy. I've written papers for government departments, contributed to professional guidance documents, trained thousands of people, written a book that has sold over 8000 copies, supported aspiring CPs in various ways, and my tools are used in the care of hundreds of children I'll never meet. I've gradually learnt how to run a business and grown to embrace the fact I'm now a tech entrepreneur and small business owner as well as a CP. Most remarkably, almost all of my work is still funded from the public purse and is free for the recipient at the point of access, though the supply chain is different. So my ethics have remained the same. And whilst I've earned less than I did before, I'm definitely happier now and feel like my work has the potential to make a bigger impact.
Miriam

See my blog at http://clinpsyeye.wordpress.com

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Re: Social justice and psychotherapy

Post by aufbau83 » Fri Jul 24, 2020 10:32 am

First, I appreciate the responses. Aside from it making for a very interesting and thought-provoking discussion that has challenged some of my assumptions, it’s made me rethink my own professional objectives.

Experience
“Aufbau83, you have written elsewhere that you work in a very different field and haven't yet gained any practical experience working with people who are experiencing psychological distress. What you're saying here isn't grounded in any evidence; it's a theory that you've made up while completely detached from the field.”
This is true, and I’m certainly not an experienced practitioner. That said, I’m not wholly lacking in “relevant experience”; I’ve volunteered at a crisis line / drop in center for the past three years. Again, not exactly extensive experience, but my pontificating is not based on nothing whatsoever.

'Symptoms' as 'rational responses' to 'complicated life experiences'
I suppose this is where I have to lay my cards on the table and concede that I’m a positivist rather than a constructivist. I think there’s a single tangible reality out there, which can be empirically verified, and that it is incumbent on us to remain as aligned with this reality as possible. I’m not convinced by the radical subjectivism of more constructivist approaches which hold that reality itself differs for each individual person. In my view, individual perceptions can be more or less aligned with reality, and the process of therapy, to my mind, is about aligning perception with reality. This doesn’t exclude a political dimension, by the way, because I would imagine that some individuals who come into therapy think that they and they alone are responsible for their suffering. In such cases, therapy could be about helping them realize that broader systematic factors lie at the root of their distress. This would, in effect, constitute an alignment of their perception with the reality of a fundamentally unjust society. But it’s still learning how to think rationally ::wink wink::

I suppose the irony here is that my history thesis took a constructivist approach to Nazism, and if you told my supervisor I was a positivist, he’d laugh in your face. Maybe I’m just a contrarian sophist who likes to argue or, as my sister recently put it, “a first class gobsh*te”.

Measuring rationality
To me, rational basically means in touch with reality. My views on the fundamental immutability and empirical verifiability of reality are outlined above. To me, rational thinking is basically about Cartesian doubt. Because reality is so extraordinarily complex, approaching it rationally (i.e. realistically) means exercising extreme caution around our conclusions. The suffering people I’ve talked to at the crisis center were frequently persuaded of either (a) their fundamental worthlessness, or (b) the basic malignance of the world. It’s this level of conviction and certainty that is, from the perspective of Cartesian doubt, inappropriate, and which needs to be undermined.

So what I’m saying is that rational is not so much the opposite of irrational, as it is the opposite of dogmatic. That doesn’t necessarily imply that being rational is concomitant with being confused and unable to come to any conclusions about anything. Though I must admit, I consider myself fairly rational, and it takes me about 20 minutes to decide which socks to put on in the morning.

Clinical psychologists don’t primarily do therapy
OK, I didn’t realise this, and it’s a big problem for me, because I am predominantly interested in the theory and practice of therapy. Maybe I need to look more into IAPT, or even some kind of psychoanalytic training, which it might be possible to do here in Germany (by the way, I think that, whatever their differences, both CBT and psychoanalysis take the strengthening of the “reality principle” as their object).

Politics
“A disclaimer that I personally disagree with your thoughts that democratic capitalism has brought 'half a century of peace and prosperity'. For whom? Certainly not the people who live in countries that we have been 'at war' with, certainly not for the people who were wrongfully deported during the Windrush scandal, certainly not for the people who do not fit in with our societal 'norms', I could go on. I fundamentally disagree that the solution to systemic inequality lies within the liberal democratic system, the system was built to uphold these inequalities and as such is working perfectly for those who created it.”
Yes, and maybe our basic disagreement about what therapy is or could be about stems from this basic political divergence, which is expressive of different ways of seeing the world. I’m not totally uncritical about liberal democratic capitalism, by the way, and I know that the inhabitants of the Global South aren’t quite as sanguine about the “half a century of peace and prosperity” as I am. I would probably still locate myself in the Labour party, but more on the Blairite right than the Corbynite left. Maybe that’s reflective of my age and my belief that, when social democratic parties turn socialist, they tend to lose elections, with the result that the people they were designed to protect suffer the most. Also, that last half a century of peace and prosperity was preceded by historically unprecedented levels of destruction and bloodshed. Our current system sucks in some respects but it could be a thousand times worse, and in my view, anyone who doesn’t share that pessimism doesn’t understand history.

The Pre-Frontal Cortex
“I'd say it was the fact I had supportive parents, who gave me the belief I am worthy of love and care, taught me to regulate my emotions and meant that my ability to problem-solve is maintained (to some degree at least) under stress.”
You mean, they taught you how to think? 😊
“Your individualism ignores the fact that we only get to use that intellectual facet of ourselves when we are safe, rested, warm, and our hunger and thirst is sufficiently sated, and we feel secure that our future basic needs will be met. That pre-frontal cortex you rely on for your rational thought model is switched off when we face threat, and many people face threat day in and day out. On top of that, we are social beings and responsive to those around us. Even our neurochemistry/anatomy is developed to match our environment and early experiences. This is known fact. To give one example by way of illustration: Babies exposed to domestic violence in utero or before 12 months of age have poorer attention and more aggressive play at age 6 and 8. It is a rational adaptive response to life experience that is not subject to reason or intellectual correction.”
This is a powerful paragraph, especially the reference you slipped in to the pre-frontal cortex, because if I was to formulate my argument in my neurological terms, I would put it exactly like that; therapy is about strengthening the PFC. The idea that certain levels of stress simply decommission it, and that such stress levels have a systemic basis… well, not an easy point for someone with my approach and worldview to reckon with, unfortunately. I’m not ready to yield just yet though because I still think it can be done, that everybody can be profitably taught how to think, that therapy can be an appropriate venue for doing this, and that, in fact, civilization depends on it. But the idea that this can be accomplished without accompanying political change is maybe a little “romanticized”, as Samays put it.

Back to the drawing board!

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Re: Social justice and psychotherapy

Post by ChrisCross » Fri Jul 24, 2020 11:58 am

This has been an interesting discussion to read, so thanks for inviting a conversation about this.
aufbau83 wrote:
Fri Jul 24, 2020 10:32 am
I’m not ready to yield just yet though because I still think it can be done, that everybody can be profitably taught how to think, that therapy can be an appropriate venue for doing this, and that, in fact, civilization depends on it. But the idea that this can be accomplished without accompanying political change is maybe a little “romanticized”, as Samays put it.

Back to the drawing board!
aufbau, I'm particularly interested in this notion that therapy is a space to "teach people how to think." I'll be open and say that my immediate reaction was one of aversion and I've been mulling it over since. I suppose my own experiences have led me to conceptualise therapy differently - namely, as a relational space to be and, perhaps more importantly, to be with. I've sat on both sides of chair, so to speak, and in both of these roles I find that what seems more important is the attunement and connection that takes place between therapist and client (hence there is so much literature attesting to the value of the therapeutic relationship). To reduce this experience to "teaching someone how to think" fills me with a great sense of loss and sadness. The human experience is so much more than a series of thought patterns and I think this approach risks minimising the depths of who we are.

It also speaks to a theme of power, so far as the therapist has access to the 'correct' way of thinking, which they impart onto the client as a gift. This is something that I personally challenge, as to construe the therapist as an 'expert' deters from the client's own lived experience and expertise. Ironically, I tend to find that therapy is usually most helpful and profound when the roles are reversed; when the therapist is able to learn from the client and both parties come away feeling changed. There could be several reasons for this, but the notion of the 'wounded healer' is one that speaks to me personally. As therapists, I believe we must be careful not to project our own suffering onto the people that we work with and, instead, acknowledge that we are both human beings - traversing life as best as we know how. It is not my place to "teach" my clients how to think; nor is it my therapist's place to "teach" me. But together, we can make room for curiosity and acceptance - and these, I believe, are key ingredients for change.

On a slight tangent, you mentioned Lancaster and so I just wanted to chip in as I'm a current Lancaster trainee. I won't speak on behalf of the course, but I will say that there is some diversity amongst trainees. Whilst 'social justice' does indeed seem to be a pillar that we hold to as a collective, there is variation in the way that we construe this and we are encouraged to think critically about ourselves and the world that we find ourselves in.

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Re: Social justice and psychotherapy

Post by reishi » Fri Jul 24, 2020 1:13 pm

I think there’s a single tangible reality out there, which can be empirically verified, and that it is incumbent on us to remain as aligned with this reality as possible.
I just have one question: who gets to decide which of the multiple versions of a reality is the real reality?
"Ever since psychoanalysis was developed, almost everyone is ill one way or another"

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Re: Social justice and psychotherapy

Post by aufbau83 » Fri Jul 24, 2020 2:03 pm

I just have one question: who gets to decide which of the multiple versions of a reality is the real reality?
A special committee comprising Mr Spock, Hal from 2001 A Space Odyssey, and the ghost of Francis Bacon.

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Re: Social justice and psychotherapy

Post by aufbau83 » Fri Jul 24, 2020 8:43 pm

PS. Joking aside, I get why you ask this. There's an implied authoritarianism to what I'm saying, as ChrisCross points out. Give me time and I'll try to offer a less flippant response.

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Re: Social justice and psychotherapy

Post by Geishawife » Sat Jul 25, 2020 2:31 pm

aufbau83 wrote:
Fri Jul 24, 2020 10:32 am

'Symptoms' as 'rational responses' to 'complicated life experiences'
I suppose this is where I have to lay my cards on the table and concede that I’m a positivist rather than a constructivist. I think there’s a single tangible reality out there, which can be empirically verified, and that it is incumbent on us to remain as aligned with this reality as possible. I’m not convinced by the radical subjectivism of more constructivist approaches which hold that reality itself differs for each individual person. In my view, individual perceptions can be more or less aligned with reality, and the process of therapy, to my mind, is about aligning perception with reality. This doesn’t exclude a political dimension, by the way, because I would imagine that some individuals who come into therapy think that they and they alone are responsible for their suffering. In such cases, therapy could be about helping them realize that broader systematic factors lie at the root of their distress. This would, in effect, constitute an alignment of their perception with the reality of a fundamentally unjust society. But it’s still learning how to think rationally ::wink wink::

I suppose the irony here is that my history thesis took a constructivist approach to Nazism, and if you told my supervisor I was a positivist, he’d laugh in your face. Maybe I’m just a contrarian sophist who likes to argue or, as my sister recently put it, “a first class gobsh*te”.

Measuring rationality
To me, rational basically means in touch with reality. My views on the fundamental immutability and empirical verifiability of reality are outlined above. To me, rational thinking is basically about Cartesian doubt. Because reality is so extraordinarily complex, approaching it rationally (i.e. realistically) means exercising extreme caution around our conclusions. The suffering people I’ve talked to at the crisis center were frequently persuaded of either (a) their fundamental worthlessness, or (b) the basic malignance of the world. It’s this level of conviction and certainty that is, from the perspective of Cartesian doubt, inappropriate, and which needs to be undermined.

So what I’m saying is that rational is not so much the opposite of irrational, as it is the opposite of dogmatic. That doesn’t necessarily imply that being rational is concomitant with being confused and unable to come to any conclusions about anything.
Interesting.... So rational is the opposite of dogmatic. You have suggested previously that in order to be healthy emotionally we need to be rational. So, by this line of logic we need to be rational, not dogmatic. Yet you state there is only one, real, tangible reality, which strikes me as being just about as dogmatic as it gets!

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Re: Social justice and psychotherapy

Post by lingua_franca » Sat Jul 25, 2020 7:43 pm

aufbau83 wrote:
Fri Jul 24, 2020 10:32 am
I’m certainly not an experienced practitioner. That said, I’m not wholly lacking in “relevant experience”; I’ve volunteered at a crisis line / drop in center for the past three years. Again, not exactly extensive experience, but my pontificating is not based on nothing whatsoever.
As you know, almost all clinical psychology doctorates require you to have had a minimum of twelve months' full-time experience before you can even apply, partly to acquaint you with the field, but also to lay the foundations for reflection and demonstrate your ability to learn from your experience. Most volunteer roles are for just a few hours per week, and unless you were able to significantly reduce the hours of your lectureship for the past three years, it's unlikely that your voluntary work would be enough for you even to apply for training. But it's enough for you to make sweeping claims about the nature of reality and how therapy works? Most practitioner psychologists would hesitate to make the claims you're making, and it's not because they have a different epistemological position, it's because they're experienced enough to know what they don't know.

The impression I'm getting from your posts (which may not be reflective of the reality) is that you view the requirement to gain experience as a pesky hurdle in your way - "the laborious and narrowly defined grinder of clinical experience" is a pretty negative way to describe vital opportunities to develop reflective skill. You also come across as much more focused on the problems of your hypothetical patients and how you will help to solve them than you are on your own background, motivations, and biases. All my therapeutic training to date has been psychoanalytic/psychodynamic, and one thing I appreciate about this approach is that it encourages me to be acutely aware of these things, and to reflect on how my beliefs, attitudes, and feelings might be contributing to the dynamic between myself and the young people I work with. The kind of therapist you are describing is a paternalistic figure, here to "teach" people how to think (which implies that he knows how, unlike them), to explain to them what might be causing their difficulties, and so on. I suspect any psychoanalytic training would want you to explore why it's so important for you to be that paternal figure of knowledge, and what your fervently held beliefs are defending you against. Fear of uncertainty? Sense of powerlessness? All the students on my Tavistock course have found the experience to be quite raw and bruising at times, and based on what you've written here, I don't think psychoanalytic training (or possibly any therapy training) is what you would expect.

Another thing that I picked up from your post is how you go from presenting rationality as the mainstay of therapy, to describing therapy as "inherently western", to suggesting that civilisation depends on rational thought (with therapy being a vehicle for promoting it). I'm getting a strong White Man's Burden vibe from that. If that wasn't what you meant, I think you need to be more careful in how you word and link these ideas.
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"Suppose it didn't," said Pooh, after careful thought.
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Re: Social justice and psychotherapy

Post by Spatch » Sat Jul 25, 2020 9:04 pm

OP you may benefit from reading Martha Stark's Modes of Therapeutic Action. Although the book is more about the underlying mechanisms of therapy, she proposes an interesting framework of 3 models about how different types of therapy are conceptualised. Taken from the blurb
Model I is about knowledge and insight. It is a one-person psychology because its focus is on the patient and the internal workings of her mind. Model 2 is about corrective experience. It is a one-and-a-half-person psychology because its emphasis is not so much on the relationship per se, but on the filling in of the patient's deficits by way of the therapist's corrective provision; what ultimately matters is not who the therapist is, but, rather, what she can offer. Model 3 is about relationship, the real relationship. It is a two-person psychology because its focus is on patients and therapists who relate to each other as real people; it is about mutuality, reciprocity, and intersubjectivity.
It's quite dense reading, but if you are into the more theoretical side you could get a lot out of it. I often nick ideas for supervision with my own trainees and qualifieds, and it tends to go down well.
Shameless plug alert:

Irrelevant Experience: The Secret Diary of an Assistant Psychologist is available at Amazon
http://www.amazon.co.uk/Irrelevant-Expe ... 00EQFE5JW/

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Re: Social justice and psychotherapy

Post by miriam » Sat Jul 25, 2020 11:05 pm

Well said, ChrisCross and Lingua. Therapy is about relationship, respecting the experiences and beliefs of the individual, and being mindful of the power structure, not imposing your better/more rational ways of thinking. Other people's distress is not your theoretical puzzle to be solved, and we are not your subjects to be fixed to your model of what is right.
aufbau83 wrote:
Fri Jul 24, 2020 10:32 am
You mean, they taught you how to think? 😊
I don't think you have any idea how offensive it is for you to say that. To be reductionist and patronising about my lived experiences. And I say that as someone without a significant history of trauma or maltreatment, and with a generally positive view of the nature of other people. I can't begin to imagine how this kind of comment would impact on others.
Miriam

See my blog at http://clinpsyeye.wordpress.com

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Re: Social justice and psychotherapy

Post by aufbau83 » Sun Jul 26, 2020 10:35 am

Another thing that I picked up from your post is how you go from presenting rationality as the mainstay of therapy, to describing therapy as "inherently western", to suggesting that civilisation depends on rational thought (with therapy being a vehicle for promoting it). I'm getting a strong White Man's Burden vibe from that. If that wasn't what you meant, I think you need to be more careful in how you word and link these ideas.
Wait. You think I'm white? Have I indicated that?
I don't think you have any idea how offensive it is for you to say that. To be reductionist and patronising about my lived experiences. And I say that as someone without a significant history of trauma or maltreatment, and with a generally positive view of the nature of other people. I can't begin to imagine how this kind of comment would impact on others.
Sorry if you were offended. Wasn't my intention.

This discussion has become unexpectedly rancorous. Maybe time to take a step back, from my point of view.

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Re: Social justice and psychotherapy

Post by lingua_franca » Sun Jul 26, 2020 12:38 pm

I said that your idea of therapy as a.) inherently western and b.) of such huge importance to civilisation is reminiscent of the White Man's Burden. Even if this isn't your area of academic research, as a historian of the twentieth century you will surely know the phrase and that it refers to (neo)colonial attitudes, not the ethnicity if a particular speaker. You wouldn't have to be white to hold such views. You are dodging the point I was making, and to be honest, that is a very defensive white thing to do - "How do you know I'm white?!" is an all too common response to any online criticism of points like the one you made. It's a way of diverting the conversation away from the uncomfortable issues.
"Suppose a tree fell down, Pooh, when we were underneath it?"
"Suppose it didn't," said Pooh, after careful thought.
Piglet was comforted by this.
- A.A. Milne.

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