This post is part of CTC’s Reflections from our Clinicians series. These series consists of blogs written in the first person narrative, meant to reflect our values of independence while ensuring a broader diversity of topics, styles and opinions.

 

New York, December 18, 2016

In light of the recent election and the anti-immigrant messages in United States politics, I wrote down some ideas and experiences of my reflections while working with immigrant patients.

I am a passionate social worker, and I am an immigrant myself. What is so unique about working with immigrants? Is there any difference between working with immigrant patients and non-immigrant patients? Do we have to even ask patients about their immigration process? Or, even their immigration status? Do we need to bring immigration into our therapy sessions? In this moment in time, can we ask questions about immigration without scaring our patients? And how do we do it? Well, these are some examples of questions that I hope clinicians ask themselves in their practice. For us, at the Critical Therapy Center it is always already part of the dialogue.capilla del hombre guayasamin (480x640)

Since the personal is always political, I can start with myself. I am a very proud Colombian woman who had the opportunity and privilege to be a US citizen. I came to this country, only with the idea that I will stay for 3 months, and I have been here 16 years. I confess that there has not been any year in my 16 years of being in the U.S., that I did not miss my country, my family, my culture.  In America, I have a beautiful daughter and an incredible partner, who is Colombian as well.  As for my daughter – she was born in New Jersey. And with her birth, I begun to wonder how do we create another culture within our culture? Do we forget our own to become or to integrate within another?

As a therapist working with immigrants for the past 16 years, I always see in their eyes something special when they are talking about their countries — a tint of sadness, a melancholia when describing their countries, their families, their lands, their dreams.  Every one of my patients have an amazing story that I wish I could record.  I am grateful because they have shared with me. Additionally, I have worked with some immigrants who tighten up and are a bit frightened when talking about their country of origin; for these folks their country of origin brought persecution and pain, resulting in a very ambivalent feeling about what they left behind.

While working with immigrants I have the unique opportunity to hear thousands of stories and to meet amazing people. As social workers we have a responsibility to hear these stories and if we lose, or miss, this opportunity we are losing the chance to get to know our patients in a deeper way. To lose this opportunity is to lose the incredible aspect of our patients and their dreams, their families, their sadness, and their losses. Looking at the acculturation process is an important part of therapy. It offers us a better understanding of the many losses patients had to face when coming here. There is trauma in each story, even if the process of coming to this country was on simple (with a visa, with his/her family member(s), with a job). There are always loses, and we need to be aware of them. We need to learn to identify them and to respect them.

In my work I have identified phases that immigrants undertake as part of the immigration process. Some of the phases start before they arrive here; for example: reasons why they decided to come to the US, process in which they came, experience arriving to US territory. Others happen once they arrive here like: the roles they assume, how others perceive them, and their experiences here. Lastly, yet very significantly, the experiences they might have had with mental health professionals, or with health care professionals, or any other interaction with US agencies. For example, refugees usually go through a mental health screening to assessed whether or not their stories of trauma and pain are indeed true.  More recently, how the anti-immigration rhetoric is affecting them, their families and loved ones.

I love working with immigrants, because they are, a mirror of my own loses, of my own love for Colombia, and my gratitude to the US, and the opportunities I have here, but especially because it gives me the opportunity to learn, to question what we do (politically, personally, socially) and the way we do it.  It also gives me opportunities to reflect on our system of immigration and how as a country, the US treats its immigrant population. After listening to stories of pain, loss and hope, I feel I have gained a better and greater understanding of how brave immigrants are, and how many strengths we have and need in order to survive each day.

Working with immigrants helps me asses what matters most: my deep respect for the Other. It also encouraged me to create the idea of a second or third culture. We don’t have to give up certain traditions, and we can integrate some from this country.  We can keep what we love and assimilate what speaks to us, and in the process creating our own unique and multicultural traditions. As immigrants we constantly negotiate between there (home) and here (not home, yet home now), while in the process we are creating a blend of cultures, of experiences, of families… a third, forth or simply anOther unique culture based on our own personal histories and experiences.

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The recent presidential election, more than any other, highlighted how politics matter in our daily lives. It showed how the personal is political. Issues such as: sexual assault, women’s rights, minimum wage, taxes, immigration, religion, they all affect our lives in a very real way. As therapists, we have to be cognizant about the psychological message and meaning of this election. Trump’s victory signifies a setback for sexual assault victims, for immigrants, for people of color (to name but a few). It is also a setback for all of us who aspire towards a more democratic and progressive society. If we see Trump as a reflection of some of our values as a society, we are clearly in trouble.

This election has been traumatic, especially for specific groups targeted by Trump the candidate. There is fear, there is loss, and there is real uncertainty about the future; these issues coupled with mental health problems such as: depression, anxiety (and others), will worsen and create even more stressors. Questions such as: will there be more deportations? Will women feel less empowered to speak up in the face of sexual harassment and assault? Will Muslims be targeted by people who now feel empowered to do so because we have a president that condones violence and harassment against this particular population.  All these issues are coming up for most of us, and one can clearly see how it may negatively impact one’s mental health, and one’s well-being.

As volunteer members for the Asylum Program for Physicians for Human Rights, and as mental health professionals who work with and among immigrant communities, the recent political climate, the hostility towards refugees, asylum seekers, and other immigrants, is deeply troubling. Regardless of what legislative and executive decisions will follow from this election, people are suffering and will be suffering the effects of this hostility.

Some of our patients compared the day after the election with 9/11. As a Trump presidency puts certain populations more at risk than others. You can imagine that the same sense of uncertainty that we all felt after 9/11, about whether or not we are at risk of being attacked again, for some folks, that uncertainly, that deep fear, was felt and is felt with this election. This fear is not pathological, but rather a normal reaction to what Trump the candidate, said he would do as president.

Donald Trump by Gage Skidmore 12

Further, psychologically, when one encounters a traumatic event, all other unresolved traumatic experiences return. For people who have been structurally oppressed by our society and systems, this election has brought to the surface some of those unresolved traumas.

Yet, not all hope is lost. Although most of our patients were deeply disturbed and hurt by this election, they are also resilient, as most survivors of trauma are. It is important to remember that healing takes time and stages. The day after the election we dealt with the shock, and in days to come we will process the fear. Further down the road, we will also encounter hope, which will bring action and rebirth. This election can also be seen as an opportunity to self-reflect, to acknowledge how the political will always be personal and how to organize to create a more just society. In that spirit, CTC has just signed on to a published statement entitled From America’s Healers: A Letter to our Patients in the Trump Era, created by the Social Justice Coalition of the Cambridge Health Alliance; this statement speaks to our values and our continued commitment to social justice.

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September 2016 – Megan Chinn, LMSW joins Critical Therapy Center in the capacity of Vice-President.  She is a licensed psychotherapist with years of experience providing therapy in various community-based settings including high schools, residential homeless facilities and LGBTQ youth services organizations.  Megan practices holistic psychotherapy with an emphasis on trauma-informed care, while drawing on mindfulness, intersectionality, and harm-reduction approaches.  Her clinical focus is on applications of critical race theory, transformative justice, and spirituality within the therapeutic context.  Currently she is developing interventions bridging critical therapy theory with transformative justice practices.

Megan Chinn

Megan Chinn

Megan received her master’s degree in social work (MSW) from the Columbia University, and bachelor’s degree in sociology and global studies (BA) from the University of California Los Angeles.

Prior to joining the Critical Therapy Center, Megan has partnered with organizations such as Reciprocity Foundation, Community Connections for Youth, and Women in Leadership and Development (WILAD) in West Africa.  While in Ghana, she conducted research for the Queen Mothers of the Ashanti tribe and planned summits for them to explore the experience of community power structures, colonialism, and matriarchy.  She also brings a demonstrated expertise in transformative and restorative justice practices and has presented at conferences such as Transformative Practices and Restorative Justice Conference.

CTC’s Executive Team (left to right): Monica Roldan, Megan Chinn, Silvia Dutchevici and Carolyn Jacoby.

CTC’s Executive Team (left to right): Monica Roldan, Megan Chinn, Silvia Dutchevici and Carolyn Jacoby.

In her psychotherapy practice, Megan partners with people to enhance their understanding of self and to arrive at a place of healing through a collaborative therapeutic process. She provides opportunities to bring spirituality into the clinical hour with patients and believes that there are many modalities that promote healing within the therapeutic context.

Founder and president, Silvia Dutchevici stated  “I am excited to work with Megan, as I know she will challenge us, the way she has challenged me to expand our practice of critical therapy. Also, in the process she will be instrumental in expanding our services, particularly in the area of transformative justice.”

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This post is part of CTC’s Reflections from our Clinicians series. These series consists of blogs written in the first person narrative, meant to reflect our values of independence while ensuring a broader diversity of topics, styles and opinions.

 

New York, May 2, 2016

As a feminist I have heard arguments for and against pornography.  Throughout the years, my position on pornography has changed. Initially I believed that porn can be liberating to women, claiming our sexuality any way we want to. However, having counseled many women, including sex workers and survivors of human trafficking, my idea about pornography changed. I truly believe it is damaging to women, men, mental health, relationships and society.

Recently, TIME magazine published an article about the negative effects of porn, on men, as the first generation of men who grew up with unlimited access to it (online mostly) report how detrimental and harming it has been to their sex life. As the article points out consuming porn, especially at a young age, leads to many sexual problems, including what is now know as PIED (porn induced erectile dysfunction), the term describing lack of sexual response in relationships, or the inability to perform sex outside of watching porn.  It is also damaging to girls.

Learning about sex from porn can deeply damage one’s expectation and understanding of sex and love. The Kinsey Institute survey found 9% of porn viewers said they had tried unsuccessfully to stop. Studies also show that porn changes the brain, and can become highly addictive. Similar to drugs, the more one watches it, the less s/he enjoys it and the search for that first high keeps coming up, unfortunately never to be found again. Further, when one connects and understands sex to be only a mechanical and physical act, one tends to lose the ability to connect with one’s partner(s) and worse begins to objectify the other. Young men who watch porn report loosing the ability to truly connect with their partners – and through the objectification of their partners, seeing them as merely body parts for pleasure, they also lose the humanity of sex.

For young girls growing up with porn, and porn culture, also influences their view of sexuality, as Peggy Orenstein’s new book Girls & Sex reveals. While researching her new book, Orenstein spoke with more than 70 young women between the ages of 15 and 20 about their attitudes and early experiences with the full range of physical intimacy. She documents how girls today are receiving mixed messages, mainly they hear how they should be in order to be sexy and perform sexuality, but their own sexual pleasure is hardly addressed. They start seeing themselves as objects and learn that sexual intimacy is about performance and satisfying the other. This is further complicated with issues around gender norms, race and class.

Further research on the effects of porn are equally troublesome, as Destin Stewart, PhD, and Dawn Szymanski, PhD, at the University of Tennessee, Knoxville, found that for female college students those who perceived their boyfriends’ porn use to be problematic experienced lower self-esteem, poorer relationship quality and lower sexual satisfaction.

The sex industry hurts both men and women. Worse, it has permeated into our view of sexuality and the erotic, as more and more music videos and movies personify sexuality in general, and women in particular. Yet the commodification of sex does not just stop with porn, it is seen in our culture through our music and movies (to name but a few). As consumers in a capitalist society, sex is but another commodity to be exchanged and sold for profit. TV shows such as The Girlfriend Experience, or music videos such as Ne-Yo She Knows, clearly display how sexuality is a commodity and in heterosexual relationships, women are the exchange currency.  It also shows the pornification of our culture.

Yet, not all hope is lost. And to be clear, I am not against men and women exploring sexuality, or the erotic within or outside a relationship. Yet, the question dwelling on my mind is how can women enjoy sex and not objectify themselves? According to a study cited by Orenstein comparing American and Dutch women at two similar colleges,

“[The] Americans, much like the ones I met, described interactions that were ‘driven by hormones,’ in which boys determined relationships, male pleasure was prioritized, and reciprocity was rare. As for the Dutch girls? Their early sexual activity took place in loving, respectful relationships in which they communicated openly with their partners (whom they said they knew ‘very well’) about what felt good and what didn’t, about how ‘far’ they wanted to go, and about what kind of protection they would need along the way. They reported more comfort with their bodies and their desires than the Americans and were more in touch with their own pleasure.”

As Orenstein points out, the difference in the perception of sex between the Dutch and American girls is that Dutch girls spoke with teaches, doctors and parents truthfully about sex and pleasure and also about the “the joys and responsibilities of intimacy.”

Teaching young men and women about sex and pleasure is essential to ensuring that they will have healthy satisfying sexual relationships. Even further than that, it requires that both men and women reclaim their subjectivity as subjects and refuse to give into unrealistic expectations of masculinity, femininity, sexuality and pleasure.

Whether we talk with kids about sex, or we openly protest the porn industry, and criticize the overall porn culture, we all need to reclaim our sexuality based on pleasure rather than performance. And although as I mentioned, there is sexism in (to give an example) music videos (metal, rap, country, etc.), as Jacqueline Pereda shows us, young women can reclaim that space, laugh at sexism while empowering young girls.

 

Silvia

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This week The New York Times featured an article by Richard Brouillette, entitled Why Therapists Should Talk Politics, discussing the role of politics in the consulting room. Brouillette makes the point that:

psychotherapists are playing a significant role in directing this blame inward. Unfortunately, many therapists, because they have been trained not to discuss political issues in the consulting room, are part of the problem, implicitly reinforcing false assumptions about personal responsibility, isolation and the social status quo.

Critical Therapy

We couldn’t agree more.  And that is precisely why four years ago, we created the Critical Therapy Center with the belief that traditional psychotherapy helps, but does not produce the much needed transformational change. We believe therapy should be transformational and empowering, moving individuals to action.

Historically good therapy is considered to be a-political and the therapist’s role is at most, supportive and at least that of a blank slate. Yet, those practices of therapy as Dennis Fox, Tod Sloan among others, (2009; Sloan, 2000) point out serve the status quo and lead individuals to believe that their personal problems are just that – personal. Instead of integrating the personal within the political, therapists are trained that ideology and politics have no place in the consulting room.  Yet, the feminist movement has taught us that the personal is political (Hanisch, 1969). Psychological science and practice is no different. Ideology is always already present in the clinical room. We just pretend to be neutral. Worse, by being neutral we are unconsciously or tacitly promoting and accommodating the neo-liberal ideology, the status quo.

Freud believed that analysis is based on both verbal communication between the patient/therapist and unconscious communication. If the therapist’s ideology is partly unconscious, can we assert that our ideology always already comes into play in analysis/therapy (Varchevker, 1989)? When adopting an objective, apolitical, asocial stance, the therapist is silently siding with the dominant discourse of oppression and fails to address patients holistically as individuals and as members of society.

To ignore politics in therapy, is to ignore a big part of a person’s life. Issues such as: poverty, sexual harassment, family leave, access to healthcare (including mental health), work-life balance (to name but a few), are good examples of how politics and mental health are interconnected.  Clinically, in our current culture, good therapy is seen as a place where one separates the psychic from the social; and those therapists who talk about the social are seen as “political.” In this fashion, dominant culture encourages people to go to therapy, to work on their issues, rather than form social alliances and rebel (Layton, 2004).

Feelings of guilt for being poor have replaced the fight against social injustice. And the anxiety that one is not good enough has pacified people so that they not only work longer hours in their jobs but often work equally hard at remaking themselves. (Salecl, 2009, p. 179)

Salvadoran psychologist Martin-Baro (1994) believed that the role of a psychologist is not to explain the world, but to change it for the better. He challenged psychologists and mental health professionals to engage with the sociopolitical challenges and movements around them, rather than understanding them from the perspective of scientific spectators. He believed in de-ideologizing everyday experiences, and as a social psychologist he did this by advocating for participatory research. In the therapeutic setting this translates by admitting that the therapist cannot be neutral. The critical therapist enters the clinical hour with a preferential option for the oppressed and the marginalized and is always mindful of the ways power is refracted (for example) through race, class, gender and religion, and questions how it interacts with the therapeutic process. S/he receives and explores the patient’s experience, particularly the avoided and dissociated aspects, by returning it to the patient as data and dialoguing about it.

A Spanner Wrench stuck between cog gear wheels.Critical therapy leads to individual and social transformation. The understanding by a patient that her/his oppression is partially constructed by social inequality is the first step. It is the role of the therapist to facilitate the continued interrogation of the notion of social inequality, revealing how the personal is political, and how the patient’s liberation and empowerment is related to and depends upon that of others. As a result of this process the patient becomes not only an agent of personal change but of social transformation as well. Through her/his practice of liberation and empowerment the patient begins to create safe spaces for others while helping them to explore healthy personal and social identities. Critical therapy makes possible different kinds of relations to others and those relations invite others to explore their own liberation and empowerment.

In critical therapy, the consulting room becomes the place where patient and therapist begin to look at social conditions as part of psychological problems, and together they can focus on internal problems as well as social transformations. To be clear, our work is not about forcing our patients to be political activists, but about asking them questions regarding their personal feelings, as well as about society and the world we live in. To make them aware of the social conflicts they struggle with every day and how their story fits into the larger picture. Perhaps, the biggest lesson they will learn is that they are not alone. In this manner, practice becomes revolutionary.

Aside from offering therapeutic comfort and therapeutic insights, therapy also becomes a performative practice where patients actively reflect on their own power and relationship to the ongoing project of an unfinished democracy. It is precisely this relationship between democracy and therapy that is hopeful and empowering.

 

References

Fox, D. Prilleltensky, I. & Austin, S. (Eds.). (2009). Critical Psychology: An introduction. London: Sage.

Hanisch, C. (1969). The Personal is Political.

Layton, L. (2004).  Dreams of America/American Dreams. Psychoanalytic Dialogues 14(2): 233-254.

Layton, L. (2004).  Relational No More: Defensive Autonomy in Middle-Class Women. Ann. Psychoanal. 32: 29-42.

Martin-Baro, I. (1994). Writings for a liberation psychology. Essays, 1985-1989, A. Aron, & S. Corne (Eds. & Trans.) Cambridge, MA: Harvard University Press.

Sloan, T. (2000). Critical Psychology: Voices for Change. New York, NY: St. Martin Press.

Varchevker, A. (1989).  Psychoanalysis and revolution in Latin America: Marie Langer interviewed by Arturo Varchevker. Free Associations 1: 44-59.

Salecl, R. (2009). Society of Choice. differences 20(1):157-179.

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