By: Lucia Sarmiento Verano

^{Featured photo credit: Kristina Flour}

Introduction

What we’ve witnessed in the last year and a half is, for me, sadly reminiscent of what I witnessed growing up in South America: complacency and the silence in the face of immense violence and horror. It makes me sick. The feeling of nausea has been present for a very long time. I believe most readers of this blog will agree that living in a harming world harms us in our sense of ethics and our humanity. It makes us rage and grieve. Trying to assert our profound values we declare ourselves all for human rights and equality. However, that seems to be what everyone (or at least a great majority of people) is saying.

If that is the case, how come the silence of so many in the face of violence is so deafening? Particularly in professions like ours, that are based on values of care and empathy, that supposedly strive to support fellow humans in a path towards wellbeing, silence in front of genocide and colonial violence, and the disregard for human life and suffering (to the point of wanting to silence others who do want to speak up!) have been the most present. Contradictions, between discourse and actions, between declarations of intention and ways of being, that leave some of us, the ones feeling nauseous, sometimes dumbfounded and lost, enraged, or full of grief.

I have dedicated the past few years of my life to understanding these ambivalences and contradictions. Through my own research I am looking in details in the psychic life of a population who believe themselves to be open, inclusive and caring but who at the same time commit colonial violence and/or stand by it silently. I’m writing today to offer some reflections I’ve encountered on these human contradictions. I will be looking at our society’s most esteemed declarations, it’s mainstream discourse: liberal ideology and liberalism.

Full disclosure: I grew up in circles of middle-class people with mainstream mindsets, and had no contact with people who espoused any kind of radical, anti-establishment perspective. In this “normal” society, being a liberal, also sometimes called a progressive (nowadays there is a whole group of therapists calling themselves that), was undisputedly the best thing to be. It was seen as morally superior. I have now grown out of that fantasy (thank goodness) and have started to look at how society led by people who have that mindset actually works, and the underlying, harmful mechanisms it enables and reproduces.

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The contradictions of liberalism

Liberalism may be defined as a political and moral philosophy that arises from the European Enlightenment, which also results in a mode of political and social organisation of our societies. It became popular in the West after the American and French revolutions, and the rejection of monarchy as a governing structure. Liberalism was established as a basis for governments in Europe and the Americas in the 19^th century. Its main tenets are: individual liberty, equal rights, private property, market economy, rule of law, democracy, and the universalism of these ideas.

There is a fundamental contradiction though, between the principles and ideals liberals say they espouse and the way their ideas have shaped social structures. Fundamentally and in practice, the rule of law (whose law anyway?), the right to private property and certain aspects of freedom of speech go against the ideals of equality and liberty for all. In his article about mestizaje and the violence of liberalism, Peter Wade argues that:

“Liberal rule – including its neoliberal variants – is characterized by fundamental tensions. It is beset by the constitutive conflict between the democratic inclusion demanded by ideologies of liberty and equality, and the political and economic exclusions demanded by the need to govern ‘properly’ and the need of governing elites to preserve the hierarchies of economic stratification in which they hold a dominant position.” (Wade, 2016, p.324)

Equality in liberal ideology means equal citizenship and rights under a state and its laws. However, it doesn’t do well in dealing with the realities of difference in a way that is coherent with these ideals. In practice, difference is relevant to rights and citizenship, as there is always a judgement about who is fit to be a good citizen, who is fit to lead, and who makes decisions about these questions. Thus, moral judgements about the “quality” of people create and justify the hierarchies necessary to maintain the political and economic division of labour that keeps our system going (capitalism is part of liberal ideology remember?).

The realities of difference as a hierarchy under liberalism are then denied in discourse by simply invoking its principles of equality. Differences may then be explained away through ideas like meritocracy and access to education. Another strategic move liberalism employs it to deny the relevance of difference to the question of citizenship and rights by consigning them to the private sphere of life. Sexism, racism and other isms are an individual issue, caused by cognitive bias but are generally not a public issue as the state and its laws consider everyone equal.

At times, and under liberal rule, there are also attempts to eradicate forms of difference through assimilation, forcible displacement, cultural genocide or the physical extermination of communities. We have seen this in Abya Yala (the Americas) repeatedly. This, despite the system needing difference and hierarchies to continue functioning. Perhaps this happens when certain forms of difference are deemed too problematic for the system. Universalism and derived ideas play a major role in this. Peter Wade adds:

“As a mode of governance, liberalism moves between sameness and difference or universalism and particularism in a strategic fashion, emphasizing one or the other, in order to regulate change and maintain hegemony. Universalist and public claims that everyone is equal before the state and the law coexist with particularist and public discriminations on the basis of difference.” (Wade, 2016, p.325)

Ideas on proper ways to organise and lead society have of course varied over time but always within the framework of liberalism in the West, which includes capitalism. Like I stated above, because a market economy requires a political and economic division of labour, and this, no matter what types of labour (paid, unpaid, slave labour) or how the division lines are drawn (race, class, gender), its functioning presents direct contradictions with human rights and equality. And in most of the world where western imperialism has landed, the division of labour has historically been drawn along racial lines.

On the Peruvian case, sociologists David Sulmont and Juan Carlos Callirgos remind us, the modern concept of race was consolidated during the rise of modern liberal ideas of equality which helped in rationalizing European colonial expansion. “In the Peruvian case, racist doctrines […] departed from modern/liberal conceptions of equality and served to rationalize social, economic and political inequalities, as well as solidify the position of the elites.” (2014, p.133)

Equally, studying the 19^th century Atlantic world, the historian Thomas C. Holt argues that racism was always at the core of what seemed like a nonracist liberalism (1992). This we know. And the insidiousness of violence under liberalism is such, that the widely espoused ideas of freedom and equality give liberals a weapon to shut down dissent. People calling out discrimination and violence are often faced with reassertions of universalism and accused of creating division and difference themselves, or to bring it to the public domain where “it doesn’t belong”.

Within this system mental health knowledge and practices were used to reinforce and reproduce the differences that, under liberalism, are put into hierarchies that justify the division of labour. It does this by categorising people as more or less able, often according to race and gender (by categorising supposed capacity and intelligence levels), and by pathologising behaviours that seek to change the norms.

Not only the mental health field has historically actively participated in this, but its evolution within this system makes it so it presents the same structures within the field. Let us now turn more particularly to the liberal aspects of the profession, the harm they cause, and the barriers for change.

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A liberal profession

Let me ask you, does all this remind you of something? Maybe how the entire mental health field is structured? The ever-present contradictions between the openness to diversity and care for all it professes and the actual practices that end up excluding minoritised people and harming them.

The illusion of innocence, empathy and good intentions, which is usually very gendered, in our profession dominated by white women, may cover practices of extraction, gaslighting or silencing. Clear signs of selective empathy accompany declarations of equality. And institutions saying they will offer spaces for minoritised members only end up policing them and shutting them down.

The list of examples can go on and on, we do not need further proof. And yet, examinations of the issue of harm and inequality seldom go beyond surface level research, designed to answer questions which have been answered time and again instead of disrupting the status quo and implementing change. In the following paragraphs I will draw some parallels between how liberalism functions and how the mental health field works. The list is non-exhaustive, of course. I would go as far as saying that today, these are more than just parallels: the mental health field is liberal at its core.

Firstly, universalism is deeply embedded into our theories: the idea that this one model of the human mind and emotional landscape is equally applicable to all people. As in liberal systems, universalism in mental health denies the relevance of difference, invoking sameness and equality vis-à-vis our theories and practices AND vis-à-vis the therapist (the law?). Have you ever seen therapists say “I treat all my clients equally”, “I don’t see colour”, or “I only see the human”? As in liberalism, it then constitutes difference as relevant through moral judgements made about clients and service users. In the case of mental health: pathologisation or problematisation of said difference, and who is fit or unfit to receive support.

Private property and market economy are also embedded in the structure of our profession. This includes extraction of labour and exploitation, with a prevalence of unpaid labour in the sector and business-wise practitioners and institutions praying on individual practitioners’ needs for further training and CPD. Our own need to survive in this system and pay bills also tends to make our work inaccessible to a majority of people who would benefit from mental health support. The production of theory has also historically been led by people with privilege and power (white middle-class, Global North citizens) publishing ideas they extracted from others’ ancestral wisdom or emotional labour.

Then there is the separation of “public” and “private” with the assignation of questions of difference to a space other than our immediate field. In this case questions of difference are assigned to the public sphere (outside of the therapy room, which is seen as private and separate from the public sphere) as opposed to the general liberal discourse. This is simply because picking and choosing where to assign valence of difference is not about objective truth or a true analysis of social questions. It is about a strategy to AVOID those questions and diminish their importance, or deny their presence all together in the field that we can influence. Instead, they are assigned to a sphere we have no control or very little impact over, so we don’t have to do anything about it in practice. We can call this avoidance, dismissal, gaslighting, or denial. A strategy that constitutes harm in the therapy room but is completely aligned with our liberal professions way of playing with discourse and practice to maintain violent and oppressive status quo untouched. This applies to the status quo outside of the room as well as the one inside, in the client-therapist relationship.

Since our profession now espouses liberal tenets in both its mindset and structure, it also holds the contradictions I described above. Deep tensions between the ideals it professes and the harm of its practices should not surprise us. It is one of the realities we should aim to challenge and change.

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Choosing genocide over change

Perhaps the most widespread recent example of this way of functioning is the reaction, or general lack thereof, of the mental health professions to the genocide in Gaza, and to the colonial violence in occupied Palestine. Not only silence, but an active silencing of practitioners who are trying to speak up about this, accusing them of being aggressive, creating division, being antisemitic, etc. is routinely seen.

This is where the strategic assignation of the question of different to another sphere (that is not ours) is seen in all its power to silence and deny violence. Politics does not have a place in here, even though it is ever present.  This is also where the logic of the market and property come to play. Some practitioners are first and foremost worried about their livelihoods, and the system uses that to promote those who stay silent, and marginalise those who do not toe the line. On top of this, we all know at some level that a harmful society also keeps a steady stream of distressed clients coming in through our consultation room doors, let’s not forget that.

We can also see how principles of the rule of law and “proper ways” of governance are used to maintain silence and the status quo. Institutions responding to their members’ challenges by reminding us of “the proper way” of doing things (even if such “proper way” may change and shift unofficially to suit their interests and the interests of those in power) to shut down, silence or sideline disruptors.

All of this still under the guise of innocence, care and empathy. Let me be clear: the profession is not silent on the Palestine’s struggle despite its liberal mindset that espouses ideas of equality and human rights. It is silent on the topic because of it. And it has given many the power and possibility to enact harm at an individual and systemic level while feeling innocent and “good”.

Another quick example of this might be the therapist that tells clients that they ought to take care of themselves by not engaging with distressing news from Palestine. This is, in fact, assisting in the production of a compliant individual, encouraging extreme individualism and reductions in empathy. They will end their working day telling themselves they have helped a person feel better and done a good job. Same goes for applications of manualised therapy that exclusively focus on symptom relief before sending people out back into a harmful society.

For a more in depth and very accurate exploration of our profession’s “innocence” I recommend reading the chapter on Psychoanalytic Innocence in Lara Sheehi and Stephen Sheehi’s book Psychoanalysis Under Occupation (2022).

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Concluding thoughts

We have seen how a system based on discourses of equality empathy care and liberty is also the one that creates, and reinforced difference, hierarchies and violence. These are not two separate aspects of our system; they are one and the same.

Truth is, challenging the supposed goodness of liberals, as with mental health professionals, is deeply threatening and may lead to severe outburst of aggression, violence (expressed in wildly different ways, some more subtle than others depending on the target) and denial. This touches on a deep sense of self of many therapists, especially the need to see oneself as “good”. The truth is, no human being is wholly good or wholly bad, but full of complexities and contradictions. We are to sit with those if we truly wish for transformation and justice. We also need to face a field that does not wish to sit with it and will do anything to ostracise and shut down those who bring attention to what is uncomfortable.

I’m writing this to try and show you why we should not be afraid of directly working against harmful systems. Under the guise of goodness, these systems can sometimes make us doubt. They may label us violent, aggressive, disruptive. It is our job to cut through the bullshit. If you, like me, have beel feeling nauseous for a while. If you find all of this a true problem and a barrier for change, I call on you as a fellow practitioner. Let’s not be afraid to step out of line. Because in the current state of things, to toe the line is to be complicit. Speak loudly, through whatever channels that are accessible to you.

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REFERENCES

Holt, T. C. (1992) The Problem of Freedom: Race, Labor, and Politics in Jamaica and Britain, 1832–1938. Baltimore: Johns Hopkins University Press

Sheehi, L. & Sheehi, S. (2022) Psychoanalysis Under Occupation. New York: Routledge.

Sulmont D., Callirgos J. C. (2014). ¿El país de todas las sangres? [Race and ethnicity in contemporary Peru]. In Telles E. (Ed.) Pigmentocracies: Ethnicity, race, and color in Latin America (pp. 126-171). Chapel Hill: University of North Carolina Press.

Wade, P. (2016) Mestizaje, multiculturalism, liberalism, and violence. Latin American and Caribbean Ethnic Studies. 11:3, 323-343

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