Clinical Work . Coloniality

Therapy as a Site of Resistance PART 1: Being in the Client’s Corner

On July 24, 2023 by

Featured photo credit: Alexandre Dinaut

By: Lucia Sarmiento Verano

Last year, I wrote about Epistemic Justice in the therapy room and what it may look like through practices like Conscientization and naming oppressive dynamics. Today I wanted to continue the reflection on this topic. This time, focusing on the therapist stance, their approach and the potential for supporting clients resist oppressive systems while trying to avoid reproducing oppressive dynamics within the room.

This are reflections in progress, as I continue to develop my work and try to locate my practice within a wider social context, especially when working with people who are confronted with structural oppression. The overarching questions I keep considering to help me in my work are:

What does it mean to stand with one’s client as a co-conspirator against the system, as opposed to what we have been taught about ‘collusion’? How to navigate the space given to personal/inner process and social realities in the work, to achieve a balance without avoiding or dismissing one or the other, and to make necessary links that can be helpful for the client?

Perhaps a question that can summarise the above is: How does praxis look like in therapy? This, beyond the activities of self-reflection, thinking, writing, or speaking to colleagues which very often end up being mere intellectual and emotional exercises without great impact on the work. I am interested in a real praxis. Truly challenging one’s limits to hold space in which change is fostered, within the room, and continuing to stand with our marginalised clients in our daily lives, outside of the room. This, at a time where people’s rights are being attacked and where the system continues to crush individuals who ‘do not fit’.

In this process of truly “getting waist-deep into the mud” with my clients (as it sometimes feels), sometimes the inner and outer boundaries of work get bent out of shape. As I feel bent out of shape as a practitioner, to meet clients who, again, ‘do not fit’ in any way the clients who were described to me during my training. How do I ensure then, that I do not become another element of society who will crush an individual’s soul?

I attempt, in this piece (and its upcoming second part), to elaborate on some ways in which I try to do this, with the support of the literature that has helped me finally put words on this way of working. These are reflections in process, very much unfinished work. Things I like to keep in mind throughout my practice and apply to myself as a practitioner, for my practice to be as congruent and as aligned to my anti-oppressive ethos as possible.

Here I develop the ideas of “being in the client’s corner and seeing their process from an anti-oppressive approach”. Part 2 of this piece will reflect on “Locating oneself withing the system and resisting the split”. It is a challenge to combine knowledge of social systems and this anti-oppressive life ethos with therapeutic concepts and processes. The line is never clearly defined and the reflection on how to do this effectively and safely is always ongoing. This piece is my second attempt at putting words on this learning process.

Being in the Client’s Corner…

As I stated in my previous piece, therapy can be a space in which we clearly name dynamics of oppression and harm, a space for the process of conscientisation, helping our clients discover the source of their distress. I’d like to expand on this as this process does not only entail naming and recognising what the client has endured or is still enduring, but also about making clear connections between personal distress to collective and historical oppression.

In this way, clients who have been through oppressive harm, who might be having reactions akin to the ones people who have been through abusive relationships can have, can feel less isolated, and can gain a deeper understanding of what happened (lessens confusion about the “why”). They can become better equipped to resist internalising the oppression, feeling shame or self-blaming.

Some examples of wording that I find helpful to introduce this in the work, after thoroughly exploring a person’s experience and its meaning for them:

  • It reminds me of the messages/stereotypes about… that are transmitted in society or groups, do you feel this might be linked to what you shared with me?
  • It seems that you have received some very negative messages about yourself OR that you have been made to feel unwelcomed.
  • When I hear about your experience, I can’t help but think of how … people/community have been treated historically

There is obviously a caveat: it is important not to see clients as “victims” and reduce their identity formation and selfhood to a reaction to or to the impact of oppression. This would amount to espousing oppressive views of marginalised people as unidimensional beings. There is something we should not forget, despite the oppression suffered by them and/or their communities, they are still here. They live full lives and maintain their identities, ways of life, and will to live fulfilling lives.

Which brings me to the process of exploration of coping and resistance strategies. Including the ones that exist and support the person outside of their awareness.

…And Adopting an Anti-Oppressive Approach to Their Psychic and Emotional Processes

By this I mean considering emotional and psychological processes not only from the individualising perspective we’ve been taught, but from a decidedly social and political perspective. Let me explain with the help of two examples: rage and disobedience.

Many frameworks aiming to support marginalised people talk of the need for a space to process all reactions to oppression, including grief, shame, rage etc. We also learn about anger being a natural reaction to abusive dynamics, usually masking other more vulnerable emotions like hurt or pain. We learn to go beyond the anger, or to make space for it, to feel and process it, so it can calm itself, for the benefit of our clients and their healing processes.

This is all fine, but let’s consider working with anger that stems from the abuse and harm someone endures under an oppressive social or historical structure. There are many more elements to consider in this case, not least the fact that the structure is crushing of a person’s sense of self, agency or dignity, and the harm is ongoing, meaning it’s not likely to end within our lifetimes. In cases like these, I would argue for the need to gradually move away from approaches that only aim to alleviate symptoms, so a person can be less disruptive or assimilate better in a society that actively harms them. Yes these ‘symptoms’ are distressing. Oppression is distressing, but this distress is the natural and normal human reaction to abnormal, inhuman situations. Let’s not forget this.

Recognising Rage:

A good example of a resistance mechanism that might be misrecognised in therapy is what Beverly Stoute calls Black Rage (2021). She argues, from a psychoanalytic lens, that Rage is a psychic adaptation to the trauma of oppression and moral injury. One that provides a defence, resilience, and the opportunity for psychic growth in the face of racial trauma and degradation.

This is why, in the case of anger and rage, we need to ask ourselves, are we in front of a reaction or a resistance mechanism? We can then explore the client’s experience of it in depth and distinguish Rage that mobilises energy and resources to help a person resist the crushing dehumanisation of oppression, versus the aspects of this anger that might become destructive to them. This can be dependent on context and change with time, for example as a person learns to direct their anger to the system instead of themselves or loved ones, taking meaningful action and reclaiming a sense of agency instead of sabotaging relationships.

By not doing this we might be “misdiagnosing”: taking an individualised approach and seeing distress out of its social context. We can thus worsen the effects of trauma, by missing an important aspect of what helps clients survive and effectively robbing them from resistance mechanism that might be crucial to the preservation of their wellbeing. All of this while we are trying to help.

Reframing Disobedience:

My second example is the one of disobedience or rebellious behaviour. This can be seen as an obvious coping strategy, albeit a problematic, and at times, self-sabotaging one. It is typically one of the ‘coping’ mechanisms we will learn to challenge, redirect its energy, and achieve ‘symptom alleviation’ so the person can become more ‘integrated’ in society (meaning less disruptive). This will be framed as something to do for the benefit of the client, and not what it can be, which is for the benefit of the status quo.

Again, let’s consider this from a socio-political perspective and se Disobedience as a reaction from someone who has suffered different kinds of oppression through life. Disobedience is linked with what Sarah Ahmed calls Wilfullness: “a failure to comply with those whose authority is given” and “persistence in the face of having been brought down” (Ahmed, 2014, p.1). In the face of an oppressive system, being “wilfully disobedient” can amount to refusing to be “an agent in one’s own harm” (Ahmed, 2014, cited in Sheehi & Sheehi, 2022, p.64). Similarly, Margarita Palacios thinks of disobedience as an act which creates space for autonomy and agency of the subject in an oppressive environment (Palacios, 2013).

Reframing disobedience in this way, it is easier to see why our system, or the structures in our society tend to see it as a problem to be solved, a behaviour that needs changing. Individualised approaches and practitioners acting as agents of this system will seek to help the person ‘integrate’ better, or to be less disruptive. It is worth, in my opinion, reflecting again on what this process is also doing to the client. Would we then be dismissing a key element of their resistance strategy, something that would help them reclaim a sense of self, agency and dignity?

Like with the example of Rage, Disobedience can be separated from impulsivity and self-sabotage. One helps the client survive; the others might harm them. A lengthy and in-depth exploration process of the origin of these behaviours and their consequences might be warranted in order to untangle these, and help clients retain what is most helpful to them. Let’s learn to honour what helps our clients survive a system that is constantly trying to crush them in different ways.

Lastly, as therapists trying to work differently and truly being in our client’s corner, it might be worth asking ourselves how we are resisting the rampant oppressiveness of our profession, how we are refusing to comply with things like the individualisation of issues, rigid boundaries that do not fit every client’s needs, or other ways in which we are told to practice. How are we, as professionals, also being Wilfully Disobedient in order to meet our clients where they need to be met?

Concluding thoughts:

I am often thinking about the consequences for marginalised people who do not have access to practitioners that help frame and understand their experiences and their reactions/adaptations from such a socio-political perspective. It is so that people can experience re-traumatisation in therapy, and are frequently robbed from the opportunity to recognise, honour and make use of resistance strategies which can protect them from oppressive violence in the long term and help them thrive.

We need to remember that our refusal to collude with the system’s perspective does not mean colluding with the client. For me, this kind of work means sometimes navigating a very fine line to maintain my capacity to also challenge my client when needed, but being careful to recognise where this challenge might come from and if I am not missing something that might help them or working from a perspective aligned with the status quo.

This can mean a lengthy and careful exploration process of what aspects of a reaction feel harmful to a client and what aspects can be empowering. A co-created process where awareness of the social context and its impact on people is always held. This, in my experience, is epistemic justice and conscientisation directly applied to therapeutic work. To do so, many of us professionals, need to dare go way beyond what we’ve been taught, and sometimes, beyond our own fears. I will develop this idea more in the second part of this piece, where I will write on the process of locating oneself and potential harmful transference, as well as refusing the split.

In the spirit of trying to drive this change I am planning to hold spaces for practitioners who truly wish to undertake this work. Training events will be help in September 2023 and in the future. You’ll find more information on the Events page of this website, or by subscribing to the newsletter. The deepest changes will happen when we come together to hold space, challenge and support each other to apply these anti-oppressive principles to our work.

Read PART 2 HERE

References:

Ahmed, S. (2014) Willful Subjects. Durham, NC: Duke University Press.

Palacios, M. (2013) Radical Sociality: On Disobedience, Violence and Belonging. London: Palgrave Macmillan.

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

Stoute, B. (2021) Black Rage: The Psychic Adaptation to the Trauma of Oppression. Journal of the American Psychoanalytic Association. 69(2)

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