`The Context of People’s Lives...’

Social Justice and Advocacy in Counselling & Psychotherapy

Pam Stavropoulos

MY CLAIM: That the professions of counselling and psychotherapy should engage more directly with sociopolitical contexts, both academically and clinically, and specifically with principles of social justice

Objections and problematics:

• The nature of our professional terrain (`inner’, `private’ subjectivity of individuals)

• Our training and skill base (focus, including of systemic and group approaches, is traditionally `micro’ and small scale)

• Logistics (how would it even be possible to embrace social as well as psychological contexts?)

• Professional identity (how to distinguish ourselves from community advocates and social workers?)

The untenability of not doing so...• Objections predicated on individual/social dichotomy• Counselling and psychotherapy are practices –

industries – within a social context which is liberal, individualist and capitalist

• The `politics of therapy’ is operative whether or not we choose to engage with the implications of this

• Therapy not just an interaction between counsellor and client but `a social institution which is embedded in the culture of modern industrialized societies’ (McLeod, 1999:2)

The necessity and stakes(of engagement with the social)

Our profession has only belatedly engaged with the social realm, even as it has been crucially shaped by it:

`When I qualified in psychoanalysis in 1937, members of the British Society were occupied in exploring the fantasy worlds of adults and children, and it was regarded as almost outside the proper interest of an analyst to give systematic attention to a person’s real experiences...Almost by definition, it was assumed that anyone interested in the external world could not be interested in the internal world, indeed was almost certainly running away from it’ (Bowlby [1978] 2006:48).

`...maybe, just maybe understanding context might help us to understand the individual. This was an antidote to Freudian notions of needing to delve into the individual neurosis. Perhaps instead we could look in a different direction. We could broaden out our approach to look at the context of people’s lives...’

(Silverstein, Newmark & Beels, in Denborough, ed. 2001:60)

1960S and 1970s: in response to cultural upheaval, `an attempt to assimilate a cultural dimension into mainstream practice’

And also a deeper addressing, where culture seen as central to identity construction

`It can be argued that [such attempts] do not go far enough’ (McLeod, 1999:162).

• Few contemporary clinicians would deny the significant, and even constituent, role of social factors

• But reference to social context is not the same as engagement with it

• Biases of foundational frameworks continue to be reproduced

The case for reappraisal• `...virtually all counselling theories embody a

middle-class, white, Judaeo-Christian perspective on life’ (McLeod, 1999:28).

• `The original, foundational approaches to counselling...were clearly `monocultural’ in nature’

• `Western society is becoming increasingly diverse, yet our therapy models are based primarily on Eurocentric assumptions’ (Corey, 2009:28)

The case for reappraisal, cont.

• `Counselling is an activity that has emerged within Western industrial society in the twentieth century as a means of promoting and maintaining individualism...’ McLeod, 1999:10)

• And a particular type of individual

• `The profoundly individualistic nature of...counselling limits its applicability with clients who identify with collectivist cultural traditions’ (McLeod, 1999:28)

• ...as well as having wider cultural implications in terms of the type of society we inhabit and the nature and scope of global challenges

• `There are pressures in the direction of social conformity and control in all counselling situations’ (McLeod, 1999:25)

....WITH WHAT IMPLICATIONS FOR SOCIAL CRITICISM?

The `missing’ dimension of social context: admissions from within the field

• Insoo Kim Berg (re movement from psychoanalytic approaches)

• Salvador Minuchin (`as child psychiatrists of the time [ie prior to the emergence of family therapy] we were concerned only with the internal story of the individual’, `...it was possible to dismiss the current context of someone’s life as mere disturbance’, [in Denborough, 2001:12).

• ....and the omissions within family therapy: `In the beginning I thought the feminist group was into using

ideas that were contrary to family therapy. But over years I began to realize that this was a blind-spot for me and that i needed to look at the ways in which I described families’.

(Minuchin in Denborough, 2001:20)

...admissions from within the field• Monica McGoldrick (the challenges of gender awareness as both

`personally revolutionary’ and `very upsetting’; `they signaled the need to re-think all the theories which [she] had learnt...[and] every aspect of [her] family life’:

`It has only been in the past few years that I have been realizing how oblivious I have been to matters of white privilege and just how wrong the social set-up is. This has significantly affected how I understand my life...I feel like I’m just crawling out of a cave and beginning to say, okay, what on earth is happening here?’ (McGoldrick, 2001:25).

Thinking about the `large’ domains of social context and social justice

Challenges are two-fold, and stem from:

(1) The nature of the society (western, liberal, individualist) in which counselling takes place

(2) The more specific nature of counselling and psychotherapy per se

(1) Liberal norms: the `shadow’ side of individualism

• A bias against collective forms of identity • Non-recognition of structural

discrimination• Rejection of the concept of oppression as

applicable to western democracies (Young, 1990)

`...the vast and deep injustices some groups suffer as a consequence of often unconscious assumptions and reactions of well-meaning people in ordinary interactions, media and cultural stereotypes’ (Young, 1990:41)

Oppression in western societies is operative

`within the everyday practices of a well-intentioned liberal society’ (Young, 1990)

Because unconscious, oppression in western societies dismissed as `beyond the reach’ of politics and moral philosophy

But this the terrain of psychotherapy, such that our field is not exempt from the need to address?

Anatomy of contemporary marginalizations: Iris Young and postmodern perspectives

• Formal commitment to equality in western societies coexists with group-based fears and prejudices structured by the emergence of specifically modern institutions:

` Modern racism, sexism, homophobia, ageism, and ableism are not superstitious carry-overs from the Dark Ages that clash with Enlightenment reason. On the contrary, modern scientific and philosophical discourse explicitly propound and legitimate formal theories of race, sex, age, and national superiority’ (Young, 1990:125)

Anatomy of contemporary marginalizations, cont.

• Dichotomy between mind and body; reason and emotion• Bodily, emotional and affective responses associated with non-

dominant groups

• `Public etiquette demands that we relate to people as individuals only’, and that gender, ethnicity, class etc should not be called attention to

• `the liberal imperative that differences should make no difference’; 134)

• But that those at the receiving end of group oppression `cannot forget their group identity because the behaviour and reactions of others call them back to it’ (Young, 1990:120)

`Conscious acceptance, unconscious aversion’ (Young, 1990:130)

• `Much of the oppressive experience of cultural imperialism occurs in mundane contexts of interaction – in the gestures, speech, tone of voice, movement, and reactions of others’ (Young, 1990:123)

• `Pulses of attraction and aversion modulate all interactions, with specific consequences for experience of the body. When the dominant culture defines some groups as different, as the Other, the members of those groups are imprisoned in their bodies’ (123)

DRAWS ON GIDDENS’ THREE-TIERED THEORY OF SUBJECTIVITY (1984) (1) Discursive consciousness (easily verbalizable) (2) Practical consciousness (habitual, routinized background awareness) (3) `Basic security system’ (ontological integrity; it at this level that

unconscious prejudice arises) (131)

`Conscious acceptance, unconscious aversion’, cont.

`Those exhibiting [discriminatory] behavior...are rarely conscious of their actions or how they make the others feel. Many people are quite consciously committed to equality and respect for women, people of color, gays and lesbians and disabled people, and nevertheless in their bodies and feeling have reactions of aversion or avoidance toward members of these groups’ (Young, 1990:134)

Such reactions are suppressed from discursive consciousness due to: (1) Threats to basic security system (2) Continuing cultural separation of reason from body and affectivity (with ongoing devaluation of latter) (3) `[t]he liberal imperative that differences should make no difference’ (puts a sanction of silence on what, at the level of practical consciousness, people `know’ about group difference (Young, 1990134)

Kristeva’s concept of the abject• Distinction between symbolic capacity (dependent on repressions; on the

opposition between conscious and unconscious association) and the semiotic (the heterogeneous, bodily, material aspect of speech, `always present with, but not integrated into, its signification: gesture, tone of voice, the musicality of speech...The speaking self always carries along this shadow, its spilled-over body expressed in comportment and excitation’ (Young, 1990:143).

• The moment of separation (`the border between the `I’ and the other, before an `I’ is formed, that makes possible the relation between the ego and its objects’-

`Abjection is the feeling of loathing and disgust the subject has in encountering certain matter, images and fantasies – the horrible, to which it can only respond with aversion, with nausea and distraction. The abject is at the same time fascinating; it draws the subject in order to repel it’ (Young, 1990:143).

Oppression `structured by reactions of aversion?’ (Young, 1990:142)

• `With the concept of the abject, Julia Kristeva offers a means of understanding behavior and interactions that express group-based fear or loathing...’ (142)

• Towards a revolution in subjectivity, as well as culture, as necessary? (`Rather than seeking a wholeness of the self, we who are the subjects of this plural and complex society should affirm the otherness within ourselves, acknowledging that as subjects we are heterogeneous and multiple in our affiliations and desires’; Young, 1990:124)

• Increased acceptance of our plurality, rather than a `drive to wholeness’ as preferable, and the role of consciousness raising as a strategy in this regard?

(2) Neutralized potential: Psychotherapy as especially individualistic

• Social myopia as particularly operative within the `micro’ world of counselling

• Key concepts (eg `speaking for self’) explicitly devalue social constituents of identity [eg Quaker client]

• While our professional practice is predicated on self-reflection and awareness of internal complexity, we tend to take the biases of the culture for granted

• The role of wider social forces in generating the problems which present to us is not interrogated:

`Mental health trades are ordained to rise in a society dominated by so basic a contradiction in personal life...as capitalism moves to its contemporary stage, the crisis of the family and of personal life in general sees to it that the pursuit of mental health reaches truly industrial proportions’ (Kovel, 1981: 119).

Drivers to change (ie to an expanded social perspective)

1. The enormity of global challenges (multiple)

2. The increasing diversity of client base

3. Implications from neuroscience (`the social brain’)

Subjectivity and its social correlates

• Experience becomes `a physical reality in the brain’ via organization of neural networks (Schore, 2003; Cozolino, 2002; Siegel 1999).

• While the psychotherapeutic focus has been on interpersonal experience, cultural and social factors likewise impact brain development and functioning

• `In a very real sense, the sociocultural environment becomes physically structured in the brains of individuals’’ (Castillo, 1997: 268)

Subjectivity and its social correlates, cont.

• The interior realm of subjectivity as itself collective?

• If social and cultural organization have `psychobiological correlates’ in brain organization, does this mean that power dynamics, too, are part of subjectivity and self-organization?

• Castillo (1997): culture-based socioeconomic stressors and schemas shape the construction of subjectivity and affect groups differentially

• Interior worlds are no less subject to broader societal – not just `familial’- dynamics which operate along axes of race, gender and class?

• Subjectivity and social inequality are not separable realms?

• A (further) compelling reason why questions of social justice are highly pertinent to the practice of therapy?

`What is to be done?’ Rectifying omissions, both curricular and clinical

• Contextualization in the teaching of modalities• Ongoing scrutiny of residual exclusions/bias (...)• Culture as constituent of (not incidental to) identity formation• More contentious? The clinical implications of such reform; the extent to

which we willing and able to act on it• Casting too wide a net? `Bias’ legitimately toward personal agency rather

than social change? • But if sociocultural dimensions impact interactions not only between

individuals but within them, `either’/`or’ is no longer an option. Such dimensions operative and pervasive in `inner’, no less than `outer’, worlds of individuals and themselves part of the construction of subjectivity.

To this extent, it is not a matter of whether to engage with these clinically, but how

Clinically engaging with the social field

• Attuning to `the links between personal problems and political/social realities’ (McLeod, 1999:173)

• Questioning assumptions about `the seemingly opposite realms of psychotherapy and politics’ (Samuels, 2001:ix).

• Towards a more nuanced conception of `advocacy’: `Soft’ – ongoing engagement with the social constituents of

identity (eg. implications for working with anger) `Hard’ – active intervention/advice on the client’s behalf While `therapist as social critic’ may have an heretical flavour to

some, the `soft’ enactment of agency is not only legitimate but arguably increasingly necessary?

A case for some revision of ethics codes?