Psychology vs social justice: social responsibility for therapists

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How much might psychology impinge upon the clients right to be dissatisfied with the current world order?

Much psych therapy, very generally speaking, encourages people to adapt to societal status quo, rather than fight to change it. Indeed psychologists have a strict duty of care to employ methods that can be empirically validated as effectively alleviating client concerns, but there is much more we could do.

We know that minority groups have drastically different mental health outcomes than the dominant group. For instance, women have around twice the depression and anxiety than men, younger Aboriginal people have around 5x the suicide rate of the white population. In light of this, do we need to be doing more than sending people home with a pocket of tissues and a packet of SSRIs? Do Aboriginal youth need more CBT, or do they need opportunities to seek justice for living through genocide and ongoing colonisation?

People have the right to mobilise for social justice and the psychology academy has the obligation to better inform its students of the social justice issues that are hampering individual’s abilities to good mental health.

For instance, I had ONE lecture in six years from an Aboriginal woman, and it resulted in a group of students (notably white and male) going on racist diatribes about how it wasn’t their problem. More recently I have come across a ‘psych practitioner’ who has published sexist tirades about how domestic violence is exaggerated. We should not have health practitioner graduates entering the professional world whilst harboring harmful attitudes.

Psych research tells us that inequality is harmful and moreover that inequality is growing. Not only inequality of the sexes but also in wealth and other outcomes. Yet psychology has fairly little to say about it and in fact is moving toward the trend of mindfulness and other de-politicized solutions that may pacify and silence the oppressed.

In this context, every psych professional has a moral obligation to integrate social justice into their praxis, to ensure clients are not further internalizing or blaming themselves for living with the harms of social injustices.

I am not advocating for anyone to avoid psychologists or therapy, but I do hope that all clients recognise their rights to find a therapist that truly suits their needs.

I’m told there is a saying in Brazil that goes ‘plastic surgery is cheaper than psychotherapy’. I would argue social justice is cheaper than both and everyone has the right to access it.

 

More about this can be found in Totton (2006) Power in the Therapeutic Relationship

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3 thoughts on “Psychology vs social justice: social responsibility for therapists

  1. I’m deeply troubled by the liberal push in the US to view psychology/psychiatry as “just another branch of medicine, equal to other branches” in light of it’s particularly bad record concerning women and oppressed people in general. It almost seems as though the field was invented to explain away the complaints of people to whom the dominant class(es) did not wish to listen – and then some good happened to come out of it in spite of itself. But I find it hard to say anything about it to friends without being lumped into the class of “anti-science loony”. I am in fact very positive about Western Medicine in general – but I take exception to a lot of modern practices concerning psychiatry, not the least of which that individual practitioners (in the US, in any case) have so much leeway they frequently do not even follow the instructions recommended by clinical trials when dispensing medications.
    This, plus the frequent advertising that psychiatric medication can solve all your ills because if you are unhappy or angry about anything at all it must be the fault of mysterious chemical imbalances in your brain (not anything wrong with the perfect American life, oh no) leads people to doctor shop until they get the meds they want for themselves and their children.
    I currently know someone, for example, who has a difficult four year old girl child (tantrums) and doctor shopped for her (the first several doctors told her nothing was wrong with the girl) until finally she found someone willing to put her on medication. Now she is complaining that it hasn’t helped. She is being lauded as a concerned, struggling mom. Doubtless she is – although I would say her real struggle is with her rather worthless husband – and she can’t drug him against his will, so the solution for the happy American family is clearly to drug the children. She takes some sort of psych drugs too, because she can’t figure out why she’s so unhappy with her unemployed husband who does nothing to help around the house and her friends who have all told her he’s worthless until she told them she won’t permit them to talk bad about them. It’s all her fault, and now her child is mysteriously out of control. Psychiatric drugs will surely fix it all.
    And if you say anything, you are accused of “not taking people’s mental pain seriously” or “minimizing mental illness”. Well mental illness is a thing, but I don’t really think half of all Americans (especially the female half) have it.

  2. Is there a reason for excluding substance abuse disorders from your statistics in looking at the ratio of men and women suffering mental illness?

    The US National Institute on Drug Abuse indicates that it is a mental illness closely associated with other types of depression. “[…] The resulting compulsive behaviors that override the ability to control impulses despite the consequences are similar to hallmarks of other mental illnesses.”(http://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/drug-addiction-mental-illness). Indeed it seems normal practice to report substance abuse disorders along with depression and anxiety disorders when reporting mental illness statistics. (e.g. Australian Bureau of Statistics: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by+Subject/4125.0~Jan+2012~Main+Features~Mental+Health~3150 UK Mental Health Foundation: http://www.mentalhealth.org.uk/help-information/mental-health-statistics/men-women/ )

    When taken together these types of mental illness paint a more nuanced picture than you have in this article, where men are marginally more likely to suffer mental illness throughout their lifetime (see above links). Additionally there is some evidence to suggest that men under-report certain types of mental illnesses (see the linked studies in the UK Mental Health Foundation link above).

    I certainly agree with the author that those from minority groups experience higher rates of mental illness. This applies to substance abuse as well as depression and anxiety (see for example: http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter756Oct+2010).

    The picture isn’t that simple for men and women though. Perhaps you have some insight from a particular study that links depression and anxiety disorders in particular to oppression above substance abuse related illnesses, if so I would very much like to read it.

    It is possible that the reason this picture is complicated is that emotional repression effects psychological wellbeing. Some study has been done on this (Sorry this is the best example I can find right at the moment: http://psycnet.apa.org/journals/abn/106/1/95/). The masculine archetype most preferred by conventional patriarchy favours the repression of emotions other than anger, and does not allow a high degree of personal expression in, for example, dress codes. Additionally, it is well understood that men do not form the same types of friendships as women do, that these are not as open nor emotional in their interaction. It’s this lack of an effective social network that results in men suffering more in divorce (http://www.mediate.com/articles/psych.cfm).

    In my opinion this is one of the areas in which men have the most to gain from feminism. It’s for this reason that I find it odd that you have chosen to neglect substance abuse from the statistics on mental illness in men and women. And why I would be most interested in your reasons for doing so.

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