The politics of therapy

Early in my corporate career, I mentioned to a friend in confidence, how my boss’s inappropriate sexual comments at work made me feel uncomfortable. The next day, I came into work to discover that my desk had been relocated into the basement, hidden in a sea of unfamiliar faces. Being banished from my team, without a word, was the painful rudimentary punishment for talking about my experience.

Since the election, I’ve been wrestling with whether to warn everyone or wait until things play out then shrug, as we all wrestle with the consequences of—too late. Still haunted by the times I’ve been erased by men and scolded by women for talking about things which shall not be spoken.

This week I joined a community forum with over a hundred therapists to discuss how the new administration’s plans and policies will impact our clients and our ability to provide support as therapists. The room was filled with fear, apprehension, thin optimism, heartbreak and anxiety. People strategize about how to maintain a level of political anonymity while marketing to and serving vulnerable communities, small ways to resist the onslaught of new legislation designed to separate individuals from providers and the potential implications of speaking publicly to advocate for the rights of those we serve across the political spectrum.

Together, just by being there, we acknowledged that therapy is inextricably intertwined with politics. The systems of health care, capitalism, and politics have been constructed upon our history of colonialism, patriarchy, and white supremacy. Attempting to extricate politics from health care is a sophisticated strategy of avoidance and self protection. Remaining ‘neutral’ sacrifices those we support to shield ourselves with the illusion of safety that comes from proximity to power. Deciding to sit this one out because it’s too political is fragile privilege at best.

So the question isn’t whether I’ll accept the risks of speaking up again—my ability to provide therapy and my clients ability to utilize therapy is in jeopardy either way.

Bills have been proposed and laws have been passed making it increasingly dangerous for my clients to discuss abortion, safe sex practices and contraception, immigration status, gender affirming care, and sex education. Health care professionals are already trapped between laws that require providers to protect patient data and new state laws that mandate that providers break confidentiality to report routine health care procedures (abortions). In other instances, providing a client with a simple referral can result in criminal prosecution and loss of license for the practitioner.

The ability for practitioners to provide quality health care, speak openly with clients, support their well-being, help them make informed choices and protect their right to confidentiality is being eroded and many health care professionals, myself included, are afraid to speak openly while being caught in a double bind.

I hadn’t anticipated that this year I’d be writing about being enough as a therapist in the rapidly shifting political health care landscape so going forward, some posts will be paywalled to create a safe space to write honestly and openly.

Together, Kate xx