Investment in Therapy pt 1

Running the Black Men’s Therapy Group has gifted me and my co counsel Sheila Samuels with more evidence of how necessary the Introductory course/workshop is for Black Men.

A previous post Jitters, observed the negative side of what too often happens, when someone does not get the help so often not looked at as a support. Therapy is often a last resort and sometimes barely that. How can therapy be successful when there is so much at stake? There are a number of reasons for the reluctance to engage. Cost. Culture. Cures and Cons.

Cost
Therapy is not generally a low cost investment. See Kwanda’s initiative to redress this. IAPT was seen as a possible panacea for the masses to engage with psychologically trained individuals to access C.B.T. (Cognitive Behavioural Therapy).

Helping those who wanted psychological support to begin resolving and managing their experiences of depression and anxiety well. The NHS support was provided through GP services for those who either expressed need or were found to be able to access C.B.T. support. The cost for a person wanting C.B.T. is nothing but time. Current waiting lists are between 6 – 18 months in some areas.

Culture
For many people there is a sense of unknowing and unconscious/conscious fear when thinking to access talking therapy (a stigma). TV shows like In Treatment, Queer Eye, In Conversation with John Bishop and Couples Therapy allow viewers to see the process outside of themselves. Sort of like a fly on the wall. Viewers don’t get the first hand raw experience of what therapy does. Therapy can often be a truly eye opening experience. It can be scary too. Don’t let fear prevent you doing great things, again!

Uncoupling
However living with the pain of what potentially is lying hidden could be seen as worse. On a number of levels the person living with the pain knows this too.

Many cultures across the globe have differing ways of managing internal scars. Some attend to these scars in community settings, some go to see a Doctor or psychotherapist, some a faith healer, shaman or spiritual leader a wise elder in the community. The aim is similar – to unbuckle the experience of (emotional, physical, psychological, historic) pain from the present.

Not for Me
Therapy supports a person or group to achieve this aim of unbuckling. In a Western technology filled world. Some cultures have developed a socially accepted space in the minds of their people for therapy to be an acceptable form of treatment. For some cultures including the African Diaspora, Asian Diaspora and South East Asian Diaspora, therapy is often seen as something that is not to be touched. Therapy is for other peoples.
“We don’t speak our family matters to outsiders.”
“It makes us weaker as a community that has already suffered and is going through our own ongoing struggles with it’s identity purpose, history and future.”

Cures
Therapy is not a cure. It has helpful elements that have curative affects for individuals and for groups but it by no means can wipe out past traumas and pains in a single shot. The process can take time – sometimes for a few years.The accumulative effects are like a river cutting through rock or an overnight heavy snowfall. Therapy cannot undo centuries of pain. What therapy can do is support a better understanding to support groups and communities resolve current and past experiences.

Finding a Heart

It is Written
Books like The Body Keeps The Score and It’s Not Always Depression support an individual and groups to begin reviewing their current lived experience and review them critically. The two books highlighted above and therapeutic encounters generally encourage people to take out the parts that are not working for them anymore. Observe the learning from an array of differing experiences. Begin implementing another way to live and live well. I can think about a number of clients I have worked with for 1 – 5 seasons who have all gained somethings from therapy and found a way to let their past demons die and accept their now to live as best as they can making improved choices.

Cons
Therapy has it’s good, bad, and indifferent encounters between therapists and clients. The right mix often happens when skilled therapists meet willing clients to address their difficulties. At times an incompatible mix can happen of cultures, sexes, compassion fatigue of therapists, unconscious biases, identities and egos are amiss and both the client and therapist cannot make the therapeutic encounter work. The fatigued battle weary therapist and enthusiastic risk aware client would be an interesting dynamic to supervise.

Cons?
The thinking behind IAPT’s 6 appointment model is that a short focused piece of work can be effective when a single problem is looked at solely. This is equal to 300minutes of considered time and can be effective to resolve an issue. The difficulty arises when more than one primary concern is activated or pulled through. Which can happen as a result of discussing the other factors around the initial reason a person engages in therapy.

Time is a valuable commodity as is a
successful outcome for the work for client and therapist.

Cons??
Six appointments at times does not touch the sides of heavily affected people’s challenges like complex post-traumatic stress disorder (CPTSD). Another difficulty that the Global Majority has with encountering therapy are the historic experiences of colonisation, criminalisation, cultural appropriation and theft, villainizing communities and splitting groups of people along tribal, ethnic and gender lines. An implicit encouragement of groups to fight politically or physically inside of these constructed divisions, and then them to be offered a westernized approach to heal communities seems like an insult to a historic injury.

Cons!
Where would trust exist within these paradigms to complete a piece of effective work? Western approaches to therapeutic outcomes were developed originally for a small group of people in Europe!

If we were to widen the lens and take in the planet through a global and pan view, communities from Central and South America, the indigenous populations of Australasia, Inuit communities, Sub Saharan Africans and Northern African communities may not access therapy marginally or fully because of their own senses of culture, their community understandings, religions, beliefs, sense of collectivism and historical legacy experiences with the West. A Eurocentric approach with therapy would need to be de-colonised and become incorporated within the cultures therapy hopes to support.

Cons!!
There are also the experiences of what White psychiatrists, and White therapists have perpetrated against Global Majority communities which adds to the sense of historic mistrust against westernised approaches to healing.

Resources
Black Issues in the Therapeutic Process – Dr Isha McKenzie-Mavinga
Black Bodies TEDx Devante Sanders

Images
Photo by Shane Avery on Unsplash
Photo by Roman Kraft@romankraft Unsplash Autumn Love Signs

4 thoughts on “Investment in Therapy pt 1

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