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

An Origin Story

Musings on Therapy
I can remember the moment that counselling, psychology, psychotherapy or psychopathology became the most important career choice I ever made. I was 33, this was in the summer of 2007.

Balance
3 years before I met Laos I worked at Harris academy school for girls in East Dulwich. I had begun an introductory course of counselling at Morley college. The teacher Ian Mendelberg was a great example of Carl Rogers and Fritz Perls, I was later able to appreciate. Ian was able to combine wisdom and grace with humor and presence.

SSCO
I was the school’s Specialist Sports Co-ordinator providing group and individual sports and pastoral care support. I also coached basketball in the morning as a Breakfast Basketball initiative. Within 2 seasons the programme helped beginners take 3rd place in London’s Central Venue League Basketball tournaments. A crowning moment for the team, the school and for me their coach.

Clarity
The crystalisation moment mentioned above was realised at an individual mentoring appointment with a student of the school. My own a ha moment. Goodbyes carry an emotionally laden content that is difficult to contain and manage. A yr9 pupil was relocating to a different school for the next academic year.

By me asking if she was going to be alright she replied:

“I’m gonna have to be aren’t I.?” Her South London brogue attempting to deflect the suppressed emotions of loss and attachment to her school and friends. The tears were kept inside but we both acknowledged their presence with a nod and pleasant ending phrases.
“It’s been good working with you.” I said
“I hope that the course works out for you.” She offered
“I think you can see that it has this effect on people.” I said
“Oh, right, yeah, Mr Opoku. You might be on to something.” Shaking her head
“Shall we end it [the appointment] here then?” I said
“Yeah I think now would be a good time to stop, or I really might start…” She insisted
“Okay then…”
“Good bye then and… thanks…”
And with that she got up and left.

Something…
I have since gone on to complete a Masters in Therapeutic Counselling, courses in Brief Solution Focused Therapy, Trauma Based Cognitive Behavioural Therapy, Rational Emotive Therapy and a course at Westmeria College to become a counselling supervisor. The latest training has been to complete Eye Movement De-sensitisation Reprocessing (EMDR) that is reconfiguring, reconceptualising what I thought I knew about counselling and psychotherapeutic support.

The Climb
The interest in supporting others has not yet reached it’s zenith. The craft, this high art has become a greater thing than looking to care for just 1. By helping another the environment around them and the person doing the helping is immeasurably changed. I look back at the moment with the yr 9 student and said yes let’s have a conversation, which lead to many more conversations at that school and took me out of Harris Academy to other change spaces including: A boys secondary school, 7 Probation offices, supervisees, a team of Forensic Mental Health Practitioners, 6 prisons and 6 counsellors in Kent and clients in a range of settings including prisons..

I fell in love with the idea of living my purpose: the Artist repackaged. All day and everyday. ‘This Artists Way’ thing is more than most other things I have been before. Parenting can never be bested. However thinking creatively about Psychoanalysis is what I have been climbing towards. Climbing beyond a challenged past. The journey has been difficult and not for the faint of heart. I have crossed ravines and archipelagos never before seen by me, or that I ever knew existed. I have fallen and wondered about not getting back up. Events have brought me to my knees and I have asked for support in being raised back up on to my feet.

Gifts
This path that I chose has not been a bed of roses getting where I have. The challenges are seemingly insurmountable and I have failed many times. However the successes far outweigh the losses. The smiles, the thank you’s, the nods, the hand shakes all make the art worth it. There is still much to learn and to achieve.

Attempting to support service users that appear blocked and fearful of change. Supporting other professionals to grow outside of set protocols and policies to think creatively and act courageously, to support people in their communities. A drug or alcohol misuse dependency should not determine whether that person could or should get access to good psycho-social support and yet currently it does.

As a friend said in 2016 the person should want change, not the set of difficulties they have to continue. I offer that mental health services could be just as solution focused. Offering a label free, diagnosis opposed care centres treating a person with needs – compassionately. Diagnosis can be limiting. Diagnosis can also be explanatory. It is the person that experiences the difficulty that is to be helped.

Mental health support is about offering change along a continuum. Beginning at a super light spot that’s easier to assist a client experience change. Then graduating the person to access support that genuinely alters self-perception by fractions/degrees. The small changes aspect of psychological support is what I feel is most important. Great distances are walked by taking a single 1st step.

We raise we.
Not I or you.
Alone.
A simple singular exchange.

For me it is:
Collaboration,
Connection
Community.

Change
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