Politics, Race, and Class in the Analytic Space: The Healing Power of Therapeutic Advocacy

Abstract

This article brings forward a conceptual framework to serve as a dialogic bridge between the dyadic world of psychotherapy and the wider sociopolitical world in which that world is embedded. The framework incorporates the explanatory power of complexity systems theory with the experiential insights of a trauma-centered dialogic approach to bring forth a radical contextual view of the psychotherapeutic process whereby the sociopolitical dimension constitutes a continuous and vital presence in the therapeutic field. A clinical corollary to the above is a wider understanding of therapeutic action, including advocating for the patient within traumatizing and abusive systems in the patient's current world. A case discussion illustrates the consequences, both rewarding and painful, for context-sensitive therapists willing to embrace the complex challenges inherent to therapeutic advocacy.

“If she had helped me to solve the problem at my workplace, she would have cured me”: A critical discourse analysis of a mental health intake

“…To consider some, some different things from what they have learned so far. To consider, for example in my specific case what is needed is a medical evaluation [to the committee] so maybe … now if she had helped me to solve the problem at my workplace, she would have cured me!Sima’s advice echoed critical perspectives in social work and psychology that urge therapists to expand the context of their work to embrace social, cultural, and political issues (Avissar, 2009; Fook, 2003; Prilleltensky et al., 2008; Sucharov, 2013). Moreover, more critical views of the use of psychiatric diagnosis suggests that medicalizing psychiatric nosology and discounting the political context in which psychopathology emerges—is used to justify predetermined social structures, and at the same time, it serves to control and contain disturbed behavior and provide care for dependents while maintaining the social power structure and oppression (Moncrieff, 2010; Pilgrim, 2007).…”

“…Critical approaches in therapeutic professions (such as psychology and social work) have been gaining more ground in recent decades (Avissar, 2013; Fook, 2003; Nakash et al., 2010; Prilleltensky et al., 2008; Sucharov, 2013; Totton, 2006). These approaches are committed to social justice and focus on exposing mechanisms of social oppression (Clark, 2002).…”

“…From a critical perspective, psychotherapy can no longer be viewed as politically neutral, in the sense of “political” as related to distribution of societal power and resources (Sucharov, 2013). On the contrary, psychotherapy is “a field of political action, a place where power is exercised and contested, as therapists try to affect clients’ lives and clients acquiesce, resist or do both at the same time” (Totton, 2006: XV).…”

“…Over the last three decades there has been a prosperity of critical approaches in social work and psychology including feminist (Chester and Bretherton, 2001; Morley and Macfarlane, 2012) and critical psychology (Parker, 1999), political sensitive therapy (Avissar, 2009; Sucharov, 2013), and radical, anti-oppressive, and human right-based social work (Fook, 2003). There is a debate in the literature whether these approaches should be grouped together (Fook, 2003; Morley and Macfarlane, 2012); yet, for the purpose of this paper, we identified common aspects shared by many of these new approaches toward the shaping of a critical discourse in psychotherapy.…”

‘I felt part of the solution’. A qualitative study about the interface between lived experience advocates, professionals and organisations in the field of persistent pain

“…People who work with patients in a helping capacity may have a need to feel as though they are fair, open and good people. 24 To some degree, this could lead to a degree of blindness to their own contributions to inequity. Potentially, this narrative could apply to individuals working within the field of pain, especially if they have previously been overwhelmed by their organisation’s (or state) bureaucracy with regards to sourcing and making appropriate payment.…”