Psychology: Exile or Liberation?

May is "Mental Health Month" and the American Psychological Association's Public Education Campaign is organizing a "Mental Health Month Blog Party" to educate the public about mental health issues. The badge at the top of this article indicates that I’m participating. Although much of what we have posted here has been about, or at least related to, mental health, I hesitated to participate in this APA event because of what this connection to APA might signify to our readers. One of the tensions we have held within TJP leadership is whether Psychology as it is practiced in traditional, academic institutions (such as graduate programs and APA) is an appropriate or effective place to locate work toward liberation, or instead whether it maintains the oppressive structures and hierarchies that we are trying to resist and revise. I ended up deciding to participate strategically and with intentionality, with the goal of exploring the complexity and multiplicity of "psychologies," rather than taking an either/or perspective. Often I have been in situations where there is an adversarial discussion between those coming from a place of community activism and organizing, versus those coming from more mainstream or institutional settings. The assumptions about one another can lead to not finding common ground, when maybe in fact it's actually there. So, I am going to continue holding the dialectic here that TJP has struggled with all along, reviewing some of the major criticisms and limitations of traditional psychology, but also highlighting some of the liberatory work that's being done by individuals and organizations in psychology. This can only be a brief review, but I hope it will stimulate some thought and discussion.

Many critiques have been leveled regarding the ways that mainstream psychology maintains oppressive structures. To highlight just a few:

- Mainstream psychology upholds the values of the dominant (white, male, heterosexual, middle class, Christian) culture. One example of this is that psychology upholds autonomy and individuation as more mature levels of emotional functioning than interdependence, despite the fact that many women, some non-white ethnic groups and non-Christian religions, and many non-Western cultures place a high value on interdependence, community, and relatedness. As long as individuals with relational values and worldviews are compared to those white, male, Eurocentric “norms” of behavior and emotional functioning, they will be viewed as less mature and less evolved.

- Behaviors that are resistant or rebellious toward dominant group members are often labeled as deviant. Examples include children getting angry with adults, People of Color who point out discrimination being diagnosed as paranoid, and women who express too much anger being labeled as unfeminine. This focus on the individual ignores the power dynamics at play in each situation and pathologizes what might be viewed as normative behavior if the lens were widened to view the behavior in context (for the above examples, context might be an abusive parent, racially based discrimination, and sexism in the workplace). This also applies to more global identities or sets of behaviors, such as being gay, lesbian or transgender, all of which have at one time or another been institutionally codified as pathological in the highly utilized and internationally referenced Diagnostic and Statistical Manual (DSM).

- Prevailing treatment approaches, including cognitive-behavioral, psychodynamic, and humanistic, have all been intrapsychically (or, at most, relationally) focused, and have tended to myopically ignore community, cultural, and systemic factors, including power and oppression, that might be playing a large role in the individual’s functioning.

- For many members of marginalized groups (including LGBT individuals, POC's, and immigrants) acculturation is emphasized over maintenance of one's culture - despite empirical evidence strongly suggesting that people who both maintain aspects of their origin culture and acquire some aspects of the dominant culture have the best mental health outcomes. In fact, in many cases forcing individuals to detach from their culture is legal and institutionalized (e.g., Spanish speaking children being forced to speak English in school, most businesses and schools only honoring Christian calendar holidays, etc.) although the latter actions may not be perpetretated directly by psychology or psychologists.

- The science of psychology has largely been conducted by members of dominant groups, who hold a great deal of privilege including whiteness, higher education, and financial security. Further, research has often been conducted on skewed samples who are themselves often members of those same dominant groups - yet conclusions from those studies are sometimes generalized to members of marginalized groups.

- Not only is obtaining graduate education in psychology costly, but obtaining psychological services, especially in a private practice setting, is highly costly as well, often prohibitively so - especially for those who are unemployed and/or uninsured. Further, the assessment and intervention strategies offered by psychologists have not always been evaluated for efficacy with marginalized group members .

- For all of the above reasons and more, mainstream psychology (and psychiatry) has been indicted by many as upholding the status quo and maintaining, rather than dismantling, systemic oppression.

On the other hand...

- Multicultural psychology has strived not for universal, absolute norms of behavior, but instead for culturally relevant ones. More recent iterations have also added a critical understanding of power and oppression to the analysis of the role of culture.

- Many in counseling psychology are exploring effective ways to infuse social justice and anti-oppression work into graduate level training, including curricula, clinical supervision, research, and practicum experiences.

- A growing body of research on racial oppression (and more recently on homophobia/heterosexism) has documented the deleterious effects of bias and discrimination (both personal and systemic) on individual well-being, social functioning, health, and mental health.

- APA recently added advocacy skills as the 13th basic competency required for entry into the practice of psychology, thereby lending validation to this important set of skills which are defined as “actions targeting the impact of social, political, economic or cultural factors to promote change at the individual, institutional, and/or systems level” and include promoting client empowerment, as well as professional involvement in promoting change at the level of institutions, community or society.

- Several organizations associated with APA, including Psychologists for Social Responsibility (PsyR) and Society for the Psychological Study of Social Issues (SPSSI) have tasked themselves with addressing some of the largest and most difficult social issues of our time, including poverty, racial discrimination, genocide, torture, human and civil rights violations, and global conflict resolution.

- Researchers are increasingly relying on qualitative, community based, and participatory action research methods to increase understanding of culture and oppression and to put the purpose and uses of research more in the hands of its participants

- Liberation psychology, originating in Latin America with the work of Martin-Baro and others, has begun to have a foothold in North America. For example, a clinical psychology graduate program (Pacifica University) has a strong liberation psychology foundation, and two of its faculty (Watkins and Shulman) have recently authored an excellent book on the topic. Promoting analysis of the social inequities confronting individuals and empowering them to address those inequities, liberation psychology simultaneously provides an alternative viewpoint to mainstream psychology while still drawing on it.

So what do we do? How do we reconcile this dialectic of strong critiques leveled against mainstream psychology as oppressive, alongside the reformative and transformative work that is being done by many in the field? I would like to end with this quote by Albert Camus: “We all carry within us our places of exile, our crimes, and our ravages. But our task is not to unleash them on the world; it is to fight them in ourselves and in others.” Many people have been exiled by psychology, it’s true – but many others are working to reduce oppression, address the huge social challenges of our time, and work toward liberation. If I have challenged readers to think about the viewpoint that is less comfortable or familiar to them , then I will feel this posting has been successful. I welcome your comments!