The cost of compromising to belong - A behind the scenes view of Clinical Psychology trainings
By DrLibbyNugent, Jul 11 2019 02:55PM
I think most Clinical Psychologists are drawn to this profession for restorative reasons: our individual, family and community wounds have taught us the impact of unattended pain. Part of my private practice I have made available to provide therapy to trainee clinical psychologists during this life-changing chapter. I have witnessed the stepping into this professional identity from a behind the scenes view. In addition to this, I have also at different times provided group reflective practice to assistant and aspiring clinical psychologists, supervision to trainee clinical psychologists, therapy to qualified clinicians as well as individual and group supervision. My therapeutic approach is systemic and narrative and I am currently in the training process to become a group analyst.
The trainees that have come to me for therapy have typically wanted to make sense of different parts of their identity whilst in the context of training. The hidden or marginalised parts that do not fit the assimilated white, female, straight, young, able-bodied, identity of the clinical psychologist caricature. Non assimilated identities have included: being black; being brown; having a religious faith; uncertainty around sexuality; being working class; carrying a mental health diagnosis/ lived experience of the mental health service; fertility problems; loneliness; being a rape survior and survivor of complex childhood trauma.
I am sharing these details to make the point that I am in a relatively potent position regarding observation of the psyche and culture of clinical psychology training. I hope sharing my reflections on our culture is taken as an additional part of this work and provides a degree of advocacy regarding some things that need to change for the better in our profession.
In this therapeutic work what often gets discussed is the tension between the different parts of the self. What I have come to think of as the good girl versus rebel dilemma. The good girl identity wants to be seen as reasonable, a scientist-practitioner, who is kind and thoughtful and fits in to CP culture. She wants to keep her head down and make the most of opportunities with minimal friction. She has a propensity for avoidance. The rebel is full of feeling, heart ache, pain, anger and aggression; she wants to tell everyone how her life really is and who cares if everyone thinks she’s too much; she has a propensity for self-righteousness. My witnessing of CP culture is that it is likely to encourage a compromise be made between the two positions: a bit knocked off from each part and ideally the worst bits: have a voice, speak your truth just as long as no-one is made to feel too uncomfortable. ”The culture will not learn if people are shamed” is what we are told. “So how do I find the right balance?” is so often the question posed by trainees.
My Mormon childhood (white supremacist and misogynistic) also gave me the narrative that I must compromise to belong: I could have my ideas and my frustrations with the community but being kind and thoughtful were highly valued characteristics and as such I needed to find a middle road. So I could be opinionated and give feedback about the misogyny but not so much to cause another too much discomfort and certainly not shame. Or rather not to cause the superior white male shame. It likewise would not have occurred to me to think that a person of colour would be anything other than pleased for me to be prioritised over them. Their servitude was my reward for being nice. Should a person of colour have tried to give me feedback regarding how they were experiencing any of my entitled behaviours. I would have assumed they were truly overreacting - that would have implied I was somehow a racist and I was far too good and nice to ever be that.
I left the Mormon community as I wanted to be seen as a whole person. This turned out to be quite different from what I was anticipating. Through having a psychoanalysis I have found how important it is to honour all the different parts of my life fully and the danger of cultures that do not contain anger but instead demand compromise and assimilation. Through experiencing this analytic relationship I learned the difference between containment as an expression of a need to control and containment as an opportunity to engage and allow for change.
I have a love of dreams and faerie tales and I thought I would bring two here as a way to continue my conversation with whoever is reading this.
Here is a dream I had following my own qualifying as a clinical psychologist and a faerie tale that I’ve spent considerable time contemplating:
I am in a campervan being driven by a clinical psychologist supervisor. We are driving in a neglected part of our community. On the side of the road I notice a beautiful woman. She is smiling at people and busy doing tasks to tidy up the area. The woman is dressed as a Geisha. People in the road observe her from a distance. As the vehicle moves closer to her I realise the Geisha dress is a very shoddy costume and is in fact disguising a white man who is filled with pain and rage and behaving violently sometimes to himself and sometimes at others. For every tidying up action “she” does, “he” undoes. People around are pretending they don’t see him and I am reminded of the story of the emperor who had no clothes.
The Faerie Tale:
An insecure emperor, who cares too much about how he appears to others, hires two weavers. The weavers claim to make the most beautiful clothes in the whole world. In actuality, the weavers are tricksters who convince the emperor they are using a special magic fabric that appears invisible to anyone who is either incompetent at their role or hopelessly stupid. Of course no one can see the alleged fabric but everyone who is invited in to view the weavers work pretends that they can for fear of appearing unfit for their role. Finally, the weavers report that the suit is finished and they mime dressing the emperor who then marches in procession before his subjects. The townsfolk uncomfortably go along with the pretence, not wanting to appear unfit for their positions or stupid. Finally, a child in the crowd blurts out that the emperor is wearing nothing at all and the cry is then taken up by others. The emperor realises the assertion is true and continues the procession - still naked. (Wikipedia,2019)
I have come to invest importance in these images to both my personal and professional identity. I will leave it to you to have your own associations but hopefully it is apparent why the symbolism might be relevant.
I think if we genuinely want the system to change we need to take head on this dominant culture as a collective. We must not continue to leave people in marginalised subgroups with the tasks of self care and the burden of rescuing this culture that is too insecure to listen. To do this I think we need to take seriously the intersectional complexity of our relationships; and embrace nuanced feelings, experiences and conversation where we can all see ourselves as both oppressed and oppressors.
If the profession really wants to engender equitable change my experience shows this is not an academic task. This is where I am in agreement with those that suggest CP culture would benefit hugely from providing compulsory analytic reflective space, for training staff and individual or group therapy for trainees. In this way we can begin to grapple with the hidden parts of ourselves and each other. I appreciate that may seem a strong position but how else do we start to see the unseen?