Becoming Ethical

Waking up and becoming more conscious, as indiviudals and as a collective is a never ending task.  We can each only do our bit.


No one person has all the persepectives, or all the answers.  There are so many paths that need to be followed and explored.


My hope is that the more we connect through conversation we can understand ourselves and each other, then maybe we can chose more clear eyed and wisely the world we live in and the paths we take.  

By DrLibbyNugent, Oct 26 2019 08:32AM

An internal critical voice is an incessant stream of destructive self talk. Common critical conversations with the self can include scripts such as: “You’re ugly,” “You need to try harder” “You are too loud shut up” and “You’re stupid” “Nobody likes you,” “You are fat and useless”, “You are too much for people”, “Don’t be diffiuclt”, “You are better off on your own”, “You are a mess”...

Sadly this stream of uncontained internalised aggression forms a powerful anti-self that might provide an instant motivation, but will then often discourage a person from acting in their own interest over the long term - Instead fostering self-hate and a retreat from an honest interaction with the world. As such it can corrode every part of life, including self-esteem and confidence, personal and intimate relationships, and performance and accomplishments at school and work.

From some psychology narratives it is tempting to believe that these inner voices come solely from redundant unhelpful thinking styles. They suggest that if you test them out aloud in adult reality you will see that no one really cares how you look, treats you differently or thinks you “need improvement”. But what do you do when the critical voice is not only from the past, but very real and present in the world? When you are explicitly told you have to play by different rules because you are the wrong: social class, colour, ethnicity, religion, gender, weight … just not quite socially acceptable enough to be a recipient of what is fair.

Typically, you learn to make do with what you can get. To swallow the inevitable shame you experience in this process of being in a world where everyday you are different, you are less than. This shame can also come with a self-preserving rage - but you learn to swallow that too. The angry AND fat/ black/poor/female/gay person will only be punished further. You learn to avoid these experiences of shame and rage at all costs. You are told they are pathology and toxic in and of themselves. Better to be placid and likeable. Better to leave those feelings alone. Rise above it. Just do better. Be better.

I still have, at times, a reflex to smother my rage and shame when my shameful parts are provoked even though now I have learned better.

So what does it mean to now know better? It means that I have learnt that whilst there is truth that shame, internalised, is toxic and that rage uncared for is massively destructive, there are also lies. It is not always unhelpful to be in touch with my rage or toxic to pay attention to my shame. Through dreams and storytelling imagery I have come to associate both experiences with the symbol of fire: The white heat of shame, the burning of anger. Like fire, uncontained, shame and rage can storm through life destroying indiscriminately. However shame and rage when held with compassion and their sources examined can open up new world views. When these experiences are harnessed with a view of the self as equal to others and that self is worthy of love, the same fire that was so destructive offers the possibility of cooking up a transformation. Anger and the examination of shame can be used as fuel to cook up the other elements in our psyche that then provide nourishment, cleansing, protection and even prepare the ground for new life. It takes the forces of the steady flame of a self-caring rage to maintain a refusal to keep shame hidden that in turn can break through that which is trapping us.

For a long time I didn’t want to know about my wounds, or rather I knew but didn’t want to think they were big a deal. My inner critical voice firmly in place helped me keep my head down. I wanted people to see me as easy going, friendly and helpful. Likeable. I have enough privilege in my life to harness the denial required to achieve much of this persona. Whilst I knew other people suffered I believed my critical voice and survival strategy of enforced niceness was a sign of my resilience rather than my hidden shame and uncontained aggression. I would tell myself that compared to other people I had nothing to complain about. Anger without self love has a strange way of minimising and dismissing our lived experience so that we see our experiences as so lacking worth or value, that distress can only be located in other people; that is to say it has a way of leaking out and displacing itself as a projection onto others. So at the same time as me being ‘fine’ i could become wildly impassioned on behalf of others. Incensed at their injustices, their oppressions, their hurt. Furious with their aggressors. Or equally, I could also aggressively accuse anyone who wasn’t going to collude with how nice I was. Always the rage, the badness, the disgust was in the other. I was just helpful and nice.

Much of my awakening could best be described in the story of the Frog Prince:

In the tale, a young and protected (or defended) princess reluctantly befriends the Frog Prince, whom she met after dropping a golden ball into a pond. He retrieves it for her in exchange for her friendship. However she did not really want to be friends with the frog. She didn’t know how to voice her disgust of him, and so she pretends to be nice; she then tries to run away and leave him behind. The king hears of this and holds her to account for the promise, insisting the frog be invited into their home. She is too ashamed of her feeling of disgust and so again pretends to be ok with it. The pretense goes on and on until the frog ends up in her bed. Finally the tension of holding both rage and shame break through. The princess gives in and throws the frog against a wall in anger. ‘I can’t do this anymore. Think of me what you will but i’m not going along with it. This ends now.”

In this surrendering into aggression by the princess, the Frog Prince magically transforms into a handsome prince or rather a perfect partner for the princess.

In modern versions, the transformation process has been sanitised: triggered when the princess kisses the frog. I find this sanitised version does not resonate with me in the same way.

Here are some present day examples of such transformations:

In the anti racist book club for psychologists we recently read ‘Why I’m No longer talking to white people About Race’ by Reni Eddo Lodge. This is an incredible example of the individual liberation that comes from a mixture of anger, self-care and an examination of the shame she was being forced to hold. Likewise the Australian comedian Hannah Gadsby in her work “Nanette” owns her anger and outs her shame - refusing to humiliate herself ever again by making jokes about homophobic violence directed towards her. Additionally the singer Lizzo, embracing her plus size black body singing ‘Truth Hurts’ whilst dancing in unapologetically revealing clothing for the BET awards ceremony is a joyous moment. For these people turning towards their own pain, anger and shame provided extraordinary space for creativity and connection with others. In all these cases it appears to be born from making a commitment to see the self as equal, and being honest about what they are experiencing in their internal world: self-love, despair, anger, rage and shame. Producing life changing shifts not only for themselves but so many around them.

What would happen if clinical psychology as a culture took up this call? Where would it take us? How might our professional world be different if there was a place to go where you are nurtured to become yourself. Letting go of the need to cover up or defend and instead accept all of your idiosyncrasies, fears, wounds, false belief systems, flaws, difficult moods, body size, skin colour, gender, sexuality etc and be supported as unique and imperfect instead of hiding, rejecting and wishing that we were different or like somebody else.

Ironically, when a person or culture claims and accepts their shadow, that which is rejected and suppressed about themselves, transforms from being a source of shame to being strength of character - the unwanted frog becomes a perfect partner. The pain and shame offer soul. Such people and systems give others permission to accept themselves as they are, their freedom becomes contagious. There is so much potential in our professional world. Imagine if as a profession we could embrace this. This is the profession to which I want to belong to.

As a final attempt to convey my point I will turn to The West Indian poet Derek Walcott . He describes this process incredibly in his poem Love After Love:

The time will come

when, with elation

you will greet yourself arriving

at your own door, in your own mirror

and each will smile at the other's welcome,

and say, sit here. Eat.

You will love again the stranger who was your self.

Give wine. Give bread. Give back your heart

to itself, to the stranger who has loved you

all your life, whom you ignored

for another, who knows you by heart.

Take down the love letters from the bookshelf,

the photographs, the desperate notes,

peel your own image from the mirror.

Sit. Feast on your life.

By DrLibbyNugent, Sep 1 2019 12:42PM

In my therapeutic work as a clinical psychologist I have regular supervision. In fact it is a professional requirement. It is essential to my work and keeps me focussed on what is going on as well as providing me with great insight and support. One of the most valuable lessons I have been offered, over and over is this: it is not about me.

This sounds obvious. I’m there to support people. It's the client who is the center of attention, and everyone knows it. But learning to decenter the self, in order to place someone else at the center, is always harder than it sounds. It is obvious. But it's not easy. Often our drive to help, be useful and take care are really about centering our own needs to be seen as useful or caring and not about what is going on for the person sitting opposite me. It is so tricky that I now consider learning to decenter myself as an ongoing task - a bit like a form of emotional personal hygiene.

For me, there are two distinct tasks required to achieve this. First, it means working to deliberately put to one side my doubt about being good enough and let go of any impulsive reaction to this thought of wanting to show how hard I am trying to do a good job. I think this is a human default phenomenon - imposter syndrome. But I have to tolerate this feeling of not knowing rather than act it out. Providing therapy and working as a qualified clinician isn't about proving myself, to anyone. Not to the individuals or services that might employ me; not to the doctors, social workers or nurses around me; not to myself, even. It's about being there. It's about paying attention to what's happening with someone else, closely, so that I can witness as much as possible what is going on, maybe gain some understanding and maybe even anticipate needs as they arise, so that maybe, just maybe, I might offer an intervention. In theory this should occur without my needing any acknowledgment from the client of my internal world because it's not about me, what I know, what I don't know, or even some of the more noble reasons I’m there. It is about the other.

Second, it means identifying, owning, sorting through my personal and social baggage around culture, life and relationships both good and bad. We don't get to leave these bags behind: I can't hide my gender, my white skin, my northern accent, my body shape and functioning, my clothing/hair choices etc so there is an importance placed on decentering them. But I can't decenter it if I don't know the personal value of these parts, their social currency and what these factors do to my relationships. For this I need curiosity, exploration and feedback. This task is uncomfortable and challenging at times but vitally important if I want to do this work.

I recently noticed some collective feedback to clinical psychologists. It was offered in reference to the ancient Greek myth of Procrustes who claimed he had a bed that could accommodate anyone perfectly of any height. I hadn’t heard of this myth before; it’s a powerful metaphor and cautionary tale:

It warns of the dangers of imposing our own ideas of what is helpful and necessary to do, in the name of caretaking and kindness to others;

It exposes how: what is storied up as kindness can often be thinly veiled aggression with entitlements enforced with tyranny.

The feedback came via social media. I occasionally had been involving myself in a Twitter debate regarding equitable access to clinical psychology training courses. Then I noticed these twitter posts:

“Really disappointed with *some* of the conversations on twitter regarding the low numbers of people from ‘BAME’ backgrounds on the DClinPsy. The conversations completely lack the voices of ‘BAME’ applicants & trainees”.

“Its impossible to sum up such complex conversations on twitter and it’s also quite bizarre for non-‘BAME’ people to discount real experiences of racism and discrimination in the profession.”

“Non-Bame people dominating these conversations reminds me of aggression disguised as hospitality. The greek myth of Procustes captures this behaviour very well.”

Not being familiar with the myth I went to Google ...

In the Greek myth, Procrustes was a son of Poseidon. Poseidon is the god of the sea, earthquakes, storms, and horses and is considered one of the most bad-tempered, moody and greedy Olympian Gods. You can only imagine what his son would have experienced from him and what he had to learn to do to avoid his wrath and get his needs met. Procrustes lived in a stronghold on Mount Korydallos at Erineus. This resting place was along a sacred route between Athens and Eleusis and has many passers by. At this resting place he had a bed, in which he invited every passer-by to spend the night. He would tell them he had a bed that fitted all sizes perfectly. Everyone was welcome to stay. His kindness and hospitality was plentiful, yet things soon took a dark turn as when night falls he sets to work on them to either stretch them to fit the bed or amputate their excess length; in fact nobody ever fitted the bed exactly, everybody had to be adjusted. Procrustes continued his reign of terror until he was captured by Theseus, travelling to Athens along the sacred way, who "fitted" Procrustes to his own bed.

Theseus became known as the unifying king. He battled and overcame foes that were identified with an allegiance to an archaic religious and social order. His role has been called the “agent of major cultural transition”.

The term “Procrustean” has now been appropriated in English and used to refer to situations where different shapes, sizes or properties are force fitted to an arbitrary standard. This is what can happen when our ideas, attitudes and generalised societal norms are left in the centre of our thinking and we attempt to impose them. They stretch apart or cut off the unique aspects of the self or group that doesn’t fit in, and forces these parts to hide. Instead we wear masks.

Clinical Psychology culture often has an excellent critical eye. This is a good thing in so many ways as it allows us to identify need and be truly hospitable care takers in terms of our formulations and research endeavours; but this critical eye also has a shadow. Particularly when turned internally or on to othered aspects of the group or the self. As a culture we are able to use this critical function and provide relentless adjustment in the name of support: We can have opinions on everything. This constant need to tweak narrative - to find the flaw and offer improvement can be destructive. I think it comes from a place of our culture aspiring to provide perfect caregiving,

Most psychologists are familiar with the concept of the ‘good enough’ mother. However whilst never explicitly said, giving imperfect but ‘good enough’ care is often understood as being something that has to be tolerated like a ‘just passed’ grade: a shameful defeat that has been salvaged by compromise or a sad ‘settling for and making do” because of life’s limitations. Good enough is rarely discussed as the thing that is desirable of itself. That “good enough” is what is essential to provide optimal opportunities for relationship and exchange between carer and caregiver. We all need a little wiggle room in bed, and some more than others.

As for the twitter debate: whiteness is a collective effort and not really about any one person’s individual contribution. No one person could be called Procrustes, but a group of us working together creates the same effect. Each white worldview jumping in to be ‘helpful’ is like another chisel cut, or twist to stretch the bed. Our collective helpfulness in saying to the other, “we will do this for you”. We know what you need, and we will help you, is really an instrument for dominance being used to assimilate the other into the shape we want.

This noticing is not an endorsement for negligence, rather an encouragement to find our internal and collective Theseus. The travellers on the mythic journey did need rest and care. It is not a case of ignoring and dismissing those that walk past our door on their quest. It is cruel and uncaring to not address wounds and tend to fatigue from the journey when we have resources. However, just as the myth ended, we need to kill off our Prosecutes culture, by being mindful of who is dominating our conversations, whose voices are centred and inviting them to decentralised. There are other ways. We need to learn to unify and integrate the different voices in community: to take individual and collective responsibility for the self awareness required to achieve this. We need to practice the discipline of tolerating our fears and learning what social and cultural baggage we bring to the conversations we are trying to have so that we can work at decentering them and creating space for care.

By DrLibbyNugent, Aug 15 2019 08:59AM

“It is through the alignment of the body that I discovered the alignment of my mind, self, and intelligence.” B.K.S. Iyengar

“Knowing your own darkness is the best method for dealing with the darkness of other people.” Carl Jung

Like many other white, middle class, women, I am a fan and intermittent practitioner of yoga. There is so much structural racism in this phenomena to unpack, but if you can bear with me, I will put that part of this conversation on hold for this piece.

My relationship with yoga is multilayered and as such my ambivalence is high: wanting to practice /not wanting to practice, loving and avoiding, attraction and apathy, talking about rather than doing, wanting the reward without the effort etc etc It is very similar, in fact possibly identical to my relationship to being in an analysis.

I find it is when I am practicing both yoga and being an analysand that my ability to hold compassion for myself and have a real view of the world is at its greatest capacity. Helpful personal understandings emerge between the two spaces, some of which I want to share here.

My observations so far show me that yoga and analysis both provide me with the structured environment needed to gain insight and understanding of what it is like being me. Both invite an examination of my limits and how to negotiate them. How do I approach and define my lived averageness, my unwanted parts, my imperfections, my being human? How do I aspire for change without engaging in self attack? Can I bring awareness to parts of myself I am blind to, that shape my existence and yet I feel no connection to? Thinking about yoga and doing yoga are two very different experiences. Likewise the true impact is an embodied experience that can only be known through the doing. Feeling fit and flexible is not as I imagined. Sessions are always effortful and uncomfortable regardless of my experience in my practice and it does not offer a peaceful utopia although life is absolutely qualitatively different when I practice and for me life is also improved. For all of this, the same is true of my experience of analysis.

One of the initial curiosities I had with yoga was my instructor’s supreme confidence and ambition in the possibilities of the shapes my body can make. Without giving too much detail about my body I hope you are more or less comfortable with knowing that my feet are big and mostly unresponsive. I would attend yoga classes and whilst mid-downward dog (this is white lady yoga), have this fascistly enthusiastic women shouting ”lift your arches, spread your toes” - to me seemingly impossible and trivial tasks. My toes do not spread or arches lift and what difference would it make if they did anyway. They are still, fixed even, and it has been like this for as long as I can remember - I get about my business just fine. I have never ever considered my lack of toe stretch an impediment. Yes of course it could be improved but my feet do the job they are supposed to, they get me places. I am able bodied. It surely was a pointless, irrelevant alignment and she was wasting my time ignoring the bigger more impactful aspects of my woeful physical landscape that needs attending to.

As the weeks and months rolled on I became aware that despite my best efforts to ignore her, the foot task had become firmly fixed on an agenda for me. With her continued insistence I began to pay attention to my feet, I also began moving through a range of reactions to this attention - hilarity, awkwardness, play along, shame, hopelessness and occasional panic. Finally curiosity. Why did she remain so insistent? What might she know? If she is right and there should be a connection between her suggesting I spread my toes, me thinking about it and then it occurring, why wasn’t it happening? Was her just telling me repeatedly whilst I mentally willed an impossible physical action enough to really make it occur? If there is no felt connection how do you do things differently, how do you bring alive connections you can’t see or feel? Even if I did, what difference could it possibly make? My feet are really not that important, are they?

The short version of this anecdote is: I don't know how or why things changed, I just know they did. Whilst my toes are in no way in toddler reach territory, they definitely do now offer significant and effective stretch. My arches lift, a bit. This has in fact gently but profoundly impacted my alignment across my entire practice and made so much more possible. I am more stable and grounded in a way I was not previously and that I had not known was lacking. Who knew? My yoga instructor apparently.

I also now have an awareness of the importance of trusting the entire process: I do not know what I do not know and sometimes it requires a guide to help switch the light on and show me the way out of the dark. This change however, requires humility. My resistance to being open to her guidance and my refusal to acknowledge the possibility of her knowing something I did not, was exhausting and, I think, caused the majority of my slowness to change.

My analyst was doing a very similar job at the same time. He was sat with me giving me repeated instruction, coaxing my attention towards my underused and inert resources. He would repeatedly draw my attention to particular aspects of my relationships - more often than not my beliefs about, and my experience of, the other. He appeared compulsively to bring into our conversation compassionate reflections of the other’s part in my interactions. It seemed entirely unnecessary. I did not need to be reminded of the politics of sexism, or that black people having feelings, people being different from each other, or that there is the role of privilege to consider. I did not need to have this drawn to my attention because I knew this stuff. Really well. I had left the Mormon church decades ago, I wasn’t in that system anymore. Yes there is always a bit more work to be done, but not there surely. How guilty was I supposed to feel? It sometimes felt like a waste of time - we had my childhood to talk about. Surely we should be focussed on that? Eventually, over time I realised this was firmly on the agenda for me. I used humour regularly to try and bring the conversation back to what I considered the real issue. Occasionally I would feel some awkwardness at his comments, sometimes play along, then shame, hopelessness and occasional panic. Finally curiosity arrived and the light dawned. He was bringing my reality into grounded alignment. Allowing my emotional reactions to connect with their true cause. Helping me see that in alignment the world looks and is experienced very differently.

Another part of my yoga learning was the shock I felt discovering this exhausting downward dog pose I was working so hard at, was actually a “resting position” ! A space for me to collect myself in between more dynamic poses. In analysis this was equated to the shock I discovered in realising that my acknowledgment of my whiteness, my class, my education, my body, my privilege, are merely alignments to help with my resting pose in the dynamics of relationships. Just like my feet provide the foundation of physical poses, these aspects of my social self form the foundation of every interaction I have with the other. The work of actively engaging in a more conscious and ethical relationship with the dynamic real world is what we were preparing for.

A final thought: I have learnt from both yoga and analysis that my defences are guides towards reality and so there is huge value in noticing, attending to and caring for my anger, shame and guilt. As a result of these two endeavours I can hold myself in discomfort for longer, knowing that discomfort, danger and pain are not the same experiences and that long as I resist any experience of discomfort, no growth can occur. In allowing myself to see who I really am I can also see how things might be and pathways forward.

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:

The Dream:

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?

By DrLibbyNugent, Apr 9 2019 08:35AM

I am part of a Facebook group for Clinical Psychologists in private practice. I find it a profoundly helpful group that offers support and reflective space when working in the world without the NHS structure.

A few weeks ago, a discussion was being had about resources for women experiencing vaginismus. This discussion was particularly holding in mind women from the Muslim faith. There was described an experience of being able to successfully work towards achieving sexual penetration, but not being able to achieve having the pain stop. At one point someone mentioned that they found working with this group could be challenging, as there seemed to be a push to be goal oriented; they often experienced this group of women as not very psychologically minded. These seemingly gentle observations sent off a panic in my chest. I went to reply, but have since decided to write this letter instead:

In some ways I should be the last person to be standing up as a voice on this subject of structural racism. I grew up in a mormon community which has explicitly a vivid white supremacist history. A history I am deeply ashamed of, but it only makes it worse if I deny its existence - seemingly absolving it through silence. However, if I acknowledge my own experience, then perhaps I can ask people of whiteness to think about our own part in perpetuating racist and traumatising cultural narratives.

The culture I grew up in was not only racist it was also misogynistic: teenage brides and polygamy being very much a part of the narrative. As a white woman, I learned to be obedient, particularly to white men (of any age post puberty) and to never expose any “not knowing” by them. If I did, it would have been my mistake, and therefore me to be thought accountable. You could be clever and outspoken, but only in service of the white male authority: the neck that turns the head so to speak. To achieve my obedience in a way that didn’t expose the aggression of this, I performed liking my role and displaying gratitude.

To be not only a woman, but a woman of colour, was the lowest status of all. It would have been unlikely you would have been chosen as a wife and therefore mother and as such could not be seen as useful or of value. I couldn’t acknowledge or think about this, and so didn’t. At that point I was in denial of my whiteness, my being inherently racist and having any white privilege. I justified my inaction by believing that this was someone else’s fight and that my silence was neutral. I wanted to see myself as just a good person that wanted to be picked.

My brothers had a different narrative in our culture. From a young age they were told they were very special and their role was to spiritually care and financially be responsible for the well-being of others who were less capable - namely lower status people. My brothers’ prayers, we were told, had direct communication with god; as such they needed to take this responsibility seriously and invest in their own spiritual development: the closer they were to god the more useful they would be. To maintain their status they needed to be seen to be righteous and not contaminated by wrongdoing - past or present. They also wanted to believe that racism was someone else’s fight and that their silence was neutral. They just wanted to meet their responsibilities.

In my late teens I left this community. Part of my leaving was that I knew I needed more from life and I wanted to use my brain and celebrate it. At some point I found clinical psychology - it seemed like a career that I could maybe have it all. I could stretch my academic self and really grow. I ditched god and men and found rationale science and feminism; I had swapped prayers for reflective practice.

I thought my psychologist role was solely for good and was about being a responsible caring person, helping other people less fortunate than me with their emotional pain - and in the NHS, where they didn’t need to pay. I was aware not many people of colour were chosen to be in the profession, but I couldn’t bear the thought of thinking about this and so I didn’t. I decided the lack of diversity was probably best dealt with by someone else, as I was aware if I started to speak I might well expose my own racist heritage and I couldn’t afford to be exposed as broken or bad. I just wanted to meet my responsibilities in the least troublesome way possible.

Oh dear.

You can take the girl out of the Mormon but it’s much harder to take the Mormon out of the girl.

My career progressed and I became aware I needed some help to be a better therapist for my clients. I had the answer: go to therapy! You know, for work. In some ways I wasn’t wrong.

When I started psychoanalytic therapy I had a shock:

I struggled with my therapist that he would not tell me what to do.

I struggled that he would not acknowledge how good I am, how nice I am.

I was offended when he suggested I might be full of anger and pain.

I struggled to notice and connect with my internal world.

I struggled to be psychologically minded.

Why? Because asking me about my shame was like asking a fish how the water is and their reply is: “What water?”.

“Psychological mindedness refers to a person's capacity for self-examination, self-reflection, introspection and personal insight. It includes an ability to recognize meanings that underlie overt words and actions, to appreciate emotional nuance and complexity, to recognize the links between past and present, and insight into one's own and others' motives and intentions.” wikipedia, 03/04/2019

I didn’t ‘know’ when I was drawn to clinical psychology I was replicating a pattern from my traumatic childhood. That I was looking for a new ‘right answer’ on how to live life that didn’t challenge my learned self-image. Now I do, and it has been both a painful and enriching awakening.

My lack of insight into my unconscious motivations (my lack of psychological mindedness) to be a clinical psychologist is not unusual. I suppose what is less usual in professions that work at least in part as psychotherapist, is that as a culture psychology has relatively little interest in having these motivations drawn out into the open. Personal or group therapy is not essential to complete training and only a small number of people chose to attend, even fewer are categorised as having ‘lived experience’.

Although personal narratives are intellectually regularly acknowledged there is a curious silence surrounding the felt pain of our collective histories and possible subsequent enactments.

Intellectually, we know that silence is a form of avoidance and acts to deny pain. We also know that social and cultural groups can hold collective trauma and cultural wounds; they become the building blocks of the social unconscious. When this pain is kept out of consciousness we project our anguish onto others, typically sub groups, and they become the traumatised bad object; the scapegoat who we accordingly determine are just not psychologically minded enough.

When I read the Facebook discussion it reminded me of my own and my brothers’ behaviours in the face of the Mormon culture: racism silently active in denial of its context and living with the conviction that there are only kind intentions being exchanged. I suspect anyone in the Facebook discussion group who did have conscious concerns did not express them, for fear of being “ too harsh” and then the abusive gaze being turned back on to them.

The profession of clinical psychology is actively both avoiding addressing, and also in its silence perpetuating, structural racism. The Facebook discussion was perpetuating the belief there is an “us and them” and that the models used were not effective because the Muslim women were somehow lacking an ability to “get it”. I am suggesting that the lack of psychological mindedness, (due to unacknowledged trauma) belongs in our culture and does not belong to those subgroups who do not ‘get’ our models. We are just like the Garfield cartoon character who wants to lose weight quickly and so surrounds himself with fat friends.

This scapegoat way of thinking does not just extend to the ‘hard to engage clients’. Clinical Psychology is one of the least diverse health care professions in the NHS. As a group, we know this is not an accident; I don’t think many of us view this as acceptable. What do we ask our members with colour to carry in service of the white privilege narrative?

We know we need to stop perpetuating the cycle - but how?

I believe we need to own our own traumas. We know British culture has a violent history of slavery and that the profession of psychology has acted abusively: IQ testing, Human Nazi experiments and the Aversion Project to name three hideous examples. We need to understand ourselves as a profession trying to survive in treacherous times and bring into consciousness our pain and shame so that we can heal and thrive.

We need to make space for people collectively to explore these dynamics, allowing a range of perspectives, not only to acknowledge the cultural abuses and wounds, but also the pain of each group member and for them to be held and attended to. Maybe if as a culture we start to take into account all of our wounds - and not continue to avoid them, we can stop requiring subgroups to be scapegoats for our pain.

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