Hello! I have recently completed my MSW and am doing a lot of independent research towards a macro level social work practice model. I've been slowly bringing over Substack notes that act as a "thinking out loud" space for me to consider the readings. I am also putting together my own theoretical framework for a diagnostic tool with the goal of putting the social world on the analysand's couch. Here's my first note - any feedback would be very welcome!

I’m finally getting curious about the world again post-graduation from my MSW and am starting through my book pile, beginning with Kenneth Gergen’s Relational Being. I would love any discussion!

One thing I’m really enjoying is the fruitfulness of measuring Gergen and my ideas against one another. Here at the beginning, Gergen and I are having some hefty ontological disagreements. He rightfully advocates for a model of self that serves as an alternative to traditional Western conceptualizations of an individualistic, bounded self. I join him in this project, and propose the Greek middle voice as the structure of an "agent-in-the-world." I'll spare the lengthy explanation to summarize this as: I produce the action in the social world that returns to produce me.

Where I first diverge with Gergen is his notion that the bounded self is the problem - he calls it a prison - and relational being is the solution. We are both lovers of Buddhist thought and many of these ideas infuse our scholarship. But taking dense religious concepts like nonduality and emptiness, which he expresses by locating the self as a wave that recedes back into the water and then putting them to sociological and psychological work doesn’t hold for me.

Firstly, I don’t see bounded self as pathology to which relational being is the cure. I admit, he may have a more nuanced position behind relational being, but it looks a lot like a less structured version of how Chinese sociologist Fei Xiaotong (From the Soil, 1947) talks about differential modes of association. For Fei, Chinese identity is construed relationally, though a self is still present. Instead of Gergen’s dance or duet metaphor that entirely disappears the self, Fei posits a social structure like concentric ripples formed by throwing a stone into a lake with a self at the center.

If this is not a picture of relational being, then I may have misread Gergen. But with Fei’s model, the pathology diagnosis cuts both ways. Let’s take the idea of narcissism, something that Gergen specifically pointed to as evidence of pathology of a bounded self. Chinese culture has this, too, from what I observed when I was over there. They call it zilian, or self love. But when I pressed the idea in my conversations, as opposed to a bounded self’s hyperinflation of it’s own ego, zilian looked more like a relational self’s hyperinflation of others’ estimation of the relational self’s ego. Relational constructions of being seem to suffer pathology as much as bounded self constructions of being do. The diagnostic tool is capturing the wrong thing as far as I can see here at the onset.

My counter is that this is a both-and situation. The self is just as ontologically significant as the thing to which the self is relating. While Gergen only talks about relations among selves as of chapter 2, I would extend relata to not just include other bodies but also matter and environment, and samskara (a Buddhist term for mental constructs).

Nonduality and emptiness are still relevant to me because even though there is actual hardware with bodies and matter, our interpretation of that hardware is effectively the only thing we have access to. So in that sense, yes, subject-object relations is empty. And, as Thich Nhat Hanh once said, I fully agree that with this ultimate view in mind that “if the wave is capable of touching himself and the other waves very deeply, he will realize that he is made of water. Being aware that he is water, he transcends all discrimination, sorrows, and fears.” It’s a powerful image.

But my picture of self-within-reality, at least while we are all out here relating to one another, would not be the wave and the ocean. It would be the jewel net of Indra. Here, a 3D positioned net has a jewel on each knot. And each jewel is cut in such a way that it reflects every other jewel on the net. It preserves the interdependence that Gergen is gesturing to as well as the self represented at each knot. Whether or not this all recedes into an ocean at the end is not in my purview. But I am a social worker who wants to do transformative social work, and I think we need a both-and picture of subject-object relations.


Originally posted by u/Great-Alfalfa-8543 on Reddit.


Top comment by u/ProgressiveArchitect

I propose Lacan’s split-subjectivity as very explanatory of the mechanisms which then lead to the development of a "self”and Lacan’s concept of Extimacy explaining the inter-psychic / intersubjective process of Buddhist interpenetration.

Additionally, Lacan’s concept & goal of "subjective destitution" is almost the equivalent of Buddhist Non-Self. (anatta)

Lacan is also a social constructivist and social constructionist of sorts, but through the medium of semiotic linguistics & discursive structures. So it’s a natural fit for the model you are putting together.

 

I've been thinking about how therapists handle difficult emotional reactions to clients and would be interested in others' perspectives.

Clients may be angry, provocative, demanding, manipulative, sexually inappropriate, or simply difficult to be around, and our own histories and sensitivities make reactions inevitable. The question is how we use them.

I'm analytically trained, and understanding personality, defenses, transference, countertransference, and relational patterns helps me explore what's happening rather than simply taking it personally. For example, some male clients relate to women in highly sexualized ways. That can be uncomfortable but may also be important clinical material: can we help the client recognize the pattern while maintaining appropriate boundaries? At times, however, firm boundaries or termination are necessary.

What interests me is the distinction between having a reaction and letting it determine how we practice. We all have limitations and populations we may not be equipped to treat. But when does routinely taking a client's behavior personally signal a need for self-reflection rather than a reason to reject the client?

How do others distinguish between a reaction to work through, a legitimate boundary issue, and a client or population we should not treat? How much do theoretical knowledge and emotional maturity factor into that judgment?


Originally posted by u/Commercial-Gur-5399 on Reddit.

 

This might sound like a strange question, but I’m probably writing this out of despair. I’ve been diagnosed with CPTSD, and I’m not a professional. I also don’t know much about critical psychology. Only a little having read some articles about critical psychology etc

My question is difficult to put into words, but I’ll try. I live in a country with a relatively stable social system (whatever that really means). However, I have to obtain a Krankschreibung (a sick note from a doctor) every four weeks.

At the moment, I’m not getting these sick notes from a psychiatrist because all three psychiatrists I’ve seen so far have been somewhat subtly reproachful towards me. Comments along the lines of, “How come you’re not well enough to work after so many months?” have left me feeling judged rather than supported. I haven’t found a therapist for Cptsd after contacting 60 therapists.

There also seems to be an underlying expectation that you should take antidepressants because they’re often presented as the go-to solution for everything. And there’s this strange power dynamic in which I, as the patient, am expected to agree with the professional rather than have too many opinions about my own situation.

It’s difficult to explain, but I hope you understand what I mean.

I’ve now given up on psychiatrists altogether and will be going to a rehabilitation centre, not for addiction treatment (I don’t have addiction luckily) but because of my exhaustion and trauma-related difficulties. They call it medizinischer Reha here.

However, I’m afraid the same thing will happen there. I often get the impression that professionals don’t particularly appreciate you standing up for yourself or expressing your own perspective, especially when you don’t simply agree with everything they say. That doesn’t mean I’m thinking „Nope I’m not doing anything, I’m just being stubborn and not trying anything.

Please don’t get me wrong. I have nothing against medication, and I know that not every professional is like this. I’m describing my own subjective experience. But it’s incredibly frustrating to be in a position where you need professional support and, at the same time, feel that you have to defend yourself against the very people who are supposed to help you. They read my past assessments and see I’ve been experiencing domestic violence from the time I was born, violent father, and abuse for years.. except treated with kindness I tend to get this strange attitude where ppl are suspicious.

Now anyone could say „oh that’s a trauma response you are generally suspicious about authority“ but that’s not it.

I’m exhausted by this dynamic, and I honestly don’t know how to navigate it anymore?

I wonder if that’s my own selective perception


Originally posted by u/ProfessionalEbb911 on Reddit.


Top comment by u/HELPFUL_HULK

Many people report such paternalizing and dismissive attitudes from psychiatrists - in my experience and personal opinion, psychiatry of all the psy fields tends most toward dehumanization, which is in part a structural issue. Needless to say you're not alone in experiencing it, even if your own perception is at play to some degree.

I've also had many experiences of doctors becoming offended when faced with any degree of pushback on their sense of authority and 'professional opinion'; but I've also had psychiatrists who were quite humble and open-minded. I have found myself learning to stick up for myself in strategic ways that do not offend the egos of the practicioners I'm navigating the system with, which has come from years of experience of being dismissed; but also from years of experience of trial and error with various psychiatric meds. (In the UK, it also generally requires acknolwedging that they are often bound by cost-effective systems which require patients moving through "first-line" treatments before trying other ones.)

I'd imagine there's a significant chance you'd experience different treatment in a recovery centre, but that's impossible for me to affirm at large as it varies per culture, per centre, and per practitioner. It is a constant issue in any given healthcare system, but it is also one that (IMO) varies per different fields within health systems, as it intersects with structural issues and people's varying investments and tendencies as practicioners.

Perhaps worth searching for and connecting with survivor support networks in your area, or online. Peer support can be life saving in navigating these systems.

 

It's really a bummer that everyone who seems like a halfway decent MH provider is doing private pay only.

I understand all the challenges and complexities that insurance brings, but in a mental health care system where the majority of providers simply aren't actually that skilled and where the ongoing quiet crisis of late stage capitalism is grinding us all to dust, it'd be cool if folks with genuine empathy didn't reserve it for a narrow socioeconomic demographic. I'm just perplexed by the number of people doing it who have all these leftist, socialist values and then...

I have a decent job with good insurance and a ton of debt so while I'm probably squarely middle class, I can't afford it and a lot of people are a lot worse off than me.

The whole field feels like such a sham in so many ways but this is just one of those ways coming from a group of people I wouldn't expect whose values and practice don't seem to match up.

Agree/ disagree?


Originally posted by u/sabo_cat_x on Reddit.


Top comment by u/Rebsosauruss

I used to feel exactly this way. I'd get resentful when private pay therapists charged their full rate and wonder how that could ever be fair or sustainable for clients.

Over time I've come to see it the opposite way. If we don't value care work, including our own, we feed the same system that underpays and burns out the people doing it. Therapists charging a living rate isn't the problem. A system that doesn't fund mental health care is.

Accessibility still matters to a lot of us. Many therapists offer sliding scales, like the Green Bottle method, so people can pay based on their actual resources. It's worth asking about when you reach out.

And when I noticed how much resentment came up for me around this, it turned out to be worth getting curious about where it was coming from.

 

sorry if this is off topic, i really don’t know who else to ask about this.

basically back in march i attended a peaceful protest that ended up having heavy police presence and all it took was one small thing and suddenly i was seeing protesters get brutalized really badly by police and i left because i was terrified.

fast forward to today, more protests regarding the same issue are picking up again and because i still run in these circles, I’ve been asked to come a few times but i’m still terrified after that last time and the thought of being there again around so many people and so many cops makes me feel like i’m going to vomit.

has anyone else experienced this and how do you recommend i stay involved with the movement while afraid of being on the frontlines again?

once again sorry if this is off topic


Originally posted by u/Just_Lime5134 on Reddit.


Top comment by u/Wackrobat

There are many ways to be an activist. Ways that help people directly right now. Mutual aid, networks, community building, skill sharing/teaching, organization, etc…

Not everyone has to be a frontliner in the Revolution. The lesbians that took care of gay men with AIDS during the crisis are just as important as the queer people that torched cop cars during the White Night Riots. We all contribute in our own ways using the skills and resources we have access too.

That’s one of the big reasons I became a therapist specialized in queer populations. These are skills I have accumulated with the resources I’ve had access too and I will use them to help people who need it right now. I also host community convos on how to do/organize activism in sustainable ways to avoid burnout.

 

I'm hesitant to ask this specific question because most people aren't disabled and can't relate. But I felt more comfortable asking a more progressive group. Fingers crossed.

How do you feel about therapists wearing masks during sessions?

I have a neurological disorder that causes tremors throughout my body and muscle contractions in my face. I wear a mask everywhere I go to avoid being harassed and humiliated.

I'm just nervous about being deemed "unprofessional " in session. But I don't want my movements to distract clients.

My therapist told me to unmask during sessions but she has a radical mindset. I'm trying to keep clients on my schedule so I can get paid.

Any comments telling me to get a different job will be blocked, deleted and reported. That's not a option rn.


Originally posted by u/Disabledgoddess2 on Reddit.


Top comment by u/LeftyDorkCaster

I masked for in-person sessions for years, and it only ever bugged one client (who had specific medical trauma). I do all remote now.

Do it and fuck the haters. If any client asks, just name that it's part of your own disability justice practice. Especially if you're open about having a liberatory therapeutic approach, your clients will either have further questions to learn and consider their own feelings and praxis, or they'll be like "Oh, cool. Anyway about my parents..."

 

Has anyone ready Psychoanalytic Liberation Psychology by Nick Malherbe? Care to share your thoughts? Comments? Criticisms?

I’m a first year graduate student and am in a psychodynamic class and also an integral yoga/multicultural counseling class. I’m finding myself having a hard time connecting to psychodynamics so far (only really have gone over some Jung, Freud, Winnicott, and this week Kohut). There’s pieces of psychoanalytic theory and depth psychology that I feel passionate about and want to incorporate into my practice one day, but there’s also a part of me that is so disgusted by the history of psychoanalysis and its complicity with injustice and capitalism that it’s preventing me from wanting to better understand psychoanalytic theory beyond what I currently know now (which is pretty surface level but still feels powerful.) ESPECIALLY when it comes to Jung. I know he’s extremely foundational to depth psychology, but I can’t get myself to give AF about what he has to say because of how much of a horrible person he was and how all his theories were built through a lens of racism, sexism, homophobia, etc.

Anyone else have moments like this in graduate school? I’ve started looking for literature that incorporates anti-capitalist liberation psychology and psychoanalysis/psychoanalytic theory and it seems like the Nick Malherbe piece I’ve mentioned is a good place to start.

Thanks in advance!!


Originally posted by u/harnessurhopes on Reddit.


Top comment by u/ASoupDuck

I haven't read the book you're referencing but I personally found these 2 really great at exploring cases+theories from leftist psychoanalytic perspectives:

Psychoanalysis in the Barrios: Race, Class and the Unconscious edited by Patricia Gherovici, Christopher Christian

Psychoanalysis under Occupation: Practicing Resistance in Palestine - Lara Sheehi, Stephen Sheehi

I haven't read it yet but I have The Capitalist Unconscious: Marx and Lacan by Samo Tomsic on my list.

Personally I did not like Jung much either, I have meanwhile really loved Lacan's work, though a bit of a project to understand it all.

 

Alright here it goes again because mods called my post low effort.

Essentially I study graphic design and I am currently writing my thesis on Antipsychiatry, Mad Liberation and Consumer/Survivor/Ex-Patient movements. Now you might wonder why I am writing a thesis on this within the field of graphic design?

It’s because I think it’s very important and close to my heart and I’m very tired of the dispersed movements and non-understanding of our struggles in a broader context, so I am theorising that it’s a communication issue and unfortunately that we have fragmented our own movements that overlap in many ways.

Essentially I am talking about these movements in terms of a broader context of hermeneutical injustice, where the language or the collective understanding might be fragmented and therefore does not bring epistemic justice to the collective that have experienced horrific things, but also in terms of testimonial injustice where the subject is rendered irrelevant as a knower due to judgement on their identity as a subject. Further into communication theory, Habermas made a theory comprising of the ”public sphere”, which by Habermas was understood as a way to shape society by having a group of people assembling and forming ”common sense” or consensus. But other communication theorists have argued that there are people that historically and contemporaneously have been excluded from the public sphere and therefore formulated the theory on ”counterpublics” which constitute smaller collectives outside of the conception of the public sphere which can establish their own ways of communication and recognition of one another, such an example would be that at some point the notion of ”sexual harassment” did not exist, and this was formed by counterpublics within women’s circles until it spread into the public sphere.

Now I am applying this theory onto psychiatric survivors, mad people, consumers, ex-patients and so on to bring more accessible counterpublics and hopefully establish a wider recognition to these struggles.

In this search I now have to find a more general symbolic and visual language that can be used to express these zines that I’m planning to make as the actual graphic design part of the thesis, so where can I find this? Are there any symbols associated with us? Any images? Videos? Pop culture? Games?

This is my most urgent question, the second question is, how can I do this fairly and do you have any ideas or want to contribute somehow? My idea is to make some resources on psychiatric drugs, institutionalization, poems, history, stories, radical psychiatry, movement explanations and differences.

TLDR; I am writing a thesis in graphic on antipsychiatry, mad liberation, consumer/survivor/ex-patient movements, I need help finding visual resources and symbols for my zines that will be the visual product. Any other recommendations or ways to go about this and what I could contribute with in these zines?


Originally posted by u/Shot-Entry-3178 on Reddit.


Top comment by u/HELPFUL_HULK

The newly published CERFI - Analysis Everywhere should be right up your alley. Free digital copies available on there. Schizoanalytic so lots of overlaps with mad and antipsychiatry movements, albeit from the counter-perspective of 'institutional psychotherapy'

A bit more tangential but the counter-cartographic book This is Not an Atlas also might be inspiring!

 

Here is a Wikipedia article explaining the topic of this video: https://en.wikipedia.org/wiki/Institutional_psychotherapy


Originally posted by u/ProgressiveArchitect on Reddit.


Top comment by u/toadslimerick

This is a great topic, but I cannot not criticise this video's emetic style of propagating the information. Particularly because the movement involved art as therapy, I believe this point goes beyond mere online nitpicking. After I read some of the comments on a recent post here, I relistened to an interview with the scholar Camile Robcis on a podcast titled Uncovering Radical Psychiatry and Institutional Psychotherapy in Postwar France, put out by Mad in America (I don't know how to link to video on Youtube). Admittedly, the interviewer was kind of awkward, but it'd probably be of interest to some of you folks.

 

How do you handle people who’ve deployed into your country and possibly been part of the effort to destabilized it? If they refer to your ethnic group in derogatory terms while they share with you vulnerable information especially pertaining to ptsd how do you deal with it? Or do you refer them? Not take them at all?

NAT I’m a first year MA psychology student just curious though.


Originally posted by u/Sea_Report_7566 on Reddit.


Top comment by u/wavesbecomewings19

I don't take them unless they're anti-imperialist.

 

I'm going to get downvoted significantly but it's my truth.

As I am diving more into clinical work, I notice the hive mentality many clinicians have. If you have a different outlook on something or you acknowledge that not every client may benefit from a standard or systemic approach, you're outcasted and deemed "unprofessional. "

I have been outcasted for saying something as small as self disclosure can be helpful when used strategically.

A lot of research and frameworks were created from serving white abled-bodied neurotypical people. Most people who are represented in research have most of their basic needs met like a home, money, community.

We're losing a significant amount of people in therapy because clinicians refuse to bend to others lived experiences despite the research.

Additionally, this is why continuing mental health research that focuses on marginalized populations is important.


Originally posted by u/Disabledgoddess2 on Reddit.


Top comment by u/sugarplumbanshee

I totally agree with your overall point that elevating lived experience in research is vital (let’s go PAR!!) I also share the experience of the other commenters, that this has not been my experience in the field, whether in my grad program or now working professionally. The idea that you’d be outcast for saying that sometimes self-disclosure can be helpful- something that is widely regarded as true- is quite frankly, absurd. There are better communities out there for you to be surrounded by, I promise!! I hope you get out of whatever toxic educational or professional environment you’re currently in and find those better communities and colleagues!!

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