The practice of psychotherapy is not for sissies. An agreement to engage in a therapeutic relationship becomes, in many instances, an invitation for one human being to accompany another into the darkest, most terrifying spaces in the cosmos: the depths of the human psyche. It's a private space, the boundary of which is held and protected by the therapist so that the patient can explore those depths as far as they choose to without harm.

That's why I find myself at odds these days with the Tennessee Legislature and with Governor Haslam, who recently signed HB1840 -- the Counseling Discrimination bill -- into law. With his refusal to veto this bill, Gov. Haslam took us outside the boundaries of reasonable rules of practice into nanny-state meddling and legalized assault against the LGBTQIA+ community.

The state of Tennessee requires that I have a license to practice therapy. To maintain that license I have to play by the rules, which include completing a minimum number of continuing education (CE) hours every year. Not that many years ago, rules for professional counselors, marriage and family therapists and pastoral counselors were amended to require that 3 clock hours of professional ethics be included in the total number of hours required in each 2-year license renewal cycle.

Ironic, isn't it. My practice board (the members of which are generally appointed by the Governor) seems to value ethics competency enough to call them out specifically in the rules. Yet the Governor and legislators in Tennessee can make a law that specifically invalidates the codes of ethics for which professionals are held accountable.

Why do we have professional practice boards? Here's what the state of Tennessee says:

The mission of each board is to safeguard the health, safety and welfare of Tennesseans by requiring those who practice health care professions within this state to be qualified.

In other words, professional rules and standards are meant to protect the citizens using professional services. So why did Gov. Haslam sign a bill that changes the rules to protect therapists, instead, thus demonizing a specific subset of citizens?

Of course, supporters still insist that the bill also protects citizens needing counseling services.

Just days before Gov. Haslam signed HB 1840 into law, NPR's Steve Inskeep talked him on Morning Edition's special broadcast from Knoxville. During the interview, Haslam posed a question that I think is crucial to the whole discussion on HB 1840:

HASLAM: So on the therapist bill - I mean, the American Counseling Association says that you should always counsel from a valueless position. In other words, you don't put your own values into the conversation. You're there to help. I personally wonder, like - I think regardless of whether you're a religious person or not, everybody comes into every conversation with a particular worldview and things that you believe are right or wrong. And so I think the question is can you counsel from a totally non-value-based position?

When I heard him say this, I actually gave Haslam a spontaneous thumbs-up. What a great question! It goes right to the heart of the whole discussion about HB 1840. How can you counsel from a totally non-value-based position?

If you are a mental health professional, you have likely (I hope!) given huge amounts of time to study, contemplate, and consult with experienced practitioners on this very question. You think about the answer from your first day of professional training until you retire from practice...and maybe even beyond that. Really, can a human being do anything from a totally non-value-based position?

My answer is, we can't.

What we can do, though, is to cultivate awareness of our own values and worldviews. We can discover from the patient what they need to make the therapeutic space safe enough for them to do their psychological work. We can learn how to respectfully explore the subjective experience of people we see, rather than make people into objects. We can stay aware of the thoughts and feelings that arise when we're with someone, and explore these in self-analysis and with peers and supervisors to identify biases and unhealed aspects of ourselves that may create barriers to healing for the patient.

A decision about whether or not we can work together is best made collaboratively by me and the person seeking help. The standards of practice in my profession have always included ways to help people find the best care possible, even if it isn't from me. Respectful referral in a way that does not harm the patient is not a big mystery to those of us who do this work. We don't need interference from politicians to get it done.

One of the best ways we, as helpers, can be professionally accountable to the public is to take full responsibility for our own psychological health and development. That includes personal work that can take us into the dark and terrifying spaces of our own psyches.

Therein lies the gift, I think, that mental health practitioners of all kinds can offer to the world. Doing such work with ourselves and others allows us to see that discovery and full integration of human experience, no matter how dark and terrifying, is possible. Such a process, for one thing, liberates us from the inevitability of projecting our own fears onto others, seeing them as real, then needing to enact hateful, discriminatory legislation to protect us from terrors we have only imagined as out there.

See these related articles:

Counseling bill detrimental to clients' health (Letitia Flores, May 2, 2016 / Knoxville News-Sentinel)

Message from ACA CEO Richard Yep Regarding Tennessee HB1840 (American Counseling Association, April 27, 2016)

TN's HB 1840 Negatively Impacts the Mental Health of LGBTQ Youth (Statement from The Trevor Project)

Bill Would Discriminate Against Vulnerable Patients (Dianne Bradley, April 5, 2016 in The Tennessean)

Related articles

Bill Allowing Therapists to Refuse Service to LGBT People Becomes Law if Governor Doesn't Veto Today

Tennessee tourism parody ad hilariously exposes the absurdity of state's new anti-gay stance

[Cross-posted from Raising Cain.]

Recently I discovered a great blog -- Who's Afraid of Social Democracy -- by psychoanalyst Elisabeth Young-Bruehl. Today she posted an article on the subject of prejudice, and I thought I'd say a few words, toss in some quotes and post a link to it here at Raising Cain.

On her blog, Young-Bruehl writes about current affairs and reflects on contemporary political issues and questions. Prior to her psychoanalytic training, Young-Bruehl was a doctoral student of the political philosopher, Hannah Arendt, and eventually wrote her biography. Young-Bruehl has also written many papers and books on gender issues, as well as a book very relevant to her blog post today, The Anatomy of Prejudices.

Since I formalized my anti-racist journey by becoming an activist in organizational anti-racism transformation, I've spent much time integrating what I'd previously discovered about human relating and relationships from my psychoanalytic training and practice. The intersection of the individual psyche and the collective mind of society has become an edge of tremendous interest and discovery for me personally and professionally.

That edge is not an either-or space: we need to know a lot about how people come to be who they are AND how the collective mind and societal systems come to be as they are if we want to get beyond racism. The individual and society co-create each other psychologically just as, in a parallel process, a baby and her mother co-create each other. If we would like to change ourselves and the systems in which we live, I believe we'll have to become aware of these complex dynamics.

I have a sense that Young-Bruehl's last two blog posts have opened doors and moved my thinking about all of this forward.

Speaking about a changing view of the nature of prejudice after World War II, Young-Bruehl says:

That decade of psychoanalytic work was extremely important because it opened up for exploration the whole domain of unconscious motivation. But, to my mind, it was also very flawed and replete with misleading generalizations. For example, in Adorno’s and Allport’s books, there is no prejudice against women because all prejudice is against minority groups and women are not a minority group. (By the same crazy logic, there would be no prejudice against blacks in South Africa because the blacks are not a minority group there…) During the Civil Rights movement of the late 1950s, the ethnocentrism synthesis began to unravel under pressure from people whose victim experience it misconstrued or overlooked. People of color pointed out that racism is not just like anti-Semitism. Look, they said, did the white people who invented tests to show the inferior intelligence of people of color also try to show the inferior intelligence of the Jews who supposedly masterminded the international Jewish banking conspiracy?

She follows the evolution of this notion further into the feminist "gender-race-class" discussions of the 1970's, but notes:

Meanwhile, prejudices continued to flourish in ever-changing appearances. Nonetheless, many hoped to be able to interpret America as a nation marching in the direction of being “post-racial,” and many hoped a “post-feminist” era was dawning because women have made considerable social progress. These hopes, it seems to me, reflect the still-prevalent confusion about prejudices and how they operate. Even if the acts and appearances that are typical of a prejudice do abate or ameliorate, the needs or unconscious purposes served by the prejudices remain –and can rise up again or reassert or take new directions as circumstances change. There’s not much lynching going on now, but huge numbers of black men are hung up in jail, and that is not very “post-racial.”

With that, I'll leave you to your own investigation of Young-Bruehl's ideas. I get uneasy sometimes excerpting from pieces that seem so coherent as Young-Bruehl's impress me, so I hope you'll read her entire article.

She references her previous post as well, and you can access that one here.

For people in the Knoxville, Tennessee area, I'm pasting this notice from the Appalachian Psychoanalytic Society. If you are a mental health professional with interests in serving the LGBT population, you may also be interested in the seminar on Saturday morning sponsored by the Appalachian Psychoanalytic Society (APS) and also presented by Dr. Grossman: Developmental Considerations in Psychoanalytic Psychotherapy with Gay Men. CEU credit is available for attending the morning seminar. Information for both events is available at the APS link above.

Supportive Parenting of Gay and Lesbian Teens: Addressing the Challenges Faced by Gay & Lesbian Youth and Their Parents

Saturday, January 9, 2-4 p.m.
Tennessee Valley Unitarian Universalist Church
2931 Kingston Pike F Knoxville

This meeting is free and open to parents and other adults interested in learning more about creating supportive homes for teens who self-identify as gay or lesbian, or who may be questioning their sexual orientation. Parents of youth questioning their gender identity will also find the discussion helpful.

1. How do I respond when my child "comes out" to me, or expresses confusion about his or her sexuality?
2. How does my child "fit the pattern" of other gay and lesbian youth?
3. What do I need to look for?
4. What are the milestones in the formative years of gay and lesbian teenagers?
5. How do I foster positive emotional development in my child?

Our speaker, Dr. Gary Grossman, is a psychologist and psychoanalyst with over 25 years of clinical experience working with gay men. He has taught in a variety of academic and clinical settings on contemporary psychoanalytic perspectives on lesbians and gay men. He is Assistant Clinical Professor, Department of Psychiatry, University of California San Francisco; a member of the faculty of the San Francisco Center for Psychoanalysis; and the former Chair of the American Psychoanalytic Association's Committee on Gay and Lesbian Issues.

Sponsors
Appalachian Psychoanalytic Society
Greater Knoxville PFLAG (Parents Family & Friends of Lesbians and Gays)
Tennessee Valley Unitarian Universalist Church

For more information, contact Lorraine at 637-3293.