Anxiety and Other Mental Health Issues Nullify Reproductive Culture
Effective talk therapy relies on complete privacy and trust between patient and therapist. These are the basics of the open, frank and difficult conversations necessary to get to the root of personal problems. But in several of my recent sessions, it felt like there were more than two of us in the room.
In a world increasingly hostile to differences of opinion, my patients and I are afraid to use our voices.
the full-spectrum cancellation culture overreach is making its way into therapy offices, which is worrying for clinicians and patients alike. Both sides must feel safe from litmus social tests and politically motivated legislation that restricts conversation and reduces complex psychological issues into good and bad ideological positions.
Mental health is best served when therapy is not just faith-based but helps people make changes in their lives. Such change occurs when therapists use their expertise to promote self-awareness in patients, which patients can then act upon. Behavioral changes can be as subtle as apologizing for a mistake or as profound as leaving an abusive relationship. If the patient or therapist is walking on eggshells, the possibility of meaningful dialogue that leads to such healing is greatly reduced. Yet in a increasingly hostile world for differences of opinionmy patients and I are afraid to use our voices.
In some cases, the fear of social repercussions creates a new type of isolation and anxiety that makes it difficult for my patients to process their emotional responses to events, even with some of the closest people in their lives. One of my patients, for example, has a transgender daughter. As she travels this journey with her, she often complains to me that she has to put on a false front to the outside world. “Expressing anything other than joy that my child is trans makes me feel unsupported and risks criticism, or worse. I only feel safe to tell you all my complicated feelings. I love my child and will defend her to the end of the world, but I need time to assimilate this change and come to terms with it. Her legitimate fears that others will hear her struggle as a lack of support led her to distance herself from friends and family and delete her social media presence.
Another patient, a faculty member at a university, suffered an abrupt tenure review because he held a different conservative view than his colleagues. This experience led him to go to therapy because he couldn’t sleep and was afraid of losing his job. He was vulnerable and feared being misunderstood, so before he trusted me with the details of his situation, he spent many sessions ensuring that my inclinations on matters related to his field would not affect my view of him. “I don’t understand how they can espouse academic freedom when they expect me to toe a line that’s the opposite of that,” he told me. I reassured him that I was there to offer him the help he needed, regardless of my opinions, and that there were no political lines he had to follow during our sessions. Giving him the opportunity to speak openly about his beliefs was essential for his ability to continue to function in his work.
The very palpable reality that having a different point of view is not only uncomfortable but also potentially dangerous makes it difficult for someone to speak their truth. If patients’ self-expression might cost them their jobs or their friends, it’s hard to argue that they should share their thoughts. Yet, as therapists, we know that staying silent leads to distance in relationships and damages people’s self-esteem.
To complicate matters further, the reality is that therapists are no more culturally immune than patients. Opportunity to give and take can only occur when there is mutual trust and the penalty for a violation of that trust is the injury of a misunderstanding, not the revenge of a lawsuit or the defamation of social networks.
However, some states have passed laws stipulating that doctors can’t discuss options with their pregnant patients and that teachers cannot discuss LGBTQ identity with students. It is not unreasonable to conclude that therapists might start to look over their shoulders and worry about the potential fallout if they bring up certain topics.
The fear is particularly acute for therapists working in an institutional setting that might already be covered by those laws, laws that can go so far as to dictate what can and cannot be discussed in session. Whether it’s supporting a young person’s decision to come out to their parents or asking questions about the presence of guns in the home, the content of these sessions can now seem risky for job security. There is also a real concern that someone could record a session and publish it.
There may also be barriers that patients erect themselves with therapists. Historically, therapists have worked with people from a variety of backgrounds with a range of issues different from their personal experience. For example, as a heterosexual woman, I created therapeutic relationships that helped male patients and members of the LGBTQ community. But in our current climate, a difference in identity can be perceived by patients as a sign that their therapist does not understand their situation and can be a reason for mistrust. Yet it is both unrealistic and limiting to expect therapists and clients to fully reflect each other’s experiences. In fact, respecting differences is part of building trust.
At the same time, I am aware of the ways in which I am sometimes the one who put limits on interactions. During the pandemic, I found myself asking patients about their vaccination status and mask use out of concern for my own health. As a healthcare professional, I was within my rights to request this information, but my questions about vaccinations and mask requirements made my position clear to all of my patients and could have alienated those with points. of different view.
It is imperative that patients can be open about their real concerns – no matter how unpopular their views may be – if they are to get the help they need. Clinicians too need to be open and trust that their words will not be taken out of context and weaponized against them. There are no easy answers here, but avoiding difficult conversations is certainly a recipe for disaster for therapists and patients alike.
The dangers of cancel culture make it all too easy to seek comfort in echo chambers and resist exposure to dissenting opinions. By standing up against legislation and challenging cultural norms that aim to shut people down and divide us, we can help fulfill the promise of therapy as a place to address the whole human condition. Our world desperately needs more bridges and fewer silos.