While incredibly helpful therapeutic tools, many clinicians, educators, and social justice advocates have expressed frustration at the Window of Tolerance, the Polyvagal Theory, and other psychological concepts for their lack of focus on social-cultural sources of distress and trauma.
For all it’s gifts, psychotherapy is still very much part of the medical industrial complex; a system guided by a very niche definition of what “health” is and what the “right” or “wrong” ways are to “achieve” it. And, subsequently, a presumption that when it comes to the things we go to therapy for, therapists are, or should be, experts.
Now, don’t get me wrong. Therapists can very well hold a great deal of expertise. But, woven within our systems, there’s an often unconscious impulse - from therapists, clients, insurance companies, etc. - for this expertise to be absolute.
I recently learned the origins of the word “shrink” to describe psychotherapists. The term actually derives from the history of “head shrinkers,” which a brief Google search (here and here) tells me was a practice of an Amazonian tribe who would preserve the heads of their enemies by skinning the skull and shrinking the head. (Disclaimer: this was a very brief Google search and I’m sure there are more layers, but you get the picture).
While this isn’t what therapists do, the linguistic history here points to the power dynamic between providers and clients, and evokes stigma and shame as a result of needing psychological care. While it seems we are in a new era of mental and somatic wellbeing, this history is still highly relevant; we would be remiss not to explore our own embodiments of this history, conscious or unconscious.
Without inquiry, our collective tendency toward expertise and evidence-based practice keeps us locked firmly into the characters the system needs us to play. Because human bodyminds are so complex, while expertise is important, curiosity is even more helpful. Yet, I know so many therapists who feel they must continually be getting certified in something new, or can’t shake the impulse to be everything for everyone. Clients aren’t immune from this either. So many of us come to psychotherapy with the hope of being “fixed”.
As I re-build connection to the lineages that inspire my work and pay attention to the factors outside of session that change my clients lives for the better, this question keeps coming up for me:
Are therapists stand-ins where community, culture, and traditional healing have been colonized, suppressed, or invisibilized?
Because the truth is that, while psychotherapy can be incredibly magical, it’s not the only way to experience healing. Effective therapists already know that people need more than therapy. That money and shelter and quality food are prerequisites for wellbeing. That opportunities for safety and belonging have to be present in our lives.
I think often of the history regarding Maslow's Hierarchy of Needs. How Maslow "borrowed" from a Blackfoot Nation model to create his own. How interesting that Maslow categorized Self-actualization as a final destination rather than a birthright and basic needs. It makes me curious: what are the implications of assuming that a person needs something before they can be themselves, heal, decide what they want for their lives?
Us therapists, we have a lot of great insight about how positive change happens. But, I think, we aren’t doing our job if we assume our insights are always right. Because then, we’re just perpetuating this idea that there are right and wrong answers, and that credibility comes from blanket expertise, rather than community values or personal wisdom.
All that to say, I consider the WoT model and PVT useful educational tools as long as we are honest about their limitations and situate each individual within their own unique context of safety and danger. These are frameworks to be expanded on and re-contextualized.
And, I trust that as more leaders of color, more queer leaders, more disabled leaders voices are centered we can develop more complete models for doing this work. Resmaa Menakem’s work has been seminal in rebuilding the context of historical, intergenerational, persistent institutional sources of trauma in addition to personal sources of trauma (he calls this the HIPP theory). Amber McZeal has been running a series on decolonial somatic practices that addresses this concern as well.
I’m personally excited to be a therapist at a time where we can evolve this work with tender intention. There is so much value in using what we have while exploring what else is out there within our cultures, or has been lost to colonization.
Menakem, R. (2017). My grandmother’s hands. Central Recovery Press.