I was teaching a class to masters students in counseling when I was challenged by a student how I could work with women or gays. This wasn’t a polite challenge, it was more of an accusation: Who do you think you are, believing that you can be an effective counselor for those who’ve had different life experiences as you? Wiping the flung tomatoes off my shirt, I explained that I can be an effective counselor for those who’ve had different life experiences as I, because it’s not about me, it’s about the client.
One way to suck as a counselor is to believe that you understand your client merely because you share a significant life experience. It doesn’t matter whether you’re both women or men, gay or straight, black, white, or share any ethnicity. It doesn’t matter if you practice the same religion, were both abused as children, both had substance-abusing parents, both are vegans or omnivores, conservatives or liberals, or both suffer from rooting for losing sports teams. Individuals come with a variety of life experiences, and one-size identity counseling does not fit all.
What do I mean by identity counseling? It’s whenever the adjective that comes before the word “counseling” is alluding to the client rather than the approach. LBGT counseling is alluding to the sex (or transformed sex) of the client. Feminist counseling alludes to the client’s lack of power in society. Christian counseling describes the client’s core beliefs. In contrast, brief, psychodynamic, Gestalt, and person-centered refer to the therapeutic approach of the counselor. I can and have worked with all the former, successfully, while practicing one of the latter, brief therapy. To me, each client is unique. It does a disservice to label them as belonging to either an identity group or a category of mental illness (which I’ll get to below).
Identity politics in counseling is far from new. The theories of those who founded modern psychotherapeutic practices—Freud, Jung, and Sullivan—all contained elements of cultural, religious, or personal provincialism. Their personal experiences and those of their clients were not as universal as these early theorists believed. Pioneers, however, don’t have the benefit of learning from the mistakes of predecessors, and later generations of counselors and psychotherapists should know that their personal issues are not universal. Over-identifying with your clients may be hazardous to their mental health.
The counter argument to mine is that some experiences so overwhelm that they define you. If true, that’s part of the problem. If accepting who you are means you’ve been colonized by identity politics, then you’re accepting how others see you, rather than how you see yourself. This seems to be a betrayal of the whole point of identity politics: don’t let the prejudices of others define you.
As with many things, identity politics started out trying to be helpful. Be proud of who you are, your background, your ancestry, your ethnic group, your gender, your sexuality, your genetically influenced body type, a significant life experience. Don’t let the majority culture disrespect you. Don’t fall into the Stockholm Syndrome of attitudes, where you agree with your oppressors’ or abusers’ beliefs. However, when identity champions become too influential, they can become the new oppressor, the new abuser. Now they’ll tell you the right way to think and feel.
Most counselors who use identity politics to market their services have a genuine belief that what they have in common with certain clients will be of great benefit in their work with those clients. And to a degree that will be true. But counselors who promote identity politics must be vigilant that they use their commonalities as the briefest of starting points in therapy; that they’re humble in their assumptions of how much they can assume about their clients; that they remain curious and respectful of their clients’ uniqueness.
I once did an internship at a clinic that resisted the trend to view personal problems from a systems perspective; the clinic remained steadfastly psychoanalytic. Case presentations would go something like this: The therapist would discuss the client’s issues and then state the difficulties of working with that client. As befits an approach that has little to offer in the way of a theory of change, rarely did any clinician offer help. Invariably, the dominant clinician would state that “this is a very difficult patient.” And, nearly on cue, another clinician would ask, “How do you see this client, diagnostically?” We played the diagnostic game and moved on. In my nine months there, I don’t recall a single presentation that ended in a new approach to the client.
A second way to suck as a counselor is to invest too much into diagnosing your clients. And how do you know what’s too much? As pointed out many years ago by psychiatrist Thomas Szaz, among others, psychiatric illnesses are diagnosed by only observation of behavior. There are no blood tests, urine analyses, or biopsies that tell a mental health professional that someone is schizophrenic, has a bi-polar disorder, or is clinically depressed. The chemical imbalance theory of mental illness is a pharmaceutical industry and psychiatric sourced fairy tale, where the promoting parties got to marry the very wealthy (if not necessarily handsome) prince.
Clients who have been in “the system” for several years, thanks to computerized medical records, will have shed personhood in favor of casehood. No longer will these clients be judged on their current behavior, because they carry the ball and chain of past diagnoses. And I will emphasize once more, those diagnoses came from the subjective minds of random mental health workers, many of whom—even when they mean well—are poorly trained, poorly paid, and overworked.
If you went into the counseling field, unless you were hugely misguided you didn’t do it for the money, you did it to help people. As a counselor, a necessary prerequisite to helping people is to respect them, and respect begins with treating people as individuals rather than as stereotypes. Just as with playing identity politics with your clients, focusing on a diagnosis is a way to ignore who is in front of you, to disrespect and dehumanize a human being. Obviously, that won’t contribute to curing what ails him or her.
In conclusion, the way to suck as a counselor is to ignore the human being in front of you, and prefer the brand, whether it comes in the guise of identity politics or the DSM.