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Ableism and Therapy: An Exploration

Yes even therapy and therapist can be ableist. Let's explore it rather than shut it out. This blog post does just that- explores what could be a problematic issue within the therapeutic relationship. *art by @frizzkidart



What is Ableism?

Before we begin examining whether therapy and therapists can be ablest we first must look at and agree on a definition of ableism. For those of us who are disabled it is something that we unconsciously become aware of at an early age, preverbal many times. It is the feeling, and the belief that able bodied form is preferred and the norm leaving the disabled form to be discriminated against because it is "not worthy". This can be seen throughout society, and through the world and time. It is a pervasive ideology that has had dire effects on the population as a whole. Yet we still, as a population, engage in microagressions as it relates to ableism daily. (Have you ever said "Ugh I am so lame"? thats rooted in ableist language).


Can Therapy Be Ableist?

The short answer is yes.


This might lead you to the next question of- "How can this be when most therapists try really hard to validate and support their clients?"


Well lets take a look at history and some other cases of therapists thinking that they were doing something helpful but that in the long run was harmful. Here is a Content Warning for the rest of the article as well as I will be comparing traumatic historical events as a way to garner understanding.


The first thing that comes to mind is that of conversation therapy. The very sad thing here is that this is not of the past, but very much of the present.


Therapists, have acted in these programs for years believing that they were helping the folks who were forced into these programs. Rather than addressing their own biases around relationships, who should or shouldn't be in them, they instead "projected" their own beliefs. Some therapists believed that this was wrong and that they needed to be "fixed". Come to find out, that this kind of "therapy" and I use that term loosely, is extremely damaging to folks and has life long implications to their mental health.


Through this small explanation of a very large systemic issue (conversation therapy), we see that therapists are humans, and that therapy is a human thing, i.e. we create the space that is holding the client. Thus if the space we create has biases or prejudices in it, that will permiate the space. The healing space of therapy is not immune to the hateful rhetoric of oppression.


This is why as therapists, we must constantly be checking our own projections and privileges as providers. We must constantly be in relationship and communication with those who don't look like us and with those who think differently than us. To help us stay grounded in letting the client lead the healing rather than having us force our ideals onto the client.


How can this happen related to ablesim?


Well the idea that any sort of mental illness needs to be fixed is an ableist idea. To have a therapist believe this is not only harmful but also makes me think about those who do not find their mental illness problematic. Often this leads to conflict as the therapist will have one agenda and the client will, understandably not want to be "fixed".


Unless the client comes in and specifically says to you that they want you to fix them, that should not even enter the framework. Healing isn't linear, all we can do is the best we can do at any moment. This will change given the day and circumstances. This does mean though that nothing is ever truly fixed, but rather managed. Allowing space for acceptance of where they are, not the situation but rather the mental health that they occupy is a key mental shift we need to do as a mental health community.


We also need better training in how to manage physical pain and mental health. Many times therapists will move to breathe work and mindfulness meditation right away. Yes, mindfulness is historically proven to be helpful for some individuals, however when you are in tremendous pain, like a flare, and you cannot stand to be in your body, mindfulness is not the most grounding technique, or even the most accessible. In fact it can do the opposite of what was intended and it can actually disregualted individuals.


There is a sweet spot for mindfulness and pain and its right before the flare starts. Once it begins you need to just do what you can to manage it (ie heating pads, CBD, medication, napping etc). Once the flare begins to subside, or a space can be felt, then a space has opened for mindfulness again.


As a healing space, its about finding the space in the pain for people, allowing time to rest and recover rather than forcing people to show up in pain. We cannot force someone to heal mentally and we cannot force someone to heal physically. By allowing them the time to express it and be in it without trying to make it better we allow the skills to be built to do this on their own which is in all reality what the end goal is.


To witness, to be with, to validate. These are what therapy needs to do more of with disability and pain. Without it, the therapy room can fall into being extremely harmful and ableist for our clients. We never want to do more harm to our clients and I invite all of those in the mental health field to begin to do work around ableism and the mental health community.



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