Dear Comrades
I write to you from the fading days of Feb as we approach fall. The fall of summer, the fall of civilisation, all these things really. Since I last wrote, we’ve had #TRUSK assume power in the White House and the world’s biggest unnamed coup commence. It’s been difficult to watch and I’ve found my head spinning as I’ve followed one piece of bad news after another — the US leaving the UNHCR, funding being pulled from NIH, federal agencies disbanded, the US severing ties to the WHO, climate targets being eradicated, and removing all DEI initiatives, Zelensky (amongst much, much more). It’s been suggested that the pace of orders and the disarray is deliberate and designed to ensure people cannot collect quickly enough or organise their counter-actions, and there is a ring of truth to this. I’ve found myself taken aback by Musk’s incursions into the White House (I really want to know what he has on Trump) and the end-point of this is extremely concerning; the dismantling of democracy, the eradication of federal and state services and outsourcing to the private sector led by Musk and cronies for their own profits, and a change in the world order and rule of law.
It’s an entirely new form of government and is nothing other than a dictatorship and a coup. I’m waiting for the mainstream media to name this as what it is. I’ve witnessed coups before — I was about 13 when the Pakistani coup occurred in 1999 and we watched this from neighbouring India with some anxiety about what it would mean for bilateral relations and the safety of the region. I also lived through a very brief war around that time (the Kargil war) and while I was not personally impacted, I remember well the anxiety of those who had lived through wars, and stories of blackouts and bombings as we practised what we needed to do in a black out. Peace felt tenuous as the regime changed by force. The only difference now is that the army is not out in force in USA, but who needs the army when you have a tech oligarch? Modern wars are not fought in trenches anymore.
Some thoughts on how to resist here. All this is coming to Australia too, I feel certain Rinehart is poised and waiting rubbing her grubby little hands together, so it’s useful to start preparing for how we will individually and collectively try to combat this (get door knocking pre-election!, VOTE). Also recommend Sarah Wilson’s substack.
I’ve been checking in with a few American therapists I know, and the mood is grim. Shock, horror and increasingly bizarre and complex scenarios to consider and work through, like deciding how to document trans/enby clients or deciding whether to adhere to orders to ask each hospital attendee whether they are documented. Therapists in general are a pretty compliant and conscientious lot, and this will be a challenge for everyone in the health/therapy fields as far-right dictatorial influences swing into action globally. The question of non-violent civil disobedience to protect democracy will be challenging given it means going against innate personality structures and decades of compliance and requires that people risk professional censure.
I can only hope that our constitutional protections are more robust in Australia and will protect us all from having to make these terrible and hard choices someday, but it’s looking grim.
Compliance is dangerous when monsters are in charge.
I hope any therapist or medical practitioner reading this thinks long and hard ahead of time about how they will protect ethics and their patients in the event that this form of authoritarianism swings onto our shores. One of my favourite DBT skills is COPE AHEAD and this works as well for societal chaos as it does for more circumscribed problems. Prepping, but for the psyche. Some questions to ponder:
How will you manage care for transgender clients if a gender binary is enshrined in law?
How will you record details of abortions/miscarriages if reproductive care is challenged?
How will you manage forensic work if the death penalty is enforced?
How will you manage care for disabled clients in the face of increasing discrimination?
Will you speak up or stay silent if it means losing your job?
I’d suspect that how you’ve acted since October 7th (or during Sudan, Ukraine, the Voice referendum, the gay marriage referendum etc etc) will be a good barometer of how you will witness and challenge injustice, death and harm visited upon others into the future.
Psychology and silence
I feel like I talk about this a LOT, but I am passionate about using psychology for good, not just to assuage the fears of the worried well (like me ;))
Practitioners in the psychology profession are by and large silent about structural harm, which is tricky when so much of mental health is about these structures. I cannot help but feel disillusioned by my profession as people just let awful things happen to others and let themselves be cowed by fear. The threat of AHPRA is well present (and weaponised by those who wish to silence others I add), people are too busy and tired to learn about the world or take action (including me), psychological concepts are used defensively to justify harm (‘everyone is entitled to their opinions’ or ‘let’s just be impersonal and polite’ after saying something which harms a minority group, ‘have you tried re-framing that thought’), and there’s a real immersion in the ‘I turn the news off to protect my peace’ ethos. While we need to titrate trauma exposure so we can do our jobs and be present for people we care about, this is Western individualism taken to extremes. Many people will only start paying attention to these questions when other people like them are being harmed (white, middle class) by which time it will be too late.
Ignorance is not a flex.
While I feel powerless to tackle apathy and chosen ignorance, I can offer some sense of how to use the structural power you have while staying on the right side of the law and AHPRA.
I prefer to work from within by changing the profession and systems for the better, which means carefully curated action largely via speech, reviewing my own practises and some direct action (e.g., donations). Recently there has been much clamping down on protesting, and speech itself has led to cancellations for many. This is making legal and impactful protest harder.
Here are some tips for mental health professionals who wish to use their voices while remaining cognisant of respectful client care and adhere to codes. (Don’t be like this please.)
And, there are many ways to act without speaking publicly — direct action is possible in many other ways, but act somehow we must.
First, never act in a way that compromises client care. Client care comes first, and I always run anything I post or write through a filter of ‘how would a reasonable person/client feel if they saw this’. Yes, this does involve much self-censoring at times, but this is what we sign up for in our roles. Now, you’re not responsible for how someone feels about your words, just your words alone. I could say ‘stop torturing doctors’ or ‘boycott weapons manufacturers’ and someone might be very offended by this (a friend was reported to AHPRA for a statement like this…), but my words are reasonable when viewed through a human rights/healthcare rights filter and are aligned with AHPRA’s social media policy (hence the ‘reasonable client’ proviso). I always ask myself whether my words are respectful, may be considered to be inciting hate, are overly biased, may harm anyone, or may seem discriminatory, and I always check my sources. I don’t want to BE any of these things either (hateful, discriminatory) so asking myself these questions is a good check for my own attitudes as well. Our attitudes and beliefs can become entrenched and dogmatic over time through defensive processes like reaction formation, so it’s really important to engage in this self-reflection. I tend to steer away from hot button slogans because the argument about the use and meaning of these slogans can detract from the message I want to provide and the people I wish to support. Also, always, if you feel like you cannot provide appropriate care to someone for political/religious/any reasons, please refer on (and speak to your supervisor about this).
Understand and know the codes you need to abide by and don’t be afraid to voice speech if it’s aligned with those codes.
Read widely and be aware of what’s happening in the world and around you. The news is hard but you don’t have to take in all of it, you can still have limits for yourself without ignoring it all completely.
Vote — simple, but so important.
Invest in some education about structural issues in psychology and the way these issues interface with mental health and health. I can recommend Decolonizing Therapy by Jennifer Mullan.
Engage with the backgrounds of all your clients, especially those from minority groups. Minority groups come in many forms, it’s not just about men v women (pls let’s stop with the white feminism) or brown v white. Ask curious questions about what they have experienced and faced and acknowledge the importance of these issues.
Stop cultural appropriation. If you are using yoga nidra as a mindfulness technique, call it that, not iRest.
Take feedback on board and at least consider it. If someone challenges how you are practising, don’t dismiss it as them simply being ‘angry’ without thinking it through with trusted peers (ideally, your peer group would have some diversity).
An interesting paper here on civil disobedience in psychology. Read it.
There’s also a whole conversation here about liberalism vs radical politics and I wish to acknowledge it, but it’s too large a topic to fully explore now except to say that I’ve made a range of deliberate decisions around how I need to engage and use my words and power for the (hopefully) greater good. I know others have more radical stances re activism and this is fine, we all contribute in different ways to a social movement. I emphatically reject the idea that we need to adhere to a certain defined stance or set of views to create change. Most medical/health providers will have to be temperate and apolitical but issues-focused in their stance and views if they wish to protest/create change successfully while staying in their professions, and each person can find ways to contribute to causes using their constellation of strengths.
Your work does not mean that you cannot speak/protest/write/donate/act/volunteer — you just have to be exquisitely careful with your words and ensure that you are focusing on safety, healthcare and human rights as the key issues in any public communication or action. It’s better to do some due diligence and determine how you’ll proceed with a thorough self-auditing process (and consults with peers/supervisors) in place, than to remain frozen in silence, or to be impulsive and say something inappropriate which will result in a sanction.
The power of courts
For obvious reasons, I follow court proceedings closely. Recently, I’ve been keeping an eye on the Lattouf/ABC debacle (I bought and ate a Lebanese cucumber in protest, srsly ABC, did someone have a bad sleep the night before to come up with that defence?), the Sam Kerr case and a public inquiry into the Lucy Letby case in the UK. An interesting summary here of the risks of expert evidence as applicable to Letby.
I provide expert evidence to courts in my capacity as a forensic psychologist and have seen first-hand how the courts and public struggle to interpret expert evidence. As an example, when we say an offender is at ‘moderate’ risk, we usually mean they pose the same risk of re-offending as an average offender (recidivism stats vary based on types of offences), but people usually interpret this to mean that they are at higher risk, with the baseline anchoring at low risk. I use the words might and may a lot when I write (my editor pointed this out when I was writing Reclaim) and my work with courts influences why I do this — it’s so important to be tentative about knowledge and explain what we don’t know. I generally think this has made me a better psychologist too, I learnt early that it’s ok to say I don’t know or even that I don’t understand someone’s offending or behaviour or can’t answer certain questions the court wants me to. I rarely have to do this, but knowing I can takes the pressure off.
When I was studying civics in year 8, I learnt about the three arms of governments and the need for the judiciary to balance and check the powers of the executive branch of the government and to implement and support (…or question) the administrative branch of the government. The courts hold immense power and are often the last bastion staving off authoritarianism or other political harm (though apparently in the States this is the alt Parks department…? Go kings, we ride at dawn). Courts are only as powerful as the rule of law and can also do immense harm if stacked or biased, consider the overturning of Roe v Wade as an example.
The challenges brought before the courts often reflect the societal issues consuming us and are an important way to keep a finger on the pulse of society. Issues of race, free speech, employment vs speech are clearly at boil in our societies. I heard a fascinating talk by Amy Remeikis at Sydney Writer’s festival last year about the use of courts to challenge existing orthodoxies and the manner in which cases can highlight issues and steer discourse, regardless of a win or a lose. Recommend following her work, here is an excellent piece.
While I don’t know what courts will find in the matter of Lattouf v ABC, it will be a judgement I read with interest.
The less said about the Kerr case the better too – while she was a total idiot while intoxicated, I don’t think this is illegal…? It reminded me of the double standards we hold for men v women (how many male footballers have done much worse while drunk?) and brown v white people. (PS ‘Reverse racism’ is not the smart devil’s advocate point you think it is, because race is structural and about power). An interesting book about the demands we make of women, especially focused on ‘being kind’ and how this entrenches sexism. I’m a distinctly UNKIND person if I see harm/unfairness, and have been called ‘prickly’ because I point out shit.
Badge of honour.
A writing (and life) update
My memoir continues apace, and is currently sitting at about 2/3rd done. There will be a LOT of re-drafting though and I can see the holes and repetition in what I’m writing but am not bothering to untangle as I write — the psychic burden inherent in memoir writing and the creative work itself are enough to grapple with for now without needing to edit. Given I have the narcissism of any writer (come on, why else would we think our lives and thoughts are interesting to others?) the de/re/construction of the first 2.5 decades of my life has been a fascinating process. Writing creative non-fiction is so different to non-fiction in the mental health field, where I was essentially just trying to transmit information in the simplest way possible.
As I’ve written, I’ve found myself drawing out themes I did not realise were present, and sifting and re-arranging information thematically and chronologically. It’s been a gift, this chance to revisit the past with a bit of a screen between the worst and myself. I recommend this process to anyone approaching mid-life as a nice ‘taking stock’ moment (disclaimer: I cannot be held liable for any family estrangements which ensue).
The process of writing itself has been staccato, with stops and starts in unexpected places, much like my early life itself. While I wrote daily when writing my first two books I’ve found myself unable to do this, simply because I’m much more tired now when I wake at 5 am to write than I was 3-4 years ago (locky d…). I’m grateful for my little memoirists group sharing my challenges with me, and for all the excellent writers who have come before and reflected so wisely and honestly about their lives, and the process of writing about their lives. Mary Karr and Melissa Febos have been especially useful with the latter task.
Meanwhile, I’m also vaguely looking at my third book again, which should be out in early 2026 (give or take).
Outside writing, I’ve taken up knitting as a hobby, am working my way through Nancy McWilliam’s oeuvre, and am commencing my masters in public policy and management soon, with health policy being my first subject. Lots of naps with Karla too of course.
Books
I’ve read a couple of good books recently but have felt a bit scattered with my reading and have not got my teeth into the year yet. Recommendations gratefully received.
The Thinning - Inga Simpson, still on my dystopian kick (…I wonder why)
Nightbitch - Rachel Yoder (late to the party, but get on it!)
Media and Events
I wrote this piece for the Guardian on complex grief and family estrangement.
It’s going to be a year of learning and listening more than talking, and for this I am grateful.
Stay sane, stay humble, eat little snacks in bed (remember the greyhound cheese tax).
The horrors persist, but so do you.
Ahona (+ Karla)