The Sneaky Violence of Nonmaleficence

A few months ago, I was chatting with a friend about her experience of medical school and her sentiments as she transitioned into residency. She told me about the well-known mantra in the medical field: "It's not if you kill your first patient, it's when."

I usually have to re-read that sentence to allow it to sink in. It's a somber statement about how the reality of practicing medicine is in contradiction with the oldest ethical tenants of the field: First do no harm.

[image description: an image of the symbol of the medical profession: two snakes wrapped up a staff with two wings extended at the top. The background is yellow and there is an image of green grass at the bottom. "FIRST DO NO HARM" is typed on the bottom. Image found on Google Images]

Even while the phrase "first do no harm" is not verbatim in the Hippocratic Oath, the morality of this statement is deeply ingrained in the motivations and philosophies of people in helping professions and healing professions around the world. It is also deeply internalized by people of all religious and spiritual backgrounds. One version of it, Nonmaleficence, is outlined in the American Counseling Association ethics:

These professional values provide a conceptual basis for the ethical principles enumerated below. These principles are the foundation for ethical behavior and decision making. The fundamental principles of professional ethical behavior are

• autonomy, or fostering the right to control the direction of one’s life;

• nonmaleficence, or avoiding actions that cause harm;

• beneficence, or working for the good of the individual and society by promoting mental health and well-being;

• justice, or treating individuals equitably and fostering fairness and equality;

• fidelity, or honoring commitments and keeping promises, including ful lling one’s responsibilities of trust in

  professional relationships; and

• veracity, or dealing truthfully with individuals with whom counselors come into professional contact. 

The concept of "first do no harm", the internalized morale of nonmaleficence (aka non malevolence), and the nonchalance of "It's not if you kill your first patient, it's when" have been swimming in the back of my mind as I have watched the media, the nation, and the world erupt over recent events. Events from Brock Turner's rape trial, to election campaigns and candidates, to Nyle DiMarco and the Alexander Graham Bell Foundation's critique of him (they did have a follow-up response), to the Pulse Orlando massacre, to the dozens of other less publicized (related and unrelated) stories of injustice, murder, and discrimination. 

I have been watching as people question how these atrocities could happen, as people pour out support, as people condemn each other over the events, and as people criticize each other for their political beliefs and their responses to relevant events. As blame and judgement cycle and spiral back and forth, I've become curious about a pattern I have noticed.

No one seems to believe they are causing harm.

In fact, most people seem to think they are helping. Helping to dispel myths. Helping to eradicate ignorance. Helping to rid the Earth of people who are seen as Other and less-than. Helping our children. Helping protect our country. Helping themselves to wealth or pleasure. Helping...

“Practice two things in your dealings with disease: either help or do not harm the patient.”

— Thomas Inman

After all, how many of you wake up in the morning and think to yourself, "Today I will intentionally and unintentionally cause harm to others."?

[image description: a graphic of a sign post with four different signs. Each sign is an arrow, pointing in a different direction. At the top is a green arrow inscribed with "HIS FAULT". Next is a yellow arrow inscribed with "HER FAULT". Next is an orange arrow inscribed with "THEIR FAULT". The last arrow, at the bottom, is red and states "NOT ME". Image found on Google Images.]

Even when confronted with the pain we have caused, we seem to have internalized our moral nonmaleficence to the point that it does not compute. We think, "No. It couldn't possibly be my fault. If harm was caused, it must be someone else's fault or someone else's problem." We may even think, "That person needs thicker skin. They're taking this too personally. Quit playing the victim!" 

I know what you're thinking. OTHER people blame. OTHER people cause harm. OTHER people blame. Not me.

Maybe you practice honesty and accountability in your life. Maybe you donate to good causes. Maybe you engage in restorative justice practices. Maybe you volunteer your time. Maybe you're a therapist or a doctor or a teacher or a police officer, or a policy-maker with a heart for justice. Maybe you diligently practice your religion. What does all of this have to do with you?

I'm curious, too. Has our morality of nonmalevolence immunized us from accountability? Has it become a sneaky shield of protection, blocking out information that will highlight our fallibility and vulnerability? Do our moral standards imply that if we are good, we cannot cause harm? 

How prevalent is it that we each cause harm, anyway?

Anecdote #1

A recent episode (#716 Voice of Reason) on the Snap Judgement podcast shared the story of a new, bright-eyed lawyer (Christina Swarns) doing her best in 1994 to "help" a chronically homeless man who would dine and ditch in order to get arrested. He developed this routine in order to have a place to sleep--jail. Like many people who have drive to help the less fortunate, this case tugged at her heart. In her efforts to publicize his dilemma and raise support, he experienced humiliation by other incarcerated people for wanting to be in jail. The only place he had developed for safety, was no longer safe. Ultimately, he ended up not accepting any of the support that had been obtained for him, and was never heard from again.

anecdote #2

A recent episode (Update: Alleged cult leader plays shell game with US foreign aid) on the Reveal podcast shared the story of how billions of dollars from the US government, donated clothing sales, and employees' paychecks are being siphoned off by Planet Aid into untraceable foreign bank accounts, rather than being allocated to projects. This organization appears to be exploiting the generosity of others, claiming to offer humanitarian services, and the money is all but disappearing. And because it is documented that money is allocated for these programs (that never take place), it is difficult for these communities to get additional support elsewhere. Unfortunately, many well-intentioned NGOs and Non-Profits offer services that are never utilized. Schools are built and the buildings are abandoned. Donated money is allocated to donors' intentions rather than what is needed at a grassroots level (i.e. Haiti). When you donate money, how do you know where it is actually going? Do you track where your tax money goes?

anecdote #3

In the novel, Shantaram, and the sequel, The Mountain Shadow, by Gregory David Roberts, the main character, Shantaram (aka Lin) befriends a mouse while in prison. He feeds him. He extends generosity. He trains him to the point that they have a safe relationship. When he is moved to another cell, he informs the next person that the mouse in that cell is well-trained. The inmate subsequently tortures and kills the mouse. This haunts Shantaram, and he questions whether his generosity was the predicating factor that made the mouse more vulnerable to harm. If he had not taught the mouse he was trustworthy, the mouse would not have altered its self-protective behaviors. It would not have had the audacity to approach the next inmate. It would not have died cruelly.

“Sometimes we have the best intentions, but we’re focusing on the wrong thing. Are you willing to consider the possibility that, just maybe, you have focused on the wrong thing?”

— J. Parrish Lewis, www.munkymind.com

[image description: cartoon image of a person standing in front of a mirror, angrily pointing at the mirror. The person is wearing green pants, a blue shirt, and glasses. They appear to be blaming and yelling at their own reflection. Image found on The Barefoot Spirit.]

Perhaps we all are causing harm every day. Even the most ethical, most honorable, most logical person lapses. This pattern of unintentional hypocrisy is deeply embedded in our colonial history. During the Crusades, Crusaders believed they were manifesting the Kingdom of God while killing non-believers. During westward expansion and Manifest Destiny, homesteaders believed they had a right to the land that was usurped from Native tribes. During slavery, Protestants believed that because they were Christian, stealing, killing, raping, and forcing labor upon slaves couldn't possibly be a bad thing. Our morals and internalized positive self-image (or desperation for a positive self-image) appears to have the capacity to blind us from the reality that we cause harm.

We all partake in the game of judgement, passing on the toxic burdens of shame and blame to the next person. 

In the practice of supporting optimal social, emotional, and psychological well-being, we must be able to differentiate between guilt and shame. Unfortunately, we are exceptionally good at deflecting guilt (and responsibility) by engaging in shaming practices. We've learned from Brené Brown's work, shame deteriorates our psyche, our relationships, and our communities. Judgement and blaming are useful tools for deflecting shame and vulnerability. They are less useful for creating positive change and creating healthy, safe communities. 

Ethically, what does this mean? As a counselor, bound to the ethics listed above, I believe this means letting go of these standards as a measure of myself and my work. I believe it means that I stop assuming that I am being helpful when I think I am, and stop assuming that my good intentions preclude me from causing harm. It means I spend less energy tracking for evidence of my help, and more energy tracking and acknowledging where I missed the mark. It means I am prepared to appropriately apologize, to admit when I am wrong or when I don't know, and to make amends. 

Why? Because it is possible to learn that a) having inherent value as a human, and b) inevitably causing harm, are not mutually exclusive. Because healthy relationships are less about never causing harm (as the Hippocratic Oath and Counseling Ethics may imply), and more about repairing a relationship after hardship.

What would happen if we let go of the introject that we must only be good and must never cause harm? What if we came to terms with our own pain, our own malevolence? What if every time we wanted to criticize, condemn, or judge someone, we looked inward and could acknowledge "In some way, I do that, too."? What would happen if we all took a deep breath--a slow inhale that filled our bellies and an slow exhale of release, and could also extend gentleness, love, and compassion for ourselves? What if we engaged in the artful mastery of appropriate apologies?

And what if you're already doing these things? Take a moment and check...are you judging the people who aren't?

---

One of my mentors, Carla Sherrell, frequently reminds me and others that oppression is "sneaky." Carla's work, words, wisdom, and her own mentors, teachers, and ancestors therefore created a foundation for the thoughts expressed in this blog.

My clinical supervisor, Duey Freeman, has been influential in my understanding of how repair is essential to the development of healthy relationships. His work at the Gestalt Equine Institute of the Rockies (GEIR) and the Gestalt Institute of the Rockies (GIR) has also created a foundation for the thoughts expressed in this blog. The GIR summer intensive (August 2016) will look at some of these topics in A Call To Action: Exploring the Depth of Racism, Privilege, Power, and Diversity.

Intersectional Allyship as a Path to Wholeness

“You have to be open to meeting face to face, and even dancing with, the truth that pertains to your life right now. You have to find a way to collect your fractured pieces, examine them, and then accept them as part of who you are. Spiritual practice is about transformation, but it’s also, and more importantly, about working with what is.”

— Angel Kyodo Williams

As the leaves transform and fall, revealing the true colors that chlorophyll has been hiding for months, the autumn season begs us to reflect on our changing colors. A week ago, many people were celebrating Halloween, a holiday rich with the opportunity to explore your parts and shadows. Following these themes, it seems like appropriate timing for a post on intersectionality and allyship. Let’s start with some definitions: 
Intersectionality is the study, acknowledgement, and honoring of intersections among two or more forms of oppression, domination, or discrimination. Allyship, based on the concept of friendship, is the life work or practice of building relationships based on trust, consistency, and accountability with marginalized, oppressed, or dominated groups and individuals.

[image description: There is a rough sketch of many words forming a circle. Sections of the circle are in different colors--pink, purple, blue, teal, green, yellow, red. Examples of the words include "religion", "silence", "classes, "inclusion", "representation", "slavery", "asylum", "pollution", etc. In the middle of the circle, in big black letters, is the statement "ALL oppression is connected!" Image found at Scottish Women's Aid.]

So what does this have to do with counseling and mental health?

A very common complaint in my office is a sense of fragmentation. This may be presented as compartmentalized components of one's life, feeling divided, feeling broken, or feeling scattered. It may be a sense that you cannot be fully seen for all of your simultaneous identities. Fragmentation--that grinding sensation that not all of you belongs at one time in one place--is a rule of oppression.

Oppression states that you are either female or male, either Deaf or hearing, either beautiful or ugly, either smart or stupid, either sane or insane. It does not recognize non-binary experiences. Oppression states that if you are female, you cannot be strong (and if you present as strong, you may be criticized, harassed, or assaulted for it). It also states that if you are male, you cannot be sensitive or patient (and if you present as sensitive or patient, you may be criticized, harassed, or assaulted for it). If you are reading this post, I imagine that you may believe that you are more than those categories and the limitations that society may put on them. And you may also be familiar with how hard it has been for you to take ownership for your "sensitive part" or your "angry side" or your "aloof part" or your strength.

[image description: A black and white photo of someone's reflection in a broken mirror. The person's face is fractured and segmented along the lines of the broken glass. The whole face cannot be seen in any single chunk of class--only parts. Source unknown. Photo found here.]

The rules of privilege and oppression divide us. Oppression robs us from the opportunity to "collect your fractured pieces, examine them, and then accept them as part of who you are" as quoted above (Angel Kyodo Williams). How do our family history, the institutions in charge, our friends/family/colleagues, and our own personal beliefs encourage this fragmentation? How do we actively befriend these fragments in ourselves and others? 

In this context, intersectional allyship is critical for the development and continuation of our society, for our personal relationships, and for our own self-acceptance and self-love. It is the recognition that privilege, when (intentionally or unintentionally) exerted as power over another, is intrinsically experienced as self-oppressive, as well. Whatever we oppress in another, we oppress in ourselves. It is the recognition that my health and well-being is connected to your health and well-being.

“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.”

— Lilla Watson, Aboriginal activists group, Queensland, 1970s.

When it comes to personal work, we face multiple parts of ourselves. In our relationship to self, we address the things we like, don’t like, and feel ambivalent about. Within our own being, we have identities that are lauded and identities that are oppressed. We have many norms, stories, and experiences that tell us what is okay, acceptable, appropriate, and worthwhile. Sometimes these things are societally imposed (i.e. racism and other -isms), and sometimes they are unique to an individual's experience (i.e. being a cisgender, heterosexual male and being repeatedly told by your mother that she wished you were a girl). Typically, we try to promote the desirable parts of ourselves and hide the parts of ourselves that are not accepted. According to Carl Jung, our hidden parts are our shadows, and we are often afraid of our shadows even though we cannot separate ourselves from them.

[video description: Babies scared of their shadow. This compilation of clips shows young children frightened by the discovery of their shadows.]

Oppression can be brilliantly subtle. One of the most fascinating aspects of oppression is that it only takes place in relationships (relationships to self, other people, society, nature, spirituality, etc.). It often dictates how we can feel, behave, and think in different situations. Oppression, as a relational phenomenon, creates a web of connections between self and others.

“We are hurt in relationship and we are healed in relationship.”

— unknown source, Counseling Proverb

Oppression intricately weaves our wounds together, requiring relational work (i.e. intersectional allyship) in order to heal. The personal work becomes less personal. When you practice allyship towards yourself, you bolster your capacity to be an ally to others; when you practice allyship towards others, you bolster your capacity to be an ally to yourself.

[image description: A twist on the old "We Can Do It" poster of Rosie the Riveter during World War II, this cartoon has seven people in brown pants, blue shirts, and red headbands with white spots. The seven people are of different heights, skin color, cultural/religious/ethnic background, and physical ability. They have tufts of different colored hair coming out from their red bandanas. Image found at Pros and Kon. The signature at the bottom appears to say Tyler Feder.]

Our intersectional identities need balance and love. How do we support ourselves through struggle and take ownership for the undesirable parts of ourselves? How do we reduce the sense of fragmentation we feel regarding all of our diverse identities, parts, passions, interests, and experiences? Perhaps, through actively practicing intersectional allyship. The Buddhist practice of maitri is a great example of this. Supporting (or receiving) diversity training may be another way.

For many people, self-compassion can be more difficult than cultivating compassion and forgiveness for others. For some, it may be easier to start by practicing allyship with our loved ones, and then branch out to people we feel neutral about, and then people we struggle with, and then ourselves. For some, the process may be opposite.

Ultimately, when it comes to relational work (partners, families, groups), allyship is crucial. Allyship goes beyond equal pay for equal work, beyond reducing police brutality, and beyond activism. Allyship shows up in nuance and subtlety, in the most ordinary moments of our lives. At the grocery store. At the bus stop. While watching the football game. At a meeting for work. Allyship activates even when other influences suggest it might be (momentarily) safer not to engage.

“First they came for the Socialists, and I did not speak out—
Because I was not a Socialist.
Then they came for the Trade Unionists, and I did not speak out—
Because I was not a Trade Unionist.
Then they came for the Jews, and I did not speak out—
Because I was not a Jew.
Then they came for me—and there was no one left to speak for me.”

— Martin Niemöller

We need allyship, for ourselves and for our loved ones, in the nuance especially because many of us are much more active about recognizing and condemning the irritating and undesirable parts of others. The ordinary parts of life are the frontlines. In the moment that I complain about my father's tendency to pile dishes in the sink, rather than in the dishwasher, I not only forget his consistency with cleaning the bathroom, I distance myself from the reality of my own messy tendencies. 

We are much more quick to judge the Woman who has the abortion (or doesn’t), the Muslim who adheres to prayer times (or doesn’t), the Black person who is angry (or isn’t), the Deaf person who does not speak (or does), the child with Autism who tantrums (or doesn't), or the Criminal who has re-offends (or doesn't).

[image description: A black and white sketch shows a giant foot stepping on another person's back. That person, although slouched over by the weight of the foot, is stepping on a smaller person's back. That person, although similarly slouched over by the weight of the second person's foot (and collectively, the first person's foot), is stepping on the back of another smaller person, who is also bent over. It appears that the process may be continuing indefinitely. Source unknown.]

When someone experiences life in a vastly different way, we don’t understand. How do we go beyond what we understand in order to support the ones we love? How do we actively love their differences and the parts of themselves that even they do not like? How do we collectively heal the wounds of all the areas in which we are told that we are "wrong", "bad", and "unloveable"? Perhaps through the practice of intersectional allyship. 

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I write this blog from multiple locations of privilege, and some marginalized identities.  Every day, each moment, I do my best to take ownership for all of those identities, how they inform my worldview, and how they support or inhibit my capacity to stay in relationship with people I meet. This process initially started as part of my training as a teacher in Teach for America and continued as I trained to be a therapist. Now, it is evolving into reclaiming my humanity.

One of my mentors frequently asks me, "What is the cost of your whiteness?" After repeated reflection on this question, which will continue into the future, I have integrated many lessons. I have started to recognize the parts of myself that I have rejected due to what it means to be a "white person." The question hints at one of the lies the privilege tries to instill--that their are only gains and rewards in privilege. That privilege provides immunity. The reality is, that when unchecked, my whiteness separates me from people. It can limit my social circle, limit my range for empathy and compassion, and rear up in harsh judgement. My whiteness separates me from myself. It claims that I cannot be angry, I cannot know my own cultural heritage, I cannot have a big presence. It is an ongoing practice to challenge those claims. I will pursue wholeness.

What is the cost of your privilege?

“Only someone who is ready for everything, who excludes nothing, even the most incomprehensible, will live the relationship with another as something alive and will sound the depths of his own being.”

— R.M. Rilke, Letters to a Young Poet

Empathy, Tolerance, and Diversity in Therapy

Empathy is a huge word in therapy. It is touted as the cornerstone of emotional intelligence—a key ingredient in developing and maintaining satisfying relationships. Therapists need empathy for clients. Clients often intentionally or secondarily develop empathy for other people in their lives.  

[image description: Two babies, with different skin colors, are sitting near each other. The baby on the left is crying. The baby on the right is reaching out to the distressed baby, placing a hand on the upset baby's shoulder. Thanks Scary Mommy.]

Empathy may very well be the driving force behind why some people choose a career in the mental health field. It is a great quality that predicts many positive outcomes. It is inversely related with perceived levels of loneliness, and highly correlated with prosocial behavior. Empathy helps us connect deeply with others. And when it comes to long-term change in therapy, empathy isn’t enough. 

Andrew Solomon’s book, Far from the Tree, contains great evidence that empathy and understanding does not cross all areas of difference. Even while our own experiences of oppression, isolation, bullying, and marginalization can develop our capacity for empathy and enhance our ability to see parallels in pain, our pains are not the same. Empathy is not our end goal. It is not our last stop. 

“Almost everyone I interviewed was to some degree put off by the chapters in this book other than his or her own. Deaf people didn’t want to be compared to people with schizophrenia; some parents of schizophrenics were creeped out by dwarfs; criminals couldn’t abide the idea that they had anything in common with transgender people. The prodigies and their families objected to being in a book with the severely disabled, and some children of rape felt that their emotional struggle was trivialized when they were compared to gay activists. People with autism often pointed out that Down syndrome entailed a categorically lower intelligence than theirs. The compulsion to build such hierarchies persists even among these people, all of whom have been harmed by them.”

— Andrew Solomon, Far From the Tree

Empathy depends on our existing capacity to understand another person. It depends on having enough personal experiences which we can compare to another person's experiences. Regardless of how skillful we are with empathy, we can never fully understand another person's experience. For example, a pregnancy can be a cause for great celebration, great despair, or anything in between. A loss of a job may be experienced as liberating. Our emotions are often complex and layered. We experience things uniquely. A woman may experience various degrees of sexism and sexual harassment, just as a Person of Color may experience various degrees of racism and systematic oppression. These experiences vary and sting in different ways. Empathy is great for having compassion and tolerance for differences--especially in the people we already love. And even in the people we love, we can misunderstand and miss their pain entirely.

“Positive social emotions like compassion and empathy are generally good for us, and we want to encourage them. But do we know how to most reliably raise children to care about the suffering of other people? I’m not sure we do.”

— Sam Harris

But what about acquaintances and strangers? Empathy is much harder to activate for a random passerby. Imagine the person who cut you off on your commute today, or the person you saw kicking their dog or yelling at their child. Imagine the person in the wheelchair with a can in their hand on the street corner, or the traveling musician busking for money downtown. Imagine someone with schizophrenia or autism or pedophilia. Imagine someone so different from you that you feel that twinge of aversion and repulsion. Does your empathy still reach that person?

“Relying on empathy means black people faced with horrific levels of police brutality must make white people “feel our pain.” It forces us to stream the bodies of our dead sons and daughters on a loop. It requires there to be dead sons and daughters in the first place. It always demands more spectacles of pain.”

— Hari Ziyad

If therapy's aim is to provide healing, then we must consider where empathy falls short. We must look at the lines we do not cross regarding power, privilege, and oppression. We must explore the spectrum of rejection, tolerance, and celebration. Then we can begin to address the intergenerational trauma that is carried from oppressive experiences like racism and the Holocaust--both of which have demonstrated long-term negative health and mental health impacts. Undoubtedly, audism (yes, that is spelled correctly), transphobia, and mental health stigma can have similar impacts.

[image description: Cartoon image with caption, "EMPATHY would this help?" In the image, a person is sitting on a street corner in tattered clothes with a hat in front in order to collect money. The person is holding a mirror in front of his/her/zir face in order for the person walking by to see his/her/zir own reflection. Thanks Axis of Logic.]

As a therapist I make a point to read articles and blogs by people from various backgrounds and perspectives. It is a practice that helps me develop my understanding and empathy for people with experiences outside my own reality. Theoretically, this will enhance my capacity to sit with any client who comes into my office. Ideally, understanding and listening to various perspectives and experiences will enable me to conduct sessions non-judgementally, regardless of any conglomeration of symptoms, complaints, behaviors, attitudes, and beliefs that a client presents. A couple of weeks ago, I read this article on why empathy won't save us in the fight against oppression. 

Here, Hari Ziyad (also quoted above) points out
“But the belief that empathy can solve the world’s ills relies on the idea that we are all similar enough that someone else’s pain can be understood through the understanding of our own.

What happens when we do not understand our own pain? What happens when we really are different, and substantially so? What happens when those differences cannot be understood? Or, at least, what happens before those differences can be understood?”

[image description: The Pain Measurement Scale, which is often used in doctor's offices. A scale of 0 (no pain) to 10 (worst pain imaginable) with correlating faces, smiling to miserably crying.]

Hopefully, in this case, you can see a counselor who has exceptional practice in his/her/zir own pain and the capacity to be with someone else's pain without denying it, minimizing it, or judging it. Hopefully, you can find someone who will believe your pain, even if they do not comprehend it.

[image description: There are five lines of text that are all crossed out. They read "It's not that bad", "Just be happy", "Don't be sad", "You'll get over it", and "You're overreacting". The final line of text is clear: "I believe you."]

Whether you are a therapist, a therapist-in-training, a client in therapy, or a human interested in self-growth, empathy is a critical part of your ongoing emotional intelligence. It is also critical to continue to examine and challenge your assumptions, biases, fears, and internalized stigmas regarding who has value and what makes them valuable. As Michelle Alexander addresses is The New Jim Crow: Mass Incarceration in the Age of Colorblindness, which of your values and judgments justify legal, social, and economic boundaries between “us” and “them”? Remember that person you called to mind earlier, the one who elicited your aversion? This is when our empathy takes a back seat, no longer activating our mirror neurons. 

[image description: A graphic art image of two human shapes looking at each other. Inside their heads, there are blasts of color, representing neural activity. Some of those blasts of color (neural activity) are bridging the physical gap between the two people, representing mirror neurons. Thanks Psychology Today.]

Luckily, mirror neurons are activated through consistent interaction and eye contact. Therapy, therefore, can be a be a new frontier for moving beyond empathy. When you are in a therapy office, sitting across from another human, you have a unique opportunity to engage with someone who is entirely similar and entirely different from you. Whether you are therapist or client, take this opportunity to breathe and to engage with the humanity in the person across from you. Regardless of the difference, confusion, frustration, joy, relief, and support that arises in the therapeutic relationship, return to the humanity in yourself and the person across from you again, and again. It is an art and a practice. Breathe, notice, and return.

*Note for clients: If your therapist does not have the capacity to stay present with your pain, especially if you identify with one or more marginalized identities, call them out and/or find a new therapist.
*Note for therapists: If your client identifies with one or more marginalized identities and expresses a lot of anger and pain, it is not personal. If it is too much for you, get supervision and/or refer them to another therapist.