I am a psychotherapist in New York City at a female-focused private practice. I am a white, cisgender female and many of my clients hold a similar identification. I state these facts because they are essential in understanding the impact of this decision on my life, and I feel it is essential to honor and name that before I offer my opinion and insight on how to best navigate my own emotional distress while also supporting my clients. The reality is, given my race, location, and socioeconomic status, should I need an abortion I would be able to safely receive one. Unfortunately, this is not the reality for the majority of women in America now. I am carrying the awareness of my privilege as well as my disgust, sadness, and fear into my sessions with me, as they cannot be left at the door.
Over the last few years living through the global pandemic, I, like many other therapists, have become acutely aware of the fact that therapy cannot and should not exist removed from the realities of the outside world. Oppression and privilege play essential roles in the formation of the therapeutic alliance, the presentation of symptoms, and the experience of trauma. In my training as a therapist, I was taught to understand, name, and openly communicate about the role of my privilege and possible oppressive actions in the therapeutic space to build security for my clients. Beyond that, I was taught to be aware of myself to ensure that I am not bringing my own experiences in the room in a way that is minimizing or distracting for my client. We analyze the ethics of self-disclosure and how it may be beneficial or harmful. However, over the past few years, as the world faced the collective, global trauma of the Covid-19 pandemic, there was no denying that as a therapist I was struggling alongside my clients. This felt like a shift from my formal training and something I’ve discussed at length with my colleagues. How do we remain objective and ensure we are not taking up space, while also acknowledging the shared experiences at hand? This is distinctly different than having faced an experience individually and sharing that with a client now facing something similar. This was mutual trauma and stress that had to be named, used, and carefully navigated in sessions. Once again, I find myself navigating the difficulty of a shared experience. As a female therapist, with primarily female clients, I’m faced with the question: how do I care for myself and protect my peace, while showing up for my clients and supporting them to the best of my abilities as we process and protest the overturn of Roe v. Wade?
First, and most importantly, we must care for ourselves. In order to be a present and effective therapist, you must engage in self-care and maintain boundaries as needed. In the face of the news of the overturn of Roe v. Wade, it is essential that we care for ourselves in any way that feels nurturing and safe. If you feel your emotions are overwhelming today, if work allows and it’s clinically appropriate, reschedule sessions. While our clients need support through this, we also must prioritize our mental wellbeing so that we can hold space for our clients. As most clinicians know, self-care and boundaries are essential in effective and ethical care for our clients - it allows space for us to remain objective, kind, and supportive. However, as we go through another shared trauma alongside our clients, the space between clinician and client shrinks and the need for self-care and boundaries grows. I urge my fellow mental health colleagues to take days off if necessary, to protest or engage politically in ways that feel healing, to return to therapy themselves, and to utilize group and individual supervision to process the experience of being a support system during this time.
Beyond taking care of yourself as an individual outside of sessions, it is important to be mindful of how to best engage with clients during this time. While we need to be honest and open about the reality of the collective experience, we also must remain aware of how our own experiences can be taking up space or mimicking oppression in the therapeutic experience. Check in with yourself about your intersecting identities and how they are relevant to the overturn of the law and overall reduction in reproductive rights. Don’t be afraid to name and acknowledge the role of intersecting identities in the impact of Roe v. Wade has on communities and individuals, and open the door for clients to speak of how it may be impacting the therapeutic space and relationship. We can share in our horror and sadness with clients, but we need to remain cognizant of our own space in session and ensure that this time is used for our clients.
Finally, be honest. As therapists, going through an experience alongside our clients is new. Name that to them, and be clear that there is no set rulebook on what to do during this time. Talk to clients about the importance of ongoing collaboration and communication to confirm you’re meeting their needs and the therapeutic space is being used in a way that feels effective and supportive for them.
This post was contributed by therapist Lily Ostler in the wake of the Supreme Court’s decision to overturn Roe v. Wade and endanger the lives of millions of girls, women, and childbearing folks.
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