“Brother, Can You Spare the Time?”: Psychotherapists Don’t Reach out to the Unemployed
Our families, friends, and true companionship are thus among consumerism’s principal casualties…We are hollowing out whole areas of life, of individual and social autonomy, of community, and of nature, and, if we don’t soon wake up, we will lose the chance to return, to reclaim ourselves, our neglected society, our battered world, because there will be nothing left to reclaim, nothing left to return to. -Gus Speth – America the Possible: Manifesto for a New Economy (New Haven: Yale University Press, 2012).
Psychotherapists of all disciplines have long thought of themselves as social advocates. We’ve been taught that individuals are embedded in families, and in extended families. These families are embedded in neighborhoods, cities, regions and countries. Ultimately, climate decimation is teaching us that countries are embedded in a shrinking planet that is seriously hurting.
So I began a research project to answer the questions “How responsive are psychotherapists today to the needs of their local communities?” “How do they reach out to those who are in economic as well as psychological pain?” “To what extent does their advertising suggest that they are well aware that the western world is in the worst economic crisis since the last Great Depression?”
I made the task easy for myself. I chose seven cities that have the worst rates of unemployment and related social problems, then did a Google search. I had written previously about how unresponsive psychologists were during the last Great Depression, actually appearing to find the topic of world economic hardship unworthy of study. Surely in an age of global networking, instantaneous news, and easy mobility, we would see psychotherapists announcing their willingness to help the unemployed, not just those still prosperous “worried well.” At least acknowledge that these are hard times.
Alas, little has changed.
My research found scant evidence in advertising profiles that psychotherapists in private or group private practices are aware or responsive to the economic crisis that is overwhelming their cities. While they may identify specific stressors that are the result of joblessness, they virtually ignore acknowledging the social, economic, and environmental issues that are dominant worries for many urban Americans today.
Seven Worst-Hit Cities
Below are the seven cities having both high unemployment and related social issues. In the parenthesis are the “official” unemployment statistics for that population:
- El Centro, CA (30.3%)
- Yuma, AZ (28.7%)
- Rockford, IL (15.7%)
- Riverside, CA (15.2%)
- Detroit, MI (14.3%)
- Los Angeles (12.5%)
- Cleveland, OH (9.3%)
Those of you who read John Williams’ “Shadow Statistics” knows that you have to add at least 9 points (he says 14 points based on governments own stats) on to those numbers, if you were to take into account discouraged workers, involuntarily part-time workers, and the like. So counting the truly under- or unemployed we learn that El Centro, CA as a city with 4-5 of every 10 people without a job, could have twice as many workers unemployed than during the last Great Depression.
In Search for a Listening Ear for the ‘Lost-My-Jobbers’
I put myself in the mindset of an average person who has been laid off. I want to find someone to talk about it.
I go to the internet, and read through the descriptions found on the first two pages of a Google search – keyword: “therapist” and then individually add each of the worst hit cities listed above—(e.g. “Therapist” and “Cleveland, OH”).
Here is what I found:
There were hundreds of listings. Most describe themselves as “compassionate and kind.” Some offered koans like: “Each person is different, and we are all alike;” or nautical themes like “helping you navigate your way through life’s difficulties…” They promised to help me “reach [my] full potential.” Some asked the reader probing questions like: “Are you falling apart?”
None of them mentioned that the planet is falling apart.
Most talk about “meaningful change” that will help me to discover my “true self.” Does this include economic change that has caused chaos in the lives of so many people?
And when I’m asked whether my “productivity at work” is off, I imagine I might blame myself if I were unemployed, asking: ”Is that the reason I’m not working? Was I unproductive?” Why don’t they mention the massive lay-offs that are happening in their cities? Why don’t they mention the emotional hardship unemployment brings?
Some agencies clearly state their preference for seeing only the remaining “high- functioning clients” “seeking more fulfillment…and joy in their lives.” They also consult with employers to “uncover ways to reduce cost, [and] enhance employee morale.”
“Employee Morale” is a big problems when you let go a significant portions of your work force. Often larger corporations hire “motivational speakers” days after the layoffs are announced, to promote a “positive attitude” as the “key to success” for their remaining work staff. I wrote about this phenomenon in 2010:
In 1994, the same day that AT&T announced it would lay off fifteen thousand workers, it sent its San Francisco staff to a big-tent motivational lecture by Zig Ziglar who told the crowd:
“It’s your own fault, don’t blame the system; don’t blame the boss—work harder and pray more” p. 115.
No one in Los Angeles, CA mentioned that residence live in one of the most expensive housing market in the country, with a sharp rise in the crime rate. Nobody in Riverdale, CA mentioned increasing poverty rates or a rising level of pollution that is impacting the children.
In Cleveland, OH, a city with more robberies per 100,000, than any other city in the USA, a psychotherapist proclaims: “Clients deserve to get what they want.”
“Okay,” I mused, “I have a list for you: I want my job back; and a planet with half the population, a city that is safe and neighborly, and cheap gasoline.”
Sometimes the listing shocked me with the insensitivity shown–like the therapist who worked with parents who argued: “The cost of services is less than the cost of a child’s funeral…”
“I Get It. Times are Hard.”
I wasn’t looking for much. I just wanted some acknowledgement that the person clients were going to open up to, to reveal their deepest fears to, actually recognized larger scary concerns.
In Detroit, it is great to “shine my light,” but I wanted some indication that the psychotherapist knew that the city’s lights were being shut off.
I found one:
“Hello, we live in a very stressful time and things are becoming more difficult for couples, families and children every day. I have over 7 years of clinical experience and I understand many of the societal, family, and interpersonal factors that contribute to the challenges we face today.” Gerald Mc Gee, MSW, LICSW.
Thank you, Mr. Mc Gee.
In Rockford, Il, a city as hard hit as during the Great Depression, David Heuser, a minister, wrote:
“Lack of insurance should not be an obstacle to receiving help. If you do not have insurance, if money is tight, I am willing to discuss with you how to deal with the financial arrangements of receiving counseling while dealing with the real issues that are important to you.” Mr. David Heuser, Counselor , LCPC , CADC , MSEd, MDiv
Bless you, Reverend.
Of perhaps hundreds of profiles I read in the seven worst cities in the US for unemployment, pollution, or crime, only these two profiles gave any hint that clinicians knew that bad things were happening to good people.
Many of the therapists claimed to be “practical” or “down to earth,” but none had anything to say about the deteriorating condition of the Earth or the fact that you had to be “practically blind” to not see the obvious: the cities they practiced in were financial war zones.
A Significant Source of Stress
As professions, we know the impact of terrible economic times. Information is out there. Seventy-eight percent of Americans report money as a “significant source of stress” (APA, 2009). Economists Daniel Sullivan and Till von Wachter estimated “a 50 to 100 percent increase in death rates for older male workers in the years immediately following a job loss, if they previously had been consistently employed,” as well as a higher risk of suicide, disease and divorce.
And yet, only two psychotherapists gave any indication of the impact of job loss or community degradation in their profiles?
Position Mergers not Work Sharing
Countries like Germany are well aware of the emotional damage caused by unemployment, and have instituted ‘workshares,’ to keeps workers from being laid off. The German government helps companies keep employees on their payrolls by subsidizing their wages with the money saved on unemployment benefits. All work fewer hours, but all still work. In contrast, in the US, managers are merging two jobs, and increasing the unemployment rolls.
The Stress of Being Unemployed
Not doing productive work does terrible things to a person. According to the APA, the chances of depression, anxiety, psychosomatic symptoms, low subjective well-being and poor self-esteem double with unemployment. And those still working often end up with a heavier work load and the constant fear and anxiety that they’ll be next. Parental job loss even increases the incidents of punitive and arbitrary punishment of children.
And unemployment doesn’t only impact individuals, it impacts entire communities.
More from the APA:
Widespread unemployment in neighborhoods reduces resources, which may result in inadequate and low-quality housing, underfunded schools, restricted access to services and public transportation, and limited opportunities for employment, making it more difficult for people to return to work (Brisson, Roll, & East, 2009). Unemployed persons also report less neighborhood belonging than their employed counterparts, a finding with implications for neighborhood safety and community well-being (Steward et al., 2009).
While APA does call for extending the Temporary Assistance for Needy Families program, it continues to advocate for more research on the psychological impacts of unemployment, and pushes job re-training. I argue that we know plenty about these impacts, and retraining only works if there are actual jobs to train for. Often these programs provide good jobs only for the workers who run them. Those who entered the computer programming field after being “retrained” can attest to the impact of repeated job displacement.
A Call to Action:
In the worst-hit cities, and indeed all over the USA, grass root action is happening, and I would like to invite my colleagues to join it or initiate it in their own communities. We need to radically transform the way we provide mental health in this country, one psychotherapist at a time.
Our profession has become so tethered to health insurance companies, that we’ve stopped considering those without insurance coverage as “client eligible.” The unemployed fall into this category.
It is clear that economic and psychological insecurity due to employment displacement is a real psychological issue. How do you ignore 40% unemployment or underemployment? How does that not get mentioned as a “specialty” under “problems treated”? It is not enough to call it a “loss” or “life transition.”
And the silence about the context of psychological suffering in these profiles sends another message implicit: Silence says that economic hardship, rising crime, deteriorating environmental conditions, and sky-rocketing energy costs aren’t appropriate issues to discuss in psychotherapists’ “safe offices.” The message is “your pain is not connected to your deteriorating world.”
Some will argue that those in financial need are served by public mental health clinics, and don’t belong in private psychotherapy offices. This argument is spurious, at a time when funding to pay for public services are dwindling. The mental health clinic I worked at that served the poor exclusively had a six-month waiting list.
If psychotherapy is truly a ‘calling’ where empathy reigns, I urge my colleagues to find psychologically sound methods of providing these services to those in need, regardless of their financial situation.
And because productive work enhances mental health, “Sliding scales” and hand-outs aren’t the best solutions.
Community Exchange Systems
One way to provide mental health services to the un- or underemployed, a strategy used successfully during the first Great Depression, is Community Exchange Systems (CES). To again quote my former article:
When the Great Depression fell upon the American public, Self-Help organizations sprang up as a “spontaneous mass movement” and became a part of daily life for many people. By the end of 1932, there were self-help organizations in over 37 states with 300,000 members (equivalent to 2.1 million people today). Their work involved direct exchanges of goods and services (partially in cash), cooperative production for sale or trade. The largest group, in Seattle, WA, the Unemployed Citizens League (UCL) had twenty-two local commissaries around the city where food and firewood was available for exchange for every type of service and commodity from home repairs to doctors’ bills. Local farmers gave unmarketable fruits and vegetables over to their members to pick and people gained the right to cut firewood on scrub timberland.
These systems are not direct bartering. “Bartering” poses ethical dilemmas for therapists and can, for example, muddy the therapeutic relationship. Instead, trading system “clients” are in no way obligated to the therapist directly. They instead are obligated to the community, “paying back” their psychotherapy by delivering/selling something to another trader in the community. It is, in the true sense of the word, a “favor bank.”
Giving to the War Effort
Today, as during World War I, psychotherapists have rallied to help returning veterans and the US Military, and this effort demonstrates how effective Community Exchanges are as applied to psychotherapy. CES organizations like Give An Hour , ask clinical volunteer professionals to give an hour of their time to provide critical mental health services to U.S. troops and their families who have served in Afghanistan and Iraq. This organization is proof that such a system can work well for our profession.
Surely the economic ‘War on Workers’ deserves our attention no less.
The Dangers of Psychological Terrorism
I’ve developed a deep respect for how powerfully psychology frames reality. Misuse this power, and we pathologize a person’s emotional reactions, attributing psychological symptoms, such as anxiety and depression to past traumas, when these reactions are perfectly appropriate given the current situation or potential threat that presents itself. The sorrow over the death of a parent, for example, is not a mental illness, it is an appropriate emotional response to what has happened to you. Unemployment and the resulting social and economic damage is no different.
When we pathologize predictable responses to life’s difficulties, and disconnect actual events from common emotion reactions to it, we inflict what I call “Psychological Terrorism.”
When, as a group, we psychotherapists don’t acknowledge economic hardship, energy depletion, or environmental degradation as legitimate concerns for exploration in therapy, we send a powerful message to people implying that these aren’t “real” concerns, or that these are “personal” as opposed to “collective” issues, that require only personal help. Referring the un- or under employed to movements like UCubed allows them to see themselves as part of the 31 million Americans without work. It contextualizes their pain. It promotes collective action. It enhances mental health.
While mentioning “I know these are hard times” or “I’m sensitive to environmental concerns’ in their advertising will hardly be a revolutionary act, it is an initial step in first and foremost labeling this severe economic depression as “real.” Imagine if physicians, dentists…all health and allied mental health professionals included in their advertising the phrase “We know you are hurting from this bad economy. Let us know how we can help you get the help you need.”
This type of advertising says “It’s real. It is happening to all of us, not just you.” It labels these concerns as legitimate stressors that intensify the need for treatment, as well as being a legitimate topic for treatment.
Community Spirit Lives
Community Exchange Systems (CES), Local Exchange Trading Systems (LETS), Mutual Credit trading systems or Time Banks are trading systems that are truly workable in communities decimated by a crumbling economy. When psychotherapists join them, participate in them, it tells our communities that we are aware of what is happening, and we are active participants in healing the suffering. We put our own labor on par with that of other community workers and we are willing to exchange that labor to those who are willing to work for others. Our very participation in such CES organizations are bolstering the care we provide, by providing the opportunity to work.
We Live in Historically Significant Times
My colleagues, let us not be judged harshly by history yet again. Eighty years ago, we responded, as a group, to the war effort, while ignoring the unemployed:
“When the United States entered the First World War, psychologists,
as an associated group, volunteered their professional services. Their contribution was considerable, both to the conduct of the War and to psychology.
When the United States entered the big world depression, psychologists did nothing and, as a group, have so far done nothing.
For nearly 10 years we have suffered through a national social and economic crisis; yet, from an examination of our professional journals and the programs of our professional meetings, one might conclude that psychologists were oblivious of the fact that our social institutions are rattling about our ears.
In fact, the world at large is as ignorant of the possible contributions of psychologists as psychologists appear to be about the world.”
From: The psychologist’s understanding of social issues. Gundlach, R. H.; Vol 37(8), Oct, 1940. pp. 613-620
Will history repeat itself?
We can take action, as a profession, developing psychologically savvy and effective ways to empower those now ravaged by the second Greater Depression. We can add our voices to the growing choirs that say “growth is a dead end on a finite planet” and that a “debt-based economy harms people.” We can tell our clients “It isn’t you. You are living in a time of great social upheaval. Don’t blame yourself.”
We can refuse to participate in Psychological Terrorism.
We know and teach that relationships, not material possessions bring us happiness. Now we must model that conviction in our work, by interweaving our efforts into our wounded communities, giving and receiving services, not only money.
By our actions, we demonstrate our motivation to change our world for the better and earn the label “healers.”
Dr. Kathy McMahon, “The Peak Shrink,” is a clinical psychologist who chides herself, as well as her colleagues, for not pushing harder to find better ways to reach the un- and under-employed in her community. She’s learned something about unemployment when her husband lost his business and was un- or under employed for 18 months. She’s learned about “job merging” when her “promotion” was withdrawn and “combined into” another existing higher-up position. You can critique her own professional profile by entering in “Psychologist” and “Cummington, MA,” or just Google Kathy McMahon.
She welcomes your comments.
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