Sarvenaz Moshfegh Asiedu

America is a Prison; Cultural Hegemony in Mental Health

Sarvenaz Moshfegh Asiedu 



first edition July 2014, edited May, 2016

 
Abstract

 

Explored in this paper are the cultural beliefs implicit in the field of psychology supporting hegemony, through a sociohistorical account of the involvement and development of the field of mental health particularly in relation to the United States Prison System.

Written in the spirit of critical pedagogy, I include my embodied personal experience as witness to the inner-workings of the in-justice system as a mental-health intern the Middlesex House of Corrections in Billerica, MA. 

There is no neutrality in the face on oppression.  There is only solidarity or consent.


In the words of Judith Herman (1997):

When the traumatic events are of human design, those who bear witness are caught in the conflict between victim and perpetrator.  It is morally impossible to remain neutral in this conflict.  The bystander is forced to take sides.

It is very tempting to take the side of the perpetrator.  All the perpetrator asks is that the bystander do nothing.  He appeals to the universal desire  to see, hear, and speak no evil.  The victim, on the contrary, asks the bystander to share the burden of pain.  The victim demands action, engagement, and remembering” (loc 96-7).


 
Introduction

 I walked behind my supervisor, a thin blond white lady in her 50’s in the dim hallway, heavy steel doors wall to wall on both sides, cement floor.  I felt fear, and despair and powerlessness.  Behind each door was a man confined, punished for some alleged infraction of the jail’s rules, from having an extra candy bar in their cells or refusing to go back to their cells.  I was there as a mental health intern, shadowing my supervisor as she checked on each man in “the hole” to make sure  no one wanted to kill themselves – or at least to check off that someone had asked them.  Some put in notes to the mental health staff, reaching out for help.  We spoke to them through a slit in the side of the locked heavy door. 

“I’m not doing good.  I’m real depressed.  I miss my kids.  I’m losing it.” 

My supervisor listens compassionately.  What can she offer them?  If they say they want to harm themselves or are out of control, they will be shackled and brought to the infirmary, stripped naked and dressed in the “turtle suit”, locked in a cell with a camera, watched from the infirmary bubble.  If they are determined to be in severe psychosis, they may be eventually transferred to Bridgewater State Hospital, only to be sent back to the jail weeks later. 

Inmates that see mental health cannot be seen by their counselors (graduate interns) while they are in segregation or in crisis.  Their counselor can check in on them and they may “put in a slip” if they feel worse and want to come to the infirmary.  No visits in “the hole”.  45 minutes of time outside the cell per day. That is the consequence of emotional vulnerability in jail. 

In my time there, I’ve known people to stay in segregation for up to three weeks, which is supposedly the maximum in the county jail.  In state prisons, there is no maximum time in isolation.  Some spend years or decades in “the hole”. 

           

My story starts in this dark, smelly place, of men young and virile, men old and worn out, men that won’t stop fighting, men that have given up.  Who are the players?  There’s the inmates, the “cops” (correctional officers), the case workers, drug counselors, the medical staff (nurses mostly and doctors) and the mental health staff (one LSCSW, one psychiatrist, one Doctorate level psychologist and a few interns per thousand inmates) (Middlesex House of Corrections, 2014, n/p).  Who’s the boss?  The cops of course.

There is nothing ethical about incarceration.  There is no ethical way to be complicit in the torture, degradation, and humiliation of animals, let alone human beings; stripping them naked, handing them like objects, because they have been convicted of breaking the law, or are suspected of breaking the law.  When does a person become dehumanized?  When they challenge power? Or when their existence is a threat to power? 

The primary role of mental health within a correctional institution is not therapeutic; it is in service to the institution to attend to the vulnerable guard against claims of neglect.  Standards of treatment are not equal to that on the outside.  Medical and mental healthcare is dispensed reluctantly as a “privilege”.  Men are constantly accused of  “malingering”.  Why would someone fake a urinary tract infection?  “They just want attention.”  One man in the infirmary had one testicle amputated due to negligence.  One man, weak and pale from prostate cancer, is shackled hands and feet to the chair in the hospital when he receives his chemo. Any expression of impatience, discontent, or questioning towards the staff are punished.  “Let him wait.”

Mental health professionals are all required to study ethics and to agree to uphold the “Code of Ethics”.  Within any correctional institution, the mental health staff is expected to follow the rules of the institution, and conform to the culture of the institution.  There is no guarantee of confidentiality. Patients are spoken about between staff without dignity or discretion.  Cries for help and answered by isolation and punishment.  Psychiatric prescription are determined by institutional policy. Survivors of sexual abuse suffering from severe symptoms of post-traumatic stress are confined for 22 hours a day, strip searched at any moment, forced to shower with other men.   The majority of inmates have been suffering from drug addiction, locked up for property crime, their disease arrested for months or years, to be released indigent onto the streets, . 

“They did it to themselves.”  “Anti-social personality” “emotionally disregulated” “no impulse control” “piece of shit junky” “drug-dealing scumbag” “heartless gangbanger” “thief” “crackhead” “knucklehead” “punk” “manipulator” “institutionalized” “homeless” 

Researching the current role of psychologists within the prison system and the lack of response to injustice causes me to reflect on the mental health profession as a whole.

           
The American Psychological Association Code of Ethics (2014) was written primarily retro-actively, in response to lawsuits and complaints, focusing its language on research and treatment of people as individuals.  The only mention of the psychologist’s relationship with society is in the preamble:

Psychologists are committed to increasing scientific and professional knowledge to improve the condition of individuals, organizations, and society.  Psychologists respect and protect civil and human rights and the central importance of freedom of inquiry and expression in research, teaching, and publication.

 (APA, 2014, p.3)

Mainstream psychology and mental health fields avoids addressing systemic problems, taking an individualistic and non-political approach in addressing well-being.  By taking a seemingly neutral stance on systemic corruption, professional psychologists and psychology as a field tacitly or intentionally consent to systems of oppression. 

History of Psychology as a Tool of Oppression

 “Once we accept that power and interests affect what we do, we don’t accept the premise that research is neutral, that interventions are not affected by politics, and that we are just healers” (Prilleltensky & Nelson, 2002, p.6)

In the education of mental health professionals, there is a scarcity of critical inquiry of the political basis of psychological theories and research.  Standard textbooks relay the history of psychology as apolitical, thus ignore the unflattering practices of the past and present, that helped to shape and support the prosperity of the few: economic disparity, the obscuring of national liberation movements, white supremacy, economic and psychological violence against women and people of color, internalized oppression, xenophobia, consumerism, the fragmentation and destruction of Native American communities, the continued racial oppression of African Americans, and the growth of the prison industrial complex (Prileltensky,2002; Haney, 1997, p.500).  Only when we endeavor to understand the function of psychology within a socio-political context, can we begin to understand its influence in shaping human experience through culturally implicit internalized beliefs and motives (Prilleltensky & Nelson, 2002, p.6).

The American Psychological Association (APA) grew into a centralized national organization in the United States in financial and ideological symbiosis with the growth of government “intelligence” agencies such as the O.S.S. and the C.I.A. (Chalquist, n.p., 2013; Arrigo, Eidelson & Bennett, 2012, p.3).  Today we can see this in the proliferation of psychometric testing for employment in government agencies, police and military roles, and corporate jobs. You can’t work at a supermarket today without completing an online psychological test. Research funded under the guise of human advancement is in actuality in service to an agenda of control and the consent to authority (anonymous, n.p, 2012).

Chalquist (2013) describes in his article, “Why I am Not a Member of the American Psychological Association”,

In the U.S., John Watson, a president of the APA, taught behavioral techniques to mass marketers after losing his professorship at Cornell University. Hugo Munsterberg, an early APA member, started industrial psychology by writing Psychology and Industrial Efficiency in 1912. “The psychological experiment,” he wrote, “is systematically to be placed at the service of commerce and industry.” Walter Dill Scott directed psychology into personnel screening and wrote The Theory and Practice of Advertising. Scott, who had arrived at the idea of workplace efficiency while plowing a field, also advocated appeals to emotion to override reason and heighten consumer suggestibility. (n.p.)

 

Power

Critical psychologists, Prilleltensky & Nelson (2002) define power as “the capacity and opportunity to fulfill or obstruct personal, relational, or collective needs” (Prilleltensky & Nelson, 2002, p.7).  Power can be applied to self, others and collectives having “varying degrees of awareness” of how their actions impact others (Prilleltensky & Nelson, 2002, p.7).

 Power is variable, intersectional and contextual.  Social class, gender, ability, and race can be factors in power differentials, as well as valued cultural attributes such as beauty, intelligence, and assertiveness. Power is dynamic within a particular setting, relationship and individual (Prilleltensky & Nelson, 2002, p.7). “The outcome of power is based on the constant interaction and reciprocal determinism of agency and contextual dynamics” (Prilleltensky & Nelson, 2002, p.7).  Agency is the individual’s or collective’s ability and volitional activity and the contextual dynamics are made up of opportunities based on social and historical circumstances (Prilleltensky & Nelson, 2002, p.7).     

Power in American society is not always expressed through coercion.  The population internalizes “cultural prescriptions” (a euphemism for mind-control) and self-regulates by restricting their life choices to fit the status quo (Prilleltensky & Nelson, 2002, p.7). Internalized oppression and social prescriptions motivate people often outside of their conscious awareness, which means that actions and behaviors may not evolve from innate desires but from “internalized social prescriptions” (Prilleltensky & Nelson, 2002, p.8). Humanistic approaches to treatment are well meaning, but cause people to blame themselves for unconscious beliefs that are an outcome of governmental programming (Prilleltensky & Nelson, 2002, p.8).

History of the American Prison System

The use of punishment is justified by modern Western judicial systems based on retribution, deterrence, incapacitation and rehabilitation (Grillor, 1983; Kerper, 1972 as cited by Weinberger & Sreenivasan, 1994, p.161): retribution comes from the Biblical notion of “an eye for an eye”, deterrence is based on the idea that punishing one sets an example for others, incapacitation renders the offender unable to re-offend and rehabilitation is the treatment or “correction” of offenders in order to re-enter society (Weinberger & Sreenivasan, 1994,p.161). 

Rehabilitation during early colonial times was believed to be accomplished through severe punishment in the form of stocks and gallows (Weinberger & Sreenivasan, 1994, p.161). Through most of the 17th century, criminals were viewed as persons who had “wandered astray” which put an internal limit to their treatment by the community (Haney, 1997, p.516).    In the eighteenth century, Protestant values influenced the belief that institutional rehabilitation would be achieved through solitude, hard labor and contemplation, which evolved into “penitentiaries” (Weinberger & Sreenivasan, 1994, p.161).   The American colonies at this time were sparsely populated and social control concentrated on “biblical” offenses such as adultery and blasphemy rather than property crime (Haney, 1997, p.516).  The “alleged wickedness” of criminals and the causes of crime were debated in popular discourse in the 19th century which had a great influence on prison policy and operations (Haney, 1997, p.516).  Psychological theories played a key part in the transformation of social consensus about crime (Haney, 1997, p.516).  

Psychological individualism was the nineteenth-century concept that facilitated the creation of a vast prison system and made confinement the first response of the criminal justice system (Haney, 1997, p.516).   The belief in the “perfectibility of human nature” created the use of the prison as a place where change would be coerced in the individual (Haney, 1997, p.516).  Physical control was believed to be needed for successful rehabilitation (Haney, 1997, p.516). 

Psychological theories in the science of human behavior convinced the public that penal policy was a science (“prison science”) (Haney, 1997, p.517).  Metaphors such as “crime-as-sickness” and “moral disease” were popular along with the genetic or biological theory of the “born criminal type” (Haney, 1997, p.517).  Penology was perceived as a methodical system “in accord with the true science of our common human nature” (Haney, 1997, p.517).  Parole, vocational training, early release for good behavior and individualized treatment were introduced during this time based on the medical model (Weinberger & Sreenivasan, 1994, p.161).  

Individualistic psychology became more prominent in penology in the first half of the 20th century (Haney, 1997, p.517).  Indeterminate prison sentences were introduced, which determined release entirely on demonstrating personal transformation (Haney, 1997, p.517).  Juvenile courts shifted the focus from the nature of the offense to the character of the child and probation officers were created to intervene in and observe individuals once they were released from prison (Haney, 1997, p.517). Psychological experts were relied upon directly to make decisions concerning all aspects of the penal system and the practice of classification of prisoners based on their personal characteristics (Haney, 1997, p.517). Psychiatrists and psychologists took posts inside prisons for the first time during this period, though their role was narrow, primarily to legitimize incarceration and underline the message that crime was a product of the pathology of criminals (Haney, 1997, p.519; Weinberger & Sreenivasan, 1994, p.161). The legacy of Darwin’s “survival of the fittest” model of evolution influenced models of criminology in the early 20th century:

In 1876, Italian criminologist Cesare Lombroso argued that criminals were a "throwback to earlier stages of Darwinian evolution," and in 1924 Clar­ence Darrow argued (in defense of Leopold and Loeb) that criminals were "programmed for crime by material forces over which they had no control." Since eugenicists believed that criminal tendencies were inherited, they strove to curtail the breeding of groups that produced criminals. By the early 1930s, thirty states in the U.S. had sterilization laws, and by 1958, around 60,000 Americans had been sterilized, many by coercion. When Oliver Wendell Holmes, a Supreme Court Justice, approved of Virginia's forced-sterilization law, he said it was the way to "build a race." Later, when Nazis forcibly sterilized the "unfit" in the 1930s, they claimed to be acting, like us, on "biological principles." Hitler even declared that he had studied the laws of several American states for the sterilization of people whose breeding was "injurious to the racial stock."

Gardiner, n.p., 2008

Until the 1970s, psychologists played minor roles setting limits to prisoner cruelty and in rehabilitation (Haney, 1997, p.519).  Shifts in psychological concepts of social behavior that emphasized social context during the 1970s could have made an impact on the penal system had they not been displaced from positions of any influence during this time (Haney, 1997, p.519). The 1970s were an era of prison reform; the trial of Angela Davis brought the conflict to the greater public and prisoners agitated for unions and political organizations (Bernstein, 2010, p.4).   Prison activists such as George Jackson helped inmates to understand their confinement from political and historical perspectives, and sought to inspire large-scale revolt (Bernstein, 2010, p.2).  Reactionary politics, fear tactics, and suppression brought upon as a reaction to the expressed dissatisfaction with government in the 1970’s influenced acceptable public opinion and halted progressive thinking about crime and punishment (Haney, 1997, p.521).

There was little commentary or analysis in the field of psychology concerning the changes in promoted political movements concerning incarceration (Haney, 1997, p.521). Psychologist Robert Martinson published an influential article in the 1970s that stated that “nothing works” in prison rehabilitation and that attempts at rehabilitation of criminals was futile (Haney, 1997, p.521). His claims were based on his role along with Lipton and Wilks in the evaluation of 231 studies on offender rehabilitation, entitled, “The Effectiveness of Correctional Treatment: A Survey of Treatment Evaluation Studies” (Miller, 1989, n.p.).  This study was funded by  the “New York Office of Crime Control Planning”, created by then Governer of New York, Nelson A. Rockefeller in 1968, (NCJRS, 2016, n.p.; Rockefeller, 1968, n.p.).  The programs he evaluated were highly limited based on meager budgets and did not take into consideration the conditions for inmates once they were released (Haney, 1997, p.517).  This opinion government sanctioned and disseminated to the public; it became widely accepted in the field of criminology and rehabilitation lost favor in public opinion (Haney, 1997, p.523).   Prison was for punishment and not a place for rehabilitation. (Haney, 1997, p.523).   Nelson Rockefeller as governer of New York, approved an assault on prisoners during Attica riot of 1971 that ended in the massacre of 39 men (Roberts, 2011, n.p.).  “Rockefeller drug laws” were enacted in the following years as the “War on Drugs” took off (Schlosser, 1998, n.p.).   Indeterminate sentences were replaced with mandatory minimum and maximum sentences based on the criminal act itself with no regard for circumstances of the crime or “amenability to treatment, personal and family history”, previous efforts of rehabilitation or alternatives to prison. (Miller, 1989, n.p.; Haney, 1997, p.524). This shift in ideology moves the focus from the character of the individual to the government determined severity of the crime (Haney, 1997, p.524). 

The rejection of rehabilitation and the institution of “just deserts”-based sentencing eliminated any clear mandate for institutional programming (Haney, 1997, p.525).  Less programs, less incentives to participate as sentences were fixed, and massive overcrowding caused serious disciplinary problems in some institutions (Haney, 1997, p.525).  Since the goal of prison was now punishment and no longer reform, public and legal concerns about psychological destructive practices in prison were dissipated (Haney, 1997, p.525).  The role of the psychologist in the prison system changed during the 1970s and 1980s, deemphasizing treatment for security and public safety (Weinberger & Sreenivasan, 1994, p.161).  Psychologists remain in this role today.

Present Day

The sheriff or warden of institutions has authority over chief psychologists and other mental health department heads and has the final word in implementing policy regarding mental health (Weinberger & Sreenivasan, 1994, p.162).  Institutional justifications for placing mental health under correctional administration are financial and a way of maintaining the culture and authority of punishment.(Weinberger & Sreenivasan, 1994, p.162).  There is in fact very little money devoted to mental health and medical health in the US prison system.  Placing mental health under the jurisdiction of the institution means that ethical issues brought to the attention of mental health professionals within jails and prisons are not resolved due to their lack of authority (Weinberger & Sreenivasan, 1994, p.162).

From the perspective of the correctional administration, the role of mental health professionals is to ensure compliance and a manageable inmate population (Weinberger & Sreenivasan, 1994, p.162).  Psychologists are expected to act in “custody-oriented activities” such as inmate discipline reviews and searches for contraband (Weinberger & Sreenivasan, 1994, p.162).  This dual role obviously causes harm to the therapeutic relationship and integrity of the psychologist in the eyes of those he/she is supposedly “treating” (Weinberger & Sreenivasan, 1994, p.162). 

Areas of ethical concern were addressed by “Specialty Guidelines for Forensic Psychologists” developed by the APA in 1991 (Weinberger & Sreenivasan, 1994, p.162).  Areas of concerns were confidentiality, use of psychological assessment and treatment interventions (Weinberger & Sreenivasan, 1994, p.162).  Despite the creation of these standards, the same concerns are present today, almost a quarter of a century later.  Despite research done twenty years ago, highlighting the powerful influence of social context on prison violence, psychologists and criminologists continue to focus on individualistic pathological and biological bases of behavior (Haney, 1997, p.503).

The following was published in 1997 by the APA, in an article “Psychology and the Limits to Prison Pain”:

Modern psychological theory thus contains several powerful lessons for contemporary criminal justice and penal policy, virtually all of which have been overlooked, ignored, or disregarded in recent trends toward ever increasing levels of imprisonment: (a) that exclusively individual-centered approaches to crime control like imprisonment are self-limiting and doomed to failure if they do not simultaneously address criminogenic situational and contextual factors; (b) that prison environments are themselves potentially damaging situations whose negative psychological effects must be taken seriously, carefully evaluated, purposefully regulated and controlled, and when appropriate, changed or eliminated; (c) that programs of prisoner change cannot ignore situations and social conditions that prevail after release if they have any hope of  sustaining whatever positive gains are achieved during periods of imprisonment; and (d) that long-term legacies of exposure to powerful and destructive situations, contexts, and structures can mean that prisons themselves may act as criminogenic agents – in both their primary effects on prisoners and secondary effects on the lives of persons connected to them – serving to increase the amount of crime that occurs within a society.

(Haney, 1997, p.504)

            Nineteen years later, the prison system has grown exponentially, and the voices raising concern are not coming from the APA but from prisoners themselves. In Califoria this year (2016), “an historic settlement agreement with the California Department of Corrections and Rehabilitation (CDCR) that is bringing an end to indefinite solitary confinement in California prisons. The Settlement Agreement includes hard-won (and unprecedented) periodic meetings between the CDCR and the prisoners who initiated the lawsuit and led the protests against long term solitary confinement” (Ashker, 2016, n.p.). 

Why is the field of psychology silent?  Perhaps because it is focused on creating disorders such as “selfie-addiction” and conducting yet another study concerning the differences between men and women, or devising new ways to torture enemy combatants (Huffington Post, 2014, np).  Most likely they are all busy treating middle-class people with depressive disorders or children with ADHD. 

The education of mental health workers to this day focuses on the Diagnostic and Statistical Manual (DSM), which is written by agents of Pharma (Brooks, 2012, n.p.). There are no requirements for trauma-informed training for licensure in mental health, nor any required courses on trauma in graduate programs in psychology or counseling.  The required exam to become a LMHC, or social worker or psychologist is based on repeating the prescribed diagnosis and treatment advocated by the APA, and not challenging the system.

The current figures for US prison population are “2.4 million people in 1,719 state prisons, 102 federal prisons, 2,259 juvenile correctional facilities, 3,283 local jails, and 79 Indian Country jails as well as in military prisons, immigration detention facilities, civil commitment centers, and prisons in the U.S. territories” (Wagner & Sakala, 2014, np). Michelle Alexander (2011) describes the consequences for being in the criminal justice system:

Once a person is labeled a felon, he or she is ushered into a parallel universe in which discrimination, stigma, and exclusion are perfectly legal, and privileges of citizenship such as voting and jury service are off-limits.  It does not matter whether you have actually spent time in prison, your second-class citizenship begins the moment you are branded a felon.  Most people branded felons, in fact, are not sentenced to prison.  As of 2008, there were approximately 2.3 million people in prisons and jails, and a staggering 5.1 million people under “community correctional supervision”- i.e., on probation or parole. Merely reducing prison terms does not have a major impact on the majority of people in the system.  It is the badge of inferiority – the felony record – that relegates people for their entire lives, to second-class status…..For drug felons, there is little hope of escape.  Barred from public housing by law, discriminated against by private landlords, ineligible for food stamps, forced to ‘check the box’ indicating g a felony conviction on employment applications for nearly every job, and denied licenses for a wide range of professions, people whose only crime is drug addiction or possession of a small amount of drugs for recreational use find themselves locked out of the mainstream society and economy – permanently”  (p.94).

 

            The International Association for Correctional and Forensic Psychology (2010) cited an increase demand in the past decade for forensic assessment and expert testimony roles, which may indicate that are incentives for many in the field of psychology to further support the prison system (p.766).  Laughably, the emergence of stress-related disorders such as Post Traumatic Stress Disorder, is attributed to “current military actions” and not to solitary confinement or other institutional trauma (IACFP, 2010, p.766).  As a standard , the IACF states that “Inmates who are seriously mentally ill (psychotic, bipolar, severely depressed) are assessed minimally every 60 days” (IACFP, 2010, p.777)  When “mentally ill” inmates are put in segregation/isolation, “the stresses associated with segregation/isolation status can result in further emotional and cognitive decompensation, resulting in a cycle of even longer periods in segregation” (IACFP, 2010, p.783) Standards for dealing with suicidal inmates are taken seriously in the ethical standards due to the risk of litigation (IACFP, 2010, p.784). “Inmate suicide remains one of the leading causes of inmate death… Litigation is a highly stressful process and settlements can be very costly and can place professional careers in jeopardy” (IACFP, 2010, p.791).  Rather than protest conditions that cause so many men to take their lives, the IACFP chooses to protect them selves from the stressful situation of a lawsuit. In 1996 the “Prison Litigation Reform Act” made it more difficult for prisoners to file lawsuits against correctional facilities, requiring them to exhaust “administrative remedies”, instituting a “three strikes provision” that limits the number of times an individual can file suit, and requiring demonstration of physical injury alongside with any mental injury (ACLU, 2002, np).

            The IACFP (2010) itself notes that more developmentally disabled individuals than ever in history are being incarcerated due to deinstitutionalization and changes in criminal legislation, and more than half of the prison population of 2.5 million suffer from mental illness (p.694, 768, 756). Before the 1960’s, the “mentally ill “were seem as ill first and criminals second; now the reverse is true (IACFP, 2010, p. 756).  Although the IACFP recognizes the suffering of prisoners, by labeling individual pathology, they neglect to address the sadistic culture of the criminal justice system.

“Labels can mask sources of oppression” (Prilleltensky & Nelson, 2002, p.105)

The Use of the DSM in diagnoses emphasizes a diagnostic label, disregarding the context of individual experience and masking oppression (Prilleltensky & Nelson, 2002, p.105).  Despite the data, psychologists are still focused on individual, dyads and families in their interventions rather than socioeconomic determinants (Prilleltensky & Nelson, 2002, p.9).  Comparisons  of the health status of populations in countries of highly unequal income distribution (such as the United States) and those with more equitable distribution demonstrates that economic disparity is linked to poor health status; this indicates that collective social factors have a great influence on the well-being of individuals  (Keating & Herzman, 1999, as cited by Prilleltensky & Nelson, 2002, p.11).

Conclusion

            Definitions of well-being based in intra-psychic factors concentrate on cognitive and emotional factors to the exclusion of  “social, material and political roots and effects of lack of power” (Prilleltensky & Nelson, 2002, p.11). Conditions that support well-being require social and political conditions free of economic exploitation and human rights abuses (Prilleltensky & Nelson, 2002, p.11).

            As future or current professionals in the “helping professions”, I challenge you to answer the question, “Who are you working for?”  I challenge you to ask why cognitive behavior therapy is continually used to treat highly traumatized populations, such as people suffering from long-term substance abuse and individuals with a history of incarceration.  I challenge you to ask, why in 2016, trauma-informed treatment is not required for licensing of mental health professionals.  I challenge you to ask why your psychology textbooks leave out the context and history of theoretical approaches.  I challenge you to ask why many of us humans that are not of the White middle-class continue to be wary of the field of psychology. 

            Do you want to serve the machine? Or do you want to serve humanity?  There is no middle ground.

 

 

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