We’ve Got Your Back!

I want to share with you a note that was sent to the Social Therapy Group after our “Play Pride” event, Sexuality, Gender and Development. As a contribution to our dialogue, Yemayah raises a profound issue concerning the development of African American youth:

I wanted to say that I enjoyed yesterday’s discussion — it was interesting, provocative and funny. Later, I had some thoughts about race and how it pertains to the development of young people of color that I’d like to bring into the conversation.

During the conversation we talked about allowing people to grow and develop without oppressing them with our individual and/or collective conservatism. Each story — the one about Mark’s son and Tinker Bell, and about Christine’s young patient who dressed up in his sister’s clothing — was touching and very human. I began to think about those examples and how they would play out if those boys were African American. Now, I admit that I don’t know the racial makeup of the young boy in Christine’s example, but I assume he wasn’t African American.

We understand that the world we live in is very oppressive in many aspects. I believe that progressive growth and development is severely lacking in the African American community and I have a theory on why I think this is true. African American children (especially males) do not have the same “wiggle room” that other children have. By “wiggle room” I mean there is not the same space for self-expression and trial and error. This is evident in how the school system treats young African American boys. African American boys are often feared and judged by their size, the way they move and the way they play and express themselves. African American mothers have to teach their young sons to negate their natural, authentic selves in order to fit into the paradigm that is acceptable to the people who are in positions to alter their lives. Many mothers in my community are extremely fearful and will not tolerate their children behaving in any way that might be perceived as queer, criminal or intimidating. This is the beginning point of oppression. It starts in the family and then continues to play out in the larger society; the world. 

I say all this to point out that African American children often do not have the luxury of stepping outside of societal expectations because then they risk negatively altering their lives in a permanent and irreversible way. Using Mark’s example of Tinker Bell, an African American child’s parent probably would not allow a male child to even entertain the thought of dressing up like a female. I do not believe that conservatism is the sole rationale for this reaction. African American parents know that their children have to be extraordinary just to be able to compete in the world. Our children cannot afford to screw up because they may not get a second chance. I understand that there are other issues that perpetuate this idea of having to be exemplary, such as limited resources, lack of quality education and plain poverty. If a young African American child makes “poor choices” his family may not have the resources to get him back on track; or may not have the power or know the right people to help them. So believing they are protecting their children, these parents are very reluctant to allow behaviors they feel will undermine their child’s success in life.

Does this mean that the African American community cannot afford the luxury of growth and development? Are we destined to be oppressed and stuck in the quest to fulfill societal expectations? If this is true, how does this oppression play out in our families, relationships and community?

I am interested in hearing your perspective regarding my theory.  

— Yemayah

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Dear Yemayah,

Thank you for writing — the questions you raise are profoundly important. Here’s what I’m thinking: conservatism, oppression and lack of opportunity (for all people) and the limited choices that follow from them are deeply upsetting. The institutions of education, psychology, healthcare and the justice system are in sharp decline. Racism and poverty are most certainly alive and well in our country. And as you point out, the profound scarcity of environments for African American youth to grow is a stark reality.

To me, the question is what we can do about it. Must we accept the profound limitations of an oppressive culture and adapt our children to the material and emotional poverty that exists? Limit childrens’ capacity to play and perform and inhibit who they can become as adults? Are these our only choices? Is development, as you ask, an unaffordable luxury for the African American community?

I say no. Development is part of what it means to be a human being. Do white youths have greater access to environments to play and perform? Sadly, yes. But it’s important to know that playing with gender and sexuality has consequences, no matter who you are. The question is always: how do we work together to create environments that support all people?

You describe the particular constraints and pressures on African American youth — their limited resources, the very real fear that making a “wrong” choice can affect their future. Not knowing the right people who can help them if they get into trouble can destroy their lives. These are the profound consequences of underdevelopment, and I see what you’re describing as a profound need — the need we all have to break out of the isolation of racial identity and work together, to learn from each other and to be there for one anothers’ children.

Addressing this need — creating institutions and practices that are environments for growth and development for all people — has been central to the last forty years of building our community. It’s a development community whose work was begun by Fred Newman, the founder of social therapy, a working class Jew from the Bronx; and is carried on by Lenora Fulani, who grew up poor in Chester, Pennsylvania and was the first African American woman to run for the U.S. presidency in all fifty states; along with thousands and thousands of progressives nationally and internationally who are working to support the growth and development of young people in the context of an explicitly multi-racial movement that has development as its centerpiece. [You can read more about Dr. Fulani’s work on the subjective and psychological consequences of growing up Black and poor in America in this white paper.]

As a social therapist who grew up in the racially polarized neighborhood of East New York in the 1950s, I strongly believe that it is our responsibility to build community together. We need to build with everything we’ve got — our underdevelopment, our passions, our love of humanity, and our fears of a rapidly destabilizing world. And to build together, we all have to grow emotionally. It is the play and performance of white, Black, gay and straight America saying to one another — we’ve got your back!

— Christine LaCerva

I invite all of our readers to continue this important conversation. We want to hear from you!

Play Pride: Sexuality, Gender and Development

by Christine LaCerva

Mark Beauregard & Christine LaCerva

On May 17 the Social Therapy Group hosted a community dialogue on sexuality, gender and development as part of our new “Conversations with Practitioners” series. My guest at the event was Mark Beauregard, a creative arts and drama therapist who has done groundbreaking work using play and performance with his clients. I found our conversation, held in front of an audience of forty, to be extraordinary, and it was very moving to both of us. As therapists, we don’t often have the opportunity to create an open and exploratory dialogue with a community that is committed to creating a new, developmental psychology.

As therapists Mark and I are both madly in love with what we do, and our conversation helped us discover more about our work. We are both passionate advocates in our work with LGBTQ youth, and deeply committed to our patients’ democratic rights to grow and develop — sexually and otherwise. Neither of us make any claims of being neutral, and we both agree that this advocacy is central to growth — the patient’s and the therapist’s. We believe that people have the right to be who they are, as well as to become who they want to be. Our conversation went beyond the usual boundaries of child therapy as we explored our mutual passion for creating a place, an environment, for play and performance. We had a lot of stories to tell.

Mark talked about sessions in which he invites children to play and perform with cards that show archetypes, superheroes with a variety of characteristics. He told the story of a young boy who was struggling with his gender — can a boy wear pink and play with Tinkerbell? What happens if he does? The boy was experiencing disdain and dismay from both children and adults. Mark asked him to choose one of the archetype cards, and he picked the card that said “an ordinary person.” It was striking to me —both saddening and understandable — that a child who is having conflicts around gender has to deal with the limited societal choices prescribed by the gender-specified world we live in. It’s easy to imagine the pull for this child to want to perform as an “ordinary person,” someone who can make his own decisions and not be made to feel as if they are doing something wrong. The question this raises for me is: What is wrong with a culture that negates our capacity to play and perform new ways of being boys and girls (or men and women) together?

This “tyranny of the normal” teaches children very early that boys are not supposed to be into — among many other things — the color pink (yes, that is still going on!) and that girls must behave themselves — not be too loud, too aggressive, and definitely not be in charge. These are the rules and roles that are presented to our children every day. But how can we help young people who can’t, or won’t, or are just not interested in adapting to the existing culture? As therapists, I believe our job is to offer them something different, a new set of possibilities. In social therapy, our offer is the performance of being a “culture maker.”

In my work with families in social therapy, creating environments for this new performance is key. I want to share with you a transcript of this work in helping families learn how to play and perform together as culture makers.

Years ago, I worked with a five-year-old boy I will call Eddie. His parents brought him to social therapy because he was acting out in school and at home; for example, dressing up in a ballerina outfit (a pink one, of course), and prancing around when his sister’s friends came over. The family was horrified, and punished him and sent him to his room. Eddie’s sister wanted him banned from the apartment when her friends came by, and his parents — successful young professionals — told me they were frightened by what their son was doing.

First session

I met with Eddie and his family and I asked the family to share their concerns. They said they felt he was acting out to get attention. Eddie’s mother felt they had spoiled him; his father was worried that this was about Eddie’s sexuality. They said they came into therapy to get the opinion of an expert. I told them that my expertise was in helping families play together and break out of the ways they were performing their relationships that were preventing them from being close. Eddie seemed thrilled by what I was saying — he said he thought he was here because he was “doing bad things.” I asked him what the “bad things” were. He said it was when he wore the ballerina outfit. I smiled and said nothing. The conversation with the family continued for awhile, and Eddie started to seem bored.

Eddie:  What are we going to be doing here?
Christine:  We’re going to get to know each other.

Eddie jumped on my lap and began singing: “Getting to know you, getting to know all about you…” He knew all the lyrics. I invited his parents to sing with us, and we all sang the song together. We were doing a new performance of family, and it was very emotional for all of us. Eddie was delighted.

A few sessions later

Christine:  (To Eddie’s dad) What kind of help do you want?
Father:  I want to know if Eddie is gay.
Christine:  How would that be helpful to you?
Father:  I want to know if there is any way we can have an impact on him.
Christine:  How do you want to impact?
Father:  Do you think he is gay?
Christine:  I have no idea.
Father:  What’s with the ballerina outfit?
Christine:  If what you’re asking is “what is the meaning of all of this?” I think we have no idea. And I think that is, in fact, a good thing. I’m not interested in imposing any meaning or interpretation on you or your son. We can create something together without knowing very much about what anything means.
Mother:  I think my husband is saying he wants you to make sure that Eddie isn’t gay.

There was a silence.

Christine:  (To Eddie’s mother.) How do you feel about this?
Mother:  I want to be close to my son, whatever he decides to do with his sexuality.
Father:  Okay — now I’m being portrayed as the bad guy. I just don’t want Eddie going out to the ice cream store in his ballerina outfit.
Christine:  How come? What’s the problem?
Father:  He’s being ridiculed. People are snickering as we pass by, laughing at him.
Christine:  I hear you. That sounds hard. I do have a question for you, though. Do you want to be close to your son?
Father:  (Angry) Why are you asking that? Isn’t clear that I love him?
Christine:  I think it’s important to work on how you perform your love for him. Do you want to love him from a distance. or from up close. This is a complex issue for your whole family. If you want to be close to him, then — given who Eddie and you are right now — it’s possible that some new performances are needed.
Father:  (Exasperated.) Uh-huh. Okay, so what do you suggest?
Christine:  Let’s do some exploring right here. If you’re worried about people making fun of Eddie, maybe you could join him.
Father:  Join him? What do you mean?
Christine:  Well, maybe to be closer to Eddie, you could play with him, play with what he’s doing. This has nothing to do with Eddie being gay or not — I have no idea what will come from this. We’re playing around with what matters to Eddie right now.
Father:  How?
Christine:  Well, you could dress up in your wife’s clothes, Eddie could wear his sister’s ballerina outfit and you could go get ice cream together. That’s one way to play that might help you get closer. Your problem would vanish! You wouldn’t need to worry about Eddie in this scenario.

A long silence.

Father:  (Quietly.) What would I wear?

We all started laughing.

Mother:  You could wear my bathrobe and fuzzy slippers.
Eddie:  Yeah, you could wear her pink robe!

We all sat there and let ourselves experience the power of creating a new performance of love and intimacy in family life.

A few days after the session, Eddie and his father went for ice cream dressed in their respective outfits.

They told me about this in the next session, and I became emotional. Eddie asked me what was wrong. I told him nothing was wrong, that I was very proud of him and his dad because they were working hard to be close and show how much they loved each other. Eddie got out of his seat and gave his dad a hug.

My work with Eddie and his family was completed near Eddie’s fifteen birthday. He told me he was ready to leave therapy. He had done a great deal of work on what kind of young man he wanted to be. There had been — and would be — struggles, for sure. He was continuing to explore his sexuality. And he was just fine.

I would love to hear what you think about play and performance and their role in sexuality, gender and development. Please leave a comment!

Meeting Rachel Mickenberg and Social Therapy

by Christine LaCerva, Director
Social Therapy Group

Hello everyone,

A few weeks ago I had the pleasure of hosting a celebratory community event at the Social Therapy Group to introduce Rachel Mickenberg, a talented social therapist who is joining our staff. As a way of continuing to build community with all of you, I’d like to share with you the talk I gave that evening.

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As we begin our celebration tonight I want to tell you a bit about where you are. This is the Social Therapy Group, a community therapy center with offices here in Manhattan and in Fort Greene, Brooklyn. We also have centers in Philadelphia, Boston, Atlanta and San Francisco, and colleagues and practitioners who have been influenced by our approach in Uganda, Mexico, Norway, Denmark, South Africa, Argentina, India, and Brazil, to name a few.

But what is social therapy?

Social therapy is, first and foremost, a group therapy. Its methodology — what we call the practice of method — stands in sharp contrast to traditional approaches based in natural science and focused on the individual. In social therapy, we focus on development, and on the collective creativity of human beings. We understand human life to be primarily social, cultural, and relational.

Social therapy is a “performative psychology.” Performing is the human capacity to be who we are and who we are not at the same time. We relate to people as performers with the capacity to perform “ahead of themselves,” and who are in a social process of becoming — transforming, learning, and developing.

Social therapy is challenging and it is curative. It requires a particular kind of performance, “emotional improvisation” — creating developmental conversations that challenge our most deeply held notions of who we are, how to be together and what we are capable of. We bring together diverse groups of people and support them in performing this emotional improvisation together, creating new ways of “doing relationships” and of living their lives.

We reject the authority of the therapist as a “knower,” and support the leadership of the therapist as an organizer of developmental environments in which people can grow. Through the process of the group creating its therapy together with the therapist, a new experience of who they are and who they are becoming emerges.

Social therapy was founded by an extraordinary person, Dr. Fred Newman, who passed away a year and a half ago. He was a Marxist, with deeply held beliefs about changing the world we live in. He wanted to eradicate poverty, to address the failure of the education of our young people, and bust up the gridlock of the American political system, which continues to hold us all back. Fred understood that in order to create social change, people had to grow and develop emotionally. He knew we needed a new psychology that focused on human development and not on telling people what’s wrong with them and what box they fit into, what medications will “fix” them, or interpreting what’s “inside their heads.”

Fred Newman’s life work and legacy includes a constellation of independent institutions, of which the Social Therapy Group is a part. Among others, It also includes the East Side Institute, an international research, education and training center for human development and community; and the All Stars Project, a non-profit organization that creates outside-of-school development programs and activities for thousands of poor and minority young people using an innovative performance-based approach closely related to our own. The All Stars also offers classes and activities for all ages through its university-style school for development called “UX,” and runs the multicultural off-off-Broadway Castillo Theatre, which produces post-modern political theatre and is a home for Black theatre, the avant-garde, improvisational performance, and free training in the theatre arts for young people.

Tonight I have the pleasure of introducing you to a “being and becoming” social therapist, Rachel Mickenberg.
We love her. She is a deeply caring person who is dedicated to helping people grow and develop. And I want to share with you how much Fred Newman, the founder of social therapy, loved Rachel Mickenberg. What did he love about her? He loved that she’s tough, and passionate. She’s a progressive, from a family that has worked to do something about what’s going on in the world. As a progressive Jewish man, he loved that she’s a progressive Jewish woman, an ordinary woman who’s doing extraordinary things with her life. He loved that Rachel is willing to have the fights that need to be had, and her commitment to the young people she does social therapy with at the High School for Public Service. There, she helps them work together to perform ahead of themselves, and not be victims of a culture that does not recognize their value or offer them any opportunities. Rachel is helping them become the creators of their lives.

When I would meet with Fred to discuss how the work of the Social Therapy Group was going, he would often ask how Rachel was doing. “Don’t be too easy on her,” he’d say. “Make demands, help her grow. She’s got talent, you know. I think she could be a really good social therapist. What do you think?”

My answer to Fred Newman’s question was to create this event, to celebrate both social therapy, and Rachel Mickenberg as its newest practitioner.

— Christine LaCerva

Radical Acceptance

Christine LaCerva

In my last blog entry, I wrote about new ways of thinking, seeing, and creating possibility in our lives and the broader world. A key aspect of this kind of growth and development is an activity — a revolutionary idea, in fact — that Fred Newman called “radical acceptance.” The transcript below of a social therapy group led by Dr. Hugh Polk will give us an opportunity to explore and discuss this idea further.

Dr. Polk, my longtime colleague at the Social Therapy Group, will be teaching a class on the foundations of social therapy in late February. I urge you to sign up — especially if you want to be challenged to think and see in new ways. Dr. Polk is a progressive psychiatrist (an unusual combination!), a terrific teacher and a very talented therapist. I’d love for you to know him better and to learn from him.

Here’s Dr. Polk:

I lead social therapy groups in Manhattan and Brooklyn. The people in my groups are struggling with all the issues Christine wrote about in January. How do we deal with all these difficulties in social therapy groups?

We start by helping group members to become “radically accepting” of the conditions of our lives. And by this we don’t mean being passive. After all, social therapists are activists committed to changing these conditions. What we mean by radical acceptance is taking an honest, straightforward look at what’s going on in our lives rather than wishing that it weren’t. If you don’t know what you’re dealing with — what you have to work with — you can’t grow or change anything. Radical acceptance is how you start the hard work of changing things.

The following is a rough transcript of a recent session of one of my social therapy groups as they worked on this. The group, which has been meeting for several years, is — like all social therapy groups — very diverse; it’s made up of women and men, young and not-so-young, from a variety of ethnic backgrounds and walks of life. I’ve changed their names to protect people’s privacy (but I’m still “Hugh”).

Jane:  I’d like to start off tonight because I’m in real trouble and I need help badly.  Andrew [Jane’s husband] still hasn’t found work and we’re broke. He’s getting more angry every day, always mad at me and the kids for something. Life at home is chaotic, frantic – the house is a mess, someone is always yelling or crying, the kids don’t get up when they should, so it’s a daily struggle to get them to school on time…I’m starting to get down on myself even though you all keep telling me it’s not my fault.

Tina:  Whew! That sounds really hard…I feel for you. We’ve done a lot of work in here on you being the leader of your family, organizing them to work with you on how you all act toward one another. How’s that been going?

Jane:  Honestly, I’ve mostly forgotten it. I’m too busy thinking that I’m to blame, somehow…that I’m just not a good wife and mother. Maybe it’s irrational, but that’s what I think.

John:  Are you and Andrew talking about this?

Jane:  Not much lately. We’ve been staying away from each other a lot. He feels bad about himself for not having a job, and I don’t know what to say to him…whenever I’ve tried to talk to him, it seems to make things worse. Then I think there’s really something wrong with me…I can’t even talk to my own husband. I don’t know…I’m a mess.

Cassandra:  Jane, I’m getting a little frustrated, to tell you the truth. You keep saying the same thing, no matter what any of us says…We don’t seem to be able to get through to you.

Greg:  Hugh, could you help us here?  I’m not sure where we should go with this conversation.

Hugh:  It seems to me that Jane and the group are having a hard time accepting the facts of Jane’s life. How come?

(Long silence)

Greg:  What do you mean?  I don’t want her to accept her life! What she’s been telling us is that it sucks…Not everything about it, maybe, but it’s pretty bad.  She’s got to change it.

Luke:  Hugh, you mean she should just sit back and let things play themselves out?

Hugh:  No, far from it…I’m not suggesting that Jane should be passive. I’m saying that Jane is refusing to acknowledge that her life isn’t going the way she wants it to.  Blaming herself is an alternative to accepting that this is where things are, which would make it more likely that Jane would honestly ask for, and take, our help in figuring out what to do. Instead, she insists on blaming herself no matter what we say, the group responds by being frustrated and distant from her…and that makes it pretty unlikely that we can give her much help.

Sue:  What you’re saying makes me wonder if the way Jane is with her family is the way I am in my dating life. I go out with guys, things don’t go well, and I blame myself and them. When I talk about it, to my friends and in here, that’s what I’m doing.

Georgina:  I think that’s right, Sue. When you do that, you’re covering over the fact that you don’t know how to organize your social life, which is hard to accept. Being mad at these guys, or at yourself, lets you avoid dealing with it.

Hugh:  I think what Georgina is saying is really helpful. What’s so hard about “radically accepting” your lives?

(Long silence)

Jake:  It still feels like accepting your life means you’re being passive about it.

Kate:  It’s like the only choices are to be furious with what’s going on in your life or to just sit back and let it happen.

Joan:  I don’t want to accept what’s going on in Jane’s life — or in mine, for that matter. It’s too painful and ugly. I don’t want to look at it. It makes me feel hopeless.

Hugh:  Yes, a lot of people feel that way about their lives. But I think that learning to take a hard, honest look at what’s going on — the uncertainties, the difficulties, the ways that we don’t, and can’t, control everyone and everything — is the first step in figuring out what we can do. And I think it’s easier — not easy, but easier — to do it together. How do you all feel about working on this with me?

Greg:  I find this conversation very upsetting. Things in our lives are painful and difficult. But I can see that it doesn’t help to pretend they aren’t there, and that blaming is a kind of pretending. So I’m with you. What do the rest of you think?…

Kate:  I don’t want to stay away from Jane or anyone else in the group, so I’m down for it. I mean, I hear a little more of what you’re saying about accepting our lives as a first step in making changes. What about everyone else?

I’m engaging the group on the ways that it’s leaving Jane alone. We’re beginning to discover some of the pulls — strong and understandable — that draw people away from the painful uncertainties in their lives.  And we’re working on this as a social, rather than an individual, problem. I’m trying to lead the group in a collective enterprise of reorganizing how we all “do” uncertainty, difficulties, and pain. We can learn together how to radically accept the difficult realities of our lives, as a condition for doing something about them.

Radically accepting the difficult realities of our lives requires that we change how we see. That’s not a small task! Nor is it something you ”get,” like riding a bike, and then you’ve “got” it for good. Rather, this new way of seeing is something that requires practice, every day, or we’re likely to fall back into the old ways of seeing, and the old ways of thinking and speaking that accompany it.

As children we all learn to see any and every difficulty as a problem to be solved, as well as the assumptions that everything can be solved if we just try hard enough, and that if we don’t come up with a solution then it’s someone’s fault — usually ours. Think about the way we talk: “Nothing is impossible if you put your mind to it,” “Just say ‘No’ to drugs,” “You would if you really wanted to.” But real life is much more complicated and difficult than such language implies. There are many things in our lives and in the lives of the people we love that we don’t and can’t control. We have to become more sophisticated in understanding how the world  works — including what we can and can’t change about it — and learn how to deal with it, given how it works. “Radical acceptance,” in other words, is the opposite of being passive. It’s the ongoing activity of creating a whole new way of relating to and being in the world as it is.

We’ll be talking about this and more at my upcoming class at the East Side Institute. Please join me in this ongoing conversation of how we can work together to build our lives. I hope to see you there!

Hugh Polk, M.D.

“Let’s Develop!  An Introduction to the Practice of Social Therapy,” will be held on three successive Saturdays, February 23, March 2 and March 9, from 1:30 – 3:00 pm, at 99 Madison Avenue, Fifth floor (between 29th and 30th Streets).

To register go to East Side Institute or contact Melissa Meyer at mmeyer@eastsideinstitute.org, 212-941-8906, ext 304.

A New Year — A New Conversation

by Christine LaCerva

Hello, everyone.

As we move into the New Year I’m experiencing a whole range of emotions. In conversations with my clients in our social therapy groups, it’s become clear that I’m not alone in this experience. Many clients and community members have expressed how they feel overwhelmed and challenged by what is happening in the world.

People are talking to me about the ongoing impact of Hurricane Sandy, the tragic shootings of children and their teachers in Newtown, Connecticut and the daily newscasts of young children, teens, adults and the elderly getting bullets in their bodies. Mass shootings in movie theaters, schools, on the streets of Brooklyn, walking your child to school. It is a frightening, confusing time.

Recently the New York Times reported that more Americans die by gunshot wounds than in other countries of wealth. We have the highest rate of death by violence, teen pregnancies, sexually transmitted disease, and assaults on women and children, and the highest percentage of poverty — in the richest country in the world. Many ask: what is going on here? What is happening to us? Is the world falling apart? Is there anything we can do about it?

Once again, psychology has asserted itself as the arbiter of what’s normal and what to do about those who are outside those limits. Through the media, the mental health experts have created a national dialogue of explanation, telling us we need better tools, more accurate assessment, so we can get better at identifying people who are capable of this kind of violence. They urge mental health care providers to target young people in their teens. They call for more mental health facilities, training in parenting skills, training teachers to recognize the characteristic of problem kids, gun control. On the internet, endless psychologists and therapists analyze how mentally sick Adam Lanza was — labeling him as a menace and a crazy, unfeeling monster. Or was it the mother’s fault? The theories are astounding — and offensive. Nowhere to be found are the far more upsetting and frightening issues of where we are as a culture.

As a social therapist and longtime community activist, I think we need a different kind of dialogue, that at the very least acknowledges the limitations of how and what we see, how we think and how we talk about these issues.

Fred Newman, the founder of social therapy, and the creator of a development community full of rich and growthful activities for young people, had a lot to say about how we think about all of this. Over the years that I worked with him, Fred repeatedly raised the issue of the ways in which mental illness is used to explain violence and horrific crimes, leaving the larger social and economic questions in the shadows, unexplored. Psychology itself is full of premises and presuppositions that explain everything in terms of individual dysfunction. What about the environment that we are living in? What about the failure of our schools to educate and nourish young people? What about the norms of therapeutic work that tell people with psychiatric illness they cannot get better and need to be on medication for the rest of their lives? Fred asked a different kind of question. He asked whether the society is mentally ill.

I think ordinary people know well that there are deeper structural and political underpinnings to what is happening. We all know that there are larger social questions that are not being explored. But what many of us don’t know is that the current methodology — how we think, have relationships, understand the world — keeps us locked into conservatizing ways of living our lives and limits what we see as possible in a culture that is dramatically changing. Causality and explanation blind us to the larger picture.

What is there to do? My answer is to build community; come together. And of course this raises the question of how we do that. What kinds of environments need to be created so we can ask different kinds of questions — questions that don’t have ready-made answers because they’re outside of what we know. They are questions whose answers need to be created.

What do you think about all this? As we begin 2013, I would like to start a conversation, in this blog and through therapeutic dialogue, that explores a variety of new conceptions — how to think, how to see, how to grow and develop. It’s possible that through our conversations we can learn to ask new kinds of questions and develop our creativity in how to see what‘s possible.

So what’s on your mind? Please leave a comment, ask a question, and we’ll build this conversation together.

Happy New Year, everyone!
Christine LaCerva

A Developmental Mess

by Christine LaCerva

I hope you and your families are safe and sound in the aftermath of this horrendous hurricane. I live in the Fort Greene area of Brooklyn, and we were quite lucky here. There was little damage — just a few trees down in the park. Most residents of the area were home, since there were no subways to Manhattan. The dogs and their owners said hello to each other as we walked around the park. The Social Therapy Group was closed for a couple of days so I was not on my usual packed schedule. I had the time and wherewithal to go slow, to watch the coverage on TV, to hear the conversations in the park and local coffee shops. I’m teaching an online class called “Therapy Play! Children and Families in Social Therapy,” and I had more time than usual to work on it. Halloween was a lovely night of children trick or treating. The local restaurants were packed and the Greenlight Bookstore was selling lots of books. People in the community were unusually relaxed. In a very strange way, it was quite peaceful.

where the boardwalk landed

After 24 hours it also became disorienting and disturbing. A few miles away, in Far Rockaway, Staten Island, Breezy Point, and the Jersey shore, people were without power. They had no food, and no heat, and it was getting colder. The housing projects had no electricity and therefore no elevators. The media began to change what they were covering. We began to see the rescue missions, the deaths, and the tragedy. People were hungry. Some had lost homes, their loved ones, or their children had died. People were screaming at the mayor that older people in these areas had no food or water for three days. And we were seeing the searing poverty that many New Yorkers live in all the time. It was enormously upsetting, and the contradiction of my experience was deeply emotional, painful. I missed doing therapy, where I am often engaged in life-giving conversations.

On Thursday, my internet came back and I saw many messages from patients. I began to call them and email them to find out how they were. I saw that the group members were talking to each other online, giving the details of what was happening and how they were feeling about what was going on. They didn’t want to miss their groups.

people filling up jugs from the fire hydrants

Two of my patients contacted me to say they had set up a conference call that could handle 60 people so we could conduct the group on the phone. I sent out the information to everyone, with the subject line “We Are Having Group Tonight. Crazy? You Bet.” I was so touched that they had taken the initiative to make the group happen.

I shared the experience I was having in Fort Greene, and the great deal of pain I was feeling about the state that our city and country are in. The group responded, and people were very emotional about what was going on. Many said they were feeling disconnected, or felt alone. Some asked for help to be more emotional. People engaged how the group was talking about all of this. Some people said they felt like “a mess.”

“Fine,” I said. “What’s the problem? This is a messy, painful situation. I think you and we need to decide what kind of mess you want to be. Do you want to be a mess that’s paralyzed and made powerless by the way this storm has exposed the fragility of our infrastructure and the horrifying differences between middle class, working and poor families? Or do you want to be a developmental mess?”

“A developmental mess?” someone asked. “What are you talking about?”

A developmental mess is somebody who is horrified and terrified at how people all over the world are suffering, who sees and fears the changes in this country that are destroying people’s lives — but who decides to find a way to do something about it, and keeps reaching out to others.

Being a developmental mess is creating the performance of working collectively with other human beings to do something about what is going on — we call this revolutionary activity. It can look many ways: working to create structural changes to our political system that is thoroughly dominated by the two parties, volunteering in programs for young people that help them get out of poverty and demand that they help to create a better world. It can mean not picking a fight with your boyfriend because you feel like it. It can mean teaching your children about the inequities of the world. It can mean making decisions that thoughtfully include their impact on others.

Can social therapy change the world? End poverty? Stop racism? No, it can’t. But it can create environments in which different kinds of people can come together and support the kind of human creativity and growth that doesn’t just adapt to the way things are. We are part of a community that supports one another in building with whatever exists — pain, despair, poverty, privilege, good will… Social therapy helps people build with the emotional impact of the contradictions and failures of our lives and of our country.

photographs courtesy of Cathy Stewart, Far Rockaway Nov 1, 2012

The Diagnosis Dialogue Continues

In my March post (Abnormal? Unusual? Who Decides?) I wrote about a controversial topic in the field of psychology — the pending publication of the American Psychiatric Association’s new manual of psychiatric diagnoses, the DSM 5. Much of the controversy and ensuing dialogue centers around new diagnoses (and changes to old ones) that are potentially harmful to us and our families. As a community therapy center, the Social Therapy Group wanted to include ordinary Americans in this dialogue — and not just leave it up to the “experts,” the psychiatrists and psychologists, to debate such issues, which can affect people’s lives in profound ways.

Our staff of therapists and clinical interns have been out on the streets of Brooklyn, New York interviewing the community about mental health diagnosis. We quickly discovered that people from all walks of life were eager to talk to us and really care about these issues — especially about children getting psychiatric diagnoses. Here’s some of what we’ve been hearing.

A majority of the folks we talked with feel that it is damaging to children to be labeled as mentally ill, that it stigmatizes them, and that they often internalize the label and feel the diagnosis defines them as damaged and sick. People were concerned that these labels then follow children, often for the rest of their lives. Many people expressed serious concerns about the stigma associated with psychiatric diagnosis, and most felt that there are many ways to get help with emotional problems other than getting a psychiatric diagnosis, suggesting “talk therapy” and other activities, including talking to friends and family.

In addition to our survey we spoke to a number of our social therapy clients. These are people who have chosen to be in a non-diagnostic therapy, and across the board they had strong feelings about psychiatric diagnosis. They overwhelmingly endorsed the growth-producing activity of social therapy group-building. “It’s liberating,” one person said. “There’s a lot of possibility in creating new things and new emotionality as a collective. Diagnosis is individual and self-absorbing, but creating in social therapy is not individual and not in your head.” Most people questioned the scientific validity of psychiatric diagnosis, pointing out that it’s more political than pure science, and driven by money and power. Several people said that being in a social therapy group helped them be more connected to other people, and to stop labeling themselves and others. One person commented that giving up the comfort of having a label for everything was very demanding; that social therapy “actually asks me to do work and develop.”

I want to continue to stimulate this important dialogue. Please share your thoughts in the comments. We’re also making this survey available online to give you and thousands of others the opportunity to participate and make your voices heard. Below is the link to the survey. Please participate, and forward it to friends and colleagues as well. At the end of the survey, you also have the option to join our international network by providing your contact information. I welcome your participation.

Take the survey HERE

Is That Gay?

Gay Pride month is in full swing, and its celebration of diversity and creativity in how we perform gender has gotten me thinking about the ways our lives can be shaped by the roles and rules we’re taught for how to be women or men — and it starts when we’re very young. How do we help our children deal with these issues? The exploration of the conventional and cultural expectations of young boys, in particular, is an ongoing dialogue in the field of psychology.

One of the important voices in the field is the very talented child psychologist Dr. Tony Rao. He and I spoke about many of these issues in a public dialogue at the East Side Institute a couple of years ago. His book, The Way of Boys: Raising Healthy Boys in a Challenging and Complex World, gives wonderful support to parents, teachers (and clinicians) who want to create environments that allow boys to be who and how they are, without turning their every hyperactive move into a pathology. (On June 29,  the Institute will show a video of that discussion as part of a webinar entitled “Breakthroughs in Child Psychology.” If you’re interested in participating, you can contact mfridley@eastsideinstitute.org. And you can have a look at the video here: http://vimeo.com/18562495.

Another seminal voice in this area is Dr. William Pollack, the Harvard Medical School researcher who for over two decades has studied the emotional turmoil — the confusion, the loneliness and sadness — that boys can experience. This work is documented in his book Real Boys: Rescuing Our Sons from the Myths of Boyhood, which focuses on how to help boys develop more confidence by challenging expectations of masculinity. Do read it.

As a social therapist, my contribution to this dialogue has emerged from our multi-family groups, in one of which I work with five nine- and ten-year-old boys. Along with their families, we’re exploring how to deal with the ways they feel unsure, conflicted and perplexed about how to be a boy. They often feel enormous pressure and a deep need to turn off their emotionality, toughen up, to act like things don’t bother them, and never express their caring for each other. And at all costs resist having a play date with a girl! (What would the other boys think?) These cultural standards of maleness are the price of acceptance by other kids (and sometimes even their parents).

I have been working with these five boys for over two years. In their school settings the boys find social relationship to be quite challenging. Some have diagnoses, some don’t. They’re quite different from one another, but are all energetic, creative and playful. One boy, Tom, has a particularly difficult time joining the group conversations and performances. He often likes to play with a small set of toys I keep on my desk — puppets, miniature paintings, plastic animals — and once in awhile he’ll join our group activities. We love him and the boys are kind to him — they always invite him in, and accept his difficulties.

One afternoon, in a children-only session, I introduced the idea that we were going to play with how we talk to each other. One child asked if there were any rules. I said yes, the rule is that we are not allowed to make any sense at all.

They became very animated and excited, and began running around the room. One boy asked if I was included in that rule. I said that indeed I was, but now we were breaking the rule — we were making sense! “Oh, no,” he said, and then ran away, laughing. Along with my steadfast co-therapist, Lew Steinhardt, I ran around the room with them.

We began a series of games — speaking nonsense and gibberish, using words “incorrectly.” It was silly. The children were incredibly joyful. I felt joyful with them, and laughed through most of the session. The children created movement, ran all around, and rolled on the floor as they played with the activity of communicating in a new way. We thoroughly enjoyed doing this together. How interesting, I thought. I had not seen them so joyful and so much of a group in awhile, if ever. As we played, we were making up new ways to be together, which were not coherent with the rules and roles for children and adults. The boys became very affectionate with each other. I had not seen them do this so openly before.

Near the end of the session I asked them how the group was doing. They became very sheepish and put their heads down. I was perplexed, and asked them what was going on. One boy, Michael, said it was embarrassing. I asked him what was embarrassing. No answer. Then Michael said the group felt close today. “Close. Yes,” I agreed. Then I decided to push this issue even further.

“I would even say that you really love each other,” I said. They were silent.

Tom, the ten-year-old who has difficulty being a part of the group, said, “Yuck that’s gay.”

Another boy asked, “Is that gay?

I thought about how I wanted to answer. What would be most valuable for them, given the struggles they have with their emotionality ?

I said, “Yes. It is gay to love whomever you want to.”

Tom said, “Gay is disgusting.” The other boys said nothing, and the session ended.

The following week, Tom spoke first, and said, “Christine, I have something to tell you.”

“Great,” I replied. “Tell all of us.”

He said, “I am now in a gay relationship.”

“Really?” I said. I noticed that the boys didn’t giggle. They were curious about what Tom was saying.

Michael asked, “Who are you in a relationship with?”

“Pikachu,” he answered. (For the uninitiated, Pikachu is a well-known character in the world of Pokémon.)

“Congratulations!” I said. “I’m happy for you. What do you love about Pikachu?”

“He’s yellow,” Tom said. Everyone laughed.

“I get it,” I said. “I think I get it. I love yellow, too.” Everyone laughed again.

Another boy in the group calmly said, “You can’t be in love with a fictional character.”

Tom asked me, “What do you think about this?” I assured him that a lot of people are in love with fictional characters. Lew and I laughed.

Tom asked again, “So Christine, how do you feel about this?” I said that I was very happy for him and Pikachu. The boys smiled and nodded. They nonchalantly began to play some floor games. Tom joined them for the remainder of the group play.

I would love to hear what you think about all this. I find these conversations to be quite a provocation, and I think they were wonderfully helpful to the boys and their families. Leave a comment and let me know your thoughts!

Autism in the World

By Christine LaCerva

April is Autism Awareness month. I do a great deal of work with autistic children and those on the spectrum, so I’m all for it. But I think there’s something missing in the Autism Awareness media flurry.

Here’s some of what we’re being made aware of: diagnoses of autism have nearly doubled since 2007 (New York Times); autism is more prevalent in boys than girls (Huffington Post); and along with the usual understanding that autism is characterized by a lack of communication and difficulty being empathetic, there is now a widespread belief that autistic children lack a “theory of mind” (that is, a conceptual understanding that other people have a mind [Asperger Syndrome and Psychotherapy, P Jacobsen 2005]).

As a social therapist, what’s on my mind is the language being used in so much of this discussion. It’s the language of deficiency, of limitations, and of what’s missing. The limitations are categorized as intellectual, perceptual, and linguistic. The scientific communities of neuropsychology and psychology are involved in research on autism’s organic deficits. Remediation is the only possibility; nowhere in any of this discussion is the notion that people with autism can grow.

In Kiefer Sutherland’s new TV series, Touch, the central character is a young autistic boy. He does not speak and will not allow himself to be touched. But he’s a mathematical genius who mysteriously organizes good deeds, bringing people together to ease their pain and change their lives. The show is sweet and touching — and I would think heartbreaking and probably insulting for parents whose autistic children are unable to be benevolent or mathematical wizards. It seems to me that the ways in which autism is portrayed — either as profound organic deficiency or as a reification of the specialness of the autistic child — are equally problematic, and in my opinion inhumane.

Many years ago I worked with a young autistic boy. He was neither a genius nor was he unable to grow. I was not interested in remediating him — traditional approaches of remediation had failed. My work with him had nothing to do with trying to teach him something he didn’t know how to do, but was based on awareness — the awareness of two human beings working side by side and building something together. Awareness was the activity we did together. I allowed the space and time for our relationship to grow. I was uncertain of how to proceed. I  made decisions to create an environment that was unlike anything the boy and I had ever experienced. I learned a great deal from that work, and I’d like to know what you think about it.

I am happy to introduce you to Matthew, who taught me about awareness and watchfulness and development. I have changed the names of this client and other factual information to protect his privacy.

Matthew, age 6, came into social therapy with his mother. He did not speak, and rarely, if ever, made eye contact. His family had a painful and disappointing history of trying many, many therapies to no avail. His mother wanted him to be able to communicate verbally but he had never done so.

In our first few sessions, Matthew mostly liked to look out the window of our 14th-floor Manhattan office. I allowed him to stand on a chair and do that.

One day I brought in paper and crayons and we drew and colored pictures on the floor. I sat on one side and let Matthew figure out for himself where he wanted to sit or lie down. He went as far away from me as he could get while still staying in the room. He often went under the chairs of the therapy office with his crayons. I offered him no direction.

His mother was quite concerned that I was not demanding that Matthew make eye contact with me. Most therapeutic approaches to autism insist that children make eye contact, on the understanding that looking at someone eventually becomes part of social development. Most autistic children I know hate doing it. Some have told me it physically hurts them to do so.

Matthew’s mother explained to me that she had been taught to cue him by pointing to her eyes and then to his and saying “Look at me.”

I told her I understood why she wanted me to do that, but I was not going to. I did not want to use the tools that Matthew knew from his previous therapies — they hadn’t helped him. I wanted to create a kind of relationship with Matthew that he had never had before — I didn’t want to teach him anything. I wanted to be with him in a new way; to create a new, relational, “form of life” with him. As you can imagine, this was quite challenging for Matthew’s mom. I asked for her support, even though I knew it was extremely difficult for her. With great reservations, she gave it.

For the next six months, Matthew and I had our sessions lying on the floor. I would draw for half an hour and he did, too. He stayed far away from me, and I felt no need to change that. I would talk out loud about what I was drawing, what I had for breakfast, where I was going after work today. I made sure not to look at him since he found it so uncomfortable.

Matthew seemed to be developing an awareness of what I was doing. I could tell he was aware of my talking, since he would pause when I began my chat. One day I talked about the house I was drawing and the little dog that I wanted in my picture. At the end of the session I helped Matthew get up off the floor and noticed that for the first time he had incorporated what I had been talking about in his drawing. I thanked him for doing that. I told him that I thought it was really giving.

One afternoon, Matthew and I were doing our thing. He was drawing, and I was talking and drawing — and he began to talk. He said, “I am drawing a cat. The cat is going for a walk. I think I’ll go with it.” I froze with surprise. Not only had Matthew not spoken before — his family (and doctors) did not know whether he had expressive language at all.

Our sessions continued, and Matthew continued to talk. A few sessions later, he came over to my drawing and made a stick figure of a boy. I thanked him — and we made eye contact for the first time. Our eye contact continued as our sessions — transforming now — went on.

Was this magic? Well, there were no rabbits, no hats, and I didn’t wave a wand. But yes, it is a kind of magic — the magic of human beings creating a relationship that’s not governed by rules and roles; of a revolutionary reorganization of how the adult/child relationship lives and breathes. Magic, for sure.

Social therapy works to explore, to investigate, to play, to enhance the socialness of what it means to be a human being. It is unscientific, fundamentally creative and not knowing. It is full of the awareness of the complexities of a human being’s social-relational capacities. The success of this work with Matthew comes from this awareness — not of autism, but of relationality, of the human capacity for growth.

My sessions with Matthew were a search for method — not knowing how to proceed and doing so anyway allowed something new to emerge. What was it? An awareness, a non-imposed awareness of the other. And by participating in creating it, Matthew was able to develop. He is still autistic, but now he can speak. He can be with people, he can participate in social relationships, and he can be in the world.

Abnormal? Unusual? Who Decides?

By Christine LaCerva

There is a fight going on in psychology. And we — the staff of the Social Therapy Group —  want you to know about it.

I’m talking about the controversy surrounding diagnostic labeling of patients in the field of mental health. It’s a national fight, in response to “DSM-5,” the American Psychiatric Association’s upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, and it’s currently being fought by progressive practitioners and the various professional organizations they belong to.

DSM-5 is the official manual of characteristics used to define emotional illnesses and make the diagnoses that mental health practitioners must give patients in order to be reimbursed by insurance companies, and/or to prescribe the medications that you or your children might need. The new edition makes many changes to the criteria for various diagnoses, and there has been a level of professional and public reaction rarely seen in the hidden corridors of the mental health field.

This controversy is of great interest to us at the Social Therapy Group. As you may know, social therapy is a radically humanistic, non-diagnostic group therapy. Social therapy is explicitly pro-development and explicitly anti-label.  My close friend and colleague Lois Holzman, director of the East Side Institute, has written passionately and eloquently about these issues (click here for one of her blog posts on the subject). As Dr. Holzman points out, controlling and defining diagnosis is nothing less than a turf war, as official organizations fight for (more than) their slice of the treatment pie. It’s a big, lucrative pie, and getting bigger all the time as more and more people suffer the emotional ravages of living in a society that increasingly fails to provide for the needs of ordinary people.

For years, along with many other progressive practitioners and postmodern social scientists, the Social Therapy Group has spoken out against the inhumanity of diagnosis-driven mental health treatment, which we think is pseudo-scientific labeling that can greatly affect a patient‘s well-being. For children, there’s a particular danger — diagnostic labels can track them down a road that’s very difficult to reorganize. In social therapy our work with families and children has helped many children grow beyond their labels. But their families have to work incredibly hard to get them declassified — that is, out of special education and with the diagnosis removed. Many schools will not accept children with a prior diagnosis, regardless of any progress they have made!

But as disturbing as the impact of specific diagnoses can be, there’s an area of this controversy that’s even more important to me. In a recent article in the New York Times reporting on the fight around DSM-5, the author poses what he sees as the central question of this debate: “where to draw the line between unusual and abnormal.”

I find that question offensive. How did it become the question in the first place? What kind of descriptions of human beings are these?

For us at the Social Therapy Group, the central question is why diagnose at all?  I mean this in no way as a denial of mental illness — depression, anxiety and many other extreme and painful emotional experiences are real, and affect millions. But who benefits from diagnosing them?

Diagnostic categories are not benign. They have a long, turbulent and well-documented history in this country that exposes and clarifies the many ways in which diagnosis shapes our world. We can look back to the 1950s and ’60s, when large numbers of African American children were diagnosed as “mentally retarded” while their white, middle-class counterparts with the same challenges got the more acceptable diagnosis of being “learning disabled.” Today, many critics of DSM-5 point out that these categories that shape peoples’ lives are heavily over-determined by government funding and partnerships with pharmaceutical companies. No, diagnostic categories are not neutral. They are social/political phenomena and function as methods of social control, determining who receives benefits and who doesn’t; who gets the “socially acceptable” label and who doesn’t.

In my experience as a clinician, diagnoses can be stigmatizing; at the very least they over-determine how people feel about themselves. When I ask children I work with if they have been given a diagnosis (they often have) I ask what it is, and what they think it says about them. Often, in a variety of ways, they answer that their brain is broken. What follows, of course, is their understanding that only medication can impact on what is happening to them — whether it’s Attention Deficit Hyperactivity Disorder (ADHD) or Pervasive Developmental Delay, these children learn that they are helpless.

Abnormal? Unusual? Who gets to decide?

I think that rather than focusing on changes in definitions and spending untold millions of dollars coming up with the “right” kind of label, mental health professionals could  consider doing more of what the Social Therapy Group does: working together with diverse groupings of adults, families, therapists and young people themselves, to create new solutions that will help all of us — unusual and usual — to grow, create our lives, and develop as creative, productive citizens of our communities.

I want to know what you think about all this. The issue of diagnosis is a sensitive one. Many people have felt relieved to have a name given to their painful human experience. Others feel that getting help to grow and develop is what’s primary. We want to know what you think about this controversy and the questions we are raising. Let us know where you stand — we’d love to hear from you, so please leave a comment below.