Exiles in their own flesh: A psychotherapist speaks
Posted on August 22, 2015
https://4thwavenow.com/2015/08/22/exile ... st-speaks/
This is a guest post submitted by Lane Anderson (a pseudonym), a practicing psychotherapist who has worked extensively with “trans teens” and their families. She shares with us her clinical insights into her clients, adolescent psychology, and the impact of the transgender phenomenon on our society as a whole.
If there are other mental health providers reading this post, please consider guest posting or responding in the comments section below the article. See this earlier post featuring Dr. David Schwartz for another critical perspective from a psychotherapist.
I am extremely grateful to Lane and Dr. Schwartz for speaking up. Time is of the essence, since the American Psychological Association recently released new guidelines which will make it even more difficult for clinicians to step forward.
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I am a licensed psychotherapist. I’m writing this post on my last day at a teen health clinic, where I’ve seen patients and their families for nearly a decade.
In the past year especially, it’s become increasingly clear to me that I cannot uphold the primary value of my profession, to do no harm, without also seriously jeopardizing my standing in the professional community. It’s a terrible and unfortunate conflict of interest. I’ve lost much sleep over the fact that, for a significant portion of my clients and their parents, I am unable to provide what they profess to come to me seeking: sound clinical judgment. Increasingly, providing such judgment puts me at risk of violating the emergent trans narrative which–seemingly overnight and without any explanation or push-back of which I am aware–has usurped the traditional mental health narrative.
When I am suddenly and without warning discouraged from exploring the underlying causes and conditions of certain of my patients’ distress (as I was trained to do), and instead forced to put my professional stamp of approval upon a prefab, one-size-fits-all narrative intended to explain the complexity of my patient’s troubles, I feel confused. It’s as if I am being held hostage. No longer encouraged or permitted to question, consider or discuss the full spectrum of my patient’s mental health concerns, it has occurred to me that I am being used, my meager professional authority commandeered to legitimize a new narrative I may or may not wish to corroborate.
It’s been perilous to simply admit to not fully understanding it all–let alone disagree with the trans narrative. There was no training or teaching. I was just suddenly told that some of my patients thought they were trapped in the wrong body and that was that.
After much soul searching, I felt I had no choice but to remove myself from this crippling work setting. Being told to exercise my clinical judgment with some clients, while ignoring it with others, made me feel like a fraud.
Throughout my career, I have come to my work with these thoughts in mind: that life is complex, that people are complex. But in one way or another, most people tend to balk at that kind of ambiguity. I try to assist people in flexing a little, try to help them find ways to manage life’s gray areas, and the occasional distress that comes from simply being conscious. But at the end of the day, I couldn’t deny it was a little weird for me to go on believing I could effectively teach others to be less rigid, more free people facing their lives head on, when I myself, their humble guide, was being exploited, tongue-tied by a new party line.
There are so many complex forces, from many different realms, coming into play with this trans wave. Most people are completely unaware of these intersecting interests.
Unfortunately the culture war has done a number on the concept of critical thinking. I have considered myself liberal my entire adult life, and I still am. But for a long time I couldn’t find anyone questioning this trans explosion who wasn’t on the far right. It made me feel like only conservatives were allowed to think, to consider this issue, but ultimately their thoughts were rendered meaningless due to their branding by the culture war. It’s essential that left-leaning people model critical thinking for the masses in this regard.
It’s important to link people like us together, who have been silenced, so we can resume contact with our critical thinking skills and reduce our growing sense of self doubt. Divide and conquer is best accomplished through silencing, through calling into question those who speak out. There is so much of this attached to the trans movement. Even just wondering about a profound concept such as transgender is labeled transphobic. What I think has happened is that people are now phobic about their own gut responses to life. We are being systematically separated from our own intuition. This is fatal for a civilization, I think. Not that our intuition always tells the truth with a capital T, but it is a critical piece of who we are. Without it, we remain profoundly directionless, and more susceptible to coercion of all types.
What frightens me most about the trans movement is that the establishment has gotten involved and is leading it. I think that’s really weird. Clearly they are benefiting from it financially. So sad. It disturbs me to see how giddy my former medical director is to be part of this growing craze. We used to treat kids with mental health problems, but now it’s all about validating their emergent and shifting identities. As professionals, if we don’t loudly prioritize their identities as being the most important thing about them (and identities do shift constantly in kids and teens), we risk coming across as unsupportive and even immoral. Identity development has always been a teen task, but in the past it wasn’t necessarily supposed to become a lifestyle, or colonize the entirety of your existence.
Our world is in a profound state of flux. We can’t begin to comprehend what the Internet has done to how we see ourselves. People are looking for ways to belong, ways to understand who they are in place and in time. They are looking to reduce the anxiety that comes when too much change happens all at once. I try and look at trans folks as people who are seeking to answer the new questions that have emerged in this early 21st century. I have been trying to find a way to understand their urges to detach from their bodies, to undo that feeling of exile they experience in their own flesh. We all want to get back to ourselves; it is our duty to reconnect with those weighty parts that inevitably sink to the depths of us, the parts too heavy to remain on the surface of our lives.
From what I can see, the age-old human task to reclaim that which has gone missing appears to be manifesting with great prominence in the trans community. The problem is this: we all look for shortcuts to finding the lost treasure. It’s human nature to resist the long and serpentine journey to our own sense of personal truth. In our fear, in our self doubt, we calculate the risk and often decide it is preferable to be shown what another person–a “helping professional” or an activist–bills as a sure thing, a direct path to what we sense we lack. We all, on some level, hold a childlike fantasy that someone else has figured it out and can provide us a direct map to ourselves. And that’s what the trans narrative does. It promises to guide the follower to their essential, authentic self. But this, unfortunately, doesn’t happen, because the essential self, whatever that is, is not created from another’s road map, but can only be comprised of the trails we forge ourselves.
What saddens me the most is the way children are being trained to think their parents do not love them if mom and dad don’t jump aboard the trans train. To me, this is a brutal aspect of a near-dictatorship being foisted on everyone. The kids are too young to see that there are no other people who will have their backs, throughout life with lasting devotion, in the unique way their families will. They think these new friends they’ve made online understand them perfectly. And in believing this unquestioningly, they find themselves lulled by the frictionless experience delivered most powerfully by group think.
Of course, I’m describing the pull of all cults; that deep human desire to be known through and through and through.The cult experience seeks to end the frustration that naturally comes when we mature and begin to see ourselves as separate beings. In our separateness, we must do the hard work of truly learning to know another. Group think reduces the fear that comes when we are unsure if we will be located by another, when we remain unable to locate ourselves.
Cults and closed narratives neutralize and tame what we see as the unknown. I think somebody needs to put a refresher out there on the cult mindset and group think. People seem to have forgotten that we are all very easily influenced by each other. Carl Elliot wrote about this in relation to body dysmorphic disorder (people wanting to amputate their own limbs because they disidentify with them) in the Atlantic, “A new way to be mad.”
One common trait I’ve noticed in nearly all the trans kids I’ve met has been their profound sense of being different, and too alone. They often have had little success with making friends, or what I would call contact with “the other.” Because of their psychic isolation, they are prime targets for group think narratives. But in addition to looking for a way to belong, they are also craving protection and the stamp of legitimacy, perhaps because they feel a profound lack of it.
Now that the government and medical communities are involved in the creation of who trans folks are, this class of individuals have finally found their safe havens. Now, rather than being merely invisible and awkward, they have been transformed into veritable leaders of a revolution. Now, rather than cower in the shadows, they have commandeered the narratives of others into a similar dark and brooding place where they once were. The tables, as they lived and viewed them, have now turned.
It’s got to be dizzying for these formerly “ugly ducklings” to find themselves at the center of a flock of swans. To become a part of the movement, to finally be seen and found as whole, alive, and most importantly, wanted, all they have to do is renounce the very bodies in which they feel they have been imprisoned. In doing so, the promised payoff is very big, for they have finally found a way to render mute all those who once discounted and disbelieved them. Through silencing others who threaten them, they have unearthed a means of silencing their own self hate. Rather than being afraid of themselves, they make others fear what they have become.
Psychologically these interpersonal tactics would once upon a time have been categorized as immature, “primitive” defenses erected by an undifferentiated self that cannot see the self or others as whole creatures. But as I witness it in my own practice, this is the basic thinking underlying the psychology of the trans narrative. In her recent blog post, “My Disservice to My Transgender Patients,” Dr. Kathy Mandigo talks about feeling threatened by some of her MTF patients. Many of the trans kids I’ve worked with will joke about how they and their friends are dictators, “masters of the universe!” I find that clinically significant. This is something toddlers do when they are first discovering they are separate from their rulers (parents). Rather than fear the parent, they seek to control the parent, exert their will on the parent and co-opt the parent’s power as their own. In doing this they hide from view their terror at facing their own powerlessness. Ideally, the child will gradually outgrow this urge to control, will gradually relinquish the dictatorial need to create safety through controlling the external realm. When that happens, we say it is a sign of maturity. As our own sense of agency grows, we are better able to forfeit the habit of controlling others. We also begin to feel guilt at the idea of controlling others, as we begin to see them as separate from us, 3D human beings instead of mere props on our psychic stage.
Unfortunately some people have a hard time making this shift. They get stuck or addicted to manipulating their external environment, and will continue to create inner safety through the constant and relentless work of controlling others.
Last week in a team meeting, our medical director said he was meeting with a girl who identifies as FTM to discuss top surgery and testosterone treatment. Apparently, according to the director, the girl’s mom is slowing down the process of transition. Bad mom, right? The director added that the girl’s mom told her that 9 out of 9 of her daughter’s friends also identify as FTM.
At this point I couldn’t hold my tongue any longer. I said, “Can we not be honest and see that we are dealing with a trend?” Of course, everyone else at the table was mute. Considering I’m leaving my post, I felt bold enough to say that I found it infuriating we couldn’t discuss this topic clinically. More silent colleagues (except their eyes were wide as if they wanted me to keep talking and taking the risk for them). I said that what we were doing as a medical community was potentially very harmful, and made mention of some of the videos I’d watched featuring transmen who decided to go off testosterone. The medical director prides himself in providing special services for those patients he deems unjustly marginalized by society. But he can’t see how the medical community has become complicit in the oppression he earnestly seeks to remedy.
A large part of the problem comes with the revolution in health care. More and more, we are giving people the power to define their own treatments. This is good in many ways, but the trans movement is using this moment, and is actively recruiting young, psychologically undefined and frightened people to push their agenda through the medical community. It’s clearly not that difficult to do. These kids are just pawns. That’s how it looks to me anyway. The trans community needs more converts so that the narrative becomes more cohesive. I’m guessing the push for this comes from a need to further cohere so they will have more members to fully cement a fragile, constructed reality.
We–people who don’t identify as trans–are the external realm that must be controlled to bring the trans community the inner peace they now lack. But they don’t get that they will never find calm or strength this way. You cannot find yourself through coercing others. You cannot extinguish your fears by turning from them. The trans community must face their own fears, face themselves and their own demons. They can’t wipe out their fear that they are not really transitioning by censoring the thoughts and expressions of others. If they believe they are trans, they shouldn’t need to spend so much effort foisting that belief on others.
The fact that they do dictate to others is to me diagnostic of their very condition. They are uncertain about who and what they are. No sin in that. That’s human. The transgression comes in refusing to accept this uncertainty, and in sacrificing the lives and consciences of others to nullify your own self doubt.
https://4thwavenow.com/2015/08/22/exile ... st-speaks/
The comments are also well worth reading, including her own very interesting and civilized exchange with someone who is "transitioning". Here's one of her longer replies, almost a small essay in itself:
1234lane on August 22, 2015 at 7:48 pm said:
It is not for me to know what a “wise course” looks like for any one person. My practice evolves around the approach that a person engages with their deeper self and comes to rely most heavily upon the authority gathered there This is not a speedy process, it takes time. It is a privilege to go through this process. Many many people are never given a chance to explore who they are outside of how they can benefit powerful others, which leads to emptiness and chronic searching. It leads to obsessions and compulsions to manage the emptiness.
This development of the self would be a process whereby a client is assisted in the difficult task of creating a kind of consolidated sense of who they are. Personally, I think these core parts of us should function, or ideally function best when they are functionally somewhat autonomous, yet healthfully interdependent with others. I guess what I’m saying is, if a person doesn’t really yet know who they are independently, if they have a sort of “empty center looking to be filled from without”, I would work with them until they were able to find some weight within their own psychic core before they engaged in any sort of drastic changes. Signs that this consolidation is happening would be the individual not requiring others to excessively validate who they are. Ideally the individual should not be excessively too dependent upon the thoughts and opinions of others to maintain their sense of self.
As I have worked exclusively with teens, I cannot speak to the adult experience of gender transition. Teens by their nature are seeking identity. They don’t tend to have strong core selves just yet, and those with mental health issues are often extremely deficient in having fulfilled this developmental task. Neuroscience now shows us that chronic Instability of affect and mood inhibits the development of the self, or the capacity to observe the self. Unstable folks are neurologically incapable of observing others outside of how these others can fulfill their immediate needs (think narcissism, which is basically a sign a person is too dependent upon external others to construct the self. In being overly dependent in this way, the empty person uses others to create an image of themselves, they use others to literally ” feel” who they are. Obviously, this is all unconscious. Most people with a lack of a cohesive self are not aware they are using others in this way, but they will feel the effects of this habit and often not understand why they continue to have poor interpersonal and disrupted relationships with others).
So, for me, to get back to your question, I would work to look at whether or not a person has accomplished basic psychological developmental tasks before I would encourage their transitioning. However, this is all a bit of a [moot] point, for my exploring such with people who come to me saying they seek to transition will now classify me as transphobic and out of compliance if I explain what I’ve here explained to you. The fact is, not one of the kids I met with who wanted to transition was manifesting psychological health. They were very hurt individuals and had attributed their very real pain to the theory that their bodies and gender brains were misaligned. The vast majority of them had severe deficits interpersonally, experienced profound social anxiety, suicidality, to name just a few of the issues I saw emerging. These were souls fearing psychic extinction, living with the terror of being too different, too alone. They nearly all found their new identities, along with a whole new slew of friends, in others who experienced similar or equal psychic terror. How could I take seriously their sudden belief that they were trapped in the wrong body? How could I not see that they had stumbled upon a very viable and critical path to locating themselves amongst similar others.
Of course, I could not say this to any of them as they would claim, as they had been schooled online, that I too didn’t understand and was transphobic. I am not transphobic. I really don’t care if a person finds life more meaningful, livable as transgender. All I’m saying is, the reasons, I witnessed that appeared to lead the kids who saw me to choose this path did conflict with how I conceptualized a hearty sort of mental health.
I also think the kids were using an oppositional narrative to serve to consolidate their emerging identities. You know, people do this all the time, its Us vs. Them. Cold wars come in all shapes and sizes, and I saw the kids using this narrative to find a premature and unearned sense of closeness with others who claimed a similar path. But you see this sort of thing playing out everywhere in our culture now. Everyone is against everyone, everyone is so sure they know the truth, we are a divided society because we have been lured by the easy and disposable intimacy that comes with joining a group.
I’ve always been a loner, not because I don’t love people, I do absolutely love people, sort of too much, and because of this love I have been unable to find my exclusive allegiance in banding with one group over another. It has come at a very high cost. My own self doubt comes when I think that perhaps most people are not designed for what I have experienced, perhaps most people are happier and more at peace in narratives that while closed, and limiting in some way, allow them to find others in place and time.
With this thought in mind, I find I need a kind of faith, not in a god or anything like that, but in the human spirit to find the other without words. I just read an incredible letter written by the poet Rilke. It blew my mind and made me think of myself and my own solitude and how even if I don’t buy into a prevailing narrative enough to feel the delicious puddingness (I just made that up, it means swimming in and amongst others in a viscous and sweet substance that keeps you all afloat together), I have my faith that there exists a greater reverberation between souls of all kinds, and I cannot sacrifice the immediate life in the pudding for that greater knowing.
http://carrothers.com/rilke1.htm
I hope this long response sort of answers your question a little. If not here’s a link to the Rilke letter.
Best,
Lane