When I travel to teach, I do so in hopes that my presence will be a catalyst for change in the communities I visit. I know I am in any community for a brief time, just long enough to share some ideas and tools, and learn a little about the people and place. Sometimes all I can do is listen and support, and that has to be enough.
The Earth is in the midst of enormous change. Communities around the world feel and know this. Many mental health clinicians are eager for new tools with which to confront the issues and problems that accompany such change. I try to support them in their work, even after I fly home.
One of the concerns clinicians spoke about on this trip was that professionals from the West might hold clinicians in developing countries to the same standards we are held to. Given the immense need, and the paucity of training programs and experienced teachers in many psychotherapy disciplines, in developing countries, this would seem unwise. Perhaps our focus should be on providing affordable training opportunities for clinicians. We would be much better served were we to offer aid, support, and encouragement to the clinicians and trainers who are seeking to aid their communities.
Much of the world is critically short of experienced mental health professionals. War, gender violence, and economic uncertainty are rampant, and the need for services greatly outstrips available resources. Climate change threatens to further destabilize life for people everywhere, most immediately for those in developing nations.
Climate change was a topic in both India and Hong Kong, and that led me to think a good deal about carbon footprints during our trip. After all, given the rapid intensification of climate change, how is one to justify flying essentially around the world? I found myself wondering whether one can possibly do enough good to justify the resource use. I don’t have an answer to that question.
In most of the world’s countries, clinical work takes place in the context of desperate need. Climate change and population growth have resulted in wide-spread, acute, water shortages in many regions, including South India and Hong Kong. Rising sea levels threaten infrastructure and salination imperils agriculture. For people who live day-to-day, including many in the developing world’s middle class, these are real and immediate threats to well-being. The spread of mosquito borne illnesses, economic dislocation, and violence are growing concerns for most of the world’s people, and all are intensified by climate change.
I sometimes wonder whether there is a disjunction in clinical circles in the U.S. between professional gatekeepers and the real needs of most of the world’s people. Perhaps our relative affluence and distance from the impoverishing and life threatening effects of war and climate change limit our awareness of global needs. Perhaps the economic squeeze experienced by many of us, as health care dollars move from clinicians to pharmaceutical companies, has made us desperate. Either way, our collective gate keeping seems to me problematic.
We have benefited greatly from the colonial enterprise, and our culture continues to utilize a disproportionate percentage of the world’s resources. There is an old Six Nations saying, “The Creator gave us enough. Scarcity is a distribution problem.” I believe we can share our knowledge and skills with others, and trust communities will develop norms and expectations that are locally appropriate, without our imposing our beliefs and standards. Maybe we can also relax into the notion that sharing is rewarding in itself.