Ethics and the Healer

Summer!Its a beautiful day in the neighborhood, a lovely day in the neighborhood…..Today is warm and sunny, a good day to clean the beach, and later today, neighbors will gather to do that.

Yesterday we attended an ethics training, one of those gatherings mandated for, and, often, dreaded by, licensed professionals.

The day got off to a rocky beginning when one of the presenters outlined his, “common sense”, model for understanding ethical stances and dilemmas. He suggested a model of several overlapping circles, beginning with the individual’s ethical stance in the world, and ending with the larger societal view. All of these circles appeared to be contained within a vast circle that delineated the domain of litigation.

One concern I have with this view is that, while it fits the practice environment of many mental health clinicians in the U.S., it is disrespectful of Native people. For many of us, all ethical understanding begins in the community (people, other beings, and the landscape). My personal ethical views are secondary to those of the community, and, ideally, arise from many generations of thought about right relationship to the world and our fellow beings.

From this view, I, as the person who occupies the position of a healer (someone who engages in conversation and ceremony to alleviate suffering) must consider the person or family I am aiding as deeply embedded in a world rich in relationships and meaning, and filled with interactive spirits, including ancestors. This world is understood with an ethical worldview in which the person has a direct, personal relationship with the Creator and a unique life path, and in which each person is responsible for maintaining correct relationship to the community.

This relationship is reciprocal. The community protects, nurtures, and honors women, children, and elders, and supports and appreciates men. When warfare is necessary, returning vets are acknowledged, and ceremony performed to remove the harms of war and reintegrate them into the community. If they are disabled, they, too, are cared for by the community.

From this ethical frame, late capitalism is misguided, and it’s individual-centered ethic destructive. How can one maintain right relationships when the focus is on self?

This conflict in worldviews presents Native clinicians with a prickly problem. How are we to practice ethically in an institutionalized system governed by a worldview we may perceive to be unethical, even immoral? This is a good, even central, question. Many mental health professional organizations speak of cultural competency while simultaneously adapting culturally harmful codes and practices.

These different understandings of the world and of ethics assure Native clinicians will be subject to numerous microagressions in the course of most conferences. This is painful, and largely invisible to the vast majority of clinicians and presenters in the room. That’s a problem. Yesterday, in the second half of the conference, we began a conversation about these things. Over the course of half-an-hour, those in the room spoke together about difference and harm. This was a fine beginning, the depth of the conversation rewarding. Hopefully the conversation will continue and grow.

16 thoughts on “Ethics and the Healer

  1. This is very interesting, Michael, thinking about ethics, personal and societal. It is very complicated. I think of the pharmacists who refuse to serve certain customers because they don’t believe a woman, even if she has been raped, should be allowed to take a morning after pill, just in case. It is an individual’s belief based upon what his religious community believes, within the larger community which has decided that a woman has the right to choose whether she carries her rapist’s baby, or anyone else’s. Personally, I support a woman’s right to choose what is right for herself. I also support that pharmacist’s right to go get a job he can do with a good conscience, without imposing his religious beliefs upon others in a way that impinges their freedom. What if our larger society were to revoke Roe vs. Wade? Should we accept society’s judgement that a woman no longer has the choice to decide whether or not she will bear a child? Yes, it is very complicated.

    1. Naomi, yet is complicated. With this post I am beginning to grapple with decolonizing mental health practice. The issue yesterday, and often, is the very structure of therapy (and the field of therapy) tends to reinforce the very colonial issues we are struggling to address. For well educated, partially assimilated urban Indians, we may deal with loss of tribal affiliation, racism, and the expectation that we will adapt colonial methodology in our professional and academic careers. Issues of identity are often enormous, and parents and grandparents may reject Native identity. As clinicians and educators we confront colonialism and racism in the very structure of our work, and try to address its presence in the lives of our clients.

      More directly in response to your concerns, traditionally most tribes placed reproductive choices firmly in the hands of the women. Colonial attitudes undercut this in some tribes or regions, along with many other traditional beliefs, such as the freedom of each person to find a sexuality and gender appropriate to their life path. Although the “Founding Fathers” adapted Indigenous models of governance to their needs in writing the constitution and other early documents, they did not adapt the ethos that made those models viable. In fact, they undercut the traditional governance and religious practices of Natives in an active effort to destroy our standing as First Peoples.

      1. Dear Michael,
        I can’t even begin to understand the position of The First People, from the invasion of their land to all the subsequent mistreatment. It makes me sad, because I am certain the racism and mistreatment goes on today, some of it blatant, some of it more subtle, all of it damaging. People need to keep doing what you are doing, which is to speak out again and again to make people understand what is happening and how wrong it is, and why. The public needs to be educated. I applaud you and support you in this very important cause.

        (I brought up reproductive choices because, as a woman, I can understand how dramatically one’s life can be affected by the ethics of other individuals and society as a whole. It had nothing to do with the First Peoples’ stand on gender issues).

      2. Naomi, thank you. There are many similarities between the impingements made against Indigenous people and those made against women. One should not be shocked that Native women are disproportionately targeted for violence, overt and covert. That reflects long colonial practice as well as the vulnerability of all women in our culture. At the same time, there has clearly been a long, and concerted, effort by some in the US to disenfranchise women. Our women friends in India, even those of the upper classes/castes, face much discrimination and the constant threat of violence. Tribal women, and those of low caste, are also disproportionately vulnerable. It is crucial people have ownership of their lives.

        I have been largely silent on issues related to the impacts, of clinical theory and practice, on Indigenous people. This reflects my own struggle to make sense of my own experience as a student, clinician and teacher. I am curious to see where all this goes.

    1. Michael, I think the differences are more in the realm of ethos than in practice, although there are many culturally attuned practices that may be culture specific. The overall task of of creating an identity that embraces all of self is made more complex by the generations of passing, hiding, displacement, and culture loss that many urban Natives face. There are a host of other issues that arise from the experience of colonization. This is true for many Indigenous people around the world.

  2. Ji,Thank you for this. I have been reflecting on these themes with regard to psychology research and indigenous communities and the meaning-making differences that affect praxis and ethics. There is a new book coming out soon, Decolonizing “Multicultural” Counseling and Psychology: Visions for Social Justice Theory and Practice which has some good articles.

    1. Thanks! I will look for it. Do you know the publisher? I am just now trying to theorize my experience so am eager for new material to read, as well as others to ponder with.I would love to hear your further thoughts.

      1. Yes. George Mason University Publisher: Springer SBM (as part of the Culture & International Psychology Series edited by Anthony J. Marsella & Wade Pickren). Eduardo Duran has a very insightful article on Story Science which will appear there– and is very congruent with your narrative approach. Strongly recommend you contact him.

      2. Thanks, Ji Hyang, I read Duran a few years ago, and know he continues to be a guiding influence on the field. I am curious as to whether the book will address the concerns we have here in VT where many Indigenous people passed as European for many generations. All the normal colonial issues: violence, substance abuse, identity confusion, suicide effect our communities, although with that twist of invisibility.

  3. When we leave our hearts and take up full time residence in the mind we forget how to respect one another. Taking more than occasional trips to the heart begins to soften and enlighten us. It’s so easy and so hard. It’s a practice with intention and being gentle.

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