In the mental health system today, identity is very imaginary and rife with politics. Take a look for yourself and step inside a vast channel of never-ending systems issues and clinical jargon. Somewhere along this ride is the authentic self of the clinician and peer.
Cultural re-appropriation is rife and considered business as usual in Western psychiatry.
I want to make a term visible and define it: ‘Passing.’ Passing is the act of concealing to hide or disguise a piece of a person’s identity as if (insert pronoun) ‘naturally’ is a part of the dominant group. To excavate just enough meaning to get a ‘working’ understanding of the language so the reader can repurpose these ideas and take them in (insert pronoun) journey through the system.
These terms evoke other ideas and theories. Some of them, include right to ‘ownership’, ‘diversity’, ‘equity’, and ‘inclusion’. The capacity to interfere and eliminate discrimination based on lived experience and belonging. To make these secondary concepts more meaningful, I want to share an anecdote from my experience as a Peer Specialist working on an ACT Team with shared clients.
The Vocational Specialist and I had a good connection with a particular client. Given that we were on a team and helping this client work towards a goal, we tried to align our interventions to reach this goal: acquiring a pair of shoes for the client. To make matters more complicated, the client had a history of ‘splitting’ team members and having them work at cross purposes. The splitting came off as innocent. The client began making minor, cutting remarks about other team members’ abilities in front of select members of the team.
My understanding of my own client’s mental status was ‘crippled.’ Conflicting reports about my client began to circulate, and I needed to apply a great deal of re-engagement to get treatment back on track.
I was expecting this. I was no stranger to working on my own when I was either the sole ally in a client’s life or the only team member working with a few clients on the roster.
My position on the team was somewhat strange- given my disclosed lived experience and my clinical role. To fulfill my job responsibilities and work, I would have to cover one identity in favor of another to do the work without stepping into a dangerous dual role. With dual roles and a complicated identity game, I did not expect the client to turn my lived experience and use it as a bargaining chip to position my teammate and me against each other.
He was a police officer before joining our ACT Team.
Police officers don’t come from a homogenous population. All walks of life become cops. And yet, all cops must assume this single identity as an officer of the law above personal reproach. In this sense, officers must cover aspects of the essence to pass as this monolithic police force. In terms of ACT teams, most of our clients, especially those we were working with, had a history of trauma from police intervention. The vocational specialist was competent to keep this information to himself, at least, until it could be unpacked at a later date if it ever surfaced.
The question is: if you’re not a peer, is there ever a reason to disclose lived experience?
One day, I stumbled into a minefield of questions regarding the vocational specialists’ training and history after one of his visits went sour. Given we are a team and work to patch up rapport gaps with mutual clients, I allowed myself to walk into the minefield of identity, exposure and got very hurt in the process: “why was he asking me all these questions? The client asked me.
I explained to the client that he was doing what he knew, given his training and style. He wanted to learn more about you (the client) to serve better and make sure the client reached the goal ultimately went the plan and the shoes obtained. “He was a police officer before he came to the team, and this is him learning how to serve you better”..” A cop!!!! Oh, no, I’ll never speak with him again” (inconsolable cries and muttering). Indeed, this is an example where identity politics can devolve into a sordid game of ‘othering,’ and later, in this mental health example, ‘splitting.’
My mistake was I shared someone else’s experience in life to engage with a client on my level and terms. In doing so, the team member whose identity I revealed no longer had space or the option to pass or cover to complete his job work and engage with clients successfully. In a clumsy, albeit gungho attempt at team diplomacy, I revealed the team member’s history before working on our team, possibly putting him at risk of violence and certainly disengagement in the rooster when working mutually with this client.
While I had the best intentions, I DO NOT ‘own’ my team members’ history, and I had no right to disclose it to others. My team member had every right to cover as a former job as a cop (albeit with some visible pushback and clumsiness) to keep his safety intact and continue passing as a viable ACT team employee. Now, here is where things took an even darker turn for our team. Despite processing all of this as a team together, the incident continued to leave a lasting mark. The vocational specialist fed into the client splitting and refused to relate with me or work with me further.
Now, the futility of this is apparent, but the long-term implications to mental health are clear. When we use identity politics to scorn and ‘disable’ pathways for ongoing dialogue, communication, and discussion, we let our niche and bold identities become the very flags hailing our surrender to microaggressions and infighting in mental health.
Author Info:
Max E. Guttman
Max E. Guttman is the owner of Mindful Living LCSW, PLLC, a private mental health practice in Yonkers, New York.
