29 July 2022
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Registered Clinical Psychotherapist Dr Gávi Ansara (he/him), Convenor of PACFA’s Diversity in Gender, Body, Kinship and Sexuality Interest Group, talks about why ‘therapeutic self-disclosure’ can be beneficial and sometimes necessary, why he doesn’t use the word ‘client’, and more, in this fascinating member profile.
1. Can you share something of your journey to becoming a psychotherapist? On your website, you talk about using an ‘Anti-Oppressive Clinical Practice’ framework, can you describe how using such a framework supports therapy participants’ safety and therapeutic process?
My journey toward becoming a psychotherapist and my ongoing, lifelong journey in Anti-Oppressive Clinical Practice are inextricably entwined. Over 20 years ago, when I worked in a psychiatric rehabilitation program, I was troubled by the dehumanising and condescension I witnessed daily. Professionals spoke authoritatively about people, without ever considering their legitimate concerns.
All the people with whom I worked had strengths, resilience, and inner resources that were chronically neglected. Most were prescribed so many psychiatric medications that they took additional medications just to manage the severely negative effects of their initial medications; some were even prescribed contraindicated medications that pharmacology texts caution should never be prescribed together.
By failing to listen to people’s own accounts, practitioners caused debilitating iatrogenic (physician-caused) impairments that persisted for many years before being taken seriously and finally addressed. By then, the iatrogenic impairments were often irreversible.
Years later, I learned about the Hearing Voices Network and clinical successes in listening to, rather than eradicating, the voices— what devastation could we have prevented?
Months of clinician notes recorded that a respected religious leader in our care was having daily “schizophrenic” episodes. As a result, they increased his psychiatric medication dosages until he had very little capacity to speak, stand, walk, or clean himself. When I observed him closely, I discovered that these daily ‘episodes’ were not psychiatric symptoms at all. He was observing his daily religious prayer times in a normative way for his community. Clinicians who did not understand his observances had made inaccurate clinical judgements, because they could not see past his psychiatric label and lacked the cultural humility to recognise their misconceptions. Many similar encounters with oppressive practice from “unhelpful helpers” taught me the clinical necessity of cultivating critical self-reflection and cultural humility.
Since then, I have completed a PhD in Psychology, a Master of Counselling, and specialised training in complex trauma, sex and relationships therapy, family therapy, neurodivergent-affirming practice, refugee mental health, and other areas. My most important training by far comes from therapy participants themselves. As I re-learn daily, they are the best authorities on their own lived experiences, even when they may seek my assistance with better understanding and communicating their needs and wisdom to themselves and other people.
Anti-Oppressive Practice supports participants’ safety and facilitates the therapeutic process by allowing me to attend clinically to how dynamics of power, privilege, marginalisation, and oppression affect the intra-personal, interpersonal, institutional, and societal levels at which therapeutic relationships occur. We don’t use the term ‘clients’, because the work requires active engagement and collaboration from people. Safety comes in part from knowing this isn’t something we do to people, but with them
2. You’re the Convenor of PACFA’s Gender, Body, Kinship and Sexuality Leadership Group, which ran an ethics workshop in July about self-disclosure and how ‘extensive research shows practitioner self-disclosure can be beneficial-- even essential-- with therapy participants whose genders, bodies, kinship, and sexualities have been excluded or marginalised’. Is there a particular piece of research you can point towards for members who want to know more?
It's fascinating to me that some Freudian notions rejected even by some of Freud’s psychoanalytic contemporaries have resulted in unscientific taboos against all Therapeutic Self-Disclosure (TSD), even among ostensibly ‘humanistic, person-centred’ practitioners. Freud’s psychoanalytic protegé Sándor Ferenczi challenged Freud’s “sterile surgeon” approach, instead promoting a warm, explicitly caring (not ‘neutral’) psychoanalytic stance in his 1928 guide to what he called Judicious Self-Disclosure.[1] In addition, practitioners who fit dominant cultural norms are often unaware they are constantly communicating to those of us from marginalised lived experiences that they are, for example, of cisgender, heterosexual, monogamous, white Anglo Australian, affluent experience, as much by omission, avoidance, unspoken gesture, or word choice as by intention. Total non-disclosure is a myth that stems from unexamined practitioner privilege.
Aboriginal colleagues have shared that they draw on thousands of years of community wisdom about how cultural safety requires TSD. For over four decades, the now-extensive field of peer-reviewed, published research on TSD among racialised cultures and marginalised gender, body, kinship, and sexuality communities has established an evidence-based consensus that TSD with our communities can often be beneficial and essential. This isn’t a single paper, but many.
The field has shifted from asking simplistic, binary questions like ‘Is it OK, yes or no?’, to focus instead on which factors affect when, how, within which boundaries, and to which extent. We shared multiple pages of relevant peer-reviewed references with our recent webinar participants. Instead of singling out a specific piece of research in a field with many worthwhile studies, I would encourage members of our PACFA community to learn about this topic in a way that centres accounts from practitioners and therapy participants with lived experience.
3. Could you outline where self-disclosure could be essential with clients of particular marginalised communities?
Participants who constantly expend energy making our lives intelligible to other people can find tremendous relief from practitioners articulating that they understand how their social position can limit their own familiarity with our lived experiences. The Kink and Polyamory Aware Professionals Directory classifies practitioners by three levels of familiarity and skill, defining what constitutes a Friendly, Aware, or Knowledgeable practitioner.
This means participants give informed consent regarding how much therapy space they use educating practitioners and explaining in-group terminology. Even when practitioners are ‘Friendly’ or ‘Aware’, the emotional labour expended to make ourselves intelligible can be exhausting and detract from actual therapeutic work. By selecting a Knowledgeable practitioner—especially if their bio discloses lived experience in the community—participants report feeling able to spend more time on deeper therapeutic work, trusting that the practitioner can ‘handle it’, instead of feeling self-conscious, self-censoring their expressions, or offering PD during their own therapy.
Read about other anti-oppressive practices for working with marginalised communities in the Community of Care Guidelines developed by Dr Ansara and Clinical Psychotherapist and Relationship Therapist, Phoenix (she/her).
4. Finally, what is it about being a psychotherapist that still surprises you and gets you out of bed every morning?
What keeps me passionately inspired as a practitioner is my cultural reverence for people whose transformative journeys I am honoured to share. This work moves and changes me as much as it does the people who participate in therapy or clinical supervision with me—their insights, struggles, triumphs, and awakenings.
I feel privileged to have a professional life where I can integrate the values of authenticity, critical self-reflection, lifelong learning, cultural humility, and challenging oppression into my everyday work. The capacity to move people deeply, and to be deeply moved by people, is at the heart and soul of therapeutic change.
About Dr Gávi Ansara
Dr Gávi Ansara (He/him) (PhD Psychol, MCouns) is an AAFT-Accredited Clinical Supervisor and PACFA-Registered Clinical Psychotherapist living on unceded Boonwurrung Country (Kulin Nations). He has provided over 20 years of Anti-Oppressive Practice alongside people and communities with lived experience of marginalisation and oppression. One of his specialisations is polycule-centred clinical practice. He has over a decade of experience providing clinical supervision and therapy that value and prioritise polyamorous people, families, polycules, kinship systems, and communities.
He also has specialist qualifications in complex trauma and dissociation, family and community trauma, youth and refugee mental health, emotionally aware child caregiving, BIPOC-centred ecotherapy, and group facilitation. He has received the American Psychological Association’s Transgender Research Award for original and significant research, the UK Higher Education Academy’s National Psychology Postgraduate Teaching Award for excellence in teaching psychology, and the University of Surrey Vice Chancellor’s Alumni Achievement Award for outstanding contributions to standards and policies in international human rights and social justice.
[Practitioner positioning statements are an evidence-informed and internationally recognised form of ethical self-disclosure in Anti-Oppressive Clinical Practice.] Positioning statement: I am a multilingual, mixed/hybrid polycultural, polyamorous, neurodivergent, and gay/androsexual man of faith who grew up in urban and rural China, on the unceded lands of the Eora Nation, and elsewhere. I have multiple names in multiple languages, and they are all my “real” names. My polycule contains secure attachment bonds that include queerfamilial kindred and other chosen family. I have lived experience of disability, homelessness, intergenerational forced displacement, poverty, being targeted for racist violence, and gender, body, kinship, and sexuality oppression. I strive toward cultural humility regarding my literacy, educational, allistic (non-Autistic), binary gender, sighted, and non-Aboriginal privileges.
For more information, visit http://ansarapsychotherapy.com
[1] Ferenczi S. The elasticity of psycho-analytic technique (1928). In: Balint M, ed. Final contributions to the problems and methods of psychoanalysis Vol III. N.Y.: Basic Books, 1955:87–102.