Therapy, Trauma, and Our Therapist Friends - Interview with Kelsey Harper, Psy.D.
What we get wrong (spoiler: it's a LOT)
JAN 17, 2024
(This is an excerpt from an interview of Kelsey Harper, Psy.D. conducted by Alex Benke for the substack Unpopping. Please connect and follow Unpopping for more from Alex Benke.)
Dr. KELSEY HARPER, Psy.D., is a practicing psychologist, writer, podcaster, and sexual assault survivor with a background in community work and activism. Her unique path to psychology, profound lived experiences, and inherent creativity have given her a vast perspective and razor-sharp discernment when it comes to treating her clients.
Posting this interview has me fluttering with delight. Enjoy!
🧠 Tell me a little about your journey becoming a psychologist. Did you always dream of being a therapist?
KH: I always wanted to do something that would make a significant contribution and change in the way people are hurting in the world. In high school, I joined the school newspaper and eventually became the editor in chief. I loved having this space to give voice to issues my peers were experiencing, to feel a sense of reclaiming some power in how things were operating in our community and world.
When I went to college, I was an activist for Planned Parenthood and worked with residence halls in community building. I loved the feeling of mobilization and making change, and helping others see that they matter to their community.
However I saw how slow progress is through that work, and felt there was more support I could provide in small groups and individually—particularly around how people experienced transaction with the stresses and pain of this world.
I turned toward psychology and community-based interventions at that time, and continued to pursue this path.
🧠 My sense is that that trajectory—from the community-wide focus to the individual, is fairly unique. It seems to me that a lot of young people just starting to study psychology have a pretty narrow scope on what it means to “do good” and “help others,” and as they continue to focus on psychology, they can start mistaking the forest for the trees. Your background in organizing and activism have no doubt given you an especially valuable perspective, especially in your work with sexual violence survivors. But, more than later 🤓 as readers continue to get to know you:
🧠 Many people perceive therapists to have “all their shit together” in their personal lives. But, therapists are people 😝 would you like to share any of your not-together shit?
KH: Excellent question! I think that as therapists, we’re providing a secure/safe and supportive relational dynamic for someone to do recovery work, self examine, and repair psychological injuries. Rather than it being that therapists are these supreme healed/elevated humans, we practice holding space safely for a process to occur.
🧠 So, in other words: therapists aren’t therapists because they have “mastered” mental health (whatever the hell that means). Rather, therapists are able to apply skills to treat others.
KH: Exactly.
My not together shit: I’ve experienced anxiety ever since I was a child; it was very difficult, and led to a lot of overcontrol and over-compensating behaviors, like looking like I have all my shit super together and then falling apart when any problem would happen.
This pattern helped me get through school and graduate school successfully, but caused a lot of stress.
Since then, I’ve learned a lot through radical acceptance of the messiness of the world, and connecting that to being intentional about how I want to live in the messy world.
Ten years ago I was SA’d and developed chronic PTSD with high anxiety, dissociation, flashbacks, difficulty sleeping and eating, and isolating from all relationships. I had work as an anchor, a way of surviving and getting through, and pursued a lot of different things to help with healing in addition to traditional therapy—somatic based therapies, spiritual interventions, witchy stuff, all kinds of things.
Now, I feel much more grounded and “back to myself,” and share a lot about this journey in my podcast and in my work with SA survivors.
Last year, I experienced a relapse of trauma symptoms and had to focus on recovery work again; and, I learned even more about how psychological injuries like this can have a lasting impact—even after “successful” recovery—and how to care for that need in me without judgment.
🧠 You’ve shared with me that the SA you experienced occurred within the context of your career as a therapist. Would you like to share more about that event, and how it has impacted your perspective and practice?
KH: I was attacked by a client during a therapy session. This caused the onset of chronic PTSD I described earlier, and that brought me to a trauma recovery path and experiencing first hand how winding and complex that path is.
My symptoms and my needs around those shaped how I approached boundaries in my work and helped me focus on how to shape a life where I can exist as a full human and continue to make this contribution to my community. My recovery changed my focus in my work as well to build and offer effective and accessible services specific to survivors of sexual violence that include perspectives on how our culture transacts with gender based violence. In many ways this work required my healing and also facilitated it, and enabled me to become more radically authentic about myself in the world.
🧠 It’s amazing that you’re able to be so candid about your experience, and how that experience continues to inform your work (and how your work has informed your recovery!). In one sentence, can you describe your current therapy practice? What would you say are your main strengths? What common elements do you see of the people who gravitate to you as a therapist?
KH: I provide trauma recovery therapy using science-backed methods and sociopolitical perspectives.
I approach therapy with a skills-based focus, equipping individuals with practical skills they can use right away to help make change with how they’re feeling and experiencing life.
I focus a lot on shame reduction and intervening on common victim-blaming myths, so that people feel heard and supported in their recovery.
Skill building is essential to recovery. But, it’s equally important to contextualize our experiences, and traumatic experiences, in the sociopolitical systems in our culture and communities—and to work towards dismantling those harmful systems in ourselves, to align with our values in how we engage in the world.
People often gravitate to me for my genuine approach with validation and compassion, including how I address the role of these oppressive systems operating in our culture and impact each of us.
🧠 “Dismantling oppressive systems” and “sociopolitical contexts” are buzzwords these days—but your background community work and activism have obviously equipped you with the ability to radically embody and practice these values in a genuine way. Which is pretty fucking bad ass 😎
🧠 You have a well-earned confidence and crystal clear perspective regarding your particular professional practice. But I’m curious: how has your perspective on being a therapist, and your practice, changed over time?
KH: Through my schooling and early training experiences, it was really impressed upon me that the role of the therapist is to be very neutral—to have little to no subjective presence in the space, and keep everything focused on the client and what they speak to. Ultimately, this is to allow the client to have the whole space shaped for them, and allow them to unfold whatever needs to be seen.
However, through my ongoing work and my own experience as a client of that type of approach, I quickly learned that we don’t experience relationships this way.
Regardless of a therapist’s effort to be a blank screen, they are experienced as a whole person—with thoughts, feelings, history, needs, etc. For many clients with complex trauma that occurred in relationships, having a blank screen therapist is unsettling and activating, not knowing how the therapist may react or respond.
I want clients to feel safe and secure in therapy, in doing the work they want to.
So, I began learning how to practice genuineness and presence in a professional way. I am me in the room with clients, and the therapeutic relationship is a real relationship with the same needs and hurdles of real relationships—but, it’s not about me.
Additionally, learning more and more about systems of oppression and privilege, and the impact of community based/institutional trauma and oppression trauma made it very clear to me that for therapy to truly work for people, I can’t ignore the systems at play in our lives and how they also exist in the room.
Trauma doesn’t happen in a vacuum—none of us live and act apart from the sociopolitical systems of the world; rather, they shape a lot of our experience of mental health.
Recovery from an individualistic/oppressive perspective is that people take individual responsibility for their mental health symptoms (thoughts, feelings, behaviors) and manage those things with skills, self examination, control, etc., in order to return to “normal functioning” and be productive in a capitalistic society. But that’s not actual recovery—that’s simply being shaped to be compliant and conforming under oppression; traumatic injury is going to continue to happen.
Recovery from an abolitionist/decolonizing perspective is to identify the systems shaping our lives, effectively place responsibility within the systems that operate, learn more about how systems create traumatic injuries in us, heal/repair those injuries while connecting to our own values and communities, and mobilize in a way that aligns with our values to disrupt and dismantle those systems.
This creates the potential for change—not just individually, but collectively; and, it reverses the oppressive action of blaming the oppressed for their own suffering.
Therapy must be political in order to truly work, and therapists must be working on their own dismantling/decolonization within themselves in order to truly help.
🧠 What do you go through/experience second-hand as bearing witness to a lot of trauma and pain? What can folks do to support you, considering you can’t tell them in detail what’s going on?
KH: It’s always helpful to reach out and connect. Even if I can’t talk about what’s happening, it’s nice to have time with friends and family.
Many folx try not to “burden” their therapist friend/family member with sharing their tough stuff, but please include us! We want to be your friends, and we can let you know if we’re at capacity.
When I’m feeling the weight of things, I tend to disconnect/numb and isolate—so having people reach out just to catch up can be really helpful, reminding me to get out of the cave. Connection with friends and community, doing anything together (knitting circle, supper club, book club, live music, whatever it is), is really powerful in supporting therapists and diffusing the weight of the work we do.
🧠 You shared with me that you recently experienced a devastating loss. Is there anything at all you’d like to share about that experience?
KH: I recently lost a client to suicide. It’s extremely painful and sad, and I’m feeling a lot of grief for them.
It’s important that we as a community don’t underestimate how serious mental health issues are, and that they can be life threatening and should be cared for as such. We still have a lot of stigma around mental health, and judgment particularly around suicide and behaviors that alienate people from community and effective care.
Suicide isn’t a selfish act, and people who are suffering need connection and support.
🧠 Speaking of stigma and disinformation—you and I have chatted at length about how deeply misunderstood trauma and trauma responses are, especially as a result of social media. What do you think are the most common misconceptions? What would you say is the most important fact-versus-fiction you want the world to know?
KH: There’s a paired misconception that sticks with me, which is that 1) trauma is anything hurtful or emotionally overwhelming, and 2) trauma is the only justification for needing and seeking support and mental health care, and/or things that aren’t trauma are less severe/significant and don’t need as much support and healthcare.
Trauma/traumatic experiences and trauma responses/symptoms are very specific psychological injuries that require specific interventions.
There are many hurtful and overwhelming experiences that are not traumatic and do not require those specific interventions, but that can really benefit from other interventions.
Conflating emotional pain with trauma can cause serious issues, and basically result in accessing ineffective care, unhelpful therapy, causing symptoms of emotional distress and overwhelm to persist.
It’s important, especially for therapists and providers, to be specific in how we diagnose and provide care.
Human experiences are hardly quantifiable in such a way that makes comparisons like this— “trauma means you need help, no trauma means you don’t”—at all useful. Pain is pain, and when we are suffering, it fills our space, no matter where the suffering stems from; and, it is inherently valid, and legitimate, and worthy of attention and care.
Absolute beliefs like this about trauma tie back to old ideas about “bootstrapping” in a way that deflects culpability from harmful systems onto individuals’ abilities to cope.
An event doesn’t have to be trauma to cause pain and suffering; it doesn’t have to be trauma to warrant attention and care; and it doesn’t have to be severe to justify seeking support and to be seen/heard in your experience.
As humans we naturally gravitate to and benefit from community, and that includes bearing witness to all our experiences—without qualifying them as worthy or not. Therapy is no different—you and your experience/story matters.
🧠 Now, the first time you and I ever hung out, we ended up ranting about the shortcomings of the psychodynamic modality, especially in treating trauma-related symptoms. Of course, you and I both agree that there are skillful therapists who use psychodynamics effectively; but we also agree it is far from a cure-all, and very often overused. Can you share more on that?
KH: I was trained early on to approach therapy with a psychodynamic theoretical basis and orientation, which involves a lot of introspective process, connecting to the subjectivity of the current experience, and unfolding what might be held within to know oneself better. The expectation is that through building insight into one’s own psyche and psychological processes, one will naturally make change if needed, but change isn’t the focal point or target.
I found this approach worked really well with understanding how we can feel something and experience something from our past in a present situation, how we project in relationships, and how our psychological being is far more complex than simply thoughts, feelings and behaviors.
I also saw how little it did to change the discomfort, difficulty and pain people were experiencing, and also how it did not (at the time) effectively address collective cultural constructs and systemic issues that impact and transact with us and our psychological being.
Many of my clients needed practical support and training around skills to regulate emotions, manage stress, communicate effectively, and problem solve, in addition to understanding themselves better. For many, they didn’t necessarily need to understand themselves better, but really wanted some change or relief. I often get feedback from clients that reflective therapists are “helpful because they listen” but “didn’t help [them] change anything”.
There are also times when insight-based work can be harmful; in cases of chronic emotion dysregulation/borderline personality, trauma and complex trauma, thought disorders, disorders of overcontrol like OCD, this type of work can worsen symptoms. It can activate distress, strip away natural defenses that help a person stay regulated and present, and cause symptoms like emotional dysregulation and dissociation, hyperarousal and hypervigilance, compulsive rumination to worsen.
It’s important that psychodynamic work be considered as one option of mental health care intervention, and used with informed consent and very deliberate purpose around achieving specific goals that the client is seeking.
🧠 You love the career you’ve chosen. In terms of the day-to-day, what’s the worst part of being a therapist?
KH: Oh boy. The worst parts relate to the realities of providing this kind of service in a capitalistic society; meaning that in order to live and pay bills, I have to charge a rate to clients. And, because American healthcare is also privatized, it’s expensive—I have to charge a lot to be able to live life and pay bills. The access issues around mental health extend far beyond individual private practices and luxury treatment programs, into how our systems engage with healthcare as a whole, that healthcare is maintained as a privilege for the privileged and not a right for people.
This makes it hard to navigate how to effectively provide care, take care of myself as a part of this community, and make changes in how we approach healthcare.
🧠 Amen, comrade. Now, what’s the best part of it?
KH: All the people! I get to meet so many people and hear their stories and bear witness to their lives. It’s so meaningful to be a part of witnessing someone’s life and to know close, vulnerable parts of them. It feels very sacred to carry this role in the world.
🧠 Follow-up question: What is the most surprising part of it?
KH: The impact this work has had on me and my life. My view and perspective in the world is constantly expanding, whether I try to do this deliberately or not—and this expansion really aligns with my values around justice and liberation. It’s impossible to avoid changing as a person when you experience the humanity behind everything.
🧠 Finally, where can people find more of you?
KH: If you want to start your trauma recovery journey today, sign up to work with me here. I offer trauma therapy with multiple approaches to best meet the needs of trauma survivors. You can sign up for my mailing list to get tips for trauma recovery right to your mailbox. You can also listen to my podcast, Initiated Survivor, anywhere you hear podcasts. Follow me on Instagram, TikTok, Facebook, and Youtube to get awesome survivor content.
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