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Finding Possibility Within Harmful Systems: Hope, Solidarity, and Systemic Thinking in Therapy – An Interview with Travis Heath, PhD

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Finding Possibility Within Harmful Systems: Hope, Solidarity, and Systemic Thinking in Therapy – An Interview with Travis Heath, PhD

Most of us were trained to look for the problem inside the client: their thoughts, their history, their coping. Yet the people in our offices are also living within economic pressures, cultural expectations, and institutions that weren’t built with their wellbeing in mind, and so are we. Widening the lens to see clients in the systems they inhabit can feel like a lot to hold. How do you name harm you can’t fix in a single session, keep showing up for your clients anyway, and still help them find possibility where it looked like there was none?

Curt and Katie welcome Dr. Travis Heath back for a long-awaited second conversation about the stories we inherit about success, certainty, and individualism, and what becomes possible when therapists stop locating problems solely inside the people they work with. Travis talks about helping clients find a livable relationship with systems they can’t simply opt out of, why uncertainty can open the door to hope, how Black abolitionist thought and solidarity show up in clinical work, and what productive therapy might actually mean.

Transcript

Click here to scroll to the podcast transcript.

(Show notes provided in collaboration with Otter.ai and Claude AI.)

About Our Guest: Travis Heath, PhD

Travis Heath is a licensed psychologist and Associate Professor at San Diego State University, where he serves as Chair of the Department of Counseling & School Psychology. His work explores how culture, power, and dominant stories shape people’s lives, with particular attention to practices that honor dignity, cultural knowledge, and people’s authorship of their own lives.

His work has explored cultural democracy, Black abolitionist scholarship, the use of rap music in narrative therapy, working alongside people entangled in the criminal legal system, and community healing practices. He is currently working on a new book examining how stories about success, certainty, individuality, and our sense of self are largely inherited from culture, family, and institutions.

Travis is co-author, with David Epston and Tom Carlson, of Reimagining Narrative Therapy Through Practice Stories and Autoethnography (Routledge, 2022), and created the 2024 Psychotherapy.net video series Reimagining Multiculturalism: A Contemporary Narrative Approach. He hosts the Therapist Confidential podcast through Psychotherapy.net and has facilitated workshops and spoken in Australia, Canada, Denmark, France, Hong Kong, India, Italy, New Zealand, Norway, the United Kingdom, and the United States.

In this Podcast Episode: Systemic Thinking, Narrative Therapy, and the Stories Clients Inherit

Travis first joined us in 2020 for Therapy as a Political Act, and this conversation picks up those threads six years later. He describes how dominant cultural stories pass as common sense, why asking about the genealogy of a client’s values so often opens up rich conversation, and how he works with clients who feel stuck between a system that doesn’t fit them and no visible way out. Travis also reflects on how he sustains himself in this work (starting with remembering he isn’t above any of it), shares a story from his internship about holding his ground on diagnosis, and offers an important caveat about questioning everything: the point is to open up possibilities, never to leave people destabilized.

Key Takeaways for Therapists: Systemic Problems, Client Agency, and Hope Amid Uncertainty

“To me, therapy becomes more interesting when we stop asking just what’s happening inside of you, and we start asking questions like, ‘What’s happening around you? What’s been asked of you? Who benefits from believing this is entirely your problem?’”

— Travis Heath, PhD

Contextualize before you cope. Many of the “choices” behind a client’s exhaustion were shaped by the systems they live in. Surfacing that context invites a different kind of agency than coping skills alone, like deciding when email and notifications get turned off, and why.
Get curious about where values come from. Travis asks clients how a value became theirs, who taught it to them, and what they hope it will deliver. He isn’t trying to label anyone’s wants as false. Tracing their genealogy helps clients decide what to hold onto, what to let go of, and what they might create.
Look for the in-between space. Most clients can’t fully exit late capitalism, and prescribing a path rarely works. Exploring the particulars of a person’s context can reveal micro-alternatives, the way Travis’s university salary and benefits make his radical sliding fee scale possible.
Leave room for hopelessness, and for hope. Drawing on Rebecca Solnit, Travis notes that “everything will be fine” and “we’re doomed” both assume certainty, which crowds out hope. Feeling dejected today doesn’t make it a permanent state.
Practice abolition in small, present ways. Black abolitionist thought separates reform from imagination. Travis points to Mariame Kaba’s framing of many small experiments and Fred Moten’s idea of presencing, which asks what we can do differently in this room, with this person, right now.
Solidarity asks for action. Empathy can help someone feel understood. Solidarity names a collective struggle and asks us to do something about it, often around labor and resources. Travis’s test for institutions: how is your budget standing for that?
Rethink what counts as productive. Slowing down and staying with what a client says may not satisfy a five-session model, but it may be where the therapeutic value lives. You can meet agency requirements, choose your battles, and still practice in a way that feels like you.

“We question things with the intent, one, to understand, and then two, to try to create possibilities that may fit better for the person. If we were just doing nihilism disguised as therapy, that’d be probably pretty awful.”

— Travis Heath, PhD

Resources on Systemic, Narrative, and Abolitionist Approaches to Therapy

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Therapist Confidential podcast with Travis Heath, PhD (Psychotherapy.net): www.psychotherapy.net/perspectives/podcasts
Travis Heath, PhD, San Diego State University faculty page: education.sdsu.edu/directory/travis-heath
Reimagining Narrative Therapy Through Practice Stories and Autoethnography by Travis Heath, David Epston, and Tom Carlson (Routledge, 2022)
Ideas discussed: Rebecca Solnit on hope and uncertainty, Mariame Kaba and Fred Moten on abolition, Black abolitionist thought, solidarity, narrative therapy

Relevant Episodes of MTSG Podcast

Meet the Hosts: Curt Widhalm & Katie Vernoy

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

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Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements)

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist Survival Guide, where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:15
Welcome back, Modern Therapists. This is the Modern Therapist Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the ways that we go about our work, the ways that our profession looks at things, and kind of the balance between what it is that we learned in grad school and the rest of what it is that we want to learn in life, and the way that we go about our work. And today we are joined by Dr. Travis Heath for a long overdue round two. Katie and I consistently look back at our first interview with him as one of our favorite episodes from many years ago, and it set the bar pretty high. And today,

Katie Vernoy 0:58
No pressure, Travis.

Curt Widhalm 1:00
Today we are picking up with some of the themes and the ways that they’ve involved with what Travis continues to work about the quiet, powerful stories that we inherit about success, identity, and certainty. And so I’m just excited to jump right in. Thank you so much for coming back after all these year.

Dr. Travis Heath 1:22
Gosh, yeah, it’s been too long, and in some ways, it doesn’t feel that long. Like I can remember that conversation, I can remember being a part of the conference that you hosted around the COVID times when all of that wildness was happening, and it went online. And so I have a lot of good memories about the conversation and just some of the work that we did together, and yeah, the bar has been set pretty high. All these years later, I didn’t know that my interview you looked at it that highly, so I’m going to get loose and see if I can deliver a good episode too here.

Katie Vernoy 1:52
Yeah, like Curt was saying, I’m super excited about this conversation, but I’ll ask you the question to start with that we ask all of our guests, which is, “Who are you, and what are you putting out into the world?

Dr. Travis Heath 2:05
Yeah, that’s a great question. I guess first, I’m a I’m a human being who’s trying to navigate all the complexities of my own life and of the world that we exist in, the ever changing world that we exist in. So I locate myself there first. You know, I’m I’m someone who’s multiracial. I think that brings an interesting lens sometimes to the world. You know, all the professional stuff. I’m a professor, a psychologist, department chair. Try to be a writer. Been hosting a podcast the last year and a half, so trying to you know take some cues from y’all. So, I’ve got like you know various different professional things going on, but I think probably like being a parent is feels foremost in my consciousness right now. And I guess you know I’m always entertaining questions about the world. I think questions are so interesting, and I’m fascinated by what’s possible when we stop assuming that problems live entirely inside of people. And of course, in the work we do, we deal a lot with problems and challenges that people are up against. And so, just that idea of wondering what’s possible when we don’t locate the problem solely inside the person. And I’m also interested in in discovering how we can open up possibilities for people when maybe they didn’t see any of those previously. So those are questions I think about frequently in my work, but also I guess just in life too.

Curt Widhalm 3:37
I’m hearing this from some of my clients. I’m hearing this from other therapists, that a lot of people who are coming into therapy more recently are talking about living in a society where it’s not just individual problems; it’s the ways that people are coming in. They’re presenting problems are almost ‘I don’t understand how to live in the world that we’re in now,’ and helping to separate kind of this individual process from the one that’s connected to the larger, deeply more cultural political systems around us. What’s your advice for therapists? What are the stumbling blocks that therapists run into in these kinds of conversations.

Dr. Travis Heath 4:23
Yeah, it’s tough because first off, we’re all a part of this system too. So, like all the things I’m about to say are aspirational, and they’re things I try to put into practice. But you, you have to remember, I’m a part of the same system, right? And so, in that way, this is ongoing work; it never really ends. But therapy can often-I hope that’s a fair thing to say-can often become a place where you know what we do is we individualize problems, and that makes sense. I mean, psychology, psychiatry sort of advocate that sort of position, but I would ask us to consider that perhaps. These problems aren’t exclusively individual to begin with. And so, like, I’ll give you some examples, I see these all the time. I’m sure y’all see them in in your work too. You know, someone’s exhausted by the working conditions, how many hours they’re working, etc. You know, people are so busy now they can’t even make a meal. Seriously, they can’t make a meal. It’s like they’re just working all day, and then they come home and go to sleep, and they do it again. Relationships suffer, and I don’t just mean romantic relationships. I mean friendships, familial relationships, etc. And so, okay, you look at all that, and often what therapy does is it sort of tries to get people to cope with that, so they can go back out into the world. And you know maybe there’s some benefit to that, but I wonder if we can do more than just that. Right, the world isn’t just fine, and we need to become better at living in it. The world has some ways of operating that are actively harming people. But here’s the rub, because I get this all the time. People go, “Well, how are you going to change all that in therapy?” Well, I don’t think that I’m going to change all of that in therapy. But one thing that I can do is I can start to highlight these and bring them to the surface, right? Bring to the surface specific ways that the systems are functioning. Like for example, people will say, “Gosh, I don’t know why I’m so tired. I’m just exhausted all the time.” You know, and it’s like, well, okay, let’s think about that. Why are you exhausted all the time? And they start describing the reasons why. Often it involves work and all sorts of responsibilities and side hustles and all the things. And those weren’t all individual choices that people made, right? They are some of them are choices they made, but they were almost forced into those choices by virtue of the system that they’re in. And so, if we can’t change the system, at least we can highlight it, and we can say, “Oh, okay, this is. We can slow down and say, “This is what’s actually going on.” And once we’ve done that, then we can invite people into different relationships with the system. Even if we can’t change the system, we can invite them into different relationships with the system. And to me, therapy becomes more interesting when we stop asking just what’s happening inside of you, right? And more, we start asking questions like, “What’s happening around you? What’s been asked of you? Who benefits from believing this is entirely your problem.” Right? These kinds of questions. And again, that’s not to say that people can’t be accountable for things in the world, there’s not value in accountability. But it’s to contextualize what people are up against. And once we contextualize it, people actually have start to have more agency and can think about how they wish to be in relationship with this, and part of that could be actively resisting dominant parts of the system, right? Like, wait, I actually do have some choice in how I interact with work. A simple example: I’m going to turn my email and text off at this time. You know, my notifications go off, or I put my phone in another room, right? And when we’re doing that for sort of the reasons that I just talked about, that’s a little different than just coming up with coping skills, right? It’s like a different kind of agency. So I think that’s a great question you’re asking, Curt. I think it’s complicated, and that’s my the shortest answer I can give in ways that we can start to navigate that a little differently.

Katie Vernoy 8:21
Since our first conversation, and and potentially even since the beginning of the work that I’ve done as a clinician, I feel like that conversation happens a lot. What is impacting your behavior? How do you fit into the larger system? What does that mean for you? What choices do you want to make with that information? And those conversations are very rich. I think sometimes they can feel very hopeful. They can provide agency where there’s not agency, and then there are times when it becomes very daunting because the system seems very entrenched. It seems overwhelmingly like there’s nothing I can do. This is just how it is. And and so there’s there’s a couple of questions I could kind of go from here with, but I think the the first one. So I’m going to try to stick to just one at a time because sometimes I’ll just do like so many questions. But the first question I want to get to is: there are parts of us that want to do things, and there are parts of us that feel like we have to do things because this is how it is. And so, how do we sort through what are our own internal desires, our own plans versus these stories that we inherit about success, identity, certainty, individualism-like the things that you talk about. How do we get to what do I want? Because that is so challenging when these stories are so powerful.

Dr. Travis Heath 9:54
Yeah. Now I know why our first interview is going so well. You ask a great question. So yes, I agree. What makes this so challenging is that these sort of dominant, powerful cultural stories don’t announce themselves as cultural stories, and often we start to refer to them as common sense, right? Like, like nobody has to explicitly tell us more money or status or accomplishment or certainty or independence, whatever, will finally make us feel like enough. Right? We just absorb those ideas; they’re kind of present in the water supply. And so, when that happens, to the point you’re making, Katie, I think then we start to absorb the values, goals, whatever it might be, ethics of the society as our own, and it can be really hard to distinguish then what we actually want. And so that distinction fascinates me. I I’ll tell you, I was working with a couple just the other day, and we were working through values; first their individual values, but then their relational values, right? And one of the things I like asking, not just with couples, this just happened to be with a couple, is like, how did you learn to value these values? How did this particular value become yours? Who taught you about it? What are your hopes about it that it might deliver? You know, and what’s interesting to me is that very rarely, when I ask these questions of people, usually what they say is like, “That’s a really good question. Like, huh? Nobody’s ever asked me that before.” Which I get why because it’s taken for granted. But those are the places I like to start, and it’s not an interrogation, right? I’m not interrogating people about their values or their wants or desires. Also, I’m really not interested in telling people that their desires are false or wrong. What I’m trying to do is become curious about like their genealogy, right? Where did these come from? And that often opens up rich conversation that then can start start to get at what people might actually want. There’s also one other part I’ll add to this that I think is tricky. Is it’s a moving target because I what I want today may not be what I want in a week, may not be what I want in a month. And also what I want and I’m not trying to deny any influence of biology here but like I didn’t come out of the womb with wants. I came out of the womb with instincts. But to the best of my knowledge I didn’t come out of the womb with wants, so all of those to a degree are culturally shaped, right, and familial shaped. But of course, that’s part of culture as well, and how we come to think of families and all the things. And so, in some ways, I don’t know that these things can be totally teased out, but at least we can ask questions of them, right? And maybe we can start to consider letting go of some things that maybe we were told to hold on to that we don’t wish to hold on to, and maybe there are others that we might want to hold on to, or maybe we can create new values that aren’t values, wants, or desires of the dominant culture. So I really appreciate that question, and I think just really being curious and asking questions goes a long way. And for me, I could spend, to be honest with you, an entire session. I could spend two or three sessions, and actually, I feel like my work’s going best when I slow down and really ask questions and understand. Like if somebody says, “Well, my value is kindness,” I don’t just go, “Oh, okay, or “I want to be a kind person.” Okay, kindness. I know what that is. I actually am not sure what kindness is. I have an idea of what kindness is, but what does that mean to you? And what does it look like in the world? Why is it important? How did you come to value it? Do you value it in conjunction with other things, or does it stand on its own? I mean, there’s so much room to explore, and I think once we do that, we can start to see what it is that maybe we might want, with the understanding that we can’t disentangle anything completely from the culture it’s a part of. At least that’s my sense of it.

… 13:45
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Katie Vernoy 13:47
I’ve gone through some of these conversations with clients who had not really assessed these things, and there is a point at which, and I want to see if this is a common experience or just something weird to me, where suddenly their existence becomes almost so uncomfortable they can’t continue to lead it in the same way, and it becomes so hard to continue to comply with systems that, to a certain extent, require them to show up in a certain way to do the things that they want to do, their larger goals, whether it’s earning a particular amount of money or being able to finally build generational wealth, for example, or something, and it becomes so uncomfortable to continue to comply with the system that their mental health actually starts getting a bit worse when there isn’t a clear path out. What are your thoughts about that?

Dr. Travis Heath 14:48
Yeah, I wonder if this is part of what you’re getting at. You can tell me if it’s not. Is that I think a lot of times we get sort of stuck in between places, right. Where, like I’ll give you an example. People will, I think therapists do this all the time, and I’m glad therapists are wrestling with this question. You know, people will say like, “Gosh, the way this late capitalist system functions doesn’t suit me.” Usually, they say it using other words, but you know, you get the idea. They’re saying this doesn’t suit me. All right, and it’s like, okay, and but but they look around and they go, but there’s no alternative. Like like people will say, well, I wish I could live off the grid. Well, let’s actually think about that for a minute.

Katie Vernoy 15:32
Yeah.

Dr. Travis Heath 15:32
I don’t know. I’m no expert on living off the grid, but at least in the United States, to the best of my ability to understand that you’re going to have to have land to do that, and if you’re going to have land, you have to have money to buy the land, or you have to have family that had money that already bought the land that gives it to you, right? Or the government owns the land. Well, you’re probably not going to be able to live on that land forever. And I could go on down the list of ways that even if we did that, we couldn’t completely disentangle ourselves from the system. And I think that’s probably important to know, but it can also double down on that sense of hopelessness that people have sometimes. And for me, the place where I’ve tried to get with folks is like, okay, if we can’t get rid of this system completely today, which economic systems I’m not aware of how we can do that today. I mean, the whole thing could crash tomorrow, and then we’re going to have to figure out how to do it. And maybe we’re closer to that than we realize sometimes, but that’s probably still unlikely, even at this juncture, right? And so then, if we can’t change the system, how do we occupy an in-between space where we can be in relationship with that system in the best way that we know how, right? Or in the way that feels best to us. I mean, one example for me is working on a sliding fee scale. I work on a radical sliding fee scale. However, there’s a caveat to this. I also am a university professor. I get a salary. It’s not a great salary to live in Southern California, but I get a salary, and it has benefits, right? So I have health care, which it’s weird how in this country healthcare is tied to you know having a job, but here we are. And so like for me, I can afford to do that, right? It’s not going to break me, whereas someone else might not be able to. So in having these kinds of conversations, I think prescribing something like here’s what you do isn’t so good. It tends not to work so well, but instead trying to find particularities of a person’s context. And I think in all of our contexts we have ways we can relate to these systems that will feel better than others. Are any of them perfect? Likely not, or we would have already been doing that. But sometimes the way these systems function is they make us think there’s no alternative. Capitalism absolutely functions this way. It makes us believe there’s no alternative, and in some ways, right now there’s not. But there are like micro alternatives, different decisions we can make in relationship to it, and and that’s where I think people can start to find some hope. But in order to do that, it requires being in conversation with people about getting away from all or nothing sort of ways of thinking. And then sometimes they’ll point out like exemplars. They’ll be like, “Well, that person overcame capitalism. You know, I saw them give a keynote on the…” Okay, well, let’s think about that for a minute. So the dude flew in on a private jet, got paid five figures to give his keynote, hopped back. Maybe not a private jet. That’s going overboard. Let’s say first class.

Katie Vernoy 18:26
All right, all right.

Dr. Travis Heath 18:27
First class is that’s more fair. Flies first class, still more expensive, right? Gives his talk, leaves the conference early, collects his check, and goes home and is giving a talk about how he overcame capitalism, right? And so I’ve thought about that a lot because I saw that happening a lot, and I’m like, gosh, I want to offer critiques of capitalism because I have them, but I don’t want to either as a therapist or as someone on a podcast or as a professor, as a citizen of the world, I don’t want to act like I’ve figured out how to overcome it, right? And I think actually, where the magic exists is somewhere in that in-between space.

Curt Widhalm 19:04
A lot of what you’re describing sounds like dealing with moral injury and about inventing ways to be able to not have all of your goals and ideals be based on just kind of whatever the systemic dream is. That recognizing that you can control certain things, you can make connections out of certain things. You don’t have to necessarily reach a certain dollar amount as far as a salary or things that you acquire, but also just being able to focus on the things that can end up working for you. Now, as you’ve described, there’s still kind of a certain relationship that you have to have with that system, but it’s kind of a in addition to rather than a full replacement of.

Dr. Travis Heath 19:53
Yeah, I mean that’s definitely how I start to think about it. In addition to in relationship with. And , I think actually having conversations with people over time that embraces these spirits and ethics is useful because then people start to consider using some of the same language and taking on some of the same energy themselves. And, and I want to be clear that within all this, I think there has to be room for hopelessness sometimes, and there has to be room for people just feeling done and completely dejected. And because we feel done today or hopeless or completely dejected, doesn’t mean that that’s our fate forever and ever and ever. It probably just means we’re feeling really beat down. And you know, I’m not so big on validating in therapy. I’m more interested in being curious and listening and trying to understand. And I think if we’re curious and we try to understand that level of dejection or hopelessness that these systems can bring, that can usually be enough then to get people into this place where they’ll consider how they’ll be in relationship to things. I like what Rebecca Solnit says a lot about hope. It informs work I do probably on a daily basis, even when I’m not conscious of it. She talks about hope, and she says like, you have people that will tell you, like COVID’s a great example of this, like during COVID, in the first couple of months, there were some people that said, “Hey, when we get to the summer, everything’s going to be great. Everything’s going to be back. Whew, we’re going to be good.” And I remember having hearing clients say that, and I listened, and you know, but inside I was like, “People smarter than me seem to think it’s not going to be that way. But okay, I’m interested in understanding how and why that’s important to you.” But then you would have other people that would say we’re totally screwed, like everyone’s going to die and we’re done. And what Rebecca Solnit says is like, what’s interesting about both of those positions is that they assume certainty, and so assuming certainty actually, this is her contention, and I tend to agree, assuming certainty actually gets in the way of actual hope, because what hope is predicated on is the possibility that something could go different, right? And something unexpected could happen. Something could take a turn. And of course, we see these things happen all the time in small ways in our own lives, and also in more macro ways. Things take unexpected turns, and there could be hope in that. Now there could be tragedy in that too, of course, or anything else in between. That’s the risk. But another idea, as you were asking that question, Curt, this came to mind for me that I played with is this idea of certainty, and that on some level people are like, “Oh yeah, I know we don’t have certainty.” Yeah, but they still try to create certainty, you know, even though they might say that intellectually, like someone will say, “Well, I’m a vegetarian.” Why are you a vegetarian? “Well, it’s a healthy way to live.” That’s not the only reason why people are vegetarians, of course. But if you keep digging deeper and deeper, what they’re actually saying is like, Well, because I think I’ll live longer, and maybe there’s this hope that I can like cheat death in some way, right? Same, same with the person that eats all meat and all these different diets. It’s like somehow I can find certainty. Now there is one certainty, as near as I can tell, which is that we will all die. So you can’t cheat that. But life, and especially in the modern world, it’s filled with uncertainty. And then how do we maintain a sense of hope alongside uncertainty, and that to me is so much the task of what we’re doing. And the systems that we’ve been talking about contribute to this. But how do we maintain hope alongside uncertainty? And then how do we understand that uncertainty, as Rebecca Solnit points out, can actually be a gateway to hope for people.

… 23:43
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Katie Vernoy 23:43
It’s so interesting. As you were talking, another word kept popping into my head, which was grief, and how whether it’s the grief of what we thought was certain, or the grief of what has happened, but when we’re really looking at it, a lot of what we’re setting out to do as therapists is to provide folks with the the support, the conversations necessary to increase distress tolerance with this idea of uncertainty, to seek out where their positions of hope are, because if we have no hope, what’s the point of doing anything different? And then navigating this grief of what can’t be or wasn’t, you know, as certain as we wanted to be, or whatever. And it becomes, for therapists, I think potentially a very daunting task when we’re, as you said, also in these systems that feel like they’re not providing us with what we hoped for. I think there there is a small portion of folks who believe that things are on the right track, and there’s a lot of us who feel like they we’ve lost a lot of what we’ve gained. And so, I don’t know that I have a question here, but just in reflecting on that, how do you take care of yourself? Maybe I’ll go to that. How do you take care of yourself with these deeper conversations and the uncertainty and tragedies and horrors that we’re facing as a society right now?

Dr. Travis Heath 25:20
Yeah, I feel like that’s the kind of question students often ask, and what they’re hoping for on some level is a more trite, certain answer. You know.

Katie Vernoy 25:30
Of course, yeah.

Dr. Travis Heath 25:31
Once we can find out how to do that, and of course, I understand your question is something much deeper than that, and I think for me, it’s actually trying to let folks know whether they be clients I’m working with or people in the world that I’m a part of these same systems, that I have the same hopelessness that they do sometimes, right, that I have the same relationship with grief and uncertainty around this in a general sense. It may be over specific things you know that can vary. But so the kind of humanization of that I think becomes really important. And to relative to your question of taking care of myself, I can’t. I don’t think I can take care of myself. Well, first of all, I’m not sure I can take care of myself all by myself, anyways. I mean, I like to think I can. I like to think I’m very autonomous, and I have my stuff together, and I can take care of myself. But like, probably all of us need a community of folks to help with that, and it’s not just about us doing that. And I respect the question, and part of how I do that, I think, is reminding myself that I’m not somehow, as a psychologist that’s been doing this for 20 years, I’m not somehow above any of these things. I’m not above grief. I’m not above uncertainty. I’m not above miscommunication. I’m not above sometimes stating things in ways that are hurtful to others. I’m not above you know communication challenges. It goes on and on, right? Like literally, all the things that people come to me with, I haven’t experienced all the things that people come to me with, but I’m not above experiencing any of those. Like it’s funny because sometimes clients will say, I remember one person I was working with, and she’s like, ‘Gosh, you must be great to be married to and as a father.” And I’m like, let me tell you something about that. I mean, I think I don’t think I’m awful at that. I think I care, and I think I try to be good in relationships as a father, etc. But in my own life, I’m susceptible to all the same things, right? And so, at least for me, when I am able to acknowledge that, like really acknowledge it-not intellectually acknowledge it, but like on a heart level-really know that, gosh, I’m struggling with some of these same things from day to day. That’s actually helpful in taking care of myself. Because I think where I get into trouble is if I start to think like, oh yeah, see, I know, I know how to help other people navigate this stuff, so I’ve got all this stuff down, you know. And I know that we’re not supposed to do that as therapists, but at least I’ll speak for myself. I can be very susceptible to that. Of like, I’ve helped this person navigate this successfully. Obviously, I understand it. Because I don’t necessarily believe, by the way, this notion that we have to get, like we can only take people as far as we’ve gotten. No way, people have gotten way further than I’ve ever gotten in my work together. Now I’m not sure, I I’m not sure I solely took them there, right?

Katie Vernoy 28:36
Sure.

Dr. Travis Heath 28:36
We can end up on a journey with people that’s further than where we’ve gotten. And so yeah, I mean, for me, taking care of myself, it’s it’s not falling victim to that intellectual trap of feeling like, oh yeah, I’ve got all this stuff, or I’m not really with, I don’t really have this grief, or if I do, I know how to navigate it perfectly. I mean, who among us knows how to navigate grief? That’s preposterous. Grief, grief knocks you on your ass every time.

Katie Vernoy 29:01
Yeah.

Dr. Travis Heath 29:02
Real grief knocks you on your ass every time, and I, I’ve, I’ve, I have some wisdom about how grief functions now that I’m 46 years old. But I can’t tell you that when it circles around again, I’m going to navigate it better. Grief has that effect of just knocking you over. So, anyways, I think, for me, it’s my acknowledgement that I’m susceptible to all of these things at any time.

Curt Widhalm 29:29
Some of what we love about the content that you bring, and you spoke at our conference before, you spoke on our previous podcast. A lot of the work that you do is around black abolitionist thought, and a lot around the dignity and freedom and community and a lot of the various possibilities that you’re talking about here. So I’m just wanting to open this up to what does that work look like? How has that evolved for you since our last conversation?

Dr. Travis Heath 30:01
Yeah, thanks for that question. I mean, I I think when I think about black abolitionist thought, the first thing that comes to mind is distinguishing the difference between reform and imagination, right? Because reform is where we often go, and that’s like asking us how do we make an existing system better, right? Whereas I think abolition is more imaginative. It asks something like whether that system should organize our imagination in the way it does in the first place. And so I love that idea. And and the idea then, a question that follows from that, or could follow from that, is something like, “What would we build if we weren’t interested in in in maintaining these systems that we have to begin with?” Now, of course, people go, “Well, but you you have no choice.” I understand, and if we’re going to be imaginative, imagine a world where those systems don’t exist, what would we want? What would it look like? That’s actually a really hard question to answer. If you’ve ever tried to do it, it seems simple, but it’s tough. So when I when I think about black abolitionist thought, I a lot of people hear abolition and they think destruction. Mariame Kaba does a nice job of reminding us. No, it’s not about destruction. She calls it like a million tiny little experiments. And I love that idea. I love that idea for my life. I love that idea in my work, and I love that at a societal level. And I think all of this matters enormously because, you know, in mental health, we’ve you know we’ve already inherited so much around diagnosis, surveillance, coercion, expertise, institutional power. I mean, we could go on, right? And so, I think black abolitionist thought challenges some of that. I’ll add just a couple more, really quick. I love the work of Fred Moten, and what Fred Moten says about abolition is that it’s mostly about presencing. So it’s about building and practicing something different right now. It’s not about like waiting for a future moment when the entire system can change or has changed. And so if we think about it that way, then we start asking questions like, what can we do differently in this room, in this conversation we’re having right now with this person in therapy, whatever it is, right now? And I actually think that’s that’s really important because abolition or changing a system can seem so big, and when Moten breaks it down to presencing, that feels accessible, and it feels accessible to our work too, because are we presencing ourselves in a way that is privileging psychological knowledge, psychiatric knowledge, like capitalist knowledge? I mean, certainly we are in some ways. None of us are immune to that. But are we actively trying to presence ourselves with the possibility of something else? One other thing I’ll say, I imagine I said this before. I can’t remember what the heck I said the first time I was on here at the conference, but I’m really interested in the idea of solidarity, not solidarity over empathy. I think empathy has its role, although I think it’s almost become like some weird rote practice in therapy that sometimes doesn’t feel human, and I don’t like that kind of empathy, you know. And I get it. It’s often, especially when we’re learning how to do therapy, we try to act like someone else we’ve seen do therapeutic empathy. I think empathy is at its best when we’re just kind of living it and doing it, not trying to practice it. But solidarity is a little different in the sense, like empathy, I think the way Moten describes it, I’ll try and get this right, is that empathy is like recognizing yourself or your struggle in someone else, right? Which there could be some value to that. It’s like when people say, “Try to put yourself in someone else’s shoes.” I actually think that’s horrible advice. Because I’ll tell you why. If I put myself in your shoes, I’m at risk of saying something awful because if I’ve gone through what you’ve gone through and it didn’t hit me hard, I could just be like, “Oh, well, just do this.” And that could feel awful to a person, or I could just give really bad advice for that person, right? I think the exercise is more about trying to become that person as much as we can in their own shoes. Now we can’t do that completely, but that requires a sense of understanding them at a deeper level, right? And so, if we think about solidarity, it’s it’s not about seeing ourselves in someone else, it’s about it’s about seeing something that’s collective, something about the collective struggle that we’re all in together, right? I hope I’m explaining this well so that you can see there’s a systemic component to that. Because empathy is often about your individual experience as opposed to what the experiences are we are up against together. Like Katie, you were asking that question about like the current state of affairs. Let’s say in our country, I don’t know if you said it that directly, but that often a lot of us are feeling not so hopeful about it. There’s solidarity to be had in that, right? And solidarity also then gives us the ability to show up for someone that we can’t understand their experience, right? But I can show solidarity in my actions in relationship to that. Like, for example, as a man, I can’t know what a woman’s experience is like. Now, I’ve listened to many. I have some idea of that, right? Empathy just requires me to listen and sort of help them feel like, oh, I get how you feel. Solidarity actually requires me to take some sort of collective action in support of what’s happening. So the other thing I love about solidarity is it takes us outside of the therapy room. Like in academia, people will say oh well this is inequitable, this is inequitable and so something should be done, and or this, they’ll even go further and say, “Well, this is racist or this is sexist,” and they might be right, by the way, when they say these things. But often, when they’re saying them, they’re thinking of them through an individual lens, right? Of like, “Oh, this one person’s doing something racist or bad, as opposed to understanding how the system is. And the way that we might show solidarity there is to look at things like land, labor, and resources. Right? I mean, these are things you can actually do something about. So, if I think about this in my university life, land, well, they’re not going to do anything with land. Let’s just be honest about that. No university is that land is no matter whose land it once was. It’s the university’s land now, and it’s United States land now. But labor and resources, we can do something about that. If a show of solidarity then is to advocate for labor and resources, right? Perhaps less labor and more resources. And that’s that’s what I think of as like a qualitative budget statement, right? So, like when people say, “Oh, well, we stand for all these things.” Great. How’s your budget standing for that? Like, can you show me in your budget how you’re adjusting labor and resources to meet, you know, what people are experiencing here as racist or sexist or whatever? And so those kind of movements to me are movements of solidarity. Movements of empathy can be nice because people can feel understood. It has its place in therapy, of course, but movements of solidarity actually require action and can move something systemic. And so, I know that’s long-winded. Sorry, but you’re getting me into something I really enjoy. So, when I think about abolitionist thought, these are some of the first things that come to mind for me and how they might be germane to our work.

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Katie Vernoy 37:38
Talking about abolitionist thought, and then also standing in solidarity, I am imagining clinicians who are seeking certainty, who are seeking structure, freaking out. I go in, I question everything, and then I also now must stand in solidarity and do stuff outside of the therapy room, where I feel completely overwhelmed, I’m exhausted. I don’t have the resources, and all of those things. So I think there’s there’s a call to action here, and I think that there is potentially some clarity on what actually are you talking about as far as the both the individual and collective responsibilities that I think we do have as therapists, as stewards of the profession, as citizens of the world.

Dr. Travis Heath 38:32
Yeah. Well, I mean, I think the calls to action have to vary to what specifically is happening, right? I mean, we can look we can look back and see some relatively recent calls to action, right? And then the and one way we do this systemically is that we we try to hold the larger crediting bodies, institutions accountable for things, right? And we try to hold them accountable for things not just in BS statements that they release, you know, to the public, but in what they’re actually doing. What are they doing in terms of education? What are they doing in terms of licensing requirements? What are they doing in terms of resources, whether that be monetary or otherwise, to address these things? And so, I think that’s at a more systemic level. That’s some of what we can do, and we’ve seen that work with the APA and others to a degree, anyway. And then if you’re talking about like the individual clinician, it’s like, well, of course you can join movements like this, right, in the profession or elsewhere. But I don’t think people have to to do those things, by the way. I’m not saying that ‘Hey, if if you’re not showing solidarity in these larger movements there’s something wrong with you, or you’re not fit to be a clinician. I actually think that to do the to to join any of those in a way that didn’t feel, God, I hate this word, but I can’t think of a better one right now, authentic to one’s self. It’s probably. You know, it’s it’s probably not worth doing anyway at that point. You know, and so I guess what I’d ask people to do is think about what are the causes and movements that feel most important to you, right? Or maybe you feel most moved to contribute in some way. And then you know, in our individual work with clients I don’t think it’s separate in the sense that when we start to see the world more systemically, and then we start to take actions as sort of one small piece of a systemic world. I think that influences how we interact with the people that are sitting across from us, right? Because I think what we start doing is we start asking some different questions. Maybe we stop asking questions that are so individualized. Not that those questions are never helpful, but we stop asking exclusively individualist questions, right? And our questions start to look beyond just the bounds of the person, or they they start to understand that almost everything we’re up against in the world, everything we feel think is connected in some way to other people and to communities, right? And if we conceptualize it that way, I think it changes, like fundamentally changes how we interact or how we ask questions. Now, I know not everyone asks questions. In fact, in graduate school, I was told you aren’t allowed to ask questions, which was bizarre to me because I was like, “How do you get to know someone without asking any questions? That’s strange.” As someone influenced largely by narrative therapy ideas, I ask a lot of questions, and I notice that how I am located in the world, how I’m sort of showing up in the world, what I value, what’s important to me, as dictated by my actions in the world, influences how I show up as a therapist because, of course, I don’t go put a therapist hat on and then a person hat on. I mean, these these two things, I mean, sometimes I feel like, especially working with students, they feel like that’s what you’re supposed to do. I was having this conversation with students in a class. I think it was yesterday. I’ve sort of it was really interesting. These students are wonderful, and what we would have them do-it’s like a skills practice class. Although I don’t think we teach it right by the way we’re supposed to, I think we teach it fine. But you know, there’ll be one person who is a therapist, one person who’s a client. We have them do real play, not role play, where they actually they’re talking about something in their lives that they’re up against, and then we have a witness. And what’s interesting is the students were saying things like, you know, I notice that I listen better when I’m just the witness, but then when I’m the therapist, there’s like all this pressure that I’m supposed to do something. And it’s like, huh, that’s interesting. Where did that pressure come from? How do you understand that? And then they’re saying like, I think when I’m the therapist, I’m just going to try and be a witness, and I thought that’s really interesting, and they notice that they’re actually listening better as a result of that, right? Because they’re challenging ideas about what it means to be a therapist. Now I say I share that story to say, well, if I looked at being a therapist as being only confined to these sort of formalized, rigid ideas of what a therapist would be, I would have pushed back on that. I would have been like, “No, you’re a therapist, and you’re professional, and you do X, Y, and Z, right? And as opposed to being open to the idea that what might be most effective for the people sitting across from us might sometimes vary from these sort of rigid, structured ideas or personas of what a therapist should be. So I’m just a big believer that we can hit this on multiple different levels, right? Systemic levels, and even, by the way, even a relationship between two people is a system. Now, it’s not a larger societal system, but it is a system. Even conversations that I’m having in my head, that’s systemic. I know that sounds weird, but the voices that I’m, and we all have voices in our head. If you don’t believe me, you’ve just proven my point, haven’t you? But we we all we all have these conversations in our heads, and those conversations aren’t they’re not monologs. They’re actually dialogs. If you listen to them, even though they’re all my voice, it’s often me sort of being in conversation and tension with other ideas, societal ideas. Some of which I’ve internalized, some of which I might be in the process of internalizing. So I would argue that even the conversations we’re having in our own heads are systemic. That might be a little too far for some folks, but when for me, when I start conceptualizing things these ways, it changes the questions that I ask, and it changes how I show up. Now, to someone listening to this, I’m not saying this is the right way to do it, mind you. I’m just answering the questions you’re asking. For some people, this may not be the best way for them to move forward, which I actually think is great because one of the worries that I have is that we start prescribing certain ways of being a therapist that everyone has to adhere to. I actually think that’s really dangerous because people are different, and you know the the way that some, especially the theory wars and how that shows up. It’s like if you’re not doing this, you’re doing it the wrong way. And I think some of the beauty of the art of some of this work is it can take on many different forms. Hopefully, some of us or many of us share a lot of the same core spirits of that work or ethics that guide it, right? But if someone’s listening to this and they’re like, “Well, I don’t want to do that or this doesn’t fit for me,” I would say, “You know what? Don’t do that. Then don’t do don’t do what I’m saying if it’s not going to fit.” But that’s very different than saying like I’m interested in that, but that sounds scary, man. Or I’d really have to confront X, Y, or Z. Well, if you’re thinking that, then it might be worth looking into a bit further. So being able to distinguish between those things. Because boy, that happens to me a lot, where I’ll listen to someone and I’ll be like, “Screw that idea! What are they talking about?” And then I’ll notice, like, I think they’re onto something. They’re onto something that’s poking at me, you know. And I have to be willing to recognize, like, okay, this isn’t sitting well with me, and maybe the reason why it isn’t is because they’re poking at something that maybe I should pay attention to.

Curt Widhalm 46:02
I know we’re running really long on time, and I want to be respectful of your time and your day here. I do have one question to kind of wrap up here. I love a lot of what you’re talking about, and for the therapists that are still hanging with us in this episode, that Are working in environments that are governed by productivity and success, and how does this translate into successful work and productive sessions?

Dr. Travis Heath 46:36
Yeah, gosh, this is a great question, and I don’t think there’s an easy answer. I think it’s one we’re often intentioned with. And for me, I’m pretty lucky where I’m at now because I am in independent practice. I can do whatever I want. I mean, not whatever I want, right? But you know, I don’t have to follow particular rules around this. I think productivity is so interesting to me because I’m not even sure that sometimes what we label as productive is actually that productive. You know what I mean? Like in academia, it’s like, oh, you published X number of articles. Yeah, but if no one reads them, who cares? Like, is that productive? I mean, I guess on paper it is. So, I mean, you’re probably not surprised to learn the first place I’ll go is asking questions of those ideas. But what does it actually mean to be productive? Agencies and society has its ideas about that, right? But I’d ask us to think about what does that actually mean to be productive. And I like the older I’m getting, and maybe the combination of my age, but I don’t think it’s just that. I think it’s also what’s happening in society is my experience of it, and the experience of many people I’m in conversation with seems to be similar. Is that everything’s speeding up. Like, and maybe it’s this AI stuff. Like, yeah, the AI can write the whole paper. If it can write the whole paper, now you can write five papers or whatever, right? That’s not just AI, but a lot of things just seem to be moving faster. And one of the most therapeutic processes that I’ve found of late, and I find so much of my work is trying to focus on this, is just slowing down. Like when somebody says something, staying with that for a minute and going, oh, that’s interesting. You said blank. Is all right if I ask you a little bit more about that? I’d like to understand more about that. I wonder if this might be important. So slowing down and is that productive? I don’t know. It depends how you define productivity. You know, like if someone’s like, well, you only get five sessions, and you better go, and you better solve X, Y, and Z problems, and you better have these treatment goals completed. Is it productive in that sense? I don’t know. I’m not sure, to be honest. I’m leaning towards not. But is it productive in terms of the experience of what’s happening with the person and the actual therapeutic value? It could very well be. And so, then, how are we defining these things now? Good luck challenging agencies with these. So, for people that are kind of caught in between, what I often talk about is I think there’s a way to do what the agency is requiring of you because you have to, right? But also in your own work, being able to practice in a way that is you and that makes sense to you, right? And I think there are ways to accomplish both. Now, if you’re in my kind of clinical setting, you can do that a lot easier because I have more say in how that goes. So easy for me to say. I get it. But I I remember doing that in Los Angeles as a as a intern, a master’s level intern. I remember having these same tensions and being like, in fact, somebody came to me. I was subcontracted for the City and County of Los Angeles doing work out in the community, and somebody came to me and they’re like, like someone on high, you know, and they’re like, “Hey, 95% of your diagnoses are adjustment disorder, and I was like, “Huh?” And they’re like, “Well, you can’t do that.” I was like, “Well, what do you mean I can’t do that?” Like, out of the diagnosis, you’re telling me I have to diagnose, and out of the diagnoses that are available, this is the diagnosis of best fit. Surely you’re not telling me to give them a diagnosis that I don’t believe that they actually have. Correct? That there’s no evidence that they actually have it.” “Well, no, of course we’re not doing that. But you have to pick one of these five,” and I’m like, “but they don’t fit, so I’m not going to do that.” And I remember not doing that and still using adjustment disorder because I had to give a diagnosis. And actually, it fit the majority of people I was working with, not some of these, you know, like major depressive disorder. That’s a hell of a label to give someone, you know. And so for me, that was like one of those lessons where it was like sometimes you have to hold your ground, and I did hold my ground there. But you don’t have to fight every battle. There were plenty of other battles that I didn’t fight, and I was like, okay, I’ll play the game. I’ll do what they’re asking me to do. But I can also, as I’m doing this, work in ways that feel authentic to me. So for people that are caught in between, I think there is an in-between space that you can exist in at least for a period of time. I don’t know if you could exist like that forever, but you know, for a few months, couple years, as people often do, I think you can. But I, I would ask that we just even think about what’s productivity, what is actually productive, and in in this case, what is actually productive in therapy?

Katie Vernoy 51:20
It’s interesting because I just to to summarize what I’m hearing. It’s sitting with uncertainty. It’s questioning everything and choosing your battles.

Dr. Travis Heath 51:32
All those, I think I’m guilty. Yes, on all on all counts. And I will say that yeah, questioning everything. There can be a destabilizing effect to that, and I want to add something else. Yes, I do tend to question, if not everything, damn near everything, with folks. But I I don’t question it just to destabilize it and leave it there, right?

Katie Vernoy 51:55
Sure.

Dr. Travis Heath 51:55
A lot of times, my questions they may be destabilizing sometimes, and actually, I think one of the biggest myths of therapy is that it should always feel good. I actually think sometimes therapy is working at its best when it’s not feeling so good, and not feeling good like I don’t mean like people are humiliated or something like that. I just mean that there’s like a tension, you know, there’s a there’s something they’re being pushed in directions maybe they haven’t been pushed in before. I actually think sometimes that can be a really good sign in therapy, and and so yes, we question things, but we question things with the intent one to understand, and then two to try to create possibilities that may fit better for the person. So if all we did, if we were just doing like nihilism disguised as therapy, that’d be probably pretty awful.

Katie Vernoy 52:43
Yeah.

Dr. Travis Heath 52:44
Probably wouldn’t be that useful. So, yes, I think questioning is important, but I just wanted to add that little extra piece.

Katie Vernoy 52:52
I think that’s an important caveat, and I I understood that, but I’m glad you you added that on there.

Curt Widhalm 52:59
Thank you so much for joining us today. Where can people find out more about you, your work, your podcast?

Dr. Travis Heath 53:06
Yeah, well, good question. I’m pretty much like on no social media. I have an old Twitter or whatever they’re calling it now, but I don’t, I don’t really put anything on there, so I’m not in the social media game. But I do have Therapist Confidential podcast that goes through psychotherapy.net, and I’m doing some content, interviewing people for them as well, which is a lot of fun. I wrote a book about narrative therapy a couple years ago. I don’t remember the title. That’s a form if you want to find me. But I wrote it with David Epston and Tom Carlson. So if you Google narrative therapy and my name, David Epston, you’ll probably find it. Yeah, and you can always drop me an email. I teach at San Diego State, so if you Google me or Chat GPT me or whatever everyone’s doing these days, I’m sure you can find my email there.

Curt Widhalm 53:50
We will include links to all of Travis’s stuff in our show notes over at mtsgpodcast.com. Follow us on our social media. Join our Facebook group, the Modern Therapist Group, to continue on with this and other conversations, and until next time, I’m Curt Widhalm with Katie Vernoy and Dr. Travis Heath.

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