This week I want to talk about the Liberation Health Model.
The word “liberation” in the model honors and acknowledges the work of liberation theology, out of which grew liberation psychology, a way of thinking about healing that was practiced by Ignacio Martín-Baró, a Spanish-born Jesuit priest who trained in psychology at the University of Chicago. Martín-Baró was concerned that the individualist focus of therapy could encourage people to adjust to the status quo. Psychology’s attention to individual behavior, and the ways behavior is seen as an expression of the individual’s consciousness, keeps both the problem, and the solution to the problem, inside the arena of the self.
The work of psychology, Martín-Baró wrote, should be that of concientización, a term he took from the philosopher and educator Paolo Friere. Friere, who was born in Brazil, is responsible for a way of teaching he named pedagogy of the oppressed—he wrote a book of the same title, which outlines his method.
Friere argued that the pedagogy of educational institutions was based on what he called the “banking method.” The educator, standing at the front of the classroom, is literally positioned by the architecture of the room as the holder of knowledge, the one who has more standing than his students. The teacher “deposits” his wisdom into the empty heads of his students, who are willing and passive receivers of his deposits.
Inspired by Friere, Martín-Baró argued that psychology could also take as its goal that of concientización. Liberation psychology allows us to ask an important question: if the banking model teaches people to be passive receivers of knowledge, could we see the practice of therapy, of social services, of “helping professions” as that of creating a similar power dynamic between therapist and client, expert and patient?
This complex interpersonal dynamic is why overt conversations about power can be so crucial to the work of liberation psychology. The therapist is situated, institutionally and structurally, as the one who knows; the client is situated as the one with the problem. The “collaboration,” between them, if it occurs within this framework, is that of the therapist gently educating the client about the best way to proceed, working hard not to dominate, but at the same time, “helping.”
I think that if the mental health practitioner opens the scope of conversation as he suggests, the idea that there is one answer, one intervention, one diagnosis for a mental health condition, goes out the window. This means that both the therapist and the client have to become comfortable with ambiguity, uncertainty, fear, and loss. They have to grieve, together, the suffering that so many people are enduring. And in that lack of clear direction, of a simple solution to a problem, collaboration between the two becomes a necessity, rather than a concession the therapist makes to the client at her own discretion.
So when you see the word “liberation”—liberation psychology, liberation health—you want to think about people coming together to discuss the social context that influences their world, and to help one another see and describe the structures of violence and oppression that make it difficult for them to access and engage their individual and collective power. By doing so, they will be encouraged to stop blaming themselves for “failing”; they will start to question the source of their shame; they will stop, as Martín-Baró put it, “acting like a dominated being or a dominator.”
When Dawn Belkin Martinez, a social worker from the United States, started practicing, she wanted her work to include attention to power, culture, and context. Since she couldn’t find the training she was looking for in the U.S., she went to train with Friere. Luckily for her, when she came back to Children’s Hospital Boston where she was working, the people there were very interested in what she learned, and encouraged her to design a model of healing that drew on Freire’s method.
If any of you reading this are already practicing with this model, please let us know how it’s going in the comments section. What struggles have you encountered, using this approach? What has surprised you about using it?
Also, here are some questions I use myself, when I’m trying to broaden my scope of inquiry about a problem, whether it’s personal or collective:
* Whose knowledge (What is the source of the information; what “counts” as knowledge?)
* Whose power (Who is said to be in the power position; is power circulating through the group, or is it concentrated in a hierarchical orientation?)
* In what context (What are the unacknowledged assumptions about the problem and the best way to fix it? Where does the problem begin and end? What happens if the context is made larger than the individual or the group?)
* To whose benefit? (When you think about the proposed solution to the problem, who will gain from having it solved in this way, and whose needs are excluded?)
* To what end? (What is the ultimate goal of the solution? Is it a temporary solution? Does it silence further conversation and analysis? Is it open-ended or closed?)
