Hi there friends,
It’s good to be with you again. Feel free to watch/listen to the recording above for some additional thoughts and commentary from me aside from what’s written below.
The more people argue with clinicians' knowing, the more I have to write about and mirror back to you..
“We have to work with the system we're in” is a common retort when we talk about systems change or clinician advocacy.
Translation: We expect you to continue tolerating harm, performing compliance, being overworked, and sacrificing integrity — so the machine keeps running.
Mental health professionals are angry because we’re done pretending this is okay.
We won’t work harder so others can profit off our burnout from within an "industry" that claims to be grounded in liberatory wellness. [insert laughter]
You can effect real change from inside the same system that harmed you — without burning it all down, it’s true — but not by complying with it.
Daily acts of resistance might look like:
*Refusing to overwork clinicians — letting people end the day on time, take breaks, and not work off the clock
*Documenting unethical demands or dilemmas and bringing them to light.
*Naming harm out loud in meetings or supervision — “This feels like we’re prioritizing billing over care”
*Backing up clinician colleagues who speak truth — solidarity makes resistance less isolating.
*Refusing to build a product , service or business model that depends on clinicians working at high volume
*Refusing to internalize “poor outcomes” that stem from a broken system — shame will not be used as a strategy for control.
*Rejecting the use of “bad therapy” narratives to legitimize payer rules — therapy is uniquely and continually shamed for not proving its worth in a medicalized model it was never built to serve.
Side bar:
Every profession has bad actors — therapy is no different.
But therapy is uniquely shamed, surveilled, and expected to prove its legitimacy in systems that were never built to support it.
And if we're being completely honest, this isn’t just about standards — it’s about structured misogyny.
Therapy is disproportionately delivered by women — especially white women — and like all feminized labor, it’s undervalued, overregulated, and treated with suspicion.
The work is relational, emotional, and grounded in love/care — all things capitalism mistrusts and patriarchy devalues.
(And yes — white female therapists have caused harm, particularly to clients of color. This must be named and addressed with humility, accountability, and real change inside our profession. That is a separate and lengthy conversation)
But let’s be real clear: that’s NOT where the system’s skepticism comes from.
The scrutiny we face isn’t rooted in a desire for justice — it’s about control, devaluation, and profit.
The actions of resistance named above (I barely scratched the surface) don’t generate profit — and that’s exactly why they’re at odds with the system.
They're simply examples of what internal system advocacy can look like.
But here’s the rub:
When clinicians do these things, we’re often quietly invited to leave.
Not because we’re wrong.
But because we’ve stopped performing the version of “clinician” the system requires in order to keep extracting from us.
Stay curious,
Brittainy
“To be truly visionary we have to root our imagination in our concrete reality while simultaneously imagining possibilities beyond that reality.” - Bell Hooks
“Your refusal to comply with oppressive norms is a therapeutic intervention.” -@pat.radical.therapist (Instagram)
“The victim who is able to articulate the situation of the victim has ceased to be a victim: he or she has become a threat.” - James Baldwin
Share this post