One of the first things they teach trainee therapists to look out for is the word “should”.

When you sit with people who are struggling, you hear it a lot.

“I know I should call my parents every week, but each time I speak to my mum I wind up feeling worse.”

“People shouldn’t have children if they’re not going to look after them.”

“My partner should be able to tell when I need a hug.”

It’s generally agreed by mental health professionals that it’s helpful to examine these ideas, look at where they came from, and then decide what you actually want.

The word “should” implies that there’s a list of rules somewhere, a charter of acceptable behaviour.

One way that therapy can help you to feel better is by gently guiding you to notice when you’re holding yourself (and others) to these rules.

Where did you get the idea that you should call your parents weekly? Whose rule is that? Is it working for you?

Doing this helps you to heal, and to grow.

Healing means suffering less. And we know that people suffer less when they make decisions based on their own values, rather than some external rules that have been pressed upon them.

Growing means becoming more emotionally mature. And examining the “should”s you carry is part of that. Because when you drop the rules that aren’t working for you, it frees you to respond to the situation as it exists right in front of you, in the here and now.

The United States of America is the world’s superpower (for now at least) both militarily and culturally.

So we’re all watching, listening, and worrying as Roe v. Wade is overturned.

The US and the UK are, as George Bernard Shaw once noted, “two nations separated by a common language”.

And we’re separated by so much more: the intricacies of our democracies, and what sometimes feels like a gulf in our worldviews.

Training as a therapist changed me, fundamentally. (Even Myers-Briggs picked it up: I crossed the border from INTJ to INFJ.)

As I sat in circle with other trainees, in a personal development group, we tried to make sense of what was happening to us.

We had signed up to learn to do something, or so we thought.

But gradually it dawned on us that you don’t really do therapy.

It is, as Carl Rogers says, “a way of being”.

We were encouraged to be warm, understanding, and – importantly – authentic.

To share our own points of view sparingly and thoughtfully.

But to have strong boundaries, a clear sense of what is okay and not okay, especially when it comes to racism, oppression, violence, or abuse.

I described my own personal shift (not the bit where I learned to feel as well as I could think, another bit) as “be more American”.

“Britishness” felt like a good shorthand for so many things I was shaking off: reticence; hiding my vulnerability; the shame that underpins it all.

I tell my couples counselling clients all the time, “you’re not as see-through as you think you are”.

I encourage them to let each other see more of what’s going on inside.

I still think of it as “being more American”.

I wanted to understand better, so I listened to The Yale Law Professor Who Is Anti-Roe, But Pro Choice on Honestly With Bari Weiss.

Like I said I’m a Brit, and a therapist, so I don’t know much about the US judicial system.

Listening to Akhil Reed Amar helped clarify the role of the supreme court, as he explained why he believes – even as someone who is pro-choice – that abortion rights should be decided on a state level.

As I listened I started to wonder: is the constitution like… the bible?

There are so many different ways to look at conservative vs. progressive values. But in that moment it felt like a simple continuum from ‘everyone should be made to do what the ancient texts say’ to ‘people should be able to do what they believe is best for them in the here and now’.

My heart is broken, for the women and children who will suffer now.

For the lives pulled in one direction, when we know the opposite direction is the path of healing and growth.

Tradition is peer pressure from dead people.

Therapists have our own version of the founding fathers – and mothers.

Sigmund Freud started it all, of course (but don’t hold that against us – the mindset required for that level of innovation leaves the door open for some interesting ideas).

We learned from Carl Jung, Melanie Klein, Donald Winnicott, Fritz Perls, Eric Berne.

And Carl Rogers, most of all.

They taught us to trust our hunches about our clients, but look for the evidence to back them up. And even when we found it, to always, always hold our ideas lightly.

Stay curious. Be open to changing your mind. Let things keep evolving.

I love how J. M. R. Higgs puts it, “Whatever you believe imprisons you. Convictions create convicts.”

This bit was hard for us trainees. We wanted to help, and we thought helping meant knowing.

We had to learn to sit with the not knowing.

Luckily we found that the more we did it, the more we actually helped.

Mixed feelings especially are uncomfortable, and frustrating.

Wouldn’t it be so much easier if things were more black and white?

It was psychoanalyst Melanie Klein who noticed the tendency in our culture – as well as her patients – to “split” opposing feelings like love and hate.

It’s too complicated for the infant to understand that mother is sometimes “good” (generous, loving, fulfilling) and sometimes “bad” (withholding, frustrating, unsatisfying). That she is both good and bad.

So they are often split into two, which is why so many stories have a good mother and a wicked stepmother.

The gradual depolarisation of these feelings is an important part of childhood development.

Sometimes people’s development gets stuck, and they continue to see something in particular, or things generally, as black and white.

The Madonna-Whore complex is an example of this: splitting women into loveable saints who provide children, and desirable sinners who have sex.

Sometimes the development of whole cultures gets stuck.

That women can get pregnant can be one of our greatest strengths, and our greatest vulnerability.

And I know, as a woman and as a psychologist, that there are men who can’t bear this, and find themselves hating us.

They can’t bear that they need us, and they can’t bear vulnerability (which they perceive as weakness) in any form.

So they try to control us.

To punish us.

To make out like somehow it’s a woman’s fault when sperm meets egg (never mind how it’s the sperm that makes the journey).

To insist that sex (for women at least) should be about procreation, when we all know that bonding and pleasure are what make life worth living.

There’s a version of masculinity that pervades the globe, which posits that men are strong and women are weak.

A worldview that is terrified by the truth: that we need each other.

Perhaps it’s a worldview held by men who don’t know how to truly bond and share pleasure with women.

Notice how the origin story of humanity, according to the Abrahamic religions, can be summed up in four words: it’s all her fault.

How dare she taste that delicious fruit.

Most men don’t hate women.

But it would appear, based on who we see speaking up, that most men think of abortion as a women’s issue.

They seem to see it as a niche concern. (Men are default; women are “other”.)

Gynaecology isn’t their business.

Abortion rights aren’t their problem.

This is not okay. We need men to do better.

Do they know that women’s rights are human rights?

Do they know that women are people, too?

I became a therapist because therapists helped me.

And a big part of why I needed that help in the first place was because of the harm done to me by my Catholic upbringing.

Almost all organised religions are structures designed to uphold patriarchy.

As Tim Minchin puts it (in the recovering Catholic’s Christmas anthem, White Wine In The Sun), “I have all of the usual objections to the miseducation of children, who in tax-exempt institutions, are taught to externalise blame, and to feel ashamed, and to judge things as plain right and wrong”.

(But I quite like the songs.)

Most religious people are not extremists, of course, and most spiritualism or faith is probably a force for good.

As David Foster Wallace says, “There is no such thing as not worshipping. Everybody worships. The only choice we get is what to worship. And the compelling reason for maybe choosing some sort of god or spiritual-type thing to worship–be it JC or Allah, be it YHWH or the Wiccan Mother Goddess, or the Four Noble Truths, or some inviolable set of ethical principles–is that pretty much anything else you worship will eat you alive. If you worship money and things, if they are where you tap real meaning in life, then you will never have enough, never feel you have enough…Worship power, you will end up feeling weak and afraid, and you will need ever more power over others to numb you to your own fear.”

The trouble comes when men insist they’re worshiping their god, or their country, when what they’re really worshiping is power.

Is this about what the constitution says? What the bible says? Or what a few men want?

We all engage in motivated reasoning.

Some of the healing and growth that takes place in therapy happens when we find the places where our thinking is black and white, and look for the shades of grey.

Maturity means holding the nuances.

I believe in the absolute human right of bodily autonomy.

And zygote to embryo to foetus to baby is another continuum we have to grapple with.

When does the foetus become a person?

There isn’t a neat, clean line.

Anyone who’s ever held a newborn knows it must have happened a little while ago.

If you want things to be simple – to feel uncomplicated, and absolute – conception looks like your answer, doesn’t it?

But things are rarely (if ever) that simple.

We’d all love to live in a world where no one’s rights are ever denied.

But we don’t, because sometimes one right is in conflict with another.

Soldiers lose their lives in battle.

People are killed in self-defence.

Opinions and laws differ on the death penalty, and euthanasia.

Thou shalt not kill has its exceptions across the world’s religions and cultures.

Abortion was decriminalised in Northern Ireland in 2020, but two years later no treatment centres have been provided. So women still have to travel (usually to England) to get the healthcare they need.

Abortion is still in criminal law in England, Scotland, and Wales.

You legally need permission from two doctors to terminate a pregnancy. And the maximum sentence for doing so without permission is life in prison.

The doctors who sign them off have to choose from one of four permitted reasons for the termination. Currently around 98% are marked as protecting the pregnant woman’s mental health.

Does a woman need two doctors to confirm that continuing with a pregnancy would put her mental health at risk?

Can she make that decision for herself?

Could it become more difficult to find two doctors who agree to this?

Is de facto abortion on demand enough?

Do we need to decriminalise abortion here?

Here in the UK, where gun deaths per capita are one fiftieth of what they are in the US, we’re constantly, endlessly trying to make sense of how we can seem so similar, and yet so different.

They taught us that the founding fathers left here because they wanted to separate church and state… but US laws and conventions seem to be much more deeply impacted by religion than British ones.

I try to link the various threads — the geography, the individualism, the determination that the people must be able to fight back if the government goes rogue.

It seems to come down to the tension between idealism and pragmatism.

From the American Dream to the Second Amendment, it’s a culture that looks fixated (from here at least) on How Things Should Be, never mind dealing with How Things Actually Are.

That idealism, and the optimism that seems to underpin it, is part of what we love about American culture.

Melanie Klein calls the black and white thinking phase “the paranoid-schizoid position”.

When we learn that the light and the dark coexist, she calls it “the depressive position”.

Maybe there is something depressing about having to face reality: that things are complicated, and people are never going to agree.

That the basic human rights to not be forced to stay pregnant, give birth, take care of or give up a child, might feel in conflict for some people with the rights of the foetus.

But people who have abortions are not murderers.

We know this because if someone tells you they had an abortion, you might feel a whole range of emotions, but none of them will be fear.

It gets easier, sitting with people who don’t know the answer, not knowing the answer.

Sometimes you want to tell people what to do.

But when they keep coming back, telling their stories, sharing bits of themselves with you as they unfold… you realise that you can’t possibly know what’s right for someone else.

When I was struggling with a choice once, my therapist told me, “There are no right or wrong decisions. There’s just the path you take, and the one you don’t.”

When we let go of the idea that things are black and white, right or wrong, it frees us to deal with the reality in front of us.


You can support Planned Parenthood in the US here, and the British Pregnancy Advisory Service here.

Image from the Women’s Equality Party. Join their campaign to decriminalise abortion here.

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