Dr. Hayat Nadar, a Syrian licensed clinical psychologist based in Uptown, warns her patients: “Don’t go to the hardware store for milk.”
It’s her response to a shift in the way patients have been searching for care in the wake of the war in Gaza. The people coming to her — from marginalized communities in Chicago and those who support Palestinians living in the region — are looking for someone who understands from personal experience what they’ve been through, she said.
That way, “they don’t have to explain their entire experience and be met with resistance about what reality is for them,” she said.
As the war rages on with no end in sight, Chicago’s mental health care providers are now facing questions about how to best treat patients impacted by the violence. Some in the field view neutrality on the conflict as harmful to patients and say that providers’ experiences have a place in therapy. Others argue that abandoning an empathetic yet impartial approach to care is counter to how they should do their jobs.
“People want to know you’re a safe space,” said Anna Finkelshtein, a Jewish licensed clinical social worker in Skokie. “Being a therapist is all about being inclusive and helping marginalized populations.”
But under the new way of thinking, “it’s like you have to pick a side. It goes against everything we’ve been taught.”
Finkelshtein was trained to perform therapeutic neutrality, a concept that dictates she remove herself from the session to better help a client. If viewpoints run too deep, the provider can give a referral to someone else. But she has felt pressure in recent months to disclose her views on the war.
She has also seen a professional impact from the shift. In March, her name appeared on a list of “Zionist therapists” posted to a local Facebook group; the post said health care providers should not refer patients to people on the list. She said she’d never voiced her opinions on Israel publicly to avoid them interfering with her practice. She believes she was singled out for her “Jewish-sounding name.” Ultimately, she found that she gained other clients who had seen her on the list.
Shaina Campbell, a Jewish licensed clinical professional counselor who practices with Finkelshtein, said “regardless of whether or not our views differ from a client, it should be about meeting their needs and being curious or compassionate about their perspective.”
Dr. Vaile Wright, a licensed practitioner and senior director for health care innovation at the American Psychological Association, said that as mainstream care has moved away from psychoanalytic models, in which neutrality is the norm, more providers have been able to use “self disclosure.”
For any practitioners struggling with finding a balance, Wright suggested consulting peers for advice, but said providers need to consider the best way to treat a patient on a case-by-case basis.
“There’s a lot going on in the world right now, so acknowledging that and saying, ‘I’m feeling that, too,’ can be helpful,” said Wright, a Villa Park resident. “The challenging part is making sure the therapist doesn’t make it about themselves.”
Some recent studies have also been critical of training that ignores the effects of global conflicts.
“Health care professionals should be trained in structural competency to challenge the depoliticising effects of medical neutrality, with the aim of enhancing peace, health equity, and social justice,” wrote researchers Zvika Orr and Mark Fleming in a 2022 study published in Global Public Health.
Nadar said remaining neutral can shift blame for the mental health struggles caused by structural prejudices onto patients.
“If I don’t acknowledge the systems in place that trigger these feelings, I’m just saying the client is sick,” she said.
Evanston-based psychotherapist Nadia Greenspan — who works summers in trauma zones such as Rwanda, Serbia and Ukraine, and has worked with patients from Gaza — said privilege can influence providers to see issues facing patients as “politics,” about which they have to be neutral.
“Not often do I have people of color, people who aren’t straight or people who aren’t neurotypical talk about their lives and call it ‘politics’,” Greenspan said.
But Finkelshtein and Campbell said the pressure to reveal their views have pushed them and other Jews to retreat into their own communities.
“I never felt targeted or marginalized as a Jew until this year,” Finkelshtein said.