We need to kick wokeness off the therapist’s couch

Mental-health statistics today provide a sobering insight into how people perceive themselves and their capacity to cope with what life throws at them. The number of people experiencing anxiety and depression – the two most frequently reported mental-health problems – has long been on the rise. Now, post-Covid, the figures for those seeking professional help are at an all-time high. Yet for those who do eventually manage to negotiate NHS waiting-lists, or can pay for a private therapist, much of the treatment they’ll currently receive is highly questionable at best.

We expect counsellors to be good listeners, carefully attuned to the specific problems raised by individual clients. We expect them neither to make assumptions about the cause of a patient’s issues nor to offer pre-determined solutions. Instead, we assume that through sensitive questioning, therapists will lead their patients to a greater understanding of their own situation, enabling patients to work out new approaches to problems for themselves. This is how therapy has helped many millions of people for decades. Until now, it seems.

Cynical Therapies: Perspectives on the Anti-Therapeutic Nature of Critical Social Justice, a new book edited by writer and psychotherapist Dr Val Thomas, sets out the activist turn that professional psychotherapy has taken in recent years. Over the course of 21 chapters, British and American psychotherapists and counsellors lay out the alarming changes they have noticed within their own profession. They show that therapy today is no longer a client-centred, politically neutral practice. Instead, it has come to be shaped by critical social-justice (CSJ) ideology – a way of understanding society grounded on notions of group identity and hierarchies of oppression. Contributors explore the devastating effects of this ideological capture on vulnerable patients.

Rather than treating their patients as individuals, CSJ-minded therapists come to see them as representatives of their race or gender group. Rather than experiencing specific problems arising from unique circumstances, patients are labelled as either oppressed or privileged. The contributors argue that activist therapists are more concerned with recruiting patients to their cause than with listening to them. This results in an anti-therapeutic process that is not healing, but harmful.

The title Cynical Therapies recalls the 2020 book by Helen Pluckrose and James Lindsay, Cynical Theories, which explored the emergence and development of critical social-justice ideology in academia. The key principles of critical social justice (CSJ) are: that language constructs reality; that one’s ‘lived experience’ trumps objectivity; that one’s identity determines power in society; and that all binaries, including sex, encapsulate a power relationship. Pluckrose and Lindsay explain how the once obscure intellectual movement of critical theory has now been reinvented as the practice of CSJ, turning scholars into social-justice activists.

CSJ is now firmly established within psychotherapy training courses, perhaps having initially entered professional psychotherapy through the ‘Trojan horse’ of diversity, equity and inclusion (DEI) modules. However it entered, therapists today are trained to shape their practice according to the underlying principles of CSJ. As Val Thomas argues, this means that for CSJ-minded therapists, the ‘social and cultural context is now viewed as the most important dimension of human experience’. Accordingly, ‘the therapist’s role is now to facilitate collective rather than individual change’. This approach sits comfortably alongside activist therapists’ long-standing adoption of a ‘biopsychosocial model’ of mental health, according to which mental illness results not from problems within individuals, but problems within society. For proponents of CSJ, this view means that depression and anxiety arise out of power imbalances between the privileged and the oppressed. So, Thomas explains, rather than helping individuals better adjust to their circumstances, ‘professional [therapy] institutions are increasingly concerned with changing society as a whole’. What’s more, today’s activist therapists are now setting about this task with ‘a new certainty and moral conviction’.

Cynical Therapies shows us how this new approach to counselling plays out in practice – especially with regards to people struggling with their gender identity. Traditionally, a therapist might prompt a client to consider why he feels uneasy with his biological sex, what led to such feelings and how he thinks life might be different if he changed gender. By contrast, a therapist influenced by queer theory would see all such questions as a denial of the client’s lived experience. Adolescent counsellor Sasha Ayad and psychotherapist Stella O’Malley co-author the first two chapters, on the increasing number of young people expressing a desire to change gender. They point out that for therapists who see ‘no stable, objective reality defining “gender”’, there can be ‘no valid challenges to an individual’s stated gender identity’. Therefore, ‘to respond in any way [other than with] agreement and compliance’ is considered by such therapists to be ‘harmful and oppressive’.

For therapists in hock to CSJ, the sources of an individual’s gender-identity struggles are not to be found within the individual, but in an unaccepting world. The only acceptable approach, then, is to unquestioningly affirm a client’s adopted gender identity, while advocating for transgender rights in society more broadly. In this way, Ayad and O’Malley note, ‘the most zealous gender experts seem eager to encourage more cases of gender dysphoria’. Tragically, this means that troubled young people, a disproportionate number of whom suffer from autism or have been sexually abused, are denied the chance to explore the other, underlying sources of their distress. Instead, they are diagnosed with gender dysphoria and directed towards life-changing medical interventions.

Elsewhere, the clinical psychologist Carole Sherwood and the social psychologist Dina McMillan put critical race theory (CRT) itself on the psychiatrist’s couch. Sherwood notes that, ‘It was clear from the outset that CRT did not want to see me – a white psychologist – discussing its beliefs’. Meanwhile, McMillan, who is black herself, worries that those in hock to CRT ‘would view my standard professional dress as indicating I was an “assimilationist”, and therefore someone who had adopted the beliefs and standards or “white supremacists” rather than supporting black empowerment’. Sherwood suggests that CRT ideology ‘traps’ its proponents in a ‘vicious cycle of hypervigilance, anger and recrimination’, while McMillan writes that CRT-influenced therapists spend their appointments ‘permanently scanning the environment for racial bias and systemic injustice’. Both argue that CRT ideology makes people unable to acknowledge alternative perspectives and hostile to the idea of personal responsibility, leaving them aggrieved and angry. McMillan’s conclusion is especially critical of counsellors who practise therapy with a CRT lens. ‘[Promoting] an extreme political or ideological viewpoint’ to a vulnerable client, she says, ‘betrays [therapists’] duty of care’.

All the contributors to Cynical Therapies express concern that CSJ-influenced therapy may actively harm patients. This is especially true of those patients who may have been reluctant to seek help in the first place or who are loath to divulge their feelings. John Barry and Dennis Relojo-Howell, both academic psychologists, argue that CSJ’s attribution of ‘privilege’ to men, combined with a seemingly contradictory view that masculinity is toxic, may ‘negatively impact men’s mental health and may contribute to suicidal behaviour’.

Relojo-Howell argues that in focussing on the workings of society rather than the individual mind, CSJ utilises an ‘external narrative’ which is unhelpful when trying to confront ‘an individual’s internal struggles’. Clinical social worker Lisa Marchiano is clear as to where this leads: ‘When we frame all problems strictly in terms of group identity and oppression, we take away from patients their ability to adapt to their individual reality and to make their own meaning.’ Others argue that, unlike cognitive behavioural therapy (CBT), which seeks to move people away from unhelpful narratives and behaviours, CSJ encourages people to continue to perceive themselves as victims. Indeed, CBT practitioner Philip Pellegrino notes that the premises underpinning CBT and CSJ are fundamentally incompatible. When CSJ drives therapeutic practice, clients are not encouraged to take a more positive view of their situation, to move on from past difficulties and to assume control of their lives. Instead, being a victim becomes a central part of their identity. This robs them of agency. CSJ-influenced therapy encourages patients to forever dwell on old grievances rather than to heal and move forwards.

Such an attitude is disastrous not just for individuals, but also for society as a whole. Dividing people up into victims and villains, the privileged and oppressed, creates what psychology lecturer Kirsty Miller describes as a good ‘in-group’ and a bad ‘out-group’. She points out how dividing society in this way readily leads to situations where activists believe that they must ‘protect and defend the in-group’. We have recently seen terrifying examples of this played out in the treatment of feminists like Kellie-Jay Keen at the hands of transgender activists.

Cynical Therapies shows us that counselling and psychotherapy can be added to the long list of cultural practices – including education, journalism, publishing, healthcare, the legal system and policing – that have been captured by woke thinking. Each incidence of an institution moving away from its intended purpose to promote an unforgiving, inhumane and divisive ideology is shocking. But therapists have a particular responsibility: they deal with us at our most vulnerable, exploring what makes us who we are, and shaping how we perceive our most intimate relationships. Yet ‘political activists’, as Thomas says, ‘are turning therapy into an anti-therapeutic practice, one that weakens the individual, nurtures resentments and encourages victimhood’. In doing so, they are abusing the trust we place in therapists for their own political ends.

The contributors to Cynical Therapies have bravely shown the world what’s really happening in the profession of therapy. As Thomas rightly argues, the capture of therapy by woke activists is turning it ‘into a practice of moral re-education that serves the interests of an authoritarian elite’. Cynical Therapies should serve as a clarion call to those therapists trying to resist the ideological capture of their profession. It’s a reminder that the first duty of a therapist should be to the needs of their patients.

Cynical Therapies: Perspectives on the anti-Therapeutic Nature of Critical Social Justice, edited by Val Thomas, is published by Ocean Reeve Publishing. Order it here.

Joanna Williams is a spiked columnist and author of How Woke Won, which you can order here.