Woke Therapy Weakens the Client

Oct 27

This article is reproduced here by kind permission from Critical Therapy Antidote. It was originally published here on February 5th 2022.

Introduction
Critical Social Justice (CSJ)-driven therapy (aka ‘woke’ therapy) is a completely different practice to traditional counselling and psychotherapy. This point cannot be overstated. The mistake that many people are making is that they perceive this new politicised approach as a development or evolution of therapy—the social justice turn, if you will, in the counselling and psychotherapy disciplines. The fact that the president of the British Association for Counselling and Psychotherapy (BACP) could state without any reservation in an address to a 2019 conference that “Social justice frames what counsellors do” is indicative of this position now held by therapy institutions. This framing is how CSJ has been sold by the activist scholars in the field, and is a cynical move designed to disguise the way that a new type of cultural practice has piggybacked onto traditional established therapies. Presenting CSJ-driven therapy as just an evolutionary shift obviates the usual requirements of any radically different approach which would include both explaining exactly how it works and also providing evidence for its therapeutic efficacy. Due to this sleight of hand, practitioners, trainees and therapy educators sign up for this approach anxious lest they be castigated as reactionary or out of touch or, even worse, bigoted. Any concerns and unease that maybe, just maybe, there are very significant problems with this new ideological application to therapy are repressed—no one is discussing this in public, no one wants to be cancelled. However, it is crucially important that such concerns are brought out into the open before the therapy field is completely harnessed to a nontherapeutic political project; one which urges, counselling psychologists, for example, towards ‘…dismantling White supremacy at the level of organizations and systems, especially predominantly White institutions and including professional psychology’ (p 481).

“Presenting CSJ-driven therapy as just an evolutionary shift obviates the usual requirements of [...] explaining exactly how it works and also providing evidence for its therapeutic efficacy.”

In this short essay I will be building on an argument I have made previously that the worldview which is baked into CSJ-driven practice is antitherapeutic by its very nature. As others have noted (for example, see Valerie Tarico’s exposition), its ideological tenets are very likely to translate into poor clinical outcomes, and, in worst case scenarios, actually damage clients. As mentioned at the beginning, CSJ advocates are expert at disguising the true nature of this ‘therapy’; framing it as an emancipatory endeavour and deploying rhetorical strategies of obfuscation. In order to grasp the unreconcilable differences between traditional therapies and CSJ-driven approaches it is important to be clear about the ground on which these practices stand. The perspectives taken on fundamental issues will inevitably shape the clinical encounter along particular lines. In this essay, I will be exploring one of these basic issues—the nature of the individual—to illuminate the importance of understanding the implications of the philosophical commitments of therapy. In particular, I intend to show how CSJ’s discounting of the individual in favour of the collective dimension of human experience has inescapable and profound ramifications for therapeutic treatment. In essence, I will be arguing that the world view informing CSJ is turning counselling and psychotherapy into practices that weaken the client.

However, before I begin, it is important to issue a caveat. What follows should not be taken as upholding a simplistic view of traditional therapy as an unalloyed good because it supports the individual. There is not enough space here to engage in any depth with a more complex critique. As a corrective, it is worth bearing in mind the following points. It could be argued that traditional therapy has paid too little attention to the shaping forces of society and this failure has allowed a political ideology that privileges the collective dimension to gain such a purchase on the field. And, it is also important to recognise that CSJ contains a germ of truth: membership of particular groups will inevitably play a role in shaping the individual’s experience of their social world.

To start with, it is necessary to remind ourselves that what characterises CSJ’s ideological ground more than anything else is its collective nature, its commitment to the socially-constructed nature of truth, and its political agenda. From its perspective, the social world is composed of a nested structure of power relations; each person is positioned within this matrix dependent on their memberships of oppressed/oppressor groups. What this means in relation to the individual is that group membership trumps all. Each person is defined according to the identities claimed by them or bestowed upon them. The uniqueness of each person rests on their particular constellation of intersecting identities. There is no such thing as a separate, freestanding, as it were, individual in relation to society. Instead, the person is wittingly or unwittingly merely an agent or victim of collective oppressive systems. Furthermore, due to its reliance on social constructionism, objectivity is completely discounted in favour of subjectivity. The individual’s ‘lived experience’ in relation to their particular oppressed group membership is the final arbiter of truth.

“due to its reliance on social constructionism, objectivity is completely discounted in favour of subjectivity.”

This stark delineation should serve to flag up the complete incompatibility between the CSJ-driven view of the individual and the view developed within modern Western culture. There can’t be an overlap or continuum; these views are informed by completely different orientations towards the world. Furthermore, ideas about the universal nature of human experience that might offer some way of bridging the gap are antithetical to the CSJ worldview. So, given these two fundamentally different positions, the question arises as to how the client’s individuality will be construed by a traditional therapist and a CSJ-driven practitioner and what the implications might be for clinical practice.

Traditional Therapy and the Individual
So, starting with traditional therapy, the focus on delivering treatments which strengthen the client is so basic and self-evident that it is rarely articulated in such an explicit way. The outward facing communications of professional bodies provide explanations of therapy still in accord with its traditional telos (presumably because they don’t want to alert the general public to the ideological capture taking place in the professions). For example, the BACP states in its introduction ‘Your therapist will help you explore your thoughts, feelings and behaviours so you can develop a better understanding of yourself and of others.’ The American Psychological Association (APA) offers the following: ‘Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well‐being, alleviate feelings of distress and resolve crises.’ The notion that the client will be strengthened in some way is implicit in both of these statements. A measure of a successful therapy treatment would be an improvement in the individual’s ability to function effectively and resourcefully within their particular context.

Now, it is important to emphasise that the individualism (and universalism) that is baked into disciplines shaped by modernity does not mean that the collective dimensions of human experience are ignored. To a greater or lesser degree, traditional therapy schools would recognise the part played by societal conditions in shaping clients’ difficulties. At one end of the continuum would be therapies that discount social conditioning; an example would be Victor Frankl’s Logotherapy. Frankl devised this meaning-based therapy from his experience of the extreme conditions of concentration camps where he observed that the prisoners who had a way of making sense of their experience were more able to survive the terrible conditions. The other end of this continuum would be approaches that emphasise the role that social conditions play in clients’ presenting issues—an example would be feminist therapy. However, even though therapies of this latter type would foreground the role of historic oppressive social conditions in the shaping of the client’s difficulties, the therapeutic treatment would still focus on helping to strengthen the individual in relation to the wider context.

So, how would traditional therapies be working in order to strengthen the individual? Therapists from the various therapy schools would all have a different take on clinical theory and practice but all of them would align themselves with the general goal of increasing the client’s capacity to live and function effectively and in fulfilling ways. A client in a state of vulnerability should expect with a degree of confidence that the space for reflection and dialogue provided by the professional would be geared towards enhancing their capacity to make improvements in their lives. This very general and implicit goal could be broken down into various interdependent components, four of which are particularly germane to the discussion of the essential difference between traditional and CSJ-driven therapies.

First, there would be an emphasis on increasing the client’s agency and acceptance of personal responsibility. All of the main therapy schools would regard holding on to a passive victim position as detrimental to psychological health. No matter what the circumstances there is always a point where the individual has power in terms of their response to their circumstances. The client would be encouraged to have an internal locus of authority and, as a consequence, to think for themselves.

Second, there would be a move towards promoting greater self-awareness and insight. This in turn would increase the client’s ability to identify aspects of the self previously hidden from consciousness and express these more consciously and productively. An expected by-product would be an improved ability to recognise and regulate ones own dysregulated emotional states. Alongside this the client would be encouraged in the process of differentiating the authentic self from rigid roles and identities taken on from/or imposed by the wider social world.

Third, a focus in therapeutic work would be increasing the person’s capacity for authentic fulfilling interpersonal relationships—many of the difficulties that clients bring are problems in this dimension of life. Through greater insight, clients can understand their blind spots and relational patterns. This should improve the ability to relate to others. Therapy should facilitate a better grasp of the subtle co-created nature of interpersonal relationships.

And finally, fourth, there is a move towards realism. By that, I mean, the client will be encouraged to recognise their illusions about themselves and their life and develop a more realistic grasp and appraisal of the threats and opportunities presented by life. This direction could be characterised as a process of maturation whereby the person is helped to move on from childish narcissistic positions and come to terms with a more adult perspective that accepts the inevitable constraints imposed by reality.

What happens to the individual subjected to CSJ-driven therapy?
These four dimensions can now provide a helpful framework for considering how the individual will fare in therapy provided by a CSJ-driven practitioner. It can be demonstrated that in each case, the individual is diminished, reduced, undermined and weakened.

Agency
In the first instance, it is obvious that the client’s agency will not be encouraged. From the CSJ world view, ‘… the etiology of mental illness and developmental delays are viewed as a response to various social illnesses rather than an intimal derivative (e.g., biological substrate, trauma)’ (p. 485). The origin of any psychological distress is always external because the individual is merely an avatar of the group: problems in living arise as a consequence of the client’s particular constellation of intersected identities. The therapy work will focus on identifying how systems of oppression have impacted on the client’s sense of self and lived experience of the world. The inevitable outcome is an increased sense of victimhood and passivity. There is only one permissible avenue for agency and that is political action. Consequently, there would be therapist encouragement for the client to take on an activist role through identifying and then confronting sources of the perceived oppression.

In addition, there will be no support whatsoever for the notion of taking responsibility for one’s attitude to circumstances. In fact, this move would be interpreted as a form internalised oppression.

Insight and Self-awareness
Developing insight and self-awareness is promoted but along particular narrow lines. The goal of the Critical Theory aspect of CSJ is the instantiation of Critical Consciousness (the ability to detect the workings of oppressive systems in operation). Consequently, the CSJ-driven therapist will be guiding the client towards taking on this worldview.

The client, therefore, will be encouraged to limit their self-exploration to their membership of identity groups, as, from a CSJ point of view, this is the true locus of the self. This emphasis can be seen in the 2017 APA Multicultural Guidelines (p23) which quite explicitly encourages the practitioner to engage the client in ‘identity’ talk. Consequently, rather than a move in the direction of uncovering the authentic self, the client will be facilitated in a rigid identification with roles and stereotypical attributes of particular identity groups. Instead of creating opportunities for clients to explore, understand and potentially release themselves from the grip of self-defeating negative emotions, CSJ-driven therapy justifies the client’s anger and resentment and thereby further entrenching them. A good example is the enthusiastic take-up of the concept of microaggressions, a theory with little evidence to support it, that justifies any negative perception that the client may have of a social interaction.

Interpersonal Relationships
One of the most potentially destructive aspects of CSJ-driven therapy is its reductive view of human relationships. Because it views power as the ground of the social world, all relationships are power dynamics at play. CSJ does not accept the universal nature of human experience and consequently there can be no authentic relationship between members of different identity groups. It is not difficult to see parallels here with rigid attitudes of previous centuries that militated against relating across class divides. This lens prevents any move towards relational depth which would require a grasp of the subtle complex co-created nature of interpersonal relationships. In other words, all relationships are reduced to a set of transactions. The client will be encouraged to interrogate their relationships based on power dynamics. Female clients, for example, will be urged to view all interactions with men as a site of patriarchal oppression (note the APA Guidelines on Psychological Practice with Boys and Men Guidelines which reframes traditional masculinity as harmful). Clients of colour will be expected to view all white people in their lives as agents of white supremacy, etc..

“Dustrup’s recent article ...lays out ways in which white therapists working with white clients can deliberately introduce the salience of race into the clinical work no matter what issue the client is bringing.”

Furthermore, CSJ is incapable of making productive use of the therapeutic relationship itself, in particular—its capacity to provide a reparative modelling of a healthy respectful relationship. The CSJ-driven therapist has a political agenda which trumps the healing agenda of true therapy. To this end the client will be subjected to manipulative strategies. For example, Dustrup’s recent article in the Journal of Health Service Psychology lays out ways in which white therapists working with white clients can deliberately introduce the salience of race into the clinical work no matter what issue the client is bringing.

It is also worth noting that traditional therapy has a wealth of knowledge regarding interpersonal relationship that cannot be utilised by a CSJ-driven therapist. A good example of this would be attachment theory, a very well researched framework for understanding how early experiences of parenting transfer onto current relational styles. This theory would be incompatible with a CSJ perspective as it takes as a given that individuals will have idiosyncratic experiences of parenting that are not automatically predicated on group membership of oppressed/oppressor groups.

“Circumstances that thwart our desires cannot be acknowledged as objective features of our situation, but only as intentional acts by evil forces”

Realism
In terms of the move towards realism, it is far more likely that this ideology would prompt a move in the opposite direction. CSJ’s exclusive focus on subjectivity and its exaggerated postmodern philosophical commitments militates against a better grasp of reality. Instead, as it takes as axiomatic, the idea that the client’s reality or ‘truth’ is socially-constructed, feelings and ‘lived experience’ will always trump objectivity or a detached perspective. For instance, there is no way that a CSJ-therapist could draw on the repertoire of evidence-based methods developed within the Cognitive Behavioural Therapy school used for testing beliefs and attitudes. Instead, clients, especially those with an ‘oppressed’ or ‘marginalised’ identity’ will be confirmed in their views of the world no matter if these views do not correlate with reality, for example, that there is no biological basis for sex (for an authoritative and detailed discussion of the way that trans-activists are pushing to dismantle this category in law with potentially disastrous consequences for therapy see Jenkins). Furthermore, any questioning of the client’s views or experience will be construed as hostile. As Schwartz notes regarding the CSJ worldview: ‘Circumstances that thwart our desires cannot be acknowledged as objective features of our situation, but only as intentional acts by evil forces’ (p.117).

Conclusion
In summary, the argument being made in this essay is that the philosophical and political commitments of CSJ will inevitably drive its application to practice in an anti-therapeutic direction. Traditional counselling and psychotherapy approaches believe that the power to resolve and/or manage difficulties is located in the client. Therefore, therapists would in various ways focus their efforts on strengthening the individual; the assumption being that an empowered individual is better placed to deal with their problems. CSJ-driven therapy foregrounds the collective dimension and this fact, combined with its philosophical commitments to social constructionism and its Critical Theory derived political agenda, has significant implications for clinical work. Instead of being strengthened, the individual will be weakened across at least four significant dimensions. Some of the negative potential consequences of CSJ-driven therapy for the client are likely to include: a decrease in agency and responsibility; a narrowing of the self into merely a rigid identification with group identity; a decreased capacity for building and maintaining authentic relationships; and a weakened grasp of the constraints of reality. As such, this new version of therapy cannot claim to be therapeutic as traditionally understood.

The least worst consequence of a CSJ capture of the counselling and psychotherapy disciplines is a performative simulacra of therapy, devoid of any healing potential: the most likely longer term outcome is the widespread establishment of a cynical cultural practice that weakens the individual. We should view the clinic of a CSJ-driven therapist with suspicion; in this private space, a client’s difficulties can be leveraged for a non-therapeutic political agenda. Every effort should be made to expose this authoritarian ideology and resist its parasitic intrusions into the therapeutic field.

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