Activist therapists are driving people away from psychotherapy. Here’s what can be done.
Therapy is becoming politicized in ways that deviate from its foundations and turn people away from its unique benefits. One need only watch popular shows such as "Ted Lasso" or "The Shrink Next Door" to see mortifying examples of therapists unethically using their client’s time, attention and even money.
There are certainly precedents for psychotherapy as activism. In the Civil Rights era of the 1960s, feminist and Afro-centric psychotherapy sought to empower women and African Americans by framing their problems as a function of inequality in the world. These approaches gained some popularity, but they remained firmly on the fringe. What’s new is that mainstream psychotherapies such as cognitive-behavioral therapy and psychodynamic therapy have become influenced by broader ideological assumptions that clients are either victims or perpetrators of power structures, and therefore must be classified on this basis and treated accordingly. Working to change hierarchical forces (or decrying them) thereby becomes the focus of therapy.
The reconceptualization of therapy is now widely accepted by the field. Consider the American Psychological Association and the American Counseling Association, which have publicly announced that their missions now include the redefinition of therapeutic work to address social change.
Yet the most fundamental assumption of cognitive-behavioral therapy, informed by the stoics in the West and Buddhists in the East, is this: Our beliefs about events, and not the events themselves, are primarily responsible for our reactions and, in some cases, overreactions. The work of therapy logically translates to understanding these reactions and reconsidering the self-defeating ones. However, if psychological distress is solely caused by “systemic structures” outside the person, it wouldn’t make much sense to examine our own role.
My rage at being put on hold for 30 minutes by my bank is not caused by my bank; it is caused by my beliefs about being put on hold. If I have rigid and dogmatic beliefs about the behavior of others, I will forever be upsetting myself when, inevitably, not everyone answers my calls within two minutes. On the other hand, if I have preferential beliefs, then my emotional reaction to the annoyance of being put on hold will be much milder.
While there is no doubt that societal forces influence individual outcomes and impact lives, therapy has traditionally avoided becoming a vehicle for activism because its power lies in identifying patterns within the person and between them and the people in their lives, thus helping the patient to become more psychologically and interpersonally effective. Individual psychotherapy is not well equipped to change systemic causes of despair; when we try to do so, we risk increasing despair.
Through an activism lens, the work easily becomes a joint exercise in resentment at the world, conveying to patients that they are aggrieved and victimized instead of doing the empowering work of overcoming barriers. If one believes that systemic power structures are the main causes of psychological problems in people, it doesn’t make much sense to examine whether people have unhelpful or dysfunctional beliefs.
As activist therapy grows in popularity, there are increasing reports of patients turning away. Since most psychologists are progressive in their politics, this has led centrist and conservative clients, in particular, to avoid the entire endeavor, creating a new and dangerous barrier for those who need mental health care. Ironically, many therapists believe deeply in inclusivity, but their approach has made psychotherapy less inclusive, particularly with clients who have real needs but fear being perceived as oppressors.
That is why I helped launch the Open Therapy Institute, a national organization founded on the core principle that clients can express opinions without fear of judgment or attempts at indoctrination from their therapist. Similarly, therapists at the OTI strive to focus exclusively on the client, keeping their own beliefs out of the relationship. As Sigmund Freud said, “The doctor should be opaque to his patients and, like a mirror, should show them nothing but what is shown to him.”
We can’t let the political polarization that infects so many other aspects of American society into this unique, important space.
Camilo Ortiz, Ph.D., is an associate professor of clinical psychology at Long Island University-Post, and a fellow at the Archbridge Institute's Human Flourishing Lab. He is a licensed clinical psychologist and runs a private psychology practice on Long Island, New York.
This article originally appeared on NorthJersey.com: Activist therapists driving people away from psychotherapy
