Introduction

There can be no doubt that therapy, along with other applied health and social care professions, is in crisis. The whole raison d’etre of an organisation such as Critical Therapy Antidote has been to provide a platform for dissident clinicians who question the politicisation of our professions as well as raise awareness more broadly that the contents of the tin labelled ‘therapy’ is being changed.

However, as I have argued in a previous essay, it is time now to look at how we can move beyond this crisis and the looming schism in the field. To undertake this daunting task in a productive manner we will need to think deeply about the conceptual underpinnings of traditional/classical therapy. We can’t go backwards — Critical Social Justice (CSJ) has exposed a weakness in traditional approaches to therapy, one that made it vulnerable to capture by a regressive antitherapeutic  ideology. It is time to go forward.

This move begs the question: what kind of frameworks/paradigms could help the field reset itself? I would argue that any worthy of consideration needs to meet at the very least two criteria; it will need to provide the following:

1. A coherent explanation of the ideological capture of therapy;
2. The conceptual ground for a balanced integration of the individual with the wider societal/cultural/environmental context in practice.

In my previous essay I offered Integral Theory as a potential candidate, in particular, Wilber’s four quadrant framework which explicitly deals with the balanced relationship between the individual and collective dimensions of the self. In this essay, I am proposing another candidate worthy of consideration: Iain McGilchrist’s thesis of brain hemisphere asymmetry.

This essay opens with restating the difficulties currently faced by traditional/classical therapy. I will then explain, in summary, McGilchrist’s thesis, identifying the most salient features, before going on to consider how this paradigm meets the two necessary criteria flagged up above.

Restating the problem

I make no apologies for returning once again to restate the crisis in therapy and how we have arrived at this point (see my discussion of my first chapter in Cynical Therapies). It is my contention that once the majority of clinicians grasp the essential nature of the ideological capture of therapy it will create a groundswell of informed opinion that can protect the healing ethos of the therapy professions.  

In summary, the historical focus on the individual in therapy started to be challenged in the late 20^th century and, over a short period of time, the field exhibited an increasing concern with the client’s cultural/societal context. Now in the third decade of the 21^st century, the societal/environmental/cultural  context is increasingly privileged over internal psychological processes with regard to diagnosing the client’s difficulties. If this were merely a temporary over-corrective swing of the pendulum from a focus on the individual to a concern with the collective, it would presumably be not too difficult to rectify. But the situation is more complicated than this (see the essays laying out the problem in Cynical Therapies).

Many of the voices advocating for this move to the collective were (and continue to be) activist scholars,  clinicians, and senior administrators. Their aim was to insert a new worldview with a political agenda into the professions, and with it, a radically different conceptualisation of the therapist’s role: no longer would the therapist be healing the individual, instead they were charged with the mission to change society (see the APA’s designation of the ‘citizen psychologist’ in its 2017 guidelines on multicultural practice.) Once Critical Social Justice (CSJ) became entrenched in the therapy professions there was no hope that the pendulum would naturally reset towards the mean. Instead, the ideology with its hermeneutics of oppression — the lens through which it views the world —has cemented the imbalance into place; trainee therapists are now increasingly being taught that their clients’ difficulties  result solely from systemic oppressive societal conditions (see the recent independent inquiry into the politicisation of UK-based clinical psychology training programmes). Current CSJ-informed notions such as ‘decolinisation’ and DEI policies are deployed to entrench political agendas within the bureaucratic systems that control professional training and practice (see the recent revisions of the Ethical Framework proposed by the British Association for Counselling and Psychotherapy). But, as critics of this ideology have been arguing,  the last thing practitioners and clients alike need is the widespread adoption of an authoritarian collectivist anti-relational worldview that nurtures victimhood and promotes narcissism (see chapters in Cynical Therapies detailing these problems) . So, what can we do?

We could start by identifying moves that are unlikely to work. Put simply, these would be likely to fall into one of two categories. The first would be attempts to shore up the conceptual underpinnings of traditional/classical psychotherapy. The second would be attempts to build on the already-existing ideas about integration within the field such as, for example, pluralistic approaches. Unfortunately, neither of these types of responses can deal with the challenge delivered by the arrival of CSJ as they are  both freighted with the same weaknesses that made therapy vulnerable to ideological takeover in the first place. Put simply, this vulnerability could be characterised as the inability of cultural practices informed by Enlightenment epistemology to defend themselves against the dismantle/destruct operations of applied postmodernism (James Lindsay has pithily termed Critical Theory as an ‘industrial grade  dissolvent’).   .

We don’t need more of the same. Instead, we need something more radical: the resetting of therapy from the ground up. This move would surely require new paradigms or meta-frameworks that can expand and build upon the accumulated wisdom, expertise, research-informed knowledge of core classical therapy approaches and  open them up to a wider and deeper integration of all dimensions of human existence in a balanced and productive way.

 So now, let’s turn to a paradigm with the potential to offer a deeper level synthesis: Iain McGilchrist’s thesis of brain hemisphere asymmetry. As readers may not all be familiar with McGilchrist’s ideas I am going to take the opportunity here to lay it out in some detail.

McGilchrist’s Thesis – overview

Iain McGilchrist, a Scottish psychiatrist and polymath, first came to the public’s attention with the publication of the now classic Master and His Emissary in 2009 where he outlined his thesis of brain hemisphere asymmetry (and in shorter form here )  — it is this first articulation which I will summarising here.

By the end of the 20^th century interest in cerebral asymmetry — the idea that the two hemispheres of the brain exhibit structural and functional differences — had dwindled. Despite this topic being out of favour, McGilchrist, who had a particular interest in neuropsychology, spent two decades engaged in an extensive and detailed review of the extant research literature. Then drawing on multiple lines of evidence, he produced a groundbreaking thesis on the nature of the differences between the two hemispheres and the implications for human experience and culture.

McGilchrist argues that the grounds for the importance of hemispheric asymmetry is due to its being a structural characteristic of the brains of all higher animals from birds upwards. A distinctive feature such as this must have fundamental implications for experiencing the world and cognitive processing. McGilchrist concludes that the two hemispheres have a different attentional focus. The right hemisphere is the primary hemisphere and its job, as it were, is to deliver information about the immediate environment or context; whereas the job of the left hemisphere is to focus on something specific within the wider environment. To illustrate this, McGilchrist gives the example of a bird feeding on the ground. The right hemisphere identifies a potential patch of food e.g. seed distributed amongst gravel. The left hemisphere then attends with precision to the task of sorting edible seeds from similar sized pieces of stone. Meanwhile the right hemisphere maintains its wider attention providing a vigilant overview to detect potential predators as the left brain continues with its focused task. The two hemispheres will need to work together in spite of a fundamental incompatability regarding focus, tasks and experience. This is achieved through lateralisation: the two hemispheres control different sides of the body.

McGilchrist then reviews the evidence for the consistent differences between hemispheric focus in animals. In general, social experience, emotional responses and topography are related to the right hemisphere, whereas instrumental vocalisation, categorisation of stimuli and fine control of motor response are related to the left.

The same basic attentional difference in focus operates at the level of the human brain. There is the narrow focus of the individual self that is competing for its needs and manipulating the world and then there is the more open diffused focus that is required for being in relation to the wider context of the world at large. However, the human brain’s much greater sophistication with its developed frontal lobes and the way it is self-reflexively situated in a wider human culture means that brain hemispheric asymmetry expresses itself in a more complex and nuanced way.

McGilchrist’s thesis: difference between left and right hemispheres

To summarise McGilchrist’s synthesis of research on the differences between the ways that the left and right hemispheres pay attention to the world, we see these significant features:

LEFT HEMISPHERE	RIGHT HEMISPHERE
attends to what is known and familiar	attends to new experience
communicates in verbal language	is mute and utilises non verbal communication
sees the part and relies on a narrow divided focus	sees the whole
deals with conceptual representations of what is present	deals with direct experience of what is present
constructs categories	distinguishes individuals
interested in the impersonal	interested in the personal
associated with non-living, machines and tools	associated with living things
its emotional signature is anger	its emotional signature is complex — it deals with empathy, emotional perception, ascribing emotional value and emotional expression
its attitudinal disposition is unrealistically optimistic	its attitudinal disposition is realistically pessimistic
deploys explicit reasoning	deploys implicit reasoning
deals in abstractions	sees things in context
literal-minded and does not grasp nuance	understands metaphor, ironic humour

In summary:

LEFT BRAIN	RIGHT BRAIN
creates representations of the context, makes maps and manipulates what is presented to it	deals with direct experience of the wider context, the territory

McGilchrist’s Thesis: implications for wider culture

McGilchrist believes that this thesis also applies to the wider culture. His main argument is that although the right brain is, of necessity, the primary hemisphere, over the course of the last two thousand years the left hemisphere has become the dominant one. A healthier balance needs to be restored between two equally important modes of knowing and perceiving the world.

The reasons for this growing imbalance is due to the interaction between the two hemispheres. We are becoming increasingly locked into a one-sided narrative and way of being in the world i.e. the analytic, technical and conceptual modes of the left hemisphere. There appear to be three main factors implicated in this problem and these are:

• the narrow focus of the left hemisphere;
• the all-encompassing technological nature of our environments that favours left brain thinking:
• and, finally, by the way that the communication between the two hemispheres is mediated by the corpus callosum.

To deal with the first two factors briefly — the left brain is not aware of anything outside its own domain so that when it is involved in its tasks of representing reality it has no awareness of the right hemisphere. Logic, linearity and language allow the left brain to create systems of thought and thus control the discourse — the right hemisphere is mute. Furthermore, the world we inhabit with its increasingly globally networked and technologically driven environment is a product of the left brain and this context is presenting a concrete reflection of the left brain back to itself.

Finally, and crucially, this one-sided state is further held in place by the particular operation of the nerves in the connecting tissue of the corpus callosum. The main function of this connective channel is to share information but keep the worlds where that information is handled separate. However, due to physiological factors, the left hemisphere is better able to inhibit the right hemisphere.  Consequently, the left hemisphere, that views its partial nature as the whole story and is increasingly mirrored back by an environment of its own making, is also physiologically better equipped to suppress another radically different mode of awareness competing for attention.

Before I discuss whether McGilchrist’s thesis meets the minimum two criteria specified earlier (for having the potential to provide a deeper-level conceptual integration), I want to mention its reception in therapy briefly.

How has McGilchrist’s thesis been received in therapy?

Very shortly after the publication of his groundbreaking book, experiential psychotherapists recognised its value for thinking about the nature of therapy—therapeutic processes must, at a fundamental level, rely on the functional inter-relationship between the two hemispheres. They were particularly interested in the justification his thesis provided for methods such as Gendlin’s ‘focusing’ which helps the client get in touch with nonverbalised communications arising in the right hemisphere. Over the last decade, as the therapy field has become increasingly interested in the neuroscientific evidence for the efficacy of therapeutic interventions,  the explanatory power of McGilchrist’s thesis has made his work increasingly popular (for example see a professional article arguing counselling effectiveness requires the integration of both right- and left-brain processing.  

On a personal note, I, too, have found his thesis very helpful in developing my thinking regarding the application of mental imagery in therapeutic and creative processes (see here and here). In my doctoral research project, I analysed published reports of clinicians from different schools employing mental imagery with clients. My findings indicated that there were six main types of generic imagery functions — how the imagery was used in clinical settings. As different schools favour particular functions. I struggled to find a  framework that could integrate the six main types  until I came across McGilchrist’s thesis. I still recall the lightbulb moment when I realised that the different imagery functions could be helpfully conceptualised as an interactive communicative process operating between the right and left brain hemispheres.

However, in this essay, I am suggesting  that McGilchrist’s thesis may be able to offer something more fundamental than these useful but somewhat piecemeal applications so far. It could be a paradigm with the potential to offer the integrative ground for resetting therapy itself. In the next section I will consider if it can meet the two basic minimum criteria identified earlier as being necessary for such a purpose.

Does McGilchrist’s thesis provide a coherent explanation of ideological capture?

The current ideological capture of cultural practices, of which therapy is just one example, has been bewildering to many. People have watched helplessly as cultural institutions increasingly adopt ideas which until recently would have been generally regarded as delusional e.g. that there is no biological basis of binary sex. However, if we view this phenomenon through the lens of McGilchrist’s thesis it makes sense as follows:

CSJ can be understood as a conceptual product of the left brain exhibiting all of the characteristics of this hemisphere in action.

• It is highly abstract (society is theorised as a nested structure of oppressed/oppressor groups)
• It cannot see anything outside its limited view (it seeks to deny or ‘cancel’ anything not in accord with its view)
• its emotional signature is anger
• It deals in categories (group identities) and not individuals,
• It is focussed on dividing up into parts (an example being theories of intersectionality)
• It privileges representations of reality over reality itself (an example being gender ideology).
• Language is privileged over other forms of communication (because language is thought to have the power to generate social reality, there is an obsessive concern with rhetoric and definitions of terms).

The right hemisphere, with its grounding in direct experience of reality, is shut out and therefore unable to provide any form of corrective (see McGilchrist making the argument that ‘woke’ ideas arise out of a dominant left brain).

Can McGilchrist’s thesis offer the ground for the resetting of therapy?  

As mentioned at the beginning of the essay, one very important task involved in resetting therapy is locating a deeper ground of integration — a ground which can bring together the individual and the social/cultural collective context in a balanced way. What can McGilchrist’s thesis offer here? To start with, his ideas give us a different way of conceptualising this integration project — one that is not dependent on psychological theories.

It is beyond the scope of this short essay to explore this in any depth. Instead, I am going to restrict my observations to the main point. Put simply, the deeper level integration offered by McGilchrist’s thesis is grounded in the inter-relationship between the agentic individual and the wider context in which the individual exists and operates. But, crucially, this inter-relationship is actually structured into our biological make-up through brain hemispheric asymmetry. Each of us operates independently but everyone is inextricably part of a greater context comprising relational webs and society/culture and the physical environment. And, as McGilchrist observes, this relationship has become lopsided. Ironically, we as a culture in the West are now caught up in the left brain’s current very limited conceptual view of context as comprising oppressive societal systems and we have jettisoned the right brain’s grasp of the totality of our environment

McGilchrist’s later work, his magnum opus in 2021: The Matter with Things , expands and builds on his original thesis. He discusses in great detail his view that the right brain is where our sense of ourselves in relation to the cosmos itself is located. Or, in other words, it is the source of our religious sensibilities. If we take these further developments into account, they raise an intriguing possibility.

His thesis provides the means for conceptualising not just the relationship between the individual and the social/collective/environmental context but, even more fundamentally, between the self and the ground of reality itself (listen to McGilchrist expand on this in a recent interview with Jordan Peterson). It is hard to imagine a deeper locus of integration; one that can encompass the full range of  epistemological and ontological positions of the different therapy schools.

Conclusion

The possibility being mooted in this essay is that McGilchrist’s thesis, similarly to Wilber’s Integral Theory, offers us a means of advancing therapy beyond its current crisis. It can explain the capture of therapy by an antitherapeutic ideology – once CSJ is understood as a conceptual product of the left brain divorced from any grounding in the reality of the right hemisphere, it becomes easier to see ways of tackling this problem.

On the one hand we have the left hemisphere which focuses on the specific and is associated with individual autonomy and motivation. On the other, we have the right hemisphere that sees the whole’ environment and wider context—not just culture/society but much more broadly as the context of reality itself. Employing the terminology of therapy, we could say that these different ways of being in the world could be conceptualised very broadly as ‘individual’ versus ‘collective’ (although it has to be said that this conceptualisation has very significant limitations).  

McGilchrist’s thesis offers a possible solution: a framework for reconnecting the individual with the collective context in a balanced and deep way. My hope is that  clinical theorists and practitioners will recognise the value of exploring his ideas. This is an urgent task. Currently, the therapy professions are being diverted from their original purpose. When self and context is properly integrated, therapy will be in a position once again to make a healing contribution to individual clients and through them to the wider world.

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By Val Thomas, DPsych, a psychotherapist, researcher, writer and formerly a counsellor educator. Her specialism is applications of mental imagery. She is the author of two Routledge publications: Using Mental Imagery in Counselling and Psychotherapy (2015) and Using Mental Imagery to Enhance Creative and Work-Related Processes (2019). She is also the editor of the 2023 collection of essays, Cynical Therapies.