When a mental health professional begins working with a client, there’s a common phrase which suggests the first course of action: “meet them where they are.” In essence, this means in order to help the person, you need to first understand how they conceptualize themselves, the problem they face, and possible solutions. Each person is unique in this way, even if their diagnosis and broad identity-group membership is similar to that of others. As such, the best course of action is to get to know the person in front of you as a whole, complete, unique person. This includes the client, their environment, their support systems, and cultural considerations. The core of therapy is empowering individuals to make changes in their lives, which often requires a heightened level of personal responsibility. The focus here is on the individual, not their identity group membership, because group membership does not accurately meet the client where they are. This is just one way the identity-focused Theory of Critical Social Justice (including, for instance, Critical Race Theory) goes wrong.
Consider intersectionality, for example. Kimberlé Crenshaw describes the theory as taking a macro-level approach, but macro-level work in therapy does not make for a sound therapeutic relationship (which happens to be the best predictor of positive therapy outcomes). If therapists reduced their clients to their identity groups, they miss out on the important specificities of the client that make them unique. As humans, we like to be understood; it feels good. But understanding a client in terms of their immutable characteristics (e.g., race, gender, sex) and tying these identities in their relation to socially constructed power struggles is hardly descriptive. And yet, Theory would have us believe this is sufficient information for myriad other assumptions for which there is little to no evidence. One of the best examples of how Theory misses the mark in relation to mental health is Jonathan Metzl’s Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland. In his book, Metzl points to the fact that white men kill themselves at much higher rates than other groups because they commonly hold racist attitudes, which causes them to continue voting for politicians and advocating for policies which prevent stricter gun control. This explanation is insufficient at best and evil at worst.
What is the rhetoric of Theory capable of doing to the mental health of those who follow it? Continuing on a broad scale, there is clear evidence that the language and mentality is triggering and disempowering. Consider some of Theory’s diversity trainings, which commonly ask individuals of minority racial groups to center their racial identity, talk about racism at the workplace, and call unassuming white people “racists” guilty of “white supremacy.” This is often difficult for a relatively mentally well person to take on, but what happens when the person being called out is already struggling? We know that overwhelming feelings of guilt is a common symptom of depression, especially for women. To add accusations of racism based on a theory they know little to nothing about and manipulating a vulnerable person’s guilt and desire to do good is vile. A reasonable person might ponder what can happen internally for someone with a mental health condition when told they should feel the guilt and shame of the privilege they possess, the “racism” they perpetuate constantly, and their “complicity” in a system that actively and directly harms minorities. Similarly, asking someone to disclose prejudice or racism they’ve experienced in front of a crowd could certainly be harmful, especially if the memory is still traumatizing. Whether called out for racism or called to speak about experiences of racism, Theory’s tools applied on a broad scale can have real, negative consequences on mental health— especially if they lack the proper support systems to help make stay on track.
Proponents of Theory may argue, “you can still get to know the individual while also taking an intersectional lens.” To which one should ask, “What’s the point?” When it comes to conceptualizing the problem one has, a macro-level approach is not specific enough to do so with sufficient accuracy. And when it comes to solutions, intersectionality nor its Theoretical roots will be of much help because the Theories do not apply to individuals, opting instead for abstract groups. What Theory actually manages to get right can be much better delivered through applied universal liberalism, which fundamentally focuses on the individual. This implies a few key ideas, such as the idea of an objective reality that we can know things about.
Mental health professionals often work with individuals who are considered to be “out of touch with reality” in one form or another. There is a range in severity, of course. For example, a person with generalized anxiety disorder may be out of touch insofar as he has excessive worry about day-to-day stresses. In comparison, a person with some form of psychosis is more heavily out of touch with reality, in that she may see or hear things that are not there. And when we’re working with clients with depression, we often work to show them that reality is not as terrible as what their brains are telling them. The most heavily empirically supported therapy for mental health conditions is cognitive behavioral therapy (CBT), which has roots in stoic philosophy. The theory relies heavily on the assumption that objective reality both exists and we can know things about it. In many ways, CBT can be said to improve the mental health of clients because it trains them to better view objective reality. Clients who take on CBT can learn to challenge negative automatic thoughts (thought patterns that form over time which can cloud judgment and have the tendency to form our perceptions of an event, whether the event was good or bad, in a negative way). Clients can also learn about thinking errors they commonly use, such as filtering (magnifying negative details while filtering out positive details of a situation), black and white thinking (all-or-nothing fallacy), overgeneralizing, jumping to conclusions, catastrophizing, emotional reasoning, and mind-reading. Being wary of when we err through these cognitive distortions helps us actually think better, such that we are more likely to think more on-par with reality and view our circumstances in an accurate light. Theory simply does not fit—rejecting CBT’s theoretical underpinnings outright and working as a kind of reverse CBT in practice.
First and foremost, the idea that objective truth can be found is outright rejected by Theory, insisting instead that reality cannot be known by anyone and that knowledge relies upon claims to authority that are illegitimate and ultimately political. This follows from the view that in the eyes of postmodernism, each voice has its own truth which is no better than any other except as defined by Theory, and it is enhanced by Critical Theory and its radical egalitarianism, wherein one has more freedom to speak truth so long as they are of a sufficiently oppressed social group. How is a counselor to call out possible faulty logic or inconsistencies if reality does not matter?
Critical theories like these are also guilty of numerous thinking errors relevant to professionals of mental health, and thus to their patients.
- Black-and-white thinking: As seen in antiracism, proposed by Ibram X. Kendi in How To Be an Antiracist: “One endorses either the idea of a racial hierarchy as a racist, or racial equality as an antiracist.” There is clearly room for more nuance than is allowed in this statement. One can be non-racist, when we treat everyone as the unique individual they truly are, with their own thoughts, feelings, emotions, and actions, and we hold each person reasonably accountable for those actions based on the appropriate context.
- Catastrophizing: speech and words are legitimately violent. Pointing out an inconvenient truth is violence. To Theory, disagreeing with any of their premises is violence. “Concept creep” takes hold, and the original meaning of words lose their power as they are applied too broadly (see also, microaggressions).
- Filtering out the good, highlighting the bad: One of Theory’s favorite games to play.
- Step 1: Point at an institution of Western civilization
- Step 2: point at where it is not perfect
- Step 2b: ignore what it does well
- Step 3: Problematize it in a way that aligns with Theory
- Step 3b: read everything in the least charitable light
- Step 4: Infiltrate the institution with Motte & Bailey tactics
- Step 5: Take over and corrupt or dismantle from the inside
Just because Theory rightly points out where our institutions do indeed fail, this does not mean the correct next step is to tear down the entire institution. It is certainly possible to keep what works and let go of what is ineffective.
- Jumping to conclusions: Where there exists a group difference, Theory necessitates that the difference is due to sexism, racism, ableism, or another sinister plot formulated by those in “power.” In a just society that has thrived on the ability to conduct sound science, we can do better than this. We can control for factors that might contribute to a given group difference—and when we know we’ve controlled for all of these, and there still remains a difference, we can have a reasonable discussion and debate about how equity might be found.
- Emotional reasoning: Lived Experience is number one. Because objective reality does not exist and only uses appeals to “reality” when it is convenient, perceptions of lived experience steeped in emotional reasoning are to be unquestioned, especially by those with more privilege (see also, Position/Positionality). The “oppressed” person is able to see and understand more of the world, and the “oppressor” could never understand this position. Further, each person could only speak as a mouthpiece for their group, as socially identified because of the importance of standpoint epistemology, which tells us that one’s position within power structures determines how much and which knowledge(s) one has access to. Simply put, a straight, white female counselor would have far less access to knowledge(s) than a black, lesbian woman precisely because of their respective positions in relation to Theory’s beliefs about systemic dominance and oppression. Typically, mental health professionals listen to an individual’s lived experience, and from this we are mindful of what might be true and what the client might claim to be true but might be at risk of using thinking errors such as the ones described here. Through the lens of Theory, however, lived experience is the primary way knowledge is implicitly and explicitly said to be created. Theory also claims that lived experience goes deeper than the story one tells and includes experiences of alleged dominance and oppression experienced from social structures. The understanding of this dominance and oppression must be understood through Theory and a critical consciousness (see also, Wokeness). In other words, one’s lived experience must be filtered and spun through the lens of Theory before it gains “authenticity.” If a client from a marginalized population describes his own experiences, but it does not follow the rules of Theory, it does not count. Indeed, they may be said to be experiencing internalized oppression or internalized racism, or perhaps of “acting white.” As such, a person of a minority group cannot simply disagree with Theory’s claims but is said to be suffering from internalized oppression that they cannot yet see, and to help this person would be to show them how oppressed they truly are. This has sinister ramifications for mental health counseling. The role of a counselor is generally to help the client feel empowered to improve their circumstances, focus on what is within their control, and begin to live the life they wish. But when a counselor takes Theory to its logical end, the right thing to do would be to highlight how oppressed a client truly is, which fosters victimhood-centrality and a victimhood culture, wrongly suggesting that development of a critical consciousness is necessary.
- Mind-reading: Biases alleged to be held by those with privilege and power are often regarded as unseen and unacknowledged. To correct this false consciousness, one must cultivate a critical consciousness (that is, Wokeness), which allows them to see their bias. Emphasis on implicit bias is seen to prove Theory’s correctness in that they are the ones who really know what that bad person with false consciousness thinks.
This list of issues raises the question: how exactly would counseling work under Theory? A white counselor can never not be racist according to Robin DiAngelo, nor can anyone who is not actively antiracist in impact and not intention, as suggested by Ibram X. Kendi. Surely this would impact the therapeutic relationship and slow or stop progress if this were true. Why would any client want a counselor who holds racist views about their race? Why train anyone who does not subscribe fully to Theory to work with people of different cultures if it is true that the alternative is racism? Why train any counselor to work with a client who is more oppressed than they are if it is true that the counselor’s identity group leaves them with more power than the client, thus indicating the counselor could never understand the client?
Multicultural counseling competencies essentially suggest that counselors should keep an open mind and focus on the individual in front of them. They should work to keep their biases in check and never stop learning about and from the client. These competencies began reasonable enough. Through Motte & Bailey tactics, however, Theory has begun to show its true colors in much of the protocols helping professionals are to use in our work with diverse populations.
Consider how Robin DiAngelo’s conception of “white women’s tears” (White Fragility, chapter 11) would play out in a therapeutic setting. Suppose you are a counselor, and given the current climate surrounding race, a white woman comes to your office for help. She explains she’s just been through antiracism training at work, and is now experiencing increased anxiety and difficulty focusing. As she tells you the story, she begins to feel upset because she tries her best to not be racist but was informed she always has been and always will be. She begins to cry. Having been informed by DiAngelo in how to handle this, you state that her crying is actually making her racism worse. She is putting her fragility on full display and doing so “recenters white pain” which can “get black men killed.” Further, the client’s emotions themselves are political and recenter whiteness. This suggests only the pain, hurt, and trauma of some people, but not others, are valid. This idea is as helpful as telling someone with depression to “just be happy, someone has it worse than you do” and would do serious harm to the client. This, of course, directly violates the “Do no harm” clause in almost any code of conduct a mental health professional is required to follow.
This example symbolizes the slogan “the personal is political,” which has been popular amongst proponents of Theory. However, in therapy this simply cannot be the case. What is hurting a client is not innately tethered to their political views, nor are they tied inextricably to their group identities, no matter how the complexities of intersectionality theory attempt to show they are. A client is not the culmination of their group identities. Instead, they are individuals who, while indeed experiencing culture and societal influences, have the ability to think for themselves, and are not to be reduced to their social group identities. To recognize someone as anything less than an individual or view them as political abstractions is to deny them their full humanity, and to deny them this is to deny them the ability to harness their full power.
Steve Dreesman is a temporary licensed mental health counselor who has worked closely with individuals with concerns of anxiety, depression, suicidality, stress, men’s issues, perinatal mental health, and relationship issues. You can follow him on Twitter @SteveDreesman
Great article. Well put.