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On April 6, 2021, Dr. Aruna Khilanani, a psychoanalyst, addressed a group of mental health experts at the Yale School of Medicine’s Child Study Center. The invited speaker titled her talk “The Psychopathic Problem of the White Mind” and delivered her remarks from New York City via Zoom. As she settled into her presentation, Khilanani told an audience of psychiatrists, psychologists, and social workers about her murderous impulses. “I had fantasies of unloading a revolver into the head of any white person that got in my way, burying their body and wiping my bloody hands as I walked away relatively guiltless with a bounce in my step, like I did the world a fucking favor.” Talking with white people, she said, was a “waste of our breath. We are asking a demented, violent predator who thinks that they are a saint or a superhero to accept responsibility.”

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Around the same time, another New York City psychoanalyst, Donald Moss, came to attention for his article, “On Having Whiteness,” published in the Journal of the American Psycho-analytic Association. Moss, who is white, wrote that whiteness is “a malignant, parasitic-like condition [that] renders its hosts’ appetites voracious, insatiable, and perverse.” These appetites, once established, “are nearly impossible to eliminate . . . there is not yet a permanent cure.” As one disenchanted reader of the paper remarked, “it is unfortunate that psychoanalysts like Donald Moss, who express their views in a more temperate fashion [than Khilanani], still espouse a kind of racial essentialism to explain extremely complex social realities.” 

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Social justice and “decolonizing” psychology are the twin missions of the American Psychological Association, the APA. The association has vowed to “work [to] dismantle racism in important systems and sectors of society.” A 2021 APA report on racism within its own ranks confirmed its commitment to “a critical examination of how the discipline structures opportunity in ways that uphold White supremacy.” Cited in the report was the association’s Chief Science Officer, who stated that “until we can embark on scientific practices that are not dominated by White supremacy, we’re only going to be getting part of the truth.” In a piece last year called “Psychologists Must Embrace Decolonial Psychology,” Thema S. Bryant, president of the Association, explained that “decolonial psychology asks us to consider not just the life history of the individual we are working with but also the history of the various collective groups they are a part of, whether that is their nationality, ethnicity, gender, sexuality, religion or disability.”  The code of ethics of the National Association for Social Work requires all members “to practice through an anti-racist and anti-oppressive lens.” The Association now stipulates that “antiracism and other facets of diversity, equity and inclusion must be a focal point for everyone within social work,” and has expressed its commitment to “confronting and working to change policies, practices, and procedures that create inequities amongst racial groups, understanding these systems of oppression are based in and uphold white supremacy.” In 2015, the American Counseling Association (ACA), representing over sixty thousand professional counselors, published a document called Multicultural and Social Justice Counseling Competencies, which divided counselors and clients into “privileged” and “marginalized” groups and encouraged them to “possess an understanding of their social identities, social group statuses, power, privilege, oppression, strengths, limitations, assumptions, attitudes, values, beliefs, and biases.” It identified “social justice” as “one of the core professional values of the counseling profession.” My own professional organization, the American Psychiatric Association, issued a report in 2021 that called for a four-year curriculum to teach trainees “skills [to] address racism in the clinical setting and in-patient care.”  Whether the social justice imperative will eventually dominate psychotherapy remains to be seen, but clearly it is already tainting the practice. These national organizations mandate the standards for training program accreditation, and the programs, in turn, dictate required curriculum for their students. Accordingly, faculty in psychology, social work, and counseling programs are populating their curricula and workshops with the popular rhetoric of progressive movements. 

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Essential to our work with patients was the development and maintenance of the “therapeutic alliance,” a core bond of trust nurtured through a non-judgmental, empathic approach, mindful about not imposing our own values on the patient. We were taught, as well, to reach an agreement at the outset of therapy, about treatment goals and concordance about the way therapy is supposed to work. Freud called it the “analytic pact.” Volumes of data confirm that the rapport between patient and therapist is a reliably strong predictor of positive results. Enter Critical Social Justice–driven therapy (which I will call CSJT). The British therapist Val Thomas first used this term to indicate “a practice that views people not as individual actors but rather as representatives of particular groups which are nested within systems of power and trains therapist-activists to diagnose patients through a collective lens.” Though many years in the making, Thomas says, it seemed to blindside conventional practitioners when it emerged as a finished strategy. “Therapy would no longer be focused on helping individuals;” she writes. “Instead, it would be reframed as a political practice, a means of dismantling systems of power believed to be oppressive.” 

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Thus, if a client were white, the counselor’s job was to help them see how they unwittingly perpetuate white supremacy. “We were encouraged to regard white clients as reservoirs of racism and oppression,” Elliott told me. If the client were black, Elliott was instructed to ask how it felt to sit with her, a white counselor. If the client felt at ease, “my job was to make him more aware of how being black compounded, or perhaps caused, his problems, regardless of what brought him to therapy.” White women, one professor informed a class, were “basic bitches,” “Beckys,” and “nothing special.” Elliott was also struck by the degree to which her program inculcated “selective empathy” in the students. A faculty adviser told Elliott in an unapologetic manner that the program was producing counselors who were not going to be able to work with Trump supporters. (If Trump supporters are so deranged, as a cynical colleague of mine pointed out, don’t they need more mental health care than others?) After the death of George Floyd, Antioch’s three-year program intensified its focus on race and oppression, making clear that counselors were to be foot soldiers in the culture wars. “Incredible as it sounds,” said Elliott, “we were encouraged to see ourselves as activists and remake ourselves as social change agents.”

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How is it possible that therapists increasingly believe that they are political activists rather than healers? Val Thomas suggests that the answer lies mainly in the deployment of sophisticated rhetorical strategies. Critical Social Justice Therapy, she says, “does not advertise itself as a new modality; if it did then it would be subject to the usual testing of new therapeutic approaches. Instead, activist clinical theorists positioned it as the natural evolution of the field.” This clever move, she continues, puts anyone who criticizes CSJT or asks for evidence of its therapeutic value, at risk of shunning, derision as a bigoted reactionary, or reputational damage that could lead to a loss of employment. “Without public debate and critique, therapy could then be subverted and harnessed to a political agenda, as happened in other domains such as education, the label on the therapy tin is retained but the contents are being radically changed,” Thomas explained. As if contemporary psychotherapy is nothing more than a contest between discourses upon which nothing empirical or evidentiary can intrude.

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The other root system is a practice called multi-cultural counseling, which is taught in psychology, social work, counselor training. The first textbook on the subject, Counseling the Culturally Different, was published in 1981, and was grounded in the idea that conducting therapy with minority populations required a distinct set of competencies. By 1992, the ethics code of the APA held that a psychologist could be sanctioned if he or she is not behaving in a manner that could be considered “culturally sensitive.” The APA’s “Guidelines on Multicultural Education, Training, Research and Organizational Change for Psychologists,” from 2002, set a perfectly sensible standard for culturally sensitive practice, stating that “psychologists are urged to gain a better understanding and appreciation of the worldview and perspectives of those racially and ethnically different from themselves.” Indeed, there are broad variations in culture, such as individualist versus collectivist values, and variations in levels of acculturation within immigrant groups, as well as variations in family-of-origin differences. Some ethnic and racial groups are more likely to report emotional distress in the form of bodily sensations; sometimes culturally specific metaphors allow therapists to make a point more clearly. Such cultural adaptations have been incorporated with success into well-tested cognitive behavioral therapy strategies. A “culturally competent” practitioner is, in reality, little more than an otherwise competent therapist who has made necessary and thoughtful accommodations to patients with different traditions of disclosure, habit, and help-seeking. Less recognized as potential key aspects of identity are sociopolitical values. “This element may form the core of a client’s personality and identity,” I am told by the psychologist Richard E. Redding of Chapman University, one of the first scholars to research political values in psychotherapy. “Because mental health professionals overwhelmingly tilt to the left politically, they should be cognizant of the fact that their politically conservative, libertarian, and centrist clients will not share many of their values.” Redding refers here to the moral intuitions driving attitudes about issues such as abortion, affirmative action, welfare policy, crime-control, immigration, or gender politics. “Clinicians must be sensitive to the impact this may have on the therapeutic alliance and the ways in which this influences their diagnostic and therapeutic choices,” he cautions.

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To see what CSJT looks like in the real world of the clinic, imagine a depressed white man in his twenties talking to his therapist, a psychologist, about career woes. He has just been turned down for a coveted research fellowship and speculates that he lost out because of affirmative action. The hunch so unnerves the therapist, who is non-white, that he looks for guidance from colleagues during a weekly staff meeting where difficult cases are shared. In the Brooklyn clinic at which this scenario played out in real life, a colleague of mine, another psychologist, was at those meetings. “The group discussed the patient’s comment about affirmative action and the consensus was strong,” recalled my colleague. “They strongly advised the therapist who consulted them to tell the patient that if he didn’t overcome his biases, he would be transferred elsewhere.” The rationale? The group argued that it would be unfair for a clinician of color to be asked to treat a “racist” patient, my colleague explained. Andrew Hartz, a psychologist in New York City, recently published an account of his experience in City Journal: A few years ago, I provided therapy for a young heterosexual white man . . . he told me that he had experienced pervasive racially charged bullying at both his elementary school and his high school. . . . Much of it was explicitly racial, including comments like “white faggot” and “white bitch.” . . . He said that he had held back from telling me about it in part because he worried that I would frame him as privileged or “just not get it” — reactions he had experienced in the past from his friends.

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The mental health professions today are home to therapists who are overwhelmingly female, liberal, and politically aware. As self-declared enemies of privilege, they are primed to imbibe the social justice narrative and accept it as the proper objective of therapy. They reflexively impose the narrative on individuals who seek their help and react harshly to those who resist their efforts. The talking professions, I’m afraid, seem to be attracting as trainees people least suited to the job — and making that job inhospitable to would-be therapists who do not wish to be part of a highly politicized profession, one where therapy becomes politics by other means. The pipeline to the professions is skewed from the outset. A Yale psychologist colleague told me that he was “struck” by the number of applicants to his program “who were unabashed activists with their minds made up about best practices in psychology.” One of them declared that she had already staked out black feminist theory as her template for practicing therapy. “If what I saw is at all representative of incoming graduate classes, the future of psychology doesn’t look good,” my colleague said. Signing diversity statements and pledges are now part of the application process at many training programs. But perhaps the most potent deterrent is the exposure of poor training and psychological abuse in some programs.

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In one of Suzannah’s classes, a professor asked who they thought their most difficult client would be. “To a person, the class said a bigoted white man was their nightmare client,” she told me. In class she had mentioned that the Buddhist practice of reducing focus on one’s self could make it easier to act on one’s values — a tenet that Suzannah saw as consistent with the goals of secular psychotherapy. After all, suspension of obsessive self-regard is an element in cognitive behavioral therapies, she pointed out, further arguing that it could help therapists foster compassion for even the most challenging client. The professor disagreed. After several months in the program, her professors told Alexander that her thinking was, as she puts it, “too concrete.” They also objected to her allusions to Buddhism, calling it “bad thought” and resented her refusal to concede that she should be ashamed for being white. “I knew this was abusive,” she later wrote is a wrenching account. “I was determined not to quit until I absolutely had to. But I was discouraged.” Eventually Alexander’s adviser told her that she would not be able to take practicum (hands-on clinical experience), an activity without which she could not graduate and obtain a counseling license. Alexander left the program and is now seeking legal redress for her wasted tuition. “I doubt I’ll ever be a counselor now. I’m not even sure I still want that. More’s the pity, so many have told me I would have been great at it, and I do feel for the many men who find suicide to be their only outlet.” 

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By no means are all training programs so ideological, but the experiences of Leslie Elliott, Suzannah Alexander, and Lauren Holt are not rare outliers. In the years since Val Thomas, the British therapist, launched Critical Therapy Antidote in 2020, an online community for practitioners and clients dedicated to “protecting the integrity of talking therapies,” she has posted dozens of articles written by trainees who resorted to self-censorship (and near-nervous breakdowns) upon finding themselves the targets of indoctrination by professors, intimidation by faculty, mobbing by fellow students, and retaliation by their schools despite Orwellian reassurances that their programs were “safe spaces.” They include also many testimonies on professors scrimping on the basic facts and models of human psychology in favor of teaching dumbed-down mental health propaganda. 

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