Mental health and talking therapies.

[NotHavingIt]

Cynical Therapies shows how social-justice activism is doing serious damage to troubled people.

An interesting book review in Spiked which looks at the way that mental health therapies are becoming influenced by 'social justice' type theories which encourage individuals to locate the source of their suffering in the world outside - rather than enabling them to arrive at a place where they can take responsibility for, and create, their own meaning out of life's events.

https://www.spiked-online.com/2023/04/10/we-need-to-kick-wokeness-off-the-therapists-couch/

Wow. No wonder.

"Relojo-Howell argues that in focussing on the workings of society rather than the individual mind, CSJ utilises an ‘external narrative’ which is unhelpful when trying to confront ‘an individual’s internal struggles’.

Clinical social worker Lisa Marchiano is clear as to where this leads: ‘When we frame all problems strictly in terms of group identity and oppression, we take away from patients their ability to adapt to their individual reality and to make their own meaning.’

Others argue that, unlike cognitive behavioural therapy (CBT), which seeks to move people away from unhelpful narratives and behaviours, CSJ encourages people to continue to perceive themselves as victims. Indeed, CBT practitioner Philip Pellegrino notes that the premises underpinning CBT and CSJ are fundamentally incompatible. When CSJ drives therapeutic practice, clients are not encouraged to take a more positive view of their situation, to move on from past difficulties and to assume control of their lives. Instead, being a victim becomes a central part of their identity. This robs them of agency. CSJ-influenced therapy encourages patients to forever dwell on old grievances rather than to heal and move forwards"

Does anyone have any experience with these CSJ forms of therapy?

Hi there,

this is interesting to me as I’ve recently started working in mental health, seeing clients on a one to one basis. I’ve squarely in the gender critical camp in private but when I’m talking to clients who need support, I put my opinions to one side (in this and as many other aspects as I can) and listen/respond in as non-judgemental and compassionate way as I can. So this does mean I take what people say as read, if a man comes in and says he would like to be referred to as a woman’s name and with female pronouns and speaks about his troubles, anxieties and stresses around this - I meet him where he’s at.

I’ve had several clients (young women too, but mainly men in this trans category) like this and I feel I would do more damage to their mental wellbeing if I questioned their choices.

I hope I’m not part of this growing problem being reported in this article, but it doesn’t sit right to me to do anything other than provide emotional support to someone who badly needs it, rather than to try to change their view or their life path.

As I said, I am a strong proponent of sex-based politics in my own time.

I think many in MH are misogynistic and have weird ideas, mixed in with some sensible ideas.

It's basically a form of a religion made up by two dues, one who victim blamed and the other anti Moses 10 commandments, so I am not surprised his followers tell lies about biology

I guess that depends on what their presenting issues are?

What is the theoretical model you are training in?

I don’t have any training, just lived experience of mental health stuff and the right qualities of compassion, empathy, creating a safe space etc. I don’t work as a therapist or anything qualified like that.

We are there to listen and provide support (like Samaritans) so we’re a safe space to offload however a person is feeling.

That’s why I read that article with interest because I wouldn’t want to be part of the problem but in practice I think maybe I am in a global sense. But for that individual who’s in distress, I’m part of the solution for them in that moment. There’s someone in the world who will listen and be with them where they are.

The article has made me think about the comments from the TW CEO of the Edinburgh Rape crisis centre who said :

" Sexual violence happens to bigoted people too. But if you bring beliefs that are discriminatory, expect to be challenged on your prejudice"

^^

It's like yoga which is part of the Hindu faith I gather, at one point the NHS wanted the taxpayers to fund that.

If people want to practise religious moves and chants, they can under uk law, they shouldn't be doing so at work whilst claiming it is a secular institution at taxpayers expense.

Why are uk taxpayers funding all these religions at school, NHS, civil service etc?

They are wasting money, inducing illness and putting the County back.

If children were learning sensible things and well, we would be able to stay in the G8, instead their nonsense is pushing us out of it fast.

Do you ever challenge any statements a client might make, or is your practice to affirm everything?

"The contributors argue that activist therapists are more concerned with recruiting patients to their cause than with listening to them. This results in an anti-therapeutic process that is not healing, but harmful."

You can see this with Prince Harry.

Psychopaths get off on harming people and it's a great money maker.

https://www.nhs.uk/mental-health/conditions/fabricated-or-induced-illness/overview/

"CSJ is now firmly established within psychotherapy training courses, perhaps having initially entered professional psychotherapy through the ‘Trojan horse’ of diversity, equity and inclusion (DEI) modules."

Just reading through again and this strikes me as being like seminaries. Which is what HR training in high Stonewall/ ESG credit scoring companies along with the public servives seem too. I would also add intersectionality top trumps as being in there also.

Psychologist Jonathan Haidt who wrote an interesting book about the culture of safetyism that has taken hold of university campuses in the U.S ' The Coddling of the American Mind, suggests that:

Therapies informed by CSJ " are form of ‘reverse cognitive behaviour therapy’ (CBT). Haidt also points out that even psychotherapy can be viewed as a microaggression if it challenges a client’s view of the world and so undermines their ‘lived experience’. In fact, CBT has been described by CSJ proponents as ‘epistemic violence’, ‘his master’s tools’ and suggestions made that it be ‘dismantled’.

Do whatever you would do if your client asked to be called "your highness" because he is christ incarnated and you know he truly believes and knows this to his very core.

While I can kind of see what they're getting at, and I've seen something like this set of attitudes permeating the culture of a Reddit forum for (mostly US) psychotherapists that I spent a while reading a year or two back, it's not something that's I've seen actually coming through in the practice of therapists I've seen personally, as a patient.

I couldn't give you a precise number, but I guess I must have seen easily a dozen different people for therapy over the years, more if you count those leading/facilitating group therapy. Some just for a few sessions, some much longer. NHS, private, and through organisations (like college, university, or charities). Psychotherapists, counsellors, clinical psychologists, counselling psychologists, CBT therapists — lots of different titles, lots of different levels of training, lots of different memberships of and affiliations to professional bodies, and lots of different theoretical orientations.

This whole thing of framing everything as groups and binaries and power and oppression, encouraging you to think of yourself as a victim of social hierarchies and the sum of your identities, encouraging you to shift the locus of control entirely outside yourself and into a nebulous conception of "society", just hasn't ever happened within my personal experience.

Having said that, my personal experience is that of a white, middle-class girl/woman with a very obvious serious mental illness, so it's possible that firstly, there's just not much apart from my being female for them to latch on to, and secondly, it's harder to attribute the kinds of difficulties I have solely to oppression. The only thing I've experienced that's vaguely close to what's being described is therapists trying to help me think of my ASD more positively, or reframe past events using my current knowledge of the fact I have that condition.

TBH I think a lot of the conversations about things like sexuality, race, culture, class, sex etc., and how those are relevant in the therapy room, need to continue to happen, because they're relevant in people's lives and to the things they seek therapy about, and issues around these things play out in session as well as needing to be tackled in therapy more generally.

For me as a patient/client, it's fairly easy for me to find a therapist who is likely to have a good general grasp of what it's broadly like to be a white, middle-class, educated woman who lives and grew up in the UK, because most of them fit that description themselves. Nothing I say to them about my family background and family expectations will have to be explained, the ways the world reacts to my basic demographic features will not be something I have to convince them of, I will never have to double-think the things they say to me and wonder if they said them because of bad assumptions they're making about my background or cultural heritage.

I have had some questionable attitudes to my sexual orientation from mental health services more generally, and MH services are no less vulnerable to prejudice towards those with mental illness or neurodevelopmental disorders than other people are, IME, but therapists in particular, I've really not had that much difficulty with.

I prefer it if therapists are aware of ways in which life can be made trickier for people who aren't straight, through no fault of their own. Presumably others feel the same about characteristics they have which result in difficulties that aren't their fault.

It's true that reframing every problem to be a result of societal oppression and entirely outside of a person's control would be unhelpful, but failing to recognise those external structures and social issues would also be unhelpful. Sometimes people already blame themselves for things that are at least partly down to systemic problems, and helping someone to see that their difficulties fit within a bigger context, that they're not just useless but are actually operating in a system that in some ways is rigged against them, can be an important part of working out a realistic way through their difficulties.

This, every time. We detain people to mental health hospitals, because of their delusional beliefs, if they are deemed a risk to themselves or others. People are detained if their self harm is severe enough, we detain people with anorexia, who still believe they are fat when their bmi is under 17. We detain people who believe they are a dog and bite the assessor.

I'm finding it hard to see how this approach to therapy would help people in the long run. I can see how being listened to, with empathy, is an important first step in all therapy, but surely the next steps include something more than just going on with the friendly listening?

At some point false beliefs should surely be gently challenged and catastrophising pointed out as such? Resiliency should be cultivated, the imperfect nature of reality should be made acceptable in the sense that we can still navigate it in ways which make us less unhappy etc?

This is a fascinating discussion on this topic. Amy Gallagher was/is an NHS mental health nurse who is currently suing the NHS for suspending her in the last part of training because she challenged some of the training she received in critical race theory. The discussion goes well beyond her experience and is very thoughtful on the role of psychotherapy-and how the landscape seems to be changing:

That was quite interesting at the start but I'm afraid I lost interest at the extended discussion about god.