Last month, we published an op-ed in the Wall Street Journal detailing extensive activism in the American Psychological Association (APA). While serious allegations of anti-Semitism have caught the attention of the federal government and threatened the APA’s accreditation authority, we argued that this was merely a symptom of a much deeper and more urgent problem. Large parts of organized psychology now seem more interested in advancing left-wing political causes than helping patients.
As evidence, we discussed the annual conference of the APA’s Division 39, the Society for Psychoanalysis and Psychoanalytic Psychology. Of its 90 panels, we counted roughly 70 with a political focus. All talks were left-leaning, while other political perspectives were totally absent. Topics included “family abolition,” “queer anarchist psychoanalysis,” and dismantling oppressive institutions. One session on drag and queer theory concluded with a drag performance. If you had randomly stumbled into this conference, you could easily assume it was a radical political convention instead of a professional gathering of credentialed therapists.
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Less than a week later, Division 39 President Dana Charatan responded in a letter to the Journal. Unfortunately, she ignored every substantive issue we raised. Instead, she accused us of making “biased assumptions about what belongs in psychological scholarship” and defended the conference’s overtly political focus by arguing that “patients are affected by systems in which they live” and that therapists must therefore “attend to power dynamics within and beyond the consulting room.”
We never denied that people’s circumstances can affect their mental health. Poverty, discrimination, abusive relationships, and even dysfunctional institutions can certainly contribute to psychological distress. In fact, our op-ed clearly stated that psychologists shouldn’t avoid “discussions of racism, sexuality, politics or social institutions.”
But recognizing that the outside world affects people’s mental health is not the same as making activist causes the primary goal of psychotherapy. Charatan appears to see little distinction between the two, which gets to the heart of our criticism.
There’s a deeper problem: much of Charatan’s rhetoric draws on the fashionable yet false notion that people are simple products of their environments. She and others in her field attribute distress to “oppressive systems,” “minority stress,” or various types of accumulated trauma. Biology, personality, and individual agency are often ignored completely.
While environmental factors can certainly matter, treating them as the default explanation for practically every problem can lead people to disregard solutions rooted in things they might actually be able to change. Indeed, if a therapist assumes a patient’s anxiety, depression, or relationship problems are a product of some form of social injustice, asking that person to change anything about themselves can look like blaming the victim. Why should patients have to alter their behavior or thought patterns when the real culprit is capitalism, patriarchy, or some other all-encompassing system of oppression?
This “oppressive systems” approach shifts the focus of therapy away from the individual and toward society itself. The role of the therapist is no longer to help someone navigate life’s difficulties but to become—and even encourage their patients to become—activists fixated on dismantling the political and social structures that are supposedly causing so much psychological harm.
These approaches could easily damage patients. For one, patients may feel that they can’t recover until a political revolution arrives. In the meantime, they’re likely to feel powerless, with no control over their mental health.
Moreover, patients who disagree with their therapist’s progressive politics may feel attacked, self-censor in sessions, or drop out of treatment. Conflict with therapists and collapsing trust in the field could stay with patients for years—leading to consequences up to and including suicide.
What makes Charatan’s response especially frustrating is how completely it ignored the specific examples we raised. We would genuinely like to know, for instance, what clinical skills therapists were expected to gain from a session titled “Feel the F—king Fantasy (Redux): Drag, Desire, and Queer Theory at WERK in Psychoanalysis,” which concluded with a drag performance where attendees were encouraged to tip drag queens like strippers. Why was this considered appropriate for a professional psychology conference? What practical lessons from this presentation could therapists possibly apply during a session to help their patients? These seem like reasonable questions to ask.
Everyone is allowed to have political opinions, including psychologists. But it’s especially important for psychologists to separate those opinions from their professional responsibilities. When the leaders of psychology’s most important organizations can’t recognize this basic distinction, it’s hard to see how things can ever improve.