Most people I know are in therapy, or have been at some point. For mad, disabled, and queer/trans people (who experience a disproportionate burden of mental health challenges due to the discrimination, violence, and other challenges we often face in society), therapy is one of two interventions alongside psychiatric medication that the United States medical system offers for people dealing with distress, pain, and trauma. Because of this, therapy – and the language of therapy – has become deeply linked to how many people make sense of their distress, pain, and trauma and in turn how they navigate the world ethically.

I am writing this position statement in opposition to what I would describe as a hostile takeover of ethics, morality, and justice by the professional disciplines of Western psychology, therapy, and social work. Here, I will argue four reasons why developing our sense of ethics, morality, and justice in the therapeutic setting is harming people, particularly marginalized communities. These reasons are by no means comprehensive. First, Western psychology, therapy, and social work are deeply intertwined with capitalism and with systems of oppression, and their ideologies continue to reflect that. Second, these fields are highly individualistic in their approaches and are often concerned with individual emotional validation rather than interpersonal, communal, or societal truth-telling, healing, and transformation. Third, Western psychology and therapy consistently elevate particular ways of knowing and being that reflect narrow philosophical and spiritual traditions and whose evidence base is weak behind a three to twelve month follow-up. And fourth, these fields have become notorious for extracting the knowledge, traditions, and experiences of marginalized people, watering down those beliefs, and then repackaging them to marginalized people for a profit and in ways that uphold these disciplines and practices.

In a society of weak mental health care options, therapy can be an essential tool for many people, and in some cases it is life-saving and improves quality of life. I personally benefited from therapy at many points in my healing process. I am not questioning the benefits of therapy and psychology for individuals. Where I have considerable concerns, however, are with (a) the belief that psychology, therapy, and social work hold the answers at a community and societal level and (b) the unconscious (and conscious) proliferation of psychiatric paradigms, language, and values into conversations, spaces, and communities concerned with ethics, morality, and justice.

To go into four brief reasons, first, psychology, therapy, and social work cannot be disentangled from capitalism because the entire psychiatric knowledge production system is based on what clients will pay for and to a lesser extent what governments and social services will fund. In particular, Western psychology, therapy, and social work were not designed for marginalized people; they were designed for people with the resources to pay a professional to ease their distress. Therapy as a discipline is primarily concerned with managing the distress of (historically more privileged) people.

One of the impacts of this is that psychology, therapy, and social work are often not primarily concerned with truth-telling but rather validating what an individual feels to reduce their distress. While this can be valuable for individuals, the majority of problems in society arise from the fact that (a) people do not always agree, (b) people have conflicting versions of events, and (c) some people do not tell the truth or the full truth. Therapy is designed to be a safe space, not necessarily an honest one.

As I have progressed further through therapy and different modalities, including with therapists who have “anti-oppressive” lenses, I have been continuously impressed with how narrow the idea of a “healed person” is in therapy. The healed person is well-regulated, is perpetually aware, has all sorts of boundaries, and is constantly intentional. In my opinion, this is an extraordinarily narrow view of how humans can and should be, and the idea that this is the “right” way to be for the sake of an ethical or just society is simply not evidence-based. This is rather a way to be to minimize individual feelings of distress. But alleviating individual feelings of distress is not necessarily the goal of a just society, particularly for people with some level of social or other privilege. It is also questionable whether this is an effective way to exist in a globalized world where one can rarely be intentional about everything, rarely be aware of all of one’s impacts and everything that is occurring in the world, and where the desire to regulate often means withdrawing.

Finally, psychology, therapy, and social work are often conscious of social justice topics, but in a cursory way that can do more harm than good for marginalized people. So often, I have seen professionals adopt highly simplistic views, such as that people with more privileged identities are inherently not trustworthy or good and less privileged people are inherently honest, good, and to be believed. However, this binary is practically useless to marginalized people who spend the vast majority of our lives interacting with other marginalized people, or people who hold both privileged and marginalized identities. Furthermore, learning about ethics, morality, and justice from a psychiatric professional who is repackaging community perspectives just makes very little sense. Why not go to the unedited material?

The answer to this sadly is that there is limited support at a community and structural level for community-based mental health services. While there are many healers doing their best to make things happen without this support, the reality is that most people will continue to rely on Western psychology, therapy, and social work in times of distress and crisis when they need it. In difficult moments, most people don’t have the opportunity to seek out loads of options. They take what is available and accessible to them. For now, that’s typically psychology/therapy. While well-conceived out-of-the-system services have accountability mechanisms, many don’t and instead represent individual healers operating in an independent and rogue way that offers people using these services less security.

I’m not against therapy.

Therapy and psychology can ease distress, regulate the nervous system, and teach new skills to navigate life in a healthier way. They are not however going to teach us how to be good people. Or rather, they are trying to teach us how to be good people. That is the problem.

Note: While this statement is born of my lived experiences, these critiques are by no means my own and reflect widespread critiques voiced in mad studies, critical disability studies, and disability justice scholarship.