When Ideology Captures Therapists

“You and your people sterilized me and your saying I’m abusive because I’m upset about it.”

Something is very wrong in the therapy world at the moment and real people are being damaged as a result. 

I listen to the voices and stories of detransitioners often. It is not easy listening, but doing so feels like an imperative and a duty as a professional in this field. As a therapist I can’t help but wonder what is going on? How is this happening? My thoughts circulate around and around this topic. I have personally been distanced and estranged from professional bodies and colleagues/friends because of this. It makes my stomach turn when I see colleagues put pronouns in their bios.

Over the years I’ve watched as ideology has crept into the psychotherapeutic space. When I did my training we were trained to NEVER impose our views or politics onto the patient. We were there simply to help them make sense of who they were. We weren’t there to convert them, to make them see the light or to steer them away from their beliefs towards ours. We were there to try to understand them and help them make sense of themselves. We were there to help reduce suffering and we were also trained to intervene if we felt that our patients were at risk of harming themselves. “First do no harm.”

Nowadays it is normal practice to set your patient up to be a medical patient for life, to get them on hormones, destroy their fertility and advise them to make life altering decisions before their prefrontal cortex has fully developed.

Things have changed. Nowadays it is normal for therapists to see their patients as mere avatars in a political worldview, sorting them out by race, gender, privilege and making all sorts of assumptions about them before they’ve even met them. Nowadays it is normal practice to set your patient up to be a medical patient for life, to get them on hormones, destroy their fertility and advise them to make life altering decisions before their prefrontal cortex has fully developed.

So-called “Gender Affirmative Therapy”, the therapy du jour, is based on an ideology, which stems from the halls of academic progressive feminism-Queer Theory: “You contain a gender identity non-related to your biological sex and it is what you feel it is”. However you feel about this essential question, its merits or its weaknesses, it is a belief system. As therapists we are supposed to be curious about someone’s belief system and how they came to have it, not base our therapeutic approach on it.

In the worst cases, you are perpetrating a serious crime against humanity and allowing patients to ruin their lives forever.

The obvious danger of this in a helping profession is that you end up ignoring the needs and reality of the vulnerable people that come to you. You are indoctrinating instead of facilitating. You are a preacher, a cult leader, an influencer, but not a therapist. In the worst cases, you are perpetrating a serious crime against humanity and allowing patients to ruin their lives forever.

This is why we need to listen to detransitioners. They are showing us what happens when therapy becomes ideology. “I was affirmed too quickly in my gender identity and I was put on a path towards medical transition without proper safe guarding.” This is because the therapy had a fixed idea of why you were experiencing the difficulty to begin with and offered you a bogus solution. Ideology says, “you are depressed because you haven’t transitioned.” Therapy says (or should say) “Let’s find out why you are depressed.”

I believe that within this ideology are truly bad actors-These are psychopathic people who don’t care about the collateral damage. Far too few people know about Cluster B personality disorders until it’s too late. These people are invested in advancing their ideological agenda, or career, and see any counter evidence as merely obstacles to the ends they are trying to achieve. They want to bend reality to suit them.  They hate detransitioners because they go against the certainty of their ideology; they stand in the way of success.

It is also true that some therapists are true believers-like in a religion or a cult, they see themselves not so much as therapists I believe, but more as missionaries seeking to convert and free their subjects from pain. Many of these people also have serious personality disorders with little capacity for insight.

There are also the scared therapists. They know something is amiss, but they fear being ostracized, rejected or criticized. We can’t underestimate how powerful that fear is and how it can lead to a therapist unconsciously colluding with their patient just to avoid the messiness of reality. 

There are also the incompetent therapists. The therapists that aren’t that bright and are perhaps well-meaning but haven’t actually read any scientific papers, done any personal research or had any seriously adequate training.

Wounded and Wounding Healers

It is not surprising though that the field of therapy is vulnerable to group think, ideological capture and harmful practice in the name of “treatment”. The therapy field is unique in that therapists often come from difficult lives and find a calling in being able to help or heal others as a result.  A wounded healer is someone who has found a way, through their own therapy, to understand and work through their own wounding so that they can appropriately guide someone else, aware of themselves and how to prevent imposing their needs on someone else. They know the complexity involved in working with another human being.

A wounding healer on the other hand has not fully worked on their own patterns, dynamics and injuries sufficiently and therefore is vulnerable to projecting their own needs onto the patient they are working with.

In the case of ideology driven therapy, the therapist may bring infantile needs to the therapy-patient relationship. These needs might include:

The need to play God-to feel powerful in offering a solution to the pain of their patient, rather than be able to explore and expand the capacity for discomfort. 

The need to avoid conflict by colluding with the patient in order to avoid upsetting them.

The need for approval from trainings, supervisors and other professionals meaning that they practice the ideology instead of doing the hard work of therapy.

The need to feel safe from feelings of uselessness or worthlessness

The need to feel comfort away from difficult complex emotions

The need to feel certain of the problem to avoid the anxiety of “not knowing” i.e. Yes, your problems will get better when you transition. (Actually a good therapist would be honest that this might not be the case, we can never be 100% sure about a treatment from the start)

These people can be quite dangerous as we are seeing. They don’t realize what they are doing and by doing so, they sacrifice reality and the true needs of their patients to be really understood.

This is a dangerous problem and I fear that we are just scratching the surface of it.

Have you had an experience of working with a helper who may have some of the se dynamics?

In what ways were you confused, hurt or disempowered?

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