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Why Therapy is Political

Usually when we think politics, we think elections or governments. Everyday life is political. Consider this: being left-handed was once seen as problematic, and not so long ago, homosexuality, or loving someone of the same gender, was classified as a mental disorder (even same-sex marriages only became legal in Canada in 2005). These examples demonstrate how our understanding of mental health isn't set in stone and what people think of as 'healthy' or 'sick' can change. It's all shaped by societal attitudes and knowledge that evolve over time.


A sign in a crowd that reads: resist

Fashion trends come and go; similarly, our views on mental health change over time. These shifts in traditions and beliefs are testament to society's ability to redefine 'normality'. The parameters of mental health are not as fixed as we might presume.


Understanding the political nature of therapy is essential in appreciating how mental health services are both influenced by and can influence the broader socio-political landscape. That is, how it shapes our society. This article aims to uncover the political factors that define what is considered therapeutic and, consequently, what is deemed 'mentally healthy.' Together, we will examine how we might want to participate in therapy moving forward.


When Too Many People Struggle, It's Time to Ask Why

Mental health is not a minor problem. With one in five Canadians experiencing a mental health issue annually, it's imperative to ask, "Why is this happening?" The sheer numbers point to a broader societal issue rather than individual pathology. Globally, depression is a leading cause of disability, affecting over 264 million people, indicating a crisis that is communal, not isolated.


Power Dynamics in Society

Our capitalist economic framework, which often prioritizes profit and productivity, has a stronghold on societal norms, including those related to mental health. Power and wealth influence mainstream narratives, potentially marginalizing those who don't align with the 'normal'. Mental health issues can be exacerbated by economic inequalities and the pressures of a system that rewards productivity over personal well-being. Added together with dynamics of racism, ableism, and other forms of discrimination, and what do we get?


In our society, people with more power or money often set the rules for everyone else. This can affect everything, including mental health. If only a few people decide what's 'normal,' many of us might feel left out or 'abnormal' just because we're different.



Therapy Isn't Just About You – It's About Us

So why is therapy inherently political? When in therapy, the goal often involves changing aspects of oneself, but who determines these need changing? Why are we viewed as 'abnormal'? Therapy should not solely focus on 'fixing' individuals but on understanding and validating human experiences within a compassionate framework.


Consider the journey of someone experiencing psychosis as a river shaped by the terrain of biology, personal history, and social environment. The stigma associated with psychosis as divergent experiences of reality often leads to interventions that can feel more like damming a river than understanding its course.


Therapy as a Political Tool

Therapy can aim to 'correct' certain behaviors and mental states deemed abnormal or unproductive, raising the question: abnormal by whose standards? Let’s illustrate this through examples:

Therapies like Conversion Therapy and Applied Behavior Analysis (ABA), both developed by the same psychologist, highlight therapy's potential as a political tool. ABA, often used to 'correct' autistic behaviors, has faced criticism for pushing normalization over respecting neurodiversity. Conversion Therapy on the other hand, a method once believed to correct what was deemed 'undesirable behavior' (i.e., homosexuality) is now illegal to practice in Canada. These therapies underscore a troubling aspect of psychological intervention—the thin line between support and the imposition of conformity.

Mental Health as a Societal Consideration

While therapy is a space for personal healing, it risks missing the mark if it doesn't account for the societal dimensions of an individual's experience, as well as political and social oppression. Ignoring the role of societal pressures, such as economic hardship or discrimination, can lead to an incomplete approach to mental health care.


Like a tree's health judged solely by its leaves, mental well-being is often evaluated without considering the quality of the soil. Socioeconomic disparities, a core feature of capitalist societies, feed into mental health inequities, leaving the marginalized withering.


Therapy as a Commodity and Privilege

As a final point, the privatization of mental health services in Canada reflects a political stance that commodifies well-being, often reinforcing a class divide. It also puts the onus on individuals to take care of their wellbeing, releasing the government or society from any responsibility. In its current state, access to therapy remains a privilege, gated by socioeconomic status (i.e., health benefits or higher incomes). The solution isn't just more free therapy, but consider at this point in time; who is able to and not able to access therapy and other mental health supports?


Navigating Therapy With Awareness

Recognizing the political nature of therapy empowers both therapists and clients to engage more intentionally. Therapists should be aware of potentially reinforcing societal norms, while clients should explore their experiences within the broader context of societal structures.


As therapy participants, recognizing the societal influences on our mental health can empower us. Here are some ways to engage with therapy conscientiously:


1. Critically Evaluate Norms. Question the standards of health and normalcy within therapy. It's okay to ask your therapist questions about their goals or views on therapy.

2. Consider the Whole Picture. Account for how external factors like race, class, and social stressors intersect with personal mental health.

3. Push Back. If you have the privilege and energy to do so, advocate for changes in the mental health system and societal structures.

4. Engage in Dialogue. Share experiences openly and find community for support and advocacy.

5. Find Resources. Understand the political nature of mental health through diverse sources. Listen to voices of people with lived experience. The Mad in America Podcast is a great starting place.

6. Seek Aware Therapists. Choose therapists cognizant of societal influences. Ask questions like: What do you think are the root causes of anxiety and depression for clients?

7. Influence Policy. Communicate the need for accessible mental health services to policymakers.

8. Vote Informed. Support anti-oppressive-friendly policies that advocate for equity in mental health care.

9. Critically Engage with Media. Support inclusive narratives and reflect critically on the information consumed.

10. Advocate in the Workplace. Promote mental health resources and support in your workplace.

11. Share Your Story. Help destigmatize mental health through openness.

12. Reflect on Social Impact. Discuss how social structures affect mental health with peers or in therapy.

13. Choose a Therapist Wisely. Opt for therapists who understand the broader socio-political context.


Concluding Thoughts

Therapy is a vital tool, but it's part of a larger societal picture. It's not merely about individual treatment; it's about recognizing the interplay between personal struggles and broader societal issues. By considering both, we can strive towards a more equitable and holistic approach to mental health.


Therapy cannot be divorced from its political context. The act of therapy, the structures surrounding mental health, and the very definition of what constitutes mental illness are deeply political. As we engage with therapy, either as providers or recipients, acknowledging its political dimensions can lead to a more nuanced understanding and, ultimately, more effective and empathetic mental health care.


Therapy can be a great tool, but it's important to remember it's not just about fixing something that's wrong with you. It's about understanding yourself within a larger world that has its own issues. We can all work to make things better, not only for ourselves but for everyone.



Reflection Activity: Questions to Consider After Reading

1. How has this article shifted your perspective on the role of therapy in society?

2. In what ways do you see mental health as a reflection of societal norms and expectations?

3. What are some historical examples that illustrate the changeability of 'normal' in mental health?

4. How do you think capitalism influences our current understanding of mental health and therapy?

5. Can you identify any personal experiences that may have been pathologized due to societal standards rather than individual well-being?

6. What are your thoughts on therapies that have been used to enforce conformity, like ABA or conversion therapy?

7. How might therapy change if it accounted more for social and economic contexts?

8. Why is it important to recognize therapy as a potential commodity within a capitalist society?

9. What steps can you take to ensure that your engagement with therapy is not reinforcing harmful societal norms?

10. How can understanding the political implications of therapy impact your approach to personal mental health?

11. What strategies can you employ to critically evaluate norms within your therapeutic experience?

12. In what ways can you advocate for more inclusive and accessible mental health care in your community? For yourself?

13. How can educating oneself about the political aspects of mental health contribute to personal and societal well-being?

14. What could be the impact of choosing a therapist who is aware of broader societal factors on your therapy experience?

15. How does recognizing the interplay between personal struggles and societal issues help in striving for a more equitable approach to mental health?



Did you learn something?

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References

• Bentall, R. P. (2003). Madness explained: Psychosis and human nature. Penguin UK.

• Bronfenbrenner, U. (1979). The Ecology of Human Development: Experiments by Nature and Design. Harvard University Press.

• Drescher, J. (2015). Out of DSM: Depathologizing Homosexuality. Behavioral Sciences, 5(4), 565–575.

• Foucault, M. (1965). Madness and civilization: A history of insanity in the age of reason. Random House.

• Littler, J. (2013). Meritocracy as plutocracy: The marketising of 'equality' under neoliberalism. New Formations, 80(80), 52-72.

• Marmot, M. (2004). The status syndrome: How social standing affects our health and longevity. Times Books.

• McNamee, S. J., & Miller, R. K. (2009). The meritocracy myth. Rowman & Littlefield Publishers.

• Mental Health Commission of Canada. (2013). Why mental health in the workplace matters.

• Mirowsky, J., & Ross, C. E. (2003). Social causes of psychological distress. Aldine de Gruyter.

• Moncrieff, J. (2010). The myth of the chemical cure: A critique of psychiatric drug treatment. Palgrave Macmillan.

• Sameroff, A. (2000). Developmental systems and psychopathology. Development and Psychopathology, 12(3), 297–312.

• World Health Organization. (2001). The World Health Report 2001 - Mental Health: New Understanding, New Hope.


Blog Disclaimer: While every effort is made to provide valuable insights to inform and empower you, the author kindly asks readers to use their judgment and consult with professionals for their specific needs, as the author cannot be held responsible for individual interpretations or actions taken. The information provided in this blog is for general informational purposes only and does not constitute medical or legal advice.

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