Our Clinical Therapeutic Modalities Are Oppressive

Unless modalities start out with anti-oppression, then they are likely oppressive.

Source: Used with permission from Anti-Racism Space

The history of Western science is racist, ableist, homophobic, and transphobic. Blumenbach’s racial categories were racist and biased, favoring white skulls as the intelligent, beautiful ones. We can also look at eugenics, which marginalized and continues to impact Black, Indigenous, Disabled, and more peoples (Turiel, 2020), all based on "science."

Psychology is a newer area of study and its origin is ridden with oppressive theories. We can point to the formerly used diagnosis of “drapetomania,” a term used to describe an enslaved person attempting to escape forced labor plantations. Still today, psychiatrists and psychology are predominantly white professions (Lin et al, 2018). And while APA is reckoning with his racist past (Warner, 2021), I would argue, it is more than a past. In actuality, it is a capitalistic, patriarchal, white supremacist foundation.

Many clinicians recognize the dangerous history of the DSM and acknowledge both the benefits and the harms of strict diagnostic criteria. However, just because a clinician does not strictly attach diagnosis labels to people in their approach does not mean they are anti-oppressive and inclusive of all identities. If our theories are derived mostly from white, male, cis-hetero people who did not apply anti-oppressive strategies to their work, then our practice is filled with oppression, too.

The structures, systems, powers, and even spirituality remain white in our society. Our textbooks contain whitewashed, Eurocentric versions of our history. The truth is not to be told in our education system, which therefore impacts our science (Lies My Teacher Told Me). The way in which we understand the United States is through a white lens. So, we have to look at our common practices in every institution. And, in every area of study.

Decolonization is the intelligent, calculated and active resistance to the forces of colonialism that perpetuate the subjugation and/or exploitation of our minds, bodies and lands and it is the ultimate purpose of overturning the colonial structure and realizing Indigenous liberation. —Wilson and Yellow Bird (2005)

For clinicians, we not only have to do anti-racist work but also look at the therapeutic techniques we employ. Any modalities that were created and that we use today are white frameworks unless they actively use anti-racist language and guard against the oppression of varying groups. In order for you and your work with clients (white clients, too) to be anti-racist, you have to work to decolonize the modality.

If a researcher creates a modality, and the researcher is not actively anti-oppressive in practice, then because of our dominant oppressive culture, the modality is therefore not anti-oppressive and will and can do harm to those of color, queer, trans, Islamic, Disabled people, etc.

Cognitive-behavioral therapy, various play therapy techniques, EMDR, and dialectical behavior therapy are not grounded in anti-racist and anti-oppressive frameworks. Many therapists of color attend workshops to learn these modalities and come out harmed from the space, the technique, the teachings. We have to learn anti-oppressive strategies, then utilize the therapeutic techniques while being clear to patients that we may cause harm, and be prepared to reckon with our missteps that derive from white patriarchal dominant theories.

Reckoning with our history is one thing, but acknowledging and dismantling the racism in our modalities is another. We have a long way to go.