Critical and community psychology scholarship has foregrounded the relationship between psychology and power (Hook et al., 2004). Viewing power as ubiquitous in the psy-disciplines, these critical perspectives have critiqued claims made about what is positioned as natural, universal, and healthy, highlighting the situatedness of these ideas. Such claims represent a cultural minority or a singular lens that curtails the breadth and depth of human experiences in oppressive ways (Albee, 1996; Prilleltensky, 2008). Moreover, the psy-disciplines not only institutionally take up a role as arbiter of human truths but produce knowledge embedded in cultural ideologies and structural power dynamics. Therefore, psychological practices have vested interest in promoting neoliberal and neocolonial subjectivity, to function as architects of a status quo (Thrift & Sugarman, 2019; Sugarman, 2015; Bhatia & Priya, 2018).
A critical view of psychotherapy recognizes that clinical practice is not context-independent nor value-neutral. Indeed, psychotherapy functions as a site in which epistemological violence can be enacted when individuals’ experiences are problematized in the face of equally viable alternative interpretations (Teo, 2010). Theory and philosophy are alive within the clinical encounter as tools to conceptualize and respond to clients’ distress. Just as psychotherapy can become an instrument for oppression, it also carries the power to trouble unjust social conditions through cultivating a relational frame that supports rethinking oppressive conditions. However, mainstream views of psychotherapy and the mechanisms by which it is viewed “to work” are rarely highlighting its sociopolitical function. Often, successful outcomes are determined by measures of symptom reduction or eradication, and psychotherapy is positioned as a curative treatment akin to a biomedical approach.
In 2020, I presented as part of the Clinical-Counseling Significant Interest Group of STPP at the midwinter meeting in San Diego and the APA virtual convention and STPP hospitality suite. Dennis Wendt led this important initiative in which we, a group of scholars and practitioners, applied critical theory and philosophy to reflect upon the 2019 APA professional practice guidelines. Together, we revisited the importance of epistemological diversity in the development of such guidelines. Although there were certainly commendable components of these revisions, we found ourselves coming up against an overall impoverished theory about what psychotherapy could be, how it works, and what constitutes the “best available research” to guide clinical practice.
I could not help but notice the ways that the APA guidelines obscured clients’ expertise and cultural context, reserving language of evidence and expertise to refer to therapists, researchers, and psy-professionals. Quantitative methods and randomized controlled trials (RCTs) were centered as the best available evidence, despite stated efforts to move toward valuing qualitative methods which center lived experience and other ways-of-knowing. Clients’ perspectives and contributions to the psychotherapy process were considered “preferences” and culture was depicted as an additive dimension through which treatment-as-usual could be tailored.
Engaging in these critical critiques with STPP colleagues, writing for Mad in Americaopens in new window, and witnessing what seemed to be the psychologization of everyday life at my training sites prompted me to consider how psychotherapy could promote wellness and liberation. For my dissertation, I employed critical-constructivist grounded theory methods (Levitt, 2021) and interviewed 14 eminent therapists who specialized in Humanistic-Existential (HE) and Feminist-Multicultural (FM) theoretical orientations or both. All but one of the participants consented to reveal their identity. I asked these eminent therapists specific questions about navigating the intersection of expert and cultural power dynamics in psychotherapy, based upon their theoretical orientation(s).
Therapist participants spoke of the ways that they confronted suppression within mainstream psychology, viewing their approaches as representing a paradigmatic shift and a fundamental divergence from ideologies of medical neoliberal capitalism, hedonism, and neocolonialism. Moreover, they described how their theoretical approach could translate into a decolonial practice that positions clients’ lived experience as informing self, other, and community liberation. For instance, FM therapist participants—including, but not limited to, Beverly Greene, Laura Brown, Judith Jordan, and Maureen Walker—underscored that psychotherapy ought to be a fundamentally decolonial process involving critical inquiry.
HE therapists—including Arthur Bohart, Leslie Greenberg, Jeanne Watson, Nathaniel Granger, and Kirk Schneider—emphasized that the client is the expert of their own experience and needs, and therefore, the client makes therapy work. Given this, eminent therapists did not seek to exert expertise over the content of the session, including regarding what the client should do, but rather, allied, or accompanied them, by facilitating clients’ reconnection with and exploration of lived experience. Simply put, these therapists, including those participants who identified as both as HE and FM (e.g., Theopia Jackson, Lillian Comas-Díaz, Melba Vasquez, and Louis Hoffman), detailed specific in-session practices supported by theoretical and philosophical positions to proclaim that empowerment was the goal of psychotherapy.
From these findings, I developed a Liberation Psychotherapy (Morrill, 2021) based in the merging of HE and FM theory. I put forward this modelopens in new window alongside existing proposals by Lillian Comas-Díaz (2020), Janis Bohan (2007), Glenda Russell (2007), and other scholars who have explored liberatory aims in clinical practice from myriad perspectives. Liberation psychologies, derived out of indigenous and Latinx community psychology, served as a bridge for HE and FM perspectives that clarified their liberatory aims and also served to buffer against the tendency for these theories to be depoliticized and misappropriated (Rutherford et al., 2010).
Derived out of the work of Ignacio Martin-Baró (1994; Comas-Díaz & Rivera, 2020), liberation psychology was cited by interviewees who referenced critical consciousness, lived experience/testimonials, and psychosocial accompaniment. By centralizing examination of power, privilege, and oppression, a liberation psychotherapy can connect intrapsychic and sociopolitical phenomena. One major theme from the data included the participants’ emphasis that in order for training therapists to learn responsible usage of power in psychotherapy, they needed to receive rich experiential and philosophical training (Morrill, manuscript in preparation).
The Liberation Psychotherapy model developed from these data harnesses theory to articulate how power dynamics can be responsibly navigated within psychotherapy. Salient themes that constituted this model included: (a) power in clients’ lived experiences; (b) interdependence and the power of relationship; (c) that expert power and cultural power dynamics are intersecting; (d) a critical-ecological framework; and (e) liberatory outcomes. It is important to recognize that psychotherapy has traditionally been ill-equipped to attend to the sociopolitical embeddedness of distress in individuals’ lives. Material and structural change cannot be directly attended to in the clinical encounter and therefore, psychotherapy risks misplacing disorder as residing exclusively within the individual.
Many people do utilize psychotherapy services. It is then worth considering how psychotherapy may promote wellness and liberation by subverting oppressive power dynamics rather than recapitulating them. Relationships can offer a place to explore and attend to, rather than “fix” distress. In this instance, concepts, such as those within liberation psychologies, can be powerful. Indeed, Ignacio Martin-Baro was assassinated for the ways in which he took a stand for the human rights and dignity. There is an opportunity to apply critical and community theory in order to address individual pain and social change as an interconnected, mutually informing processes. Liberation Psychotherapy presents a model that may challenge psychotherapy as an instrument that functions to adjust individuals to an unjust social order.
Finally, this Liberation Psychotherapy was defined by a critical-experiential epistemology. Within this model, lived experience is considered a veritable way-of-knowing in the psychotherapy space. Because experiences are relational and always informed by context, phenomenological exploration of clients’ sources of pain or constraints to thriving were seen to complement a consciousness-raising process that also remains rooted in clients’ worldviews and beliefs rather than imposed through an unequal power differential. However, clients’ lived experience and creative capacity for healing was sourced from their relational, communal, and other contextual ties. Thus, Liberation Psychotherapy supports clients’ healing by facilitating a process in which people come to reflect upon their system for understanding the world and the contextual factors that influence them, a process with the power to inform personal as well as collective liberation.
References
Albee, G. W. (1996). Revolutions and counterrevolutions in prevention. American Psychologist, 51(11), 1130–1133. https://dx.doi.org/10.1037/0003-066X.51.11.1130opens in new window
American Psychological Association (2019). Professional practice guidelines for the implementation of evidence-based psychological practice (Draft). American Psychological Association.
Bhatia, S., & Priya, K. R. (2018). Decolonizing culture: Euro-American psychology and the shaping of neoliberal selves in India. Theory & Psychology, 28(5), 645–668. https://doi.org/10.1177/0959354318791315opens in new window
Comas-Díaz, L. (2020). Liberation psychotherapy. In L. E. Comas-Díaz & T. Rivera (Eds.), Liberation psychology: Theory, method, practice, and social justice (pp. 169–186). American Psychological Association.
Comas-Díaz, L. E., & Rivera, T. (Eds.) (2020). Liberation psychology: Theory, method, practice, and social justice. American Psychological Association.
Hook, D., Collins, A., Mkhize, N., Kiguwa, P., Parker, I., & Burman, E. (2004). Critical psychology. Juta and Company Ltd.
Levitt, H. M. (2021). Essentials of critical-constructivist grounded theory research. American Psychological Association.
Morrill, Z. (2021). Power dynamics in psychotherapy: Eminent therapists’ experiences navigating power from Humanistic-Existential and Feminist-Multicultural perspectives (Publication No. 28645574) [Doctoral dissertation, University of Massachusetts Boston]. Proquest Dissertations Publishing.
Prilleltensky, I. (2008). The role of power in wellness, oppression, and liberation: The promise of psychopolitical validity. Journal of Community Psychology, 36(2), 116–136. https://doi.org/10.1002/jcop.20225opens in new window
Russell, G. M., & Bohan, J. S. (2007). Liberating psychotherapy: Liberation psychology and psychotherapy with LGBT clients. Journal of Gay & Lesbian Psychotherapy, 11(3-4), 59–75. https://doi.org/10.1300/J236v11n03_04opens in new window
Rutherford, A., Vaughn-Blount, K., & Ball, L. C. (2010). Responsible opposition, disruptive voices: Science, social change, and the history of feminist psychology. Psychology of Women Quarterly, 34(4), 460–473. https://doi.org/10.1111/j.1471-6402.2010.01596.xopens in new window
Sugarman, J. (2015). Neoliberalism and psychological ethics. Journal of Theoretical and Philosophical Psychology, 35(2), 103–116. https://doi.org/10.1037/a0038960opens in new window
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Thrift, E., & Sugarman, J. (2019). What is social justice? Implications for psychology. Journal of Theoretical and Philosophical Psychology, 39(1), 1–17. https://doi.org/10.1037/teo0000097opens in new window
Zenobia Morrill, PhD, is a postdoctoral fellow at Yale University. Morrill’s research interests include critical and liberation psychology, psychotherapy, qualitative methods, and decolonial approaches. Zenobia serves on the board of the Society for Qualitative Inquiry in Psychology (SQIP), the Society for Theoretical and Philosophical Psychology (STTP), and, previously, the Society for Humanistic Psychology (SHP). She also was a Research Officer for the United Nations special rapporteur on the right to health. Since 2017, she has been a Science News Writer for Mad in America, a mental health webzine.