In the darkness of 2020, the memory that comes up the most was supervising the case of a severely ill young woman who went by the “they/them” pronouns. Understanding the illness and formulating a coherent treatment plan—and, in the process, helping the counselor-in-training to develop clinical thinking—was blocked by the rage of students whose reaction to my referring to this patient as “she” ignored the life-threatening condition staring us in the face.
In those days, I had been working through a theory of my own: What if the transgender wave has underlying clinical similarities to the observations of the 1990s, when young girls were suffering from anorexia and bulimia, whose manifestations sometimes seemed to go in clusters and spread as if by contagion? It was a proper clinical question, not ideological or even conclusive. After all, inquiry and research must start with a question. What other way is there? It rolled around in my mind for a while until it became clear that posing questions of this sort was very, very unwelcome—possibly illegal.
At the time, Abigail Shrier published Irreversible Damage. I admired her investigative acumen and descriptions of her interviews and was particularly impressed by her clinical clarity. A good journalist is a perceptive clinician, I thought. She may not know how to treat the condition, but she surely diagnosed it well, and a good diagnosis is half the effort. An inquiring mind that attempts to read reality objectively is the best tool we have.
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The American Psychological Association (APA) had released its “trans-affirming psychological practice” guidelines in 2015, a 10-year effort that reads like a post-modernist declaration. The self-contradictory definition of “sex assigned at birth” occurs thirty-two times. (Does one also assign skin color? How about height? Eye color? Speed? Athleticism? Intelligence?) The authors admit that “terminology within the health care field and transgender and gender nonconforming (TGNC) communities is constantly evolving,” thus suggesting that a stable point of reference is unwelcome—ironically enough, a postmodernist stable point.
In the ensuing years, the pushback began, e.g., the Cass Report and the exposure of the “pseudoscientific” and experimentally harmful guidelines of the World Professional Association for Transgender Health. Parents became aware, and they spoke up.
The road to recovery is long, but it finally started with President Trump’s Executive Orders that restore biological truth to the federal government, protect minors from chemical and surgical mutilation, and other orders that restore objective reality. This is a most welcome event, not only because it is self-evidently valid, but because it opens wide the gates to a very large problem. For years, as the APA guidelines show, and many journalists have documented case after case, counselors, psychologists, and therapists have been on the wrong side of the clinical situation.
Instead of helping their patients, they “affirmed.”
Students, even before the pandemic, proudly insisted that their job after graduation was to affirm, not to diagnose and treat. The closer the graduation date, the prouder the activism. It is too much to ask today’s clinicians, especially those who entered school and graduated in the last 10-15 years, to think clinically, like some perspicacious journalists have, such as Abigail Shrier. It is too much to ask many clinicians today to put to good use the Socratic method that leads step by step to an increase of knowledge and insight, rather than the predetermined outcome. Schools of psychology, counseling, and social work—due to the progressive nature of the mental health field—are staffed by clinicians who see clinical events through an ideological lens. As is very well known, liberal faculty are far overrepresented in academic institutions. The confluence of cultural-ideological tendencies and academic pedagogy leads to specific problems in preparing new generations of clinicians. The distinction between a life difficulty and a disorder is blurred. The former is invisible; the second is falling out of favor. What is left is the oppressor-oppressed neo-Marxist dialectic. Life’s difficulties are seen through a lens of blaming others, entrenched systemic problems, feeling guilty, and having no way to think through the perceived victimhood.
When Trump’s executive orders reach the schools, universities, and clinics, are we prepared to do our jobs? Some are, perhaps, the whole silent majority. The prepared ones tend to be more conservative, less activist, and significantly more in touch with objective reality. The ones who are not have imbibed at the fountain of postmodernism where truth does not exist, and no rigorous method of thought can ever reach where imagination stops and reality begins. We are not prepared to undo the mistakes made unless we realize that only acknowledging objective reality will get us out of this dismal muddle. Clinical programs must teach again, not produce scores of undereducated ideologues. They must prepare a new generation of proper therapists, counselors, and psychologists who leave out political agendas and preferred points of view and stop promoting helplessness and the infantilization of human abilities. It will be difficult to do so because the teachers themselves are (1) often unprepared, insufficiently experienced, and (2) intimidated by threats to their professional licenses.
There are several structural reasons for this unpreparedness. I want to outline only one. The study of the soul (psyche, psychology) and nature (physis, physics) began hand in hand.
Physics flourished and continued because it never severed itself from the real existence of its object of study. From Aristotle to Thomas Aquinas, the study of the soul refined the conclusion that nothing exists in the intellect that does not begin in the body via the senses, except intellect itself. Thomas defines truth as the alignment of the intellect with reality, beginning with Augustine’s definition of truth as “that which is.” The psyche studies the physis, nature, and its own nature. Starting with Humanism and especially Modernism, the psyche was reduced to matter, and the soul became outdated. The study of the brain and its functions took over the study of what is immaterial in thought. Consequentially, the God vs. science—and scientific method—fallacy took hold, where the second eliminates the existence of the first. But, it is a fallacy, not a contradiction. Being (God) and method—the scientific method of every branch of science—do not face each other on the same conceptual plane. Without a being, is there truth?
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By losing the connection between intellectual capacity and the natural world, psychology fell prey to modernism’s quest for materialism and postmodernism’s negation of natural law. Currently, we are presumably more knowledgeable than ever before, yet we are quite unhappy, all the happiness studies and positive psychology notwithstanding. Achievements and corrections—including the mutilation of bodies and healthy organs—do not lead to happiness. Economists have understood this. Thomas Sowell, in his in-depth comparisons between the expert vision of idealized perfection and the vision of life as it is, accumulated through centuries of human wisdom, has written beautifully and convincingly about this clash of visions. Can psychologists?
The aforementioned silent majority, partnered with schools and departments that value classical education, are best equipped to prepare their students for their post-baccalaureate careers because they are most likely to impart a way of thinking that is most commensurate with real existence. Heeding the phenomenological-metaphysical philosophy of St. John Paul II, emotion and reflection must be balanced. If emotions take control of sober reflection, the emotionalization of consciousness leads to an imbalance that severs the link to the existence of real beings. We, as a profession, are in grave danger of having been severed from the existence of real beings. The verbiage that APA and other organizations of prominence use, e.g., “sex assigned at birth,” seems designed to maintain these severed links, to keep the real and the thought-about disconnected. Students of the helping professions, out of their good intentions, emotionalize reality, further severing the link to sober reflection of being and truth.
To best help our patients, the way forward is not to emotionalize action and decision-making. It is precisely to cool off the emotional burdens, to make emotions useful rather than commanding, founts of internal information rather than beacons of impulsive self-righteous action, forever mired in finger-pointing, guilt inducement, endless second-guessing, and crushed self-confidence—proper clinical thinking, in the small areas of psychotherapy and clinical work, should stay dispassionately untarnished by the blowing of ideological winds.
Image by Alexander Grey on Unsplash
The author is going to solve the problems of Soul and Reality. OK.
But with this:
‘The road to recovery is long, but it finally started with President Trump’s Executive Orders that restore biological truth to the federal government, protect minors from chemical and surgical mutilation, and other orders that restore objective reality.’
The mad President’s executive orders are going to do this? This is terrifying!