Decolonizing Therapy: Power, Meaning, and the Myth of Clinical Neutrality

By Dr. Patty Gently on January 26, 2025

Ellis Island

Bright Insight Support Network founder and president Dr. Patricia Gently supports gifted and twice-exceptional adults in their own autopsychotherapy through identity exploration, structured reflection, and alignment with inner values. A writer, educator, and 2e adult, Dr. Patty centers depth, integrity, and complexity in all aspects of her work.

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Modern psychotherapy often presents itself as neutral, benevolent, and scientific. It treats distress as an individual flaw, legible through diagnostic categories and correctable through expert intervention. That neutrality is persuasive, and it is also historically inaccurate. Psychotherapy did not emerge in a vacuum. It developed inside colonial, eugenic, and institutional systems built to classify, regulate, and normalize human behavior. Those origins still shape the therapist–client relationship through implicit hierarchies of authority, meaning-making, and legitimacy. As such, decolonization does not belong only in politics or education. It belongs in the therapy room.

When I talk about decolonizing therapy, I am not talking about swapping Western models for non-Western ones. I am talking about dismantling the assumption that any single system should hold supremacy over human meaning. That requires confronting the therapist–client hierarchy as a power structure, not just a technical arrangement.

This is not, at its core, a question of technique or modality. It is a question of authorship. Who gets to decide what a person’s experience means? That question is not small.

Colonial Logic as Clinical Form

Colonial systems organized the world through binary roles: knower and known, civilized and primitive, rational and emotional, expert and subject. Psychiatry inherited this logic. The clinician observes, names, and corrects. The patient is observed, classified, and treated. Even when care is compassionate, the structure remains asymmetrical. This hierarchy is reinforced in academia; another colonized, patriarchal space where authority is mistaken for objectivity. Within this system, the therapist is positioned as a neutral judge and jury, rather than as a participant in a relational process of meaning-making.

And historically, diagnostic categories tracked social power. “Hysteria” pathologized women’s resistance to constraint. “Drapetomania” framed enslaved people’s desire for freedom as illness. Schizophrenia became racialized as Black men began to be diagnosed in disproportionate numbers during the civil rights era. Though not always placed with malice, these were not scientific errors. They were political translations of threat into pathology.

That same pattern continues in contemporary form. Autistic and AuDHD people, especially women and people of color, are routinely misdiagnosed as bipolar, borderline, or psychotic when what is actually being observed is sensory overload, nonlinear cognition, trauma history, or emotional intensity. Neurodivergent regulation strategies are read as mood instability. Moral distress is read as disorder. Context is stripped away and replaced with a label that makes the person legible to the system rather than to themselves.

What is often an ecologically appropriate stress response or a form of positive maladjustment is cast as pathology. When people push back against this translation, that resistance itself is labeled evidence of deeper instability and illness.

What gets called “objectivity” has always carried hidden judgments about what kinds of behavior were tolerable, whose distress was legitimate, and whose coherence counted as rational. Therapy became a translation device that converted social and relational injury into individual disorder.

This logic persists in subtler forms—blatant to some.

The therapist is trained to interpret.

The client is trained to comply.

Meaning flows upward.

Authority flows downward.

The Therapist–Client Hierarchy as Epistemic Structure

The standard clinical relationship rests on three assumptions:

1. The therapist knows how to interpret experience.

2. The client’s account is distorted by symptoms.

3. Correct understanding produces improvement.

This creates a hierarchy of credibility, where the power to define meaning reinforces professional authority. The therapist’s conceptual framework is treated as primary. The client’s lived coherence is filtered through diagnostic and theoretical lenses. Even collaborative models often preserve the therapist’s interpretive veto power. This arrangement reproduces colonial epistemology: interpreter over native, map over territory, theory over life.

Epistemic injustice occurs when people are not treated as credible narrators of their own experience. In therapy, this happens when distress is re-coded into categories that remove its social, political, and relational intelligibility. A person is no longer responding to a world. They are expressing a disorder.

From this position, “insight” becomes agreement with the therapist’s frame. “Resistance” becomes refusal of translation. Healing becomes compliance with externally authored meaning. And a lack of movement gets placed on the client as the failed party, since, after all, they were flawed to begin with.

Political Neutrality as Myth

It is also important for me to assert here that therapy is not politically neutral. It operates inside legal systems, insurance structures, diagnostic regimes, and professional hierarchies. These institutions reflect dominant values about productivity, emotional regulation, family structure, and what counts as acceptable difference. They also reward silence and emotional neutrality when suffering falls outside what clinicians have been trained to recognize. The “blank slate” is treated as professional virtue even when it functions as distance from realities that do not resemble the therapist’s own.

When therapy locates suffering solely inside the individual, it participates in depoliticization. Structural violence becomes private dysfunction. Racism becomes anxiety. Exploitation becomes depression. Gaslighting becomes a cognitive distortion. Context disappears. And experiences that do not fit what was modeled in graduate school or dominant culture are dismissed as overreaction, cognitive distortion, or irrational belief. What is being protected in those moments is not the client. It is the framework.

This alignment does not require malicious intent. It requires only that therapy maintain loyalty to a medicalized worldview that prioritizes manageability over meaning and stability over truth. Neutrality, in this sense, becomes a political position: one that preserves existing norms while misrecognizing their effects.

A decolonized therapy does not abandon rigor. It refuses innocence. It recognizes that interpretation is never neutral, that silence is never empty, and that whose suffering is taken seriously is always shaped by power.

Language as a Tool of Colonization

Diagnostic language functions as a border patrol for experience. It decides what counts as real, what counts as rational, and what requires correction.

“Maladaptive.” “Irrational.” “Disordered.”

These terms imply deviation from a presumed norm. That norm is barely named, though it is implicitly Western, individualist, productivity-oriented, emotionally restrained, and cognitively linear. It reflects a particular way of surviving and organizing life and then universalizes itself as health.

In contrast, many experiences labeled pathological are intelligible adaptations. Hypervigilance can be understood as safety intelligence, dissociation as a containment strategy, emotional intensity as moral attunement, and nonlinear cognition as pattern detection. There is wisdom in these adjustments. They arise from real conditions and real histories. They solve real problems. However, when therapy insists on “symptom reduction” without relational or historical analysis, it performs symbolic erasure. Political injury is translated into a supposed chemical imbalance, relational betrayal becomes faulty perception, and developmental struggle becomes dysfunction. What was once a meaningful adaptation is reframed as error.

Language does not merely describe this shift; it enforces it. Diagnostic tools and DSM codes become instruments of authority, deciding which meanings are legitimate and which must be corrected. In this way, clinical language does not just name distress; it organizes power. I learned this the hard way, when being able to “get it right” with a diagnosis felt like competence and clarity. What it also did was center the framework and my ego over the person.

Decolonizing therapy requires treating language as an ethical act rather than a neutral tool, and treating meaning as something negotiated with the person who lives it rather than imposed from outside their experience. We need language that communicates and co-creates understanding, rather than language that enforces status, compliance, or control.

Relational Epistemology of Co-Constructed Meaning

Relational epistemology holds that knowledge is generated through relationship, not delivered from above. Meaning emerges through dialogue, not diagnosis. Understanding is negotiated, not imposed. This is why real change in therapy rarely follows a straight line. A session can feel stuck until a single moment of real attunement shifts the whole emotional field. What changes is not a symptom in isolation—it’s the organization of the whole system.

Seen this way, therapeutic change is relational and autopoetically self-organizing, where small shifts in safety or meaning can reorganize an inner world. This is why many hyperneuroplastic and neurodivergent clients do not benefit from more explanation layered onto their experience. They benefit from environments that support self-directed value reconstruction under conditions of safety and coherence. From this view, autopsychotherapy is a stance within therapy: an orientation toward accompaniment and self-authored growth rather than linear correction.

In a decolonized therapeutic relationship, the client remains the primary authority on meaning. The therapist is accountable for interpretive power. Theory is disclosed rather than silently applied. Interpretation requires consent. Disagreement is not pathology. And so importantly, this process relocates expertise. The therapist becomes a skilled companion in inquiry rather than an arbiter of truth.

Therapy becomes a space of shared sense-making rather than corrective translation.

Dąbrowskian Dynamism and the Misreading of Distress

Dąbrowski’s Theory of Positive Disintegration offers a direct challenge to colonial pathologizing. Dynamisms describe inner forces that drive development through conflict, valuation, and reorganization. Suffering, through a Dąbrowskian lens, is often a signal of moral and existential differentiation rather than merely a symptom. From this perspective, anxiety can reflect heightened ethical awareness, depression can signal value incongruence, inner conflict can indicate developmental movement, and emotional intensity can be fuel for restructuring.

Colonial therapy reads distress as dysfunction. A dynamistic view reads distress as movement. One asks how to eliminate it. The other asks what it is organizing. And Dąbrowski explicitly rejected the idea that mental health meant stability or adaptation to existing structures. Instead, he defined it in terms of the capacity to loosen rigid psychological organization in service of higher values:

Mental health would, thus, presume the ability to ‘loosen’ and even ‘break’ one’s own primitive, narrow, and rigid mental structure. It would presume the capacity for positive disintegration and secondary integration through transgression of the biological life cycle and of one’s own psychological type. This, in turn, would be linked with the development of a higher level of inner psychic milieu and its main dynamisms. Thus, it would be also linked with the autonomous and authentic needs of a clear realization of the personality ideal. (Dąbrowski, 1973, p. 176)

This view stands in direct opposition to colonial models of care that treat disruption as failure rather than as the possible beginning of autonomy, conscience, and self-authored meaning. It also reframes treatment from normalization to development, it preserves the client’s internal authority, and it honors meaning as emergent rather than prescribed.

Autopsychotherapy and Non‑Hierarchical Practice

Autopsychotherapy, another Dąbrowskian term and dynamism, treats the individual as the primary agent of their own psychological work. Support exists to clarify and accompany, not to replace internal sense‑making. This is not radical individualism; it is epistemic sovereignty.

In practice, this means insight is generated internally rather than implanted. The therapist supports pattern recognition instead of supplying conclusions, and change arises from coherence rather than compliance. The client’s internal logic and wisdom, that is, is assumed meaningful. They are believed in their experience. Autopsychotherapy resists colonial hierarchy by refusing to outsource meaning and restoring authorship of inner life. A decolonized therapist does not diagnose a person’s reality; they help the person engage with it.

Non‑hierarchical therapy follows the same logic: it engages with epistemic humility, transparency about theory, consent‑based interpretation, and contextualization. Power does not vanish; it becomes visible and accountable. And so this process does not abandon structure. It simply refuses unexamined authority. Therapists still hold institutional, legal, and cultural power, and naming that power prevents covert domination. A disciplined, decolonized practice avoids both coercion and romanticizing suffering by treating distress as intelligible while remaining developmentally and ethically grounded in honest integrity.

From Authority to Accountability

The need for decolonized therapy shows up in racialized trauma, gendered diagnosis, neurodivergent misattunement, chronic misdiagnosis, the medicalization of grief and moral injury, the pathologizing of intense inner lives, and the routine dismissal of social and economic harm as individual dysfunction. It also appears in how those labeled “resistant” are often protecting themselves from being translated out of their own experience while still seeking support. People are not asking for less care; they are asking to be recognized.

Decolonizing therapy is not a trend (though maybe I wish it was). It is a reckoning with the politics of interpretation.

Colonial therapy assumes that meaning should be delivered by the so-named expert. Decolonized therapy begins from the opposite premise: meaning must be discovered by the person living it.

Though it may look technical, this is an ethical shift from interpretation to dialogue, from hierarchy to relational authority, from symptom to coherence, and from control to development.

Therapy does not need to become less skilled. It needs to relinquish unilateral authority over meaning and over the direction of change. This does not make therapy passive. It makes it answerable and honest.

We are not shaping people into a predefined version of health. We are not translating their lives into categories and calling that care. We are working with living systems that already have direction, values, and wisdom. The task of therapy, in this frame, is not to author those paths. Decolonized therapists and helpers accompany humans on their paths while helping them understand their own ways of knowing where they go.