The field of psychology has been criticized for its lack of attention to the experiences of people who do not identify as heterosexual, cisgender, or male. One area where this can be seen is in the use of cognitive-behavioral therapy (CBT), which often assumes that everyone fits into these categories and that their emotions are caused by thoughts and behaviors.
A queer critique of CBT argues that there are hidden assumptions about rationality, normality, and emotional regulation embedded in mainstream clinical models. This article will explore how these assumptions impact individuals who identify outside of traditional gender norms and what alternative approaches might look like.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) is a type of talk therapy that focuses on changing negative thought patterns and behaviors that lead to negative emotions. It's based on the idea that our thoughts and actions affect how we feel, and vice versa. This approach has been used successfully to treat a wide range of mental health issues, including depression, anxiety, and PTSD.
It also has some limitations when it comes to addressing the needs of LGBTQ+ individuals.
Many CBT practitioners assume that all clients are heterosexual or cisgender, and that their problems stem from internalizing societal messages about gender roles. As a result, they may not recognize the unique challenges faced by queer people, such as discrimination and stigma.
Hidden Assumptions About Rationality and Normality
One assumption underlying CBT is that everyone should strive for rationality. In this model, irrational beliefs lead to negative emotions and behaviors, which can be changed through cognitive restructuring. But what if someone feels sad because they don't fit into traditional gender roles? Is it really irrational to have those feelings? A queer critique of CBT suggests that there is nothing inherently irrational about feeling different from social norms. Instead, these feelings may reflect an authentic experience of self.
Another hidden assumption in CBT is that emotional regulation should look like a certain way.
CBT practitioners often teach clients to 'distract' themselves from negative emotions with positive ones.
This approach doesn't work well for people who identify as non-binary or genderqueer because they may not feel comfortable expressing any emotion at all. They might prefer to sit with their feelings rather than suppress them. A queer critique of CBT would encourage practitioners to meet clients where they are, without imposing a rigid set of rules on how they should manage their emotions.
Alternative Approaches
There are several alternative approaches that could help address the needs of LGBTQ+ individuals. One approach is mindfulness-based stress reduction (MBSR), which focuses on accepting all emotions, including negative ones. Another is narrative therapy, which helps clients reframe their experiences in a more positive light.
Somatic experiencing can help clients process trauma by focusing on the body and physical sensations. These approaches allow clients to explore their unique experiences without being forced into a mold that doesn't fit.
Cognitive-behavioral therapy has been criticized for its limited view of rationality, normality, and emotional regulation. By examining our assumptions about these concepts, we can create a more inclusive model that better serves all clients. This article has explored some of the hidden assumptions in CBT and suggested alternative approaches that are more responsive to the needs of LGBTQ+ individuals. It's important for mental health professionals to be aware of these issues so that they can provide truly effective care to everyone who seeks it.
How might a queer critique of cognitive-behavioral therapy reveal hidden assumptions about rationality, normality, and emotional regulation embedded in mainstream clinical models?
Queer theory provides a powerful lens through which to examine the historical origins and contemporary applications of CBT. It challenges the assumed neutrality of the medical model, demonstrating how the dominant culture's conception of "normal" is based on heteronormative standards that perpetuate social norms that marginalize those who are nonconforming.