Jonathan Alpert has been a psychotherapist for decades, but in his new book, he questions whether his profession is doing some people more harm than good. “Therapy has never been more ubiquitous, yet we’re anxious, fragile, lost, and more divided than ever,” he writes in the introduction to “Therapy Nation: How America Got Hooked on Therapy and Why It’s Left Us More Anxious and Divided” (Hanover Square Press). One of the issues with contemporary therapy, he asserts, is that mental health professionals are increasingly focusing on identity politics and having patients frame their troubles in terms of race, gender and oppression, stoking anxiety rather than providing people with better coping mechanisms. Here, an excerpt.
Imagine a woman who has a near-miss with an 18-wheeler on the highway. Shaken but unharmed, she tries to move on. But the anxiety sets in. At first, it’s only near the site of the incident. Then it spreads.
Soon she can’t drive on highways at all. Eventually, she stops driving altogether.
With public transportation unreliable, she’s forced to quit her job. She can’t visit her mother, who lives two hours away. Her world shrinks.
Determined to reclaim her independence, she finds a therapist with stellar reviews. Too anxious to drive, she takes a taxi to the appointment, hopeful this will be the first step back to freedom.
Instead of focusing on her fear of driving, though, the therapist begins asking about her gender and race.
“How do you feel as a woman driver on the road with aggressive male drivers? What is it like for you, as a White woman, to get behind the wheel?”
Eventually, the therapist pivots to politics, asking whether anti-abortion laws are contributing to her “oppressed status.”
Confused, the woman pushes back. What does any of this have to do with her fear of driving?
The therapist snaps. “Are you here to do the work? We need to dismantle systems of oppression.”
The patient leaves feeling worse than when she arrived.
As bizarre as this sounds, it really happened to someone I know. And it’s not an isolated case. I hear more and more stories from patients who say their therapists steer conversations toward race, gender and oppression regardless of why they came in.
This didn’t happen overnight. The mental health profession has always wrestled with how much a patient’s background should shape treatment. In the past, it often got that balance wrong in ways that ignored or minimized real experiences. In response, the field rightly moved toward greater cultural awareness and sensitivity.
But in parts of the profession, that correction has gone too far.
Today, many graduate programs train therapists to view patients primarily through the lens of identity and power dynamics. These ideas are formalized in frameworks like the Multicultural and Social Justice Counseling Competencies, which place social justice at the center of therapy and encourage therapists to sort both themselves and their patients into categories of “privileged” and “marginalized.”
When a therapist is trained to see every problem as rooted in systems of oppression, it becomes tempting to steer every conversation in that direction. Anxiety becomes a reflection of societal pressures. Relationship conflict becomes a product of power imbalances. Personal struggles are reframed as political ones.
But most people don’t walk into therapy looking for a political framework. They come in because something in their life isn’t working. They want to sleep through the night again. They want to stop avoiding highways. They want to communicate better with their spouse. They want to function.
Good therapy meets people where they are and helps them build the skills to move forward. It focuses on what a person can do, not just what has been done to them. It emphasizes agency, not just explanation.
When therapy shifts away from that, patients can get stuck. Instead of developing tools to handle life, they become more focused on analyzing it. Instead of building resilience, they become more sensitive to perceived harm. Instead of moving forward, they stay in place, endlessly “processing.”
I hear more and more stories from patients who say their therapists steer conversations toward race, gender and oppression regardless of why they came in.
One of the most common patterns I see is patients who have spent years in therapy and can describe their problems in extraordinary detail but still feel stuck. They can explain their childhood, label their emotions, and identify every possible trigger. But when it comes to making decisions, tolerating discomfort, or taking action, they’re no better off than when they started.
They’ve been taught, implicitly or explicitly, to look outward for explanations rather than inward for solutions. If something goes wrong at work, it’s a toxic environment. If a relationship struggles, it’s because of someone else’s unhealthy patterns. If they feel anxious or overwhelmed, it’s framed as evidence of deeper harm rather than a signal to build coping skills.
This way of thinking can feel validating in the short term. It gives people a clear explanation for why they feel the way they do. But over time, it can erode a person’s sense of agency. If your problems are primarily the result of forces outside your control, then your ability to change your life starts to feel limited.
The goal of good therapy isn’t just to help people feel understood. It’s to help them function better in the real world. That means learning how to face discomfort, make difficult choices, and take responsibility for the parts of life they can control.
When those priorities are replaced with a constant focus on identity and external systems, therapy risks becoming less about growth and more about explanation. And explanation alone rarely leads to change.
And the consequences don’t stay confined to the therapy room.
The language and assumptions of therapy have spilled into everyday life. People increasingly interpret ordinary disagreements through clinical or political frameworks. Words like “toxic,” “trauma,” and “gaslighting” are used to describe routine human friction. Discomfort is treated as damage. Conflict becomes something to avoid rather than work through.
This makes relationships more fragile and harder to repair. It also feeds a broader sense of grievance and division, especially when personal struggles are consistently framed as the result of larger systems rather than something that can be addressed at the individual level.
None of this is to say that culture, identity, or history are irrelevant. They can be deeply important in certain cases. But they should not crowd out the core purpose of therapy, which is to help people live better, more functional lives.
The therapy office should not be a political battleground. It should be a place where people come to get unstuck, to build strength, and to move forward.
When therapy loses that focus, it doesn’t just fail individual patients. It contributes to a more anxious, more divided society.
Jonathan Alpert is a psychotherapist practicing in New York City and Washington, DC. This essay is adapted from his book “Therapy Nation: How America Got Hooked on Therapy and Why It’s Left Us More Anxious and Divided,” published by Hanover Square Press, an imprint of HarperCollins.
