The Harm in the “Gold Standard”: Why CBT Fails Neuroresisting Bodies and Must Be Dismantled

CBT is a colonial monoculture that gaslights suffering people into blaming themselves. It must be dismantled.

Photo by Luke Jones on Unsplash

Content Warning:

This essay examines emotional and psychological harm within therapeutic settings. It references colonial violence, systemic racism, ableism, practices similar to conversion therapy, and the experience of being gaslit by mental health systems. Some readers — particularly those with lived experience of these harms — may find sections activating. Please engage at a pace that feels safe for your body. The final section includes demands and alternatives; you are welcome to skip directly there if needed.

The therapy room promises relief. A clean, quiet space. A trained listener. For many, entering it is an act of profound trust — the belief that help has finally arrived.

Then the worksheet appears. The thought log. The homework that asks you to debate your deepest terrors as if they were logical errors. If your body protests — if the dread intensifies, if the hours after session leave you hollow — the framework has a diagnosis ready: you are resistant, cognitively rigid, unmotivated. The model does not bend. You are bent to fit it.

When harm arrives dressed as healing, the harm can be almost impossible to name.

You may trust the professional. You may have been taught your whole life that your own perception is unreliable. So you suppress the alarm, complete the homework, and leave each session more surveilled, more exhausted, more convinced that you are the problem.

This is not accidental. It is the logical outcome of a therapeutic monoculture built on colonial cosmology, Calvinist self-audit, and the policing of difference. For neuroresisting bodies — autistic, mad, sensory-sensitive, trauma-layered — it is not treatment. It is a second wound.

What follows is written for people who have felt this harm and need language for why. It is also for practitioners willing to examine what they are truly offering, and for anyone trying to understand why a therapy referred to as the “gold standard” leaves so many feeling broken by the very thing that was supposed to heal them.

A note to survivors: The middle sections of this piece build the historical and institutional case against CBT. That evidence matters, but you may not be in a place to absorb it right now. The final section — The Demand — speaks directly to you. You can skip to it. You can return to the rest when you are ready. The argument will be here.

The argument, in brief, is this: CBT traces its roots to a philosophy that split mind from body and used that split to justify colonization. It became the only therapy many systems will pay for, through insurance mandates and stepped-care requirements that block access to alternatives. Its methods share a documented history with conversion therapy. And teaching a suffering person to fix their thoughts rather than name the conditions causing their suffering protects those conditions. All of this leads to one conclusion.

The Soul Wound and the Mind-Body Split

Cognitive Behavioral Therapy rests on an assumption so old it has become invisible: reason must rule emotion, mind must override body. This is the ghost of Descartes in the therapy room — the same philosopher who split mind from body and gave Europe a rationale for ranking itself above the peoples it colonized. It is also the ghost of Calvin, whose theology stripped away communal ritual and left the individual alone with their conscience, ceaselessly auditing their inner life for signs of sin or grace. The CBT session is, in this sense, a secularized confessional: you report your thoughts to an authority, learn to police yourself between sessions, and mistake structural suffering for personal moral failure.

The Jamaican decolonial psychiatrist Frederick Hickling documented how European psychiatry was exported as a “civilizing mission,” diagnosing resistance to colonial conditions as mental illness. Across four generations of Caribbean practitioners, his research revealed a pattern: what the colonizer called pathology was often the sound of a people refusing to accept subjugation.

The Cherokee psychologist Eduardo Duran names colonialism’s core injury the “soul wound” — an intergenerational rupture that manifests not as irrational cognition but as profound communal and spiritual disconnection. “It is necessary,” Duran writes, “to understand intergenerational trauma and internalized oppression in order to understand Native Americans today.”

A thought record cannot touch a soul wound.

A cognitive reframe will not restore what colonization severed. To offer a worksheet to someone carrying generations of dispossession is not neutral. It is a continuation of the colonial demand that the oppressed translate their suffering into the oppressor’s language and then fix it themselves.

The philosopher Sylvia Wynter traced how the European Enlightenment produced a single, overrepresented figure of the human — rational, white, bourgeois Man — whose cognitive style became the gate through which full humanity was granted or denied. Everyone else was a deviation to be corrected. When CBT asks a neuroresisting body to override its sensory panic with a rational analysis, it reenacts this colonial gesture inside the skin. It teaches you to colonize yourself.

Cultural Gaslighting and the Monopoly on Legitimacy

How did one culturally specific way of knowing become the One Right Way?

The Black clinical psychologist Broderick Sawyer names the mechanism directly: “CBT’s political place within psychology is part and parcel with the Western medical model, that is, seeking to identify disease within individuals, rather than identify the diseased environment in which so-called ‘individual’ disease arises.” He calls this “cultural gaslighting” — the “ongoing rationalization of harm done to individuals or communities as ‘objectively correct,’ functioning to gaslight victims into internalizing the cognitions that Western culture defines for them.”

I know this dynamic through my own ancestry. The Toshavim — the Indigenous Jews of North Africa, present since antiquity — developed healing practices rooted in the body, the land, and the community. When the Megorashim arrived as exiles from Iberia in 1492, many carried the trauma of expulsion and survived by aligning with Spanish power. They became intermediaries. They called Toshavim healing "witchcraft" and insisted their own ways were the only acceptable ones. This was not abstract theological disagreement. It was an internalized colonial logic operating within a single people: one faction, bruised by empire, grabbing the empire’s epistemology and using it to pathologize the other. The colonized became the enforcer of the colonizer’s standard of healing.

The Caribbean experience Hickling documented, the soul wound Duran names, the cultural gaslighting Sawyer theorizes — these are not distant stories. They describe a pattern that repeats wherever colonization’s cognitive machinery takes hold. And it holds in the therapy room today. When a neuroresisting body cannot function in an open-plan office, when a sensory-sensitive person melts down in a grocery store, when an Indigenous person grieves what colonialism has taken — these are not maladaptive cognitions. They are bodies registering environments that are neurologically, spiritually, or existentially unsafe. As the Neuroresisting manifesto insists, this resistance is “not a pathology; it is a sign of a brilliant, self-protective system.”

This gaslighting is backed by institutional force. The “evidence base” that crowns CBT the "gold standard" was built predominantly on white, Western, formally educated, and neurotypical samples, using measurement scales blind to somatic, relational, and communal dimensions of healing. The Aboriginal scholar Chelsea Watego has demonstrated how the very institutions that proclaim evidence-based practice are the ones that systematically exclude Indigenous knowledge from the category of evidence. The "gold standard" is not a neutral scientific finding. It is a colonial tautology: Western research methods validate Western therapy models and call the result universal truth. The Black feminist theorist Patricia Hill Collins has long shown how Eurocentric knowledge systems function to delegitimize the knowledge claims of marginalized peoples — and the evidence base for CBT performs exactly this exclusion under the banner of scientific rigor.

On top of this, insurance panels and public health systems enforce a “stepped care” model that forces patients to fail CBT before accessing anything else — somatic therapy, EMDR, sensory integration, peer support. The psychologist who wants to offer body-centered work must often first document that the patient did not respond to cognitive restructuring. The system does not simply prefer CBT. It uses CBT as a barrier.

You must earn the right to heal otherwise by first failing the One Right Way.

The Lineage of Violence: ABA, Conversion Therapy, and the Same Underlying Logic

The critics who draw a line connecting CBT to Applied Behavior Analysis and to gay conversion therapy are not being hyperbolic. They are describing documented history.

The behavioral technologies that birthed ABA were developed by O. Ivar Lovaas at UCLA. While designing his “Young Autism Project,” Lovaas simultaneously ran the federally funded “Feminine Boy Project,” using identical reinforcement and punishment techniques to extinguish gender-nonconforming behavior in children he explicitly described as pre-homosexual. The goal was normalization. The method was extinguishing difference. The target was any body that diverged from a white, straight, neuronormative standard of health.

CBT’s cognitive arm extended this same logic inward. Where ABA trained behaviors through external rewards and punishments, CBT trained thoughts through internal self-surveillance. The core commitment remained unchanged: identify the deviant internal event and restructure it until it approximates the norm. It is a therapy of assimilation, built to make the individual conform to a society that is itself profoundly sick.

Eduardo Duran’s soul wound framework illuminates why this logic remains colonial regardless of the population to which it is applied. Colonialism pathologizes Indigenous ways of being in order to justify elimination or assimilation. A therapeutic model that insists on one standard of cognitive health — one definition of a “rational” thought, one set of criteria for a “functional” life — is participating in that ongoing structure, whether the patient is Indigenous, autistic, queer, or all three at once, like me.

When the harm is not a bug but a feature — when it is rooted in the model’s foundational commitment to a single normative standard of mind — reform is a contradiction.

You cannot gently reform a system of epistemic violence. You can only refuse it.

What the Monoculture Protects

When any model achieves monopoly, the essential question is: who benefits?

Broderick Sawyer connects the dots directly: “The U.S. capitalist system creates individual lifestyle stress, and then offers what I call ‘institutionalized sedatives’ for citizens to cope with the stress that the lifestyle creates… wealthy companies then profit off these sedatives without offering changes to the environment which necessitate the sedatives in the first place.” CBT, in this analysis, is one of those sedatives. It teaches the individual to manage internal reactions to oppressive conditions rather than to organize against them.

The philosopher Lewis Gordon, in Fear of Black Consciousness, examines how systems of power depend on subjugating not only Black bodies but Black consciousness itself — on ensuring that oppressed peoples internalize a version of reality compatible with their own subordination. A therapeutic model that locates pathology inside the individual’s thinking and leaves the structures of racial capitalism, ableism, and colonial dispossession untouched is performing exactly this function, whether it names itself as such or not. When CBT tells you your resistance is a distortion, it fears your liberation.

The insurance company can bill for it. The employer can return you to productivity. The state can claim to address mental health crises without confronting poverty, racism, ecological collapse, or the legacy of dispossession. In the same historical period that CBT was being manualized and scaled, the "war on drugs" was criminalizing plant and ancestral medicines across the globe — suppressing the very modalities whose existence gives the lie to the claim that cognitive restructuring is the only evidence-based path to healing. The monoculture is functional for every institution but not for the person who is suffering.

The Bait-and-Switch and the Clearing

We return now to the room where the worksheet sits on the table — and to the most intimate violence of this system, which is the betrayal of the therapeutic contract itself.

The Black psychotherapist Foluke Taylor, in Unruly Therapeutic: Black Feminist Writings and Practices in Living Room , demonstrates how therapy can “participate in deadly, racist repetitions” — not because the individual clinician is malicious, but because the structure of the encounter replicates the dynamics of domination that brought the patient into distress. The hierarchy. The assumption of pathology. The demand that suffering be translated into the clinician’s language. When a therapist treats a patient’s accurate reading of an oppressive world as a cognitive error, they are wounding the patient again in the very room that promised care.

Taylor draws on the traditions of the Combahee River Collective and the ongoing archive of Black feminist thought to refuse the individualist, cognitive framework. Her practice offers something else: witness, co-regulation, and the unwavering insistence that the source of distress is not always inside the person. It is often in the world.

This is what the Neuroresisting manifesto calls the “clearing” — a space where no one performs, where care is not contingent on output, where the body’s “no” is honored as a sign of health rather than a symptom to be extinguished. The clearing is not a supplement to CBT. It is an entirely different architecture of care, one whose relational, embodied, land-connected principles echo those my Toshavim ancestors fought to preserve against the very logic that CBT now wears as clinical technique.

The Demand

We are not calling for a more culturally adapted CBT, or a CBT with somatic elements glued on. If you must strip away the cognitive primacy, the individualism, the internal locus of pathology, and the demand for neurotypical performance to stop the harm, then what is left is no longer recognizably CBT. The only honest conclusion is that the model — as a monoculture, as a gold standard, as a first-line gatekeeper — must be dismantled.

Let us be precise. This demand is not for the prohibition of cognitive tools for those who freely choose them. The harm is not in the existence of a thought record; it is in the system that forces the thought record on every suffering person before they can access anything else. Dismantling the monopoly means ending the stepped-care requirement that uses CBT as a barrier. It means disengaging from the insurance architecture that reimburses only cognitive, manualized, short-term modalities while starving somatic, communal, land-based, and peer-led alternatives. It means refusing the “gold standard” language that dresses a colonial tautology in scientific neutrality.

For the practitioner who must survive inside the current system while working to undo it: hold this demand as your horizon, and in the meantime, stretch the tool until it breaks its own frame. Refuse the manual when the manual would harm. Bring the body into the room. Name the state. Subvert what you must while you build what comes next.

For survivors , what you felt was real. The worksheet that left you hollow, the session that made you doubt your own reality, the demand to fix your thoughts while your body was screaming the truth — that was harm, and it deserves language. You can refuse. You can bring this article with you and say, I will not be cognitively restructured. And there is a clearing out past the boundaries of this monoculture. It exists wherever people have stopped performing and started trusting the body’s no. It requires no thought record to enter, no diagnosis to qualify, no performance of wellness to be welcomed. It requires only that the violence stop, and that the people inside it mean it.

This "gold standard" is a gilded cage. We are done asking for the door to be unlocked. We are dismantling it.

This essay draws on the work of Frederick Hickling, Sylvia Wynter, Eduardo Duran and Bonnie Duran, Broderick Sawyer, Patricia Hill Collins, Foluke Taylor, Chelsea Watego, and Lewis Gordon. It is written in solidarity with every body that has refused to be cognitively restructured.