Epistemic Justice and Psychotherapy

For over five decades, mental health discourse has been divided by debates about the validity of psychiatric diagnoses. While diagnosis can facilitate support, critics argue it may obstruct personal meaning-making and potentially harm patients. This presentation challenges both diagnostic rigidity and the moral superiority often accompanying trauma-centred approaches in psychotherapy. Jay proposes a paradigm shift: centering epistemic justice in therapeutic practice. Drawing on Miranda Fricker's work on epistemic justice and Kristie Dotson's concepts of testimonial smothering and silencing, we will explore how power dynamics in therapy can amplify or silence patients' voices. This framework urges us to move beyond the false dichotomy of pathology versus trauma, focusing instead on the subtle, micro-level interactions that shape patients' ability to articulate their experiences. By prioritising epistemic justice, therapists can create more equitable spaces for collaborative care, fostering genuine dialogue and mutual understanding. This approach not only honours patients' lived experiences but also enhances the therapeutic process, potentially leading to more effective and ethically sound mental health practices.

Dr Jay Watts is a consultant clinical psychologist, relational psychotherapist, honorary senior lecturer, and journalist. More importantly, she is a psychiatric survivor and was one of the first lived experience practitioners in Europe in the 1990s. Disability justice is central to her work, which spans both mainstream roles, such as leading an early intervention in psychosis team, a family therapy service, and tier two psychology, as well as more radical efforts to address iatrogenic harm and the toxicity of the welfare system alongside Mad allies. She makes noise in various ways, from writing research papers to creating bad art, and spends too much time tweeting as @Shrink_at_Large.

Host or Publisher Southern Association for Counselling and Psychotherapy