We can roughly date the fusion of psychotherapy with Marxist principles and sexual liberation to the work of Wilhelm Reich in Vienna and Berlin in the 1930s. Also, from roots in the Frankfurt School in the 1920s, and later at Columbia University in New York, psychoanalytically entranced intellectuals like Adorno, Fromm and Marcuse refined critical theory. This developed into influential leftist-oriented schools of sociology, anthropology and other social sciences, which remain influential today via postmodernist and postcolonial psychobabble. Many new forms of therapy arose in the mid-20th century, often preaching liberation from internalised social and parental injunctions. Carl Rogers, the eminent psychologist anxious to deny his fundamentalist Christian origins, launched his anti-authoritarian person-centred therapy around 1950. Modern psychotherapy advertised not only a patched-up client but the new, liberated, egalitarian, peaceful human being.

Psychotherapy theories are built on the premise that individuals are damaged by parents, traumatic events, patriarchal capitalism, internal narratives, faulty reasoning or social constructions. Psychology injects some innate temperamental factors into this picture, and evolutionary psychology in particular argues for the reality of longstanding, hard-to-change patterns of thought and behaviour. Neuropolitics attempts to investigate the brain’s putative hardwired political biases. But much psychoanalytic theory emphasises unverifiable early life influences and attachments, and humanistic and existential theories stress freedom, choice, and emotional approaches to mental health. The leftist-adored and deeply flawed book by Wilkinson and Pickett, The Spirit Level (2009), claimed to be an evidence-based demonstration of the superiority of Scandinavian and other low wealth-gap (high tax) societies in enhancing well-being, in contrast to the US, UK and other capitalist hellholes associated with high levels of mental ill-health. Strangely, the leftist therapy crowd enthusiastically line up behind this argument, failing to note that, if true, it would undermine the core rationale for psychotherapy. Even some leftist critics of therapy, like William Epstein, dismiss psychotherapy as irrelevant and ineffective and call instead for far more welfare spending and better social housing.

Another epistemological mess is found in so-called happiness science, closely linked with neo-stoical cognitive behaviour therapy (CBT) and championed by Labour peer and health economist Richard Layard. He and Professor David Clark claimed that unemployment would be greatly reduced by the NHS providing short-term CBT through the Increasing Access to Psychological Therapies initiative (IAPT), which would dramatically reduce depression and anxiety. Time and further evaluations are showing how naive Layard’s hopes were. Some non-CBT therapists speak of “high-quality psychotherapy versus state therapy” and calculate that the IAPT success rate is only 16 per cent. But for “high-quality”, read long, “deep”, expensive and unpredictable psychoanalytic therapy. Sneakily, many regard CBT as a somewhat masculine, unfeeling, right-of-centre therapy.