In today’s cultural climate, identity is often treated as the foundation of personal truth. From social discourse to institutional policy, we are encouraged to “live our truth,” to “affirm who we are,” and to regard recognition by others as essential to our sense of self. In some circles, failure to affirm another’s declared identity—particularly in the context of gender—is viewed not simply as disrespect, but as symbolic violence. The denial of identity, it is claimed, is a form of psychic erasure so profound it is likened to murder or suicide.
Such rhetoric is powerful. It demands immediate moral sympathy. Yet it risks confusing metaphor for diagnosis, and symbolic narratives for therapeutic insight. It is here that we must pause and reflect, particularly in light of older, more cautious approaches to psychological distress.
The Divided Self and the Fragility of Identity
In The Divided Self, RD Laing offered a powerful phenomenological account of schizophrenia and extreme forms of psychic disintegration. His aim was not to medicalise or pathologise people further, but to understand how some individuals experience their own being as tenuous, unreal, or estranged—not metaphorically, but in a lived, moment-to-moment sense. For Laing, the schizophrenic or schizoid person struggles to inhabit their body, doubts the continuity of their identity, and builds defences such as depersonalisation or false-self constructs to survive in a world experienced as engulfing or annihilating.
Laing’s work is grounded in existential psychology, which seeks to reconstruct the individual’s experience of being-in-the-world, often in situations where conventional therapeutic frameworks are inadequate. It is a delicate, highly specialised approach that, as Laing himself warned, should be reserved for exceptional cases of psychosis or severe ontological insecurity.
The danger today is that this clinical model of extreme psychic dislocation is being generalised and normalised in everyday discourse, particularly in identity-based advocacy. The symbolic idiom of Laing’s patients—who spoke of having their ‘self stolen’ or of being ‘dead in order to remain alive’—has become commonplace in narratives surrounding gender identity and social recognition. Yet when these metaphors migrate from the consulting room to the public square, they risk distorting both psychological understanding and social policy.
Identity as a Cultural Fetish
The existential model of the self places a high value on authenticity, yet it also recognises how precarious and evolving our sense of self can be. Laing’s descriptions make clear that assertions of a “real self” often emerge precisely when a person feels least secure or embodied in their being. For some patients, the claim “this is who I really am” becomes not an insight into wholeness, but a defensive construct, a compensatory assertion against feelings of disintegration.
This context is vital when examining the rise of identity-based affirmation models, particularly those used in gender healthcare. The current emphasis on immediate affirmation of a person’s declared gender identity—often bypassing deeper therapeutic engagement—risks repeating a clinical error: taking the self’s declarations at face value, without exploring the psychic conditions under which those declarations arise.
The Problem with Affirmation Models
The affirmation approach is grounded in an admirable instinct to reduce suffering and support autonomy. Yet when institutionalised, it becomes rigid and dogmatic, treating any delay, questioning, or alternative view as a form of violence. In this framework, therapeutic caution—such as ‘watchful waiting’, non-medicalised support, or exploratory dialogue—is cast as denial or harm.
Laing’s work reminds us that recognition is never a simple act. To “affirm” another is not merely to mirror their assertions, but to engage them with depth, honesty, and care. The therapeutic task is not to validate identity claims uncritically, but to help individuals understand the complex symbolic structures that shape their sense of self, especially in moments of profound distress or disorientation.
Moreover, in cases of gender incongruence—particularly among children and adolescents—there is a growing consensus among cautious clinicians that exploratory approaches, grounded in developmental psychology and watchful support, are more ethical and effective than hasty medicalisation. These approaches recognise that identity is often a moving target, and that what appears as certainty in one phase of life may be reinterpreted with age, experience, and reflection.
A Call for Psychological Pluralism and Caution
Existential therapy offers a powerful but highly specialised lens for understanding psychological fragmentation. It should not be misused as a moral shorthand for validating identity claims, nor confused with a universal model for human flourishing. Laing’s patients were not to be affirmed but to be understood—often in painstaking, unsettling, and open-ended ways.
Today, as identity becomes increasingly politicised, there is a real risk that our psychological discourse becomes flattened into slogans and imperatives. We must resist the temptation to instrumentalise therapy as a tool for social validation, and instead reclaim its role as a space for reflection, transformation, and uncertainty.
The symbolic self, unlike the material self, can never be fully grasped or affirmed by others. It is always becoming. Any attempt to enshrine identity as inviolable risks foreclosing the very processes of growth, individuation, and self-discovery that a mature psychology must protect.
In conclusion, it is not denial of identity that constitutes harm, but the denial of context, complexity, and development. Let us remember that human beings are not merely what they claim to be, but what they are in the making—through struggle, relationship, embodiment, and time.
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