Critical FormulationA Non-Western Approach to Psychological Formulation

Critical Formulation is a psychological technique, completely separate and in direct opposition to therapy. Unlike it, it shifts the central question from "What is wrong with you?"—that is deeply embedded, although often not overtly, in mainstream therapeutic modalities—to "What was done to you and by whom?"—requiring examination of social structures, power relations, biological conditions, history, and even the technique and the psychologist themselves, rather than locating pathology within individuals and their biological makeup or shortcomings of cognitions and affect.

This paper presents the theoretical foundations, methodological principles, and practical roadmap for Critical Formulation. Drawing from critical realism, post-colonial thought (particularly Fanon and Freire), and biosemiotics, Critical Formulation retains the scientific rigour and hypothesis-driven approach of classical psychological formulation while rejecting the philosophical prejudices, epistemological violence, and cultural domination embedded in Western therapeutic frameworks.

We articulate what Critical Formulation rejects—including reductionism, relativism, cultural norm-setting, scientism, the cognition-emotion split, medicalisation of mental health, and trauma theory that obscures perpetrators—and what it affirms: scientific rigour without reductionism, hypothesis-driven assessment of social structures, cultural context without relativism, addressing power structures and exploitation, and integrating biological aspects without medicalisation.

The paper outlines a roadmap for developing Critical Formulation practice, including how to identify and train practitioners, how to structure the work, and how to explain it to those seeking help. We conclude by announcing plans for a pilot trainee programme to begin experimental implementation of Critical Formulation. This work represents a necessary alternative to existing therapeutic frameworks—one that addresses sources of distress rather than symptoms, that is scientific but not scientistic, rigorous but not reductionist, and culturally responsive but not relativist.