You Must Be Some Kind of Therapist

140. Gender Dysphoria as a Mind-Body Problem: A Psychoanalytic Perspective with Jaco van Zyl


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Many critical thinkers have rightfully wondered why gender dysphoria is treated in clinical settings any differently from anorexia, body integrity identity disorder, and other psychiatric ailments featuring a mind-body problem. Today’s guest is the right person to answer that question.


Jaco van Zyl, a South Africa-trained clinical psychologist now practicing in Ireland, joins me to discuss his paper, "Formulating Gender Dysphoria as an Affective-Perceptual Disturbance Involving the Body," which was recently published in the journal Psychodynamic Practice. Jaco shares his insights on the psychological underpinnings of gender dysphoria, particularly in adolescents, and critiques the current activist-driven narratives that often overshadow psychodynamic perspectives.


We explore the developmental journey of infants and how early experiences shape their understanding of identity and bodily sensations. Jaco emphasizes the importance of navigating the pleasure and reality principles, a concept rooted in psychoanalytic theory, and how failures in this process can lead to arrested development. We also discuss the implications of ideologies that discourage critical thinking about gender identity, highlighting the dangers of treating distress as a literal interpretation of one's body.


Throughout our conversation, we aim to unpack the complexities of gender dysphoria, the role of early attachment experiences, and the potential consequences of affirming practices that may overlook deeper psychological issues. This episode invites listeners to consider the intersection of psychoanalysis, gender identity, and the importance of fostering a more nuanced understanding of these critical topics.


Jaco van Zyl is a South Africa-trained Clinical Psychologist in private practice in Ireland. He has worked in the Department of Correctional Services, and in private practice at a psychiatric hospital in South Africa. Jaco has a special interest in personality pathology and its relationship with mood and anxiety disorders, trauma-spectrum disorders, gender-related distress, eating disorders and addiction. He is also interested in the psychology of large-groups, gleaning from his own experience growing up in South Africa, and the role ideology plays in mass illusion in political and ideological movements. He is a co-director of Critical Therapy Antidote, a UK-based organisation consisting of clinicians concerned with the ideological take-over of the psychology and psychotherapy field. Jaco is also the co-host of the CTA Podcast, where he and his co-hosts, Christine Sefein and Michael Olan, discuss topics related to psychology, psychological practice, and society.


Books mentioned in this episode are listed below.

  • The Luck Factor: The Scientific Study of the Lucky Mind by Richard Wiseman

View my complete list of book recommendations, including those written by authors who have been guests on this show, at https://sometherapist.com/bookshop.

As an Amazon affiliate, I earn a small commission from qualifying purchases made through affiliate links from my show notes or website. Thank you for purchases that support the show!


 00:00 Start

[00:02:05] Gender dysphoria and psychodynamics.

[00:04:31] Conversion therapy and gender identity.

[00:08:45] Psychological development of infants.

[00:13:45] Good enough mother concept.

[00:20:10] Symbolization and gender dysphoria.

[00:24:30] Scapegoating of body parts.

[00:27:41] Gender dysphoria and psychoanalysis.

[00:32:54] Psychoanalysis and queer theory.

[00:40:01] Arrested development and personality disorders.

[00:44:10] Protective factors in development.

[00:46:53] Luck as an attitude.

[00:52:23] The impact of envy on gratitude.

[00:56:38] The value of internal support.

[01:02:04] Gender dysphoria and body disorders.

[01:05:00] Body image and emotional distress.

[01:10:12] The allure of gender ideology.

[01:15:40] Untested hypotheses and self-identity.

[01:18:39] Therapy with young people.

[01:27:36] Adolescence as a cure for dysphoria.

[01:30:54] Critical Therapy Antidote training materials.

[01:33:04] Reality is more exciting.

ROGD REPAIR Course + Community for Parents is available now! Are you concerned about an adolescent or young adult with Rapid Onset Gender Dysphoria? Join at ROGDrepair.com and get instant access to over 100 lessons designed to equip you with the psychological insights and communication tools you need to get through to your kid. Use code SOMETHERAPIST2024 to take 50% off your first month.


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SHOW NOTES & transcript with help from SwellAI.


MUSIC: Thanks to Joey Pecoraro for our song, “Half Awake,” used with gratitude & permission.


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