Patient urgency names the fundamental temporal paradox confronting political movements. Social transformation is genuinely urgent. People suffer under existing conditions and cannot wait. Yet subjective transformation happens slowly and unevenly. People shaped by oppressive societies cannot instantaneously remake themselves to align with revolutionary ideals. This creates impossible tensions when movements demand immediate behavioural purity whilst acknowledging that consciousness changes gradually.
The concept emerged from Red Therapy’s experiences in 1970s Britain. This radical therapy collective, rooted in women’s liberation and anti-imperialist organising, discovered profound asynchronicity between political goals and psychological capacity. They attempted to transform sexual relationships, dismantle hierarchical family structures, and create non-oppressive interpersonal dynamics whilst simultaneously engaging in militant political work. The reality proved harder than anticipated.
The circularity of revolutionary subjectivity
The fundamental problem is circular and inescapable. People must transform themselves to transform society. Yet the society that must change is precisely what shaped those people. No external position exists from which to begin. Consciousness formed under oppression carries that oppression’s marks. Revolutionary commitment cannot simply erase lifetime patterns of conditioning.
This circularity distinguishes revolutionary from reformist projects. Reform accepts existing subjectivities and adjusts institutions around them. Revolution requires remaking both institutions and the people inhabiting them. Yet those people must undertake the remaking whilst still formed by what they seek to destroy.
Red Therapy members found they could not “will ourselves liberated” overnight. Intellectual agreement with feminist or anti-authoritarian principles did not automatically translate into transformed behaviour. Old patterns persisted. Jealousy, possessiveness, hierarchical relating and conditioned responses continued despite ideological rejection. The gap between what they believed and how they acted proved painful and persistent.
The Weather Underground’s failure
The Weather Underground confronted this gap through brutal demands for immediate transformation. Their criticism-self-criticism sessions, lasting entire days and sometimes conducted whilst participants were drugged, attacked any behaviour or sentiment deemed insufficiently revolutionary. People were denounced for showing fear during police confrontations, for romantic attachments, for liking particular poems.
The sessions aimed to achieve subjective purity, toughening participants for revolutionary action. The assumption was that revolutionary consciousness could be installed through harsh enough critique. Bourgeois conditioning could be burned away through sustained psychological pressure. The ideal revolutionary subject would emerge purified.
The result was psychological damage, increased paranoia within groups, and eventual purges expelling members deemed irredeemable. Former Weather members describe bafflement at how people dedicated to ending oppression became so cruel to each other. The brutality arose from refusing the temporal dimension of transformation. If change must happen immediately, any persistence of old patterns becomes intolerable failure requiring punishment.
The Combahee River Collective’s patience
The Combahee River Collective articulated an alternative rooted in patient urgency. Their 1977 statement declared commitment to “a lifetime of work and struggle before us.” This temporality differs fundamentally from Weather’s demand for instant purity. The Collective accepted that change happens gradually across lifetimes and generations.
Their practice of criticism-self-criticism operated as ongoing process rather than final judgment. The point was not to eliminate all traces of racism, sexism, classism and homophobia from members’ psyches through single intense sessions. It was to create sustained practice of collective examination enabling incremental transformation over time.
This patience coexisted with genuine urgency. Black lesbian feminists in 1970s America faced immediate material threats. Violence, poverty, discrimination and marginalisation created genuinely urgent needs. The Collective did not counsel waiting for perfect conditions. They organised and fought whilst acknowledging that the work would outlast them.
The key distinction lies in accepting contradictions. Members would inevitably reproduce oppressive patterns whilst fighting oppression. This contradiction does not invalidate struggle. It marks the unavoidable condition of fighting from within systems that formed you. Patient urgency means sustaining commitment despite persistent gaps between ideals and practice.
Temporal asynchronicity in consciousness-raising
Feminist consciousness-raising groups discovered similar temporal tensions. The practice aimed to identify shared oppression through discussing personal experiences. Women would recognise that problems they experienced as individual failures were actually political problems requiring collective solutions.
However, consciousness-raising sometimes collapsed into demands for rapid transformation. Jo Freeman documented “trashing,” where women were psychologically destroyed for insufficiently quick adoption of feminist consciousness. Someone who expressed desires, maintained relationships, or held opinions deviating from group consensus faced isolation and humiliation.
Freeman identified impatience as crucial cause. Women criticised other women for not having already become ideal feminists. The expectation was that once feminist analysis became intellectually available, women should immediately transform their desires, relationships and self-conceptions to align with it. Persistence of old patterns indicated bad faith or insufficient commitment.
This ignored how consciousness actually changes. Understanding something intellectually differs from transforming embodied patterns developed across lifetimes. Someone can recognise that jealousy stems from patriarchal notions of possession whilst still feeling jealous. Knowing romantic love is socially constructed does not eliminate attachment. The temporal lag between intellectual understanding and emotional transformation is not failure. It is how human consciousness works.
The problem of embodied contradiction
Vivian Gornick’s interviews with former Communist Party members revealed how people become “walking embodiments of the gap between theory and practice.” Party members committed to fighting capitalism because it dehumanised people. Yet they dehumanised themselves and each other through rigid discipline and ideological policing.
This created existential contradictions. People motivated by deepest longings for justice and solidarity found themselves isolated from comrades for minor deviations. The grand meaning provided by revolutionary commitment coexisted with petty cruelty in personal relationships. Former members describe experiencing this contradiction acutely but lacking frameworks to address it.
The Party’s temporal framework contributed to the problem. Revolution was always imminent. The current period was always transitional, demanding total commitment and sacrifice until the transformation arrived. This postponed addressing present contradictions. Personal difficulties became secondary to historical mission. Yet the revolution’s perpetual deferral meant contradictions accumulated indefinitely.
Patient urgency rejects this deferral. It insists that how people treat each other in the present matters. Movements cannot postpone addressing internal contradictions until after revolution. The means must prefigure the ends. Yet this creates practical difficulties. Taking time to work through interpersonal dynamics and psychological patterns can feel like distraction from urgent political work.
Scale and the problem of always meantime
Barbara Smith, decades after the Combahee River Collective statement, asked whether movements can wait for perfect political vocabulary before acting. The answer must be no. Political action always occurs in the meantime, before ideal conditions arrive. All we have is the meantime.
This temporality differs from both revolutionary impatience and reformist gradualism. Revolutionary impatience treats immediate transformation as possible and delays as avoidable failures of will. Reformist gradualism accepts existing pace as natural and counsels patience without urgency. Patient urgency insists change is urgent whilst accepting it will be gradual.
The concept refuses teleological narratives where early idealism inevitably degenerates into dogmatism or where movements naturally mature from radical demands to practical compromises. It instead identifies an ongoing tension that cannot be resolved but must be managed. Movements must act urgently on immediate problems whilst accepting that full transformation extends beyond any individual or generation.
Therapeutic implications
Patient urgency challenges both mainstream therapy and some radical alternatives. Mainstream approaches often aim to adjust individuals to existing society. They treat persistence of old patterns as pathology requiring cure. The goal is functional integration into current systems.
Some radical alternatives invert this, treating any psychological focus as depoliticising distraction. They insist people should overcome personal difficulties through political commitment. Psychological distress becomes evidence of insufficient revolutionary consciousness.
Patient urgency rejects both frameworks. It acknowledges that people carry real psychological wounds from living under oppression. These cannot be willed away through political commitment alone. They require sustained attention, care and therapeutic work. However, such work cannot aim at adjusting people to oppressive conditions. It must support transformation whilst accepting its gradual pace.
This creates paradoxical therapeutic stance. Help people change whilst accepting they will remain contradictory. Address psychological suffering whilst maintaining that full healing requires social transformation. Work on subjective change whilst acknowledging systemic change cannot wait for individual readiness.
Political implications
Movements organised around patient urgency look different from those demanding immediate purity. They create space for ongoing learning and transformation rather than requiring perfect alignment before participation. They understand political development as process extending across lifetimes rather than event achievable through single conversion.
This does not mean abandoning standards or accepting harmful behaviour. It means distinguishing between patterns people are working to change and patterns they defend or ignore. It requires collective practices for accountability that acknowledge difficulty of transformation rather than assuming change happens through decision alone.
The Combahee River Collective’s formulation proves instructive. They committed to examining how they internalised oppressions whilst fighting those oppressions externally. The work was simultaneous, not sequential. They did not wait to perfect themselves before organising. They organised whilst working on themselves, understanding both as ongoing rather than completable.
Contemporary movements face similar tensions. Callout culture sometimes demands instant transformation as proof of political commitment. People are expected to immediately adopt new language, frameworks and practices. Lag between understanding and embodiment becomes evidence of bad faith.
Patient urgency suggests different approaches. It maintains that people socialised under white supremacy, patriarchy and capitalism will inevitably carry those systems’ marks. Political work involves collectively examining and transforming those patterns whilst fighting the systems reproducing them. This work has no endpoint. There is no final purification. There is only sustained effort toward transformation that extends beyond any individual life.
Limits and dangers
Patient urgency risks becoming excuse for avoiding change. Claims that transformation takes time can mask unwillingness to transform. Appeals to complexity can defend harmful behaviour against legitimate critique. The concept requires distinguishing between genuine engagement with difficulty of change and refusal to change.
The distinction appears in practice rather than theory. Are people actively working to transform problematic patterns or defending them? Do they seek accountability and support for changing or resist examination? Is the appeal to time part of sustained effort or justification for inaction?
Additionally, patient urgency applies differently to different forms of harm. Physical violence and immediate safety threats require intervention regardless of perpetrator’s developmental timeline. The concept addresses how movements work with contradictions and incompleteness, not how they respond to acute harms.
The temporal paradox remains unresolved and unresolvable. Political transformation is urgent and consciousness transformation is gradual. These temporalities conflict. No theoretical solution eliminates the tension. Patient urgency names the tension whilst insisting movements must work within it rather than pretending it does not exist.