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This paper contributes to the current debate about decolonisation by rethinking the theoretical base of psychotherapy. It offers, first, a reformulation of the problem of human suffering that draws on the concept of alienation as detailed in the works of Karl Marx, Frantz Fanon, and Erich Fromm. Second, it presents an alternative reading of Wulf Sachs’ psychoanalytic text, Black Hamlet, as viewed through the prism of alienation theory. And third, while affirming the significance of that classic work for psychotherapists today as well as the salience of alienation theory, the paper raises complex questions about the integration of Marxism and psychoanalysis.