Listen to thisRecently I found myself lecturing and answering questions about the value of psychotherapy. In my presentations, I prefaced my remarks with an acknowledgment that I was a psychotherapist for over twenty years. Indeed, I was a therapist’s therapist. A huge part of my identity was tied up in my professional role as someone who provided counseling and therapy to those suffering psychological and emotional pain. Even as a parent, my identity as a therapist spilled into my family life. I don’t mean that I psychotherapized my family (although there was probably more of that than I was willing to admit), but the fact that I was a therapist was so central to my identity that I saw my family as included in my vision of being a professional healer. Somewhere in the archives is a picture of my firstborn infant son asleep in a lazy boy with a copy of The Fundamentals of Family Therapy open on his chest as though he had fallen asleep reading it. Clearly, I posed the picture as a sort of joke, but as Freud would tell us, jokes have loads of unconscious desire buried in them, and my joke was no different. I should note that my son has gone on to be a very competent and thoughtful psychotherapist in his own right. My point is that my life, both personal and professional was deeply invested in being a therapist.
All of that said, I was not a very conventional therapist. I like to say that I was fortunate to have missed out on early indoctrination into the classical tenets of psychotherapy rooted in psychoanalysis, psychology, and psychiatry. I entered the helping professions through the back door as it were. I started as a community volunteer in a day treatment program with young psychotic adults. I had never so much as taken a psychology class. I had a degree in comparative literature and significant exposure in the 1960’s and early 1970’s to psychedelically induced psychosis as the zeitgeist of the times. I guess I could say that some of my earliest experiences in psychotherapy was talking people down from “bad trips.” In any case, I applied as a volunteer in some part because I thought I knew something about being psychotic. And as it turned out I was pretty well suited to the work. I really liked working with the young people coming out of institutions in those early days of deinstitutionalization.
The mental health center where I worked was almost entirely staffed by volunteers with a much smaller cohort of psychiatrists, psychologists, and nurses. As a result, there was a need to train these volunteers in how to approach a group of clients that conventional psychiatry considered only marginally treatable with the newly emerging world of anti-psychotic medications.
It was an unsettled time for psychotherapy, psychiatry, and psychology. There was a range of alternative approaches to working with all sorts of human dilemmas that spanned anti-psychiatry, family therapy, brief therapy, Ericksonian hypnosis, provocative therapy, systemic therapy, strategic therapy, person centered therapy to name but a few. It was an exciting and innovative time to enter the field.
All these emerging fields of practice were highly controversial. Psychoanalysis was still the predominant mode of treatment and family work was considered highly contentious. Indeed, the early family therapists kept very quiet about the fact they worked with families for fear of being professionally ostracized. Milton Erickson, whose work with hypnosis provided the foundation for brief, strategic, and solution focused therapies, was loudly denounced as psychotic and dangerous. All of that said, the mental health center where I worked brought in the most radical of all these practitioners to train the staff and volunteers in how to work with the population being released from the asylums and into the community.
So, I was initially trained in the most radical anti-psychiatric, anti-psychoanalytic, and anti-diagnostic treatments available at the time. It was three years before I went to graduate school in counseling psychology and learned there was a whole other world of conventional psychological, psychoanalytic, and psychiatric theories and practices. Of course, I was aware such things existed, but I had the impression that such ideas and practices were over and done with. I was regrettably sorely mistaken as the federal monies available for community mental health increased so did the force of the medical model. The mental health center was able to hire more psychiatrists and nurses and use less volunteers and unconventional therapists. The use of medications as a primary intervention became the norm and other approaches faded.
That was too much convention for me, and I left the center. I sought further training in brief family therapy, strategic work, and Ericksonian hypnotherapy. I eventually became licensed as a Marriage and Family therapist and after a while as a Licensed Professional Counselor. I was also certified as a social worker for a few years when I worked in the prison system, but that is another story. My point is that I went deeper into the field, both in terms of credentials and practices. I had a private practice, was clinical director of several large youth service organizations. I went on to eventually train other clinicians in solution focused therapy and brief therapy. I was deeply invested in the project of psychotherapy both theoretically and in my practice.
Somewhere around 15 years into the field, I came across the work of Charles Waldegrave and the Family Center in New Zealand. I was intrigued by their attention to the cultural and political context of their work and brought them into my agency to do some training on doing what they called Just Therapy. Charles Waldegrave was trained in the same kinds of approaches I was, but had taken the justice implications of the newly emerging Narrative Therapy approach further than I had done at that point. So, I assumed that Charles and I held the importance of psychotherapy in common.
Then, one day, Charles and I were talking, and he asked me why I was still doing therapy. I was stunned by the question and stammered something like “because that’s what we do isn’t it.” He then told me that they had stopped doing therapy at the Family Center because they had come to believe that without social intervention, psychotherapy was just accommodating people in the system that was causing the problems in the first place. The team at the Family Center had moved from psychotherapy into collaborative political work with their clients analyzing the economic and politic conditions of their lives and jointly mobilizing to take direct political action. I was completely taken aback, but what he said resonated deeply for me. It took another five years or so, but it was the beginning of the end of my relationship with psychotherapy.
That was over twenty years ago now and my ambivalence in the psychotherapeutic project has only increased as the years passed. It isn’t that I think that psychotherapy doesn’t work or that it fails to ameliorate emotional and psychological hardships. I have heard far too many people over the years tell me how psychotherapy has been helpful to them and those around them. Certainly, during the time I was a therapist I saw the people I worked with successfully engage therapy in resolving quite difficult and painful dilemmas. My problem is not that psychotherapy doesn’t work, my issue is that it does.
Now that may seem like a puzzling and problematic assertion. If psychotherapy works to help those who are suffering from emotional and psychological pain and struggle, why wouldn’t I embrace it? It is a very reasonable question that requires that we dig a little deeper into what it means to have the kind of emotional and psychological relief that psychotherapy offers. I would argue that the kind of process that psychotherapy engages in the process of being helpful does more than just solve problems or mitigate pain. It also creates a certain kind of subjectivity; a certain kind of person if you will. And the kind of person that we become is a psychotherapeutic subject saturated with the logics of European colonial identity and the desires of global capitalism.
In a sense, psychotherapy operates like a silent partner in promulgating the kind of person 21st century capitalism most desires. Not intentionally of course. There are many ethical and justice-oriented therapists who seek to do the very best they can for the people they see in their practice. They try quite hard to be aware of the social determinates of health and mental health in how they approach their work. But, I would argue that psychotherapy is in a co-evolutionary entanglement with psychology and psychiatry both of which have been deeply and intimately engaged in capitalist logic from their inceptions. As critical psychologists such as Ian Parker point out, psychology is very much an industry designed to both produce good capitalist subjects and obscure from view the fact that this is its purpose.
At the most fundamental level there is the ongoing production of norms to which all psychological subjects, including those involved in psychotherapy, are measured against. This can take overt forms such as diagnosis or developmental frameworks or be imbedded more subtly in campaigns that measure what is healthy or what constitutes good self-care. Under any of these measures we all fall short and are called upon to improve and join in the march towards the “better” us. The program is prescriptive, even when it draws on our own idiosyncratic ways of thinking, living, or feeling. The prescription has to do with a program of self-renovation in which we get rid of the toxic influences in our life, set boundaries against those who diminish who we really are, and learn to affirm ourselves as positive actualizing human beings.
So, what could be wrong with that? It all sounds pretty good. We feel better, are more active, less diminished, more centered and stable. If psychotherapy can assist me in doing that, why wouldn’t I pursue it? My concern is the context for such pursuits. Psychotherapy builds a commodified relationship that can’t help but emphasize a sense of individuality and self-focus. As I write this, I can see how normal such a framework has become. Of course, psychotherapy is about me and centers my concerns, pain, and struggles as the center of the work I will do with my therapist. And of course, there is a normative hierarchy of better feelings, healthy boundaries, an increased sense of stability and so on.
However, I would argue that these assumptions are entirely socially constructed to the advantage of the existing system. The process of valorizing the well-being of the individual self in the context of a pay as you go relationship of two obscures the inherent alienation of 21st century life. We seek therapy because we have largely destroyed the natural healing ecologies of collective care. We pay for professional help because we no longer know how to trust each other to provide the kind of nurturance and support we need. We retreat into ourselves and pay for boundary training because we have become distrustful and frightened of actual messy living relations. We flee the inherent pain of living relations because our emotional auto-immune system has been dangerously comprised by the mad conditions of life under capitalism. We seek psychotherapy to bolster our capacity to resist the madness of the world that is constantly threatening to eviscerate our humanity and leave us empty of all capacity for joy.
The trouble is, psychotherapy is compromised in ways that can’t really allow it to function in the ways that someone like Carl Rogers would have hoped. It is too deeply embedded in the money matrix of capitalist relations and too distant from the actual complex ecologies of collective relations. It is infected with European colonial notions of expertise, scientific objectivity, rationality, reason, taxonomies, and hierarchies. It calls on therapists to stand apart from their clients or patients. In a word, it is too sterile to really promote love or life. Instead, it settles for solving problems, correcting thoughts, managing emotions, and creating new stories.
At the end of the day, this is just not enough for me. To survive in ways that will push back the death drive of our current social system we need more than what psychotherapy offers. While there are therapists who can assist us in decelerating our psychic spinning enough to see more clearly what is happening, that is not enough. To paraphrase Deleuze and Guattari, we need to blow the walls off the therapy room and let the free winds of life blow out the stale air of commodified relations. We need to collaborate with each other, not as clients or therapists, but as loving, caring conspirators dedicated to reestablishing the kinds of living ecologies that will reinvigorate our emotional and psychic collective immune systems. If we can do that, then maybe there will be a glimmer of light in the darkness that is enveloping the age in which we live.
