The Politics of Psychotherapy - On Psychology and Psychotherapy

Psy-Complex in Question: Critical Review In Psychology, Psychoanalysis And Social Theory - Ian Parker 2018

The Politics of Psychotherapy
On Psychology and Psychotherapy

Totton, N. (ed.) (2006) The Politics of Psychotherapy: New Perspectives. Buckingham: Open University Press.

The world of psychotherapeutic politics meshes all too well with my own personal predisposition to split and squabble, only to be able to define a position by way of what it is against. There are at least two ways to play this game, which this review paper explores.

One way would be to trace the sources of my reflex sectarianism to its real roots, to how the political domain is currently constituted. Then we have another twist to that problem, which is that bizarre as many organised political movements are, therapy training institutions often seem to trump them all. As Andrew Samuels points out in an excellent manifesto summary of his standpoint on the relationship between politics and the couch, ’therapists are completely crazy in their own professional politics and the way they organize themselves radiates that craziness’ (p. 11). At a time when governments around the world are trying to regulate psychotherapy — a process, it should be remembered, that will squeeze out any space to discuss the issues aired in this book — it is a dismal task to persuade anyone that we can be trusted to regulate ourselves. Nick Totton provides a good overview of ’fragmentation, dishonesty, authoritarianism and rivalry’ in psychotherapy organisations and makes some perceptive comments on the attempt by some to arrogate to themselves the right to say who is and who is not suitable, contrasting such hierarchical power ploys with networks aiming for ’a new model of accountability and organization’ (p. 119). We also have a window into this crazy world in Petruska Clarkson’s account of how ’ethics’ in registration bodies is turned upside down, and it is indeed against that backdrop that practitioners of ’moral psycho-education’ on the confessional television shows who reach an audience of millions seem to be the most ’observably and demonstrably helping people’ (p. 106). The antics of those leading the main therapy training groups which function as a feeding ground of petty rivalries and demands for love must have the governmental regulators rubbing their hands with glee.

The little extra toxic twist to the problem — the transmission and condensation of political craziness into the heart of the profession that pretends to have something to say about forms of self-sabotaging misery — is signalled by Samuels’ acute observation that the most ruthlessly successful politicians ’now couch their utterances in the language of the emotions’ (p. 6). We need to explore further the consequences of this transformation in politics, for it draws attention to how the very tools that psychotherapists have used to understand politics have now been recuperated. The language of the emotions, which psychotherapists often imagine that they are experts in decoding and reformatting, has been absorbed, stripped of any challenge to power and turned against those who believed that another world was possible.

This poses a very difficult question for those wanting to use psychotherapeutic frameworks to tackle political issues, for now the stuff of therapy has already worked its way into social phenomena. It is not only that complex emotional dynamics drive conflicts around the world but that the language of the emotions is part of the apparatus that is used to incite and manipulate those involved. We can see this at work in various examples of progressive psychotherapeutic interventions, and there are clearly both attempts to mobilise concepts that will resonate with participants and, at the same time, attempts to outflank and outwit the forces that already make use of those therapeutic concepts.

Arlene Audergon and Lane Arye insist, in their account of work with a mixed group of Serbs, Croats and Muslims, that they must ’discover and support the group’s innate wisdom, timing and direction’ (p. 137), and such a strategy flows naturally from their belief that therapeutic change — therapeutic change as political change — must presuppose an underlying potential for ’deep democracy’. Such an appeal to ’democracy’ as a primordial progressive bedrock for ecological, feminist and left politics is made by many of the contributors to the book. But at the same time, the notion of ’community’ is now freighted with an ideological weight in which identification and cohesion often mix in a poisonous rather than curative therapeutic cocktail of justifications and practices. The effect is twofold; for at the same time as each of the communities in Croatia, for example, seeks collective accountability and responsibility, so governmental bodies aiming to stabilise the country under the new dispensation — neoliberal capitalism as opposed to the old regime of bureaucratic state-management — also call upon ’a deeper unity’. This means that Audergon and Arye must try to sidestep such already therapeutic conceptions of community unity and depth, and so they also attend to ’marginalized voices’ (p. 136).

The difficult political question is whether it is really the ’margins of group life’ that become the touchstone for political change or whether this is but a means to an end, to reach ’underlying shared human experience’ (p. 136). Emanuel Berman quite rightly calls on analysts ’to confront openly major issues in their country’s history’, and opens up some wounds within the Israeli body politic, but this is then set in a context that works, again, in a twofold manner that has profound implications for how ’community’ is to be understood. On the one hand, there is a focus on trauma among Israeli soldiers, and here we are told that ’as psychologists we have unique expertise, which is relevant to interpreting political processes as well’ (p. 153). On the other hand, the divisions between ’some European professors’ (those calling for an academic boycott) and ’Israeli protestors’ (those searching for ’Israeli-Arab dialogue’) are portrayed as harmful, leading to a feeling among some Israeli therapists ’of being backstabbed by their foreign colleagues’ (p. 147). Once again, even though it is not explicitly named using the same vocabulary, we face a choice between seeing marginal voices as a force for change or dissension as a danger to the deep democracy to come.

Canny politicians seem to know now that while appeals to democracy can serve well enough in their rhetorical armoury, it is much more effective to draw on a discourse of ’accountability’ and ’inclusion’, and this is where the language of the emotions turns into the language of power, where the regulation of therapy meets political strategies of therapeutic regulation. The stakes are then raised for those trying to do progressive work in therapeutic settings, for the questioning of ’simplistic narratives’ about the nature of society that radicals have always provoked now becomes a liability; as Jocelyn Chaplin notes, ’this very questioning has made possible the victory of consumer capitalism in which psychotherapy has fitted all too comfortably’ (p. 159). Her account of the ’Bridge Project’ in London exemplifies the dilemmas that radical psychotherapy faces, and it does so, again, in prioritising one particular dimension, gender, and its apparently seamless fit with the Department of Health. Documents prepared by government departments that call for ’transparency’ and urge a ’partnership way of working and a reduction in hierarchy’ require those who apply for funding to mirror the new language of the emotions in the service of the state, to speak the same language. The gap between tactics and ethics opens up when the therapeutic discourse — and here it is therapeutic discourse factored through feminism that is most salient — discourse that has already been recruited by the state feeds back and seeps into what the therapists say they are doing. This is striking, for example, in the claim that we would in other contexts read as an indictment of therapy that this mental health project ’is already working in ways recommended by the government with its theoretical commitments to equality’ (p. 160).

The Bridge Project is well known among left, feminist and anti-racist therapy activists in the UK precisely because it has historically had a commitment to the intermeshing of dimensions of class, gender and culture in personal and political oppression. As with the contributions by Audergon and Arye and by Berman which show how the politics of community (whether coded through motifs of ’culture’, ’ethnicity’, ’race’ or ’religion’) separated off from other dimensions of oppression is then susceptible to being reworked within a conservative therapeutic language of the emotions, so Chaplin’s account shows how the politics of gender disconnected from a broader political analysis become vulnerable to recuperation by politicians who are keen to speak our language as long as we also agree to speak theirs.

The role of class is addressed in the chapter on social activism by therapists in the US after 9/11. Katie Gentile and Susan Gutwill are quite upfront about tensions and choices, and perhaps it was easier to make this an explicit theme in a narrative account of activities by therapists seeking to reflect upon and intervene in debates following the terrorist attacks in 2001. Here (in the last chapter of the book) the contradictions are neatly displaced from the debate between psychotherapy and politics to differences within the emerging political groups formed by the psychotherapists themselves. That is, we can start to see how therapy in the realm of the political has also had to engage in a language which is not its own. Here the references to class served to divide the left from the liberals, but it is clear that the issue of class does itself already disturb liberal psychotherapists who find it difficult, though not, unfortunately, impossible, to render class into something that can be treated in the same way as other axes of ’difference’, culture, gender, sexual orientation and so on, and as if those axes of difference can also be treated in the same way, as the names for a generalised ’otherism’ Totton claims to have detected as including ’polarizing our own position as against any particular form of bigotry’ (p. 35). As Gentile and Gutwill point out, it is one of the underlying assumptions of liberal practitioners that US society is a classless society with equal opportunity for all (and it is much easier to tackle various axes of difference in the consulting room if you think that different categories of person have had equal opportunity to get in there to start with). You cannot get very far in radical political work with therapists unless you tackle this ideological assumption and the nature of the system that cynically draws on neutralised therapeutic discourse to sustain itself, a culture ’which has a particular disdain for the unconscious, the unknown and the uncontrollable’ (p. 175).

A first task for those working at the intersection of politics and psychotherapy, then, is, as Totton points out in his introduction to the book, to acknowledge and attest that all psychotherapists always already have a political view of their work: ’all psychotherapy rests on a theory — explicit or implicit, conscious or unconscious — of how people should be’ (p. xiv). This book is so useful because it puts that argument on the agenda and then follows it through in a number of different contributions in which we, as psychotherapists, can begin to argue openly about what our political views of our work in the world are.

I learned very quickly when entering the strange reduced world of psychology and psychotherapy that we do need to take seriously the other way of playing the game of psychotherapeutic politics — the diametric opposite of that taken by our dear comrades in the struggle who write off our work as indulging emotional incontinence — and that is to search within myself for the peculiar psychological satisfaction that is obtained by engaging in political activity.

Now, we have to include in this kind of reflection some of the vantage points on the relationship between politics and psychotherapy that are advanced in this book, for there is an asymmetry in the relationship as it is staged here that should in itself ring some alarm bells. Lenin is reputed to have said of the debate between Christianity and Marxism that if it is a Christian engaging in the discussion then it is has progressive dynamic, but if it is a Marxist then this meeting of minds is necessarily reactionary. This is not so much an issue about who is more vulnerable, though a therapeutic framing might highlight the way the more defensive Marxist who refuses to acknowledge the spiritual dimension to existence is secretly yearning for something and so is the more vulnerable partner in the debate. Rather, it is an issue to do with institutional framing, in which there are few good theoretical resources to understand, from the standpoint of politics, how therapy works, and many more resources to understand, from the standpoint of therapy, how politics works. This book rehearses many of the motifs that have been accumulated over the years within the psychotherapeutic literature, by therapists wanting to connect with politics who in the process frame politics according to their own preoccupations. In this particular case we have to tackle both how psychological concepts are explicitly employed by different contributors to interpret and intervene in politics and to tackle how psychological concepts are implicitly used to make sense of the relationship between therapy and politics.

In a number of cases the reduction of politics to psychological factors is quite explicit, and there will be many practitioners who will find in this kind of reduction some comfort. It is even quite possible that a radical political position could be elaborated that draws upon the supposed knowledge that we have about human and evolutionary psychology that would serve to undermine some still dominant ideological nostrums about people, of ’how people should be’.

John Lees and Dawn Freshwater, for example, are quite clear that they are concerned with a psychological understanding of alienation that should not be confused with a Marxist understanding of the term; then ’the mutual cycle of alienation’ in therapy driven by specialised expertise ’results in devaluing the direct experience of clients and underrating their capacity to see experience as it is’ (p. 129). This approach does at least, even as it introduces a phenomenological assumption — that we could ever be able to ’see experience as it is’ — still leave open the way for another (Marxist) account of alienation to be brought in to the argument to provide a broader political frame for what is going on. Hilary Prentice and Mary-Jayne Rust likewise make an explicit ecopsychological claim about the meaning of nature to human beings that serves to unravel some of the culturally-specific notions about what meanings are immediately and obviously available for interpretation in psychotherapy; they describe, for example, the interpretation of the story of cutting down of a tree in childhood as reduced to the role of the father, and ’never about the tree in its own right’ (p. 48). Again, there is an opening to another interpretation, other than concerning the father, that we are invited to think about even if we do not want to follow the idea that there is any such thing as a thing ’in its own right’. Judy Ryde also makes the useful and conveniently overlooked argument that psychotherapy is itself ’a western phenomenon’ (p. 75).

There are tensions between contributions over the extent to which psychological phenomena could be taken on good coin and cashed out as part of a radical project for psychotherapy. For example, Sandra Bloom makes an impassioned case for the role of ’trauma’ as a master concept which will underpin her analysis of a range of different social processes, and she then counterposes to this a ’natural democratic process’ that would obtain in ’a calm, healthy, well-functioning system’ (p. 24). Chess Denman, on the other hand, gives a concise overview of dominant and alternative views of sexuality, gender and object choice which sets itself against such prescriptions for what is taken to be normal or not, including sex in the consulting room: ’Depathologising even very aesthetically disgusting or morally reprehensible sex is a necessary preliminary to understanding it’ (p. 66).

Let us turn to some of the more implicit psychological claims that are used not only to warrant psychotherapeutic practice but then also to think about how psychotherapy connects with politics. One of the ways to tackle the tension between psychotherapy and politics is to search for some kind of ’balance’, nicely formulated by Samuels as the need ’to balance attempts to understand the secret politics of the inner world of emotional, personal and family experiences with the secret psychology of pressing outer world matters such as leadership, the economy, environmentalism, nationalism and war’ (p. 4). As with the motif of ’democracy’, which is something many of us in this context (and especially among these contributors) would be loath to admit that we did not unconditionally value and love with all our being, the motif of ’balance’ is something that is valued as an unquestionably good thing by many in the book. This ’balance’ between the two sides of the equation — psychotherapy and politics — then becomes the keynote claim in Totton’s introduction to the book where it is refigured as ’mutuality’: ’Psychotherapy and politics each problematize the other, and each contribute to solving problems that the other faces.’ (p. xvii).

But what if we were to go beyond these taken-for-granted categories ’psychotherapy’ and ’politics’ and see them as having been constituted as ineluctably antagonistic domains of practice? These domains of practice are reconstituted each time in a psychotherapy session in which two individuals separated from others, and separated from each other, meet to speak in a necessarily asymmetrical encounter, and they are reconstituted in each and every appeal to the language of the emotions by politicians who seek to anchor a particular programme of social management in the felt experience of their subjects.

It could be that the very attempt to connect psychotherapy and politics will serve to blur the difference between the two domains of practice, will run the two domains together so that contemporary psychologised politics — that style of management most appropriate to neoliberal government of deregulated services, a flexible competitive workforce and bespoke consumer markets — will seek a deeper warrant for its existence in psychotherapy. Psychotherapists then risk endorsing that kind of political system at the very moment they break out of their consulting rooms and becoming more socially engaged. In that sense the politics of psychotherapy has already been framed, and it is only the separation of the two that will allow psychotherapists, at least, to develop spaces in which we can take a critical distance from ideology, from any attempt to define how people should be.