Therapy Beyond Modernity

Deconstructing and Transcending Profession-Centred Therapy

Richard House

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429922909
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book draws together radical critiques of therapy and shows how therapists have become too willing administrators of the mind, and how they then delight in the bureaucratic management of therapeutic practice.

Part I
The Profession-Centred Therapy Form

Consider:

"Regimes of truth govern what can be spoken about, and they also define what will be seen as nonsense or madness"

Parker, 1997a: 7

"... a kind of power that binds us to others, to those to whom we confess and to those who originate the language within which we confess, at the very moment as it binds us to our own identity. So when I use these words—... neurosis, self esteem ...—I am also activating a whole 'regime of truth', an array of authorities who stand behind this language and guarantee it, a complex of practices and procedures"

Rose, 1997

'"You give me a great deal of power', [my therapist] said once ... But it wasn't him who held the power. It was the situation ... What is it about sitting in a room, alone, regularly, with one other person and talking about oneself that can unleash such ungovernable emotions? Whatever the answer, it is still one which is far from being understood and until it is, therapists and their patients are liable to find themselves in a similar position to that of children playing with a live bomb"

Alexander, 1995: 86; 1998b: 95, my emphasis

CHAPTER ONE
Therapy in deconstructive perspective

"... is there something specific to therapeutic relationships that tends to dispose them towards unbeneficial consequences? Is there something inherently problematic in the therapeutic encounter?"

Spinelli, 1995: 157

"... therapeutic language, therapeutic techniques, therapeutic scenarios, the proliferation of the therapeutic through our culture, has a role in fabricating us as certain lands of persons ... the client needs to become a 'good subject of therapy' by representing their problem in a particular psychotherapeutic form ..."

Rose, 1997

This book is not about abuse in therapy, or abusive therapists, but rather, its concern is abuse by therapy itself—by the very form that profession-centred therapy takes in modern culture, with its various technical, theoretical, and 'professional' accoutrements. What I have called elsewhere the culturally legitimated "Professionalized Therapy Form" (House, 1999b) can, I maintain, routinely not only of itself be intrinsically abusive, but can actively set up a milieu in which abuse may be to some extent inevitable, irrespective of the conscious intentions of the therapist (which, of course, I hold to be predominantly well-meaning and well-intentioned).

On this view, therapeutic abuse can be said to occur to the extent that an artificial framework (of profession-centred therapeutic practice) is created in which, at the margin, infantilized patients can be thought unable to take responsibility for their own choices or behaviour. On this view, it further follows that at least some "abuse" may be uniquely attributable to, even precipitated by, profession-centred therapy's "regime of truth", with its active (sometimes deliberate) precipitation of power imbalances, transference dependencies, and infantilization experiences. In addition, so called "abusive therapists" could be seen as being just as much subject to the "regime of truth" that is artificially set up within profession-centred therapeutic discourse as are so-called "abused clients"—albeit, of course, in a different way. I think Ingleby is saying something similar when he writes that, "What the patient submits to is not the rule of the analyst, but the rule of analysis, to which the analyst is every bit as subject. The real authoritarianism of psychoanalysis lies not in the domination of patient by analyst, but in the domination of both by the analytic doctrine" (quoted in Lomas, 1987: 102-103, my emphasis).

"Rosie Alexander" (1999) has expressed something similar:

Many people have the same kind of experience in therapy, principally the invasion of one's emotional space to the exclusion of all else and the suffering of unrequited desire to an incapacitating degree. Doesn't this indicate the existence of some common psychological catalyst in the therapy process rather than a diverse collection of bungling therapists? [ibid.]

In this view, then, abuse is seen as being intrinsic to the form taken by therapy and the forces triggered within the therapeutic relationship, rather than being laid at the door of a few aberrant "rogue" therapists. I will have cause to return to this radical proposition in myriad ways throughout this book.

It is interesting to reflect on the way in which, when therapy is seen not to work, it is almost invariably "blamed" on (bad) therapists, rather than the whole project of therapy being called into question. Perhaps this has something to do with the deep "victimhood" dynamics of blaming which are so easily triggered within the framework of profession-centred therapeutic discourse (cf. Hall, 1993), with most therapeutic approaches either explicitly or tacitly embracing the ideological assumption that past experience in large measure determines present experience. For, as Alexander puts it, "Perhaps it's more emotionally satisfying to blame a person rather than a methodology—a person, after all, offers a target for all the anger and vengeance which are so often churned up [the raging infant of Jill Hall's 'reluctant adult'—RH]... but the result of this is that the 'wood' of the problem is obscured by the 'trees' of the individuals involved" (personal communication). This is a central theme to which I will return repeatedly in what follows.

The French Marxist philosopher Louis Althusser talked of "history without a knowing subject"; and in similar vein, I will attempt to show how therapy, as legitimate cultural form, may well entail certain pervasive deleterious effects, the consequences of which typically lie outside the "normal" awareness of both therapists and clients. Very occasionally, the veiled opacity of these effects is momentarily laid bare, only for the lid to be slammed shut again before the field has afforded space for mature and undefended reflection on what is unearthed. Thus, for example, (ex-) therapists (e.g. Jeffrey Masson in Against Therapy, 1988) and ex-clients (see Chapters 6-8, below) have dared, either explicitly or implicitly, to point a finger at the "Emperor's-clothes-ness" of therapy, and to suggest or imply that its iatrogenic effects go far wider than the odd "rogue" abusive therapist. Yet such critiques tend to be heavily rooted in the emotional; and while for me this does not in any way compromise their legitimacy or authority (given that there is no logical reason why the rational should necessarily be privileged over the emotional in claims to "truth"), it has enabled the defenders of and apologists for therapy to write off their criticisms as just so much "acted-out" or "unworked-through" neurotic "material" or "psychopathology" (e.g. Holmes, 1992).

As Masson himself has pertinently pointed out (cf. Masson, 1992b: 23, note 3), however, whether or not one's arguments or criticisms are valid is logically quite independent of their possible origins in "neurosis" (Hitler no doubt had many "valid" insights about all kinds of things); so the therapy establishment's deeply personal, ad hominem character assassinations that greeted Masson's Against Therapy in the late 1980s were not only in many cases deeply distasteful, but constituted a woefully inadequate response to the substance and implications of Masson's critique, however partial and incomplete it may have been (cf. Spinelli, 1995:153-154). From the client's (or patient's) perspective, Rosie Alexander points to what she calls the "hypersensitive defensiveness" surrounding these debates—a kind of "batten-down-the-hatches" mentality that is at ones both antithetical to the openness that therapy enthusiastically urges upon others, yet also hardly surprising, given the very considerable "professional" vested interests that are at stake whenever anyone—therapist, client, or cultural critic—dares to problematize the very project of "therapy".

In what follows I attempt to add decisive ballast to extant critiques of therapy with a sober, relatively unemotional deconstruction of what I call the form that profession-centred therapy typically takes—i.e. the specific therapeutic practices that therapy commonly embraces, and the theoretical justifications normally adopted to legitimize those practices. I will attempt to show how therapy, in its modern profession-centred form, increasingly functions as a "regime of truth" whose discourse actively creates identity and subjectivity (most centrally, the identities of "therapist" and "client"), and whose accompanying practices self-fulfillingly construct an ideological framework which then reinforces and guarantees the conditions of its own existence. As Nikolas Rose (1997) puts it, "therapies, their languages, techniques and types of authority, have actually played a significant role in making us up as certain kinds of self. The kind of persons that we now take ourselves to be are tied to a kind of project of our own identities ...".

More specifically, the very way in which such therapy is structured (or "framed") continually encourages and threatens to produce client infantilization and dependency through the deep unconscious dynamics triggered within profession-centred therapeutic discourse, and by the assumptive framework typically (and often uncritically) embraced by the therapist Thus, I want to make it unambiguously clear that my critique of "therapy" refers to what I call its profession-centred form (the full specification of which will become clear later). As I make clear in my concluding chapter, I draw a crucial distinction between such narrowly "profession-centred" therapy, on the one hand, and on the other, the kind of explicitly "deconstructive, post-professional therapy" which I advocate (coinciding quite closely, perhaps, with what others might call "human potential work"—e.g. Mowbray, 1995).

I maintain, then, that the very existence of profession-centred therapy as a culturally legitimate form of "intervention" serves to create a socially and ideologically constructed "regime of truth" which routinely constrains rather than liberates human experience, thereby bringing about the very opposite of therapy's professed intention—i.e. ossification rather than organic growth, change, or transcendence. More widely, furthermore, the ossifying cultural form of profession-centred, individualized therapy also serves to prevent or hold up the emergence of new qualitative shifts in the evolution of human consciousness. Perhaps the commodified form taken by profession-centred therapy has been a necessary stage in the evolution of human consciousness, and has served an important purpose. But what promised to be—and for many no doubt has been—a liberation has increasingly become a fetter which limits that very evolution; and on this view, critiques such as that developed in this book should perhaps be understood as a staging-point on the "human journey"—a harbinger, perhaps, of what I have called (borrowing terminology from Ivan Mich) a "post-therapy, post-professional era".

In similar vein, in his The Awakening of Intelligence, the formidable Indian philosopher J. Krishnamurti wrote, "How is one to examine [consciousness], how is one to expose the whole content of it? Is it to be done bit by bit, slowly, gradually?—or is it to be exposed totally and understood instantly, and thereby the whole analytical process comes to an end?" (1973: 60, my emphasis). Certainly, I would respond, such a species-wide shift in human consciousness most certainly will not occur while the ideology of therapy's regime of truth holds sway in modern culture. The contrast could hardly be more stark between the Krishnamurti-type view, expressed above, and that of analytic orthodoxy; here, for example, is Patrick Casement "There are no short-cuts to analytic experience. There is no other path than patience" (1985: 218). The problem with such a view, of course, is that it almost inevitably self-fulfillingly creates precisely what it has assumed to exist in the first place! (cf. McDougall, 1995: 235-236).

Kovel has aptly written that "To state the limits of therapy is also to recognise that the human situation has no closed end, but is rather in a state of continuous historical evolution" (1976: 93). And nowhere is this more starkly observable than in the great historical movement of human consciousness away from modernity and towards postmodernity. I believe that therapy is surely in great danger of becoming an anachronistic irrelevance unless it "post-modernizes" its approach to theory and practice, and its accompanying ideology of professionalization. For Barratt, for example, what he calls the "masterdiscourse" of modernity and the Enlightenment "is now in an irreversible process of collapse" (1993: xi). And though "we cannot yet fully articulate what 'postmodernism' will be, ... we do know that our traditional ways of thinking and speaking, of conducting our lives, are no longer viable" (ibid.). Barratt goes on to make the telling point that, "even in its death throes, [the modern masterdiscourse] still constitutes our every moment of thinking, speaking, and acting" (ibid.: xii); and hardly could one find a more glaring example of this phenomenon than the world of therapy, caught up as it still is in fighting all the old, outmoded battles of modernity and profession-building, long after the epistemological ship has left port for a very different destination.

Along with a number of colleagues (most notably those involved in the Independent Practitioners Network), I have been challenging the so-called "professionalization" of therapy and counselling for some years (see, for example, the anthology Implausible Professions— House & Totton, 1997a,b; House, 1999b); and the current book should be seen as a natural organic development of those critiques. Professionalization can never be a neutral, disinterested process— least of all in the highly peculiar field of therapy, as I will elaborate in detail below.

In what follows I intend to articulate in depth what Jeffrey Masson and other critics have erstwhile failed to address—namely, how abuse is built into the ideological discourse of therapy—into the very form that profession-centred therapy takes in modern Western culture. Yet I am concerned not to be hoist by my own petard by replacing one regime of truth with another of my own making: for as will become clear below, the difficulties I outline with profession-centred therapeutic practice lie far more in its very "being" as a regime of truth per se than it does in the specific content which that regime actually takes.

Thus, I do not by any means present my arguments as the truth about therapy—as somehow being a "better" regime of truth than that which it is replacing; for I sympathize with the Derridean view that it was and is a fundamental error of the Enlightenment project to build systems of "objective" truth which can be assumed to give us reliable, "objective" perceptions of "reality" (cf. Derrida, 1974; Polkinghome, 1990; see also my Chapter 9 on Georg Groddeck, below). Rather, my truth is inevitably a "local", subjective truth, based as it is upon my own particular and unique experiences of therapy as trainee, client, practitioner, supervisor, trainer, and scholar—and upon my best endeavours to interrogate the phenomenon of therapy as open-mindedly and in as presuppositionless a way as I am able—a state which Krishnamurti called "choiceless awareness". The late physicist Professor David Bohm embraced Krishnamurti's thinking to challenge what both saw as the tyranny and destructiveness of thinking, belief, and theoretical systems of all kinds (e.g. Bohm & Edwards, 1991; Krishnamurti, 1969, 1993)—and the emotional rootedness of that tyranny in a fear-driven experienced need for certainty ... which is in turn surely responsible in large measure for the wilder excesses and obsessions of the scientistic technocratic mentality of modernity (Bohm & Edwards, 1991). These are issues which will repeatedly crop up in the course of what follows.

It will come as no surprise, therefore, that I am an enthusiastic adherent of so-called "New Paradigm" philosophy—represented, inter alia, by the ideas informing the Scientific and Medical Network (of which I am a participating member), and by certain strands of postmodernist, deconstructionist, hermeneutic, and even vitalist thinking within Philosophy. The philosopher Henri Bergson, for example, highlighted the inadequacy of the intellect for grasping the full richness of human experience, which he saw as an indivisible continuum better represented by the artistic than by successions of "rational", conceptually demarcated conscious states. Bergson summed up succinctly the inappropriateness of the Enlightenment's hallowed "correspondence theory of truth", thus: "It is understood that fixed concepts can be extracted by our thoughts from the mobile reality, but there is no means whatever of reconstituting the mobility of the real with the fixity of concepts" (quoted in Steiner, 1973:421; cf. the ontologies of, inter alia, Karl Marx, Martin Heidegger, Jacques Derrida, Alfred Korzybski, and Jiddu Krishnamurti—Oilman, 1971; Polkinghome, 1990; Falconar, 1997).

The great—and criminally neglected—healer-cum-analyst-cum-philosopher and contemporary of Freud, Georg Groddeck, also had great sympathy with vitalist philosophy (Homer, 1988); and in the history of ideas and the evolution of human consciousness it is surely no coincidence that the recent rediscovery of Groddeck (e.g. ibid.; House, 1997a; Totton, 1998) temporally coincides with the current resurgence of interest in Henri Bergson's philosophy (Mullarky, 1999), and with the recent renaissance in Goethean science (Bortoft, 1996; Naydler, 1996). And the closely associated "re-enchantment" of science and nature (Berman, 1981; Baruss, 1996; House, 1999a), representing as it does a concomitant retreat from soulless positivism, is yet another manifestation of the paradigmatic sea-change that is threatening the hegemony of the "modem" technocratic world-view....

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• DEDICATION
• ACKNOWLEDGEMENTS
• FOREWORD
• ABOUT THE AUTHOR
• Introduction
• PART I THE PROFESSION-CENTRED THERAPY FORM
• PART II "CONSUMER" EXPERIENCES OF PROFESSION-CENTRED THERAPEUTIC PRACTICE
• PART III A NEW PARADIGM, POST-PROFESSIONAL ERA?
• PART IV WHITHER "POST-PROFESSIONAL" THERAPY?
• Conclusion: who, then, would be a therapist?
• AFTERWORD
• REFERENCES
• A SELECT BIBLIOGRAPHY Critical perspectives on/within therapy
• INDEX