Psychotherapy, Society, and Politics

From Theory to Practice

Nissim Avissar

• Publisher: Palgrave Macmillan
• Year: 2016
• Print ISBN: 9781137575968
• eBook ISBN: 9781137575975
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

This book offers a comprehensive overview of the overlap between personal and political aspects of life within the context of psychotherapy. It sketches out a clear and detailed narrative of the complex interrelations between psychotherapy, society, and politics. It articulates a theoretical basis for politically conscious and socially responsible therapy work, as well as the guiding principles in implementing this position. Many psychotherapists find themselves struggling when faced with political issues that come up in treatment, both overtly and covertly. Many of them find value in clarifying political aspects of clients' lives and psychotherapy itself, but are hesitant to touch upon this loaded issue or do not know how to approach it. Nissim Avissar's book opens up new possibilities of thinking afresh on psychotherapy, in a way that takes into account real life conditions and the effects of professional work on the social environment.   

Part I
Theory

© The Author(s) 2016

Nissim AvissarPsychotherapy, Society, and Politics10.1057/978-1-137-57597-5_1

Begin Abstract

1. Politics–Not What You Had in Mind!

Nissim Avissar^{1, 2}

(1)

Kibbutzim College of Education, Tel Aviv, Israel

(2)

Interdisciplinary Center Herzliya, Herzliya, Israel

End Abstract

Often psychotherapy and politics are considered antagonistic to one another, detached and even clashing. Conventional perceptions of these two domains also place them at two opposing ends of an absolute dichotomy: one private and the other public; one abstract—related to the psyche or mind—and the other real and concrete; while one is mainly marked by emotion and empathy, the other is dominated by power and interests; one is perceived as altruistic and the other as serving the motives of either individuals or a power group; and so on. It is then no wonder that many therapists think that politics is other people’s business and that they had better stick to their own “clean” work in therapy. At the same time, people who engage in political activity do not usually set great store by psychotherapy, the views it tries to promote or its modes of action. These then, it would seem, are two separate domains, alien to one another and functioning in a manner that clashes with each other’s means or objectives. This way of thinking is apparently the outcome of the many years of psychodynamic hegemony in the psychotherapeutic discourse and of dogmatic versions and offshoots of it. Even today, dichotomous views regarding psychology and politics are predominant in the psychotherapeutic community. Many psychotherapists are reluctant to have anything to do with politics or its associated therapeutic and social activities. They shy away from (and at times wholly avoid) the term wherever it concerns their work.

Often called apolitical, this position in fact is decidedly psychotherapeutic-political, and, like any other stance, it entails its own implications, possibilities, and dangers. While it facilitates a focus on the individual and his or her experience, which then opens the possibility for personal change of patterns and values, it also blunts sensitivity to reality and to how it affects individuals. In its extreme version, the intrapsychic approach with its convergence on the individual’s interior, unconscious world wholly ignores external factors, including extreme situations and events. It is hard to believe how this approach still has a firm grip on therapeutic discourse and practice. Clients, as a result, stand blamed (indirectly) for their own suffering, confronting the expectation to adjust themselves to reality no matter what its nature, even if it is harmful. The voice of such therapists, at the same time, is not heard in the public discourse, so that their silence tacitly condones injustice and passively supports things as they are. On the opposite side are those therapists who render themselves an account of the environment’s impact and of the damaging effects of oppressive or harmful power relations on the individual’s wellbeing. Emphasis on external sources of suffering is added to other effects the individual has on his or her surroundings, yielding an integrative psychotherapeutic perspective. Here individual and environment and client and therapist are bound together by reciprocal but not symmetrical relations. New possibilities of understanding the individual and of intervention with the aim of reducing suffering emerge at this point. Here politics constitutes an inherent dimension of human existence (including psychotherapy) that cannot be ignored.

To illustrate the difference between these two perspectives, I will refer to an episode from psychotherapeutic practice which deeply impressed me. When I was an MA student in clinical psychology, a man of about 60 was referred to me. He complained of difficulties in making contact and in interpersonal relations. He was a worker, he had a family, he was sensitive, and he had a rich inner world. Still, because of his difficult relations with his wife, he often preferred to spend the night in his car. I was aware of this and it became a main issue for reflection, with me suggesting my reservations and inquiring into alternatives. The therapy was on a once-weekly basis and, perhaps because he was a experienced client, our relationship was successful and satisfactory. At times we achieved interesting and moving insights. It seemed our conversations sparked off some internal dynamic, starting with an insight that was bound to lead to a change in personal patterns—and from there to change in his life and wellbeing. The therapy would have continued like this had I not been “forced” to present his case in supervision. My supervisor drew attention to the implications of my client’s situation, the fact that he was spending the night in his car, and what all this meant for his everyday reality and his ability to take care of his basic needs. My supervisor’s drift was that what we were witnessing here was a personal-humanitarian crisis, which I should not condone—not as a fellow human being, let alone as a therapist. I was surprised: after all, I had not looked aside and I had done what a psychotherapist could be expected to do. My supervisor’s comment nevertheless helped me connect emotionally to the situation of this client, who could have been my father in terms of his age. My supervisor reached, accordingly, an unconventional conclusion: he recommended that I confront my client with the following ultimatum—if he continued to conduct himself like this, I could not go on being a passive bystander and would have to discontinue the therapy. Now, my verbal position was backed up by appropriate action. In spite of my apprehensions and thanks to the emotional connection, I decided to take his advice. The change that occurred in my client’s life as a result of this intervention was drastic, with implications that went beyond the therapeutic relationship (though they certainly did not pass unnoticed). The client left home and moved into an apartment of his own. He began to develop other social relationships, and his way of seeing the world, along with his self-image and his vitality, changed beyond recognition. Here my dynamic-psychotherapeutic approach was dealt a blow in order then to find a new opening for the powerful impact of living conditions on psychic wellbeing ¹ : living conditions and psychic wellbeing—such a simple, commonsensical truth which is so easy to forget when you get immersed in narrow intrapsychic thinking.

This book aims to describe and formulate approaches, models, and therapeutic tools associated with this neglected side of psychotherapeutic theory and action. In this book, I refer to this side with the concept of politics. And because this is a complex notion encompassing a whole range of meanings, a definition is required for the sake of clarity, right from the outset. Politics, in the narrow and common sense of the word, refers to governance, state-related processes, public representatives, and governmental decision making. This is why “politics, most people assume, takes place only in specifically designed institutions, such as the cabinet, parliament, parties, and the judiciary, which all have to do with the state and the practice of government” (Brunner 1995, p. xxxiii). This is politics in the limited sense, a narrow and divisive politics. Mental health professionals may well be avoiding just that meaning of the term, that of factional, party politics which does not allow creating closeness and trust and will only lead to arid political wrangling and argument. However, by wholly giving up on the notion of politics they also lose out on some meanings of it that are vital to therapeutic work, indeed, some would say meanings that are right at the center of that work. Politics in the more expansive sense of the word addresses relations between human beings and the way one person’s actions affect those of others. Political action, that is, is bound to be the action of an individual who is not a public figure; in fact, such action may well not at all take place in the public domain. Politics in this sense is an aspect of all social relations (Stoker 1995). We are, nevertheless, dealing here with relations that affect an other, relations of power, whether explicit or implicit. So here the definition of politics closely implicates power, much as it was proposed by David Cooper, one of the major figures in the Antipsychiatry movement (whose name he actually coined), “politics has to do with the deployment of power in or between social entities” (Cooper 1974, p. 4).

In this broader definition, politics is concerned with power relations, with issues of influence, and with the oppression of individuals. The connection between this definition of politics and psychological work—with groups, families, or individuals—seems obvious, as there are no relationships that are not inscribed by power. And hence the political is about relationships, and those that affect people, their development, and their wellbeing. Similarly, the currently dominant approaches in psychotherapy are devoted to relationships and the ways they affect individuals. Often, it is the power relations in their clients’ lives that therapists deal with, only without calling them so. Instead, they choose to take the political sting out of the therapeutic discourse, and then to conceptualize the political drama in the apolitical terms of inner conflict. As I will show, this has negative implications both for therapy and on the societal level. It is therefore important to mention another distinction: that between overt and latent politics. Power relations may be latent both in terms of their social visibility and in the sense of being unconscious. When power relations are hidden, they may have a more insidious influence than when they are visible. They are hard to identify and to address, insinuating self-doubt. In such cases moreover, the person with power will find it hard to take responsibility for his or her actions and their outcomes. These types of power relations are also likely to inadvertently (yet nonetheless damagingly) emerge in therapeutic situations.

A definition like this, identified between politics and power and its uses in society, pulls the rug from under the dichotomy whereby the personal squarely opposes the political, for it does not limit itself to collective contexts like the relations between groups or countries, and obtains just as much for relations between and among individuals. The motto “the personal is political,” writes Jenny Chapman (1995), was first used by the US Civil Rights Movement, and only subsequently became a central motif in contemporary feminism. The author explains:

Politics is in all the decisions that shape our lives, not only those made in the restricted arena conventionally described as ‘politics’. This is not merely a matter of widening the focus from central institutions and political elites to local politics and community groups; it means that relations between individuals, even of the most personal and intimate kind, reflect the general situation of the broader group to which they belong. (p. 100)

It should be stressed that politics or power relations as such have no a priori moral meaning: power can be deployed either in a positive manner, to improve people’s wellbeing, or negatively, for instance, through oppression or violence. It is through a (critical) awareness of power in relationships that abuse or uncontrolled use can be kept to a minimum.

I take another relevant distinction from critical discourse. This theoretical discourse raises fundamental questions about reality, challenges the self-evident, and strives for a profound understanding of the hidden processes shaping our lives. Focusing on power relations and interests, this is an emphatically political discourse. It also entertains abundant, reciprocal relations with psychological theories, especially with psychoanalysis (a prominent example of this kind of productive association is the work of the Frankfurt School). Current critical discourse makes a common distinction between “the political” and “politics” (Shenhav 2009). The political represents what is divergent, what subverts the existing order and what exists, concealed, everywhere. In this sense, the political is elusive. It is not overt; it may only be identified by its implications and the discontent they create. Politics by contrast refers to the power relations between individuals and groups: in the form of discrimination or privilege. Politics thus relates to the public domain and the distribution of resources within it, even where it concerns the personal. It is, as such, likely to be overt and open. This book centers on politics rather than on the political, on the collective processes that affect the formation of an identity, relations, and wellbeing. I have not consistently observed this distinction, perhaps because the two are interconnected. A discussion of politics, for me, and of its mutualities with psychotherapy is a convenient starting point for a wider-ranging and more in-depth discussion of the political. The explicit level, that is, can serve to open a discussion of the more submerged, including its possible manifestations in therapy.

Politics, then, is realized through individuals’ acts or in relations between people or groups, including those that do not take place in the context of a state’s or a government’s activities. Seen from this perspective, the self, which is sometimes thought to spring from a person’s inside and to express his or her uniqueness, reflects the actions of the political instances (power structures) that constituted him or her to begin with. From this, one can derive that situating relations of any kind or type in a broad context of time, space, and society is an act of politicization or of exposing the political within the private. This sort of action, as we will see below, may have positive implications for the development of both individuals and groups.

Note

1. 1.
   The supervisor to whom I am deeply indebted in this matter is Prof. Haim Omer.

References

Brunner, J. (1995). Freud and the politics of psychoanalysis. Cambridge, MA: Basil Blackwell.

Chapman, J. (1995). The feminist perspective. In D. Marsh & G. Stoker (Eds.), Theory and methods in political science (pp. 94–114). London: Macmillan Press, Ltd.CrossRef

Cooper, D. (1974). The grammar of living. New York, NY: Pantheon Books.

Shenhav, Y. (2009). On the Auto-nomos of the political. Theory and Criticism, 34, 108–190

Stroker, G. (1995). Introduction. In D. Marsh & G. Stroker (Eds.), Theory and methods in political Science (pp. 1–20). London: Macmillan Press, Ltd.

© The Author(s) 2016

Nissim AvissarPsychotherapy, Society, and Politics10.1057/978-1-137-57597-5_2

Begin Abstract

2. Psychotherapy’s Forgotten Political Narrative

Nissim Avissar^{1, 2}

(1)

Kibbutzim College of Education, Tel Aviv, Israel

(2)

Interdisciplinary Center Herzliya, Herzliya, Israel

End Abstract

For a long time, politics was considered off limits by mainstream psychotherapy. So generations of therapists were instructed to keep away from any visible public activity, especially those that might give away their political affinities. Such avoidance, however, of direct involvement in politics in this narrow sense is only a small aspect of a much wider-ranging phenomenon. Even in therapeutic practice and theory, very little attention was devoted to how broad political factors (such as ethnicity, gender, or class) affect mental wellbeing and to how to refer to any political issues that might emerge in the course of therapy. Training and supervision processes have led many therapists to ignore or remove themselves from any realistic response to issues unrelated to the individual and his or her personal associations. Personal characteristics with a political interface were considered largely irrelevant to psychoanalytical techniques ...

Table of contents

• Cover
• Frontmatter
• 1. Theory
• 2. Practice
• 3. The Israeli Case
• Backmatter