Does Psychotherapy Reproduce or Disrupt Neoliberal Capitalism?

Researchers explore neoliberal influences on interactions in psychotherapy and question whether the radical potential of psychotherapy can counter prevailing social systems.

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A new paper, by Andrea LaMarre and a team of researchers in North America, examines the influence of neoliberal capitalism in the practice of psychotherapy. Their compelling work, published in the Journal of Constructivist Psychology, explores whether psychotherapy can counter the discourses that position individuals as entrepreneurial agents whose suffering is attributable to their personal or biological failures rather than to harm caused by oppressive systems.

“Psychotherapy under neoliberal capitalism can be characterized by an inherent contradiction. On the one hand, psychotherapy can be one of the key means of spreading and reinforcing neoliberal ideology and thus advancing the interests of finance,” LaMarre writes. “On the other, it can unsettle the capitalist political order by cultivating subjectivities that disturb the primacy and normalcy of the free-choosing, entrepreneurial self (this, of course, does not mean that therapeutic conversations can entirely escape neoliberalism).”

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Scholars have recently taken to exploring neoliberal capitalism and its relationship to psychology and psychotherapy. Neoliberalism is defined by the authors as “a political and economic system in which capital goods are controlled for profit by corporations and private owners rather than by the state.” They write that it can be traced to the mid-1970s reorganization of capitalism in response to the economic crisis following the Great Depression, “specifically the crisis of capital and wealth accumulation.”

Neoliberalism also refers to the role of finance in the shaping of social discourse and identities, LaMarre and team explain. Not only are ideologies of economics permeating institutional life, but they trickle into individual life by defining people by their proximity to the marketplace. In other words, people are positioned as “entrepreneurial agents” who are responsible for taking control of their own life, wellbeing, and health by working hard and promoting their own best interests.

In this way, the relatively recent economic wave of neoliberalism capitalizes on “individuals’ desires for independence, creativity, and happiness.” LaMarre and team describe that while neoliberalism has indeed benefitted the financial sector through increased profits and growth, it has “further divided society into classes,” increased debt and unemployment rates across the globe, and contributed to rising rates of social violence. Moreover, it has been criticized for protecting and justifying social power imbalances and economic control, at the expense of poor, working, and increasingly, middle-class individuals. The authors make the case that neoliberal policies result in harm to marginalized community members.

“Neoliberal policies have led to consequences that some describe as ‘catastrophic,’ including resource scarcity and disparities, increased demand for decreasing services, and human service worker distress and burnout.”

In this paper, LaMarre and colleagues discuss how a neoliberal capitalist context shapes how individuals’ problems are framed and responded to in psychotherapy and through psychological knowledge.

“We begin by examining neoliberal governmentality and critiquing depoliticized and Individually-focused accounts of people’ s experience and ways of working with clients, prevalent within psychology and psychotherapy,” they write. “Second, we discuss the role therapy practice has had and could have in neoliberal capitalism.”

In addition to this, the authors illustrate how neoliberal discourses can influence how clients perceive of themselves and their problems, either by reinforcing their perceptions or challenging them in therapy. LaMarre and team are driven by the motivation to initiate a critical discussion around psychotherapy in its surrounding context.

Psychotherapy is based on notions of individual agency and improvement, the authors contend. While some could argue that this stems farther back in history to Aristotelian and utilitarian concepts of personal wellbeing and pleasure, recent neoliberal policies have transformed health, education, and care services, such as psychotherapy, to commodities that promote individuals’ value as economic actors. The emphasis on rational and efficiency-based action within the neoliberal agenda promotes models of healthcare and public health that privilege medical models and an “entrepreneurial ethic.” As such, neoliberalism eschews the workings and impact of structural violence. The authors write:

“The neoliberal idea of the free-choosing self can be used to obscure and rationalize social inequalities and coercive interventions. From a neoliberal perspective, social problems and inequalities derive from deficits in individuals (e.g., some people are better than others at making “good” choices and taking advantage of opportunities), rather than from other possible sources, such as unjust and oppressive sociopolitical structures.”

The impact of neoliberal policies influences psychotherapy approaches and evidence-based practice guidelines when therapists, perhaps inadvertently, are complicit with these agendas and locate problems in individuals rather than in systems.

“The neoliberal emphasis on individual choice may obscure the reality of institutional racism and sexism and reinforce the notion that something is wrong with clients rather than with the economic-political system itself,” they write. “The complicity of psychotherapy in the project of neoliberalism is reflected in therapy’s propensity to advance and legitimize some forms of knowledge over others.”

The knowledge legitimized in psychotherapy is one that views autonomy and productivity as the assumed potential that individuals ought to aspire toward in order to align with the cultural ideal. The failure to achieve economic security and its promise of happiness is rendered a failure on the part of the individual. When psychotherapy is complicit in forwarding this emphasis on self-improvement and looking out for one’s best interest, it supports a neoliberal view.

Further, LaMarre and team unpack how psychological constructs, such as narcissism, social anxiety, depression, and others are depoliticized and decontextualized. However, these presentations are ways of acting and being made available within a society built around competition, self-promotion, gregariousness in pursuit of business ventures, happiness as a task, and avoidance of problematic shyness or social withdrawal.

The authors pose the following questions:

“If psychotherapy has been one of the central means or technologies of neoliberal governmentality, can we speak of antioppressive, anti-neoliberal therapy? Should therapy be eradicated as an oppressive institution or, at least, radically transformed? How might we begin to disentangle the neoliberal political structures within which therapy takes place and that it allegedly reinforces?”

LaMarre and team “optimistically argue” that it is possible for psychotherapy to involve a process of transformation that challenges neoliberal capitalist ideals. To do so, therapists must be informed of neoliberalism on various scales including at global and micro-interactions. Therapy consists of the latter, featuring discursive manifestations of neoliberalism within therapy goals and the ways in which problems are conceptualized.

The authors cite therapy approaches that focus on the role of institutions and systems in creating psychological distress including narrative therapy and feminist therapy. Further, they highlight three primary discourses that occur in psychotherapy (1) the normal self, (2) the improving self, and (3) the productive self.

The “normal self” refers to the discourse that describes the client as deficient or lacking in some way relative to an ideal norm. The “improving self” solicits the action of the individual to remedy this deficiency à la the neoliberal ideal. Lastly, the “productive self” draws most directly from an economic discourse which positions the individual as continually engaged in work toward capital accumulation.

This heuristic is put forth not because the authors believe that neoliberalism can be reduced to these discourses exclusively, but to provide “a map for becoming more sensitized to some of the ways in which neoliberalism can ‘show up’  in therapy.”

In addition to this, LaMarre and team emphasize the importance of recognizing how the promotion of neoliberal ideals cooccurs alongside other forms of oppression “such as sexism, racism, ableism, colonialism, and heterosexism.” Another opportunity for disrupting these systems of oppression, the authors recommend, is to become aware of how they are intertwined.

The authors conclude their paper by revisiting the question of whether psychotherapy can disrupt neoliberalism:

“We identify neoliberal discourses in therapy and how neoliberalism operates in therapist and client interactions in part as a way of highlighting how it might be possible to move toward styles of life that are in line with different social realities even within this system.”

“Even further, we optimistically argue that if therapists, as a collective, were committed to diversifying discursive possibilities for understanding and action in therapy, over time it might be possible to subtly undermine neoliberal governmentality, likely without subverting it entirely.”

 

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LaMarre, A., Smoliak, O., Cool, C., Kinavey, H., & Hardt, L. (2018). The Normal, Improving, and Productive Self: Unpacking Neoliberal Governmentality in Therapeutic Interactions. Journal of Constructivist Psychology, 1-18. (Link)

42 COMMENTS

  1. Neoliberal Capitalism…

    I think I understand what that means, that’s where the government makes so many rules and regulations so that only big corporations with a legal department and other resources can survive ?
    They also do things like have the police go around and bust kids for selling lemonade without a permit, cutting grass shoveling snow ect.

    Its all a bit to complex for me, unnecessarily complex as I it don’t think it much matters if the government is stomping you with a lefty boot or a righty boot you are still getting stomped on.

    “The authors cite therapy approaches that focus on the role of institutions and systems in creating psychological distress”

    Institutions and systems are doing a great job in creating psychological distress, the computerized big brother police state control grid built up in the last 30 years has brought us the epidemic of “Deaths Of Despair” https://www.wsj.com/articles/why-deaths-of-despair-may-be-a-warning-sign-for-america-moving-upstream-1519743601

    You can web search “Deaths Of Despair” and get all the left vs right political arguments and “solutions” but the bottom line is the big brother police state control grid put in place has added so much BS to peoples lives its stolen the joy of living from millions.

    IMO any therapy approaches that call out the system as the source of peoples pain would be an improvement.

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    • “I think I understand what that means, that’s where the government makes so many rules and regulations so that only big corporations with a legal department and other resources can survive?” And the therapists are the ones who have been proactively defaming, torturing, and attempting to murder all intelligent individuals who might question the insanity of such a satanic governmental system, at least since 9/11/2001.

      “…psychotherapy can counter the discourses that position individuals as entrepreneurial agents whose suffering is attributable to their personal or biological failures rather than to harm caused by oppressive systems.” In other words, disgust at 9/11/2001 is a brain disease, according to a therapist and psychiatrists. As opposed to 9/11/2001 being a disgusting event that resulted in never ending wars against a concept, as opposed to a real enemy.

      The therapists and psychiatrists want to murder all those disgusted by 9/11/2001, and the resulting never ending wars, that have bankrupted our country.

      The therapists and psychiatrists want to murder all the American banking families, that had made America great, for the satanic, war mongering and profiteering, bailout needing, globalist banking families, who miseducated you. And you’re working to bring about the satanic globalist bankster’s “New World Order.”

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  2. Great sensibilities, but psychotherapy as political education? Sure, seeing as people are not getting that education in other, neo-liberal controlled, venues. Could become a little dull though. There is something to be said for having fun, too. I just don’t think any of this is as disruptive of neoliberalism as one would suppose. I tip my hat however to any psychotherapy that would be about politicizing people, and especially those who have been marginalized.

    “Psychotherapy under neoliberal capitalism can be characterized by an inherent contradiction.” Nope, I don’t think so. “On the one hand, psychotherapy can be one of the key means of spreading and reinforcing neoliberal ideology and thus advancing the interests of finance,” LaMarre writes.” No doubt. “On the other, it can unsettle the capitalist political order by cultivating subjectivities that disturb the primacy and normalcy of the free-choosing, entrepreneurial self (this, of course, does not mean that therapeutic conversations can entirely escape neoliberalism).” Correction. “On the other,” neoliberalism has an escape valve. Neoliberalism THRIVES on un and under employment, no disruption there. It’s just another instance of the masses feeding the rich.

    You’ve got a long way to go to mount any serious challenge to neoliberalism, but politicizing the down and out is a good start.

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  3. Here are James Hillman quotes about psychotherapy-

    Now we are called defensive or resistant to the therapeutic process where once we might have been blamed for closing ourselves against God’s grace or turning from His will.

    “Well, what can I do about the world? This thing’s bigger than me.” That’s the child archetype talking. “All I can do is go into myself, work on my growth, my development, find good parenting, support groups.” This is a disaster for our political world, for our democracy. Democracy depends on intensely active citizens, not children.

    If therapy imagines its task to be that of helping people cope (and not protest), to adapt (and not rebel), to normalize their oddity, and to accept themselves “and work within your situation; make it work for you” (rather than refuse the unacceptable), then therapy is collaborating with what the state wants: docile plebes. Coping simply equals compliance.

    Now when therapy decides to cure the pathology, instead of seeing that the pathology is part of the crack or the broken window, and that something is trying to get in, then it seems to me it’s creating more pathology and keeping the Gods even further away. And then they break in through the whole fucking society.

    Recognition that the soul is also in the world may awaken us from the psychotherapeutic trance in which we pay a hundred dollars for an hour of subjectivism and no more than $19.95 for a beach chair in whose cold metallic arms and plastic lap reflection actually takes place, day after day.

    To what does the soul turn that has no therapists to visit? It takes its trouble to the trees, to the riverbank, to an animal companion, on an aimless walk through the city streets, a long watch of the night sky. Just stare out the window or boil water for a cup of tea. We breathe, expand, and let go, and something comes in from elsewhere. The daimon in the heart seems quietly pleased, preferring melancholy to desperation. It’s in touch.

    Thank You James. This is everything I have to say.

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    • He still worked as a therapist and I don’t see any evidence that his work as such was to to accept payment from individuals to make them better revolutionaries.

      Psychotherapists aren’t organizers. When they are doing psychotherapy, they are not organizing. What they are doing is pulling people into themselves, sapping their limited energy, and making it more difficult to organize.

      I have little patience for anti-Psychiatry psychotherapists who bemoan the fact that psychotherapy is a tool to create a professional class of people who’s job it is to make a decent living convincing distressed people that their distress doesn’t have a political context, all the while making a living doing just that.

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  4. “We’ve Had a Hundred Years of Psychotherapy & the World’s Getting Worse”
    by James Hillman, Michael Ventura.

    Very important book.
    I write to you one quote from that book-

    Person A is put into a sensory deprivation room and wired for brain waves, skin resistance, heart rate, muscular activity, and respiratory changes. Person B is put into another such room, also wired, and is electrically shocked at random intervals.Person A is then told to guess exactly when person B is being shocked.
    The results were as follows:Person A’s conscious guesses “showed no relation to the actual events”. But Person A’s “polygraph reading indicated significant physiological changes at those instants when Person B was randomly shocked”.
    ….(The experiment is described in Tart’s book Altered States of consciousnes and discussed by Joseph Chilton Pearce in Exploring the Crack in the Cosmic Egg)

    When a culture has gained a certain kind of power partly through not seeing, or ignoring various modes of seeing, then that culture will defend its not – seeing by any means necessary.

    Again, an interesting phenomenon is how even the so called radical elements of the dominant culture buy into its fundamental assumption that only a fairly narrow spectrum of the material world has validity….we see it in psychology,where enormous funds are being spent to try and prove that all inner experience is chemically motivated….

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  5. The idea that psychotherapy — at best a “band-aid” measure beset by contradiction — could be a tool for revolution is laughable. The commodification of human experience serves neoliberalism very well.

    Additionally the term “neoliberal capitalism” is similar to the term “biological psychiatry”; both imply that the particular “brand” of capitalism or psychiatry is what is significant — as though there were some “better” form of capitalism than the “neoliberal” kind, or a better form of psychiatry than the “biological” kind. In the case of both capitalism AND psychiatry, ALL forms need to be swept away.

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  6. I wish the psychology students/graduates writing for this website would pay mind to the way that using a lot of jargon and “academic english” perpetuates what they are critiquing, ie, that only high-status and “in the know professionals” can contribute or discuss ideas. It also gives the impression like the “hip upper class liberals” are the only people cool and smart enough to see what’s going on with the system which isn’t true; the way this piece was written is only understandable or appealing to people who are likely already from a middle or upper class background.I also want to advocate for “plain English translation” because many people shuffled into the system are working class and in therapy at a “government clinic” or another crap tier insurance plan that doesn’t allow for any choice or diversity of options/ideas.

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        • Surviving & Cat — I’m not necessarily calling it selling out as MIA has never really claimed otherwise from what I can see, though I wasn’t here at the start. I find it useful in helping people develop anti-psych consciousness, even that is far from MIA’s stated purpose.

          On a related note, I am wondering who among the survivors around here considers themselves to be “abolitionists” at this point in time. Hands?

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          • Yes of course I do, although I don’t visit this site much now. I do think it has sold out: the only anti-psych consciousness propounded (except by commenters) is very, very limited, and the sovereignty of professionals over people in distress is essentially unchallenged. It has always pretty much been that way, but it has moved further along the spectrum.

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          • One of MIA’s missions is to provide a voice to survivors. My understanding is that it has never taken an “antipsychiatry” stance, but is more intended as a discussion forum for folks of any philosophical viewpoint, as long as it is focused on the facts at hand and not on promoting psychiatric propaganda. Actually, propagandists have always posted here, too, but they don’t really have a lot of fun in general. So it might be a good place for antipsychiatry folks to get together and communicate, but MIA and Bob Whitaker have never taken and antipsychiatry stance, and that is reflected in the diversity of topics presented and commenters.

            This is just me talking, not representing MIA formally, it’s just always been my understanding of the situation.

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          • Another of MIA’s missions apparently is to provide a voice for mental health professionals. Right now, I don’t think it has ever been resolved as to what an antipsychiatry stance might actually consist of. All sorts of people disagree when it comes to what they call psychiatry, and some of us have disagreements as to what we’d be calling antipsychiatry. BTW, OldHead asked us about abolition, and I consider my answer a raised hand. I can’t quite make out yours though.

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          • He asked survivors for their hands up. I don’t consider myself in that category. The only “treatment” I received was some psychotherapy in my 20s, and there was no force, no drugs, and the therapist did nothing to “diagnose” or explain what was “wrong” with me. She was, in fact, very empowering to me. I later discovered how fortunate I’d been to find her, though this was in the early 80s before the DSM III and the “chemical imbalance” meme had taken hold. So I don’t feel I can claim being a “survivor,” except to the extent that I may very well have “dodged a bullet” by avoiding the “system” for the most part.

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          • @Frank — I asked about abolishing psychiatry (in principle, means to be determined), not ending forced “treatment”; your position on this is pretty clear by now. (Though you can see from discussions here recently that many do not accept the existence of truly non-coercive psychiatry.)

            @ Steve — MIA has never taken an anti-psychiatry stance per se; however recently RW has been actively disparaging such, which is pretty contradictory since all his research as well as most of what appears on MIA would lead a logical and consistent person to become vociferously anti-psychiatry.

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          • Can you give me an example of him disparaging an antipsychiatry viewpoint? I agree that his research leads almost inevitably in the antipsychiatry direction if followed through to its natural conclusions. How can one support an industry whose entire basis is an intentional falsehood regarding the nature of mental/emotional distress? If you remove that falsehood, what is left beyond greed and a drive for power and control?

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          • I do not see many people beyond you, OldHead, holding the same view as you. As a victim of forced psychiatry, my issue with psychiatry ends once the force is abolished. Going any further would be overkill. I think you have a simplistic and unworkable formula. Blame everything on psychiatry, and see the solution as it’s demolition. Basically, I don’t believe psychiatry is to blame for everything, nor do I believe that life would be a bed of roses if it were abolished.

            MIA was never a specifically antipsychiatry website and organization, only OldHead would expect it to be one. I know that many people feel underrepresented at MIA, and I can understand the reasoning there, and the feelings involved. I also understand that it has provided some people with an antipsychiatry perspective a voice on it’s site, and for that I, for one, am grateful. I think it is up to antipsychiatry movement activists, antipsychiatrists themselves, to form the organizations and develop the internet presence specifically devoted to antipsychiatry. As such, the responsibility doesn’t fall on the shoulders of Robert Whitaker and the MIA board in any event. It falls on the shoulders of those people who identify as antipsychiatry, or who claim to be part of the antipsychiatry movement.

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          • Can you give me an example of him disparaging an antipsychiatry viewpoint?

            First I should emphasize that, while it may be a thin line, I didn’t intend my original statement about MIA being primarily for liberal professionals as a criticism, but a statement of fact, in response to the charge that MIA had “sold out,” as MIA never claimed to represent an anti-psychiatry position in the first place. I have never begrudged it for not doing so, or harbored the illusion that I should be entitled to such an expectation.

            As for RW, I would have to do some research for a direct quote, though it probably wouldn’t take long. But I know the essence of Bob’s position, which is that since “anti-psychiatry” is a term that upsets and alienates people (i.e. mh professionals and their milieu) it shouldn’t be used (besides they might call us Scientologists). This is in contrast, I’m sure, to his day job of researching the lies and contradictions of psychopharmacology, where I doubt he ever tailors his conclusions according to how people might react to them.

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          • OK, I get what you’re saying. I could see Bob being against using that term, but I can’t really see him in any way opposing the complete deconstruction of the psychiatric profession or the way of thinking they currently represent, as I know he finds both odious and laden with contradictions, corruption and greed.

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          • I do see myself as antipsychiatry and I think using the word is one good way to thumb one’s nose at the mental illness and the pharmaceutical industries as well as the stupid people who get tangled up in their subterfuge and devious marketing schemes. Where I disagree with you, OldHead, is that I think the problem is force, legally sanctioned through legislation, and not the profession of psychiatry itself. When it comes to fighting forced treatment, I think your position misses the mark as much as that of the “alternatives” movement which is so compromised by collusion and a major contributor to medicalization, if “alternative” medicalization. If one talks about reform, in the mental health system, that talk is all about more force or less force. Talk about abolishing psychiatry is somewhere outside the ballpark whispered in some trashy back-alley and completely off the table. Abolish forced treatment, and you’ve got no force being applied to make people prisoner patients against their will and wishes. Collaborate with the enemy, or engage in conspiracy theorizing, and forced treatment remains. I see you and the “alternatives” people, who care only about government funding, as working together to keep force in place. When it comes to human rights violations and fighting psychiatric oppression, I think the movement needs to focus more on fighting oppression, and less on fighting psychiatry, feeling, unlike you, that the two terms are not of necessity synonymous.

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          • Yes. Psychiatry is just a ten letter word. Take the word “insanity”, for example. “Insanity”, although etymologically it means “unwell”, is not a medical term, it is a legal term. Psychiatrists were not born with the power they wield, it was granted to them by state legislatures. You get rid of the profession of psychiatry, and those state legislatures will merely assign the same power they’d granted to psychiatry to another profession. The problem is not psychiatry. The problem is psychiatric power. The problem is not that we have mental hospitals, the problem is that these hospitals are only figuratively hospitals and that they are literally prisons.

            You say that psychiatry is coercive by nature, and that all psychiatry has to be, to some extent, coercive. I say that is nonsense. Psychiatry is coercive because it has been granted certain powers above and beyond other professions by law. You get rid of the profession, but you don’t do anything about the “bad law”behind the power, and that power will merely be granted to another profession. Undue force is the problem, not psychiatry. You get rid of force, and psychiatry can’t touch you without your consent.

            I’ve seen lives destroyed by psychiatrists assisting the courts in ruling people incompetent. With such a ruling you, in effect, render a person a non-citizen, demoted in status to that of a child or a subhuman. This is not a power I think anybody should have over people who are, in all other regards, adult. If you get rid of the profession, and you don’t do something about that power, you’ve done nothing except change bosses.

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      • I wouldn’t expect MIA to be a leftwing journal any more than I would expect it to be a sounding board for the antipsychiatry movement, but there are people here, such as myself, who are decidedly of the left, and who have little use for psychiatry, or the system that sustains it. There are also people associated with this site, and users of it, who are psychiatrists, mental health professionals, or who work in the system in one capacity or another. MIA never sold out. MIA was in another space from the beginning. As long as it let’s people with different opinions sound off here, I don’t see what the problem can be. If you want an antipsychiatry movement sounding board, or a leftwing rag, make one, but expecting MIA to be favorable, as a rule, to your particular bias, is just expecting a little too much.

        I’d like to see some action, too, and that’s why we need to organize. If we had our own site, and our own organizations, then we could be planning and initiating political actions of our own as well. I couldn’t see expecting MIA to be the instigator of such, but there are people here, you’re talking to one of them, that would be more than willing and eager to help get that kind of thing up and running.

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  7. Uh… psychotherapy has always been a liberal (capitalist) project.

    There is a progressive understanding that somehow early analysts were radicals, but we forget that they were radical liberals, treating an upwardly mobile professional class and wealthy but powerless nobility during the last vestiges of feudal European governance (Vienna was the capital of the Austrio-Hungarian Empire with an Emperor who appointed his own prime ministers). So in the scheme of things, we think that liberalism is better than feudalism, but we no longer think liberalism is progressive.

    Isolating problems of living to individual psychopathy, whether in the form of intrapsychic conflicts/neuroses or DSM diagnoses or chemical imbalances, and dealing with them nearly exclusively in a clinical setting is liberalism. Having both private enterprise (insurance companies, drug companies, therapy schools, etc.) and the state redirect the misery of capitalism experienced in different ways across classes to individual treatment that depends skimming already stolen wage work to address is liberalism.

    I don’t know what the authors are hopeful about. No one ever or will start a revolution in the consulting room. Psychotherapy as an industry, profession, and funnel to individuate and pathologize problems that it can only solve in individual ways will never have the capacity or will to challenge neoliberalism. Let’s not ever pretend that psychotherapy can be revolutionary or even progressive. It can and only has ever purported to help problems created by the conditions of capitalism, conditions that engaging in the psychotherapy industry helps (and is legally required) to maintain.

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