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Excerpt
This creative interpretation of the complex web of social, historical, and political forces that have contributed to the development of psychotherapeutic treatments is patterned after the scholarship that followedFoucault's (1965) historical analysis of insanity (e.g.,Levin, 1987; Lyons, 1978; Rosen, 1968). Even the spatial metaphors that Foucault was so prone to rely upon are dispersed throughout Cushman's work, creating an image of intellectual constructs colliding on an imaginary field (e.g., “terrain,”“domain,” “realm,” “territory,”“frontier,” and “landscape” are heavily used throughout the volume). Cushman should be commended for extending this genre of social criticism in several new directions. First, his focus is on psychotherapy as a social institution and not strictly on “the insane” or those who have been affected by similar social structures. Second, his analysis is exceedingly more clear and understandable than most of the scholarship that follows the French tradition. Finally, he extends his work to distinguish the social forces that have influenced the evolution of uniquely American-style psychotherapy. One of the more original postulates is that American psychotherapy arises out of notions of self-liberation, whereas European healing practices are based on notions of self-domination.
What makes this book especially controversial is the conclusion that the psychotherapies are not neutral and objective scientific endeavors and that they “actually contribute to the very suffering that they are attempting to alleviate” (p. 9). Psychotherapy is purported to be harmful because most operate under the assumption that treatments are independent of political and social forces that shape all social institutions. A lack of awareness of the relationship between the power of the status quo and practices like psychotherapy is, for Cushman, tantamount to the implicit collusion of these forces. The prototypical example used throughout the book is how psychotherapy contributes to the social construction of an “empty self,” that must then be filled by desires that can only be satiated by the consumption of products. Through multiple examples and a complex argument Cushman concludes that psychotherapy contributes to the hegemony of the populace through metaphors of the self as containers and the perception that the source of suffering is within individuals and not within culture. These metaphors that psychotherapy helps to create then interact with other social forces to oppress individuals. For example, advertisers appeal to consumers to fulfill sexual and aggressive needs by buying products that will fill an otherwise empty self. Classical psychoanalytic theory is thus claimed to serve a useful function in legitimizing powerful oppressive forces of the society. Although Cushman draws conclusions about the ills of psychotherapy in general, only psychoanalytic theory is considered in detail.
The dramatic conclusion that psychotherapy is harmful goes too far. The fact that advertisers are successful in appealing to sexual urges may speak to how Freudian theory has permeated most aspects of Western culture, but being a part of social forces that have oppressive features does not imply that the theory itself actively contributes to oppression. Cushman claims that anything that happens to interact with global social forces must therefore be oppressive in a way that is analogous to some extreme McCarthy-era claims that association with a communist makes one a “red.” Thus, Cushman definitively notes that “All healing practices are social artifacts, products (and reproducers) of their cultural landscape, and as such are embedded in an inescapable web of moral agreements and political activities. Healing practices only exist in particular moral frameworks and inevitably serve particular socioeconomic functions” (p. 175).
