The Rise of the Therapeutic Society: Psychological Knowledge & the Contradictions of Cultural Change. Katie Wright
The Rise of the Therapeutic Society: Psychological Knowledge & the Contradictions of Cultural Change
for another, physically, psychologically, and emotionally.72 In spite of its limitations, the Foucauldian reading of the nexus of knowledge and power, especially as imbued in psychological and psychiatric knowledge, therapy and other therapeutic cultural forms, has provided a valuable critique of power and the regulation of disadvantaged social groups, including women. It has thus also informed some feminist approaches in theorizing the regulation of women in therapeutic culture.
The Myth of Women's Empowerment
While relations of power and control have informed many analyses of the therapeutic, the theoretical traditions so far considered have not explored the ways in which the social and cultural diffusion of psychological knowledges may register differently for men and women. In bringing the experiences of women to the centre of analysis, feminist critiques provide another lens through which to examine this pervasive cultural turn. The points of overlap and departure from other perspectives already discussed are particularly salient. For example, while Donzelot, suggested that women secured a degree of benefit from their acquiescence to and embrace of the psychological, feminists have largely interpreted psychological knowledge and practices as yet another means by which women have been controlled and disempowered. In Dana Cloud's view: "too great an emphasis on personal life—on consciousness, identity, and lifestyle—has hindered progress toward women's liberation … 'The personal is political' may not be a revolutionary challenge to the status quo but rather an unwitting collaboration with the forces of stability in contemporary capitalist culture."73
The practices of psychiatry, psychotherapy, and counseling have been subject to strong feminist critique. Psychiatry in particular has provoked much disquiet, interpreted as an especially pernicious agent of social control. Indeed, the construction of the psychologically unstable woman has been interpreted as a key way in which oppressive gender relations have been maintained under patriarchy through the male authority of the medical professions.74 In her classic text, Women and Madness, Phyllis Chesler contends that psychiatry is much like marriage, an institution that controls women through dependency and the reinforcement of ideals of femininity. Challenges to existing power relations are marginalized, discredited, or undermined, she argues, in the labeling of women as psychologically unstable. In Australia, Jill Matthews elaborated a similar thesis in her classic study of twentieth century femininity, Good and Mad Women, while Judith Allen revealed how psychological and psychoanalytic theory has historically been marshaled in the criminal justice system, often in defense of sex offenders and to the detriment of their victims.75 More recently, there has also been widespread disquiet about the medicalization of women's unhappiness, as evidenced by diagnoses of depressive disorders and the use of anti-depressants: women are twice as likely to be diagnosed with a depressive disorder and twice as likely to be prescribed psychotropic drugs.76
Rather than focusing on broader questions of cultural change, a key element of feminist accounts of the therapeutic has thus been a critique of the psy professions and associated clinical practices. Reflecting similar concerns to the critiques of therapy outlined above, Celia Kitzinger, for example, argues that while many women may be helped by therapy, it nevertheless personalizes the political by concentrating on the emotional realm and the inner life of women.77 Similarly, critiques of therapeutic cultural forms, notably self-help literature, strike a particularly strong chord in feminist accounts. As with therapy, they have been interpreted as a panacea for alienation and an impediment to social action.
According to American journalist Susan Faludi, popular psychology was instrumental in the anti-feminist "backlash" of the 1980s. In her view, the strategies of popular psychologists with prominent media profiles reinforced female isolation and pain, rather than helped to relieve it. The rhetoric espoused by self-help authors constituted, she argues, a discourse couched in the language of women's liberation, but constructed around various interpretations of the masochistic female psyche: "To the vast female readership of self-help manuals, the advice experts delivered a one-two punch. First they knocked down the liberated woman, commanding that she surrender her 'excessive' independence … Then, having brought the 'victim' of feminism to her feminine knees, the advice writers reaped the benefits—by nursing the backlash victim. In the first half of the 1980s the advice experts told women they suffered from bloated egos and a 'fear of intimacy'; in the second half, they informed women that atrophied egos and 'co-dependency' were now their problems."78
Other analyses of self-help advance similar concerns, especially in terms of its focus on introspection and healing rather than social action, and in the view that engagement with therapeutic texts offer only illusory cures for what are essentially social ills.79 Concerns have also been raised about the ways in which other therapeutic cultural forms construct notions of the feminine, and in particular, female distress. The self-disclosure typical of the television talk show, according to Franny Nudelman, "has confirmed and elaborated a certain construction of female subjectivity." In her view, we have come to believe that women "are prone to psychic pain."80 Embodying significant attributes of the therapeutic, television talk shows and self-help literature are important cultural artifacts to consider when assessing its impact, especially for women and for gender relations.81 For just as women have significantly higher utilization rates of therapy than men, it is also women at whom television talk shows and self-help books are primarily targeted.
Offering a broader approach that integrates an analysis of various dimensions of the therapeutic society with an examination of the institutions of psychotherapy and psychology, Dana Becker engages more directly with debates about the therapeutic itself. Critical of the gender-blind assumptions in cultural analyses like those of Rieff and Lasch, she notes: "American cultural critics, worriedly cautioning their compatriots about a falling away from the values and virtues of a communal past, never suggested that men and women had not experienced that past identically; they never looked beyond the construction of psychological man to ask: 'Who is psychological woman?'"82
"Psychological woman," according to Becker, "is by and large not an activist, nor is her therapist—nor are the media experts that counsel her."83 She has been depoliticized and duped, shaped by the discourses of science and individualism, her problems are constructed as psychological, rather than recognized as social. While therapeutic culture promises her empowerment, it keeps her in her place by reinforcing dominant stereotypical feminine attributes and it offers her only a compensatory form of power. For Becker, the promise that knowledge is power is the straw man of the therapeutic society. She argues that self-knowledge and self-esteem are too readily conflated with ideals of personal empowerment. While the therapeutic promises women control over their lives, she argues that "the repackaging of the psychological as power reproduces what has long been the cultural norm for women: the colonization of both the interior world of the psyche and the small world of intimate relationships."84
That the helping professions—as the institutional embodiment of the therapeutic—are themselves patriarchal is also regarded as problematic. As Becker elaborates: "The story of how psychotherapy emerged as a profession … is a story about how men developed those 'technologies of the self' … and about how those technologies came to be broadly employed and adopted."85 Foucault's influence is evident, but she also draws out more explicitly themes of depoliticization that are more reminiscent of Lasch. Becker thus provides an important feminist reading of the therapeutic society. In bringing women into the analysis, she reveals many limitations of earlier accounts. As a cultural ethos, and in its institutional form through professional practice, the therapeutic is experienced differently by women than it is by men.
In other respects, however, Becker's account does not move substantially beyond the existing framework. For while she questions the masculinist assumptions of theorists like Lasch and suggests, furthermore, that the therapeutic itself may be patriarchal, she nevertheless reaches similar conclusions in her assessment of its disabling effects. While her account provides a welcome complement to cultural analyses that overlook the centrality of gender, the implicit argument that women are duped by therapeutic culture is nevertheless problematic. Without recognition of the myriad ways in which women not only embrace the therapeutic, but also resist it and use it for their own ends, the complex and contradictory dimensions of the therapeutic society remain only partially