Читать книгу The Rise of the Therapeutic Society: Psychological Knowledge & the Contradictions of Cultural Change - Katie Wright - Страница 11

As the foregoing discussion establishes, social theoretical literature of the past half-century provides a wide-ranging analysis of major dimensions of the therapeutic turn. What distinguishes these varying interpretations from those emanating from within the therapeutic itself, exemplified by the promise of the human potential movement and the industry of self-help that it spawned, is a broad consensus that the therapeutic is inimical to sociopolitical, cultural, and personal life. That this dominant narrative is shared by divergent intellectual traditions—from the conservatism of Rieffian cultural sociology to radical feminism, the materialism of neo-Marxism, and Foucauldian analyses of power—suggests that it is a compelling critique. Nevertheless, there remain issues that have yet to be addressed.

The heightened concern with private problems and the ascendancy of a culture of emotionalism have to date been interpreted predominantly in a negative light. Yet much unease about the therapeutic has gendered undertones.⁹¹ Moreover, the composite picture that emerges from existing cultural analyses still reflects traditional Freudian notions of authority, and is premised upon an unproblematic reading of the dichotomy of the public and private spheres. Through a preoccupation with attempts to theorize the destabilization of the self, there has, furthermore, been a failure to identify and draw out the implications of changes in the personal realm and shifts in the gender order. In short, there has been little analysis informed by feminist theory and, where it exists, it is limited by conceptualizations of gender relations as male dominance over women.⁹² As Joan Williams argues, such a model oversimplifies the complexity of gender: "What women face is not a foot on their neck but the trivial minipolitics of everyday life, which are gendered in many institutions in the sense that they operate differently for women than for men."⁹³ For Williams, a more helpful model is to understand gender as a "force field" that that pulls men and women in different ways.

Utilizing a framework of gender as a system of power relations allows for a more complex conceptualization, one that can, in turn, provide the basis for an alternative reading in which therapeutic culture is more positively implicated in the destabilization of a set of traditional gendered arrangements governing public and private life. Raewyn Connell's account of gender as a social structure, a historically shifting system of power relations is particularly instructive.⁹⁴ Both Williams' notion of gender as a "force field" and Connell's conceptualization of the "gender order"—which describes the gendered patterns of social relationships—provide a way of moving beyond categories of men and women which obscure differences among men and between women.

Underpinning the analysis that I develop in subsequent chapters is the rudiment of an alternative framework from which to consider the implications of the rise of the therapeutic society.⁹⁵ The major theoretical strands in my analysis concern: the significance of cultural authority, power, and agency; the shifting relationship between the public and private spheres; and, changes in personal life. Recognition of the salience of the gendered structuring of emotions throws new light on the cultural and personal processes associated with the therapeutic society. The remainder of the chapter presents an outline of the framework I am using as the basis for my account of the rise of the therapeutic in Australia. Beginning with the question of authority, however, it also suggests alternative directions for theorizing that might be fruitfully pursued.

A belief in the necessity of authoritative controls for social order permeates many accounts of the therapeutic, as does a concomitant view of socialization that idealizes the patriarchal family.⁹⁶ The concern with diminishing authority, apparent in the interpretations of Rieff and Lasch especially, hinges upon on a Freudian model of personality development in which the father—both actual and symbolic—plays a critical role. The internalization of authority through the resolution of the Oedipus complex is regarded as critical to the development of the autonomous individual. The concern with weakening authority, or "the decline of Oedipal Man," as Jessica Benjamin puts it, thus reflects fears that the Oedipus complex "was the fundament for the autonomous, rational individual, and today's unstable families with their less authoritarian fathers no longer foster the Oedipus complex as Freud described it."⁹⁷

In Freud's account of the Oedipal drama, it is the intervention of the father that breaks the intensity of the mother-child bond and thus makes possible both an individuated personality and social life more broadly. The "problem" of weakening paternal authority—so troubling to both Rieff and Lasch—is premised upon a reading which posits that the internalization of a powerful super-ego is critical to normal development. Yet feminist theorists have forcefully criticized this position. They have drawn on other psychoanalytic traditions, notably object-relations, to question the salience of the Freudian account of infant psychosexual development that underwrites the cultural critique. They have emphasized especially the relative neglect of the role of the mother and of the pre-Oedipal stage.⁹⁸ This work not only challenges theories of development that privilege patriarchal authority, it also calls into question key assumptions of foundational critiques of the therapeutic, assumptions that are often, perhaps unwittingly, reinscribed in more contemporary accounts.

The main alternative standpoint to the Freudian informed cultural critique of the therapeutic society is that available in the works of Foucault and his followers. Such readings have proved fruitful in understanding its regulatory dimensions and the ways in which therapeutic discourses are implicated in contemporary forms of self-government. Yet, as I have already noted, there are problems too with the implicit model of subjectivity that emerges from Foucauldian theory. The theory of selfhood in Foucault's work, according to McNay, "leads to a conception of the individual as an isolated entity, rather than explaining how the self is constructed in the context of social interaction."⁹⁹ As Elliott has also argued: "Foucault's obsessively self-mastering individual is intrinsically monadic, closed in on itself and shut off from emotional intimacy and communal bonds."¹⁰⁰ His critique of the Foucauldian subject goes further, as he notes that "Foucault nowhere confronts the possibility that self-realization is itself embedded within realms of mutuality, trust, intimacy and affection."¹⁰¹ Examining the underlying assumptions regarding the self that underpin dominant critiques of the therapeutic society renders these readings problematic, but it also suggests a possible way forward.

Following the influential work of Nancy Chodorow, the concept of the relational self provides an alternative basis from which to understand personality development and thus also an alternative standpoint from which to consider the implications of weakening cultural/paternal/traditional authority.¹⁰² Jessica Benjamin's critique of the Oedipal repudiation of dependency (on mother/woman) and her appraisal of the ideal of (male) autonomy advanced in her theory of intersubjectivity also illuminates important facets of past theorizing. As Chodorow and Benjamin have both elaborated in theorizing self-other relationships, the Freudian view of development bound up with the ideals of autonomy and separation is a highly masculinist one.

In contrast to the Freudian privileging of the father's authority and the Foucauldian obliteration of connectedness, both Benjamin and Chodorow emphasize the relational dimensions of psychosocial development. In their accounts, it is the balancing of separation and connectedness that is critical, and they show how the dynamics of this process plays out differently for males and females. Whilst the complexities of their accounts of gendered personality development cannot be explored here, it is possible to utilize some basic insights from feminist object-relations theory to challenge the presumed gender-neutral self of Freudian and Foucauldian theory that have buttressed theorization of the therapeutic. A different account of personality development can thus provide the basis for an alternative sociocultural critique, one that includes women, and indeed recognizes gendered social processes more broadly, especially those associated with the division between the public and private spheres.

Though Lasch, for example, mounted his case against advanced capitalism, Eli Zaretsky establishes that capitalism itself gave rise to the particular form of family life premised on the patriarchal family, the very form that Lasch was trying to defend.¹⁰³ "Defenders of the private sphere" (to borrow Benjamin's term) thus accept not only as inevitable but also as desirable the implicitly gendered dichotomization between a public rationality and a private realm of emotions.¹⁰⁴ The major problem with this position is that it does not adequately consider relations of domination and subordination that have been associated with this split, namely women's exclusion—both physically and symbolically—from the public sphere, as well as the unequal and exploitative social relations between men and women, and indeed children, in the home.¹⁰⁵ Thus the destabilization of the public/private split, lamented by Lasch and more recently by Furedi, becomes more complex in light of feminist and other social theory that interrogates assumptions about the sanctity of the domestic realm.

For as with the supposedly gender-neutral accounts of personality development which underpin many analyses of the therapeutic, a related set of suppositions about the public and private spheres takes for granted the historical emergence of a gendered division between the private world of home and family and the public world of politics, work, and civil society. As feminist theory has long recognized, the public has historically been constructed as the real world of politics, law, culture, and morality. In opposition, the private has been regarded as the world of sexual relationships, women, children, and virtue.

Zaretsky has shown too that the way in which the public/private dichotomy emerged with industrial capitalism was itself highly gendered. As work moved outside the home and the sexual division of labor became culturally entrenched, "society divided and the family became the realm of 'private life.'"¹⁰⁶ Zaretsky provides a lead not only in understanding the gendered division of the public and private, but also in theorizing the relationship between the two spheres as historically shifting. The shift from household production to that of the market economy not only intensified the gendered character of public and private life, it entailed a devaluation of the private and the elevation of the public. The private thus became not only the realm of women and children, but also the site of emotions, which were increasingly excluded from the public sphere. Rationality thus came to characterize the domain of men and public life, as dependency and emotions were devalued and rejected as feminine.

In light of the historical dichotomization of the public and private spheres—in which masculinity was equated with a (public) rationality that suppressed femininity and associated it with (private) emotions—the unleashing of the emotional and the "private" into the public realm represents a decisive shift, one which has not surprisingly aroused significant disquiet. The rise of a therapeutic ethos in public life thus may be read, at least in part, as a feminization of the public sphere, a development that has disrupted the gendered organization of both private and public life. Rather than proceeding, then, from the assumption that the proper place for the expression of emotion and discussion of "private issues" is the domestic realm—critical and historical perspectives problematize the idealization of the public/private split advanced by cultural critics.

What is still largely missing in existing accounts is acknowledgment of the emancipatory potential of the change in the relationship between public and private life, and how "speaking out" about personal problems, or matters historically deemed to be private, has opened up new discursive spaces in which it is not only the powerful that can have a public voice.¹⁰⁷ Rather than signaling moral collapse and cultural decline, the diminution of traditional forms of authority, changing gender relations, and shifts in the private sphere can equally be read as part of broader democratic currents characteristic of the contemporary era. In considering this issue, Anthony Giddens' analysis of late modernity, particularly his theorization of self-identity, intimacy, and processes of democratization, is particularly instructive.

Giddens suggests that while transformations in the personal sphere have generated new dilemmas they have also given rise to new possibilities of intimacy and self-expression. In contrast to readings of moral and social decline, for Giddens, "the transformation of intimacy" has opened up new opportunities for the democratization of the personal order, both in the sexual arena and in family life. As with the work of John Scanzoni, who has labeled changes in the family life as part of a "continuing revolution in personal life" in which women and children have gained greater power, Giddens' work suggests a less pessimistic reading of declining paternal authority.¹⁰⁸

In his view: "There is only one story to tell about the family today, and that is of democracy … Democratization in the context of the family implies equality, mutual respect, autonomy, decision-making through communication and freedom from violence. Much the same characteristics also supply a model of parent-child relationships. Parents of course will still claim authority over children, and rightly so; but these will be more negotiated and open than before."¹⁰⁹ Giddens' assessment of changes in the family and intimate relations has been questioned as overly optimistic and as failing to recognize the extent to which familial relations remain structured by differing power arrangements.¹¹⁰ Yet Giddens himself does not imply that these changes have resulted in the disappearance of authority altogether. Rather, his work points to the ways in which communication and negotiation have become key aspirations in the conduct of family life.¹¹¹

Linked to broader sociocultural trends of democratization, transitions in the private sphere have nonetheless generated anxiety. According to Giddens, the modern self "has to be explored and constructed as part of a reflexive process of connecting personal and social change."¹¹² In his analysis, therapy itself is highly bound up with the reflexivity of modernity and self-identity. Again, his interpretation offers a more ambivalent reading of cultural change: "Therapy is not simply a means of coping with novel anxieties, but an expression of the reflexivity of the self—a phenomenon which, on the level of the individual, like the broader institutions of modernity, balances opportunity and potential catastrophe in equal measure."¹¹³

Another alternative to overly negative assessments is similarly elaborated in Elliott's work. As with Giddens, he views therapy as deeply connected to late modernity, arguing that "psychological expertise offers reassurance against the insecurities of living."¹¹⁴ Yet there is another important dimension that emerges in Elliott's work, namely his recognition of the imaginary capacity of self-representation and self-construction characteristic of the modern era. Elliott cautiously suggests that the therapeutic may be an emancipatory response to late modernity. As he explains: "In terms of the opening out of the personal sphere, psychoanalytic theory and therapy can be said to offer individuals a radical purchase on the dilemmas of living in the modern epoch."¹¹⁵

In contrast to dominant stories of cultural decline and social regulation, both Elliott and Giddens therefore point to an alternative assessment of the therapeutic turn. While recognizing that the therapeutic can foster narcissism and self-indulgence, Elliott is also open to its promise: "By constructing narratives of the self with which they feel relatively comfortable, the work of therapy ideally leads individuals to a greater emotional openness in the choosing of identities."¹¹⁶ Their readings, moreover, pave the way for a different set of moral and ethical questions to be posed from those associated with the traditional social order. Before turning to this, however, it is important to note that, in developing a more complex account of cultural change, it is necessary to consider the historical factors that give rise to practices of therapy, and indeed to the ascendancy of therapeutic culture more broadly.

Again, Zaretsky is helpful. His analysis of psychoanalysis as a theory and practice of personal life demonstrates that it has both repressive and liberatory aspects.¹¹⁷ Thus for Zaretsky, the legacy of psychoanalysis has been an ambivalent one, connected in very significant ways to the emancipatory projects of the twentieth century—notably the establishment of the welfare state, and the feminist and gay liberation movements of the 1970s. Yet simultaneously psychoanalysis "became a font of antipolitical, antifeminist, and homophobic prejudice."¹¹⁸ He notes that in the areas of autonomy, the emancipation of women, and in personal life, psychoanalysis has produced contradictory effects. In the case of sexuality, "analysis advanced cultural understandings of female sexuality and homosexuality even as it became at times a vicious and effective enemy of feminists and homosexuals."¹¹⁹ Similarly in personal life, he shows how it both undermined traditional authority and gave rise to new forms of control. Zaretsky's delineation of the ambivalent legacy of psychoanalysis holds true for the therapeutic society more broadly, especially in terms of how it has been thoroughly interconnected with shifts in the private sphere.

In many accounts of the therapeutic, such changes are often posited in terms of moral decline, uncertainty, and diminished selfhood. Yet, the transformations in intimate life that took place over the course of the twentieth century may equally be understood in terms of democratization, a process that, furthermore, has generated new kinds of moral and ethical values. Of particular importance here is the work of Jeffrey Weeks, who offers a more optimistic reading of changes in personal life.¹²⁰ As he argues, while the transformations occurring in the sexual domain and in private life may be "often muddled and confusing, marked by the uncertainty which governs public and private life today … they also contain within them evidence of care, mutuality, responsibility and love which make it possible to be hopeful about our human future."¹²¹

In this context then, the weakening of traditional forms of authority, while disturbing to conservative cultural analysts, may be understood differently. Indeed, a more complex picture emerges when the weakening of cultural authority is understood as part of a reconfiguration of the cultural-symbolic logic of gender. This reconfiguration opens up a potentially emancipatory and transformative space for women and other marginalized groups, and indeed also for many men, for whom traditional ideals of manhood are experienced as oppressive.

Therapeutic culture, especially the confessional mode, has brought the personal and the private into the public sphere in distinct ways, and has also been central to the legitimizing of the emotional realm and the speaking of the hitherto unspeakable. Elliott and Lemert's recent work on the role of confessional practices is instructive here. While they paint a somewhat gloomy picture of "the new individualism," the ambivalence that characterizes Elliott's earlier work is evident, as they argue: "Confessional culture, to be sure, can promote a narrowing of the arts of public political life; but it needn't. The public confession of private sentiments can, in fact, work the other way … and involve an opening out of the self to an increasingly interconnected world."¹²² Yet it is not simply that confessional culture may promote interconnectedness, as important as that may be. For as personal pain has assumed legitimacy in the public domain, greater accountability for and recognition of distress has also emerged. Framing this as a gendered issue, we might say that the increasing legitimacy accorded to psychological and emotional life, as well as the public articulation of personal inadequacy and suffering, has disrupted a set of gendered arrangements governing public life, and challenged a particular kind of hegemonic masculinity.

This masculine ideal, perhaps best exemplified in the film genre of the American Western was, as Connell points out, constructed around a "self-conscious cult of inarticulate masculine heroism."¹²³ Similarly, in the Australian context, masculine ideals traditionally have been predicated on a repressive, anti-emotional expression of manhood. As Connell puts it: "the hegemonic construction of masculinity in contemporary Australian culture is outward-turned and plays down all private emotion."¹²⁴ Yet the therapeutic increasingly challenges this notion of repressive masculinity, and in doing so, is playing a pivotal role in disrupting the dichotomy between rationality and emotion, split as it has historically been into the two spheres of the public and private, or in terms of subject positions, the masculine and feminine. The extent that the therapeutic is implicated in shifts in the gender order raises important questions that accounts of cultural decline and social regulation have largely failed to consider. As Connell establishes, gender ideologies, identities, and relations are heterogeneous and subject to ongoing transformation and contestation. A key task, then, is to try to ascertain the extent to which the therapeutic is implicated in social and cultural changes that have given rise to a shift towards more equitable gender relations.

Yet there is also another dimension, that of the perceived amorality of the therapeutic society. While casting their arguments in slightly different ways, Rieff, Lasch, and Furedi all regard the therapeutic self as essentially amoral—caught on a treadmill of meaningless self-improvement in an ultimately fruitless quest for subjective wellbeing. Yet such a picture is inevitably only partial. To view therapeutic culture as amoral is to fail to recognize its multidimensionality, taking, for example, the preoccupation with self-gratification, pleasure, and happiness as its only facet. Without dismissing the potential for narcissistic self-absorption, it is important to acknowledge that valuing the self also entails recognition of suffering which has a thoroughly moral dimension. This also raises the question of power, and the ways in which a therapeutic imperative, underpinned by a confessional culture, has made possible challenges to traditional authority—particularly to forms of authority that have been abusive or unjust. From this standpoint, the sanctity of the self in therapeutic culture cannot be understood merely as hedonistic and amoral. For the therapeutic has its own moral logic, one in which the authority of the self can be marshaled to speak against oppression. To the extent that therapeutic culture encourages and legitimizes the claims of damage inflicted upon the individual (often in the private sphere), the argument of amorality becomes a problematic one.

To conclude, it is important to recognize the legitimacy of concerns about the therapeutic in relation to the issues outlined above. However, without resorting to an overly optimistic position, it is possible to challenge excessively pessimistic interpretations by working toward an alternative reading that pays greater heed to the gendered and contradictory dimensions of the therapeutic society. In moving forward, it is important to look carefully at the historical processes that give rise to the contradictions, with an eye both to the potential for social control and hollow individualism—in short, the negative strands—but also to be open to the therapeutic promise: the potential for increasing caring relations and remedying forms of social injustice.

For as well as at times a self-indulgent preoccupation with personal fulfillment, therapeutic culture has facilitated the assertion of individual rights to bodily autonomy, emotional wellbeing, and personal safety. In particular, I suggest that most existing accounts do not adequately grapple with the problem of suffering.¹²⁵ Reading the therapeutic predominantly in terms of new desires for self-fulfillment and happiness obscures an equally plausible explanation, that it is not about the desire for happiness, but a shifting orientation to suffering. Through the opening up of the private, the legitimizing of the emotional realm, and the speaking of the hitherto unspeakable, therapeutic culture has engendered more complex consequences—particularly for women and other marginalized groups—than dominant accounts have thus far suggested.

In the following chapters, I trace the ascendancy of therapeutic culture in Australia. Beginning in the late nineteenth century in the context of social, cultural, and personal change, the popularization of "nervousness" and changing ideas about mental health reflected growing concerns about the "stresses and strains of modern life." Indeed longstanding social theoretical concerns about the personal consequences of modernity, about opportunity and risk, are evident in medical and popular discourses of that time. Concerns that provided, I argue, the context for the rise of the therapeutic society.