[Modified version of The Making of Subjectivity, talk given at The British Psychological Society Psychotherapy Section conference on The Construction of the Person in Relation, 21.9.02]

Psychotherapy and The Making of Subjectivity

David Smail

Psychotherapy has won the battle for recognition and respect that it fought for most of the twentieth century. And yet, I fear, the victory is empty, and indeed we may have achieved no more than to replace one form of oppressive intellectual domination with another.

When they came to considering the life—and more particularly the health—of the mind, the psychological and psychiatric orthodoxies of the last century relied upon the crushing power of a dogmatic authority almost totalitarian in its scope and its claims. The intent was to make out of Science an indisputable methodology whose mechanical application could stifle dissent and set up a ruling elite able to pronounce upon objective truth with a certainty as infallible as that of any pope.

The result of this approach was, of course, to dehumanize the subject such that s/he came to be seen as nothing more than a biological or behavioural automaton, devoid of meaning or purpose other than that instilled by, on the one hand, biochemistry and genes and, on the other, mechanical reaction to processes of conditioning. Infuriatingly for those who dissented from this view (and entirely inconsistently from any rational perspective), the high priests of orthodoxy placed themselves conceptually outside the bleak world thus created for their puppets, pulling their strings as if from within another universe.

There were throughout, of course, critics of this intellectual thuggery, the most effective of whom—the debate having moved on—are now largely forgotten (I think particularly here of Michael Polanyi, who almost single-handedly reduced the embattled monolith of Scientism to rubble (Polanyi,1958)). Apart from the behaviour therapists (and subsequently ‘cognitive-behavioural practitioners’), who allied themselves strongly with the bogus authority of ‘science’, psychotherapists of many persuasions were prominent among those who saw in behaviourism, positivism and the ‘medical model’ threats to human freedom and dignity that demanded vigorous resistance. Psychoanalysis, Analytical Psychology and Object Relations Theory had throughout offered a home to those with a deeper and wider (if not necessarily more accurate) view of human nature, and the feeling of excitement and relief generated in clinical psychology by the mid-century challenges of people like Carl Rogers, Fritz Perls and George Kelly may be hard to imagine for those who weren't there to experience it. The force of scientism was not, after all, irresistible.

In retrospect, there was more than a touch of naivety about our enthusiasm. In our celebration of the demise of the positivist-behaviourist dragon, we failed to see that other menaces were lurking in the forest—not least the invitation to self-deception brought about by our own professional interest. Furthermore, so traumatised had we been by the years of our subjugation, many of us failed to recognize that the beast was indeed slain, and even now raise the battle cry against a non-existent foe. For example, in advocating in his recent book (House, 2003) the adoption of a ‘new paradigm’ that sweeps away all the old modernist prejudices of hegemonic Science, Richard House rather overlooks the fact that the ‘new paradigm’ is already here, looking just about as comfortable and confident as the old. ‘Qualitative research’ and ‘grounded theory’, ‘discursive’ and ‘narrative’, ‘constructivist’ as well as ‘deconstructionist’ approaches are well ensconced in mainstream psychology and psychotherapy journals and taught as the new orthodoxy on the countless psychotherapy and counselling courses that have mushroomed over the past couple of decades.

In this way we seem to have picked up and elaborated those aspects of psychological and therapeutic thought that focus on the person’s autonomy, responsibility, ‘self-actualization’ and powers of self-reinterpretation, while overlooking the significance of those contributions which (like, in particular, R.D. Laing’s) saw that subjectivity is intelligible only within a social context. In our excitement at having escaped over the last forty years or so from the dominance of a disciplinary scientism, we have, it seems to me, come to prefer the constructions of our imagination to those of what I want to call, unashamedly, reality. What threatens the accuracy of our understanding now is not the imposition of a brutally impersonal Objectivity, but a rampant subjectivism that seeks to disconnect us entirely from the world.

In this way, so-called 'postmodernist' approaches in psychology that adopt what one might call a naïve social constructionism, or privilege 'narrative' above history in psychotherapy, seem to me, rather than advancing our understanding, to stand in danger of pointing us backward towards pre-scientific notions of a world in which the substance of what is is inseparable from the stuff of our fears, hopes and desires. Psychotherapists' embrace of such accounts may stem from a laudable desire to dissociate themselves from the intellectual dishonesty of any claim to a special relationship with 'the real world', but in hoping to set the human spirit free, we stand in danger of cutting our ties with enlightened reason altogether. In proclaiming our contempt for science, we lose a necessary respect for empirical enquiry such that we inevitably find ourselves authoring just another theology. This just adds to the impression that the history of psychotherapy is much more understandable as a history of competing cults than as any kind of progression, however halting, of scientific insight.

As, before her tragic blindness intervened, Susanne Langer struggled to document in her compendious and vastly ambitious, three-volume Mind: An Essay on Human Feeling (Langer,1963-1982), human beings' understanding of their world has taken shape over millennia, emerging hesitantly out of dream and religious mystery. Gradually the world has taken on the lineaments of a reality from which we can stand apart just a little, even though, of course, it will always be a world formed and appreciated by and through our own interests and embodied nature.

In my view psychotherapy would much better concern itself with our place in and relations with our world, rather than reinforcing the idea that somehow we create reality. For the latter idea is, essentially, a magical one. I don't think it would be stretching matters too far to characterize the unifying philosophy of the plethora of psychotherapies that the last hundred years has spawned as one of 'magical voluntarism'. By this I mean, of course, the idea that the individual can, in crucial ways, change him or herself from the inside out, essentially by acts of will following upon 'insight'.

I have written quite a lot about what I see as the strict limitations of this kind of view (e.g. Smail, 2001) and I don't want to elaborate upon them further here. What I would like to do, though, is try to say something - I hope rather more positively - about what I see as a more valid and intellectually justifiable role for psychology and psychotherapy in relation to emotional distress.

Contrary to what many psychotherapies claim, or at least imply, people are in my view not self-creating, self-choosing entities able, once they have seen the need, to adjust themselves through an act of will. Like the rest of nature, we are held in place within a world (in our case, in particular, a social world), and the extent to which we can change our situation within the world is dependent on the powers and resources available to us to do so. To understand the causes of emotional distress, we need to look beyond ‘individuals and their families’ to the society that encapsulates us all, patients and therapists alike.

It is necessary to stress, however, that this position does not just empty out into some kind of impersonal socio-political stance. Important though both sociological and political questions are to our understanding of and response to distress, for practitioners whose concern is with personal suffering our focus must be on the character and formation of individual subjectivity (for that is where our suffering takes place). I don't think that on the whole therapeutic psychology has dealt terribly well with subjectivity: for the most part it has sought to constrain rather than liberate it. (This process has a long history: Freud’s account in The Interpretation of Dreams (1954 edn.) of Scherner’s (1861) treatment of imagination and dreaming bristles with disapproval at his (Scherner’s) unbridled enthusiasm for the scope and freedom of the imagination. One can almost see Freud reaching for the shackles of the ‘Superego’ which he was later to think so necessary for the development of ‘civilization’.)

Subjectively, each of us lives at the centre of a private world of thoughts, feelings and experiences which is quite unique as well as, in present-day society, exquisitely vulnerable. When, as inevitably we must, we compare this world with the world in which those around us appear to live their lives, our sense of our own vulnerability may become so acute as to be almost unbearable, for their world may seem to reflect a certainty and solidity which is entirely lacking in ours. Within the secret depths of our personal experience are packed a seemingly infinite range of hopes, fears and fantasies, desires we hardly dare to recognize and shames that are anguish to contemplate. From the moment of birth, and indeed before, we are exposed to an unremitting tempest of sensation – pleasures as well as pains - to which, as we mature, becomes attached a framework of judgement that buzzes with justifications, condemnations and self-deceptions to the point where any kind of self-certainty seems impossible.

What gives form to this subjective world, makes it intelligible and bearable, is the social space in which we find ourselves located and which confers meaning on our experience. Subjectivity as a possibility arises out of our nature as embodied beings, but it achieves a coherent shape through social interaction. Our bodies, to be sure, give us knowledge of the world, but we can only truly articulate and make sense of that knowledge through the structures of meaning which are provided through our congress with others.

But that does not mean that our embodied knowledge of the world is infinitely malleable, can be made to conform to whatever stories we choose to tell ourselves. Those stories may be true or they may be false; they may guide us towards an intelligible world which answers faithfully to our embodied understanding, or they may obscure it from us in a blanket of mystery that renders our actions tentative, fearful, dangerous.

Where the public world is painstakingly shaped to accommodate, appreciate, elaborate and civilize our private experience, to take proper account of the way we understand the promptings of our bodies and put them to use, a kind of harmony may be given to our lives that, while certainly not erasing all possibility of tragedy, at least gives us a chance to live, as selves, in accord with others about the nature of the world into which we have been thrown. There comes to be a kind of satisfaction in being a subject in social space.

Where, on the other hand, the public world is shaped to exploit our subjectivity, to mystify, obscure or distort the wordless knowledge our bodies give us of the world, no such harmony will be possible. Either we may accept and attempt to live within the distortions, surrendering to a disciplinary orthodoxy at the cost of our souls, or we may be driven to live out our subjectivity in a constant state of uncertainty and apprehension, scurrying in the cracks which show through make-believe like woodlice in a rotten wall. Very rarely, some people seem to have from the start a confidence in their embodied experience that no amount of bullying and deception can shake, but even so they nearly always find themselves in a rebellious minority split off in many ways from the social mainstream.

In comparison with the centuries of art, literature, philosophy, religion and science that have, at their best, strained to dignify our subjective experience of life by building a worthy public framework for it, the stance taken by psychotherapy has been deeply ambivalent and for the most part extremely superficial. Indeed, it’s hard to avoid the judgement that, in most of its official theorizing, therapy has throughout been developed as one of the principal means of discipline whereby the subject if forced into line with dominant ideology - i.e. with the ruling dogmas of power. Very few approaches to therapy explicitly reject at least a covert form of ‘normativeness’ in which certain moral and/or aesthetic standards of human being are specified not in the subject’s interest, but in the interests of power. In this kind of approach subjectivity is, as I suggested earlier, constrained rather than liberated, and patients’ fearful expectations of being judged are only too quickly confirmed. If we are to help free people from the kind of disciplinary therapeutic regimen that Foucault criticised so effectively (e.g. Foucault, 1979), I suggest that it might be a good idea to switch our 'clinical gaze' from people to the environment in which they find themselves.

I wish we could get rid of the term ‘therapy’: there is so much that is misleading about it. But even if we’re stuck with it, there’s no reason to equate ‘therapy’ with an individidualistic struggle to change ‘selves’. The focal concern of psychology with the making of individual subjectivity in no way implies that subjectivity is necessarily self-made. In order to understand subjectivity, in other words, we have to look beyond it. If personhood, along with the subjective awareness of it, is the outcome of an interaction of a body with a world, it surely becomes the psychologist's business to pay careful attention to the constraints and influences of both.

I have no quarrel at all with the observation that to a significant extent human beings are socially constructed, indeed it would be simply absurd to deny it. What does strike me as false, however, is where what I call naïve social constructionism imports chunks of the therapeutic philosophy of magical voluntarism to suggest or imply that social constructions can be reconstructed, or indeed deconstructed, at will. This kind of ill-considered notion, often derived (with what justification it's hard to say) from rarefied 'postmodernist' philosophical discourse, contributes, as intellectual justification, to a pervasive cultural preference for make-believe over reality.

The idea of ‘choice’ so crucial to the limitless expansionist programme of consumer capitalism finds its psychological form in the belief that, along with consumer goods and life-styles, we can also choose our selves. Indeed, reality itself becomes something to be managed, truth a construct to be spun according to the needs and requirements of the market. If people are to be persuaded to respond satisfactorily to the economic and political necessities of the times, they have to be made to believe in ‘realities’ that are almost entirely artificial. The apparatuses that have been perfected to this end are truly awe-inspiring. We are right to observe that such realities are indeed artificial constructions, but wrong to conclude that this is the only kind of reality there is.

Paradoxically perhaps, the existence of make-believe proclaims the importance of truth. Notwithstanding the best arguments of naïve constructionism, make-believe is not the outcome of an ultimate relativity, but derives its importance from its ability to be taken for the truth. The possibility of truth lies behind make-believe, just as a covert truth-claim lies behind every avowedly relativist account of how things are. In this way make-believe is subservient to truth; it seeks to stand in for truth, but is always at risk of being undermined by it.

Make-believe (spin) is essential to politics precisely because politics is vulnerable, even in today’s depleted democracy, to dreaded ‘public opinion’. For public opinion is what people believe to be true, and as long as political power is contingent on what people think, it will be essential to control what they think. Hence the enormous effort that is put politically into maintaining ideological power, to controlling the formation and reception of meaning in every sphere and at every level.

But truth is still not sovereign, for behind truth lies power.

It really doesn’t matter to politicians how blatant and absurd the (mis)representation of truth becomes (to the more discerning consumers of the ‘safety-valve’ media like The Guardian and Channel 4) just so long as mass opinion continues to be controlled. Such control is necessary because what people take to be true still, just, has the propensity to undermine power by providing a focus for solidary action. If power should ever manage to find a way of subverting this last vestige of democratic influence, it will cease immediately to bother with spin and abandon with huge relief all the apparatus of make-believe, for truth will no longer be important. (At the time of writing this can be seen particularly clearly in the unconcealed indifference of the US and UK governments to what people think as they prepare their military assault on Iraq.)

The corporate plutocracy that dominates our lives still depends to an extent on a depleted democracy and must therefore sustain a notion of the ‘truth’, but this is a severely debased form of truth, i.e. truth as virtually synonymous with public opinion and purveyed by the public relations and advertising industries. Precisely because it has become so debased, so transparently fabricated and manipulated, ‘truth’ may be mistakenly represented (perhaps, indeed, in good faith) by the intellectuals of ‘postmodernity’ as an outmoded construction of the discredited ‘grand narratives’ of former times. But rather than the exposure of the, so to speak, conceptual impossibility of truth, what we are witnessing is the disempowerment of truth, its cynical reduction to technologies of spin in which there is a tacit acknowledgement that truth is on the way to not mattering at all.

Truth, and its parasite make-believe, thus only matter as long as there is a possibility of popular solidarity forming around a common understanding of what is the case (e.g. how the world works to immiserate us) and destabilizing the structures of global corporate plutocracy.

In this state of affairs, in my view, the philosophical task becomes that of rehabilitating the concept of truth, which in turn means deconstructing constructionism (in its naïve form)! We can’t do this without considering the role of language.

There can be no doubt that language is of the first importance in the formation of human conduct and society. But this does not mean that language is generative of reality itself. The over-excited embrace (and often only rudimentary understanding) in broadly ‘therapeutic’ circles of notions of ‘discourse’, ‘narrative’, etc. having their origin mainly in the writings of French post-structuralists such as Foucault, Derrida and Lyotard, has resulted in an almost psychotic disregard of the real circumstances of people’s lives. Foucault spoke, after all, of the ‘discourse of power’, not the power of discourse, and yet it is this misconstruction which seems to have gripped the imagination of the ‘naïve constructionists’, ‘narrative therapists’, et al. (e.g. Gergen, 1994; Parker, 1999).

Of course words do not directly reflect an incontrovertible reality or ‘hold a mirror up to Nature’; of course language can never give direct access to Truth. And of course language is absolutely essential to our understanding of and interaction with the world and each other. But this does not invest language with some kind of magical power of creation through which it brings worlds into being. Certainly language is the principal medium of persuasion, but it persuades by pointing to something other than itself, something that is the case rather than something that is merely said.

Language allows us to place our experience at a distance from us, to hypostatize and manipulate it. Otherwise, we could only live our experience – or be lived by it, rather in the manner of dreaming. Inevitably, we are constantly tempted to believe in the actuality of our imaginings precisely because we can clothe them in words. This, after all, is why scientific enquiry has to be so sceptical and so painstaking. But when we take imagination as definitive of reality (or alternative realities), we have sunk into collective madness.

While we may unite in criticism of a too heavy-handed positivist authority that attempted in the past to establish a direct line to Truth such that a suitably refined and specialized language could indeed be used to describe an independent reality, we need to recapture a view of language as articulating our relations with the world as best we can. We can in this way acknowledge that any form of ‘ultimate’ reality must always remain a mystery beyond our grasp, but that that does not mean there is no such thing as reality. Some things are more real, some statements more true, than others. Reality is sensed in embodied experience before it is articulated in words, and what we say needs always to be checked against other kinds of evidence, including where necessary every other possible intimation we may have of our living existence in material reality. In this respect, neuroscientists seem to have their feet more firmly on the ground than most psychotherapeutic thinkers: Antonio Damasio’s The Feeling of What Happens, for example (Damasio, 2000), gives a very thoughtful account of the relations between subjective experience, consciousness and world.

Nothing could suit corporate plutocracy more than for people to believe that the real satisfactions of life have nothing to do with a shared material reality, but stem ultimately from the cultivation of privacy; that subjective well-being, that is to say, is a matter of ‘personal growth’ from the inside. One-dimensional Business culture in fact closes down public space such that the ‘real’ world’ (i.e. the world of the market economy) becomes simply a given that people have to accept without question: ‘resistance is useless’. If the many can be persuaded that they have no say in the shaping of material reality, and that personal satisfaction is purely a matter of self-doctoring and private consumption, the world is left wide open for exploitation by the few.

When the only public meanings available are the grim and unassailable ‘realities’ of the market, people are left to scrabble together for themselves make-shift ways of sharing experiences that actually cannot be accommodated within the Business model (an example might be the rituals of grief that have developed rapidly in recent times – impromptu roadside shrines, greater emotional demonstrativeness, etc.). Quite apart from feeling politically impotent (and demonstrating our alienation by shunning the ‘democratic’ process in unprecedented numbers) we have to cast around for ways of making communal sense of experiences that inevitably arise from our existence as embodied beings but are no longer served by abandoned – and often discredited - traditions.

However, because we are social beings, individual subjectivity cannot develop and flourish in a virtual vacuum. The structures of public space necessarily supply a kind of exoskeleton for our feeling and understanding of what it is to be human, and where those structures are drastically reduced, our subjectivity becomes fractured and incomplete. At its most grotesque, people may become stripped of public identity altogether: nameless automata at the end of a telephone without powers of reason or judgement, able only to reiterate a handful of stock phrases.

It is of course understandable for people to feel that one answer to the heartlessness of the outside world is to retire into the realm, if not of the inner self, at least of the private life of home and family, etc. However, I suspect that this kind of strategy (already thoroughly considered, of course, by Christopher Lasch, (1977)) is built on the false premise that inner space, privacy, is somehow independent of public structure. In fact, if anything, the opposite seems to me to be the case. For individual people, hell is more often to be experienced within the confines of the family (or indeed the agonies of introspection) than it is in the spaces beyond, and public structures of meaning – what one might broadly call cultures - that have evolved over time to accommodate the concerns of embodied human beings may offer an escape from privacy that actually lends meaning and significance to suffering. A decent, caring, multi-dimensional public world makes use as well as sense of private pain and confusion. One of the most tormented and abused (and admirable) people I ever met was rescued as child from total perdition by films and books, which, among other things, uncovered, to her amazement, the possibility of love.

The way to rescue subjectivity is, then, not to sink further into our ‘inner worlds’, but to struggle to open up public space and build within it structures that are adequate to giving meaning and purpose to our lives. The relentless Business onslaught over the last couple of decades has stripped away practically every way we had of understanding ourselves outside the debased and stupefying vocabulary of the market economy. Deeply hostile to social, intellectual, artistic, spiritual and what

Ivan Illich (1975) called convivial ways of thinking, being and experiencing (not least because they give subjects the possibility of criticizing their condition), Business, where it cannot undermine them directly, invades them parasitically, like one of those wasps that lays its eggs on the pupae of other creatures. Intellectual life gives way to a kind of managerially authorized posturing, intelligence to the bureaucratized application of mindless rules, history to fashion. Even ordinary conversation, via the media, takes on the tones of hyperbolic advertising gibberish.

Every nook and cranny of existence is turned to commercial use and the apparatus of consumerism is everywhere. Taxation is replaced by sponsorship. Every article for sale is laden with the ‘added value’ of ever more contrived and crazy exercises in branding. Sport becomes big business. Thought, feeling, relating and understanding become standard, iterative rituals in which people no longer know what they think, or what to think, unless it is prescribed by commercial logic, or the crude dogmas of political correctness that have come to replace ethical reflection.

In this kind of situation, what we need rather more than individual therapy, I think, is the reconstruction of society. The task of the therapist becomes that of helping the person understand how he or she has been shaped by the world. This process carries with it no guarantee that individual action can make much, if any, difference to the causes of distress, either now or in the past. We have to do without the magic of re-interpretation. There may of course be possibilities for those with the necessary powers and resources—money, education, a sustaining social network—to shift their position in the world a little to their advantage, but they will always be a privileged few.

Nearly everything worth saying has been said before. I suggest that psychotherapists could do worse than see—and develop—their role as contributing to ‘liberal education’ of the kind advocated by C. Wright Mills (Mills, 1956):-

The knowledgeable man in the genuine public is able to turn his personal troubles into social issues, to see their relevance for his community and his community's relevance for them. He understands that what he thinks and feels as personal troubles are very often not only that but problems shared by others and indeed not subject to solution by any one individual but only by modifications of the structure of the groups in which he lives and sometimes the structure of the entire society.

Men in masses are gripped by personal troubles, but they are not aware of their true meaning and source. Men in public confront issues, and they are aware of their terms. It is the task of the liberal institution, as of the liberally educated man, continually to translate troubles into issues and issues into the terms of their human meaning for the individual. In the absence of deep and wide political debate, schools for adults and adolescents could perhaps become hospitable frameworks for just such debate. In a community of publics the task of liberal would be: to keep the public from being overwhelmed; to help produce the disciplined and informed mind that cannot be overwhelmed; to help develop the bold and sensible individual that cannot be sunk by the burdens of mass life. But educational practice has not made knowledge directly relevant to the human need of the troubled person of the twentieth century or to the social practices of the citizen. The citizen cannot now see the roots of his own biases and frustrations, nor think clearly about himself, nor for that matter about anything else. He does not see the frustration of idea, of intellect, by the present organization of society, and he is not able to meet the tasks now confronting 'the intelligent citizen'.

These words were conceived at the middle of the last century. We’ve got some catching up to do.


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