Looking back over my acquaintance of almost half a century with psychology in particular clinical psychology one thing is very clear. Events have not been guided by the triumphant march of science. There has been, so far as I can see, no deepening knowledge of mind or behaviour, no strengthening scientific paradigm, no rational consensus. Rather, there has been a series of fashions.
The behavioural hegemony that existed when I first encountered academic psychology in the 1950s seemed unshakeable. But it was soon shifted, in the clinical sphere at least, by a period of professional development in the practice of a much wider variety of individual forms of therapy which eventually coalesced into that strange hybrid cognitive behaviourism. The vogue for psychodynamic approaches such as psychoanalysis waned and waxed with the times; Freuds name far less anathema now than it used to be, but possibly - Im not sure - on the way down again. Preoccupation with management issues, value for money, a certain kind of evidence-base, short-term therapies, etc., has been a feature of more recent times. In the last decade or two also there has been a rejection of positivistic approaches and a contrasting enthusiasm for discourse and narrative more perhaps in the universities than in the clinics, but noticeable none the less.
What these apparent vagaries of fashion seem to have been about has, as I say, nothing at all to do with scientific progress. If anything, psychologists are split theoretically into as many camps now as they ever have been and there is certainly no sign of the emergence of a unifying paradigm. Our ducking and weaving seems in fact to have been much more about our attempts to situate ourselves as advantageously as possible within the structures of power that determine our interests. None of us these days, whether academics or practitioners, are tenured thinkers safe within a system of patronage that allows us to take whatever intellectual path commends itself to us on the grounds of reason and experience. On the contrary, we have all of us to pay careful attention to which side our bead is buttered on. Strangely enough, despite our daily experience of the evidence in its favour, we have yet as a discipline to make this state of affairs central to our explanation of human conduct. Power and interest, that is to say, may have played a highly significant role in shaping the development of our discipline, but they have featured hardly at all in the conceptual systems we have constructed to account for the behaviour of others.
This is not really surprising, however. Psychology occupies an extremely important place in the societal apparatus. Just to mention two aspects of this, psychology both affirms and legitimates the broadly established view of human nature, as well as providing (along with psychiatry) one of the principal means of accounting for and treating personal distress. In these circumstances, it would not do for psychologists to confess that the theories we adopt and the practices we advocate are determined largely by the preoccupations and interests of our paymasters. Heaven forbid that such cynicism should erode our credibility! No, what we need is authority. If we are to provide our society with the support it requires of us, we need to demonstrate that our theories and practices are founded on an authority that is independent of our interests.
One might naively think that scientific enquiry would have an exhilaratingly liberating quality about it. I dont know how it is for natural scientists, but for social scientists nothing could be further from the truth. From my earliest days as an undergraduate student I have been aware of a kind of inquisitorial power in the background affirming what it was and was not possible to think. The intimidatory force of this power, moreover, has remained pretty constant whatever and however contradictory the shifts in intellectual fashion that have taken place. The forms of authority to which such power becomes attached do, on the other hand, vary in accordance with the fashions.
In Anglo-American psychology the form of authority has been principally empiricist. That is to say, we are expected to legitimate our position via a kind of bogus evidential certitude that runs on the myth that scientific research in our discipline is cumulative and reliable. Hence in published work a position can supposedly be fortified by offering a string of references to other published studies with little or no elaboration of their actual arguments, as if publication in a peer-reviewed journal was a guarantee of validity which, once established, need never thereafter be questioned. In my view this practice, always doubtful, has by now become simply absurd. A particularly good example of the extent this absurdity can reach may be found in the book on Controversies in Psychotherapy and Counselling, edited with the best of intentions by Colin Feltham and published by Sage in 1999, in which protagonists of radically opposing views on fundamental issues in therapy and counselling frequently cite exactly the same studies in support of their position.
Continental philosophical and psychological writing often invokes another kind of authority, one which is on the increase here as well. This is to cloak its utterances in a display of erudition so oppressive, and/or a language of such head-breaking obscurity, that to challenge it would appear to risk displaying ignorance or stupidity on a catastrophic scale. Although I have in my life met one man whose apparent understanding and appreciation of Lacan came close to being infectious, I still find it impossible to understand how Lacans writings manage to earn the respect they seem to in some intellectual circles. God help me, all I can see in them is one or two fairly obvious almost banal ideas afloat in oceans of conceited and impenetrable verbiage.
Despite all these difficulties, however, I think there are important insights to be gained from the psychological study of individual people, though most have been developed more on the margins than at the heart of the discipline. Indeed, many of the writers and thinkers whom I have found most instructive are not for the most part regarded as psychologists at all: Marx, Sartre, Merleau-Ponty, Foucault, Habermas have in my view contributed at least as much to a fruitful understanding of psychology and psychological suffering as more focally psychological writers, many of the best of whom were in any case heavily influenced by them (Im thinking here of people like Fromm, Horney, Sullivan, Laing, Szasz). Interestingly, if I try to think of names within what one might call official, anglophone academic and clinical psychology who have been of fundamental importance I draw a blank. This is a shame, but I dont think we have to look very far for the reason.
Throughout my working life, my central professional concern has of course been to try to understand and as far as possible help to alleviate the difficulties experienced by people who turn for help to the established psychiatric and psychological services. For the purposes of this discussion, let me (influenced, no doubt, by Foucault) lump these services together under the general heading of the clinic. Now, if one looks at the principal theories and practices associated with the clinic during the entire course of the twentieth century one is struck by one feature they very nearly all have in common despite the wide and often contradictory diversity between them that otherwise prevails. This is that they abstract the individual from virtually any social context broader than that of the family.
Mainstream medical approaches the typical psychiatric clinic tend to ignore society altogether, preferring, so to speak, to poke around the patients physical interior, prescribing pharmacological remedies for supposedly biochemical problems, flirting from time to time with psychosurgery (at terrible cost to the unlucky recipients of their attentions) or other gross assaults on the brain such as ECT. The fashion for genetic explanations is of course now enjoying a resurgence after a period in the doldrums and will probably be unstoppable for a while. One should note, however, that some of the most effective critics of the medical model have themselves been psychiatrists (Laing, Szasz).
When it comes to the psychological clinic i.e. approaches to psychotherapy and counselling ranging from the psychodynamic to the cognitive-behavioural we find the same extraordinary absence of the social. Right at the birth of the psychological clinic, Sigmund Freud notoriously abandoned an embryonically social account of psychopathology to place the whole works in an unconscious realm where fantasy runs riot and wishfulness does the damage. The behavioural approaches of mid-century, though rejecting mentalism fiercely enough, placed before us instead a world inhabited only by a scientist, a subject and a Skinner box a world in which the scientist appeared to be the sole arbiter of reality. Then along came the immensely influential Carl Rogers with his person-centred approach. In this, as with several other humanistic approaches to psychotherapy, the world appears to be contained within the person or client, who is expected with a little non-directive help to give birth to the means of his or her own cure. With cognitive-behavioural approaches, the trouble is usually to be traced to cognitions, beliefs, schemata, etc., residing, presumably, in neural circuits somewhere in the brain but which, all being well, can be adjusted through focussed conversations with a therapist. It may also be that your troubles can be put down to your telling yourself the wrong story about the way your life has gone, in which case you should probably seek out a narrative therapist to help you construct a more congenial one.
What the psychological clinic leaves us with, then, is an individual psyche that contains both its own suffering and the means of its own recovery. This psyche is a curious entity indeed, for not only is it dissociated and dislocated, i.e., abstracted from the society within which, outside the clinic, it lives, moves and has its being, but it is also disembodied the operations through which it is to cure itself are purely mental. In all this, the therapist presides over the proceedings exercising his or her esoteric skills rather like a mediaeval alchemist, conjuring miraculous change out of nothing. In these circumstances, I dont find it particularly surprising that psychotherapy has had such a struggle to establish its effectiveness as a form of treatment for emotional distress.
The idea, so well buttressed by the psychological clinic, of an individual psyche - independent, self-choosing, free in principle to will its own condition - is of course one that is very familiar to all of us, since it is the version of our selves we all inherit from popular culture. However, it is not one that in my view (and no doubt the view of many others) actually gets any empirical support from clinical experience. Nevertheless, it surmounts this impediment with ease, just as it maintains a studied indifference to theoretical criticism (e.g. Ian Burkitt, Social Selves, Sage, 1991). The idea of the individual, autonomous, asocial self is supported by the clinic for pragmatic and ideological, not scientific reasons. It is an idea that anyone dependent on making a living from clinical practice cannot afford to abandon, and it is an idea that is equally essential to a society that runs on the exploitation of the many by a few - a society in which it is important for people to believe that their suffering is essentially their own responsibility and that environmental and cultural pollution (and all the other evils that follow from the ruthless pursuit of profit) are influences that they can choose to avoid if they really want to.
The actual experience of trying to apply the orthodoxies of clinical thinking result, however, in a rather different picture, and one that in my view those orthodoxies have utterly failed to get to grips with. Let me just pick out a few of the contrasts that I think exist between clinical theory and clinical experience.
|Theory suggests||Clinical experience teaches|
|Insight leads to change||We are not in control of our conduct; therapeutic change is not demonstrable|
|People may assume responsibility||There is no such thing as will power|
|Thought (cognitions) leads to action (behaviour)||The causes of our conduct are frequently mysterious, and rationally unalterable|
|Characteristics/actions (real or imagined) of the therapist are central to change (e.g. transference, warmth, empathy and genuineness, behavioural and/or cognitive manipulations, etc.)||Patients conduct is controlled by more potent influences in their social environment|
We can only make sense of our experience, I suggest, if we re-socialize and re-materialize people, i.e., place them back in a society and give them back their bodies.
I suggest we replace this model:-
in which 'society' is for the most part represented as within the patient's head (though it's true that, as for example in family and 'systemic' approaches, some members may actually make it as physical presences into the consulting room), with this one:-
Here, complex social influences having their origin at considerable distance from the individual in social space-time, end up, through the impress of power, as the kind of embodied sensation of distress which actually brings people to the clinic in the first place. The person's experience of the world is of course filtered through the systems of meaning which shape it, and it is in this general area that psychology has traditionally focused its attention. These systems of meaning are of course not purely personal, but may have their origin in cultural constructs such as language.
The clinic echoes popular culture in locating the causes of our conduct, and of course of our distress, precisely in this general area of 'experience': the realm of the 'psyche'. What I suggest, however, is that many of the entities we often take as causally potent e.g. beliefs, cognitions, unconscious processes, etc. are, if they exist at all in any significant sense, epiphenomena, no more than spin-offs of causal processes associated with social power, and of which we are largely unaware. Our usual psychological concepts are of very little use to us when it comes to trying to understand how individuals come to act, react, experience and suffer within the broader social environment. For this we need an entirely different set of tools and concepts. The most fundamental of these is, I suggest, power, and to understand how power permeates the social structure we need the concept of interest. Let me try to illustrate what I mean.
Some of the complexity of social space is conveyed in this diagram. A (rather stereotypical!) family floats in social space, the direction of influence between its members and some proximal systems shown by the arrows and its relative strength by their thickness. Rather as if each of the smaller spheres were like a neuron or system of neurons in a nervous system, the electrical impulse of conduction is power and the neurotransmitter is interest. But the diagram leaves out infinitely more than it can illumine. Quite apart from the different ways in which power can engage or coerce interest, it is impossible to convey the way it flows through the system. Power does not originate within the individuals, nor within the institutions shown (e.g. work, school), but is generated much more distally within and between socio-economic and cultural systems whose all-pervasive influence defies intricate analysis.
Just to illustrate another perspective on this:-
Global society, then, constitutes a system of inexpressible complexity. It is like a huge central nervous system in which social neurons (i.e. people) interact with each other via an infinity of interconnecting and overlapping subsystems. The fundamental dynamic of the system is, as Ive suggested, power, which I would define as the ability of a social group or individual to influence others in accordance with its/his/her interests. Interest is thus the principal, and most effective, means through which power is transmitted.
One can begin to see, I think, that this way of thinking contrasts strongly with our conventional psychology: what animates us is not rational appraisal and considered choice of action, but the push and pull of social power as it manipulates our interest. It is not argument and demonstration of truth which move us to action but the impress of influences of which we may be entirely unaware.
In this way the individual is not the originator of action, but the, so to speak, transmitter and host of powers which flow through him or her. An individual can in this way be defined as an embodied locus in social space through which power flows. People are thus held in place within the social environment by the influences which structure it, and their freedom to change position or influence people and events is strictly limited by the availability of power within the sub-systems in which they are located. In fact, no significant amount power is available to the individual beyond that which is or has been afforded by the social environment.
There are, Im sure, many objections to the picture Im trying to build up here. The chief among them, I suspect, concerns the question of human agency, in particular individual freedom and autonomy. Is my view not depressingly determinist; am I really saying that people cannot affect their world?
Worrying about determinism just seems to me a waste of time. If we could adopt the viewpoint of an omniscient being able to encapsulate the world in some kind of cosmic laboratory, it might indeed be possible to elaborate a fully determinist account of individual action. But we cant, so it isnt.
As for freedom, I hope it is clear from what Ive said so far that individuals may indeed be free to act in a variety of ways on their environment, but the extent of that freedom depends entirely on the availability to them of powers which originate not from some interior source of will power, but from powers and resources which are accorded to them (and become embodied by them) from outside. This answer, though, may not satisfy people who are convinced by their own sense of autonomy that there is more to it than that.
This brings us, I think, to the whole question of subjectivity and its relation to language: a question much reflected upon by psychologists and philosophers, and one I can hardly do justice to in a talk which has probably already gone on long enough. But I do need to give at least an outline of what seem to me the central factors here.
There are two principal strands to my argument: a) that we are misled by the irresistibility of our own experience into seeing ourselves as the origin and cause of much of what we do, and b) that we are further misled into thinking that the vocabulary we have developed to describe our experience actually represents substantive internal, psychological processes.
The most compelling evidence we have of what moves us to action comes from the sensations of our own bodies. We may have an intellectual appreciation that the reasons for our conduct lie out in material and social space-time, but what we actually experience is the involvement of our flesh and blood and nervous tissue as we are impelled into action. In these circumstances, it is almost impossible for us not to conclude that it is we who are the origin of our conduct and that the impulses we feel are attributable to rational processes of weighing pros and cons, intending, deciding, willing, etc., etc. Sometimes we will find these processes easy and sometimes effortful, in which case we are directed to notions of confidence, determination, will-power, etc., which in turn lead to the elaboration of moral concepts such as virtue and responsibility as personal qualities. And there we are, so to speak, as individual, autonomous selves at the centre of a psychological universe that is more inside than outside a privilege we accord to no other object, animate or inanimate, on earth.
The inner world that we construct inside our heads the last vestiges, perhaps, of an immortal soul not many of us any longer believe in is packed with a luxuriant range of entities that, at our most naïve, we take as independently potent psychological mechanisms of cognition and motivation, etc. In my view, these represent not so much the hard-won insights of psychological science as the spin-off of a kind of running commentary we learn from a very young age (à la Vigotsky) as an accompaniment for our activity. Let me give an example.
|my actions||what I feel||my account to others||the best available account||Result|
In the case of supposed personal qualities like sincerity, authenticity, insightfulness, etc., (qualities often felt to be, and represented as, of the first importance in judging moral probity) we are, I suggest, not so much dealing with relations of inside to outside, of what people do to what, for instance, are their true motives, but rather with a far less morally and epistemologically loaded relation of action to commentary. In other words, what we have here are merely psychological processes arising out of the way we try by means of language to make sense of our felt experience of what we do. The actual wellsprings of our conduct are to be found elsewhere, in social space-time that figures here hardly at all.
The same kind of analysis could be made, I think, for all sorts of supposedly causal cognitive processes for example, intentions and decisions (which I think are far more to do with, respectively, prediction and postdiction than with cause). What I am trying to suggest, then, is that what actually matters in the real world is what we do and why we do it, while those aspects of our conduct that we often tend to take as personal qualities, abilities or virtues in fact have no substantive motivational power in and of themselves, but are, rather, the product of what we do, what we feel and what we call it.
The constructive power of language is of course something that has not been lost on some critics of conventional psychology, as is testified by the relatively recent craze for social constructionism, discourse analysis, narrative therapy and other variants on the theme that there is nothing beyond the text. But, as several of the contributors to Nightingale and Crombys excellent book Social Constructionist Psychology (Open University Press, 1999) point out, these critics have leaped from the frying-pan of a hard objective reality supposedly independent of human interests, straight into the all-consuming flames of an idealism that implodes the universe into a black hole of individual consciousness.
I suppose some comfort may be derived from the fact that, despite our seeming inability after n years of philosophy to get beyond a simple opposition between a world in which we have no say and one which we invent, we do in some areas nevertheless make reasonable progress in getting to grips with our cosmic predicament (Im thinking, obviously enough, of the natural sciences). Psychology, though and not least clinical psychology has got some serious catching up to do.
As part of this we need the elementary recognition that language, while indeed we cannot hope for it directly to describe a reality that has otherwise nothing to do with us, cannot either validly be used simply to construct versions of reality in which wed prefer for one reason or another to believe. The task, rather is to develop a language that articulates our relations to reality as accurately as possible.
Though as psychologists our concern is inevitably with individual subjectivity, that does not mean that we have to look to subjectivity for the explanation of how we get to be the way we are. There are, I believe, powerful social influences at work that render make-believe an attractive option, but if ever we are to get at least a conceptual grip on those pervasive and intractable aspects of human suffering that are of our own making, we are going to have to struggle with the ways in which power and interest shape the material conditions of our lives as well as the structures of meaning that filter our understanding of our plight.