The following is a speech given at the Greens Reboot Future Conference in Sydney, 31/10/15.
Why would anybody object to happiness? Many in the psy-disciplines, by which I mean psychiatrists, psychotherapists, certain social workers and other mental health workers, and above all, psychologists, purport to hold scientific knowledge about happiness. Why should anybody try to prevent them from implementing their knowledge? That is the question that I would like to answer here, beginning with a sketch of how mental health policy came to its terminus.
Psychoanalysis may not have been the original ‘talking cure’, but it was the most famous for much of the twentieth century. Its origins were in turn-of-the-century Europe, where the fault lines between individual desire and the rules of families and communities were increasingly apparent. Its operating principle was that of transference, namely, a long-term relationship between patient and doctor, in which the former was permitted to say anything whatsoever, and even nothing at all. In contrast with the practices that developed across the Atlantic in the post-War period, it had little to do with the ‘pursuit of happiness’, and, developed largely by Jewish outsiders in Central Europe, tended not to uphold conformist ideals. Its aim, according to its founder, Freud, was to transform neurotic misery into common unhappiness, and it was preceded by a 19th Century in which happiness had been roundly critiqued by Schopenhauer, for instance, who regarded it as a pure negative, the absence of suffering, and by Nietzsche, for whom it was something rather bovine. European novelists and poets had emphasised the dark and divided nature of subjectivity, from Baudelaire’s self-torturing man, to Dostoevsky’s double. Contrary to popular belief, treatment was possible for low-income earners, though it needed subsidy, in essence, from those of greater wealth.
Darkness and division was not confined merely to the pages of literature, and the cataclysm that ensued across Central Europe created a diaspora of talking therapists to other nations. In particular, there was mass demand for treatment in the US after World War II, ranging from the brutal, such as lobotomy, or disabling neuroleptic drugs, to various forms of psychotherapy. Shorn of its Continental European underpinnings, talking therapy became less philosophical, but more evidence-based. Long-term talking treatments were still possible, sometimes for the poor, though the emphasis shifted from uncovering unconscious divisions and desires to bolstering ‘ego strength’, and modelling the patient’s ego on that of the doctor. Psychoanalysis still existed, but in the US, at least, it was a very different discipline to that practiced in fin-de-siecle Vienna, and was accompanied by pharmaceuticals, and cognitive and behavioural treatments.
From around the 1980s, in the era of Reagan, of Thatcher – let’s call it the era of neoliberalism, for short – mental health began to take on a somewhat different look. Psychiatric drugs became more refined and their use greatly expanded. It was during this period that drug companies became some of the biggest on the US stock exchange. Long-term, transferential models of treatment were replaced by directive, coercive, standardised treatments, assessed by the most reductive quantitative means, which now resembled KPIs, and encouraged the sort of short-term thinking that emerged in the corporate world with quarterly reporting. The doctor was less a guide for the patient in misery than a kind of Taylorist of the soul, who monitored the patient in rational thinking and speaking, assigned homework tasks, and instituted various methods of surveillance and discipline with the aim of having the patient internalise this into self-regulation. This was and is regarded as scientific psychotherapy, and in this era, it emphasises cost-effectiveness and soft policing above all else. The pseudo-scientific status of all this within academia and policy precludes most analysis of the ethical and political dimensions of this new paradigm. Thus, in Australia, a militant exponent of ‘economic rationalism’, Jeff Kennett, can be head of one mental health advocacy group, whilst a director of Transfield, a company which takes taxpayer’s money in exchange for a rebranded version of torture, is director of another mental health group, the Black Dog Institute of Sydney.
To be clear, mental health is not a unified field, and what I describe here are broad brushstrokes which omit many important exceptions. Moreover, whilst the medical profession is partly the author of the psy-disciplines, the present models are not entirely medical. To the extent that there is a medical paradigm in operation, it follows the pattern of expansion and refinement of discipline that has been ongoing for at least the past century. For instance, the latest DSM – the psychiatric manual listing all ‘official’ diagnoses – has now expanded to the extent that about 60-80% of Australians would qualify as having a mental health condition. Nonetheless, the medical model also sets limits to intervention insofar as it is preoccupied with the abolition of symptoms. In times of scarcity in public health, economics can come to warp the nature of medical assessments. In my city, Melbourne, the public hospitals exhibit a mania for preventing secondary gain, and so suicidal patients are routinely refused treatment on the basis of their ‘personality’, on the unproven assumption that intervention would worsen their symptoms. Political economy can reorganise the ‘science’ of diagnosis and assessment itself.
The new paradigm of the neoliberal era, however, is not merely about conquering illness, but of enhancing normality even where no pathology is present. This is a fundamental shift, however slight. By definition, and in contrast to medicine, enhancement has no limits to its domain. Again, there is the pattern of refinement and expansion, as evidenced in the growing ‘positive psychology’ movement, or in the use of neuroenhancement, as well as a growth in intervention at an institutional level. Mindfulness can now be found not just as a technique in the mental health clinic, but in the hospital, the prison, the workplace and the school. Positivity has become an urgent moral imperative, a commandment of the superego, to use the old language, and one whose counterpart is, not incidentally, an epidemic of depression and anxiety.
In all of this, I do not wish to promote some nostalgia for other times and places, and still less do I intend to dichotomise a ‘good’, Continental psychology against a neoliberal, Anglophone one. What should be emphasised is that the metamorphosis of mental health in line with developments in political economy is accompanied by changes in the kind of subject presumed by such a psychology. ‘Patients have become ‘clients’ or ‘service users’, but in effect, the clients of mental health, in a material sense, are predominantly health insurers and governments. For ‘clients’ as individual patients, most forms of talking therapy can be useful if the therapeutic relationship is strong, according to the evidence, but this finding – supported by extensive research – is almost never what is meant by ‘evidence-based treatment’ in mental health. The latter always refers to that which works for the health insurers and policy makers, not the patients, and it is the insurers and policy-makers who are the real ‘service users’. The patient, with his or her suffering, is an object in every sense. Thus, cognitive behavioural treatments and self-administered online therapy are widely promoted, despite evidence of their effects being trivial, and of these trivial effects being short-lived in any case. Never mind that this call-centre psychology is actually shown to work best when its practitioners ditch their treatment protocols. What matters is that they are cost-effective, directive, and standardised. They are poor for people, but excellent for governments.
The Anglophone world has three ‘waves’ of evidence-based psychology, the first being Behaviourism, whose mission, according to its founders, was to ‘predict and control’. The second wave is Cognitivism, and the third is a ‘spiritual’ synthesis of the two, as exemplified by positive psychology. This conceptualisation ought to be taken with a pinch of salt, but in any case, what is emphasised across the latter two waves are the supposed strong links between positivity and ‘rationality’, the proper use of reason. Again, the ‘evidence’ here is epistemologically dubious. Aristotle observed that melancholics are far from lacking in sagacity, and the empirical results tend to support him. Depressives, for instance, can be perfectly rational, when compared to their non-depressed counterparts who utilise ‘adaptive self-deception’. (We should note that, in mental health, whenever one hears the term ‘adaptation’, one is listening to an authoritarian). If the twentieth century demonstrated anything, it is that many forms of reason are perfectly compatible with enjoyment in destruction, including self-destruction. The contemporary evidence-base is innocent of such reflections.
Moreover, if we take cases of inattention, sadness, anxiety, anger, and others, to be a by-product of biochemical malfunction, or, alternatively, the poor exercise of self-mastery and reason, it allows for these symptoms to be localised in individuals in a context-free way. The symptoms can then be manipulated or suppressed with techniques, without any regard for their meaning. The techniques themselves amount to a grab-bag of positive or ‘rational’ thinking (the two now being conflated), general health tips, drugs, and exercises in distraction. In these paradigms, the person who suffers panic attacks in the context of workplace bullying, for instance, is the one who requires fixing, rather than the pathogenic context itself. When LDP senator David Leyonhjelm recently quipped that offense was purely a consequence of the bad reasoning of the offended, that one bad feeling could surely be substituted for another, better one, he was not just parroting self-serving libertarian defences of bigotry, but was echoing mainstream psychology.
It is in this milieu that we find the merchants of happiness, with their doctrine of mindfulness, authenticity and critical positivity ratios. (This is the precise ratio of positive to negative thoughts supposed to produce ‘flourishing’. For those who are interested, the number is 2.901). The previous ‘waves’ of evidence-based talk therapy were explicitly corrective in their function, attributing suffering, essentially, to the pained subject’s own mislearning or ‘distorted’ thinking. The latest wave is less an overt re-educative process, and instead emphasises pacification, and resignation. To the aforementioned techniques of the older waves are added procedures of gentle acquiescence, from a meditative focus on the present, to the use of colouring books. All this is framed in a jargon of authenticity and glossy reminders that the practices in question are ‘spiritual’. With some exceptions, the aim is not so much the pursuit of happiness as the pathologising and erasure of negativity. It is resolutely anti-intellectual, and those who take up this wave of treatment are explicitly encouraged not to think too much. The accent in this doctrine is placed on a supposed pure present, which tends to make its proponents anti-historicist. A creed that peddles the forgetting of history and opposes critical thought is inevitably on the side of the oppressors, and not the oppressed.
Still, some might wonder whether it is such a bad thing, after all, for clinicians, teachers, human resource departments and others to bring some tranquility to the minds of their subjects. The treatment in question may look a bit like an attempt to induce mild senility, to be sure, but what harm can there be in colouring books? Well, whenever governments, militaries and corporate entities attempt implement mental health protocols on a massive scale, I think it worth asking a few questions about the motives involved, and I will ask some of these questions here. The key to the psy-disciplines is that their practitioners willingly serve as the handmaidens to power, and this is why US psychologists, for example, were permitted for years, with the imprimatur of their professional regulators, to torture prisoners at Guantanamo Bay.
What does this call to authenticity mean? We should recall the concept of narcissism here. Nowadays, the term is used in a moralistic sense, to denote selfishness or egoism. Its original, Freudian meaning referred to a subject’s relations to their image and body. In this sense, authenticity – the imperative to be true to yourself – is a demand for more narcissism. The literature on the topic makes clear that the authenticity at stake is a matter of a unified subject expressing themselves in perfect self-identity, being true to themselves, and not much concerned with authenticity regarding other people. I mentioned the 19th century earlier, in which Rimbaud could assert that ‘I is an other’. This ‘I’ is a much-diminished figure in modern psychology, and needs only a little enjoyment. This model presupposes human beings who are isolated monads, who consume, and are encouraged to consume by the practice, but who do not relate. The contemporary cult of self-esteem belongs as an adjunct to this position, since to stand before real or metaphorical mirrors, scrutinising oneself, is always an exercise in narcissism, irrespective of whether one’s judgements involve self-praise or self-blame. Thus, on the notion of being ‘true to oneself’, I think we should follow Adorno, and conclude that authenticity is for hipsters and fascists.
What kinds of happiness or positivity are at stake in this approach? It appears to be something rather tepid. The evidence-based treatment protocols promote a ‘pleasant activity schedule’, the activities of which tend to be more in line with pacification (like flower arrangement, for instance) than Dionysian revelry. (Though curiously, one such protocol I saw listed share trading as a ‘pleasant ‘activity. It was the only form of gambling there). More telling, however, is the approach to suffering. Outside of strictly circumscribed situations – such as mourning – suffering is subtly but systematically pathologised. It is viewed neither as a part of the human condition, nor as an indicator of dissatisfaction in one’s life, but once again, as a personal malfunction, to be managed where it cannot be corrected.
What kind of spirituality is at play in the new wave of treatments? Its proponents frequently name-check the Buddha, but the practice is more tourism than Buddhism. One aspect of Buddhist teaching has been isolated, given a translation, and reduced to a standardised technique to be used by experts en masse in the governing of others. In short, it is about as spiritual as handing out unconsecrated communion wafers at a corporate team building day.
What is the aim of this practice? It tends to espouse several, but one that frequently recurs is that of ‘well-being’. In fact, this word is so ubiquitous now as to be virtually invisible. It is worth recalling that in psychoanalysis, for instance, there is a contrary concept, which suffers somewhat in translation, but which can be termed ‘well-saying’. This distinction is important, since the new wave of psychology focuses on being at the expense of saying and doing. It gives primacy to a narrow ontology over the concerns of ethics and history. It is no coincidence that the political implications of this are universally regressive. The new wave’s claims to scientificity only reinforce this problem, since, in masquerading as a science, the new wavers can downplay history and context. Yet recognised sciences can generalise results under a given set of conditions, as in the case of much of chemistry, or physics. No such generalisation is ever possible in mental health. There has been a recent furore in psychology about the inability of researchers to have their findings replicated. This is an epistemological feature, not a bug, since the ‘science’ in question is, by definition, a study of irreplicable results.
This shonky epistemology is not merely incidental, since it is necessarily linked to equally dubious political and ethical practices. There are numerous examples, but two of the largest and most prominent can be found in the UK and US. In the UK, welfare benefits for the unemployed are now linked to mandatory attendance at positive psychology courses, with the aim of making subjects more marketable for prospective employers. It is not enough for the unemployed to undergo a series of bureaucratic rituals to gain access to their money, but now, they must also be positive about it.
In the US, the guru of the positive psychology movement, Martin Seligman (previously a Behaviourist psychologist who attained fame through his experiments in dog torture) has led the largest psychological intervention in human history. Over a million US soldiers have received mandatory ‘positivity and emotional resiliency training’ using the techniques and doctrines that I have described. Its aim is explicitly one of obedience: the program teaches soldiers to focus on “expressing appreciation” and “correcting negative views of ambiguous events.” When soldiers receive onerous (or perhaps unethical) orders, they are asked to reframe them, see the bright side. Again, we should be clear as to whom the ‘client’ is here, and Seligman himself tells us, when he says that his program is designed to create an indomitable army.
Short-term thinking is now an established element of governmental thinking and policy-making, as well as the corporate world. It is also an entrenched part of publically-funded services, since the demand for attractive data and KPIs is generally attached to future funding arrangements. Whatever the supposedly scientific claims of psychology and related disciplines, it is not separate from its culture. When the culture, through Coca Cola, for instance, exhorts its consumers to enjoy, we should pay attention when the psychologists do likewise.