Review of CBT: The Cognitive Behavioural Tsunami, by Farhad Dalal

Back in 2014, I posted a series of essays critiquing cognitive behaviour therapy (CBT) in terms of its philosophical and ethical problems. The idea that I had at the time was to provide a rebuttal of CBT that was not from within the parameters of its own assumptions, but which examined CBT from first principles, and also in terms of its political positions. The data may supposedly be in support of CBT, I reasoned, but such data was largely irrelevant if it pertained to incoherent theories and concepts, and was used to prop up a series of coercive and unethical practices. There were many critiques of my articles, on Reddit, for instance (here is an example), though practically none of them attempted to defend the theory of CBT. Few people seem to seriously uphold CBT concepts, even among advocates of this approach. Rather, the main objection to an a priori critique of CBT was ‘evidence’, which clearly proves CBT to be the ‘industry gold standard’, at least for now. Since CBT ‘works’, principles – first, or otherwise – simply do not matter. Continue reading

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The Other, clinical and empirical: A review of Fonagy et al. on Affect regulation, mentalisation, and the development of the self

The following is taken from a presentation delivered late in 2011. Despite the age of the piece, I thought it worth sharing, as it touches on issues from more recent debates such as the nature of psychosis, the meaning of neuroscientific data, and the ethics of treatment. My views on certain matters below, such as phobia, or the nature of signification, have changed since then, but my views on Fonagy are more or less the same.

 
Anglophone psychology has long objected to the alleged individualism of Freud and
psychoanalysis. Psychoanalytic theory, they say, focuses on the intrapsychic, not the
intersubjective. Adler was one of the first to add a “social‟ element to psychodynamic
theory, positing a lack of “social interest‟ as the cause of every neurotic illness (Adler,
1928/1998). Later, a number of largely US-based psychoanalysts, led by Heinz Kohut,
championed an “intersubjective‟ or “relational‟ psychoanalysis. Continue reading

Lost in Cognition

There is a tradition among certain psychoanalytic writers and schools, to decline any engagement with the world outside of analysis. In this tradition, psychoanalytic literature becomes a continual exegesis of the master(s), devoid of reference points to the world beyond. Thankfully, Eric Laurent and his colleagues are most definitely not of this tradition, as Laurent’s new book, Lost in Cognition, demonstrates amply. Continue reading

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Who is killing the women of Santa Teresa? Or, to give the city its proper name, Ciudad Juarez? The short answer is –  the men. In Bolaño’s novel, and in Juarez since the 1990s, about 30% of the hundreds of women killed were murdered by somebody whom they knew, most often partners. One cannot seek recourse to the metaphor of a ‘war’ between the sexes, when in this context, it is more or less one sex doing all of the killing. The authorities are at best, callously indifferent, and at worst, implicated in the killings There is a lengthy scene is which the very police who are investigating the killings pass the time by telling a series of viciously misogynist jokes.

I was reminded of Bolaño’s posthumous novel, which I read only this year, by this article, on a man creating portraits of the victims of femicidio in Juarez.  That piece, by way of free association and some cursory googling, led me in turn to this piece, putting Mexico’s cartel wars in the context of 21st global capitalism. This is precisely the context that Bolaño puts them, also, as he frequently reminds the reader that the deceased (or her kin) work at the local maquiladoras, or sweatshops, the managers of whom have little sympathy for those looking for their missing loved ones. I do not know enough of Mexican culture to know whether the grim imperative for women to work in sweatshops runs against the ideals of Marianismo, but it would not be surprising. Whilst the specific nature of the horrors occurring in Santa Teresa/Ciudad Juarez may be unique, the underlying economic conditions are not, and an inventory of sweatshop horrors could be compiled, including the worker suicides of China, and the collapse of a factory building in Bangladesh. These are the modern day equivalents of Blake’s ‘satanic mills’, or of Marx’s cotton manufacturers in Capital, but, unlike in the 19th Century, the global economy implicates everybody who benefits – the Europeans, New Worlders (like Australians, and the norteamericanos), and the local elites. Indeed, some of the alleged serial killers reflect this culpability, involving a German (Haas) and a wealthy Mexican family (the Uribe family, whose name may not be incidental).

The other factor hinted at throughout the book (and more than hinted at in any recent account of Juarez) is the presence of the narcos. They are central to the economy, to law and order, such as it is, and to the city itself. Some – libertarians, perhaps – might imagine that prohibition is the root of all evil here. It is not. Organised crime, when it is well-organised, has a habit of infiltrating everything, prohibited or not. A fine book by journalist Oscar Martinez, recently translated into English, illustrated this well. The cartels of Mexico control not only the narcotics industry, supplying drugs to North Americans and Europeans, but also the coyotes (people smugglers),  the protection industry, and human trafficking. In some respects, this latter may be the most profitable of all. A gram of coke or marijuana can be consumed but once; a sex slave, under threat of death and torture, can be used over and over again.

One of the threads of 2666 is violence. There is extreme but transient grotesquery, such as the vengeances enacted in the Santa Teresa prison, gruesome as they are. Yet there are also the enormous violences of the 20th Century, such as WWI, Stalin’s Terror and gulags, and the Holocaust. The logic of 2666 – and I believe that logic is what we are dealing with here – is to situate Juarez as the heir of this violence. After all, the Mexican cartel wars seem to have killed far more civilians than the Afghan war (since 2001). Perhaps both wars have been complementary – neo-conservatism in the military politics of Afghanistan and Iraq, neoliberalism in the economy of Mexico (and elsewhere). It is fitting that the frontier of this violence should be situated on the border between Mexico and the US. Bolaño’s violence, I should hasten to add, is entirely different to that of, say, Cormac McCarthy, in Blood Meridian. Bolaño’s killers employ the full repertoire of criminality to finish their victims, and 2666 could function as a catalogue of modern slaughter. It has an unmistakable cumulative effect, as one discerns styles, patterns, typologies.These slaughters include squalid domestic murders, to horrifically sadistic tortures, to utilitarian style of executions and drive-by shootings. Yet Bolaño almost never depicts the murder itself – there is no jouissance of torture and killing in Bolaño – but the heart-rending after-effects. The nameless victim to whom investigators are indifferent, tossed into an unmarked grave. The missing adolescent, searched-for desperately by loved ones around the rubbish dumps and maquiladoras. Crime fiction is genre fiction, to be sure, but with the best of its authors – Bolaño, or another favourite of mine, Sciasca – there is nothing b-grade about it. And why should there be, when there is no neat distinction between criminality and law and the rest of life?

Finally, there is something fundamentally psychoanalytic about Bolaño’s 2666. As with his other works, dreams are of some significance, and are described at length throughout the novel.  To a lesser extent, this is true of memory, in all its fallibility. The figure of the detective – his enjoyments, labyrinthine journeys and crises – constitute one of Bolaño’s most important pieces of symbolism, from his poetry, to The Savage Detectives, to 2666. A detective, in Bolaño’s world, is never some mere proceduralist, a bureaucrat with a badge and a gun, but somebody searching for the answer to the riddles of life in life’s contingencies, obscenities, unfinished clues, cryptic symbols and horrors. If this is not psychoanalytic, then I do not know what is.

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Roudinesco, in spite of everything

When it comes to Roudinesco’s latest work – a kind of condensed life and times of Lacan – I have some reservations, as with the other of her works that I have read. Nevertheless, three points in particular stood out to me.

First, as Roudinesco tells it, Lacan ‘rejected the idea of describing symptoms separately from the subjective lived experience of insanity’ (p. 25). This idea remains radical, and within the clinical realm, is almost (though not totally) unique to psychoanalysis. One of the implicit assumptions of prevailing diagnostic systems is that one’s symptoms are more or less incidental to one’s life, and one’s subjectivity. This is turn justifies the peddling of dubious medications and generic ‘techniques’ for self-management.

Second, the following passage is worth mentioning:

‘Far from being the result of a conscious decision, freedom thus pertains to an imperative logic, unconscious in kind, which alone can break the subject’s adhesion to the imago of its servitude. In other words, in order to be free, it is necessary to be capable of assessing the determinations imposed on subjectivity by the unconscious’.  (p. 38).

In this account, psychoanalysis can be understood as upholding an ethic of freedom, albeit, by degrees, notwithstanding the structural determinism that some reduce it to. It is a very specific kind of freedom – far removed from Sartre’s conception of it, for instance – and has a number of clinical, philosophical and political implications. It is one of the reasons why Lacanian psychoanalysis is incompatible with tyranny.

Finally, Roudinesco upbraids the followers of Lacan who lapsed into total silence and apoliticism. Indeed, there remains a popular misconception that Lacanian treatment involves silence in the clinic, and silence in the world. Obviously, any analytic intervention must be carefully chosen, and silence may be a reasonable tactical manoeuvre at times, but responsiveness – whether in the clinic, or in the world – involves taking a position. There is no prudence in silence when one’s country (in my case, Australia) practices cruel forms of biopolitics over subject populations (there are many, but asylum seekers and Aborigines are perhaps the most egregious examples), or when one’s discipline (in my case, psychology) is complicit in a range of unethical activity, from Guantanamo torture and workfare (as I have observed elsewhere), to imposing norms of compliance under the cover of pseudoscience.

Roudinesco reminds us that psychoanalysis offers a praxis with something to say about human psychology, politics and freedom, and in this, it is unique among the psy-disciplines, and its discourse is all the more urgent for its being increasingly suppressed and marginalised.