In undertaking the negative task of criticism, it has been with the view to identifying the shortcomings of CBT (and psychology), not merely to point them out, but to avoid them in constructing a better psychology. To create an alternative psychology is no easy task, but there are some useful starting points. Continue reading
What is biopolitics? This term, put simply, refers to bodies of knowledge and practices of power over subjected populations, and over life itself. Different populations become the object of differentiated techniques of discipline and surveillance. In Australia, such techniques are particularly grotesque with regard to the Aboriginal population and to refugees, but also to the unemployed, the disabled, and those within the health and mental health systems, among others. Many have justly pointed out the duplicity of the surveillance state in the case of NSA, for instance, but many more intensive forms of surveillance remain almost invisible. Moreover, some practitioners of CBT claim that their doctrine is on the side of ‘human rights’; yes, we might agree, but the ‘human rights’ in question are those of paternalistic neoliberal interventionism, of which the horrors of Iraq and Afghanistan were the most chilling examples in the past decade.Two recent examples of the role of CBT and psychology at large in biopolitics may help to illustrate my points above. Continue reading
The state of ethics in psychology, in Australia, at least, is lamentably primitive, and the politics of psychological practice virtually unspoken. If psychology is presumed a science, after all, how can it be political, any more than the laws of thermodynamics, or quadratic equations? Ethics is taught as a subject to psychology students, but it amounts to little more than a few strictures and prohibitions – do not fleece patients, do not maintain conflicts of interest, no sexual relationships, etc. By themselves, these prohibitions are perfectly reasonable, but they hardly constitute a level of ethical discourse beyond that which the average five-year old might grasp. The continuities between the biopolitics of the clinic and those of the factory, the school, and the prison are invisible. Foucault, Laing, Szasz and others go unread and misunderstood; ‘anti-psychiatry’ is even used as a term of abuse, as if criticism of this or that diagnostic system was tantamount to nihilism. If academic psychology avoids direct confrontation with complex ethical questions, the same can be said of regulators, at least in Australia. The regulators certainly enforce prohibitions and punish violators, and there is plenty of evidence that they are rapidly escalating regulatory requirements (and, of course, fees). None of this gets to the heart of the matter. The more important question, generally evaded by the discipline, is what is it that is happening, ethically and politically speaking, when one does psychology? And when one does CBT, in particular? Continue reading
As a final word on epistemology, it is worth noting that the prop which keeps CBT concepts upright, and which supports most of empirical psychology, is the area of psychometrics. Psychometrics is psychology’s proudest achievement, and perhaps the only body of knowledge unique to it. As with CBT, however, its epistemological base is as dubious as the uses to which it is put. Continue reading
Having explored the dubious history and origins of CBT, it is time to turn our attention to its theory, epistemology and methodology. Despite shrill appeals to science and reason, there has been much critique of CBT from an a priori perspective, three fine examples of which can be found here, here, and here. I will not repeat their points. Much of what I say here of CBT is applicable elsewhere in mainstream, Anglophone psychology. The failings of CBT in particular, and of psychology generally – and they are many and serious – are, in my view, both avoidable and instructive. I discuss them here in order to learn from them, with a view to constructing a better psychology (by which I do not mean merely a more refined CBT, or an empirical psychology with better-researched norms). Continue reading
Psychoanalysis was the first of the systematic talking therapies. The first couple of generations of psychoanalysts consisted principally, with some notable exceptions, of Central European Jews from Vienna, Budapest, Berlin and elsewhere. By the 1930s, this part of Europe had fallen to fascism, and this cataclysm was ominous (and eventually catastrophic) for Jews. A diaspora ensued, with Freud himself relocating to London, and many others moving there also, with other prominent destinations including Paris and the Americas. In these diverse environments, various sub-schools of psychoanalysis emerged, with considerable differences in their theory and practice. ‘Ego psychology’ was the sub-school which dominated psychoanalysis in the US to such an extent that it came to be identified (by some) as the only ‘true’ form of psychoanalysis. It was out of this context – post-war US, mass demand for psychological interventions, and the growing influenced of managed care – that Beck’s CBT first emerged. Continue reading
What follows in the next few posts is a longish essay on CBT as the dominant force within applied psychology, and its place as an ideology which supports various practices of domination.The length of this essay is unwieldy for a blog format, so I have broken the piece into sub-sections, which I will publish one at a time, before eventually assembling the piece into pdf form. As ever, discussion is welcome.
The structure of the piece is as follows:
1. Cleaning the Augean Stables
2. The Founding of CBT,and Beck’s Foundational Errors
3. Psychology, Epistemology, and CBT
3a. A Note on Psychometrics
4. The Ethics and Politics of Intervention
4a. Two Brief Case Studies in Biopolitics
5. Project for an Unscientific Psychology
It seems to me an urgent task to critique the dominant ideology which has psychology in its grasp, namely Cognitive-Behaviour Therapy (CBT). As a general rule of thumb, whenever one sees an acronym in psychotherapy, one can assume the presence of glib, corporate-friendly pseudo-scientific pap, and that is entirely the case here. However, unlike NLP, for instance, (I do not mention more popular doctrines, but I mean them), CBT is taken seriously by many clinicians and patients alike. Despite numerous signs of its weakening, CBT remains strong where it is most influential, namely, in academia, third-party payers, and among regulators. Continue reading
Archives of a Divided Subject 