Apparently, in about 3-4 months, the psychoanalytic group of which I am a member will feature a debate or discussion on the topic of Jacques-Alain Miller and his followers’ contributions to Lacanian discourse: the ‘One-all-alone’, the real unconscious, the ‘autism’ of jouissance, generalised foreclosure, the limits of meaning, the non-existence of the Other, the non-existence of symbolic paternity in particular, etc. Without dismissing JAM’s contributions in toto, I’m not likely to be on the pro-JAM side of the aisle. The practical effects of JAM’s positions are not entirely benign. They include racism, homophobia and transphobia, a blindness to colonialism, paranoia as an institutional imperative, and the abolition of the Freudian unconscious, as well as sublimation. I’ll turn to some of these another time.
In Cognitive Behaviour Therapy (CBT) discourse is reduced to data, and this data is further submitted to the Aristotlesque requirement of non-contradiction, albeit, without any Aristotelian depth of intellect.
Consequently, cognitivism and CBT affirm the existence of an unconscious, but this unconscious is entirely continuous with the conscious. It’s more of the same, more or less. Contrast this with the Freudo-Lacanian unconscious, which is disruptive, punctual, discontinuous, and structurally incapable of completion.
It’s no coincidence that CBT first arose when cognitivism was displacing the increasingly-discredited behaviourism from the laboratory (though not yet the clinic, in the Anglosphere at least). This was the age of Festinger’s cognitive dissonance, in which, like good Aristotelians, the subject abhors contradiction. Since contemporary CBT reaffirms a data-based, continuous unconscious, Festinger’s ideas fester still. Show the subject that his suffering arises from the faulty conviction that he always bungles his relationships/work/studies – show him the contrary evidence, the errors in his logic – and he will be obliged, by way of contradiction, to renounce his conviction, and thereby eliminate his suffering.
It was not until the era of neoliberalism that these Aristotelian outtakes reigned supreme over the clinic, for reasons that I have attempted to explicate elsewhere, but which are largely economic and biopolitical in character.
At the heart of the adventures of Freud and Lacan is the proposition that, in at least a thousand different ways, human subjects, divided as they are, exist in permanent, structural contradiction. There are so many examples of this in the centuries that preceded them that I would say that Freud and Lacan merely articulated and formalised, rather than discovered this fact. My experience is that it is common knowledge amongst the uneducated, and that perhaps the educated have some catching-up to do.
The clinical work of psychoanalysis cannot, on this basis, be oriented toward either completeness or consistency, if one means by this the overcoming of contradiction. Repression, disavowal, denial, foreclosure, the law of the exception, the law of the not-all are but some of the psychoanalytically-articulated responses to contradiction. After Gödel,he who trades consistency for completeness deserves neither.
But let us suppose that the psychoanalytic premises are wrong, and that the cognitivists are really as evidence-based as they say. In principle, the latter would be able to work with a subject to produce an image of perfect consistency, with the offending data eliminated. The outcome would resemble nothing so much as the most brittle paranoid delusion. The subject attains an image of coherence with all that is unassimilated sent packing, much line a refugee ship at Australia’s borders. This is the best case scenario for treatment by CBT principles, and we need only look at the outcome of excessive Facebook consumption to see what befalls those who cannot live in contradiction.
The Federal Government of Australia commissioned a detailed review of the country’s mental health system. (It subsequently tried to suppress the review for 12 months, and has since abandoned some of its recommendations). Now, as Australia recovers from a Federal election cempaign, discourse of mental health policy has been dominated by a small, recurring number of self-proclaimed advocates, as well as their respective research institutes. The proposal that the present Government is implementing is to expand the bureaucratic structure of GP’s Primary Health Networks (PHNs) to allow for a division between ‘complex’ and ‘low-intensity’ treatments. The former will have treatments administered and rationed by the PHNs; the latter will be diverted to self-management apps. The Headspace model, which, other than isolated, localised successes, has been a miserable and costly failure, will be retained, albeit with some minor trimming down of administrative functions. The advocates – and the most prominent are Patrick McGorry, Ian Hickie, and John Mendoza – want the app approach to be expanded at the direct expense of the existing Medicare system, which they say needs ‘reform’ (i.e. severe cuts or abolition). Meanwhile, the advocates are silent on the perilous and worsening state of public mental health systems, and the $11 billion per year that the Government spends on subsidised ‘private’ health insurance. The aim of the theses here is to provide an alternative to the dominant discourses and speakers which purport to speak for the mental health system and those who use it. Continue reading →
Back in 2014, I wrote a critique of the work of Brian Earp and others, who were advocating for the use of oxytocin and other chemicals to be incorporated into a program for the ‘neuroenhancement’ of love. Earp et alia have written a reply to their critics, of whom there are several. Continue reading →
I recently read a couple of Foucault’s later lectures, namely Security, Territory, Population (1977-1978) and The Birth of Biopolitics (1978-1979). In this latter set of lectures, Foucault made a rare foray into contemporary economics, analysing various currents of neoliberalism (especially German and US varieties) and their relation to new forms of governmentality. I thought it beneficial, if only for me, to jot down a few notes on Foucault’s reconstruction of neoliberal thought, because I think it particularly pertinent in understanding contemporary knowledge and practice in mental health. I have a paper forthcoming in an academic journal on this topic, and perhaps after this post, I can move onto other things in 2016. Continue reading →
As we might expect, most results in psychology are not reproducible. As the authors who obtained these results say, ‘reproducibility is a defining feature of science’. From this, we could conclude, as have many in the field, that the answer is more experiments, tweaked statistics, metholodogical tinkering and the like. Or, we could make a point that is not so much epistemically radical as it is blatantly obvious, and that is that psychology is not a science at all. It does not resemble science except in the most superficial of respects. It isn’t just the failure of replication documented here, but the complete impossibility of findings in psychology ever being abstracted into formulae for precise prediction. Continue reading →
For those who are interested, I have a paper in Arena magazine wherein, via Adorno, I explore the links between so-called positive psychology and fascism, militarism and neoliberal ideology. Continue reading →
Further to a Twitter discussion from today – there is a gulf between patient and clinician, between administrator and administered that cannot be wished away with the language of facile humanism. I have tried to touch on this point before, but as always, others say it better. Continue reading →
This article raises some typical points in service of a leftist defense of psychiatry. (NB: the post I am citing summarises rather than advocates for these positions). This defense hinges on the claim that if mental illness is held to be ‘socially constructed’, this conception may lead to a denial of the existence of certain forms of suffering. This denial is something that can then be exploited by contemporary governments increasingly eager to implement spending cuts and austerity measures. One person cited in the article was Tad Tietze, for whom ‘the logic of Szasz would empty hospitals and put the same people in prison’. Continue reading →
Archives of a Divided Subject 