CBT is Aristotle with Facebook brain – A note on paranoia as an epistemic ideal


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 Ethics of Psychoanalysis

 

The following is taken from one session in a series of introductory seminars as part of the Lacan Circle of Melbourne’s activities.

 

There is an interesting remark by Miller, in a paper from 2012 on the aims of psychoanalysis. ‘The psychoanalyst’s routine is therapeutic. His business is with the symptom that has to be cured.’ Psychoanalysts can put on airs, and ascribe lofty goals to their practice, but people come to consult with an analyst because something is causing them suffering. As Miller says, ‘If somebody goes to see a psychoanalyst for the sake of knowledge and not to get rid of a symptom it is not very certain that his demand can be received’.  So, whatever one may learn of oneself in the course of analysis, analytic praxis is not reducible to a quest for knowledge. Continue reading

‘Changing Minds’: An unintentional satire of the mental health industry

In recent years, there has been an annual commemoration of ‘Mental Health Week’, a period in which Australians are subjected to ‘awareness campaigns’ by various media organisations. We tend to receive a familiar style of ‘messaging’, namely, tokenism (‘Are You Ok Day?’), advocacy for more bureaucracy, and censorship of views that do not conform to simplistic biomedical paradigms. It is in this context that the national broadcaster screened ‘Changing Minds’, a series which ‘journeys with mentally ill patients on their road to recovery, from breaking point to breakthrough.’ The setting for the doco is a hospital in Sydney, and patients and staff apparently consented to the footage being made public. Continue reading

Evidence Yields: The failure of web-based ‘treatment’ for mental health

Computerised treatment of mental health is one of the latest fads in psychology. It isn’t hard to see why it is promoted by practitioners and policy-makers. That it exists at all demonstrates a triumph of technique over transference in psychotherapy of cost-effectiveness over clinical care; of the primacy of giving a narcissistic boost over a discursive exchange; and of the privatisation and individualisation of suffering rather than its socialisation. Computerised treatment is promoted uncritically by leading mental health groups in Australia, such as the Black Dog Institute, and Beyond Blue. Continue reading

Understanding Psychosis

The British Psychological Society has released a major report on psychosis, which pushes the debate on this topic further than anywhere else in mainstream psychology in the Anglophone world. The report calls for, among other things, listening to psychotics themselves; seeing psychotic experiences as ‘understandable’ responses to distress, on a continuum with ‘normal’ phenomena; a rethink of bioreductionism and the medical model more generally; advocacy of ‘formulation’ rather than diagnosis, and advocacy of patient rights more generally; and finally, the provision of psychotherapeutic treatments alongside pharmaceutical approaches. There are numerous online responses to this report already, some supportive, some hostile. I would like to offer a few words from a critical, psychoanalytic perspective. 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