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

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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.

Theses on Mental Health Reform in Australia

 

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.

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.

Notes on ethics and psychoanalysis

The degree to which psychology trumpets its scientificity is precisely the correlate of the extent to which it evades the question of its ethics. It is entirely unnecessary for a body of knowledge to be ‘scientific’ in order to be valuable. The scientist-practitioner of psychology needs the ‘science’ to serve as a fig leaf for the praxis.

Notes on mental health and neoliberalism

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.

‘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.

Of ‘Psychopathic’ Children & Interventionist Clinicians

Researchers in New South Wales are on the hunt for ‘psychopathic’ pre-schoolers. Apparently, they have created a ‘diagnostic tool’ in which young children are shown images, either ‘distressing’ or ‘neutral’, in order to classify the child as either ‘healthy’ or ‘callous’ on the basis of their responses. The 10% of children who were found to be ‘unemotional’ can be targeted for early intervention.

Drone Psychology: A Profession Digging Its own Grave

The following reflections were inspired by a Facebook thread, responding to this article. The article gushes that, according to some corporate consultants, mental health services in Australia could be delivered for $9.70 annually, saving on the inefficiency of training psychologists for face-to-face clinical work. People suffering with problems could anonymously read fact sheets, and undertake generic courses in CBT.

Misconceptions about psychoanalysis. Part 1

It is time to clear up a few misconceptions about psychoanalysis. Culture, popular or otherwise, has changed. Once, in the film and literature of the mid-20^th Century, psychotherapeutic treatment was depicted in largely psychoanalytic terms. A protagonist would speak of themselves in an intimate way, with a figure they trusted. The popular imagination has shifted since then, and consulting a psychologist is now marketed as a didactic experience, an implementation of technique, with little or no subjective element to the process.

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.