‘Economics are the method but the object is to change the heart & Soul’.
Margaret Thatcher, Sunday Times May 1981
Psychotherapy and Counselling is not, and has never been politically and ideologically neutral. All psychotherapy approaches have developed in specific times, places and social contexts and have, as a result, often taken on particular flavors of the dominant culture within which they have emerged. When one begins to think this way about therapy, as essentially a social construction, one can start to move away from claims to truth and value neutrality that are engendered by the alignment of counselling and psychotherapy with the biomedical and scientific discourses that are powerfully promoted by neoliberal policy (LaMarre et.al. 2018). This view of therapy as ‘discourse’ allows an exploration of the impact that these concepts, and the related practices, have on the people to whom they are applied and allows us to ask questions such as what is it that these therapeutic discourses highlight and center in our attention as therapists? What do they subsequently exclude or obscure? How do they incite the client to consider and conceptualize the concern they are bringing to therapy and its resolution? Moreover, what is the sense of identity that these discourses engender in those that consult us? How does it invite people to see themselves and who is it that ultimately benefits from these particular conceptualizations of self?
These types of questions which invite us to explore the way that particular therapeutic discourses can act to constitute selves are explored by Betrando (2007), where he takes on Foucault’s notion of ‘Technology of the Self’ and applies this to the therapeutic encounter. Technologies of the Self as outlined by Foucault, refer to the way that subjectivities are constituted and in particular the techniques that allow Individuals to affect their own bodies and psychology to move towards states and qualities of life that are culturally valued. This according to Foucault is a particular technology of power and a form of governmentality. In particular, Technologies of the Self are understood to be closely linked to notions of professional expertise, expertise to ideas of scientific objectivity and scientific objectivity and related truth claims to existing power structures. It is through this apparatus that psychotherapy itself can be understood to potentially function as a mechanism for the enactment of governmentality in particular when expertise is centered with the therapist via a process of:
"inculcating desires for self-development that expertise itself can guide and through claims to be able to allay the anxieties generated when the actuality of life fails to live up to its image p.88 (Rose, 1999)
As such, the epistemology, theoretical position and desired outcomes of any therapeutic approach will inform the procedures of therapy and it is here that the technology of self is enacted. More specifically, Betrando (2007) outlines the following:
‘The technologies of the self is the habitual form of the therapeutic relationship, which is molded first of all by the rules of the setting’
Taking this further, the rules of the setting can also be subsequently understood to inform the way that the knowledge’s of therapy participants are privileged or marginalized. How a client’s concerns are conceptualized and acted upon, whether they are seen in isolation or with other members of their community. How regularly a client attends, when they are defined as well enough to finish the ‘treatment’ process and how illness and health are even classified. These rules are inextricably linked to the discourses that are brought into the therapy room, by both the client and the therapist (Hare-Mustin, 1994). These discourses according to Winslade (2015) provide the frames for meaning from within which a dialogue can occur and also invite people to take up particular positions in relation to the utterances that make up these discourses. This is based in the idea that any utterance in a dialogue only has meaning in the context of the utterances before it. As such, each time we speak, the discourse we use provides a foundation that invites the other into a position, which will inform their response. It is in this way then that these discourses can be understood to ‘operate[s] in the production of relationships and of personal subjective responses’ (Winslade, 2015 p355). As such the discourses that one brings into the therapeutic encounter and the power they are assigned by the dominant culture can be seen to have real effects on the nature of not only the rules of the therapeutic relationship but also the possible responses and subjectivities that are available to inhabit within the particular dialogical space.
With these processes in mind, of all the discourses that inform Counselling and psychotherapy practice, one of the most pervasive is that of the radically decontextualized self and the subsequent conceptualisation of people’s pain and concerns as a biomedical pathology that exists within this self. These pathologising discourses are strongly supported across multiple institutions on a global scale with the Diagnostic and statistical manual of Mental Disorder, Fifth Edition(DSM-5) acting as sacred book and psychiatric professionals as high priests for these approaches to the conceptualisation and resolution of humanities pain. While the author does not wish to be critical towards those that engage in these discourse’s and related practices with the intent to heal and lessen suffering in the world, It is extremely important to pay attention to some of the less overt, but significant effects that these discourses can have, as outlined by White (1998):
‘discourses of pathology make it possible for us to ignore the extent to which the problems for which people seek help are so often mired in the structures of inequality of our culture, including those pertaining to gender, race ethnicity, class, economics, age and so on. If we can see the difficulties for which people seek help as the outcome of some aberration rather than a product of our ways of thought and ways of life, we can avoid facing our own complicity in the maintenance of these ways of life and thought…and avoid facing the responsibility that we have to dismantle the various structures of inequality that are associated with these’ p115-116
This particular position of understanding psychological distress as a problem that exists within the individual is supportive of central principal’s in the neoliberal ethic, which minimize the relevance of an individual’s relational context and understands the remediation of these concerns being wholly the responsibility of the individual, assuming they have control over that which requires change. Furthermore as outlined by Esposito & Perez, (2014) the idea that these constructs are framed as medical truth invites them to be perceived as value free and obscures the idea that what is dictated as normal or pathological within any society is based on those dominant values at work in the particular social, economic and political context. As such, In the Neoliberal context these values are informed by what is known as ‘Market Rationality’ where that which is valued is based on what is acceptable or desirable to the Market and conversely what is seen as aberrant or problematic is that which does not fit with the assumptions of the neoliberal status quo (Giroux, 2008).
In LaMarre. et. al. (2018) the authors outline three primary neoliberal discourses that they perceived as commonly at work in therapeutic conversations that include the above medical discourses within them. The first of these is what they refer to as the normal self. This refers to understandings of a self that is defined by a comparison to some normative criteria. This often takes the form of the perception of an internalised deficit, which needs to be brought back into alignment with these norms; and to do so will often require involvement with expert systems to both identify the deviance and access the knowledge’s necessary for its rectification. This idea that these deviations from the norm need to be rectified is the second of the three discourses, what LaMarre et. al. (2018) refer to as the ’improving self’. This notion, that one must continually improve oneself, so as to be a functioning member of society, often draws upon expert driven and evidence based ‘technologies of the self’ to do so. In fact Sugarman (2015), argues that many of the therapies that were central to the development of Counselling and psychotherapy in the 1970’s and 80’s were, regardless of the ideologies that founded them, closely affiliated with neoliberal ideals. This Included therapeutic discourses such as gestalt, client centred therapy, transactional analysis, rational emotive behaviour therapy and CBT all of which shared a:
‘moral injunction[s] to work on the self to attain greater autonomy, to accept responsibility for one’s choices and circumstances, to strive to realize one’s potential and increase the quality of one’s life.’ p108
The third of the three neoliberal discourses that can show up in therapeutic conversations articulated by LaMarre. et. al. (2018) is that of the ‘productive self.’ This discourse implies that one must be continually working not only on oneself but also on the process of capital accumulation. With those that are failing to do so being understood as somehow a burden on the system. Additionally, as outlined earlier in this paper, the reasons offered for this failure to ‘be productive’ are also centred within the individual, obscuring the role of structural inequality and disadvantage in this process.
With these discourses in mind, it can be understood that therapeutic technologies, which de-contextualize people’s pain and experience. Position this as an internalized pathology within an ‘separate’ and atomized self; understand the remediation of this pain and experience as being exclusively internal and requiring the application of expert knowledge; essentially act to perpetuate existing neoliberal discourse and subsequently produce subjectivities that align with the existing neoliberal hegemony (Pavon-Cuellar & Orozco Guzman, 2017). It is here that we need to ask ourselves; is it enough to help people cope with oppressive structures while at the same time turning our gaze away from how we are complicit in and benefit from the perpetuation of these structures? If not then the question remains are their therapeutic approaches, that can act to support the liberation and emancipation of those that consult us from the oppressive influences of dominant neoliberal ideologies and support resistance to systems which facilitate the production of the pain and isolation that psychotherapy and Counselling is tasked to address. Returning to Lamarre, et. al. (2018):
‘If psychotherapy has been one of the central means or technologies of neoliberal governmentality, can we speak of anti-oppressive, anti-neoliberal therapy? Should therapy be eradicated as an oppressive institution or, at least, radically transformed? How might we begin to disentangle the neoliberal political structures within which therapy takes place and that it allegedly reinforces’ p6.
So we are left with the question; is Counselling and psychotherapy an appropriate site for resistance to neoliberal discourse? One answer to this is that it may be, however only so much that it is a site for neoliberal oppression, and is this a decision for the therapist, or rather is it a decision for the persons with which we work? What this means is that an anti-oppressive an anti-neoliberal therapy would begin by supporting awareness of the discourses and taken for granted assumptions that are brought into the therapy room by both therapist and client. Thus creating a dialogical space to deconstruct and explore the way that these discourses might be acting to constrict and pathologise one’s experience and obscure the effects of oppressive systems on the subjectivity of both parties within the therapeutic encounter. Yet it would also seek to explore the ways that these discourses might be acting to benefit the persons with whom we are engaged, and the potential for social action, which is supported by Bondi (2005) who states:
‘Neoliberal subjectivity does not inevitably generate subjects oriented solely to the narcissistic gratification of individual desires via market opportunities indeed aspects of neoliberal subjectivity hold attractions for political activists because activism depends, at least to some extent on, on the belief in the existence of some form of subjectivity that that enables people to make choices about their lives’. p499
In short, these approaches to therapy are done not only in service of social justice and broader systemic change, but also to facilitate a process where by those who consult us can position themselves in relation to these discourses in preferred ways, opening up space for greater possibility in their lives. This allows a therapeutic practice that supports one’s personal agency and individual hopes for a therapeutic encounter, yet at the same time does not loose site of the social, political and economic context in which it is taking place. This can then allow for the development of subjectivities that provide for the enactment of alternative and preferred ways of life that can exist within the wider constraints that the neoliberal system provides yet still begin to disrupt the existing political and economic order.
There already exist a number of approaches to psychotherapy and Counselling that are well placed to enact an anti-oppressive therapeutic practice of this kind. These include those that are steeped in post structural thinking and ethics of social justice including Narrative Therapy, Just Therapy and other approaches that are cognizant of the influence of both system and context on the production of subjectivity. This does not mean that other therapeutic discourses do not have a place in therapeutic practice. However it is proposed that for Counselling and psychotherapy to act as a site of resistance to the inequality, isolation and psychic pain produced by neoliberal systems, therapists need to be aware of the ways in which their choice of therapeutic model is not politically neutral and will have consequences that have wider implications for social change or the perpetuation of the status quo. Further-more models of therapy that are focused only the intra-psychic world of the client need to be practiced at all times with an awareness of the social-political context in which people’s lives and therapeutic practice takes place. This then necessitates in the therapist an awareness of, and ability to, deconstruct and evaluate the way that these dominant socio-political discourses are impacting both themselves and those with whom they work.
Note: This is an extract from an upcoming paper.
'Resisting The Influence of Neo-liberal Ideology In Counselling Training: Building learning communities through a Critical and Relational pedagogy.'
If you are interested in its ideas or the references that align with the in-text citations, please contact me.
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