Therapy Culture

Katie Wright (2006) 'Therapy Culture', from P. Beilharz & R. Manne [eds] Reflected Light: La Trobe Essays. Black Inc.: Melbourne Therapy Culture Katie Wright A pproaching the halfway mark of the  AFL season, there was a flurry of speculation surrounding one of the league’s high-profile players. Nathan Thompson, then vice-captain of the Hawthorn Football Club, was struggling. He’d been in poor form for several weeks, was a late withdrawal from the round eight match against Fremantle, and did not return to the premier league to play the following week. As speculation was building about his form – and his emotional state – Thompson revealed that he was suffering from clinical depression. In a prepared statement, he said: Five weeks ago I was officially diagnosed with clinical depression. It is an illness I have been dealing with for many years … I have been seeing the club psychologist during that time and we have worked through many issues … I hope that by speaking today, that it helps people better understand depression and the importance of being open and honest with yourself, and those around you. Thompson’s public disclosure sparked commentary in dozens of newspaper articles and radio reports, as well as reverent discussion on such bastions of masculine culture as The Footy Show, On the Couch and Talking Footy. Fox Sports’ Back Page saw the tough blokes of sports journalism endorsing the value of ‘talking through feelings’ as they discussed what constituted depression. One of the presenters even reflected on his own use of alcohol and gambling to stave off depressive episodes. Another high-profile AFL player, Western Bulldogs’ Scott Katie Wright West, also spoke about his own experience of depression. On the sports radio station SEN – described by the Age journalist Suzanne Carbone as ‘aimed at men aged  to  and their fi xation with bum-slapping locker-room banter, corked thighs, strained groins, footballers’ hairstyles and Gary Ablett’s glory days’ – West supported Thompson’s disclosure by saying that his life had improved after seeking help and ‘going public’. Within days it was reported that each year more than  AFL players utilise the counselling services of the Players Association, a figure suggesting close to half the league are getting some form of ‘counselling’. On Channel Nine’s Footy Show the same week, Brisbane Lions star Jason Akermanis spoke openly about his own psychological battles and revealed that he has worked extensively with the club psychologist, not just to improve his mental resolve, but essentially to get rid of ‘baggage’ from his teenage years. Later in the year his autobiography was released, with the wonderfully therapeutic title Aka: The Battle Within. Public revelations of psychological distress and personal weakness are a hallmark of therapeutic culture. When the language of therapy is evident even in the discourse of ‘Aussie Rules Footy’, there can be no doubt about the saturation of the psychological. Within the football fraternity, discussion of depression, counselling and emotional life generally is significant on a number of fronts. With regard to diagnoses of clinical depression, there is generally a concerted effort to situate the condition within a biomedical model of illness. It is widely acknowledged that depressive disorders constitute a major world health problem, but despite attempts to align depression with any other illness, Thompson’s revelation was regarded by many commentators as courageous – a response that arguably would not have been generated had he revealed he was suffering from a physical ailment. Other problems of adjustment associated with poor form, injury or retirement, for example, are usually contextualised within a model closer to ‘situational’ or ‘reactive depression’. But more interesting from a cultural point of view is the way in which such revelations provide a platform for discussions about emotional life more broadly. The coming together of sport – particularly the boorish masculinity of Australian Rules Football – and the emotional realm is just the kind of cultural shift that   REFLECTED LIGHT Frank Furedi, professor of sociology at the University of Kent, is so concerned about. Footballers talking about their feelings, telephone help-lines for stressed children, counselling for the police force and military – like public revelations of personal weakness – are all evidence of a world gone mad with therapy. * Therapy Culture: Cultivating Vulnerability in an Uncertain Age examines with a familiar pessimism the terrain first excavated by the American sociologist Philip Rieff. In his  treatise The Triumph of the Therapeutic, Rieff was pessimistic about the emergence of ‘psychological man’ and the cultural consequences of a burgeoning therapeutic ethos. His central concern was that the modern West was becoming increasingly remissive as a result of the weakening of cultural authority and an increasingly therapeutic orientation. For Rieff, the therapeutic imperative signalled cultural demise as it brought about the birth of a society in which the ‘self improved is the ultimate concern of modern culture’. Following Rieff, Christopher Lasch in the late s identified a Culture of Narcissism which he saw as a shift from ideals of social and political change to a focus on ‘psychic self-improvement’. This ‘turn inwards’, away from politics and engagement with public issues, according to Lasch, involved a narcissistic obsession with personal fulfilment and an unhealthy reliance on experts. Furedi continues in this tradition as Therapy Culture comprehensively maps the contemporary therapeutic landscape: the confessional mode of celebrity addictions, the expansion of counselling and the institutionalisation of therapeutic experts, the rise of identity politics and the normalisation of the idea that everyone needs therapy, even America’s most popular mobster, Tony Soprano. The book opens with the case of linguistic shifts, in which terms like stress, syndrome, addiction, anxiety and self-esteem gained currency throughout the s and are now so central to the contemporary worldview that even children complain of being stressed-out. ‘The vocabulary of therapeutics no longer refers to unusual problems or exotic states of mind’, Furedi notes, but have been normalised to become part of everyday life. He illustrates with striking intensity the example of ‘self-esteem’, noting Katie Wright that not a single mention was made of the term in  British newspapers in , but two decades later it was mentioned more than , times. The spectacular rise of the terms trauma, stress, syndrome and counselling are also noted, as Furedi argues that the language of therapy and emotional deficit ‘has become part of our cultural imagination’. Therapy Culture uncovers a pervasive therapeutic ethos in all areas of society, the legacy of the strengthening of the therapeutic over the last couple of decades. Therapeutic interventions are now commonplace in all social organisations and institutions – the school, the workplace, government – even those institutions once renowned for a culture of stoicism – the military, police and emergency services. Institutional expansion (like linguistic markers) is significant because it is evidence of how pervasive the therapeutic has become. Consequently, what used to be the routine challenges of life are now understood, he argues, as a threat to emotional wellbeing. Every stage of the life cycle has become a potential crisis and, by extension, an opportunity for therapeutic intervention. Birth, death, marriage, starting school, being bullied, the disappointments of love, divorce, losing a job, going to war: all come to be understood and experienced through ‘the idiom of therapy’. * In a familiar lament, Therapy Culture re-articulates the bleak consequences for self and society of a pervasive therapeutic ethos. And just as Lasch reworked Rieff ’s ‘psychological man’ and ‘the therapeutic’ as ‘the culture of narcissism’ and the ‘narcissistic personality of our time’, Furedi appeals to a new generation with the idea of ‘therapy culture’ – in which the emotions become the prism through which the world is experienced, and the ‘diminished self’ the inhabitant of this cultural landscape. Rieff ’s ‘dispirited modern’ emerges in Furedi’s language as emotional, weak and, it seems, emasculated. Therapeutic culture is thus the harbinger of ‘a radical redefinition of personhood’ in which emotional damage and psychological vulnerability have become part of ‘the new cultural script’. Dependency has triumphed over autonomy and all but eclipsed are the ideals of stoicism, fortitude and selfreliance. The contemporary self, according to Furedi, is ‘incited to feel   REFLECTED LIGHT ill and powerless’ as many of the normal experiences of life have been redefined as damaging to people’s emotions. Love is risky, sex is dangerous and childhood has to be carefully managed so people are not ‘scarred for life’. The sense of vulnerability is exacerbated by the broader trend of amplification of risk and danger in the contemporary world and reinforced by a belief in the need for psychological expertise to assist with what used to be the ‘routine challenges of life’. The culture of emotionalism that has gripped Anglo-American societies, according to this analysis, subjugates reason to affect – so how one feels is more important than what one thinks. Emotion itself has been depoliticised, uncoupled from social action and recast as a problem of subjectivity. But it is not simply a matter of an unfettered privileging of emotions. Rather, it is about a policing of emotions, with some affective states acceptable and others not. Expressing your feelings and emotionally oriented communication is desired, but anger has to be ‘managed’ (through therapeutic intervention). Therapeutic culture as a form of social control and a mechanism of depoliticisation is advanced through the argument that therapy culture ‘imposes a new conformity through the management of people’s emotions’. Like many others, Furedi is unsettled by a cultural shift in which emotional and psychological life have come to the fore. Therapy Culture provides abundant evidence that a therapeutic ethos saturates contemporary culture, has been institutionalised and frames contemporary experience. As such, the depiction of therapy as an insidious and menacing development is compelling. There are echoes of Lasch and others here, in the argument that this imperative recasts social problems as personal ones. The concern is that social injustice is psychologised and therefore the material and social are obscured by a focus on the psychological and affective dimensions. But while it is true that a psychological worldview has the potential to obscure the social and political, the cultural phenomenon in question is far more complex and multi-dimensional than this analysis suggests. It involves much more than a simple shift from the social to the psychological. In Furedi’s reading, all aspects of therapeutic culture are treated with equal disdain. From representation in popular culture of fictional mobsters in therapy to mandatory counselling for sex offenders, there is little Katie Wright differentiation accorded to a range of social and cultural phenomena – it is all part of the same monolithic, disturbing trend of enchantment with all things psychological and emotional. From a feminist standpoint, there are disconcerting connections made between the rise of emotionalism and shifts in the gender order. Furedi is clearly worried about the implications of these changes in the construction of manhood, as help-seeking behaviour is privileged and ‘aspirations of self-control’ pathologised. In a discussion on ‘emotions as objects of management’ and the attitudes of health professionals, he says: Men who act like women are clearly preferred to women who act like men. According to the emotionally correct hierarchy of virtuous behaviour, feminine women come out on top. Feminine men beat masculine women for second place. And, of course, masculine, ‘macho’ men come last. An inverted gender order is perhaps the ultimate expression of ‘the triumph of the therapeutic’, but Furedi should worry less. Despite the alignment of ‘femininity’ and ‘emotionalism’ in the rise of therapeutic culture, it would be impossible to sustain an argument that ‘feminine women’ or ‘men who act like women’ have actually usurped ‘traditional men’ in many areas of social life. It is difficult to imagine this even in the middle-class milieu of the educational institution, much less the corporation, the police force, the prison, or even – discussion about depression aside – the footy club. There is something disturbing too about some of Furedi’s other examples. A case in point is the analysis of contemporary representations of crime. He identifies a shift in the cultural imagination from ‘violent public crime’ to ‘high profile crimes of the emotion’ – domestic violence, child abuse and date rape. His emphasis is on the way emotional deficit and perversion are now privileged over social explanations of crime, such as poverty. He says, ‘None of these recently constructed crimes is inspired by the motive of economic gain’. But the language here is telling. To characterise domestic violence, child abuse and rape as recently constructed crimes may be a rather clumsy   REFLECTED LIGHT (or provocative) way of articulating changes in social acceptability, but to cite them as examples of yet another way in which the therapeutic is fi xated on emotion and perversion is more than a little worrying. Perhaps domestic violence, child abuse and rape are part of the ‘routine challenges of life’ that were once stoically tolerated. What Furedi either doesn’t recognise, or knowingly laments, is the opening up of new spaces of expression (through a therapeutic idiom) for those who have been marginalised and oppressed – women and children in this example. But men, too, are not immune from his attack. In the case of domestic violence against men, he writes with disdain, ‘it is even argued that relatively routine forms of physical trauma can cause psychological damage’. He stops just short of asking where all the real men have gone. For every example Therapy Culture cites, there is a more complex story to tell. Ever-expanding definitions of psychological disorder, for example, have developed alongside more humane treatment and ongoing efforts to destigmatise mental illness. Cultural life, like psychological life, is rarely simple and rarely one-dimensional. In an unfettered disdain for all things psychological, emotional and therapeutic, there is no recognition of complexity and contradiction. To claim that therapeutic culture is pervasive is one thing. But to argue that the ramifications inevitably entail the diminishment of self and society is an altogether different matter. Not only does Furedi fail to acknowledge counter-trends, but he fails to offer a structural and historical analysis of the examples cited. Instead, his position repeatedly rests on a nostalgic idealisation of ‘previous times’. Furedi’s ‘previous times’ seems to refer to a lost golden age, before the therapeutic imperative ruined everything. Few would contest the assertion that the excesses of ‘emotionalism’, to use his language, produce effects that are undesirable. The banal fi xations of emotionally driven reality television, the hijacking of the psychological by corporations and consumer culture and the excessive framing of childhood experience through a lens of potential damage are all troubling. But all aspects of therapeutic culture are not equal, and the modern trend of the management of childhood, to take just one example, is infinitely more complex than he admits. Recognition that child abuse and Katie Wright neglect have dire consequences is surely a welcome development, not simply a creation of therapeutic culture. In Furedi’s account, there is no space for the recognition that self-reliance, stoicism and the separation of the public and private spheres benefited some individuals and groups at the expense of others. For Furedi’s work (as with Rieff ’s on cultural authority) we need to also ask who suffered under those structural arrangements that he laments are in decline. To dig a little deeper, it is worth noting that debates about the therapeutic are often also debates about repression. This is most explicit in the Freudian-inflected analyses of Rieff and Lasch, but it is also implicit in Furedi’s hankering for stoicism. But valuing a cultural climate of repression fails to recognise that this comes at a cost. Therapeutic culture certainly privileges the expression of emotion, the exposure of intimate details of one’s life and subjective experiences of suffering. The question is whether in lifting the lid on abuse and suffering, people are incited to become ‘victims’. Identity politics and the apparent excesses of litigation for psychological damage are two examples. But like the ridiculous spectacle of Jerry Springer, in which everyone is a ‘victim’ in search of ‘recognition’, apparently trivial claims of compensation for psychological damage are an easy target. Equally important in such discussions, though, is the recognition of distress and suffering. An alternative reading might well value cultural shifts that give rise to greater openness, afford legitimacy to claims of violation and recognise that social injustice also has psychological consequences. The task is not to conflate real suffering and greater respect for human dignity with the ever-present extremes. Contra Furedi’s position, an argument could be made that the therapeutic ethos has provided a vehicle for the exposure of abuse against some of the less powerful groups in society. Critiques beg the question of whether the exposure of child sexual assault in the Catholic Church, for example, would have been possible without a cultural climate that encourages revelations of the hitherto unmentionable. That it is acceptable and even encouraged for victims once silenced to challenge the authority and legitimacy of oppression opens up potential spaces of transformation. The ascendancy of the emotional and the concern for psychological health mean that the psychological and   REFLECTED LIGHT emotional are mobilised politically, with ramifications beyond the inner life of the individual. Indeed second-wave feminism made the personal political. More recently, the Australian Human Rights Commission’s National Inquiry into Children in Immigration Detention stressed the long-term psychological damage to children and their families. The ‘pro-therapy lobby’, as Furedi would call them, were some of the strongest advocates and agitators for changes to government policy on mandatory detention. * Footballers talking about psychological distress and emotional life may provide an interesting case in point about the extent to which the therapeutic saturates cultural life, but two further points are pertinent. While there is now room for discussion about emotional difficulties in the context of professional football, it would be ludicrous to read this as evidence that the therapeutic had eclipsed other kinds of ‘macho’ behaviour. Public disclosure of illness and personal weakness, in this case, sits alongside the still powerful imperatives of masculinity that privilege traditional manhood. But a second, more important point needs to be made. Within the same period that the psychological entered the footy vernacular, there has been more public scrutiny about acceptable forms of behaviour. Allegations of sexual assault have meant that a range of strategies has been developed by the AFL, the clubs and the Players Association to regulate the conduct of players. In November , the AFL released a new social policy, amending the rules regarding ‘Conduct Unbecoming’ to include allegations, charges or convictions of sexual harassment and assault. These changes are brought about by a variety of social and cultural shifts that the AFL has had to respond to, one of which is the recognition of psychological damage to women following sexual assault. To view these kinds of changes merely as evidence of an enchantment with the psychological or a fascination with ‘crimes of the emotion’, as Furedi’s analysis would, does not take into account that they are part of a response to changes in social acceptability of men’s behaviour. These changes are not simply driven by the ‘pro-therapy lobby’ but have emerged within a broader context of social and cultural Katie Wright change that has forced organisations to take the emotional and psychological realms seriously. It is important when considering the spread of therapeutic ideas and practices to acknowledge that there are complex structural arrangements within which counselling, for example, has blossomed. That footballers or officials who are alleged to have sexually harassed or assaulted a woman may be forced to have counselling is arguably not such a bad thing, but importantly it is only one of a number of strategies the club or the league may adopt. Players found guilty of an offence also face action by the AFL that is decidedly antitherapeutic: like being delisted. To be sure, therapeutic solutions should never replace social and political ones, but neither should they be regarded as necessarily antithetical to social action and politics. The culture of therapy can and does operate in ways that are depoliticising and individualising. But on the other hand, the therapeutic itself also provides an alternative social critique. It provides a language and legitimacy to claims of oppression, abuse and violence, and as such it is taken up in ways – both at the individual and collective levels – that are emancipatory. Superficial characterisations of ‘victim culture’ obscure the reality that some groups have always been victimised more than others. The question is perhaps not so much whether we are all ‘victims’ now, but whether the ascendancy of therapeutic culture signals a shift in social acceptability of abuse and suffering. Therapy Culture concludes with a section entitled ‘Final Thoughts: Does it Matter?’. The same question could well be asked of the book. Despite its limitations, Therapy Culture raises important questions about the state of the self in contemporary society and has reignited the therapeutic culture debate. It was widely reviewed by the popular press and sparked heated debate in the British media, including an outraged response from the British Association of Psychotherapy and Counselling. To Furedi’s disappointment, however, debate focused more on the value of therapy and counselling than their cultural ramifications, perhaps because ‘therapy’ and its cultural ramifications are not so easily disentangled, but probably also because the thesis rests largely on evidence of the burgeoning numbers of therapists and counsellors, and increasing practices of therapeutic intervention. A polemic   REFLECTED LIGHT about ‘therapy’ was bound to ruffle feathers, and understandably divided public opinion. It is certainly true that the book was heavily promoted. It is probably also true that had it been more complex, assessing the contradictory nature of this cultural development, it would have received less attention. As a contemporary map of the reach of this cultural phenomenon, Therapy Culture makes a valued contribution. It does not, however, speak to what is largely still missing in debates on this subject – the acknowledgement of suffering and struggles for human dignity. The ascendancy of a therapeutic ethos has certainly been a mixed development. But perhaps when considering the many cultural consequences of therapy, the question that has yet to be seriously considered is whether as a society we now are in less denial about human suffering.