According to the leading Flemish psychologist, psychotherapy is now completely in thrall of the prevailing economic system. Rather than caring for individuals who need help, psychotherapy trains employees according to the needs of economy. Why is this harmful? Is psychotherapy in danger of extinction?
You aim to overthrow the tendency of the psychotherapy to cover-up the reasons for the psychic ailments with your professional and political activities. Why do you see this as necessary?
Our contemporary psychology has taken sides with the neoliberal ideology. A painful example concerns a dominant paradigm about stress-related problems. The treatment focuses on the patient’s perception of stress, and aims at changing that perception. The meaning is clear: stress is YOUR problem; it has nothing to do with your working environment.
The reason psychology has taken this turn is the very same reason our whole society has taken this turn: the dominance of the neoliberal ideology for the past thirty years is such that we have fully identified with it. The contemporary crisis may function as a wake-up call; at least that is my hope.
In his work, Michel Foucault explains how the proclaimed self-liberation also opens up a way for self-discipline in modern society. Why do you think the idea "to control myself is to liberate myself" is accepted so well?
We should not be afraid of the idea of self-discipline or self-control. Foucault demonstrates how these ideas are present since the classic Greeks onwards. The important question concerns the aim. For Foucault, this aim was ‘epimeleia’, the care that one takes of oneself (body and soul), with the underlying idea that such care will be beneficial for the society as well. Today, the aim is reversed and changed: self-discipline favours economy and not society, care of oneself is a lure.
Contemporary self-liberation is an illusion. We are told that we are free, and we have never been so powerless as today. We work far too long, virtually everywhere and every time (the boundaries between working hours and leisure, between working place and home, have disappeared), we have to be successful, and we have to compete with all others, with economic gain as/being the only criterion. The so-called ‘self’ discipline is based on the extremely alienating discourse that is present from an early age onwards, in which we are told that we will belong either to the winners, by working hard and taking every possible opportunity, or to the losers, who should be ashamed of themselves. Already in 1921 in his text Kapitalismus als religion, Walter Benjamin foresaw this evolution where capitalism became the new religion with a sense of guilt from which there is no escape.
In a person’s life there necessarily are moments when one is simply not able to work hard - for instance, when dealing with the death of a relative. Isn't the cultural denial of similarly intense emotions making us eventually unable to deal with a painful experience? Isn't it making us more vulnerable?
Again, it puts all the responsibility on the individual, with an almost total neglect of socio-economic factors. This affects our way of mourning, because it makes it almost impossible to ask for help and to share this loss with others – which is really necessary in such circumstances. The winners are always the same; today it is the five percent that owns almost everything.
It seems that not even the cultural industry with its offer of escapes to wonderlands is not entirely able to help in these moments. Why are emotions that were previously considered to be entirely normal, now perceived as undesirable? Where does this insistent imperative to "don´t worry, be happy" come from?
Happiness has become an obligation, because it is an essential part of success. We are simply no longer allowed to feel unhappy. And if we do, it is considered abnormal; a “disorder” that can and needs to be treated. At that moment, we become a target for the second most important industry in the US (after the military); i.e. the pharmaceutical world. If you are no longer productive, you should at least be transformed into a customer.
What is your explanation for the huge rise in prescriptions of drugs like Prozac or Ritalin after the year 2000? Has psychotherapy ceased to be effective and affordable – contrary to pills?
The neoliberal ideology has convinced us that happiness depends on (professional – financial) success, and that success is just a matter of doing your best, working hard, making the right choices, following the right program. Perfection can be achieved by each and every one, we can and should have the perfect body, the perfect relationship, great sex and perfect children, and – of course – a very successful career, earning lots of money. If this is not the case, it is your fault, you did not work hard enough, did not make the right choices etcetera. If at that point of failure, some master figure tells you that your failure or the failure of your children is not due to your lack of effort, but is caused by something called a “disorder,” usually indicated by a scientific sounding acronym, then this comes as a relief. I am not guilty; it is not my mistake, I am suffering from a ‘disorder’! They even have pills for it; I do not have to change my way of life or make other choices; no, the pills will do the trick (they never do). The whole discourse is presented as scientifically sound and proven – which is not the case; on the contrary.
At the end of the day, everybody is ‘happy’: the patient does not have to feel guilty any longer; the pharmaceutical industry keeps selling its stuff and business continues as usual. The only drawback is that so many people are suffering from the combination of burn-out and depression, that their number is becoming a serious threat for the economy.
A popular counter argument, when it comes to the increase in patients, claims that it is not that there would now be more people suffering from some kind of a psychical disorder than before but that with advancements in healthcare more people are diagnosed nowadays. However, the actual variety of illnesses also differs from the past qualitatively. How many people have suffered from the ADHD or panic disorder before 1990?
First of all, many of those disorders are not diseases in the medical sense of the word. They are psychosocial responses of an individual to his or her conditions of life. And although it is impossible to prove this scientifically, I am convinced that more people suffer from these conditions compared to a couple of decades ago.
I have recently encountered a scientific study in a prestigious medical magazine that in all seriousness recommended that married couples strive to improve their relationship, “for the sake of their children,” by taking some oxycodone-derived pills. This is supposed to, simply speaking, prevent cuckoldry. What is your opinion on using drugs in nonmedical conditions?
This is a painful and dangerous example of biopolitics. The pharmaceutical industry is constantly looking for a new market; way beyond the classical medically-diagnosed diseases. That is why the currently widespread problems are now labeled as “disorders,” and of course, marriage and parenting problems are one of them. If the pharmaceutical representatives succeed in the medicalization of such condition, this opens an enormous market. The example you give is paradigmatic. First, they will say that this is a matter of science, and add some general references (e.g. the evolutionary theory).Then – and this is most important – follows the appeal to the ubiquitous parental sense of guilt toward their children. This is a trick that always works: to evoke a sense of guilt or anxiety; present us with an easy solution, and people literary jump to it
The free market makes us feel that we do not need anything else but money to satisfy our needs. We can buy food, shelter, even company. But suppressing our social needs cannot be "healthy", since they are as fundamental as the needs to breathe or eat. Does psychology find any consequences of this denial of common solidarity and social dependency?
You do not need contemporary psychology to see the consequences of such a denial. Quite on the contrary: contemporary psychology helps to obstruct our view; helps with this denial of solidarity and social dependency. Psychology, as an academic endeavor, has fallen prey to the dominant discourse, at least in two ways. First, in the world of academia, your researchers have to compete with one another to get tenure. Teamwork is not encouraged and loyalty to an institution detoriates (see the talk I gave to the EU officials: http://ec.europa.eu/education/events/2015/docs/paul-verhaeghe-speech_en.pdf; video: http://ec.europa.eu/education/events/2015/1109-jean-monnet-conference_en.htm).
So universities, and this is obviously true for private corporations, too, do not trust their employees, resulting in mutual sense of mistrust. Cheating has become a perfectly normal strategy, even if it cannot appear in public.
Secondly, psychology has always focused on an individual; that is its core business. But today, such a focus dovetails with the obligatory egoistic individualism, and it neglects the obvious social causation of many of the so-called disorders. This is especially clear if you study the ‘disorders’ in children and youngsters: ADHD, ODD, and generally speaking CD (conduct disorders) are far more frequently diagnosed in the underprivileged classes. Mainstream psychology prefers to ignore this.
Which of these tendencies do you consider to be most dangerous?
What I consider to be the most dangerous effect of the so-called free market discourse, is that it has become our “reality;” i.e. we consider this to be a normal state of affairs; most of us do not question it any longer, especially not the people in charge. It has become the air we breathe (polluted air, for that matter). If you consider this state of affairs from the perspective of Hannah Arendt, then we are living in a system (anonymous and digital) that has induced thoughtlessness. Thinking has become obsolete; something of the past. You should not think too much, that is bad for you, stop worrying! Don’t think; act; do as usual; business as usual. According to Hannah Arendt this is what leads to the banality of radical evil. The radical evil is included in the system itself, because it declares every other as a potential competitor and hence a potential enemy. The evil is banal, because it is not committed by monstrous people. Normal people, who are parents themselves, who lead a normal life, take every day decisions without being consciously aware of the fact that they are destroying their own future and that of their children. And this time also, their defense will be “Wir haben es nicht gewusst”.
The freedom of an individual in the post-modern era really is paradoxical. We may be liberated from the traditional institutions as the church or the family; yet the more are we dependent on the brand new institutions that were never seen before. Still, we are supposed to act as if only our own will matters. How does this kind of pressure influence our society?
There is scientific evidence that this pathological influence is clearly there, both on the societal and the individual levels. The pathology is so significant that it determines our identity and our relationships towards all important others (i.e. in the sense of the opposite sex, the other who is the authority or my equal, as well as the intimate other, meaning my body). I have described this in detail in a book What about me?.
There are many psychosocial health indicators (teenage pregnancy, domestic violence, anxiety and depression, drug abuse, school drop out rates, etc.) that correlate with neoliberalism. Just read the studies by Wilkinson and Pickett. They discovered that the rise in income inequality in a country, a region, or even a city significantly correlates with most psychosocial health indicators. The rise in income inequality is a typical feature of a neoliberal society.
If we consider the consequences of neoliberalism on one’s mentality, it is not too far fetched to say that neoliberalism has been turning us into competitive and egoistic individualists. If you combine that with an economic meritocracy, you create a system of winners and losers, on an individual level. The step towards loneliness, anxiety, and depression is very small in such a binary system.
Generally speaking, such a system makes us unhappy because we are social animals, we need one another, and we thrive in groups. This economic system is in direct contradiction to this crucial aspect.
You have proclaimed The End of Psychotherapy in 2007. I presume the situation has only worsened.
The situation has, indeed, gotten a lot worse. Psychotherapy has changed sides. Its origins go back to the seventies, when psychotherapy aimed at helping people to get away from the then oppressive society. Today it aims at ‘helping’ people to ‘recover’ as soon as possible, in order to get them back to work. The UK government has funded a massive therapeutic project, via the GPs, to ‘fight’ depression because it is a huge risk for the economy. The important thing is that the success rate of the program was linked to the number of people that got back to work - incidentally, the whole project was a failure.
To say that "i got the blues today" has became an ordinary part of a small talk. Is really the depression diagnosis on the rise or is it some kind of an entirely new state of mind for which there is no term yet?
Concerning ‘depression,’ it is important to note that the meaning of the word has changed. Traditionally, depression was compared to mourning. Today, it is considered to be a malfunction in the brain (the neurotransmitter hypothesis), that requires pharmaceutical treatment. To be clear: there is NO convincing evidence for the neurotransmitter hypothesis. On the other hand, there is more than enough clinical evidence that many people who are diagnosed with depression, are instead suffering from a burn out, often in combination with a loss of self appreciation (‘I am a loser’).
However these so-called disorders exist even among people of higher social standing. Studies that survey appearance of the pathological personality among managers are shown regularly in the media; the talk is mainly about narcissism. Is it useful to be kind of a psychopath when hunting for a "better" job?
There are certain ideal characteristics needed to make a career today. The first is articulateness; the aim being to win over as many people as possible. Contact can be superficial, but since this applies to most human interaction nowadays, this won’t really be noticed. It’s important to be able to talk up your own capacities as much as you can – you know a lot of people, you’ve got plenty of experience under your belt and you recently completed a major project. Later, people will find out that this was mostly hot air, but the fact that they were initially fooled is down to another personality trait: you can lie convincingly and feel little guilt. That’s why you never take responsibility for your own behaviour. On top of all this, you are flexible and impulsive, always on the lookout for new stimuli and challenges. In practice, this leads to risky behaviour, but never mind, it won’t be you who has to pick up the pieces.
And now the cold shower: the source of inspiration for this list is the psychopathy checklist by Robert Hare, the best-known specialist on psychopathy today.
Paul Verhaeghe (b. 1955) is a clinical psychologist by training, psychoanalyst by education. His first doctoral work (1985) explores hysteria, his second (1992) psychodiagnostics. He is Professor at University of Ghent. Since 2000 he predominantly focuses on the influence of social changes on psychological and psychiatric ailments. His strong critique of neoliberalism from the perspective of psychology and related disciplines has provoked turbulent reactions, both positive and negative, in academia and real politics. Verhaeghe is the author of several influential books including Het einde van de psychoterapie (The end of psychotherapy, 2009) and What about Me? The struggle for identity in a market-based society (2013); revised Flemish edition of the book Identiteit, published in 2012). Czech readers can access the Slovak translation of Love in a Time of Loneliness (1988; Slovak translation, 2006).