Psychotherapy and the Consumption Principle
By Christopher Heard
As psychologists, we tend to live in an environment that is dominated by language, particularly its ability to shape perception. This is particularly true for those practicing narrative or discursive forms of therapy, varieties of therapy which have come to be categorized under the heading of the postmodern. This affinity for discourse analysis is understandable for those involved in "talk therapy", but it may be that the emphasis on language in post-structural or post-modern theory is overemphasized in these therapies to the exclusion of the material conditions which interact dynamically with language in shaping social realities.
Outside of psychology, a great deal of writing in the area encompassed by the eclectic category of postmodern theory, concerns itself with the relation of contemporary thought and intellectual practice to the social-economic environment in which it is embedded. (See, e.g., Baudrillard, 1975; Best & Kellner, 1991; Harvey, 1990; Jameson, 1991; Lash, 1990; Lemert, 1997; ). Much of postmodern psychology, on the other hand, uses "postmodern" concepts such as "discourse", "narrative". "the other", "alterity", "difference", "multiplicity" and the like as pieces of a subjectively manipulable language game. The result is to treat the world of social practices as if they could be changed by a consciously manipulated change in language. This overlooks all the nonlinguistic discourses, or institutions, engaged in the mutual and reciprocal construction and reproduction of social practice as well as the manner in which postmodern discourse theory partakes of a structuralist orientation, in a micro-structural form of localized discourses.
The danger lies, first, in confusing consciously chosen narratives or discourses, arrived at between a client and therapist, with the discursive practice post or micro-structural theory finds to be constitutive of our social reality. Second, and of concern in this article, This inflation of the language of therapy to virtual ontological status threatens to turn a blind eye towards the impact of material relations of production, including technology, on the practice of psychology itself. This article is concerned with the impact of the Internet on psychotherapy, its relation to these postmodern therapies, and the need to approach their possible union with great care and trepidation. The analysis will look briefly at the Internet's impact on the client as consumer, the client as subject, the constitution of psychotherapeutic practice, and the integration of psychotherapy with the global economy of fast capitalism, or high speed symbolic commodity consumption
Failure to undertake such analysis may result in an even greater co-option of the psychotherapeutic process then has already occurred under the current economic regime, which is presently driving the reduction of the self, or subject, to a fully commodified consumer. To understand what I mean by the impact of material production and relation upon therapy, and its assimilation into the current economic regime, it is helpful to look first at the managed care revolution.
During the 70's, when psychologists were battling for coverage under health care policies, such coverage was largely perceived as an unmixed blessing. Practices could expand, and new populations be reached, through the device of third-party payments. The numbers of psychologists blossomed, and for a brief period, there was a golden age. Then managed care arrived, a natural evolution of third-party payment. Practices began to shrivel. In a panic the discipline began to look for new ways to sustain itself and the inflated number of practicioners to which third-party payment had given rise. The demand for short-term therapy changed the way many practice, driving theoretical advances/justifications to enable psychologists to carry on under the new regime. Others have turned to new euphemisms such as executive coaching, which better fit the ascendant corporate culture, and focuses on the person as commodified entity in the globalized corporate economy.
Many, if not most, psychologists were shocked by the harsh downsizing imposed by managed care, primarily because they had not paid heed to the material conditions of production supporting third-party payment. First, there were labor unions, which demanded health care in collective bargaining. Yet by the 70's, with the decline of the Fordist, or high capitalist economy of mass production, the rolls of organized labor were shrinking. At the same time cost efficiency, running lean and mean, became paramount, leading to wholesale corporate downsizing in the economic restructuring of the new economy. Those very real material conditions should have given pause about the headlong rush to inflate the pool of practitioners in reliance on liberal third-party payments. After all, those payments were funded from the pockets belonging to those involved in the ruthless process of layoffs carried out in preparation for economic reconstruction. These signs were ignored, and the insurance revolution in therapy went forward.
Second, employers provide health care not simply due to labor pressure, but also to keep their work force productive. When psychologists began to accept third-party payments, they embedded themselves in a set of institutional structures which perceive humans in terms of productive capacity, to be maintained when beneficial, and released when inefficient. Psychotherapy, within this institutional dynamic is not about the best level of functioning achievable by a client, nor autonomy or authenticity, but about the ability of the subject qua productive unit to be maximally efficient, in a calculus based on monetary input versus productive output. Humans, being the remarkable creatures they are, can frequently produce a fully satisfactory level of output in the face of significant emotional dysfunction.
Copyright © New Therapist