The Therapy Industry

Paul Moloney

Description

Across the world anxiety, stress and depression are on the increase, a trend which looks set to continue as austerity measures bite. The official response tells people that unhappiness is just a personal problem, rather than a social one.



Written by a practising psychologist, with nearly thirty years' experience in the fields of mental health and learning disabilities, The Therapy Industry offers a concise, accessible and critical overview of the world of psychological practice in Britain and the USA. Paul Moloney argues that much therapy is geared towards compliance and acceptance of the status quo, rather than attempting to facilitate social change.



The Therapy Industry fundamentally challenges our conceptions of happiness and wellbeing. Moloney argues that therapeutic and applied psychology have little basis in science, that their benefits are highly exaggerated and they prosper because they serve the interests of power.
Introduction: The Light at the End of the Tunnel?

PART ONE: Evaluating Psychological Techniques

1. Faith, fashion and mind cures

2. The psychopathology of everyday life

3. ‘The CEO of Self’

4. Does Therapy Work?

5. ‘I’m not ill, I’m hurt’: the hidden injuries of social inequality

PART TWO: Therapy in Society

6. Sweet Medicine - psychotherapy and psychology as control

7. IAPT - theory into policy

8. The Therapy Marketplace

9. Towards a psychology that embraces what the therapy industry ignores

References

Index

Sujets

• Social Science
• Sociologie, société et politique
• Sociology
• General officer
• Psychotherapy
• General

Informations

• Publié par: Pluto Press
• Date de parution: 07 juin 2013
• Nombre de lectures: 0
• EAN13: 9781849648776
• Langue: English

Extrait

The Therapy Industry

First published 2013 by Pluto Press 345 Archway Road, London N6 5AA
www.plutobooks.com
Distributed in the United States of America exclusively by Palgrave Macmillan, a division of St. Martin’s Press LLC, 175 Fifth Avenue, New York, NY 10010
Copyright © Paul Moloney 2013
The right of Paul Moloney to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988.
British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library
ISBN 978 0 7453 2987 1 Hardback ISBN 978 0 7453 2986 4 Paperback ISBN 978 1 8496 4876 9 PDF eBook ISBN 978 1 8496 4878 3 Kindle eBook ISBN 978 1 8496 4877 6 EPUB eBook

Library of Congress Cataloging in Publication Data applied for
This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. Logging, pulping and manufacturing processes are expected to conform to the environmental standards of the country of origin.
10 9 8 7 6 5 4 3 2 1
Typeset from disk by Stanford DTP Services, Northampton, England Simultaneously printed digitally by CPI Antony Rowe, Chippenham, UK and Edwards Bros in the United States of America
Contents




Acknowledgements
Introduction: The Light at the End of the Tunnel?
PART I EVALUATING PSYCHOLOGICAL TECHNIQUES
1 Misery, Mind Cures and Fashion
2 The Psychopathology of Everyday Life
3 The ‘CEO of Self’ ... ?
4 Does Therapy Work?
5 ‘I’m not ill, I’m hurt ...’ – The Hidden Injuries of Social Inequality
PART II THERAPY IN SOCIETY
6 Sweet Medicine – Talking Therapy as Control
7 Theory Into Practice – The Programme for Improving Access to Psychological Therapies (IAPT)
8 The Therapy Market – From the Third Wave to ‘Happiness’
9 Towards a Psychology that Reflects what the Therapy Industry Will Not Tell Us
Notes
Index
Acknowledgements


For their continual encouragement and editorial advice I would like to give special thanks to Carol Morris, Dave Crook and David Castle.
I would also like to express my gratitude for the assistance of Jan Bostock, John Cartmell, John Cromby, Clive Chimonides, Bob Diamond, William Epstein, Val Gillies, Dave Harper, Carl Harris, Guy Holmes, Paul Kelly, Sue Mahoney, Barry McInnnes, Penny Priest, Kieran Lord, Zounish Rafique, David Smail, David Smith, Jan Soffe-Casswell, Biza Stenfert Kroese, Fran Taylor, Mike Tupling and Fran Walsh.
Finally, I must gratefully acknowledge the help of a grant from the British Society of Authors.

Dedicated to the memories of Mark Rapley, and of my grandmother, Gladys, and of my father, Roy
Introduction:
The Light at the End of the Tunnel?



The sense of control, hopefulness, and comfort [is] common to many forms of psychotherapy ... Through the adoption of a set of organizing principles or a coherent world-view, the patient comes to see a ‘light at the end of the tunnel’.
R.J. De Rubeis and colleagues 1
Therapeutic assumptions and jargon have spread into our lives – from school to university to workplace, from the health advice clinic to the prison, and to popular entertainment programmes where experts advise lonely people how to attract a partner, or parents how to be better ones. These specialists seek to persuade us that our troubles stem, not from the world in which we live, but from our lack of insight into ourselves and from our failure to take responsibility for what we think, feel and do. All might be well if their ideas were better grounded in science than their forerunners from even 50 years ago. The main task of this book is to show that this is not the case.
In the western world, treatments for the mad, the disturbed and the undesirable have been in continual flux down the centuries, and perhaps most rapidly in the last two. At the beginning of the second millennium, the majority of mental health professionals are acquainted only with the more recent treatments, or with as much of them as are deemed relevant to their occupational niche. They have little time or incentive to question the scientific – much less philosophical – basis of what they are doing. A historical view, however, soon shows that it has always been a mixture of fashion, political upheaval, institutional demands, and competition between rival professions and interest groups that have shaped how misery and madness have been treated, and regarded. Science, understood as the attempt to learn from systematic observation, has come a very long way behind. Insights such as these are perhaps the hardest to grasp. After all, psychologists and therapists are trained and accredited by prestigious universities and colleges, they are relatively well paid and they write books and speak confidently of their theories and techniques. As often as not, they try to pass this ebullience on to their clients. When it comes to trying to glimpse the emptiness at the heart of the therapy industry, however, the importance of a questioning, historical outlook cannot be overstated. The first chapter of this book – ‘Misery, Mind Cures and Fashion’ – accordingly tries to give a brief, critical overview of some of the main currents in psychiatry and psychotherapy since the late nineteenth century, leading on to an evaluation of the status of these fields in the twenty-first.
Despite the popularity of therapy, it is psychiatry that remains the most powerful mental health profession, the older and wealthier sibling against which all of the others must measure themselves – whether in envy, admiration, or contention. But as Chapter 2 shows, the psychiatric map of the disturbed mind – as little more than the by-product of faulty genes and of wayward biochemistry – is itself a distortion, brought about by the overweening confidence of its creators, and by the power that they enjoy in prescribing drugs for the treatment (more often the management) of distress. There is nothing like tablets and injections for conferring a spurious reality to the ‘mental illnesses’ that they are ostensibly designed to tackle. If the science of psychiatry is shaky, then this has not stopped hordes of its practitioners, with a few psychologists for company, from stepping forward to create new forms of deviance. For the shy and the socially awkward, for the restless and the disruptive, or for those who are merely ‘odd’ – a host of stigmatising diagnostic labels await. The consequences are far reaching. Outside of the Shangri-La world of media celebrity, social tolerance for eccentricity is narrowing.
If psychiatrists have fostered an impoverished and one-dimensional view of the patient, then have the talking therapists done any better? Some of these practitioners at least have seen the richness and uniqueness of the sufferer’s subjective experience, and how it echoes what their world has done to them. Too many of them, however, have assumed that, given the right therapeutic advice and techniques, their clients will be able to muster wide powers of determination, unlocking what amounts to their own ‘inner CEO’, who will take charge of their troubles. When contrasted with what 50 years of laboratory and social research have been suggesting about the limits to human self-awareness and freedom, however, this picture starts to look as myopic as its psychiatric counterpart. In 1959, the sociologist C. Wright Mills described the gap between what people say and what they actually do as the central problem of the social sciences. 2 These words remain true today. For the therapists, there is room for a lot more humility in their claims to understand, cure and console.
Indeed, this boils down to a fundamental issue of the value of what therapists do, a subject about which they have long been defensive, and cannot answer a deceptively simple question: does therapy work? Despite many years of research into the effects of psychological treatment, the standards of investigation are still so poor that it is hard to say with confidence just how helpful or unhelpful therapy might be. This conclusion applies even to the evidence quoted in such authoritative tones in the UK central government’s National Institute of Clinical Excellence (NICE) database and to the clinical guidelines issued by the American National Institute of Mental Health. Careful scrutiny of even the best of the research literature suggests that, because of the powerful placebo effects involved in this kind of treatment, and the historical failure of most researchers to adequately control for them, then all of the main psychological therapies are of marginal helpfulness at best, and are probably ineffective.
The practices and prescriptions of modern-day psychologists may be much closer than believed to the nostrums of the medical profession before the modern era: a time when a soothing touch counted most, when patients often had strong views about the correct dose of laudanum for their illnesses, and when he or she who paid the piper called the tune. The main difference between current psychological practice and nineteenth-century medicine is that Victorian doctors would frankly acknowledge the uselessness of most of their remedies, at least in private. Their patients knew that health was precarious and life often short, and they seldom expected great results. 3
If the psychological therapies do not do what they are supposed to do, then it is worth asking why. After all, most of them amount to distillations of our common-sense notions of how people change any aspect of their conduct, by making a decision to act differently, and then sticking with it. One reason might be that many of us are locked in tough or demoralising circumstances that do not admit of change, despite what our therapist tells us. Another reason, complementary to the first, might be that some of us have been seriously mistreated by other people earlier on in our lives, and, at the level of unvoiced feelings, can no more