Tuesday, March 28, 2006

"Deconstructing" Psychology

Every time I hear about "deconstruction" I feel old. Granted, I'm coming up on 60, but I still do keep up. Well, sorta. I still haven't gotten an MP3 player or a Blackberry yet.

Anyway, I encountered an article entitled, "Theorising Critical Psychology In Psychiatric Practice: Six Voices Interrupting Pathology" by Burman, et al., on the on the Social Practice/Psychological Theorizing web site. In it, the authors say,

Critical Psychology is the Practical Deconstruction of every attempt to normalise some kinds of behaviour and experience and to pathologise others.

Psychology is constructed within the horizons of capitalist society to enable that society to run more efficiently, and it constructs within that society its own images of pathology. Part of the political activity of challenging the construction of psychology is the unravelling of what we have made. The process of critique is also a process of deconstruction. It must include a practical political alliance with all those who suffer psychology and who are starting to refuse the way they have been constructed as pathological. It is a political question that calls for practical deconstruction of the theories and apparatus of the discipline of psychology. (p. 4)

This kind of nonsense really annoys me. First of all, it mischaracterizes those of us who practice in the field. We're a lot more heterogeneous than Burman, et al., let on. I characterize my politics as left of center. I've known psychologists much further left of me and some psychologists who are a little right of Atilla the Hun. The American Psychological Association (I'm not a member) has certainly taken some left-wing positions, such as support of abortion rights. To argue that, "Psychology is constructed within the horizons of capitalist society to enable that society to run more efficiently," is simply silly. Our first responsibility is to our clients. Our second responsibility is to society.

We work to help our clients function more effectively within society, but it is within the context of their goals, not ours. In some situations, we do help our clients become better workers. An employee with a personality disorder may cause chaos on the job, and we owe it to both the client and the employer to stabilize their behavior.

In other situations, we don't help the employer. I doubt there is a practicing clinician who hasn't tried to help a client work less overtime so they could be more attentive to their loved ones. That certainly doesn't help the employer.

Juggling our priorties can sometimes be a problem. We may help clients to get over losses when they have been asked to leave a social club. But if that client decides to go back there with a gun, we have an obligation to society to stop them by notifying the police and having the client hospitalized. Balancing a person's rights against society's is complicated and messy. When rights conflict, we may be forced to do what causes the least damage. Politics and power be damned.

Politics, power, and feminism always get mixed together in deconstructionist writings, and Burman, et al., are no exception:

Because models of development privilege the culturally masculine, they position women, black people and even children as culturally deficient and inferior. Their experiences are treated as mere steps on the evolutionary ladder to modern western developmental maturity. We can challenge this by pointing out the covert ways women and black people and children are considered less rational, or madder, than white middle class men.

The problem here is two-fold. First, psychology is rapidly becoming a female profession, so why culturally masculine concepts should be retained is beyond me. Second, historically, the field has been very concerned with filtering out sexual and cultural stereotypes in diagnosis and treatment. Hollingshead and Redlich (1958) were probably the first to show that people with of lower socioeconomic status are more likely to be diagnosed with more serious pychiatric illnesses.

So, it's an old problem and we continue to recognize it. We're a long way from having completed the process, but a fascinating article by Hyde (2005) deals with gender similarity and differences in a new and exciting way. This article can be found online by clicking here.

I could rant and rave about a lot of the nonsense in this paper, but I'll make one final point. There is no doubt that culture, perception, and mental health interact. Certainly, our definition of mentally ill behavior has changed over the years. However, Burman, et al., refer to psychotic speech or thought disorder as a "a construction of the psy-disciplines" (p. 6-7). That's nonsense. Anyone who has spent 5 minutes talking to a floridly psychotic person can see that there is something truly wrong. I have never encountered any evidence to suggest that a thought disorder in any society was ever truly accepted as normal or desirable.

There is such a thing as objective reality. Because reality is complex, it's often hard for us to differentiate it from our prejudices and stereotypes, especially in my line of work. But, it's there, and I believe that the closer we come to reality, the better we function. That's a big part of the way I do therapy.


Hollingshead, A. B,. and Redlich, F. C. (1958). Social class and mental illness. New York: John Wiley.

Hyde, J. S. (2005). The gender similarities hypothesis. American Psychologist, 60, 581-592.

No comments: