Psychotherapy as civics: the patient therapist as citizens.

The field of psychotherapy has failed to live up to its promise to be a force in the continued development of democracy by aligning itself with medicine and psychiatry. Psychotherapists must recognize that those with whom they work and disseminate information to are inevitably citizens and that they are redefining citizens as mental patients. By utilizing psychiatric diagnoses, which are in effect, moral labels, psychotherapy unwittingly helps create authoritarian political structures by convincing their patients and the public that they are essentially inferior and can do nothing to change that condition. A series of recommendations are made that suggest ways for psychotherapy to free itself from institutional psychiatry and medicine and build its own "house." Keywords: psychotherapy; psychoanalysis; political systems; democratic/humanistic; authoritarian/totalitarian Recently I wrote, It is my belief that psychology is the science with the greatest unrealized potential to be a powerful force for democratization of society. Moreover, the type of relationships prescribed by various psychological therapies, particularly modern interpersonal and intersubjective psychoanalysis are, at least in their theoretical ideal, the embodiment of democracy, fairness and humanism. (Simon, 2003) I concluded then and I am still of the opinion that the ideal is too often not reflected in practice, making the collective impact of psychology and its applications, of which analysis is one, a force that helps diminish what is left of the democratic/humanistic institutions comprising our society. Diminished as well are the types of psychological orientations and subjective modes of experience that nurture and are nurtured by politically democratic/humanistic relationships. An analysis of psychotherapy's failure to promote genuine democracy cannot be achieved by utilizing psychoanalytic or other psychotherapeutic theories and principles. Only by stepping outside a theoretical system and employing perspectives other than those embodied within the system can the system be evaluated, its blind spots noted, and the discourses that prevent objective evaluation be disabled. Since I am concerned with the relationship of psychotherapy and psychoanalysis with democracy and since democracy is a political construct, I shall examine psychotherapy and analysis from the lens of politics after introducing several assumptions concerning the persons involved in political interaction. I make clear the very limited nature of my analysis and the hubris of attempting such a discussion in the fitst place. (A much longer analysis of this topic and the source of much of this article can be found in Simon, 1998, 2000, 2003). I also suggest that is unclear just what anyone now means when they use the terms psychotherapy or even psychoanalysis. The fields are so fragmented, the fragments so often based on incompatible and even incommensurate assumptions, and the techniques of intervention derived from the fragments so wildly different that a political analysis of one fragment might have little that is relevant for another. Therefore, the present critique may not be relevant for any specific fragment of psychotherapy and its underlying theoretical justification. SEVERAL ASSUMPTIONS However else we conceptualize the relationship between therapists and those with whom they work we cannot escape the conclusion that they are all citizens. Not only are therapists and those with whom they work citizens as they interact in the consultation room, but each is a citizen of a family, a community, a city, a country, and the world at large. It is important to note that each individual is a citizen in relation to him or herself as well as to other individuals. I assume that at times various citizens will see it in their interest to cooperate with their fellow citizens and at other times compete with their fellows for various goods and services that reflect their individual interests. …