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Critique of Humanistic Psychotherapy

Daniel J. Castellano

(2001, rev. 2005, 2011)

1. Psychotherapy Defined
2. Humanistic Assumptions
3. What is Mental Health?

Therapeutic psychiatry has seen explosive growth in North America since the 1970s, as the field steadily gains public acceptance as a legitimate, respectable science. Millions of people from all socioeconomic backgrounds are willing to set aside the self-reliant skepticism of earlier generations, and unashamedly seek professional counseling for an ever broader variety of mental disorders, real and imagined. They trust clinical psychologists or psychiatrists to provide treatment for depression, grief, anger, anxiety, stress, lack of self-esteem, drug addiction, and countless other maladies that were once considered simply matters of emotion, temperament or behavior not requiring a medical solution. Much of the growth in psychiatry’s reputation is due to the improved efficacy and availability of mood-altering drugs, yet there has also been strong growth in the use of “talk therapy” or counseling, which proposes a psychological rather than neurochemical treatment of identified mental health disorders.

Ironically, the boom in psychiatry comes at a time when the theoretical foundations of qualitative psychology have been picked apart. The solemn certainties of Freudianism and other comprehensive theories of the psyche have lost their authority among most psychologists, and now theoretical psychology is a morass of conflicting hypotheses with relatively few commonly held principles. Although we understand the mechanisms of the brain better than ever before, this neurological knowledge is of limited use to a therapeutic counselor, who must interact with patients on a personal level, not a neurological level. While counselors may casually offer vague neurological explanations such as “chemical imbalance,” they do not conduct laboratory tests to validate such claims in their patients. Diagnoses are instead based on psychological symptoms, since it is impossible to measure the brain chemistry of living subjects.

In the absence of a strong theoretical foundation, most psychotherapists have de-intellectualized their practice to various extents. They eschew the technical analytic jargon that the Freudians so enjoyed, and instead employ a more conversational, patient-oriented therapy. This soft science tactic is good for business, as the therapist is more approachable and more customer-driven than the old school psychoanalyst. Instead of viewing the patient as a broken thing to be analyzed and fixed according to the doctor’s theoretical preconceptions, the modern psychotherapist is at the service of the patient, acting as a guide or coach to help him get what he wants out of life. It is little surprise, then, that the periphery of the counseling profession overlaps with the domain of self-help gurus and other charlatans promising pseudoscientific solutions to life’s problems.

Despite the attempts of modern therapists to project a theoretically neutral, patient-oriented approach to counseling, this “humanistic psychotherapy” contains some determinate philosophical assumptions. These preconceptions are not validated by empirical science, but are borrowed from older traditions in psychology such as the Freudian system of psychoanalysis, as well as Western liberal cultural assumptions. By examining these assumptions, we may come to appreciate that modern psychotherapy is not a culturally neutral medical practice or science, but rather it counsels patients to abide by the culturally-specific social expectations of Western therapists.

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1. Psychotherapy Defined

According to the National Institutes of Health, “Conventional psychotherapy is conducted primarily by means of psychologic methods such as suggestion, persuasion, psychoanalysis, and reeducation.”[1] Psychotherapy is a broad concept that includes psychoanalysis and any other method of psychological treatment. Some of these other methods—suggestion, persuasion, and reeducation—are little more than rhetorical techniques, potentially manipulative and susceptible to abuse. Still, such techniques might become legitimate “psychologic methods” if they are subordinate to an ethical, scientifically informed practice. Although the techniques of persuasion and suggestion were familiar to psychoanalysts of the older schools, there was at the same time an ethos that the analyst should be scientifically detached from the patient. Freud and others warned repeatedly of the dangers of the psychiatrist becoming a charismatic figure in the patient’s mind, yet modern therapeutic approaches practically require the therapist to use personal charisma to some extent as a healing tool. We will examine some of the general effects of this emotionally involved, empathetic treatment.

By packaging cold, cerebral psychoanalysis behind the friendly face of psychotherapy, therapists set their patients at ease so they do not feel they are being analyzed. At the same time, the use of emotional engagement can compromise the methodological integrity of traditional psychoanalysis. This incongruity is recognized by many therapists, who express disdain for the older psychoanalytic methods, and make conscious attempts to distinguish their practice from the Freudian or Jungian models. They may do this in superficial ways, such as not using a couch, or in more substantial ways, such as avoiding Freudian-sounding questions about childhood and sexuality. They project a sense of understanding the human mind, without articulating the determinate theses of the older analytic schemes.

It is unclear how anyone can pretend to analyze a mind without having a reasonably well-defined theory of the mind. If we are to believe that Freud, Jung, Adler and the like were all fundamentally mistaken, then what is the present theoretical framework of psychology? Current psychological literature does not fill this void with a definite answer; even college textbooks exhibit an astounding lack of uniformity in opinion on basic principles.[2] Most books will discuss psychological theories as historical background, but few will presume to impose any particular theoretical system as an operative paradigm. In a well-developed science, there is a generally accepted (though not infallible) system of established principles, such as Newtonian mechanics in physics or Darwinian evolution in biology. This is why science textbooks in a given subject usually discuss the same material. No such agreement on principles can be found in psychology. There is no large body of generally accepted theoretical knowledge in psychology analogous to what we find in the hard physical sciences.

The theoretical diversity among psychologists is paralleled by an even wider disparity of practice among therapists, many of whom combine holistic medicine and other “alternative” techniques with conventional psychotherapies. Most psychotherapists present themselves as analogous to medical doctors rather than scientific investigators. Abandoning any conceit of scientific “analysis,” therapists instead merely “diagnose” their patients. Still, a good medical diagnosis requires a medical theory that explains the causes of the symptoms. We would be very skeptical of a physician who subscribed to his own pet theory of medicine, yet most psychiatric patients do not even ask their therapist to what school of psychology he belongs.

By downplaying the importance of theoretical psychology, therapists have created the impression that they are a unified profession practicing the same science, when in fact their practice depends greatly on their personal theoretical predilections. Since contemporary psychotherapy has discarded the visible trappings of psychoanalysis, the patient is usually unaware that he is being analyzed in the context of some theoretical principles that may or may not have wide scientific acceptance. Medical diagnosis, if it is to be truly explanatory and not merely descriptive, requires the application of some theoretical principles, held either consciously or unconsciously by the doctor or therapist.

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2. Humanistic Assumptions

For this discussion, we will focus on “humanistic” psychotherapy, and its conscious assumptions. The “humanistic” approach is by far the most popular class of therapeutic methods, owing to its humane, unintimidating style. Even therapists who subscribe to other theoretical models will employ humanistic techniques in order to better engage patients, by assuring them that the therapist will not “judge” them, morally or scientifically. Humanistic assumptions, we shall see, are averse to the notion of objective morals, instead allowing moral imperatives to be defined by the patient. This approach, though flattering to the patient, undermines any objective basis for defining mental health. Without objective morals, which are normative principles defining what a person “ought” to do in a given class of circumstances, there can be no definition of mental health except in a purely functional sense, where a patient is deemed mentally “healthy” to the extent that his neurological systems function normally and he is able to achieve a desired mental state.

In practice, a therapist cannot avoid surreptitiously projecting a set of moral principles (his own or those of society) onto his patient, whether he means to or not. We can see how supposedly value-neutral humanistic psychotherapy is informed by some very specific cultural assumptions, by analyzing some of the principles of this method. Here is one sympathetic description of the tenets of humanistic psychotherapy:

  1. Humans are basically rational, socialised and forward moving (striving to be better).
  2. Humans have the potential to attain self-actualisation.
  3. Humans are constructive, trustworthy, and congruent when they are free of defensiveness.
  4. Humanistic (Person-centred) counselling creates an environment in which congruence & the potential for self-actualisation can be realised.[3]

All of these principles contain culturally specific philosophical assumptions. While the idea that man is essentially rational and social can be found in the ancient Greeks, the notion that he is essentially forward-moving, seeking self-improvement, is of much more recent provenance. It gained wide currency only in the eighteenth century, as part of the Enlightenment notion of human progress or perfectibility. Since our society is the cultural heir of the Enlightenment, we adopt this notion of progress uncritically, and neglect to note that it has not been assumed by all cultures. Some religious or philosophical traditions have held that man should return to his primordial state, or that life moves in cycles, or that stasis and stability are best. Even in our society, there are many who lack any spirit of ambition. This principle is not derived from science, but from a Western liberal “achiever” mentality, which is naturally pronounced in career professionals like psychotherapists, who expect others to be similarly motivated.

Another aspect of the first principle, also implied in the third, is its essentially positive view of human nature. Put simply, people are basically good, and this shines through once we take away defense mechanisms. While flattering, this is a philosophical assumption, one that was not shared by the Freudians, nor by traditional Christians who believe in a tragically flawed human nature, nor by the great Greek philosophers of antiquity, who noted the rarity of moral virtue. Humanistic psychotherapy teaches us that virtue is common, and that the way to be good is to be our true, uninhibited selves. Telling the vulgar what they want to hear has proven to be excellent for business.

The second principle claims that everyone has the power to realize the ambition assumed in the first. The term ‘self-actualization’ (and its equivalents, e.g., ‘self-empowerment’) contains an implicit assumption that the will is of central importance. The will is the only thing that may be considered self-actualized, since it is the only human faculty (if any) that is free. Intellect, cognition, and memory depend on received input, and this is more obviously the case for emotion, sensation, and physiological faculties. This leaves only the will as capable of self-actualization, so emphasizing self-actualization effectively means focusing attention on the will.

Humanistic psychotherapists frequently ask patients to articulate their wants and then find a means to realize these desires, sometimes ignoring intellectual and moral criteria. There is an implicit assumption that self-actualizing is fundamentally important, as though this were the key to improving oneself.[4] In fact, most if not all of our experiences of personal betterment come from extrinsic sources, such as being exposed to some new idea or experience. It is far from obvious that greater “self-actualization”—or to speak plainly, doing what we want—will generally help us have one of those character-building experiences.

There is really no way to “attain self-actualization” or improve it, since we already have free will in its fullness. Only severe mental or neurological disorders can impede the free use of reason by the will, and in these exceptional cases we might speak of a real need to improve self-actualization. Even in these cases of severe retardation or brain trauma, the will might still be free, yet a lack of cognitive abilities inhibits awareness of possible choices. On the whole, then, psychotherapy’s promise of self-actualization is just giving people what they already have, a common trope among self-help quacks.

When psychotherapists speak of improving self-actualization or self-empowerment, they are not referring strictly to those few who have impaired use of free will, but they claim that even normal people could use such improvement. How can this be, if the will is already free? This objection is answered by conceiving external circumstances as constraints upon the will. Self-actualization, in this understanding, is imposing one’s will or wish upon external reality.

There is an obvious moral danger in promoting strength of will as a sign of mental health. Strength of will is morally neutral; it can be used either for great good or great evil. Yet the desire to impose one’s will on reality is essentially prideful and egocentric. The problem is particularly acute when internal circumstances, such as moral convictions, are viewed as obstacles to self-actualization. Perhaps, the patient may be told, he needs to free himself from his old moral shackles to get what he wants out of life. This, of course, is nothing but soft Nietzscheanism.

There are many possible ways to encourage the development of self-actualization, both constructive and destructive. The methods favored humanistic psychotherapy are summarized in the third and fourth principles:

  1. Humans are constructive, trustworthy, and congruent when they are free of defensiveness.
  2. Humanistic (Person-centred) counselling creates an environment in which congruence & the potential for self-actualisation can be realised.

Person-centered counseling creates an environment free of defensiveness, thus conducive to self-actualization. When a patient knows he will not be criticized or judged negatively,[5] he feels free to express his will without inhibition. The therapist’s role is not to judge whether the object of the patient’s will is morally good—though a moralist would consider this essential to the health of the psyche (Gk: “soul”)—but to help the patient see himself as the prime mover in his life, and act accordingly.

Of course, the therapist will not take this too far; for example, he would not nod approvingly if the patient were contemplating murder. Yet he might not intervene for dubious matters that are approved by his society, such as spousal desertion or abortion. By selecting when to intervene and when not to do so, the therapist implicitly projects a set of values onto the patient. The fact that he feels morally obligated to intervene in violent cases belies his defense that failure to intervene does not imply moral approval. Person-centered counseling is in fact not neutral, but affirmative of whatever the patient sets out to do.

Whereas Freudian psychology identified neurosis as a regression to childhood sexuality, humanistic psychotherapy may actually promote a regression to childhood by creating an environment favoring self-gratification. We should perhaps not be too surprised by this reversal. Without a coherent, unified scientific theory, therapists have little choice but to draw upon the values of their society as operating assumptions. It is almost certainly not mere coincidence that the rise of humanistic psychotherapy coincided with the increasingly self-indulgent materialism of the 1980s and beyond. Since psychotherapeutic treatment is usually voluntary, therapists must employ methods that appeal to the masses if they are to succeed as a profession. Consequently, there is considerable engagement between therapeutic precepts and popular culture. The rise of moral egocentrism, the infantilization of entertainment, the retention of adolescent attitudes on sexuality into adulthood, and the infatuations with personal empowerment and emotional gratification that have become increasingly characteristic of modern North American culture, all have their parallels in modern psychotherapeutic methods. Humanistic psychotherapy tells patients what most people have already been telling themselves.

The fourth principle mentions the concept of “congruence” which was defined by Virginia Satir as a “condition of being emotionally honest” during the heyday of humanistic psychology in the 1970s. It is transparently informed by the culture of middle class America, which at the time adhered to the popular psychology of “getting in touch with your feelings.” Using congruence as a standard of healthy relationships arbitrarily pathologizes people who are emotionally reserved. This form of psychotherapy is favored only by certain personality types (especially among women) and certain cultures. It is oblivious of other cultures, such as those in Asia, where emotional reserve is considered essential to healthy social relationships. As with the focus on self-actualization, a psychotherapy of congruence upholds personal desires, perceptions, and feelings as determinants of healthy behavior, irrespective of objective considerations.

More broadly, the assumption that “healthy” social relationships are essential to a mentally healthy individual uncritically incorporates current social mores into the definition of mental health. While mental health certainly requires that the patient’s worldview should conform with external reality, it is also true that understanding reality does not necessarily mean accepting things as they are. We should not require, as a criterion of health, that a person must necessarily “fit in” or “be at peace” with his social environment. A mentally sound person might find his society to be fundamentally flawed in its values or structure, and so willingly suffer ostracism rather than assimilate its values. The humanistic model leaves little place for such melancholy or choleric souls, for it defines social disengagement as “unhealthy,” while egomaniacs might be found healthy if they are sufficiently sociable. This bias toward a sanguine, sociable temperament also reflects the current culture, which is highly averse to unpleasant confrontations in social discourse, as shown by its emphasis on sensitivity and inoffensive language. Insisting on sociability as a standard of health effectively codifies current societal values as truths, ignoring the possibility that society may be ill.

On the other hand, the humanist has no problem criticizing other societies that do not sufficiently emphasize personal autonomy. As an example, when a Hindu expressed his anxieties in the context of his belief in fate and reincarnation, his therapist encouraged him to see himself as the proactive force in his life. The therapist claimed that he had treated the Hindu while respecting his religion, when in fact he had undermined the fatalist philosophy upon which most forms of Hinduism rest. Similarly, we cannot consider humanistic psychotherapy to be respectful of Christianity, if it insists that humans by nature are inherently morally worthy and self-sufficient.[6] Many other worldviews are contradicted by the humanistic assumption that mankind is always progressing or improving. Regardless of the relative merits of these various claims, it can hardly be sustained that humanistic psychotherapy is culturally neutral.

The underlying philosophical worldview of humanistic psychotherapy, with its emphasis on personal autonomy and the creation of meaning through work, resembles a secularized Protestantism. This is no coincidence, for North American psychotherapists have merely absorbed their humanistic assumptions from the society in which they are immersed. A strong belief in the power of the individual will helps to rationalize the existing social and economic power structure, since failure to achieve social or economic success is only the result of defensiveness or fear toward realizing one’s potential, rather than the product of an objectively unjust social order. Needless to say, this “can-do” philosophy is unrealistic, as it ignores the individual’s total dependence upon the society in which he is enmeshed (on both conscious and unconscious levels), not to mention his dependence on the natural world and its Creator. The denial of such dependence results in individual egoism and more broadly, an aesthetically anthropocentric philosophy that is incompatible with transcendental religion. It is perhaps not accidental that atheism is more prevalent among psychologists and psychiatrists than in any other scientific profession. The epistemic paradigm of modern psychology would isolate man as if he depended on nothing outside himself, and measures all things by their utility in fulfilling one’s wishes. The psychotherapist (literally a “curer of souls”) adopts a priestly role, except he promotes an earth-bound or immanentist religion where man’s desire is the measure of all things. Patients subjected to this ethos are not invited to judge belief systems by objective criteria, but instead are urged to seek a religion or spirituality (if any) that best meets one’s personal needs, where “needs” are really nothing more than “wants” or desires.

When the only effective standard of truth is what one wants or desires, the result is an illogical moral philosophy where truth is defined by individual experience rather than general principles. Logically, a person might be certain of universals yet uncertain of particulars. For example, I am certain that murder in general is morally wrong, yet I could be uncertain in a particular case where someone is killed if morally culpable murder was committed. On the other hand, it is illogical to be certain about someone’s guilt or innocence if we are uncertain about the general principle. It would be absurd for me to claim, “I don’t know what murder is, but I’m sure I did not commit it.” Precisely this sort of claim is made by the egocentric patient who denies that any objective moral principle applies to his actions, yet at the same time asserts that his particular actions are morally justified. The moral relativist wants to have things both ways, saying, “Do not judge me,” (that is, by any criterion outside my will) and, “What I do is good” (i.e., I wish to be judged positively). The philosophical assumptions of humanistic psychotherapy, taken seriously, are destructive of any sound moral philosophy. Whatever ethics the patient may retain is a credit to his social background, not to nihilistic psychotherapy, which recognizes no objective good.

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3. What is Mental Health?

The psychotherapist enjoys a luxury that is denied to the physician: he is allowed to define what constitutes “health.” This luxury essentially enables him to determine his own success rate. We have seen that humanistic psychotherapy is based on precepts that ignore any notion of objective moral good, so it is only to be expected that emotional pleasure, falsely called “happiness,” is made the criterion of mental health. This is consistent with the therapeutic philosophy and with the patient’s expectations, and it is much easier to provide than a truly healthy soul. The patient-centered therapy of ego gratification, also known as “empowerment,” naturally generates pleasing emotions. Of course, this is a gift such as the Wizard of Oz might give, for empowerment is nothing more than the enthronement of the already free human will. Psychotherapy has increased its success rate and its prestige by redefining success from actually curing neurotic behaviors to simply making people emotionally happy.

Encouraging and self-enabling words are not enough for most patients to achieve even this mediocre standard of happiness, hence the millions of prescriptions for increasingly effective antidepressants that are the real key to the success of the psychiatric profession. Psychotherapists enjoy a second luxury denied to medical doctors: they get to diagnose an organ, the brain, without examining it. A patient is deeply depressed emotionally, so the therapist prescribes antidepressants to correct a “chemical imbalance” without actually measuring the serotonin levels in the brain. This represents the worst in medical practice: treating the symptom rather than the cause, without considering that the same symptoms may arise from different causes.

Antidepressants do not correct “chemical imbalances;” they create chemical imbalances. The evidence linking depression to serotonin deficiency is remarkably weak.[7] In all but the most extreme cases, such as serial killers, severe emotional depression is not correlated to a decrease in serotonin levels. In the case of some serial killers, serotonin levels have been found to be 30-40% below normal. Yet normal dosages of antidepressants, which stop serotonin inhibition, increases serotonin levels hundreds of times. This is not correcting an imbalance, but creating a severe imbalance.[8]

Serotonin is a basic neurotransmitter that serves hundreds of functions; obviously anyone deficient in it would not be able to function well mentally. Lack of dopamine, blood, or oxygen would also make someone depressed, because basic brain functions could not operate. By recklessly increasing serotonin levels, too much neurotransmitter is secreted throughout the brain, affecting hundreds of brain functions.

Antidepressants do not “cure depression” in the sense of correcting a neurological malady. Serotonin is not specific to emotional depression, and depression has no neurological correlate: there is no specific region of the brain that is a “depression center.”[9] Antidepressants “cure depression” only in the sense that alcohol, marijuana, opiates, and cocaine do the same: they abolish the sensation of depression by masking it with a chemically-induced artificial “high.” Antidepressants are simply “happy pills”[10] that do not cure any underlying medical phenomenon, but, like their illegal counterparts, can be chemically addictive, requiring increasing dosages to achieve the same effect.

As the prestige of therapeutic psychiatry rises, there is now wider acceptance of what may be called “the medicalization of behavior.” The public is given the impression that there is no practical distinction between psychological disorders and neurological disorders. If you have a psychological problem, there must be something wrong with your brain that needs to be treated. This crude materialism ascribes every psychological or behavioral malady to some hidden “chemical imbalance,” neural damage, or genetic predisposition. In reality, even the most basic psychological “diseases,” such as depression and schizophrenia, have no widely agreed upon symptoms to allow consistent diagnosis, nor are they consistently correlated with definite neurological phenomena, as are genuine neurological disorders.[11]

An unfortunate consequence of the medicalization of behavior is that certain temperaments are unfairly deemed “unhealthy,” particularly those that were classically known as melancholic and choleric.[12] Depression and anger are now illnesses to be treated rather than an important part of human existence. The religious ascetic’s willingness to suffer has little place in the current therapeutic ethos. Though not all therapists go to the same extreme, the tendency to diagnose sadness and anger as illnesses has become increasingly broad. Such a hedonistic standard of health is viable only in a pampered society. It would be impossible to apply this standard in countries filled with real suffering, without constantly prescribing heavy medication. By branding choleric and melancholic temperaments as unhealthy, the therapist, much like the society in which he lives, favors the development of sanguine personalities, which are often docile, complacent, and willing to submit to the social status quo. Despite all the rhetoric of self-empowerment, mentally “healthy” individuals are expected to devote their energies to economic and social pursuits within the existing social structure.

If sanguinity is the only form of mental health,[13] then normalcy and moral mediocrity are practically inevitable results. Emotional pleasure, unaccompanied by other feelings, encourages complacency, docility, and effeminacy. Anger and melancholy, by contrast, have played valuable productive roles in the course of human history. No nation would have ever achieved its liberty if the fires of outrage did not prod men to arms. Similarly, some of the world’s greatest artists, philosophers, and religious thinkers, while brooding over the tragedy of life, discovered some of its deepest and most beautiful truths.

Psychotherapy can expect to be well received by a society filled with egocentric adults who seek no happiness beyond emotional pleasure, such as we find in modern North America. Statistically, people in the United States are much more willing than Europeans and other people to be medicated for just about anything.[14] Still, many psychiatrists and therapists are aware of the fragility of their social status, which is why they self-consciously take pains to insist that their vaguely defined disorders are “real diseases.” Perhaps some of the older practitioners remember the mid-twentieth century, when psychology was scorned by much of the public as pseudoscience, even though psychoanalytic theories then enjoyed favor among the New York literati.

Now, in the absence of a coherent theoretical doctrine, therapists do not preach scientism too loudly, but instead present themselves as medical doctors and emphasize their professionalism. The label “mental health professional” exemplifies a shift in emphasis from the more scientific-sounding “psychoanalyst.” Professionalism appeals to North Americans who, more than Europeans and others, are inclined to seek expert, professional advice on the ordinary matters of life. Most people neglect to realize that “professional” merely means that one is paid for his services, and that quacks, charlatans, and witch doctors have equal claim to the title. As cynics may suspect, those who proclaim too loudly that their field is a legitimate profession are the ones skating on the thinnest ice.

Ironically, psychotherapists, those strenuous advocates of personal autonomy, benefit especially from the peculiar insecurity and lack of autonomy among North Americans that prompts them to seek professional help in managing their daily life. Regular therapy is sought even by people who have no serious mental disorder, or any noticeable disorder at all. Although modern therapy speaks the language of empowerment, in fact the North American population has become more docile and complacent toward the existing power structure than overt repression could reasonably hope to achieve. Perhaps this is why the Soviets were the first to require a psychiatric division in every hospital.

It will be noticed that I have painted a picture of North American humanistic psychotherapy with very broad strokes. In fact many humanistic psychotherapists do conscientiously perform their practice in conformance with sound moral values, and many of them are genuinely sympathetic toward traditional moral systems such as Christianity. There are other branches of psychiatry, closely related to neurology, that are grounded in real science and generate valuable insights into the workings of the human mind. Yet how the mind works does not tell us anything about how we should best deal with the stresses of living. Answering the latter question requires us to make normative judgments about attitudes and behaviors. It is dishonest for psychotherapists to pretend to scientific objectivity when they are in fact promoting a particular social philosophy with dubious assumptions. When people are genuinely troubled, they will grasp at whatever worldview the therapist offers, even if it contradicts the values in which they were raised, sometimes resulting in moral ruin. Whether they intend to or not, those who treat the psychologically vulnerable wield great power, so it is imperative that the practice of psychotherapy be made socially accountable, and this may begin with an open profession of its hidden philosophical and morally normative assumptions.

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See also: Psychology and the Soul | Behavioral Evolution

Notes

[1] NIH website, retrieved 2005.

[2] Psychology texts exhibit wide divergence when dealing with topics other than neurological phenomena, especially when written by a strenuous advocate of a particular school, e.g. functionalism or humanism. Instead of a generally accepted basic theoretical structure, we have a collection of experimental results whose broader contextual meaning is disputed by various academics. For an especially well-balanced presentation, see James W. Kalat’s Introduction to Psychology (9th ed., 2010), which does a good job of distinguishing what is empirically known from academic opinions. Kalat wisely denies that psychology can teach us how to analyze a mind.

[3] Retrieved from a now defunct British website in 2005. This formulation is derived from the principles of Carl Rogers (1902-1987), a founder of humanistic psychotherapy.

[4] Rogers defined self-actualization as a tendency toward fulfillment via the maintenance and enhancement of the organism. It entails an openness to experience and a willingness to be in process.

[5] Quite the contrary, in Rogers' view, the patient ought to learn to have "unconditional positive regard" for himself. Self-criticism under objective criteria is fundamentally incompatible with mental health so conceived.

[6] Such claims revive the ancient heresy of Pelagianism, which held that humans could abstain from all sin by the natural power of the will.

[7] As scientists have written in the journal PLoS Medicine, "Not a single peer-reviewed article ... support[s] claims of serotonin deficiency in any mental disorder," and, "there is no such thing as a scientifically correct 'balance' of serotonin." Sharon Begley, "Some Drugs Work to Treat Depression, But It Isn't Clear How", Wall Street Journal, November 18, 2005, page B1.

[8] See discussion in: Joseph Glenmullen, MD. Prozac Backlash (2000).

[9] Glenmullen, p. 17.

[10] Eerily similar to the "Instant Smile" drink referenced in the Twilight Zone episode "Number 12 Looks Just Like You" (1964). The mentality is the same: emotional displeasure is a "problem" that needs to be fixed.

[11] Naturally, a neurological disorder may result in psychological symptoms (e.g., disruption of amygdala connectivity causing uncontrollable anxiety or fear). Such genuine neurological disorders are statistically rare, however, compared with the diagnosed prevalence of psychological disorders. "Generalized anxiety disorder" is much more commonly caused by a stressful environment than by a problem with brain function. In such cases, we are just applying a medical-sounding term to a common problem (anxiety or fear) without knowing a definite physical cause.

[12] The names of the Galenic temperaments show that even ancient doctors assumed a relationship between mood and body chemistry. Unlike their modern counterparts, they did not consider any one temperament to be more healthy than the others.

[13] Adler went so far as to explicitly declare that the sanguine temperament is the only healthy temperament.

[14] By 2007, Americans spent over $40 billion a year on psychotropic drugs. Counterintuitively, the incidence of diagnosed mental illness in the U.S. has only been increasing rather than decreasing, despite widespread medication. Since no one understands the cause of most mental illnesses, it is perhaps not too surprising that many drugs actually exacerbate mental illness. See: Robert Whitaker. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America (2010).

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2005, 2011 Daniel J. Castellano. All rights reserved. http://www.arcaneknowledge.org