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Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex 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and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of 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Professor Throop begins this work by telling the reader a little about her state of mind while writing it: "This book is born of outrage." The object of her outrage is American culture because, as she tells us, "For decades now I have observed American culture and I remain perplexed at the inability of Americans to understand their behavior as learned, as harmful, and as supremely selfish" (vii). Throop makes a strong case that American culture has become deeply dysfunctional. The culture is insular, violent, poorly educated, and callous with regard to its neighbors, with "astonishingly high rates of poverty, child murder, and infant mortality." Throop tells us that she has been increasingly disturbed by this state of affairs and has become "more and more ashamed of [her] country" (vii). She wrote the book as a cultural intervention and confrontation with hopes that it would shock and provoke the reader to think seriously about the state of America.
Throop's background comes from an interdisciplinary mix that includes social work, family therapy, and psychological anthropology. Combining these perspectives, she argues that much of the problems with American culture can be traced to the way it fosters "immoral individualism" in its people and its social policies. The term immoral individualism is in the subtitle of the book and is a major organizing concept for the work. Throop sees American people as "individualist" because of "the dominant American cultural elevation of the individual self as the sole locus of motivation, perception, thought, emotion and behavior" (1). She sees this individualism as immoral because it keeps the American people from developing a social conscious. Immoral individualism creates a culture where a social problem, such as poverty, is seen as an "individual failing and not a systemic one." This means that "responsibility for poverty is moved from you, and you, and you, and me, and it is placed squarely on the lonely shoulders of the poor" (52).
Throop locates the cause of immoral individualism in American culture's unquestioned acceptance of the language of psychotherapy. This psychotherapeutic language has effectively replaced and erased other languages of personal and social relations—such as moral, existential, or political—with a language of inner emotions, cognitions, and childhood experiences. Throop does not cite Christopher Lasch, but her argument works along similar lines. Lasch was also concerned that we have created a culture of immature, narcissistic, individuals. These "minimal selves" feel responsibility only for themselves and have lost a sense of history, continuity, feeling of belonging, and morality (Lasch 1980, 1984). As Throop puts it, "We have become a society of overly sensitive whiners who believe that happiness is not only attainable but a human right" (27).
Throop works out the repercussions of the psychotherapy language as she sees them in separate chapters devoted to poverty, parenting, education, adolescence, child welfare, racism and mental illness. Throughout she argues that the psychotherapy metaphor has hurt our culture and harmed this country. To correct the damage, the first step is to "recognize the moral vacuity of the psychotherapy metaphor" (169). The second step is to move beyond this metaphor to other ways of understanding human relations. "We need to affirm the connections we have with each other, both within our society and outside of it. We need to understand that we as individuals are not the center of the universe; we need to understand that we as a country have no right to impose our peculiar sets of understandings on other societies; we need to understand that we live in a global economy and a global ecology. We have responsibilities toward each other... and it is time we began living up to them" (169).
Perhaps the most obvious way to respond to Throop's book would be at the "rational" level. This would mean asking questions like, "Is America really so dysfunctional? And, if it is, can we really put the blame primarily on the psychotherapy metaphor?" To me, however, this kind of analysis largely misses the point. Throop tells us at the beginning the book is "a polemic." And she tells us at the beginning that she is writing it in outrage. Her outrage is in many ways the most important part of a book. Throop wants us to know that from her perspective this culture has become deeply problematic. Assuming that Throop is an intelligent and caring witness to the culture that she lives in, then this reaction alone is important. I would argue it is more important than whether the critique fully defensible at the rational level. Rather than critique Throop's critique, it seems wiser to sit with her concerns. Throop is a canary in the coal mine, telling the larger culture that it needs to go back to the drawing board and change many of the fundamentals.
She is not alone in this insight. Large parts of the country seem to more or less agree with her. Barack Obama also told the culture that it needs to change (at about the same time Throop was writing), and he won the election against all racial odds. Six months in to Obama's administration it seems clear however that presidential politics can only scratch the surface of cultural change. Deeper change will involve extensive grassroots efforts that respond with heart and passion to America's problems. These efforts will involve dedicated and concerned individuals who try to understand the country's problems are who unafraid to make strong arguments and provoke confrontation. If "dedicated and concerned individuals" are the opposite of "immoral individuals" then it seems easy to agree that now is a time to grow more of the former and less of the latter.
Will a polemic against the psychotherapy metaphor get us all the way there? I don't really think so, but, taking seriously the contributions of psychotherapy to the country's social problems is certainly part of the picture.
© 2009 Bradley Lewis
Bradley Lewis, Ph.D., Gallatin School, NYU