James L. Chriss, editor.
Counseling and the Therapeutic State.
New York: Aldine de Gruyter, 1999, 207 pp. $US 49.95 cloth (0-202-30623-2) $US 24.95 paper (0-202-30624-0).
James Chriss opens his introduction to this collection with a series of provocative questions: Why are the assumptions of the utility and even appropriateness of the therapeutic model so pervasive and such a part of peoples taken-for-granted, everyday reality? Why are so many institutional concerns
control over the lives of people to these so-called certified or licensed experts? Why are so many people running around calling themselves therapists? While Chriss promises that his book will seek answers, most of the essays collected here address a rather different and more diverse array of questions. These hinge to some extent on an ambiguity in the word therapeutic as invoked in contemporary social analysis. On the one hand there is a body of critical writing on the therapeutic state, which turns out to be mainly about the welfare state with its various powers, prerogatives and ideological assumptions. On the other hand there is therapeutic in its more familiar sense, as a tag for a certain class of experts and the procedures they use to address our everyday ills. The collection falls into two parts, more or less in keeping with this distinction.
The first part, which appears under the heading, Conceptualizing the State, consists of four essays. The first two are indeed very much about the state and hardly at all about therapy. In Children and the Civic State: A Covenant Model of Welfare, John ONeill takes a hard look at the contractual model that underlies liberal theories of state, proposing in its place a social covenant that takes into account the role of families and communities in any viable society. Based in part on his 1994 book, The Missing Child in Liberal Theory, the essay rejects the tired antinomies of statism versus privatism and argues instead for what ONeill calls the priority of civic capital formation in the provision of a democratic society. Roger Sibeons Power and Social Action Beyond the State is pitched at an equally theoretical level, but its aim is to warn against the dangers of reification and reduction implicit in seeing the state, therapeutic or otherwise, as an agent with its own aims, motives or interests. Sibeon calls instead for a synthetic conception of public policy and welfare practice rooted in domains of governance that operate, as he puts it, beyond the state. The two other essays in this section do attend to therapy, though chiefly in its guise as an instrument of social control. James Tucker, drawing on the theories of Donald Black, argues that social control is likely to take therapeutic forms when controller and controllee are social equals. As the social gulf widens, control assumes increasingly coercive forms. Since states operate at a substantial distance from their subjects, he concludes, the notion of a therapeutic state is at the very least inappropriate and at most a contradiction in terms. The final essay in this group, by Phillip Manning, offers a thoughtful review of Erving Goffmans writings on total institutions. Since it deals not at all with the state and only slightly with therapy, however, the essay does seem a little out of place.
The essays in the second part, Counseling and Therapy in Institutional Settings, are equally diverse. In Acquiescence or Consensus? Consenting to Therapeutic Pedagogy, James Nolan examines the ways in which the whole culture of therapy has penetrated the American educational system, not just in the practice of school counselors, but in the very content and style of classroom instruction. After briefly reviewing the extensive powers and duties mandated to school counselors in state education acts, he details the growing influence of self-esteem and emotional sharing as tacit themes in American school curricula. Far from seeing this trend as something imposed on an unwilling public, however, Nolan sees it as reflecting a widespread cultural consensus. Richard Neustaders essay, The Emergence of Recovered Memory as a Social Problem also deals with consensus, though from a different direction. He looks at the striking process by which a relatively small group of claims-makers succeeded in turning both the media and public opinion against the recovered memory movement. The next two essays both advance proposals for new approaches to therapy informed by sociological insights. John Kovach argues for a truly revolutionary psychotherapy which would enable clients to recognize the necessity of organizing with others to defeat the forces of oppression. Writing in a more modest vein, Sidney Caroll Thomas urges that counselors have much to learn from critical social interactionism with its emphasis on social context and its message that the social order of everyday life is produced by people and thus open to change.
As for those provocative questions mentioned above, the only contributor who tackles them directly is Chriss himself. As the questions imply, Chriss is dismayed at what he calls the rise of the therapeutocracy, and he spends much of his Introduction trying to explain how this happened. He puts a good dose of the blame on that mother of all sociological trends, the transition from mechanical to organic solidarity. Indeed, he shows more than a touch of nostalgia for those earlier times when individuals were assured a supportive institutional fabric made up of families, schools, churches and various voluntary associations. As these faded away, he says, people found themselves increasingly at a loss for cues or guides to living, thus setting the stage for the encroachment of experts into virtually all walks of life. Chriss also points an accusing finger at the unflagging entrepreneurial efforts of the experts themselves, whose ranks and specialties continue to multiply. This leads him to a proposal: third-party billing for therapy in the U.S. should be restricted to M.D. psychiatrists, Ph.D. psychologists and pastoral counselors. There is simply no need, he says, for persons in other fields to provide therapeutic interventions
and certainly not to receive third-party reimbursement.
In all, this is an interesting if uneven book. While the essays here all bear in some way on either therapy or the welfare state (or occasionally both), it would be exaggerating to say that they have a common focus. In this sense the whole collection is rather less than the sum of its parts. Depending on the readers interest, however, one or another of these parts may well repay serious attention.