The Power Hour: Maybe Psychotherapy is Social Control After All

Christopher D. Green
Department of Psychology
York University

Presented in August 1995 at the annual conference of the American Psychological Association, New York, NY.


O'Hara (1994) has argued that constructivism "is seriously limited as a basis for clinical psychology" because it violates a crucial assumption of effective psychotherapy; viz., the belief "that all is not random and arbitrary, that...coherence exists and causes, meanings and remedy for suffering can be found." Without this, she argues, the "justification for the practice of clinical psychotherapy evaporates, either a means of commerce or of coercive social control." In this paper I argue that O'Hara is exactly right that under radical constructivism psychotherapy reduces to a form of social control, but that this is no reason to reject constructivism. Indeed, employing analyses of the functions of psychotherapy inspired by the work of Michel Foucault, Noam Chomsky, and Nikolas Rose, I argue that psychotherapy can be shown to be primarily a means of social control whether or not constructivism is true. Further, I argue that this need not be the source of any discomfort to psychotherapists because, under a Foucauldian analysis of power, psychotherapy serves an important social function-though perhaps not the one most psychotherapists think it serves-and that it is not at all clear that psychotherapy would have much purpose otherwise.

In the wake of what she called "the recent mano a mano" between Smith (1994) and Gergen (1994) in American Psychologist, Maureen O'Hara (1994) retorted that constructivism "is seriously limited as a basis for clinical psychology" (p. 2). Her basis for this grim assessment was, put briefly, that the radical indeterminacy implicit in constructivism leads away from, rather than toward, a crucial assumption of effective psychotherapy; viz., the belief "that all is not random and arbitrary, that although perhaps out of sight at the present, coherence exists and causes, meanings and remedy for suffering can be found" (p. 3). She went on to argue that if this does not hold, the "justification for the practice of clinical psychotherapy evaporates, except as Foucault, Laing, Szasz and others have charged, as either a means of commerce or of coercive social control" (p. 3). "Deconstructionist psychotherapy," which she seemed to equate with the constructionist perspective, "far from leading to greater levels of sanity, as promised, leads to cynicism and eventually to madness" (pp. 3-4).

Contra radical constructivism, she argued that "there is good reason to believe that there is more that holds human psyches together and communities together than good fictions" (p. 4). The "more" she had in mind were supposed universals of human psychology. Among those she mentioned were (1) universal decreases in serotonin levels in depression, whether or not depression is positively or negatively valenced in the society in question; (2) universals in color perception; (3) universals in emotions and their facial expressions; (4) universality of certain semantic binary oppositions such as good and bad, here and there, this and that, food and non-food, and stop and continue; and, more obscurely, (5) that "some of our categories of reality, which show up in our social constructions as 'symbols,' even 'concepts,' may already exist as chemical and topological information within human brain structure" (p. 5).

Ultimately she concluded that the contextualism of constructivism and the universality of "absolutism," as she called it, need not exclude each other, but can live in harmony. "Either extreme leads to emptiness and despair," she argued, but by charting a "fuzzy course," as she called it, between the two we will learn the rightness of taking "a more absolute position about some things, a more relativist position about others" (p. 6).

In this paper I will argue that O'Hara's assessment of the implications of constructionism for psychotherapy were pretty near to being absolutely right; viz., psychotherapy would be a form of commerce or social control. Where she faltered was in rejecting these implications, not on the basis of an adequate argument against their truth but, rather, on what seems to be little more than the sheer horror they evoke in the hearts of most sincere, well-meaning psychotherapists-a far from adequate basis for refuting them. Moreover, not only would psychotherapy be a form of social control if constructivism were true; it might well be such even if constructivism is not. I will argue that, perhaps unfortunately, but then again perhaps not, social control is precisely the enterprise in which psychotherapists are engaged, and moreover, that it enhances the effectiveness of psychotherapists not just deny this, but believe in their heart of hearts that it is untrue. Paradoxically, the adoption of more and more radical epistemological positions, such as constructionism, far from distancing psychotherapists from their participation in the maintenance of social control, actually makes them function more effectively than ever before. It is only by recognizing this participation, and then by either rejecting the job itself, or coming to recognize its positive, as well as its negative, implications, that psychotherapy can more beyond the cage it has been building for itself since the 1960s.

Before leaping fully into my analysis of the main problem, however, I must address some basic terminological issues. First, O'Hara uses the term "constructivism" for both radical (à la, e.g., Gergen, 1985) and moderate (à la, e.g., Harré, 1984) versions of what might be, relatively neutrally, called the "contextualist viewpoint." She distinguishes between these versions by calling them the "strong form" and the "weak form" of constructivism, respectively. I, by contrast, have become accustomed to calling the strong version constructionism, and the weak one constructivism. I will continue this practice, although I believe the distinction ultimately has less relevance to the main issues at hand than O'Hara contends.

Second, although the central concern of her paper is "constructivism," at one point O'Hara switches to criticizing what she calls "deconstructionist psychotherapy." This may just be a typographical slip, in which case my comments here may be superfluous, but it would not surprise me if it is not. It is the tragic fate of many Continental philosophical movements to have received their introductions to North American society via disciplines other than philosophy. This has led to no end of confusions and conflations. Jacques Derrida, the originator of the term "deconstruction," stands well apart from many other "postmodernists" in that he is not radically relativistic about Reason at all (see, e.g., Norris, 1987, on this point). Although he has spent his career analyzing, criticizing, and reorienting the understanding of Reason, he has been consistent in his assertion that, in the final analysis, we have no anti-Reason, hyper-Reason, ultra-Reason, or Reason that is somehow radically "other" to fall back on. We only have at our disposal the same old Reason that dates back to the Greek logos and, flawed as it may be, it is what we have to live with. This is a long walk from the radical constructionists who, to a first approximation, think we can "narrate" things pretty well any way we'd like in order to achieve whatever ends we have in mind. Thus, a casual shift from constructionism to deconstruction is, at minimum, a very dangerous one.

Finally, there's the issue of lumping Thomas Szasz, R. D. Laing, and Michel Foucault together in the same boat, as those who would say of psychotherapy that it is "either a means of commerce or of social control." Although each might say something loosely like this, they would say so for quite different reasons. Szasz, the Hungarian-American libertarian, has far less in common with Laing, the British Marxist and self-styled phenomenologist, than critics of the "anti-psychiatry movement" were wont to believe. Foucault, on the other hand, came to be highly critical of both Marxism and phenomenology (see e.g., 1966/1970). As one of Foucault's major biographers put it, although Madness and civilization (1961/1965) was appropriated by R. D. Laing, David Cooper, and others anti-psychiatrists, "they turned a different light on it, giving it an entirely different interpretation from earlier readings, as well as from Foucault's original conception" (Eribon, 1989/1991, p. 123; see also Castel, 1986, 1991). In short, Foucault was never a part of the anti-psychiatry movement proper and was never putting forward a program like that attributed to him by his early British advocates (and their American followers). With respect to Szasz's program to liberate the mad from hospitals, Foucault was deeply suspicious of all so-called liberation movements (see, e.g., 1976/1978)-even those that might have helped his own situation, such as the gay liberation movement (see Macey, 1993, p. 319).

Finally we get to the main point of this paper. Is the abandonment of constructionism warranted by the arguments put forward by O'Hara, and, perhaps more important, does anything significant with respect to psychotherapy's moral or political integrity turn on whether it is abandoned or not? I will argue that the answer is "no" to both these questions.

O'Hara cites five pieces of evidence against constructionism. I cited these briefly in the introduction. They are (1) the alleged universality of low serotonin levels in the brain being correlated with depression, even though depression is regarded as an sign of "illness" in the West, but a sign of "superior mind" in Buddhist cultures; (2) alleged universals in color perception (presumably following from the work of Berlin & Kay(1969) and Rosch (1973), though O'Hara cites Lakoff's (1987) secondary description of it); (3) alleged universals in emotion and the facial expressions associated with emotions; (4) the alleged universality of some fundamental binary oppositions such as good and bad; and (5) the allegation that some symbols and concepts that may exist in the innate structure of the brain prior to any experience. I have little doubt that serious counter-arguments can be mounted with respect to each of these examples by the committed constructionist, but to pursue the contrary evidence here would be to get sucked into an argument that is ultimately beside the point. My main aim here is not to argue for constructionism. As social theorist Nikolas Rose (1992, p. 364) has put it, "we would be best to be agnostic about such claims, at least insofar as they are linked to a project of developing an 'alternative' psychology."

What is crucial, however, is the form of argument O'Hara uses to infer the denial of the proposition that psychotherapy is a form of social control from the supposed failure of constructionism. The argument goes like this:

P1) If constructionism is true, then psychotherapy is social control.

P2) Constructionism is false.

C) Therefore, psychotherapy is not social control.

In the logic "biz" we call this the fallacy of denying the antecedent. Psychotherapy may be a form of social control regardless of the truth of constructionism, just as the consequent of any true conditional ("if...then...") proposition may be true even if its antecedent is false. The argument form O'Hara really wants but, alas, cannot have is modus tolens:

P1) If constructionism is true then psychotherapy is social control.

P2) Psychotherapy is not social control

C) Therefore, constructionism is false

The reason she can't have this argument is that she makes no case for premise 2, viz., that psychotherapy is not, in fact, social control. In the final analysis, however, it seems pretty clear that her whole argument against constructionism turns on the truth of this premise, for the real reason constructionism just must be wrong, all claims about psychological universals notwithstanding, is that she-and most other psychotherapists, I suspect-believe it simply couldn't be the case, on pain of something very much like the hypocrisy of the whole institution of psychotherapy, that psychotherapy is primarily a means of social control. This argument obviously won't do, for it is hardly beyond the bounds of logical possibility that the institution of psychotherapy is hypocritical.

It is, thus, time to look more closely at the claim that psychotherapy is a form of social control, and find out just what other implications this possibility, in turn, holds. What I hope to show is that it is, indeed, true that psychotherapy is a form of social control, but that the implications of this are not as horrifying as psychotherapists may at first believe them to be.

The phrase "social control" rings in the ears of Euro-Americans, so proud of their hard-fought-for liberty, of the state communism of the late USSR, China, and other totalitarian regimes. But all societies require social control. This is part of what makes them societies rather than simply contingent aggregates of humans. Societies are, at least in part, defined by their forms of social control, and what they control for. The USSR practiced, and China still practices, rather crude and, in the final analysis, not very effective, forms of social control. As Michel Foucault argued in his treatise on the history of the penal system, Discipline and punish (1975/1977), brutally and spectacularly violent displays of state power are not, in the end, the most effective ways of keeping order. They are, for one, prone to unleash forces that operate on principles too much like precisely those meant to keep them in check. The French Revolution is probably the best-known example of this principle. The Terror unleashed horrors unimagined by even the Ancien Régime that it overthrew. The goal of Foucault's book was to show that surveillance and correction are, in the final analysis, much more effective ways of exerting control than all the floggings, hangings, burnings, and quarterings that either the Ancien Régime or the Committee for Public Safety could muster.

A better method of control still is persuasion. Of course, persuasion can take many forms. It can take the crude form of simply repeating the same message over and over again until the apparent consensus is so great that no other thought seems rationally possible. This is what we get from mass advertising, for the most part. It can also, more gently and probably more effectively, take the form of apprently carefully worked out arguments and evidence which the target, who hasn't thought things out in such apparent detail, is ultimately helpless to respond to effectively. This is the form of control practiced, by and large, in the educational and political systems. One of its major advantages is that the target often comes to internalize not only the message, but also the means for persuading others of its truth.

Finally, probably the most effective form of persuasion yet devised is that where the target is encouraged to develop arguments and evidence for a given conclusion him- or herself, being gently guided along the way by having seemingly important implications of the latest tentative conclusion that he or she might have "missed" pointed out, or even by simply saying, "mmm-hmm" when a voiced line of thought seems to be leading in a "fruitful" (notice how loaded that term is) direction, and not when it's not. This, I submit, is the form of control implicit in most forms of talk-based psychotherapy. It is by no means limited to psychotherapists, however, nor is it very recent in its origin. It was articulated at least as far back as the mid-18th century by leading reformers of the penal system:

A stupid despot may constrain his slaves with iron chains; but a true politician binds them even more strongly by the chain of their own ideas [italics added]; it is at the stable point of reason that he secures the end of the chain; this link is all the stronger in that we do not know of what it is made and we believe it to be our own work; despair and time eat away the bonds of iron and steel, but they are powerless against the habitual union of ideas, they can only tighten it still more; and on the soft fibers of the brain is founded the unshakable base of the soundest of Empires. (Servan, 1767, cited in Foucault, 1975/1977, p. 102)

With these words in mind, consider the following "toy" therapeutic exchange.

Client: I'm feeling depressed.
Therapist: What about?
C: I'm not sure.
T: How are things at home?
C: They're going fine...fine.
T: Mmm-hmm...[i.e., This might be fruitful. Go on.]
C: My wife and I are actually getting along better than I think we have since we were married.
T: Hmmm. [Perhaps not so fruitful] And how about at work?
C: Okay, I guess. My boss's a jerk, but I know how to work around him.
T: A jerk? [i.e., Now we're really on to something! Go on!].
C: Well, he treats me like I'm an idiot, and sometimes blames me for his mistakes.
T: Have you looked for other jobs?
C: I've thought about quitting, but I haven't looked for any other jobs yet.
T: What do you think would happen if you quit without having another job first? [i.e., Convince yourself that this is probably not a live option.]
C: Well, I wouldn't be able to support my wife and myself. Things would be hard.
T: Mmm-hmm... [i.e., go on...]
C: I suppose it would be kind of like shooting myself in the foot.
T: Mmm-hmm. [i.e., Whew, we got past that potential crisis easily.]

Notice how the mock therapist guides the mock client around the idea of quitting his job by making the client make salient to himself the implications that reside therein. Very subtle cues are at work; cues so subtle that even the person deploying them probably isn't entirely aware of them. This is social control at its most refined. Instead of saying, "Look fella, don't be a nitwit. If you quit your job you're going to turn yourself into a social outcast, and probably loose your wife and friends in the process," the therapist encourages the client to make the argument to himself. This might seem Machiavellian, but consider that the therapist who let the client quit his job, lose his wife and friends, and slip into destitution would not be doing him much of a favor, barring extraordinary extenuating circumstances. Reasonable as this might be, however, the therapist is simultaneously implicitly reinforcing the socio-economic status quo. As Nikolas Rose (1992, p. 356) has put it, "psychology enters into alliance with such agents of social authority [as] .... doctors, social workers, managers, nurses, even accountants." In therapy, there is rarely any question of calling the socio-economic status quo into question, and if it were called into question, it would likely only be done in order to let the client convince himself that such a revolutionary idea is beyond the client's current ability to execute (e.g., "Be realistic.").

At the risk of a short digression, the reaction of some practicing constructionist-oriented therapists to this mock dialogue has been quite illuminating. Some therapists have told me that it does not correspond with their "experience" while others have told me that it "feels" quite natural. It is interesting to note that both claims-pro and con-are surprisingly strongly grounded in conventional empiricist assumptions; i.e., individual experience is the foundation upon which one makes claims about the world-even the world of psychotherapy. There is often a confusion among defenders of constructionism to the effect that it somehow endorses individual experience above all other forms of epistemic material. Nothing could be further from the truth, however. Traditional Continental philosophers who are the forebears of psychological constructionism were very wary of appeals to experience. Foucault, for instance, argued that "experience" is just as constructed as any other potential epistemic source (thus his wariness, mentioned in the introduction, of phenomenology and the Laing-led anti-psychiatry movement). In short, it is not open to the antifoundationalist-a fortiori to the constructionist-to advert to experience to decide matters of epistemic dispute.

To return to the main argument, it is important to understand that I am not implying that psychotherapy is the product of some widespread nefarious conspiracy to maintain the status quo. Psychotherapists are not explicitly told from "On High" what values to imbue in their clients, and most, I'm sure, even make an honest effort not to push their own personal values on their clients. In fact, the position of the psychotherapist, I would argue, is in some ways very much like that Noam Chomsky (1991; Herman & Chomsky, 1988) assigns to the journalist. Chomsky is often accused of proffering a conspiracy theory about the media's efforts to hush up bad American political and military behavior abroad. But that's not the point of Chomsky's theory at all. It's that those people who get to be journalists, and those especially who get promoted to the higher ranks of the journalistic establishment, have acquired "a nose" for what's likely to be salable news. They have a strong intuitive sense for the socio-politico-economic system in which they work. The absence of news about, say, East Timor, one of Chomsky's favorite examples, reflects the received truths about what people are likely to want to see on the news. Those popular wants, in turn, are to a great extend mediated by what people see and hear about themselves, not just on news programs, but on sit-coms, in movies, at sporting events, on commercial advertisements, and the like.

In order for the news system to work, however, journalists must claim to be, and be seen to be, "objective" in their decisions concerning which news to print or broadcast, and how it is to be written up. In part, the best way to appear objective is just to believe that one is objective. In fact, it's better still to go a little overboard. This, according to Chomsky, is the basis of the myth of "leftist bias" American journalism. There is little evidence that the press is leftist, even by conservative American standards. It serves both the purposes of the press and the government, however, for it to be widely believed that they are. The government can then dismiss criticism as being "out of the mainstream," or somesuch, and the press ensures its credentials of independence from government by being believed to be "a little radical" (while simultaneously gathering something like 90% of its source material directly from government briefings rather than from actually independent investigation).

Psychotherapists, I argue, operate somewhat similarly. They do not see themselves as being involved in a pervasive and continuous program of social control. They are mainly trying to get on with the business of helping people who are feeling and acting "badly" (in all its ambiguity) to feel and act "better" (ditto). The relief of suffering is precisely what psychotherapists aim to do, but this by no means excludes their simultaneous participation in social control. In fact, it often entails encouraging people-often implicitly, as in the "toy" dialogue above-to remain within, or to return to, the confines of what is considered to be a "normal" life (just consider, for instance, Durkheim's theory of the relationship between anomie and suicide). But "normalization" is nothing less than the hallmark of programs of social control.

What is more, psychotherapists' often noisy rejection of "received" philosophical stances like realism and objectivism in favor of "radical" ones like constructionism actually enhance their ability to operate effectively as agents of social control by acting to signal others that they have not been co-opted by "the system"-that they are free and independent agents who will deal with each person's problems on its own merits, without undue deference to might be perceived to be "stuffy" societal demands.

Psychotherapists are likely probably not going to like the insinuation that they are significantly, if not primarily, agents of social control. But this is exactly how they must feel if they are to operate effectively. If you put on your shingle "Dr. John Quack, Agent of Social Control," your caseload will be relatively light. Nor are many people willing to put up signs that say "Psychotherapist," but then consciously operate as covert Agents of Social Control, at least not in the way that term is conventionally thought of in the "Liberal West." The institution of psychotherapy works as it does only because people believe they are coming to solve personal problems with an independent and neutral expert on personal problems. As with the journalist, one of the best ways to behave like an independent and neutral expert on personal problems-whether one truly is or not (whatever that might mean)-is to studiously persuade yourself that you are one, and help persuade other psychotherapists that they are too. We call this process "education." Further, as mentioned above, the public adoption and open advocacy of radical points of view, such as constructionism, only go to serve as more evidence that one is not an agent of conventional society, for the client, the therapist him- or herself, and other therapists as well.

Another way of putting the issue of whether psychotherapy is a form of social control is to ask whether psychotherapists are exercising power over their clients. Traditionally in the "Liberal West," power has been regarded as an evil destructive force, used against the forces of so-called enlightenment, liberation, and the like. Michel Foucault put the lie to this, noting that the deployment of power in the name of liberation is no less a use of power than is its deployment against liberation movements. In other words, power is not, as in the traditional view, top down, used only by the illegitimate sovereign to oppress those below. Foucault argues, by contrast, that power is both a constructive and a destructive force. Without power, he says, there could be no society at all. There would be only people, unrelated to each other and with none of the mutual interdependencies that make a group a society. For Foucault, power forms a network of relations that travel "downwards," "upwards," and "sideways" throughout society (see, e.g., 1976/1978, pp. 93-94). The psychotherapist is but one node in the network of power relations. Lest psychotherapists feel queasy about this role, be reminded that the client is one as well. They can always leave and go to someone else, or no one else, and they regularly do.

Let us examine the Foucauldian view of power a little more deeply. Foucault argued that, in modern society, power is not typically something "held" by one person or group of people and "wielded" over some other person or group of people. This common view of power is a carryover from the era of kings, the maintenance of which regularly confuses us as to the details of the situations in which we finds ourselves. In the modern world, Foucault argued, power is a system of relations implicit in the complex socio-politico-economic systems we have set up since the great revolutions of the 18th and 19th centuries. Sometimes these relations are built into the very architecture of the buildings that house our institutions (e.g., boys' and girls' doors in schools, office supervisors with higher desks than workers to better observe them working). Often they are more subtle and electronically mediated (e.g., surveillance cameras, debit cards). These systems of relations are typically maintained by way of constant observation and regular correction of any detected discrepancies, no matter how minor, from prescribed techniques of behavior. Foucault called this kind of power system "discipline."

One of the great differences between the old monarchical system of power and the contemporary disciplinary one is that being powerful is more a matter of occupying a particular place (often literally a spatial position) in the system of relations than of being an individual bearing particular personal qualities of greatness or somesuch. When a king dies, the new king must rapidly, and often desperately, reconfigure the power relations that held sway before his ascension to suit his needs-i.e., he must consolidate his power. By contrast, when a new, say, prison warden replaces an old one, his power is given to him by the physical layout of the prison and the strict itinerary all prisoners (and guards) are required to follow. Within a wide range, almost anyone could exercise the same authority. It is the role, more than the individual who happens to be holding it, that matters most (Foucualt, 1975/1977).

Another main difference between the monarchical system and the disciplinary one, according to Foucault, is that the latter, though less obviously brutal, is far more pervasive and intrusive. To be more precise, it is able to be less obviously brutal just because it is far more pervasive and intrusive. Whereas it was all the monarchical system could muster to restrict people from committing a few forbidden acts-don't steal, don't kill, don't say nasty things about the king or his family-the disciplinary system has something to say about nearly every aspect of everyone's life-how and when to wake up, how and what to eat, how and when to go to work, how to do your work and for how long, how and when to go home, how and what to eat (again), how to spend one's evening, how and when to have sex and with whom, and how and when to sleep. Effectiveness and efficiency are the watchwords of disciplinary regimes. This is why Foucault says that while the monarchical system of power was merely restrictive, the disciplinary system is productive-productive of goods and services, productive of culture and society, productive of kinds of individuals, and productive of knowledge itself. Whole new realms of knowledge come into being under disciplinary systems-What do people eat? What should they eat (e.g., to make them better, stronger, longer-lived workers, lovers, parents, etc.)? How should they work? Drive? Exercise? Breathe? These are question that very nearly couldn't be asked under the old monarchical system. The power to get answers to the inquiries was simply not available. The culture of continuous questioning, polling, compiling, computing that prevails today was not then in place. The questions would have been largely idle and the answers, even if some had been formulated, would not have been widely disseminable without tremendous effort.

Psychotherapists and other "applied" psychologists, I am here arguing, are participants in a disciplinary system of power. Where once we were concerned to give "therapy" only to those whose behavior transgressed very basic principles of civilized interaction, we have become increasingly concerned to give "therapy" to those whose behavior transgresses the smallest minutiae of the disciplinary system in which they happen to be ensnared. There are detailed prescriptions for how one should act, think, and feel. One can hardly be slow, or tired, or sick, or grieve the loss of a loved one, or even die without some sort of psychotherapy being recommended by someone. The aim of such "micro-therapy" is pretty clearly "renormalization" of one sort or another-a rapid restoration of effectiveness, efficiency, and so forth. Consider, just for instance, the regular but, to my mind, quite extraordinary headlines of the APA Monitor that teams of psychologists have been dispatched to the sites of wars, famines, and natural disasters; places where the main problems at hand are apparently far from the psychological domain, and where whatever psychological problems might be at play are likely to work themselves out once the main problems are resolved. These poor people, it would seem, must be renormalized as fast as possible, often before the apprehended disaster in which they are caught has played itself out.

What is more, the existence of an actual difficulty doesn't even seem to be necessary anymore for the deployment of psychological disciplinary power. The mere anticipation of possible future difficulties is now sufficient. What I have in mind here is the "proactive therapy" that usually goes by the name of "training." Potential office supervisors are trained in methods of handling personal stress, handling office conflict, firing employees, and the like. In schools, after the unexpected death of a student, teams of psychologists are dispatched to interrogate hundreds of children as to the level of their (assumed) trauma, and measures intended to return the situation to "normalcy" as soon as possible are immediately deployed. Meanwhile, data is meticulously collected so that more efficient, effective measures may be deployed in future similar cases. Potential parents are now virtually required to take training in parental techniques, long before any difficulties have arisen; indeed before there is even yet a child. Even before marriage, couples are often required to take a "course" in married life. This is discipline with a vengeance.

Nor am I, by any means, the first to identify this development in our society. Nikolas Rose (1992), for one, has made a similar point, though in a somewhat different context. He first notes that "many different authorities-theological, medical, political, military-in different historical periods.... have defined many systems for conducting the minutiae of existence-eating, copulating, defecating, sleeping, waking, observances of faith..." (p. 363). He goes on to argue, however, that in "advanced liberal societies," such as ours, these systems of conduct have taken on a distinctly "psychological coloration" (p. 363). As he puts it,

Each [personal] encounter has been reconfigured in terms of personal feelings, desires, personalities, strivings, and fears. Psychological techniques have come to infuse, dominate, or displace theological, moral, bodily, dietary, and other regimens for bringing the self to virtue or happiness, and also those deployed for reconciling the self to tragedy or disappointment. (Rose, 1992, p. 363)

The reader may think I have painted a pretty bleak picture. Notice, however, that I have refrained from declaring that this is all somehow "bad" or "evil"; that it is to be restricted or abolished. It may be more valuable to regard these observations as simple historical facts about how our society operates; contingent, perhaps, but not easily changeable for all that (at least not for something better). Supervisors do, perhaps, now handle stress and office conflict better. Traumatized children, perhaps, get needed attention they might not otherwise get. Parents, perhaps, now expect certain things from their children they might not otherwise have expected; things that might have angered them and led to violence. Perhaps even marriages are happier, if not than they once were, then at least than they would have been otherwise under present conditions. Perhaps, in our overcrowded, overworked world, enforced normalcy is better than the alternatives. Perhaps.

It is discipline nonetheless. And discipline is about social control. And psychotherapists are among the main agents of such discipline. Therefore, by a straightforward application of the rule of hypothetical syllogism, psychotherapists are agents of social control. And this is true whether or not-to return to the claim of O'Hara's with which this paper began-they believe in constructionism, or indeed whether or not constructionism is true.

To summarize, then, O'Hara argued that constructionism leads to the view that psychotherapy is just social control, and that, it being too horrible to bear that thought, constructionism must therefore be false. In response, I have argued that constructionism may or may not be true, but that in any case the possibility that constructionism is false is no reason to decide one way or the other about whether psychotherapy is a form of social control. Its being too horrible a thought to bear notwithstanding, it seems simply to be the truth of the situation. In fact, psychotherapy is a highly sophisticated form of social control. The horror evoked by the possibility that it is a form of social control, however, is born in part of an old and inadequate view of the role power plays in modern society. Correction of that view makes the idea that psychotherapy is a form of social control, perhaps, a not altogether bad thing. As Foucault (1983, p. 231-232) himself put it, it is not "that everything is not bad, but that everything is dangerous, which is not exactly the same as bad. If everything is dangerous, then we always have something to do. [This] leads not to apathy but to a hyper- and pessimistic activism."


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Author Note

Correspondence concerning this paper should addressed to the author at the Department of Psychology, York University, North York, Ontario, M3J 1P3, CANADA, or via e-mail at A much-reduced version of this paper was presented at the 1995 APA Convention in New York City. I would like to thank Rachael Rosner and David Rennie, both of the York University Department of Psychology, and John Vervaeke, of the University of Toronto Department of Philosophy, for their comments on earlier drafts of this paper.