Book Review: Psychoanalytic Culture: Psychoanalytic discourse in Western society

Psychoanalytic Culture: Psychoanalytic discourse in Western society by Ian Parker London, Sage Publications, 1998, 258pp.

These are two books that promise to become increasingly important for those involved in the therapeutic professions. Both volumes attempt to address the current thorny questions that bedevil our professions. Such questions as; What are we doing? What evidence do we have about our activities? What is the nature of our influence on individual clients? Wider society? And those within the profession?

The first of these books is fast becoming a contemporary classic. In this book, Parker and colleagues attempt to consider the nature of psychopathology. What is it? How did we come to understand such experiences in this way? What are these understandings based on? This book is particularly important for those therapists who work in, or alongside, systems which consider human experience and distress in medical terms. While we may or may not agree with Parker and colleagues, their attempts to think rigorously and critically about human experience and the "mental health" professions is important for all of us. How often are we able to hold onto our critical capacities, rather than fall into the known routines and comforting formulae that come to characterise many of our actions? This book tries both to be critical and engender critical thinking in a number of ways. It offers an overview of a number of theories that address human distress as well as particular forms of pathology". This book effectively highlights the way that western society has taken 'normal'; and 'abnormal' emotional states to be factual entities rather than the constructed understandings of human phenomena that they are. The book also offers a brief mention of a number of organisations that have attempted to conceptualise and work with such difficulties in a non-medical manner and in doing so considers the issue of access to power of those involved in the therapeutic world - both as therapists and clients. Of particular interest to members of the society might be Parker and colleagues consideration of the anti-psychiatry movement, Laing and Lacan's relationship to existentialism, and Szasz and libertarianism.

These two books are published three years apart, but illustrate a project that Parker has been involved in for a long time. Professor of Psychology at the Discourse Unit at the Bolton Institute, Parker has been an important figure in the development of qualitative research methods in psychology in Britain and in the movement he terms "critical psychology". This movement is keen to consider the nature of psychology and its use of power. Parker's style, as acknowledged by the titles of his books, is that of deconstruction. This is an approach that I continually experience with a huge ambivalence. On the one hand I am very excited by the opportunities for learning and the insights that a deconstructive approach offers us. It seems to me that only by being willing to critically consider our profession and our activities can we attempt to limit the damage that may occur in the course of Psychotherapeutic practices. On the other hand, by its very nature, deconstruction leaves me facing a huge degree of uncertainty. I entered this profession for my own reasons and with an urge to meet the call of things that I value. I have achieved a certain knowledge base, I am qualified and for all intents and purposes I 'know' what I do and what my profession is about. To be confronted with such a clear re-interpretation of my professional world as these books present is unsettling. Deconstruction highlights the constructed nature of our endeavours in a very powerful manner and the lack of solid, unquestionable reality is frighteningly clear. The text does not come up with the answers, reality, or certainty. The results are both an intellectual and an almost physical shock.

One particular debate that Parker considers is the use of deconstruction in different circumstances, i.e. Are we open both to deconstruction in therapy? and deconstruction of therapy. Again, engagement with this text offers quite an unnerving experience. I see the value of deconstruction in my clarificatory efforts in the therapeutic process and in those that an existential-phenomenological approach to therapy often advocates. Considering the relational self-construct in a way that allows the process of its development to be considered alongside the choices involved and the implications of those choices is often important. I see the value of this in my encounters with clients, and I read about it in regular contributions to this journal. It seems that through such rigorous reflection my clients and I myself have the chance to get to recognise our selves more thoroughly and a greater engagement with life's challenges is possible. Having taken a stance whereby I see this process as being so clearly of value, I am then required to consider my experience of not wanting to entertain a deconstructive interpretation of the profession - or at least my discomfort when deconstructive insights are so clearly presented. This is Parker's main achievement in the second book. In this book he uses psychoanalytic concepts to look at psychoanalysis and the psy-complex, in general. The psy-complex is a term he borrows from Foucault to indicate the knowledge sets and practices of those professions that are involved in the regulation of emotion and human experience. Parker very clearly illustrates the discursive functions of psychoanalysis, in relation to understandings of such phenomena as emotion, and sexual, gender and moral identities. He shows that, in a sense, we see what our theories require us to see. Once a thought, or theory has been recognised, no matter how radical, it becomes as much an object that can be used in the regulation of behaviour and thought because we use it as if it referred to some type of reality. Metaphor never remains metaphor for very long, it takes its place in the mystificatory activities that characterise much psychological and Psychotherapeutic practice. Identities cease being a way of describing our experience and become ratified by therapeutic theory. They become an entity, and the question ceases to be 'Which term best captures my experience?' and soon becomes 'In order to be a good enough man/woman/mother/heterosexual/lesbian/psychoanalyst, what do I need to do/feel/ think? It is Parker's argument that psychoanalysis (and psychotherapy in general) provide a vocabulary for the experience of the self that is provoked by an economic system that operates much of the time out of people's control for much of the time. Thus, the world at large is considered rather than relying on the privileging the construction of the 'internal' world.

I am aware that my excitement and enthusiasm for the book may be very clear to anyone that reads this review. I must not however, forget to mention that these are sometimes difficult books to read. I have mentioned the emotional experience I had in facing some of the challenges to my and our profession's thinking. I think this was mainly due to an engagement in a deconstructive process that doesn't reassure me with a new certainty at the end of the reading. These books are also sometimes unnecessarily difficult, due to the terminology that Parker and colleagues use. The language is quite technical and at times jargonistic. Having said this, I am struck by a parallel with the experience of psychotherapy. Clients in therapy often experience a sense of ambivalence as their rigid self-constructs begin to change. At that point it is often pointless and unhelpful for the therapist to come in with ready made interpretations for the client. I wonder whether we might remind ourselves of how clients might find us jargonistic and mysterious when we talk about such therapeutic issues/goals as 'authenticity', 'reclaiming projections', the 'identification of automatic negative thoughts' and the like.

Overall, I think that these books are well worth the effort that they require if we are serious about being ethical and reflective practitioners. Deconstructing Psychopathology should be on the reading list of every course/module that attends to human distress. Psychoanalytic culture would be useful required reading for training in any form of psychotherapy. To think that the lessons are only applicable to psychoanalysis might be a comfort, but it would be an unrealistic comfort.

Martin Milton