The Institute jumped into the free webinar field at the beginning of this year.

It’s much simpler than I would have thought! We give people access to an audio or video. After listening/viewing, they can join an hour-long live chat, email questions and comments, or do nothing. I’ve led the online chat twice (with other Institute faculty doing the others) and I really enjoy how much we get to know each other through the improvisational conversation we create out of questions and comments.

The May webinar is on social therapy. The material is an audio interview a Brazilian psychologist conducted with me two years ago when I was in Brazil. (It’s in English.) I trace  some of the history of social therapy. I introduce my work as a post-doctoral student in Michael Cole’s laboratory at Rockefeller University in the late 1970s and my meeting Fred Newman and founding the East Side Institute. The interview presents some of the highlights of the next 40 years of engagement and conversations with radical and critical psychologists, social constructionists, humanists, Vygotskians, Marxists, activity theorists, and the narrative therapy movement. People who’ve listened to it really like it! (I’ll be listening to it before the chat!)

If you’re interested, the interview is available at http://eastsideinstitute.org/audio_files/LHolzman%20Ricardo%20Lana.WAV at your convenience.  I’ll be leading the instant chat on Friday, May 18, 12:00 PM EST. Contact Mary Fridley at mfridley@eastsideinstitute.org for webinar registration.

If you can’t make it, you can share questions and comments at webinar@eastsideinstitute.org.

There’s an extensive and excellent discussion of the DSM-5 controversy on Therapy Today.net , an online publication of the British Association for Counselling and Psychotherapy. The article—“Diagnostic Disarray” by Catherine Jackson, Therapy Today’s Deputy Editor, which appeared in April—is unique compared to the dozens of news items, essays and critiques of the DSM-5 and diagnosis appearing this last six months or so, in several ways:

• It’s comprehensive, laying out the politics (discrimination of particular groups and behaviors, the narrowing of mental life to the biological); economics (profits to drug companies, the APA and professionals); science and ethics (lack of evidence for diagnoses, and the limits on what choices we have of how to understand emotional distress and get and give help) of the DSM and its critics
• Jackson includes the opinions of the clients/consumers/patients on what diagnosis means to them
• We get a view from outside the US and how diagnosis looks in the UK and other countries where the DSM is not (yet) required by everyone who does therapy or counseling
• The article hints at the broader than psychiatry-psychology-psychotherapy problem with the diagnostic way of life as an increasingly intrusive and controlling aspect of our overall culture

One person Jackson quotes is Peter Kinderman, Professor of Clinical Psychology at the University of Liverpool and spokesman for the British Psychological Society on the DSM debate. Jackson writes that, according to Kinderman,

DSM-5 is making a bad system worse. ‘It’s trying to pathologise a vast swathe of human nature and social problems as symptoms of mental illness. It makes people look for biomedical solutions to social problems, and it allows people to prescribe medical solutions to social problems. We should be identifying people’s problems, formulating an intelligent hypothesis about why they have them, and then doing something about them. That is different from diagnosis….Where medication is helpful, it should be identified as such. But attaching the label “major depressive disorder” to someone doesn’t tell us if the drug is going to help the person or not, and the vast majority of people with a mental health problem would benefit more from therapy than from drugs. The label carries stigma; it means they haven’t got problems that are part of normal life.’

Another British voice in “Diagnostic Disarray” is Pete Sanders, retired counsellor and trainer, a trustee of Soteria Network and founder of PCCS Books. He told Jackson,

‘There is an ideological battle going on. We are seeing an alarming medicalisation of everyday life. You can’t be sad any more; you have to be depressed. You can’t be shy any more; you have to have social anxiety disorder’.

He also told Jackson that the whole mental health care system has to change. This change, he believes, will inevitably come from the bottom up, and he advises therapists to seek out their nearest mental health user or survivor group – for example, the Hearing Voices Network or Mad Pride – and support them.’

I agree with the bottom up approach, but it should be much more inclusive than Sanders’ vision. Most people who seek psychotherapy or counseling aren’t part of organized mental health user or survivor groups. And it’s my experience as a community organizer that they don’t need to be. But they do need to learn what’s going on here and be given the opportunity to organize with others, including their therapists and counselors, as a force for change.

Please write me if you know of organizing of this sort going on. I’ll be part of one event on June 8 when I join Gil Eyal, Columbia University sociology professor and co-author of The Autism Matrix: The Social Origins of the Autism Epidemic, and Christine LaCerva, director of the Social Therapy Group and the Institute’s director of clinical training, for a public conversation.

Click here to read the complete article, “Diagnostic Disarray.”

A big thank you to Dr. Eric Maisel for having me as a guest blogger at his Rethinking Psychology column at Psychology Today. Check out the 3/16/12 post, asking “What if client and mental health provider co-created a diagnosis?”And become a regular reader of Rethinking Psychology.

I don’t usually promote activities here but now is an exception. Recent posts on the DSM-5 and all that it reveals about the ways our culture relates to human emotionality have drawn new readers (much thanks to everyone who’s reposting!). I’ve been introduced to many others who are writing, blogging, and generally working hard to expand the dialogue and to share “best non-diagnostic practices.”

Which is why I decided to share one of the programs of my Institute—Social Therapy as Clinical Practice. They’re training weekends being held in March, May and November, 2012 in New York City. They’re open to social workers, counselors, psychologists, medical professionals, and educators who favor non-diagnostic, relational approaches to mental health.

Interested?

Social Therapy as Clinical Practice

Social therapy is the group-oriented, development-focused psychotherapy that relates to people of all ages as performers and creators of their lives. Its unique approach to emotionality as social activity places it at the cutting edge of postmodern therapeutic approaches.

Intensive training weekends are an effective way to learn this powerful approach to group therapy. Each four-day training will focus on a specific aspect of social therapeutic method introduced experientially through diverse learning activities: social therapeutic role-plays, observations of therapy groups, reflection sessions with social therapists, group supervisions, and seminars linking theory and practice.

2012 Schedule

Thursday-Sunday, March 8-11

Thursday-Sunday, May 17-20

Thursday-Sunday, November 29-December 2

Fee

$475.00 per training weekend. 20% discount on two or more.

To learn more about social therapy and/or download an application, go to http://www.eastsideinstitute.org/ClinicalTraining.html or contact Christine LaCerva at clacerva@socialtherapygroup.com.

Want to read something first?

Psychological Investigations: A Clinician’s Guide to Social Therapy Edited by Lois Holzman and Rafael Mendez  Psychological Investigations explores the nature of the social therapeutic group process, the social therapeutic relationship, and applications to health care, alternative medicine, education and youth development. The book features over 70 dialogues between Fred Newman, the creator of social therapy, and therapists-in-training, These dialogues, together with introductory overviews by Lois Holzman and Rafael Mendez, are a provocative invitation to both new and seasoned professionals seeking alternative modes of practice and understanding. (Brunner-Routledge, 2003)

Let’s Develop! A Guide to Continuous Personal Growth

by Fred Newman with Phyllis Goldberg

In a culture of “getting,” this is the little book that keeps on giving. The 2010 edition of Fred Newman’s Let’s Develop! has a foreword by Patch Adams (the peripatetic, clowning MD) and new introduction by Lois Holzman. Based on 25 years of clinical practice and his discovery that people can reinitiate development at any stage in life, Newman urges his readers to eschew insights, explanations or getting to the “bottom” of deep-rooted emotional problems and seek their cure in development.

 

 

 

In yesterday’s Huffington Post,  Dr. Eric Maisel asks, “Does Depression Exist?” Why’s he asking?

To show that sometimes what we call things can create false realities. To invite readers to consider that this is what’s happened to our mental life and our feelings. To add a critical political/philosophical dimension to the current DSM-5 debate. (Note: This is what I think; I haven’t asked Dr. Maisel why he’s asking, but I intend to.)

Here’s the opening to his very fine essay:

If you call your daughter “my little petunia,” does calling her that make her a flower? No, it doesn’t.

If you call your wife “the little woman,” does calling her that mean that she is no longer six feet tall in her stockinged feet? No, it doesn’t.

If you call your anguish “the mental disorder of depression,” does calling it that make it a “mental disorder”? No, it doesn’t.

Maisel goes on to expose the linguistic trick by which nearly every unpleasant life experience is turning into pathology. They then have the look of illness, even though the claim that they’re disorders doesn’t pass any established scientific test of illness.

To go further with what this essay introduces, I think we have to ask, “How did it happen? How did it come to pass that we let our feelings and thoughts become pathological and medicalized? How come what’s happening with us emotionally speaking (including how we understand these happenings) is institutionally mediated?

I invite you to ask these questions of mental health providers you know and see if they have any idea. And to find out yourself if you don’t already know (there are many books on the subject, not just those by Fred Newman and me —just do a Google search.)

If we want to take back our subjectivity, then we need to get smarter about how mainstream psychology and psychiatry took it away from us.

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To go a bit deeper into the underlying problems with the theory and practice of psychology that the controversy over the DSM-5 exposes, I invite you to do some philosophizing.

What assumptions must people be making— about persons; therapy, the therapeutic relationship and therapeutic discourse; illness, cure and treatment; emotions and cognition; and mind, body and brain— in order to have their relationships mediated by a manual? For decades, critical psychologists, postmodern psychologists and philosophers have been exploring this big question. Fred Newman and I included. Here’s some philosophical food for thought from two philosophers who’ve helped us develop our own non-medical model approach—social therapy—and to appreciate discursive, collaborative and social constructionist approaches that reject (to varying degrees) the authority of so-called objectivity when it comes to human life as lived.

First, from Ludwig Wittgenstein. He had a unique way of doing philosophy that exposed “the pathology” embedded in language and conceptions of language, thoughts and emotions, and wanted to cure philosophy of its “illness.” An illness stemming from how we think, especially how we think about “mental” processes and/or objects. As Wittgenstein detailed in his writings, the problem with our thinking is that we’re obsessed with finding causes, correspondences, rules, parallels, generalities, theories, interpretations, and explanations for our thoughts, words and verbal deeds. It gives us “mental cramps” and, in his often blunt way of putting things, he tells us:

There is nothing more stupid than the chatter about cause and effect in history books; nothing is more wrong-handed, more half-baked.

Next, the American philosopher John Searle. In his recent book, Making the Social World: The Structure of Human Civilization, Searle begins:

How, if at all, can we reconcile a certain conception of the world as described by physics, chemistry, and the other basic sciences with what we know, or think we know, about ourselves as human beings? How is it possible in a universe consisting entirely of physical particles in fields of force that there can be such things as consciousness, intentionality, free will, language, society, ethics, aesthetics, and political obligations? Though many, perhaps most, contemporary philosophers do not address it directly, I believe that this is the single overriding question in contemporary philosophy.

Psychologists need to join philosophers like Searle and Wittgenstein in asking this question instead of continuing to function with conceptions and methods constructed upon a foundation of dualistic separations of objective-subjective, physical-mental and body-mind.

Ken Gergen is among the few psychologists who have done so for decades. While I could quote from any number of his books and articles, I want to get back to diagnosis. In 1995, Gergen and Fred Newman presented a paper at APA entitled, “Diagnosis: The Human Cost of the Rage to Order” (published in Performing Psychology: A Postmodern Culture of the Mind.). It’s a polemic against psychological dualism, a critique of dominant views of the vocabulary of mind, an exploration of the philosophical assumptions that underlie diagnosis and the DSM, and a call for the democratization of diagnosis:

Despite all our facetious observations about the more absurd characterizations in DSM-IV, it ain’t funny.  Why? Because in everyday pictorial, identity-theoretic therapy these descriptions (diagnoses) are frequently used to stigmatize, constrain, and punish those to whom they are applied.  We do not change that by any kind of analysis.  We change it only by changing the diagnostic form of alienation: opening up diagnosing to everyone, continuously, although non-referentially and non-judgmentally.  We can all perform diagnosing together.  Not to get it right.  Not to give everyone a chance to do it.  But to create/perform jointly a zone of relational development (if we may take poetic license with Vygotsky’s formulation) in which we can together create new forms of life, new meanings, new lives.”

I’ve been following the controversy over the latest revision of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM-5. Compiled and published by the American Psychiatric Association, the DSM is the diagnostic bible for mental health professionals the world over—and a cash cow for the Association (which, by some accounts, earns $5 million each year from sales of the book), the pharmaceutical multinationals and health insurance companies. The DSM has undergone five revisions since it first appeared in 1952 and while each has had its share of critics, the proposed DSM-5 is getting serious pushback, complete with a petition and grassroots campaign among psychiatrists, psychologists and other mental health providers.

Here’s a summary statement of what’s viewed as problematic from An Open Letter to the DSM-5 Task Force circulated by the Society for Humanistic Psychology Division of the American Psychological Association:

Though we admire various efforts of the DSM-5 Task Force, especially efforts to update the manual according to new empirical research, we have substantial reservations about a number of the proposed changes that are presented on www.dsm5.org.  As we will detail below, we are concerned about the lowering of diagnostic thresholds for multiple disorder categories, about the introduction of disorders that may lead to inappropriate medical treatment of vulnerable populations, and about specific proposals that appear to lack empirical grounding. In addition, we question proposed changes to the definition(s) of mental disorder that deemphasize sociocultural variation while placing more emphasis on biological theory. In light of the growing empirical evidence that neurobiology does not fully account for the emergence of mental distress, as well as new longitudinal studies revealing long-term hazards of standard neurobiological (psychotropic) treatment, we believe that these changes pose substantial risks to patients/clients, practitioners, and the mental health professions in general.

By mid-December, nearly 10,000 had signed the petition, prompting its initiator David Elkins (professor emeritus at Pepperdine University and president of the Division) to comment, “This has become a grassroots movement among mental health professionals, who are saying we already have a national problem with overmedication of children and the elderly, and we don’t want to exacerbate that” (quoted in Salon).

I signed the petition. I spread the word and urge others to sign. I’m encouraged by the support the petition is getting, for it’s giving mental health professionals a way to voice their dissatisfaction with the institutionalized constraints of their work (which include the hard fact that if they didn’t use the DSM they’d be out of a job).

And yet… As supportive of this reform effort as I am, I’m not a reformer. Of course we shouldn’t OVERdiagnosis. Critiquing the DSM-5 because it “goes overboard” is one thing. Critiquing the diagnostic paradigm and the entirety of the medical model approach to human emotionality is another. Thousands of people have been helped with their “mental illness” through social therapy and others approaches that relate to human beings with integrity, that is, as human beings and not as brains, minds, bodies and/or behaviors. That relate to mental health/illness as an issue of emotional and relational growth. That don’t depend on a so-called objective assessment of a person’s “illness” by an “expert” who consults a manual that was made up by other “experts.”  And I do mean made up. The DSM is authoritarian through and through—and as far from authoritative as can be.

Fred Newman, my mentor and colleague, was a big critic of the mainstream, and he created the social therapy alternative. He got a lot of flak for it from the protectors of the status quo. Not because he objected to its “excesses,” but because he objected to its misguided and destructive “essence.”  For one of our books, Unscientific Psychology: A Cultural-Performatory Approach to Understanding Human Life, I did a lot of research on the history of how psychology created itself. For the chapter, “Psychology’s Best-Seller: Mental Illness and Mental Health,” I drew upon some excellent critiques and exposés of the medical model, pseudoscientific approach to mental health, and the chapter presents the political, economic and cultural foundations and impacts of psychology’s understanding of mental illness, and the blatant opportunism of various players who created the industry. I wish some of this back-story was part of the current campaign against the DSM-5.

I end this rather long post with something Newman and I wrote in Unscientific Psychology. With the DSM-5 revision process and grassroots movement against it going on, it’s as good a time as any to give the book a read.

Psychology has no subject matter; not in the sense that there is no such thing as human subjective (conscious) relational experience or uniquely human interaction, but in the sense that such activity, such life, is essentially inseparable from its study by those (human beings) who participate in it. A star is, presumably, “starring” whether it is seen or not. But a human seer (a perceiver) cannot be consciously seeing unless one is seen—if only by “oneself.” The study of subjectivity cannot possibly achieve the distance required to be a science. Therefore, psychology, in its vulgar commitment to its own existence and cash value, creates that distance. But in doing so it “loses” its subject matter! Scientific psychology is, in our story, an ancient religion in modern (scientific) dress.

Question: What’s it like to participate in an academic conference taking place in China and on the topic of contemporary capitalism?

Answer: An academic conference.

Which is to say that you have to do the work to create human connection/conversation outside the rigid conference structure of one person after another lecturing. It’s hard work, especially when you don’t speak the language of 90% of the participants!  But it’s well worth it in the new friends you make and the new learnings you gain.

The conference banner

This past weekend I was one of four non-Chinese guest speakers (the “Western Marxists”) at the Third International Conference on Contemporary Capitalism Studies in Hangzhou, China.  The sponsors were the Center for Studies of Marxist Social Theory, Department of Philosophy, and School of Marxism at Nanjing University, and the Center for Marxist Studies at Hangzhou University, About 70 people were there in total, “senior” and “junior” scholars, postdocs, and graduate students in philosophy, social theory and Marxist studies. While the presentations were all over the place with regard to topic, the challenge many of the Chinese presentations tried to engage was understanding how China is (and/or should be) facing capitalism: Do Marxian concepts shed some light on this question and, if so, which ones? What role do traditional Chinese values play in China’s growing economy; are they hindering or helpful, both or neither?  Are we witnessing capitalism ‘s (“inevitable”) collapse; if we are, then what’s next?

My presentation, on Fred Newman and the Practice of Method introduced Newman to the Chinese scholars and explicated our development community’s work as the postmodernizing and therapeutization of Marx. The other Westerners—Neil Harding from Wales, David McNally from Toronto and Ian Parker from Britain—introduced new conceptual tools as ways of seeing current class struggle, building socialism and engaging in resistance.

Unfortunately, there was little dialogue that might have led to us creating some new understandings. But informally I had some wonderfully lively and moving conversations with “the younger generation” who were eager to explore what it means to practice method (and not just do theory), to create emotionality, and to build community. Some of these took place at the spectacular West Lake and the park that surrounds it, and at extraordinarily delicious banquet meals.

New Friends Jayson and Lily

From Hangzhou we went to the city of Nanjing, where I led a class for philosophy postdoc students on Marx, Vygotsky, Wittgenstein and Social Therapy. I began with a brief introduction of how I came to Marx, philosophy and therapy as a political organizer (and developmental psychologist). Then I asked them to perform part of the play, “The Myth of Psychology” in which Vygotsky and Wittgenstein are in therapy and talking about Karl Marx. Just as participants in my Thought Leadership of Fred Newman class in NY, those in Nanjing really got into it. They asked how could we speak of fetishization outside of political economy, what Social Therapy looks like, what to do about “objective” unhappiness in the world, and the relationship between changing the world and changing ourselves.

I thank the students for their willingness to create a playful and open learning environment with me and for their great questions. Professor Huaiyu Liu and Dr. Jing Wu  (who translated for me) were fabulous “completers” of my thinking and my English words. All in all, a great time was had by all! I later found out that I had given No. 88 in the Marxist seminar series of the Center for Studies of Marxist Social Theory!

Last week in The Thought Leadership of Fred Newman we played with the Newman play in which Lev Vygotsky and Ludwig Wittgenstein are in therapy with a social therapist (referred to in my last post). I asked folks to break up into four groups and perform the readings of the play in any way they wanted. I said that plays are meant to be performed and that inviting them to perform it together would, I hoped and expected, create an open and creative environment for ensuing conversation. One group broke themselves up into the three characters and commented that it was lovely to hear and relate to multiple Wittgensteins and Vygotskys and Brauns. Another group played with pitch and loudness, and ended with whispering the lines into each other’s ears. There was no shortage of creativity among the groups!

The conversation we wound up creating meandered (my favorite kind) with, in hindsight, a continued focus on what it means to understand and how we create understanding, both as individuals and as a group. Specifically, we spent time speaking about “will” and “motivation” and the activity of doing the unexpected and its relationship to playing like children (what does it mean that, as one participant said, “Everyone was willing to go into the groups and perform”); about reading/performing when you have no idea what you’re reading (the assumption being this is not a good thing, but we questioned that in light of assumptions about what language is); and about the experience of appreciating what they created.

Tonight is the final week. The reading is an article by Newman and Ken Gergen, expanded from an APA presentation the two of them made in 1995. It’s titled, “Diagnosis: The Human Cost of the Rage to Order.” (It’s a chapter in my edited book, Performing Psychology.) I’m looking forward to helping the class with this challenging and important academic piece that argues for a move away from both pictorial and a pragmatic views of language to one of relational activity—and the democratization of diagnosis. Vygotsky and Wittgenstein are, again, characters. As is social therapy, this time with Newman himself.

I’m currently leading the second phase of my ongoing series, “The Thought Leadership of Fred Newman,” at the East Side Institute. For this coming Monday’s session we’re going to play around with two of Newman’s “Psychology Plays”—written expressly for performance at APA (American Psychological Association) annual conventions during the 1990s. Titled “The Myth of Psychology”, the play consists of two acts, each one a therapy session with Lev Vygotsky and Ludwig Wittgenstein and a social therapist.

I love these plays! They are delightfully comic and educative, no matter whether you are familiar with the characters or get the many, many in jokes or not. Of course I’m rereading the text of the play in preparation for my class and thought I’d share a favorite section from Act 2.

Vygotsky and Wittgenstein are now the best of friends and have come to understand each other well except on one issue: they can’t understand how the other is (in Vygotsky’s case) and is not (in Wittgenstein’s case) a revolutionary. We pick up at the point in the session where they ask the therapist Bette what she means by being a revolutionary.

BETTE: To me, being a revolutionary has more to do with how you believe or understand than with what you believe. Now, of course, the two are connected in complex and ever-changing ways. Still, how you connect or relate your subjective life with the world determines what I mean by being a revolutionary.

WITTGENSTEIN: So revolutionary refers then to a way of looking at things?

BETTE: Yes, you might put it that way, Dr. Wittgenstein.

VYGOTSKY: But doesn’t how we look at things depend at least to some extent on how those things are?

BETTE: Yes, Lev. But how those things are also depends on how they are looked at.

WITTGENSTEIN: So you’re saying that things — or whatever — have no objective nature independent of their being related to by conscious beings? Doesn’t that simply raise the old idealistic philosophical saw about whether the tree falls in the forest if no one sees or hears it?

BETTE: Well, Dr. Wittgenstein, I’m not saying that things — or whatever — have no objective nature independent of their being related to by conscious human beings. I’m saying — following your work on these matters — that the language game of objective-subjective can be and often is a no-win game — a metaphysical confusion.

WITTGENSTEIN: Well, tell that to your comrade — and my friend — Vygotsky over here. Because he believes in some Marxian notion of objective historical laws.

VYGOTSKY: I do, Bette. He’s right. I cannot accept that everything is subjective.

BETTE: Nor can I, Lev. Nor can I. But I also cannot accept that everything is objective. Indeed, I can’t even accept that everything is. And no one has made that clearer than Karl Marx and … Lev Vygotsky. Psychology, you insisted — if I understand you correctly — is a cultural understanding of becoming, not a pseudo-scientific understanding of what is.

WITTGENSTEIN: So the puzzle, if you will, has to do with that funny little verb “to be.” “To be or not to be, that is the question.”

BETTE: I think not, Dr. Wittgenstein. That is the problem. Shakespeare’s Hamlet gives us, perhaps, the purest expression of modernist alienation when he says, “To be or not to be.” For if we are, like everything else, becoming, then “to be or not to be” denies what we are by apparently exhausting all the possibilities (being or not being) without realizing that we are both — and neither — namely, we are all forever becoming.

I’m eager to see what I and 30 ordinary people from many different walks of life—all “non-philosophers”—make out of this.