Wars in the marrow
Last week the debate between CBT and psycho-dynamic therapy was once again relaunched on the back of a sizeable new study supporting the long-term effectiveness of the latter psycho-dynamic therapy that derives its "talking cure" from Freudian metapsychology. Of course, everything has its critics. The story in the Sydney Morning Herald offered a weird economic rationalism as a counter-argument:
Gavin Andrews, professor of psychiatry at the University of NSW, countered that CBT was backed by ''hundreds of studies'' as the most cost-effective standard of care.
What's strange about this counter from Prof. Andrews is how it attaches itself to capitalism and its inherent crises. I read and wrote about 'rationalism' as a mode of thought quite extensively when I put together my Honours dissertation and one of the basic problems with this mode of thinking is that any rationalism has difficulty understanding its inherent (and perhaps 'core') irrationality because to recognise such a thing results in a crisis of value for that rationality or what 19th and 20th century philosophy called "nihilism".
The problem with rationalising CBT in this cost-effectiveness way is that it overlooks the irrational paradox inherent in CBT itself: the cost-effectiveness of CBT arises from its 'promise' (which I'm tempted to call 'ideological') that 6 to 12 sessions will be sufficient to have a lasting effect on the patient/analysand yet it can often take 12 months or more of ongoing CBT treatment for this 'lasting effect' to be recognised. This means that CBT becomes as economically viable as other forms of psycho-therapy including psycho-dynamic therapy which is inherently psychoanalytic. This psychoanalytic basis emphasises that for the human subject of our late capitalist era who treats their self as an object of consumption the 'price' of therapy really has to feel like a sacrifice for any benefit to be gained. Quite directly, this means that if one has to commit a large portion of 'value' (in an aesthetico-moral sense as well as in the sense of money or capital) then one is investing a large portion of their self in this process: not because it 'costs a lot of money' but because it establishes a freely given subjection to a process of being desubjectivised. This goes far beyond consent; what it means is that the analysand is forging a symbolic link to the therapy that is of an order greater than the well-developed narcissism upon which our modern view of consumption is based.
There's a certain melancholia about legitimating psychology and psycho-therapies with economic criteria. These criteria are far beyond the range of these things. Surely we would expect the 'medical professional' we go to visit be capable of legitimating medicine in the terms of its object: the medicalised body, not the economically rational person. I'm not saying that CBT is ineffective, but rather that it is a rudimentary category error to legitimate through the external processes of capital and that this invites easy criticisms of many facets of the practise's unreflexive connection to the dominant conceptual operation of modernity, post-modernity, or whatever the hell we're in right now.
~Niveau
Gavin Andrews, professor of psychiatry at the University of NSW, countered that CBT was backed by ''hundreds of studies'' as the most cost-effective standard of care.
What's strange about this counter from Prof. Andrews is how it attaches itself to capitalism and its inherent crises. I read and wrote about 'rationalism' as a mode of thought quite extensively when I put together my Honours dissertation and one of the basic problems with this mode of thinking is that any rationalism has difficulty understanding its inherent (and perhaps 'core') irrationality because to recognise such a thing results in a crisis of value for that rationality or what 19th and 20th century philosophy called "nihilism".
The problem with rationalising CBT in this cost-effectiveness way is that it overlooks the irrational paradox inherent in CBT itself: the cost-effectiveness of CBT arises from its 'promise' (which I'm tempted to call 'ideological') that 6 to 12 sessions will be sufficient to have a lasting effect on the patient/analysand yet it can often take 12 months or more of ongoing CBT treatment for this 'lasting effect' to be recognised. This means that CBT becomes as economically viable as other forms of psycho-therapy including psycho-dynamic therapy which is inherently psychoanalytic. This psychoanalytic basis emphasises that for the human subject of our late capitalist era who treats their self as an object of consumption the 'price' of therapy really has to feel like a sacrifice for any benefit to be gained. Quite directly, this means that if one has to commit a large portion of 'value' (in an aesthetico-moral sense as well as in the sense of money or capital) then one is investing a large portion of their self in this process: not because it 'costs a lot of money' but because it establishes a freely given subjection to a process of being desubjectivised. This goes far beyond consent; what it means is that the analysand is forging a symbolic link to the therapy that is of an order greater than the well-developed narcissism upon which our modern view of consumption is based.
There's a certain melancholia about legitimating psychology and psycho-therapies with economic criteria. These criteria are far beyond the range of these things. Surely we would expect the 'medical professional' we go to visit be capable of legitimating medicine in the terms of its object: the medicalised body, not the economically rational person. I'm not saying that CBT is ineffective, but rather that it is a rudimentary category error to legitimate through the external processes of capital and that this invites easy criticisms of many facets of the practise's unreflexive connection to the dominant conceptual operation of modernity, post-modernity, or whatever the hell we're in right now.
~Niveau