And the worst? How about the crock of shit known as Evidence-Based Practice, the deplorable baloney that increasingly drives mental health policy. Day in and day out I see the legislature meet with Health and Human Service agents hitting them up for mental health funding which they justify by invoking the spurious “outcome-driven evidence based practice”, meme, which is code for “we are scientists who love us some algorithms” and, for the average consumer means Psychopharm and CBT, as useless as they are ubiquitous.
But heck, why be gloomy when I could just as well look at the bright side? Anyone can look at the bright side, I’ll just sit here keeping it real if that works for you, and really, it should, I really think it should be okay.
In the desert
I saw a creature, naked, bestial,
Who, squatting upon the ground,
Held his heart in his hands,
And ate of it.
I said, “Is it good, friend?”
“It is bitter–bitter,” he answered;
“But I like it
Because it is bitter,
And because it is my heart.”
In the Desert
Actually I am feeling downright upbeat tonight, having found a compelling champion of gloom who is not only probably not an alcoholic, but a mental health clinician who is both renowned and not insane; scoff not, I gotcher evidence right here
Good stuffings here from
Happiness is an illusion Guardian interview,
When Adam Phillips’ American publishers were planning a US edition of his book Going Sane, they insisted on giving it an upbeat subtitle. The idea drove him, if not insane, then to distraction. “The woman at the publishers said to me: ‘How about Maps of Happiness.’ I thought she was joking, so I said: ‘How about Maps Against Happiness?’ And she said: “I don’t think so. Against is such a negative word.'”
The proposed subtitle rankled because Phillips is against guidebooks to happiness. “A culture that is obsessed with happiness must really be in despair, mustn’t it? Otherwise why would anybody be bothered about it at all?” asks the psychoanalyst, closing his eyes as he does repeatedly during the interview when he wants to clinch a thought, and then leaning forward to put his head in his hands. “It’s become a preoccupation because there’s so much unhappiness. The idea that if you just reiterate the word enough and we’ll all cheer up is preposterous.”
Phillips lifts his head from his hands. Unshaven and enviably shaggy-haired, he has been compared in looks to Bob Dylan and described as the shrinking woman’s crumpet. “I don’t want happiness to be part of the currency,” he sighs, “but by that I don’t mean that I want people to be miserable, but I do think that if you have a sense of reality you are going to be really troubled. Anybody in this culture who watches the news and can be happy – there’s something wrong with them.
But isn’t eliminating the scourge of depression a good aim? “It’s very simple. The reason that there are so many depressed people is that life is so depressing for many people. It’s not a mystery. There is a presumption that there is a weakness in the people who are depressed or a weakness on the part of scientific research and one of these two groups has got to pull its socks up. Scientists have got to get better and find us a drug and the depressed have got to stop malingering. The ethos is: ‘Actually life is wonderful, great – get out there!’ That’s totally unrealistic and it’s bound to fail.”
We are sitting in the consulting room above a shop in Notting Hill that Phillips has occupied for the past 20 years. I’m on the couch (a leather sofa actually) unleashing questions, while he sits in an armchair doing what shrinks are supposed to do – look attentive and respond thoughtfully. The room isn’t just lined with books, but booby trapped with them: volumes rise in stacks all over the place. The atmosphere is paradoxically soothingly literary.
“Sanity involves learning to enjoy conflict, and giving up on all myths of harmony, consistency and redemption.”
His theme is often the strangeness of human desire. We are not merely evolutionary machines. “Darwinian psychoanalysis would involve helping you to adapt, find a niche and enable you to reproduce,” he says. “Freudian psychoanalysis suggests that there is something over and above this. These are parts of ourselves – that don’t want to live, that hate our children, that want ourselves to fail. Freud is saying there is something strange about humans: they are recalcitrant to what is supposed to be their project. That seems to me to be persuasive.” It also, you might notice, suggests humans have a design flaw. In the new essay collection, Side Effects, he offers the Phillipsian paradox that desire is unpredictable as well as insatiable. One might infer that an ironical appreciation of the mystifying human psyche is the best that sane people can manage.
Is his notion of sanity better as a goal than others’ ideas of happiness or satisfaction? Phillips answers indirectly. “What lures us into the future is the renewal of appetite. Having noticed that one’s appetite is what vitalises one – Freud talks about this a bit – there could easily be the desire to frustrate oneself. The project might be to keep appetite alive. The problem is that consumer capitalism exploits this because what it does by pretending to offer choice is that it pre-empts you finding out what you want. It’s like the way pornography steals people’s dreams. It gives you pictures of sex scenarios and so, unlike more imaginative forms of literature, stops you creating your dreams. Instead of having your own sexual fantasies the porn industry does it.
“What I want to show people is that one has a hunger to have one’s imagination pre-empted like that because working out what one wants is quite difficult, quite naked.”
Don’t you just flatter your patients’ self- obsessions? Phillips argues on the contrary that he aims to make anxious, isolated neurotics more sociable. “When I saw children my criteria about how well they were were whether they had friends that they enjoyed and whether they had found something that really interested and absorbed them.
“Most people feel much better when they’re kind, but they are much less kind than they want to be. It’s a paradoxical thing. Similarly a lot of people feel very strongly for other people and I don’t mean in a patronising way, but in a sense of solidarity. But so much of the culture pays lip service to communal virtues but encourages people to become self-preoccupied.”
Phillips’ scepticism about the desirability of human happiness is not fashionable. We live, after all, in a society where the government has appointed a happiness czar and where depression has become so costly in terms of working days lost that it has been decided that so-called “happiness centres” administering courses of cognitive behavioural therapy are necessary in order to cheer us up and get Britons back to work.
“It’s drivel,” says Phillips. “It’s totally misleading. Anybody who’s been in the therapy profession for any length of time will know that there have always been crazes – there is always the next best thing. And now it’s CBT. One of the things I value about psychoanalysis is that it acknowledges that there are real difficulties in living, being who one’s going to be and that no one’s going to be having a lobotomy.” But the prevailing mood demands that you come into therapy depressed but leave if not lobotomised, then happier – and poorer. Phillips shakes his head: “There isn’t going to be a radical personal change, which doesn’t mean that people can’t change usefully, but really that psychoanalysis is against magic. Ideally it enables you to realise why you’re prone to believe in magic and why you shouldn’t, because to believe in magic is to attack your own intelligence.”
Is he saying suffering is necessary to the examined life? “No: suffering is not essential. It’s just unavoidable. All forms of sufferings are bad but some are unavoidable. We need to come to terms with them or be able to bear them.”
If Phillips is here making a sales pitch for psychoanalysis over CBT, it isn’t exactly a hard sell. “This is not like buying a fridge,” he agrees. “This is not an investment that is of a piece with the cultural ethos. That doesn’t mean that you as a patient don’t have rights and expectations and demands. But there are no guarantees.”
What analysis might do is to help you adjust your expectations to a world that is not fit for (our human) purpose. “It’s like [Beckett’s play] Endgame: ‘We’re on Earth. There’s no cure for that.'” Similarly, Phillips argues, analysis can show there is no cure for childhood, but may help one deal with that seemingly unbearable truth. “There may be useful reconsiderations and redescriptions, but you really did have those parents, you really did make of it what you made of it, you really did have those siblings, really did grow up in that economic climate. These are all hard difficult facts. Redescribed, they can be modified, things can evolve. But it isn’t magic.”
Exactly. It’s a charade, CBT, despite or because of its sciency pretensions, where psychologically suffering patients are pressured to collude with the slick, smooth-talking logician, because if they work like slavedrivers logic will cure them, and the culture has swallowed it whole, and there is no other option for people seeking treatment in community mental health clinics, and I wonder when this will end and we can go back to our sane but heavy-hearted soul doctors, or if they will simply cease to exist like the curricula their training was based on.