Parker, I.

5 Towards Critical Psychotherapy and Counselling: What Can We Learn from

Critical Psychology a d Political Eco o y ? i D. Loewe thal ed. Critical Psychotherapy,
Psychoanalysis and Counselling: Implications for Practice (pp. 41-52). London: Palgrave
[ISBN: 9781137460561] Link: http://www.palgrave.com/page/detail/critical-psychotherapypsychoanalysis-and-counselling-del-loewenthal/?K=9781137460561

Towards Critical Psychotherapy and Counselling: What

Can We Learn from Critical Psychology (and Political
Economy)?
Ian Parker
Critical psychology is now a massive expanding field of work that encompasses many
different traditions of research around the world, and it is all the more diverse because it is
tackling a host discipline psychology that is a sprawling contradictory mass of approaches
to understanding individuals. We have learnt a lot from critical psychiatry, and many of us
have allied ourselves with the anti-psychiatry and democratic psychiatry movements. We are,
of course, against the medicalisation of distress, and there have been particular lessons from
psychiatry about how not to do clinical psychology lessons which then impact on how we
think about the place of psychotherapy and counselling (Parker 2011a).
Sometimes we have thought of psychotherapy and counselling as such as part of the
alternative as an alternative to mainstream psychology because psychotherapy and
counselling value subjectivity and are not intent on the prediction and control of behaviour.
The earlier forms of radical psychology that were a precursor to contemporary critical
psychology looked, in particular, to humanistic perspectives on understanding and caring for
others. We are a little more suspicious of those perspectives now, and the scope of critical
psychology today is much broader and perhaps a bit less tolerant of attempts to patch things
up, to make people feel better.
One of the dimensions of debate that structures critical psychology today is precisely
about the possible positive role of some form of alternative psychology. So, on the one hand

there are those who would see psychology as such as so complicit in exploitation and
oppression that our task must always and only be relentless critique. On the other hand there
are those who argue that participatory research, for example, opens up a space for
reconfiguring psychology, and that way of attending to subjectivity and action is crucial if we
really want to bring about social change. I am stretching apart the two poles of the debate to
make clear what the stakes of the argument are. There are many positions somewhere
between the two. One way of opening up the specific question of how the debates in critical
psychology might be useful now for some kind of critical psychotherapy and counselling is
to look at four aspects of critical psychology. Let us take them in turn, and think about what
they might mean for therapeutic work.

Four aspects of critical psychology

First, we question the way in which psychologists spend their time studying other people
outside the discipline whom they assume to be non-psychologists, and we turn the gaze of
the discipline back on psychology itself. We study how psychology has developed and what
psychologists do. This means, of course, that we do not buy in to the assumption that
psychology is neutral about what it studies, and we argue that the observation and
measurement of thinking and behaviour have profound consequences for those who do the
observing and measuring as well as those whom they turn into objects of their research.
There is, at least, a question here for psychotherapists and counsellors about how their
own field of work emerged, and why it is that they feel so strongly about their own specific
identity as a professional. We have seen how important this question is recently with the
development of counselling psychology and the way in which claims are staked for
distinctive expertise tied to professional identity. And we know that when moral weight is
given to the position of the therapist it is all too easy for therapy itself to turn into a process of
induction into the notion that the ideal endpoint would be that the client themselves should
become a counsellor or therapist (Rowan and Dryden 1988). That is, there is a reproduction
of a hierarchy of knowledge and insight in which psychotherapy and counselling are higher
up the pyramid, and psychotherapy often likes to think that it is higher up than counselling.
So historical analysis is necessary to dismantle this pyramid of enlightened souls.

Second, we question the attempt to stitch the variety of theories and methodologies in
psychology together in order to arrive at one complete watertight covering explanation for
why people do what they do. We work at the contradictions in psychology to give more space
for resistance to the power of the discipline. This means that we do not buy in to the
assumption that there must be a correct or universal account of psychology, either in any of
the particular approaches or as a combination of them, for elements of psychology to be
useful. Any positive engagement with any aspect of psychology is relativist, opportunistic
and pragmatic.
The question for psychotherapists and counsellors, then, is how their techniques might
be useful in enabling people to have some better understanding of themselves, but in such a
way as to avoid endorsing the complete package of any theory that houses the technique or
the complete package of therapy as a cure-all. There is a general problem in that
psychotherapy and counselling coexist with psychology and psychiatry in a constellation of
theories and practices which we term the psy complex which prescribe good behaviour,
and even correct thinking and feeling (Ingleby 1985; Rose 1985). A specific problem with
psychotherapeutic practice is that local domains of the psy complex are sometimes governed
by charismatic individuals who then provide moral examples for those whom they treat. So
attention to contradictions is necessary to unravel those particular regimes of truth and power.
Third, we question the expansion and ambitions of psychology as a framework, or set
of frameworks, with a reach and appeal way beyond the colleges and the clinics. We attend to
the increasing psychologisation of contemporary society, and the way in which psychological
models of the person facilitate the globalisation of ways of being and reflecting on ourselves.
This means that we are just as critical of pop-psychology and self-help approaches that
operate as informal and ostensibly homegrown alternatives as we are of the theories and
methods that are peddled by those who are paid to develop and test them out. Any form of
psychology that claims to describe how we develop and learn, for example, tends to end up
proscribing and then pathologising other ways that people do actually think and learn.
Psychotherapists and counsellors will respond to this problem, perhaps, by claiming
that the more intensively reflexive nature of their practice means that they would always
already encourage critique and self-critique. Their understanding of other rival theories and
of their own chosen modality is more sophisticated than that of psychologists and, of course,
psychiatrists. And the therapeutic process, it is true, encourages such reflexive work as

crucial to the cure. The problem, however, is that the appeal to reflexive mindful activity, to
the disentangling of feelings and thoughts from each other and the attempt to find a better
way to live, is exactly how psychologisation works today (De Vos 2012). So a focus on the
way in which useful frameworks congeal into psychologised systems of thought is necessary
to good critical reflexive practice.
Fourth, critical psychologists question the way in which our colleagues construct their
favourite theories, and most of the time they do that by correcting, refining and systematising
what the less canny non-psychologists already think about themselves. Psychology is
grounded in actually existing practices of prediction and control, and it has been so successful
because it formalises everyday ideological explanation and sells it back to our managers and
to us. This means that the issue here is that we are concerned not only with where incorrect
ideas come from but also with where some of the good ideas might be. When we look
critically at mainstream academic and professional psychology we ask ourselves why some of
it seems to make sense, and when we look critically at pop-psychology and alternative
psychology we explore what the appeal of those approaches are, not only how they mislead.
Psychotherapists and counsellors do, of course, build their own sense of what it means
to help someone and what their own ethical investment is in the theoretical frameworks that
they use in their clinical practice. And as they do that they piece together facets of theory and
of everyday understanding. Much more than psychology, and with important lessons for
mainstream psychological research practice here, therapeutic work involves careful listening,
witnessing and honouring of the strategies and hypotheses that people bring to the task of
making sense of their lives. Now the question is how the institutional frame of therapy
channels that understanding into what the therapist or counsellor will be able to recognise as
useful, and how we might break that frame so that we can appreciate the many different
forms of practice that are just as effectively therapeutic. So exploring non-therapy could be
a way of deconstructing the frameworks that privilege an apparently real therapy (Parker
1999).
The fantasy that there might be a domain of real therapy against which the various
components of the psy complex conspire to inhibit brings us to the even more powerful
fantasy that the state presses down on the potentially free activities of the individual
presupposed in most psychological theory. The aspects of critical psychology that I have
described so far are informed by an analysis of structures of power given by Michel Foucault

and his followers, whence comes the use of the conceptual device the psy complex (Rose
1985). However, there is another conceptual framework that is useful in describing the place
of psychotherapy and counselling in contemporary society and in addressing the vexed
question of their relation to the state. This is the critique of political economy (Marx 1867).

Psychotherapy and the state

There have been interminable analyses of state regulation of psychotherapy in the UK in
recent years. Humanist-inflected objections to regulation have railed against the reduction of
personal and relational phenomena to procedures and outcomes that can be evaluated and
monitored according to positivist criteria (e.g. Mowbray 1995). Psychoanalytic studies have
emphasised the way in which one generalised standard, bureaucratised ethics and a discourse
of the university blot out the particularity of the subject and facilitate adjustment of the
individual to the social (Parker and Revelli 2008). Across the spectrum of debate humanist
to psychoanalytic some other arguments have been mobilised to draw attention to
disciplinary mechanisms, surveillance of the apparatus of therapeutic confession and the
malign effects of the psy complex in governing who should speak to whom, where and about
what (House 2002).
I want to take a different tack one which accompanies these existing critiques but
focuses on the political economy of state regulation. This is designed to take a critical
distance from the historical moment we are living through so that we can perhaps find some
new coordinates to get through this. It draws on some of the analysis developed in critical
psychology, but by applying it to the particular question of psychotherapy, counselling and
state regulation we can see implications for the way we better grasp the nature of the psy
complex in contemporary political economy. This analysis involves some necessary level of
abstraction to grasp what is happening, so that we are not trapped in the immediately intuitive
nature of the problem, and it combines this abstraction with an account of us inside it as
something contradictory, as something we can change. Even the shift to an analysis of
political economy already pits us against a context in which certain assumptions about the
individual and the social are naturalised, taken for granted, and it pits us against the specific
ideological mutations which reflect, warrant and support life under contemporary neoliberal
capitalism. Those assumptions and mutations provide the conceptual ground for much
psychotherapy and counselling, so it is worth starting by briefly reviewing them now.

The work of individual reflection, clarification and empowerment that most

psychotherapy concerns itself with, as well as being part of the wider project of the Western
Enlightenment, rests upon conceptions of the productive citizen in a free-market economy
that followers of Adam Smith still look to today. For Smith (2008), self-interest gives rise to
the collective good, and both blossom in civil society when left unhindered by the state. The
separation of civil society from the state is therefore a precondition for the self-regulation of
individuals acting in commerce with each other. One can already hear echoes of the
reassurances given by some existing registration bodies to government that statutory selfregulation is quite sufficient, and that it promises the best measure of good behaviour. This is
not to say that judicial review of the threat of regulation by the Health Professions Council
(HPC) was not tactically the right course of action, but it does mean that this tactic chimes
with calls for the free-market big society to be free of red tape. And the defeat of the HPC
was quickly followed by what is now an attempt to get the registration bodies to regulate
themselves, overseen by the Professional Standards Authority for Health and Social
Care (previously known as the Council for Healthcare Regulatory Excellence). The
issue here is not so much the shuffling around of signifiers of health as an ideal against
which psychotherapy should measure itself as the attempt to enrol each collective body as an
obedient and adapted self-regulatory mechanism (Reeves and Mollon 2009).
One way beyond this idealisation of civil society and the contradiction between it and
the political state was to try to resolve the contradiction by appealing to broader historically
transcendent agencies. This was the way of Hegel (1991), for whom such agencies eventually
resolved once again into some kind of state apparatus. Another way out of the contradiction
was to understand the ostensibly autonomous operation of civil society as a fictional
arrangement which obscured the conflict between labour and capital, and to work towards the
dialectical resolution of the contradiction and the withering away of the state. Far from being
a realm of harmonious exchange, civil society in emerging critique referred to the place in
which the individuals relation with others are governed by selfish needs and individual
interests (Marx 1843: 59). This approach, which is that of Marx, brings us to critique of
political economy of the relationship between the state and civil society under capitalism
(Mandel 1971).
This approach entails not merely the analysis of economic forms production,
consumption, commodities, exchange value and so forth but also the political processes in

which they are embedded. Class, which is central to Marxs analysis, of course, is but one
instance of a social relation that is reified under capitalism such that it becomes a social
position tied to a form of identity, but it is itself a process (Bensad 2002). It is a function of
the labour process, a relation to the state which guarantees capital accumulation, and
conditions of life in civil society which include political representation and self-exploration
that occurs in, among other places, the consulting room (Samuels 1993). Civil society,
separated from the state, still shapes the state as a political apparatus, and it calls upon the
state to regulate it, whether that is to ensure the smooth running of the supposedly free
market or to provide welfare support so that producers and consumers will themselves be free
to participate in it. The state thereby also protects the imaginary universality of particular
interests (Marx 1843: 107) as if it were the universal interest.

Political economy of psychotherapy

The political economy of psychotherapy is a necessary starting point for thinking more
generally about the domain of psychological health under capitalism (Singer 2007), and a
critique of that political economy therefore attends to at least the following two aspects of the
practice. First, it attends to the production and circulation of value, and how the
sedimentation of this value in things bought and sold divides exchange value realised in
commodities from another apparently more fundamental use value that seems to be hidden
within those commodities. The labour of the psychotherapist is at issue here, as is the labour
of the patient, as something of value might be produced and circulated as if it were a
commodity and perhaps accumulated as a form of capital. (I will return to this form of capital
later.) The conditions in which the psychotherapist works will determine the production of
surplus value and the estrangement of the worker from their creative labour. I leave open
the question as to whether the patient is also alienated as a worker producing value for the
moment, partly because the psychotherapist does also assume the function of patient at points
in the history of the practice. It is not immediately clear whether the psychotherapist is
always only a worker or consumer or petit bourgeois with their own particular exploitative
function. This is a question that requires further work.
If the first aspect concerns the specific political economic arrangements of the
individual psychotherapists practice, the second aspect of the political economy of
psychotherapy we need to attend to is its societal function. Here we turn to the production

and circulation of abstract value in a society where psychotherapy in its various guises
becomes important, where its place in the process of capital accumulation must come under
the purview of the state. There are a variety of accidental and idiosyncratic reasons why some
legislators are interested in the regulation of psychotherapy, and it is not unimportant to keep
track of them for lobbying purposes, but the question that underpins this second aspect of the
political economy is independent of the intentions of any particular state agent; rather, we
need to ask what is produced and consumed by psychotherapy such that its form of value
becomes included in calculations that pertain to investment and growth.

Historical trajectories: Class and gender

To the first and second questions raised by these two aspects of the political economy of
psychotherapy the class position of the psychotherapist and what of value is produced by
psychotherapy in society I will add a third question, which arises from our analysis as a
critique of political economy rather than as a disinterested description; only as something
partly as it exists in reality and partly as it exists in its own view of itself (Marx 1843: 106).
If the analysis is Marxist, then the question that drives the analysis is what the point of view
of the working class is as an historical agent in relation to these issues. This is, needless to
say, an extremely difficult question, and its complexity flows from the history of modes of
production that coexist under capitalism today and from the transformations that the working
class has undergone with the emergence of contemporary globalised neoliberalism (Went
2000). Let us briefly take each of these historical processes in turn. (The first bears primarily
on the class character of the psychotherapist, and the second more on the societal function of
psychotherapy as such.)
With respect to modes of production and psychotherapy, it is still possible to find
residues of pre-capitalist forms in the networks of privilege and patronage which made it
possible for some members of the aristocracy, the haute bourgeoisie and associated artistic
circles to develop an interest in psychotherapy (Hinshelwood 1995). In some cases, medicine
specifically psychiatry was the arena in which a dilettante involvement in psychotherapy
developed. These individuals have always been quite marginal to their class, but those class
networks have facilitated personal contacts between the House of Lords and the Royal
College of Psychiatrists. They become more significant in relation to the mercantile
bourgeoisie, which is more interested in what use psychotherapy might serve, and there is

usually little direct evidence that it is useful at all. Together, they (aristocratic and bourgeois
elements) tended to exclude and disdain working-class involvement in training until the
advent of the NHS, when the provision of psychotherapy opened up access not only to
patients but also to a new layer of professionals (Miller and Rose 1988).
Then we can see the class differentiation of psychotherapy reconfigured to some
extent around professional titles, with British-tradition psychoanalysis tied more closely to
the older patrician psychiatric practice (e.g. around 1,450 registrants with the British
Psychoanalytic Council), psychotherapy opening up a space to the middle class (with about
7,000 registered through the UK Council for Psychotherapy) and counselling drawing in
more lower-middle-class and working-class practitioners (with over 37,000 members of the
British Association for Counselling and Psychotherapy). These are broad-brush
characterisations that do not do justice to the internal contradictions of each distinctive class
involvement in psychotherapy. The impact of immigration from continental Europe with the
rise of fascism is an important factor that complicates the picture, as is the involvement of
women in psychotherapy, and that issue leads us to transformations of the labour force under
capitalism in recent years (Mandel 1974).
The overwhelming majority of psychotherapists in the UK are women, a
preponderance that is mirrored across most countries of the world. The analysis that we need
must therefore be as much feminist as it is Marxist, and so must connect the two traditions of
work while acknowledging the contradictions between them (Arruzza 2013). The proportion
of women practitioners varies across different modalities, with large numbers working in
what is usually perceived as lower-status counselling. One of the peculiarities of Britishtradition psychoanalysis is also that, apart from its organisations being open fairly on to nonmedics, women have been visible as leaders, which may partly be an effect of prominent
figures who were not medically trained arriving in the 1920s and 1930s as immigrants from
central Europe and gathering other women around them (Frosh 2003). Even so, the overall
pattern of the distribution of gender in psychotherapy organisations has been that while most
practitioners are women, the higher levels of management are populated by disproportionate
numbers of men. There is an issue here to do with the image of psychotherapy as a caring
profession (which applies more to counselling and less to some forms of psychoanalysis,
which are then as a result sometimes accused of being more stereotypically masculine), as a

profession that has to some extent operated as a feminised domain of work and labour
process.
What is important now for our understanding of psychotherapy is that a certain kind
of labour in the home was carried out by women. When many women in the UK re-entered
the workforce with the rapid expansion of the service sector after the Second World War,
labour in that sector was reconfigured such that womens work, at one time undervalued
(including in Marxist analysis), now assumed a significant role. The segregation of men
labouring outside the home from women labouring inside it meant that it was women who
then brought to the service sector (and to many organs of the welfare state) what has been
termed emotional labour, no less creative and alienating when it produces surplus value
than mens manual labour (Hochschild 1983). The feminisation of work, then, does not so
much mean that it is women per se who are the workers and men have been adept at
developing stereotypically feminine skills to keep managerial positions in the caring
professions but that empathic and interpretative qualities that were historically assigned to
womens roles become valued as commodities.
It is evidently profitable for an organisation to buy this kind labour power, this labour
as a commodity, and then it makes sense for a state that is sensitised to the importance of this
form of labour to guarantee it as a source of surplus value. Abstract value, which it is the
function of the state in capitalist society to ensure the production and circulation of, now
includes as one component the kind of value that is realised in a constellation of practices that
are concerned with personal growth and wellbeing, and so it includes psychotherapeutic
labour.

Conclusions
In place of a conspiracy theory of attempts to regulate psychotherapy, political economy
provides us with an analysis of how it is that this regulative process should appear to be a
conspiracy in the first place. On the terrain of economic self-interest that capitalism bases
itself on, and that the capitalist state facilitates, cluster a number of forms of capital. These
include cultural capital that those already with sufficient resources can accumulate from
their unpaid labour in psychotherapy services for example, a form of capital that reaps
dividends when an administrative position is obtained that calls for psychotherapeutic

emotional labour (Bourdieu and Passeron 1977). There is also a distinctive

psychotherapeutic capital accrued through training and supervision, and then in committee
work that may or may not be part of paid employment, in educational settings that value the
circulation of this kind of knowledge (Parker 2011b).
These political-economic questions are preliminary to an analysis of the relationship
between Marxism and psychotherapy as such (Cohen 1986). What underpins this analysis is
an attention to this work as productive labour that gives rise to value that then operates as a
form of capital. It is at that point that it becomes of interest to the state. Political economy of
psychotherapy that is also a critique of this political economy would attend to the separation
between civil society and the state without romanticising civil society, and thereby imagining
that the state is an unnecessary impediment to good practice. The state already enters into
everyday economic transactions, shaping what we understand as a contract and the value
produced from psychotherapeutic labour. A wish to be rid of the state is a fantasy formation
that functions ideologically, in the service of capital and so eventually in the service of the
state as well.
This is important not only for psychotherapists and counsellors but also for
psychologists and critical psychologists. Psychology is necessarily entangled with
therapeutic work, with many of the more radical psychologists who express the same hope
that is voiced by most undergraduates beginning a psychology course who want to eventually
be clinical psychologists because they want to care for others. The hope is that some good
can come out of psychology, and that psychotherapeutic and counselling practice might show
the way forward. If we are to learn lessons from critical psychology for psychotherapy and
counselling, however, we need also to be critical of psychotherapy, and one way of being
critical that then has implications for the contemporary practice of all of those working in the
psy complex is to look carefully at what the psy complex is part of that is, capitalism and
the operations of the capitalist state.

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