In light of September’s SHoT (student health and well-being) survey release, one cannot but lose faith in what we as students, academics, and society at large are doing, or not doing, when 1/3 students answer they have severe psychological problems and that around 40% of students experience loneliness. What is going on in the field of psychiatry/psychology? And not to mention in our society? In this opinion piece, I try to highlight two of the philosophical lacks of mainstream psychiatry/psychology, and I argue that the fields and its practitioners should look to Lacanian psychoanalysis and post-Lacanian philosophy for guidance on how to better address these same lacks.
Psychoanalysis asks us to take a careful look at our past precisely so as
to empower us to construct a new fate out of the elements of the old.
– Mari Ruti, A World of Fragile Things: Psychoanalysis and the Art of Living
I express my concern to two specific audiences; the first one I assume is given, while the second I include because of the field’s definitional power. It is this same definitional power which I think can help psychology fill the lacks I mentioned in the heading. The audiences I am trying to reach are psychology professors, practitioners and the likes of them, and philosophers. Given that this is written for a student newspaper, I am limited to mostly scratching surfaces on what I’m trying to convey.
Philosophical lacks in mainstream psychology
I am not alone in my concern for the lack in the philosophical foundation for psychiatry and psychology as a professional field. In the book Psychiatry in Crisis (2021), authors Vincenzo di Nicola and Drozdstoj Stoyanov, rightly criticize psychiatry and mainstream psychology for lacking a philosophical base for their theories. The scientific method and the neuro-cognitivist approach – the philosophy that the fields today base their theories on – are lacking. The authors propose that the lacks lie in a crisis of knowledge and being. In others words: philosophical problems.
We see this lack best at work for how mainstream psychology tries to provide a “cure” for illnesses. As there is no doubt that these “cures”, usually involving either different types of behavioral therapy or different kinds of “happy pills”, definitely help someone, there is also no doubt that these two alternatives, are not universal “cures”.
The philosophical input or objection here would be to ask, why there is a need for a cure in the first place. Maybe the problem does not lie in providing a cure. Because what this presupposes is that we have those who are mentally sane and mentally insane; those who are pure and those who sin. Is this not too strong of a dichotomy, is it not too black and white?
The same psychology practitioners who use this dichotomy, use with a gigantic bible: the DSM (Diagnostic and Statistical Manual of Mental Disorders), published by the church of APA, which we students also must obey, through the constant torture of having to cite every ounce of our being, just to make a single argument. It is as if our thoughts don’t matter. I believe we see an allergy to philosophize/theorize here. The problem for DSM, that Stoyanov problematizes in Psychiatry in Crisis, brings up at least two questions: How can you so easily define and divide humans into categories? In what way does it make sense to reduce one human and another to a diagnosis? I am afraid there is a lack of more nuance here. Or to put it in another way: a lack of philosophizing/theorizing.
But these are just symptoms of the lack. We can find more philosophical explanations for this lack in something like the replication crisis. This is an on-going crisis in every field that has to do with human beings. This crisis tries to tell us that there is no way to perfectly replicate any experiment with humans. This has catastrophic consequences for fields that rely on the scientific method (alone). The neuro-cognitivist approach is problematized by the same crisis.
The questions/problems I brought up here are unfortunately not too popular in the philosophical field either. Though there is a slight growing interest in the problems I address, I would say this still isn’t enough. “Philosophers” today are too concerned, in their ivory towers, looking after the truth value in a fortune cookie, rather than to engage with more current issues. In addition, of course, to the necessary work of philosophy. So, on the one hand, we have psychologists who appear to act too much naive in their field, while on the other hand, we have philosophers who act too little naïve in their field. We see the effects of this in the SHoT survey.
Lacanian psychoanalysis
What can be done? In the heading, I mentioned Lacanian psychoanalysis and post-Lacanian philosophy. I believe these two subfields can help us think clearer when it comes to, not just the mental health crisis, but also the political crises that affect our mental health. Of course, this brings up a myriad of problems, as (Lacanian) psychoanalysis does have a problematic reputation, to put it mildly. I will try to scratch the surface on how Lacanian psychoanalysis provides a more nuanced perspective for psychiatry/psychology and try to respond to a usual criticism of (Lacanian) psychoanalysis.
First, what is Lacanian psychoanalysis? “Lacanian” refers to the French psychoanalyst Jacques Lacan. And here we are in the intellectual heir of Sigmund Freud. What Lacan sought to do, was to rehabilitate Freud: to take him seriously, and pick the best from him in order to develop a stronger clinic. Probably because Lacan (and Freud) saw that the clinic at the time, did not match up to expectations. Similar to how this text came about.
Before I argue that Lacanian psychoanalysis has a more nuanced perspective, enriching psychiatry/psychology, I want to mention a dimension of Lacanian psychoanalysis that is relevant to the findings in the SHoT survey; the social dimension. In Lacanian psychoanalysis this is often referred to as the symbolic (order). I will not go into much detail as that is not the purpose of this text. One way of thinking about the symbolic is that it is the social dimension of our lives: our customs, common rituals, etc.. Today, Lacanian psychoanalysts and post-Lacanian philosophers claim that the symbolic is disintegrating. I don’t think this is an unreasonable claim, and I think we see the result of this in widespread loneliness and the lack of customs and common rituals. How do we respond to this? I think we should be wary about being too hasty to conclude with action, but I do believe that thinking about these problems will help.
Therapist “vs.” patient
Why does Lacanian psychoanalysis bring a more nuanced perspective for psychiatry/psychology? Because the subfield has a more nuanced perspective on ontology; on the study of our being; who we are as a species. In effect, Lacanian psychoanalysis has a nuanced perspective on madness. I believe Lacanian psychoanalysis does not have the same top-down, dichotomic perspective that “those who are mad” are somehow some other types of beings, like mainstream psychiatry and psychology can seem to assume. According to Lacanian psychoanalysis, we are all more or less mad. It is language that tries to bind this madness. What this nuanced perspective on madness brings is a humbler approach as a therapist. Like mental health professional Eliot Rosenstock argues in Zizek in the Clinic (2019):
“The therapist, therefore, is not a subject-supposed-to-know as in the result, but instead is one who knows there is a process of modification that the client seeks, that must be mutually determined through the signifiers presented in the session”. (p. 28, emphasis added)
I emphasized the word that is important because I think this one important aspect that separates Lacanian psychoanalysis from psychiatry and psychology. Through avoiding the all too top-down attitude of the therapist, and rather emphasizing more mutual work, Lacanian psychoanalysis offers something new in the field of the psychiatric/psychological clinic. Though this doesn’t mean that the therapist is entirely devoid of offering help, like Rosenstock points at with the knowledge of the process of modification. It points to the fact that the patient shouldn’t just be served knowledge/truth, but find it, with some guidance from the therapist.
An allergy
There is one typical allergy to Lacanian psychoanalysis, and the allergic reaction is usually that (Lacanian) psychoanalysis is non-falsifiable. This means that it is not really possible to critique the theories of psychoanalysis. And that is because the theories are allegedly too “all-inclusive” and become, allegedly, a theory of “everything”. If one puts a little goodwill into it and skips the hard skepticism, one will realize that this is not the case. I will argue further than slight mockery.
What this critique assumes is that empiricism is the only way to approach knowledge, truth and reality. Empiricism is the philosophy of (sensual) experience; that we can only know something, or declare something true or real, through our experience. The usual “rationalist” objection is: “what about our thoughts/cognition?”. And it is this same objection that can be raised against the critique of the alleged non-falsifiability of (Lacanian) psychoanalysis. Because both empiricism and rationalism rely on the same philosophical premise: that there is a gap between our being and our thought, producing the questions: how do we know things? How is something true? How is something real?
The fact that we can ask these questions are a testament to the fact that every approach to anything is philosophical/theoretical. In effect, this means that the critique of (Lacanian) psychoanalysis that it is non-falsifiable is false. Because it is philosophically/theoretically falsifiable, but not empirically. And as I tried to show, there is more to knowledge/truth/reality than what empiricism can account for.
The conclusive questions
Before I conclude with anything, I want to make sure that I am not trying to say that Lacanian psychoanalysis and post-Lacanian philosophy should replace mainstream psychiatry and psychology entirely, but I hope the subfields will be able to enrich the main fields with nuanced perspectives.
My concern for philosophy is that Lacan’s so called “anti-philosophy” haunts the field, bringing the field into some kind of crisis. Which I think is fair to say we see today; look at the state of philosophy. To respond to this, I believe one must engage with Lacanian psychoanalysis and post-Lacanian philosophy. Why are not more philosophers doing that? It is only appropriate of me to quote post-Lacanian philosopher Alain Badiou (2004) here:
“only those who have had the courage to work through Lacan’s anti-philosophy without faltering deserve to be called ‘contemporary philosophers’. There are not many of them.” – Theoretical Writings, (emphasis added)
I hope practitioners in psychology, and philosophers, dare to take Lacanian psychoanalysis and post-Lacanian philosophy seriously today. Especially in light of the current predicament in mental health and the (political) crises that affect our mental health, which can be seen as at least two of the causes producing the saddening results in the SHoT survey. Because I think the subfields can help the same practitioners to think (critically) about their positions and in addition, I think these two subfields can help to explain the lack more clearly in the philosophical foundation of mainstream psychiatry/psychology.
Though I acknowledge that mainstream psychology’s approach helps some, my concern for psychiatry/psychology is that there is too little philosophizing and too little naivety. Why? Because I believe we are more complex (but in some paradoxical sense, simpler) than what mainstream psychology manages to account for. The lack of philosophizing/thinking appears to be the result of a lack of courage, curiosity, thinking and even some laziness. Why is that?
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