We have become active consumers of therapy!
This notion raises immediate alarm in the humanist and learned community for such notions stand to trivialize the suffering of many (as much as a quarter of Americans (Terlizzi & Zablotsky, 2020)) and feed the paternalistic stereotypes (e.g., weakness) around seeking help for mental issues. However, my intent is the archeology of mental health problems on the one hand, and a critique of the commodification of mental health and an uncanny attitude towards active consumption of psychotherapy in contemporary capitalist societies.
As Fromm points out, the root cause of contemporary psychological troubles is the modern society governed under the rules of unbridled capitalism that reduces individuals to competing automatons vying for extravagant lifestyles and in pursuit of unrealistic desires dictated by the plethora of choice and the illusion of infinite possibilities (Sica, 2005, pp. 508–513). I want to touch upon this idea of choice – or the paradox of it – that creates unnecessary and unreachable objects of desire before moving on to the aforementioned ideas. Choice, in social and political theory, has been regarded as something good and equated with fundamental freedoms, an example of which is a democratic choice. However, choice increases our cognitive misery. It introduces the calculus of comparison in our decisions, often complicates them, and causes frustration as a result of over-expenditure of cognitive energy. I regard choice as a damning privilege(*), a modern invention, which produces an illusion of independence while leaving us dependent on the mechanisms that make us sad and tired, like hamsters running on fixed wheels in gilded cages. The root of the contemporary epidemic of melancholy is this tension between desires arising from the possibilities – a mansion, a sports car, a vacation in exotic lands, etc. – that capitalism lays out for us through enticing advertisements, making us run as hamsters chasing these mirages while doing the jobs we hate, which do not pay us enough to fulfill our desires, which make us depressed and miserable, turn us into self-loathing filth who ends us seeking help from professionals – the psychotherapists – whose growth is tied with the growth of capitalism itself.
We live in a confessional society, and the psychotherapist is the priest we confide in about our troubles. He is not the only one to whom we turn to cry for help; we livestream our misery on Facebook, Instagram, TikTok, you name it. Capitalism has taken away the pleasure of living the moment and replaced it with a constant performance of the idealized life – the life we see on media, the life that is care-free, the life that transports us away from our 9-to-5 jobs into synthetic Eden. If we do not go to Disney World, take a vacation in the Bahamas, buy Hermes handbags, or don Gucci suits, we feel like utter failures because capitalism makes us believe that’s what the normal people do. We find ourselves working hard yet not making enough to afford a good life. This highly idealistic life itself is a mirage as I have talked to people who make as little as 20k a year to 200k a year, constantly complaining that it is difficult to make both ends meet. There is a mismatch between growing expectations and reality, and this is the source of our psychological problems. The choice or the illusion of it is making us miserable.
The reality around us is so distorted that we cannot make sense of our troubles. We turn to psychotherapists because we need someone else’s help to discover what is wrong with our personal lives. There, an interesting dynamic comes into play. People have been seeking help from the wise men, prophets, shamans, and oracles throughout human history, but those visits were often a one-time thing, and these individuals found enlightenment after talking to these supposedly gifted men and women who appeared to have the answer to their fundamental queries. The relationship between psychotherapists and their clients is a repetitive process, which is akin to weekly confession in front of a priest, in my understanding. The client confesses to his anxieties, fears, and premonitions to an impartial therapist who listens and intervenes when necessary. After that session, the client feels relieved and goes back to whatever he is doing in his ordinary life – only to come back again at regular intervals to vent his emotions.
There are three observations connected to this mode of interaction. (1) Emotions are discouraged in modern societies, so therapy becomes an acceptable zone for expressing those emotions and compartmentalizing them within the broader existence of a worker. (2) Capitalism runs on therapy to deal with the prosaic and sometimes demanding work imposed on the worker on hand and the exacting demands of consumption and imposed desires on the other. The therapist becomes an essential link in the capitalist mode of production which helps the worker stay sane against the psychological conundrum produced by these conditions. No wonder organizations have dedicated therapists on their payroll and mandate workers to see them regularly for the sake of increasing productivity. (3) On the worker’s part, therapy becomes an escape from reality – a necessary one. It becomes something to be consumed. Mental health is reduced to a commodity to be exchanged in return for wages, in turn, to maintain productivity for the capitalist and sanity for the worker. It also becomes an object of class distinction, with the rich consuming the best therapy while the poor are limited to opiates to deal with the oppressive conditions. The therapist himself becomes a worker who exchanges his labor for wages.
The second façade of this farce is individualized responsibility for staying sane, which is tied to the broader perspective of the individual as a project in modern societies. Nervous breakdowns are not attributed to external conditions, i.e., how labor is organized or how unrealistic demands are projected on the masses, but attributed to individual maladjustment. A mundane, repetitive job is seen as liberating, and the individual is urged to adjust himself. Those who fail to adjust themselves to these conditions are called lazy and bums. Those who could not stand this pressure are deemed weak and maladjusted. They are persuaded to exercise, to eat well, to take care of themselves, and a failure to do so is equated with their inability to change their lifestyles. It is never capitalism that is blamed, but the individuals who fail to join the hordes who join gyms, consume low-carb diets, take mindfulness classes to stay fit for the job. The whole movement of the individual as a project is a pathology, yet those who do not follow the herd are deemed sick. We live amidst a “pathological normalcy” (Sica, 2005, p. 512) in which the system is seen as normal while those who fail to adjust are deemed sick.
The bottom line of this discussion is that we live in an age where freedom is cloaked in choice, which obscures the fact it is exactly what makes us sick (in a metaphoric sense). This choice itself is a curtail choice, i.e., it is not the choice to abstain from consumption but to consume various alternatives. Hence, “I consume; therefore I am”. Consumption becomes yet another “pathological normalcy” along with therapy to deal with the inability to consume. The therapy itself is then reduced to an “object of consumption” to be consumed regularly to cope with reality. Mental health, in that sense, is reduced to a commodity, and so are the services of the therapist, who becomes an essential tool of the capitalist mode of production without whom the productivity of the system falls. The relationship between the person – interestingly called the client – and the therapist becomes that of economic exchange, i.e., the more one spends, the better service one gets. The therapist – and the society at large – in turn, diagnoses the problem within the individual and absolves the system of any responsibility. With the recommendation of exercise, mindfulness, and sedatives, the individual is prepared to return to his job – only to come back to consume therapy again at regular intervals.
Dostoevsky, F. (1992). The Brothers Karamazov. Vintage Classics.
Sica, A. (2005). Social Thought: From the Enlightenment to the Present. Pearson.
Terlizzi, E. P., & Zablotsky, B. (2020). Mental Health Treatment Among Adults: United States, 2019. NCHS Data Brief, 380, 1–8.
I would like to invoke here my favorite fable presented by Dostoyevsky in The Brothers Karamazov (Dostoevsky, 1992, pp. 209–224) in which Christ returns to Earth amid the Inquisition. He is immediately recognized by the folks who ask him to cure the sick and the lame and perform he does but catches the eye of the Cardinal – The Grand Inquisitor – who immediately orders his arrest, and Christ is put in a dungeon. In an ensuing dialogue, the old Cardinal reprimands Christ for hindering the good work of the Catholic Church. He accuses Christ of placing the awful burden of free will on the believers by persevering and refusing to perform miracles when tempted by Satan, which was detrimental, according to the Cardinal, for people need to see miracles to believe. By taking the high road, Cardinal argues, Christ condemned the folks actually to confusion and torment instead of freedom. The Church, the Cardinal says, is correcting his mistakes by doing the work of Satan – riding the free will and substituting it with security that comes with absolute and total obedience to the Church who satiates their spiritual and material needs and performs miracles on the behalf Christianity. Moral of the story: less choice keeps individuals satisfied?