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Psychotherapy as Praxis: Abandoning Misapplied Science

by Louis S. Berger

118 pages; quality trade paperback (softcover); catalogue #02-0038; ISBN 1-55369-225-X; US$22.00, C$34.00, EUR22.10, £15.40

Continuing his earlier unconventional critiques and proposals concerning the misapplication of science to psychotherapy, the author presents a radical approach based on psychoanalysis and Aristotle's unorthodox and virtually unknown conception of praxis. A detailed example of a praxis-based psychotherapy is developed, and its advantages over mainstream scientifically based treatments are shown. Ways of generalizing this specifically clinical praxis to other contexts (for instance, to sociocultural and philosophical issues) are discussed. The book thus operates on clinical, cultural, and philosophical levels, and will be of interest to specialists and generalists alike.

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about the book      about the author      Contents and excerpt      catalogue info

About the Book For over thirty years, Louis Berger has challenged and criticized psychotherapy's scientific ambitions and claims. However, while most critics of the mental health field typically have maintained that what was needed is more and better science, the author, surprisingly, recommended just the opposite: psychotherapy should rely on science less. This recommendation, based on Dr. Berger's extensive clinical and technical-scientific background, links up with the past century's many recurring criticisms of "rational-calculative" thinking in general. Major figures such as the philosopher Martin Heidegger have pointed out that all too often in Western culture, the scientific world view and its attendant practices - "technology" in the broadest sense S has been and continues to be dangerously misapplied, used in the wrong areas with destructive results. In two earlier monographs and more than 40 journal articles, Dr. Berger had presented critiques of the mainstream, scientifically-oriented psychotherapies ("technotherapies), and proposed alternative approaches. The present volume enlarges on these earlier efforts by introducing a new ingredient: Aristotle's idea of praxis. This complex, unconventional, unfamiliar concept, only very distantly related to our contemporary notion of "practice" (as in "theory and practice") , was intended by Aristotle for use in those disciplines where scientific approaches are inadequate and unsatisfactory. The author asserts that psychotherapy is one of these disciplines. Aristotle's general ideas about praxis are integrated with unorthodox aspects of psychoanalysis to yield a praxis-based psychotherapy, a clinical praxis. A detailed example is presented which demonstrates the advantages that such a praxial psychotherapy has over therapies that presumably are grounded in scientific thinking and research. The final chapter, "Bringing about change," includes a discussion of the potential that the praxial approach has for being used in other important applications. It indicates that suitably modified generalized versions of a clinical praxis could be brought to bear, for example, on societal conflicts (including those that may be raised in the mental health field by the introduction of a non-technological, praxis-based psychotherapy), or on philosophical problems. Thus, Psychotherapy as Praxis is a multifaceted work that operates on a constellation of levels S clinical, cultural, and philosophical S and consequently will interest generalists as well as readers from diverse disciplines.

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About the Author Louis S. Berger's rich professional life spans the fields of clinical psychology (Ph.D.), engineering (B.S.E.E.), physics (M.S.), and music (M.M.). Formerly he has been on the faculty of the Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, the Staff Psychologist at Southwest Research Institute in San Antonio, and consultant to various mental health and forensic organizations. He also has an extensive research background in applied physics and biomedicine, and for a decade was a cellist with the Boston Symphony. Dr. Berger is the author of Substance abuse as symptom: A psychoanalytic critique of treatment approaches and the cultural beliefs that sustain them (The Analytic Press, 1991), Psychoanalytic theory and clinical relevance: What makes a theory consequential for practice? (The Analytic Press, 1985), Introductory statistics: A new approach for the behavioral sciences (International Universities Press, 1981), and numerous journal papers and book reviews. Currently he is in private clinical practice in San Antonio, Texas. Also by Louis S. Berger: Issues in Psychoanalysis and Psychology: Annotated Collected Papers

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contents and excerpt

Contents

1 POLARITIES: TECHNOLOGY, PRAXIS, PSYCHOTHERAPIES

Notes

2 THE TECHNOTHERAPIES

Modernity
Technotherapies

A Generic Model of Technological Activity
The Model Applied to Psychotherapy
The Role of Theory in the Technotherapies

Notes

3 CRITIQUES OF TECHNOLOGICAL THINKING

Problems Arising in the Exact Sciences
Problems Raised in General Psychology

Poor Science
The Pretense of Objectivity: Importing Values Surreptitiously
The Premise of Universal Laws
Reification

Problems Raised in Psychotherapy
A Praxis-Based Critique
Notes

4 PRAXIS-BASED PSYCHOTHERAPY I: GENERAL CONSIDERATIONS

Aristotelian Levels of Knowledge
Praxis, Phronesis, the Phronimos

General Features of Praxis
Domains of Application
The Role of History and Experience: Character Validation

Translating Generalities into Clinical Specifics
Notes

5 PRAXIS-BASED PSYCHOTHERAPY II: PERSONAL VIEWS

History
Obstacles to the Exposition and Explication of Praxis
The Therapist's Character

The Acquisition of Phronesis
Efficacy of the Process in Psychoanalysis
Reflections on the History of the Training Analysis

Praxial Psychotherapy as a Deconstructive Process

Free Association: Mainstream Conceptions
Free Association as Central in a Praxis-Based Therapy
The Training Analysis, Again

The Role of Available Theory in Clinical Praxis
Further Considerations Concerning Training

Free Association in Therapists' General Training
Free Association's Complement: Analytic Neutrality

Notes

6 BRINGING ABOUT CHANGE

Technology's Homeostasis

Motives
Obscuring Strategies
Mechanisms of Inertia

Defensive Needs of Groups and Populations A Strategy for Change?

The Microcosm/Macrocosm Problem
Stopping the Action
Sociocultural Phronesis, Phronimos, Praxis
The Danger
Generalizations of Clinical Praxis/Phronesis

Notes

REFERENCES

INDEX

Chapter One
Polarities: Technology, Praxis, Psychotherapies

The importance of the decision one makes about
where an inquiry is to begin can hardly be
overestimated. That decision sets the character of the
questions to be addressed; and by laying down the
terms in which they are formulated, it can even carry
an implicit commitment to a certain kind of answer
to those questions.
        ­Frederick Olafson

 

For centuries, a significant feature of Western European thought has been the presence of "two rival agendas," of "a contest between the doctrine of invariance and the doctrine of flux, of a deep trouble.¹     This troubled rivalry whose presence and influence can already be discerned in pre-Socratic Greece² takes on various forms in numerous different contexts throughout history.³ Its two conflicting positions or poles have been characterized in terms of various pairs of opposing labels and concepts:

rational-technological-calculative/"essential" thinking;⁴ objectivism/relativism; natural or exact sciences (Naturwissenschaften)/cultural or social (humanistic) sciences (Geisteswissenschaften); explanation/understanding; scientific occurrence (Vorgang)/personally experienced event (Ereignis);⁵ mechanism/humanism; naturalism/natural attitude;⁶ cosmos (order of nature)/ polis (order of society);⁷ universal-ahistorical⁸ /particular, individual; fact/value; impersonal logical rationality/ personal wisdom; self-grounding, self-sufficient positivism/ tradition, historicism; scientific reasoning/magical thinking (irrationalism, metaphysics, theology, superstition, mysticism); logic/rhetoric; cognition-reason/affect-emotion- magic; structure/meaning; solitary/social;⁹ neutral-value-free-unbiased/presuppositions-prejudices-values; knowledge by acquaintance/psychological nominalism; ¹⁰ deterministic, timeless universal laws/contingent (local, historical, sociocultural, contextual) practices and beliefs; nomothetic/idiographic approaches; analytic precision/holistic richness;¹¹ science/craft, science/ethics; nature/nurture; external/internal world; primary/secondary qualities; truth/appearance; etic/emic;¹² acon-textual- instrumental-algorithmic-information-processing/ processive-historical-contingent; literal/figurative discourse; content/style; or, syntax/semantics.

    In contemporary terms we would identify the first member of each of these dyads with a scientific orientation (an emphasis on rationality, logic, precision, formalism, objectivity, timelessness, and so on), while the second evokes a humanistic perspective (a focus on history, change, culture, tradition, context, intentionality,¹³ experience, temporality, subjectivity, meaning). The modern framework underlying the first position and its supporting assumptions, beliefs, and practices is often identified and labeled as "Cartesianism."

    The clashes between these poles have become particularly acute and visible in recent times:

A certain oscillation between historicism and positivism has been a central feature of late nineteenth-century and twentieth-century thought.... [T]he theme has been history versus science, or rather broad, endlessly changing, historical conceptions of rationality versus inflexible adherence to such ideas as the idea that there is no rational method except the scientific method and the idea that science is an instrument for predicting stimulations of our nerve endings.¹⁴

    Moreover, it seems safe to say that the latter position­that the only legitimate rational thinking is natural science's, that there is no subject area or context which is not the proper domain for its application­ has been in ascendancy for centuries and now dominates the current scene; "the natural sciences are the accepted paradigms of knowledge."¹⁵

    In short, Cartesianism with its admiration of and zealous belief in modern science has evolved into scientism­a naturalizing ideology, "an obstinate insistence that the methods of the natural sciences... are of universal application.... [an] uncompromising thesis... which brooks no opposition.... [no alternative] deserves to be taken seriously."¹⁶

    In spite of its dominance and wide acceptance, however, Cartesianism/scientism has had its share of extended, thoughtful, deep criticism.¹⁷ Furthermore, the shortcomings and weaknesses which these critiques have identified strongly suggest that some disciplines (e.g., the human sciences) would profit greatly from employing a truly alternative framework or approach­that is, one that does not tacitly, covertly or unwittingly retain the main characteristics of Cartesianism. It seems, however, that such an alternative has not been easy to come by. To my knowledge, the sole candidate is a contemporary version of the approach Aristotle called praxis which will be presented and explored in Chapters 4 and 5.

    That approach is familiar mostly within the field of Aristotelian scholarship. In other contexts it is seldom described and discussed in any detail or depth.¹⁸ In any case, for the most part adequate discussions of Aristotelian praxis tend to be presented at a high level of generality and abstraction, reflecting his own bent. Consequently, it may be useful to develop an example of a specific, concrete version.     Engaging in such a project is a formidable and daunting task (particularly for someone who is not a philosopher), but the present work nevertheless hopes to at least make a start in that direction. The context for my specific delineation of praxis is psychotherapy. The explorations that follow devolve from the premise that it is legitimate, useful and meaningful to sort the broad spectrum of psychotherapies into two distinct types or classes which I will label "technology-based" ("technotherapies" for short) and "praxis-based." Predictably, the technotherapies will be identified with Cartesianism and natural science, and the praxis-based psychotherapies with Cartesianism's "other."¹⁹

    The next two chapters will outline the principal structural and clinical features of the technotherapies, and present critiques. Because as we shall soon see the technotherapies comprise generally familiar clinical orientations and practices, their delineation will be relatively brief. The critiques of Cartesianism are likely to be less generally familiar, however, and will therefore receive more attention. They will prepare the ground for the exploration of an alternative, praxis-based approach.

    Chapter 4 begins this exploration by introducing praxis as a general concept and then investigating what it would mean for this concept to be applied to psychotherapy. Here the discussion remains at a general, abstract level.

    It becomes more specific in Chapter 5. To evolve a meaningful ex-emplar of a praxially based psychotherapy, one must employ specific clinical and philosophical beliefs. Accordingly, Chapter 5 invokes my own beliefs, prejudices, and experiences. Thus, the exemplar of a praxis-based psychotherapy which is developed is highly personal; it is rooted in an unconventional, even radical, variant of psychoanalysis. I must emphasize that I do not mean for this example to be definitive, a canonical embodiment of the concept of a clinical praxis. The intent is to offer a specific example of a praxially-based psychotherapy that would make the general features of clinical praxis which had been presented in Chapter 4 more meaningful and tangible. Still, I would hope that the example has some clinical interest and value in its own right.

    The motivation for developing this version of clinical praxis has been twofold. First, it is meant to be clinically interesting and useful, meaningful and stimulating to psychotherapists and others who are interested in mental health issues. Second, clinical praxis is meant to provide an illustration of a praxis qua praxis for the generalist or philosopher. (In that latter context, the fact that the example happens to be clinical is incidental.)

    In an age where the culture at large is scientistic and dedicated to technological thinking,²⁰ proposals that advocate non- or even anti-technological approaches of any kind are not likely to be welcomed. That will also be true in the mental health field, which after all is a microcosm of the culture at large. Accordingly, since a praxially-based psychotherapy is a nontechnological approach, it is to be expected that its advocacy will raise concerted opposition. The final chapter will explore this potentially adversarial situation and offer initial thoughts about how one might deal with it productively. That discussion will necessarily widen to encompass general issues pertaining to ideologies and to the dynamics that sustain them.
    Let us begin, then, by seeing what structures and qualities characterize the treatments that I am calling the technotherapies.

NOTES

1 Toulmin 1990, 192; Margolis 1995, 6. A deep trouble is "a self-propagating difficulty* [that] tends to be recycled through successive levels of abstraction" (Collins 1998, 837)‹and, one might add, through successive generations as well.
2 Thompson 2000a; Smith 1996, 315n7.
3 The versions that have arisen in different eras and the controversies and battles to which each has led constitute a fascinating and highly complex story‹see, for example, Dunne 1993; Barrett 1978; Bruns 1992; Cook 2000; Caputo 1986, 2-3; Dallmayr 1991, Chapter 1; Roberts 1988; Cahoone 1988; Collins 1998; Toulmin 1990, 2001; Critchley 2001; Pippin 1991; Schmidt 1988; Smith 1991, 1996; Bernstein 1971, 1983, 1992; Bubner 1976; Gergen 1991; Klein 1997; Putnam 1983, 1992, 1994; Margolis 1995; Schacht 1995, Part I.
4 Caputo 1986, 25.
5 Polt 1999, 146-147.
6 Olafson 2001.
7 Toulmin 1990, 67.
8 Nietzsche's "philosophical Egyptianism" (Polt 1999, 147).
9 Bruns 1989, 65; Gellner 1998.
10 Rorty 1999, 54.
11 Garver and Lee 1994, 6.
12 Ibid., 29.
13 I am using that term in its philosophical meaning: "the capacity to be about something," the directionality or valence of thinking, striving (Thornton 1998, 3; also see Olafson 1995, 48-54, 159, 171-172).
14 Putnam 1983, 288.
15 Olafson 1995, 2.
16 Olafson 2001, 7, 76. He calls scientism/naturalism "a totalitarian view of science" and offers extended, multifaceted and comprehensive philosophical critiques (1987, 1995, 2001). A principal point which he examines in numerous contexts and from numerous perspectives, is that science's supposedly "objective," physicalist conception of a human being is covertly yet crucially dependent on our prescientific understanding of the experience of being in the world. (E.g., one first needs to know "naively" what it is to see before one can meaningfully study the optic nerve. One cannot identify or understand the experience of "seeing" solely in neurobiological terms.) This is patently true when the "object" of study is the person (or "person/brain"), but is no less so when one is studying the inanimate world. In the latter case, natural science is just as critically dependent on one's prior understanding of being-in-the-world, on the heavy reliance on what Olafson calls "the natural attitude," but here natural science's pivotal reliance on that understanding has been rendered virtually invisible by science's theorizing, methodology, and ideology (Smith 1995; Olafson 2001). In both of the two contexts the reliance on that "naive" understanding is "ontologically prior" to doing science (Olafson 1995, 252).
17 Olafson 1987, 1995, 2001; Bernstein 1971, 1983; Lovitt and Lovitt 1995; Barrett 1978; Taylor 1995; and Sorell 1991, among others, have devoted monographs to its critique. Briefer critical discussions can be found in, for example, Bologh 1979, Chapter 1; Rorty 1999, 60; Smith 1991; Berger 2001a; Ayer, in Magee 1982/2001, 95-109.
18 Dunne's and Bernstein's writings which discuss Aristotelian praxis in depth are exceptions. Yet, the term "praxis" may seem familiar, probably because currently it tends to be bandied about, used casually, and loosely equated to "practice" (an equivalence that I will reject‹see Chapter 4). Furthermore, it also appears prominently in Marxist writing, but there it has a specialized meaning that is only tenuously related to Aristotle's (Schacht 1975, Chapter 5; Bologh 1979). Accordingly, such a familiarity may be illusory in the sense that it is not a familiarity with the Aristotelian conception.
19 The meaning of this cryptic delineation will be clarified in Chapters 4 and 5.
20 See my earlier remarks concerning scientism; also Note 16, above.

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