The Rise of the Therapeutic Society: Psychological Knowledge & the Contradictions of Cultural Change. Katie Wright

he followed Foucault in arguing that new forms of knowledge about the individual subject were instrumental to the changing means by which populations were governed.⁵⁸ Taking the family as the site of analysis, Donzelot charted the ways in which government of the family gave way to government through the family. He argued that during the nineteenth and early twentieth centuries, state patriarchy effectively displaced the paternal authority embodied in the male head of the family. A critical way in which this was achieved was through the alliance that developed between women (mothers) and the moralizing agents of the state; that is, the family welfare professionals—first doctors and philanthropists, and later psychologists, psychiatrists, and social workers. While not sharing Lasch's psychoanalytic standpoint, he was nevertheless similarly concerned about the consequences of diminishing paternal authority. For as the state secured control over the family, the mother gained greater control within the household, but the father's position was increasingly undermined.

      The authority of professional expertise, buttressed by knowledges of the human sciences, formed a cornerstone of Donzelot's critique. In his analysis, such expertise functions directly through clinical encounters, professional advice, and so on, but also indirectly, through the "regulation of images"—for example, of motherhood and fatherhood—which produced new norms of conduct in relation to family life. He was particularly concerned about the implications of the colonization of private life for families occupying the lower social strata. The state and the helping professions, in Donzelot's view, formed a "tutelary complex" directed toward the socialization of working class families, a process resulting in families being "stripped of all effective rights and brought into a relation of dependence vis-à-vis welfare and educative agents."⁵⁹ By contrast, bourgeois families who willingly seized on new educative, medical, and relational norms were able to exercise greater control over their relationships with social welfare professionals. Nevertheless, for both working and middle-class families, the "protective liberation" of children, in Donzelot's view, amounted to new forms of "supervised freedom" and resulted in diminished autonomy of the family.

      Extending the scope of investigation beyond the family to links between political power, expertise, and the self more broadly, Nikolas Rose has built on Foucault's intellectual project in his analyses of "psy" as an apparatus of truth, power, and subjectification. For Rose, psy encapsulates the various "ways of thinking and acting" which have been brought into existence by psychology, psychiatry, and their cognate disciplines.⁶⁰ As he argues: "The dependence of government upon knowledge … enables us to appreciate the role that psychology, psychiatry, and the other 'psy' sciences have played within the systems of power in which human subjects have become caught up. The conceptual systems devised within the 'human' sciences, the languages of analysis and explanation that they invented, the ways of speaking about human conduct that they constituted, have provided the means whereby human subjectivity and intersubjectivity could enter the calculations of the authorities."⁶¹

      Rose underscores the centrality of psy knowledges and psy professionals in the government of subjectivity in the current era. In his account, there are essentially two means by which psychological "knowledge and know how" is disseminated. The first is via the organizational practices of those involved in the helping professions, for example in social work and nursing, but also more broadly through the work of those charged with authority over others, like teachers and managers. The second route operates through what he refers to as "psychotherapies of normality"—that is, ways of relating to oneself and others, including the development of techniques for dealing with problems, planning for the future, and devising ways of achieving happiness. For Rose, the interpretation of experience through a psychological or psychodynamic lens underwrites the vast array of therapeutic technologies, including "self-inspection, self-problematization, self-monitoring and self-transformation."⁶² With the rise of psychological knowledges and the diffusion of psychotherapeutic techniques, Rose argues that "a new culture of the self has taken shape. Confession has moved beyond the consulting room" and everyday life has become subject to a kind of "clinical reason."⁶³

      This so-called clinical reason is evident not only in processes of self-analysis and the analysis of others, but the concomitant role of talk in the therapeutic society. Foucault's genealogy of confession is useful here. He traced the history of confessional practices, particularly those associated with sexual prohibition, from the religious realm—where confession was associated with renunciation—to the medical arena where "the obtaining of the confession and its effects were recodified as therapeutic operations."⁶⁴ For Foucault, confession is a "technology of the self," a means by which the self is constituted. In the Christian tradition, such verbalization was linked to renunciation of sin; however, with the influence of the human sciences, Foucault argues that verbalization became important in its own right: "From the eighteenth century to the present, the techniques of verbalization have been reinserted in a different context by the so-called human sciences in order to use them without renunciation of the self but to constitute, positively, a new self. To use these techniques without renouncing oneself constitutes a decisive break."⁶⁵

      As through confession, constituting the self "positively" in the therapeutic society is also enacted through consumption. Rose connects what he terms technologies of consumption with psychological technologies, arguing that the two are interlinked; consumption is stimulated through advertising and market research which utilizes psychological knowledge and techniques, while psychological expertise is itself disseminated by means of therapies and products to be consumed.

      Other influential Foucauldian-inflected accounts have focused more explicitly on the ways in which the expansion of psychological and psychiatric knowledge in new networks of power has had uneven effects for individuals and groups in varying social strata. In The Rise of the Therapeutic State, Andrew Polsky employs a Foucauldian analysis, informed also by Thomas Szasz as well as the concerns of anti-psychiatry, in arguing that the therapeutic becomes a mechanism of normalization of marginal populations. He argues that both public and private therapeutic intervention generally operate as a means of support for the middle classes who are able to choose when to begin and when to end treatment: "By contrast, public therapeutic intervention aimed at marginal citizens proceeds from the assumption that they cannot govern their own lives. The state therefore seeks to 'normalize' them… Lower class clients do not seem to require merely a bit of support, like their middle-class counterparts, but instead wholesale personal and family reconstruction."⁶⁶

      Foucauldian analyses have provided important insights into the critical role of psy knowledges in the operation of power, notably through techniques and practices directed towards "the shaping of conduct."⁶⁷ As a framework for theorizing the therapeutic, however, a governmentality approach is not without its problems—at least insofar as it has been deployed to date. As Anthony Elliott has forcefully argued, studies of governmentality inspired by Foucault have tended "to offer a dark, oftentimes a sinister, account of social processes."⁶⁸ Not only does an inherent distrust of the routines of social life often emerge, but the model of personhood upon which such theorization hinges constitutes a fundamental weakness; it is highly individualistic, provides little attention to the workings of emotional life, and only a limited understanding the self in its relation with others. Moreover, as Elliott points out, both in Foucault's work and in Rose's extension of it, there is "no adequate account of human agency, since the self simply appears as the decentred effect of an analytics of governmentality … In short, inadequate attention is given to the active, creative struggles of individuals as they engage with their own social and historical conditions."⁶⁹

      The notion of selfhood that emerges from Foucauldian theory is thus deeply problematic. As Lois McNay argues, the "lack of a rounded theory of subjectivity or agency conflicts with a fundamental aim of the feminist project: to rediscover and re-evaluate the experiences of women."⁷⁰ An associated problem concerns the inadequacy of Foucault's explication of the complex relation between "care for the self" and "care for others," which neglects the ways in which "care" has been socially assigned to women and construed as "feminine" and domestic.⁷¹ This raises particular problems for interpreting critical dimensions of the therapeutic society, particularly the ways in which gender and the therapeutic terrain intersect. As feminist theorizing of the ethics of care reminds us, human dependency is a central dimension of existence and there are moral values