CULTURAL PLURALISM AND PSYCHOTHERAPY

IN THE UNITED STATES

Recent estimates suggest that there are over five hundred approaches or systems of psychotherapy being practiced in the United States. This efflorescent situation emerged since the end of the Second World War. Not too long ago, the role of psychotherapy was identified with the profession of psychiatry and of psychoanalysis. In some measure, the emergence of the "modern" therapies was a reaction against the medical and anthropological presuppositions generally prevailing in psychiatry and in psychoanalysis. The proliferation of approaches was related also to the need for psychotherapeutic services in the military services during the war and for the large number of veterans of the war who were hospitalized after the end of World War II. These societal pressures also account for the growth of the community mental health field. Another factor that favored a plurality of approaches was the cultural situation of the United States as a country of immigrants. This made it necessary to accommodate each group to the inevitable differences between it and the many other immigrant groups which constituted the population of the country. In other words, the openness of the American cultural situation, because of the diversity of its population, necessitated such openness in a general way. This was favorable also to the diversity of approaches in the field of psychotherapy as in many other fields of study and praxis.

It is not surprising, when one considers what is unique to the American cultural situation, that accommodation and adaptiveness are operative conditions which reflect themselves in the differences underlying the pluralism visible in the field of psychotherapy. In a nation of immigrant groupings, especially in the cities, demographic factors resulted in inevitable conflict. The states were united not so much by a free choice for consociation as by necessity due to the potential for conflict. Superficially, these cultural-historical issues seem very remote from the issues that concern us in the matter at hand; but one must insist that only apparently is this the case.

To be different remains at the heart of "being American". Nevertheless, this is not altogether welcome for Americans because of the understandable need of human beings to "be the same", to achieve a common collective identity; there is an essential need for unity, togetherness, etc. Because of the ever present potential for conflict which we have outlined briefly, there are strong pressures for conformity. Undoubtedly conformity is part of every human community, but this has its unique features in American society because of its cultural historical background.

We cannot imagine adequately the potential for conflict in the field of psychotherapy where so many approaches and styles of practice exist. Every approach to psychotherapy advertises itself in a typical manner: every system of psychotherapy explicitly or implicitly considers its approach as the true way, as the ideal theoretical and practical model of psychotherapy. This unblushing claim is clearly evident in contemporary psychotherapeutic literature. The examples are endless, e.g., Client-centered Therapy (Rogers, 1951), Orthodox Psychoanalysis (Hartmann, 1964), Gestalt Therapy (Perls, 1969), Transactional Analysis (Berne, 1961), Family Systems (Bowen, 1978), Hypnotherapy (Erickson, 1980), Existential Analysis (Binswanger, 1936), et al.

On the surface the different approaches to psychotherapy represent competing visions with regard to goals and therapeutic treatment. But these differences point to social, political, and philosophical factors from which many presuppositions emerge. Here, too, differences abound, though hidden in their apparent structures.

The openness of American society to the therapeutic is importantly related to the immigrant history, as Zilbergeld insists:

From the start, America was more focused on the individual--his rights, property, and ambitions--than were other countries. Ties to tradition, family, community, and religion were transformed and usually weakened by the simple fact of immigration, and the situation in the new land caused further changes in the traditional social arrangements. The individual emerged as the primary element in society.⁽¹²⁵⁾

Individualism in America emphasizes personal rights, property and personal ambitions. The person wanders about by himself, as do the literary characters of such authors as Mark Twain, Melville, and Hemingway. The mythic American, Daniel Boone, epitomizes this idealization of unfettered individualism. To live in this unfettered manner, being true to oneself and beholden to no one, to rely solely on one's values--this all sounds virtuous; but it is a difficult way to live. The primacy placed on the individual carries with it much uncertainty: whether one is making the right decisions, whether one is thinking realistically, whether one's particular choices and those of a life span are proper or correct.

The main functions of a cultural tradition are to eliminate uncertainty in matters of choice and decision, or at least to minimize the possibility of uncertainty, to keep it within tolerable bounds. When people are guided in important life choices by tradition, they do not have to be troubled by uncertainty about such things; they follow the common ways prescribed by the tradition. Without oversimplification, they just follow the rules of common sense as these are constituted by their own tradition.

In contrast, to be free to manage one's life--the first credendum of individualism--one must make one's own decisions, carry through on them and live with the consequences. This is the necessary risk and the adventure of the individualistic orientation. Often one's values and decisions about many things may differ from those of other people, and being different one is to a significant extent cut off from them. So too, isolation emerges in the situation of living among others whose values and life orientations are unlike one's own. Here, we see that uncertainty and isolation are some of the important prices that must be paid in living the individualistic ideal.

For the reasons just given, the freedom anticipated and prized in individualism is also troublesome or annoying. This is manifest in Americans who are always on the lookout for someone who will tell them or advise them on all sorts of matters, whether in business, professional, health or nutritional matters. This searching for others to advise one is ordinarily expressed as a search for "pointers", for ultimately one is to decide for oneself. This is a way in which the individual may break out of his isolation and join with others as an approach to fighting against the separateness inherent in this way of life.⁽¹²⁶⁾

Another aspect and value of individualism is "to better oneself": the moral obligation to better oneself is a part of the individualist ethic. Presupposed here is that everyone is given certain talents and potential, and that one should develop them to the fullest possible extent. What enters into such consideration is the egalitarian belief that a man must justify the "gift of equality" by making full use of the opportunities that such a way of life offers. What we see here is a belief in the perfectibility and malleability of people, a belief that men and women have a duty to improve themselves.

That some contradiction may exist between the goals of self-betterment and the good of society is not often acknowledged by Americans:

Self-improvement--or self-actualization, as we now call it--has usually had a moral tone in American life. We were bettering ourselves not only because we were concerned with ourselves, but also because such a course was in the best interests of everyone, was right, and was what God intended.⁽¹²⁷⁾

The tone of the foregoing statement accounts in many ways for the seriousness and at times self-righteousness that pervades many psychotherapeutic enterprises. Even books on how to improve one's sex life or books on how to make more money often sound as if the "salvation of souls" is at stake.

Another attitude that is characteristically American is that of unbounded optimism. A country settled by immigrants became a people who hoped and expected that life could be better. The relative absence of traditional barriers to succeeding in whatever enterprise and the willingness for hard work served to foster an optimistic outlook. Moreover, people did succeed in great part:

The sense of fate was weaker here than elsewhere (Europe). The very act of immigration was itself a challenge to fate. And in this new land, with new rules and opportunities, it was not difficult to believe that what happened to a person was more a result of what he did than what the gods decreed. De Tocqueville noted that Americans were "apt to imagine that their whole destiny is in their own hands". There seemed to be no limit to what you could do for yourself. . . .

People can become richer, happier, healthier, or anything else they desire. This kind of thinking is an important component of the therapies of the past and of the present. It is difficult to imagine therapy flourishing in a society that does not place a high value on human plasticity and the possibilities for constructive personal change.⁽¹²⁸⁾

There are societal factors, then, which constitute a favorable condition for the popularity of the psychotherapies. To value possibilities for constructive personal change is related closely to the idea that one has a right to happiness; this certainly is evident in the positive attitude of Americans towards the psychotherapies. Americans are raised to expect so much of life that almost nothing can satisfy their cravings. As people who believe they are entitled to happiness, Americans are highly receptive to anything that promises self-betterment both in the outer and in the intra-spheres of life. Any deficiency or lack of competence becomes a barrier or obstacle to the pursuit of the happy life. For our ancestors the accumulation of wealth, the strong work ethic, and even religious devotion were the usual means of overcoming obstacles. In these times, psychological development and well-being have, to a great extent, displaced these as the main way of securing happiness.

We have a great capacity to turn anything that bothers us into a problem. If something is seen as a problem, we quickly employ our native optimism in order to find a solution. In the main, our character structure tends to refuse the possibility of insoluble problems. The belief that there are solutions to anything that bothers us permeates the technological orientation of the society. This is the novel aspect of the American experience. We believe that anything that needs to be fixed--whether it is a car, a road, or a "dysfunctional" person--can be changed for the better. As one therapist writes, "Somewhere there is a technique that is just right for you." All that must be done is to find the right technique; accordingly, we can take care of everything. As noted, there are over five hundred approaches to psychotherapy.

THE PSYCHOLOGICAL MAN

We have described a few of the salient beliefs of Americans, both in the past and in the present. The self-help genre of books are a part of our history. In the nineteenth century books filled with advice for domestic problems, child rearing, how to become rich and successful, and how to be happy, were very popular for the readers of that time. Such were the beginnings of the psychotherapeutic movement. Late in the nineteenth century, George Beard published a book, American Nervousness; in it he listed a host of feelings and behaviors that medicine had previously been unwilling to acknowledge. The way was being paved for the acceptance of Freud.

Jerome Frank contends that psychotherapy can be viewed as a social institution created to fill the gap left by the decay of other belief systems and their institutional structures--belief systems that heretofore gave meaning to life and a deep feeling of connectedness to others.⁽¹²⁹⁾ The precursors of psychological well-being were what Rieff calls the therapies of commitment:

From Plato to Aristotle, through Burke and De Tocqueville, . . . therapeutic implication was remarkably consistent: an individual can exercise his gifts and powers fully only by participating in the common life. This is the classical (therapeutic) ideal. The healthy man is in fact the good citizen. The therapeutic and the moral were thus connected in the Western tradition. . . .

In the Middle Ages, this tradition was institutionalized in a church civilization, with the therapeutic functions reserved to functionaries of the churches. On the symbolic level, the integrative functions were expressed in doctrines such as that of natural law. Disagreement was largely about means, not ends. . . . Church civilization preserved those conventional understandings by which men hold together in communities, granting to the individual only a limited range of alternatives in belief and action. . . . This church civilization resorted to authority figures--those who really did have the answers, in an official sense--who could resolve . . . conflicts. Should one ask (of this classical tradition): "What cures?" the answer will be frequently tantamount to the question: "Who cures?"⁽¹³⁰⁾

According to this classical theory of the therapeutic, it is the community that cures, that answers all problems, that overcomes whatever uncertainty and troubles the individual person experiences. Likewise, all problems that emerged from the intrasphere of the human were provided with proper solutions. The function of therapist of the church civilization was to commit the patient to the symbol system of the community, by whatever techniques were sanctioned. All therapeutic efforts intended the reintegration of the subject into the communal symbol system. The priest or the philosopher or the physician each stood for the community as the ultimate corrective of personal problems or disorders. Thus, the symbol system of the community provided the cure and answers to all the problems of an individual.

Rieff and Zilbergeld agree that in the modern period these classical symbol systems of church civilization, the "commitment therapies" broke down and lost their power for integration. It was into the resulting vacuum that the psychotherapies of our time became the successors of the therapies of commitment. This transition involved a "deconversion", a period of time during which literature, sociology and other disciplines have mourned "the end of Christian culture".⁽¹³¹⁾ According to Rieff, this long period of deconversion has come to an end. The age of psychological man who succeeds believing man has arrived.

There is much hope in the new or emerging man, psychological man: "The old have given way now to their logical and historical successors, the psychologizers, now fully established as the pacesetters of cultural change." As inheritors of the dualist tradition, the psychotherapists (the psychologizers) pit or oppose human nature against the social order, that is to say, against the therapies of commitment. The image of the new man differs remarkedly from the image of the old man of the Church civilization who was conservative, ascetical, and struggled or even fought against one's needs. The image of the new psychological man is that of being a needy person "permanently engaged in the task of achieving a gorgeous variety of satisfactions."⁽¹³²⁾ Psychological man intends a cultural revolution, but it is definitely and deliberately not in the name of a new communal order. As Rieff ironically prophesizes, "the therapeutic will be a man of leisure (not a working man), released by technology from the regimental discipline of work so as to secure his sense of well-being in highly refined alloplastic ways."⁽¹³³⁾ As a reformer, the new man is optimistic:

Everything conceivable can be made universally available.

Variety has become a term of control as well as remission. Confronted with the irrelevance of ascetic standards of conduct, the social reformer has retreated from nebulous doctrines attempting to state the desired quality of life to more substantial doctrines of quantity. The reformer asks only for more of everything--more goods, more housing, more leisure; in short, more life. This translation of quantity into quality states the algebra of our cultural revolution. Who will be stupid enough to lead a counterrevolution?⁽¹³⁴⁾

In this new world of endless satisfactions, quantity has become quality: the answer to all questions of "what for?" is "more". What this amounts to, according to Rieff, is a redefinition of charity, of the inherited faith of Christianity. Out of the redefinition, our culture (and that of the West generally) is changing into a symbol system unprecedented in its plasticity and capacity to absorb. Nothing can oppose it, Rieff believes, and it welcomes any and all criticism, precisely because, in a sense, it stands for nothing. What follows from this interpretation is a view that the present struggle between capitalism and socialism is based on their being in different phases of the psycho-historical process. This difference can be resolved readily when both sides understand that they share the same goal, that both assume that wealth is a superior and adequate substitute for symbolic impoverishment. The American and the Marxist cultures are essentially variants of the same belief in wealth as the functional equivalent of a highly developed civilization.

The belief in wealth presupposes specific dimensions in the human personality. What is focal in this regard is the functional or ego dimension of the human personality which signifies the capacities of agency of the human being. Functional or ego agency gives direction to human possibilities in relation to the external world. The shaping of human action in the world of work is the central manifestation of egoic function. In this sense Rieff insists that American culture, as Soviet cultures in the past, aspires to the idea of a highly developed civilization. A particular vision of human well-being and happiness in both instances is centered in the valorization of the ego and its dynamic agency and adaptive potencies. In the psychoanalytic movement, this is precisely what personal maturity means. Accordingly, psychoanalysis intends the liberation of the individual human being's capacities (Hartmann, 1964):

The consideration of the conflict-free ego sphere leads us to the functions which are more or less closely related to the tasks of reality mastery, that is, adaptation. Now adaption--though we do not discuss its implications frequently or thoroughly--is a central concept of psychoanalysis, because many of our problems, when pursued far enough, converge on it (p. 22). . . .

Generally speaking, we call a man well-adapted if his productivity, his ability to enjoy life, and his mental equilibrium are undisturbed (p. 23).

Here again, in a more dynamic and egoistic analytical sense, we understand the historically oriented analysis of American individualism as we earlier recalled Zilbergeld's contention that the earliest buildup of the American experience was focused and gave primary importance to the "rights" of the individual, property and the unfettered fostering of personal ambitions. He is correct in his opinion that this valorization then led to a transformation and weakening of traditions, family structure, communal life and religion.

Ultimately, such valorization of the individual's functional capacities and adaptiveness would result in the problems of functionalism, of an overvaluing of psychoanalysis and most other psychotherapies influenced by its liberationist ideal centered on the goals of reality mastery. The idolization of function, of adaptiveness in traditional American psychology, has always identified itself with the natural sciences. The mastery of reality points to the primacy of objective thought and knowledge. The human scientific movement in the United States is one of reaction to, and critique of, this historic idolization of human agency or function. There is a paradox here: this excess we call functionalism emerged out of the deep ideals of "human rights" which were at the heart of the egalitarian, democratic American revolution.

To outline briefly the human science approach to various concerns, we will now articulate some of the perspectival contributions of this approach. It presupposes the work of traditional natural science thinkers and writers in the social sciences and in the philosophy of science. The philosophical anthropologial presuppositions of the natural science approach are put into question. This is true particularly of existential-phenomenological research in philosophy, sociology and psychology. The graduate program in clinical psychology at Duquesne University was founded precisely as a theoretical enterprise dedicated to taking up the foundational problems of psychology conceived as a human science. This required that its psychologists begin a work of critical inquiry within the context of the traditional scientific enterprises, those of natural scientific psychology. It is in this sense that we shall take up now some of the issues presented schematically, viewing them at this time from the more philosophical and anthropological perspectives of existential-phenomenological reflexion.

FUNCTIONALITY AS ROOTED IN FUNDAMENTAL EXISTENCE

Existential philosophers, sociologists and psychologists hold in common an anthropological view of the human being; all subscribe to the idea that there is a transcendent aspect to the human personality. What constitutes transcendence varies considerably from one existential conception to another. However, they agree that human becoming means transcendence of the ego, that human development goes beyond egoic agency. Accordingly, much of the critique of functionalism ultimately intends an affirmation with regard to transcendence as such. For example, Gabriel Marcel posits transcendence to mean mystery, the mystery of being. On this view the human being is defined as participation in the mystery of being (1967, p. 40).⁽¹³⁵⁾

Marcel emphasizes that contemporary humanity distorts the importance of the ego, of agency and function, especially because modern technology has made possible the transformation of the world, such that it threatens to destroy spiritual values, to destroy man's spiritual view of humanity and of the world. Technology places in man's hands powers that he has not earned, that offend the dignity of his own being and that threaten his own existence.

Moreover, this increase in human agency bestows upon man the right to exercise powers without a corresponding inner transformation. That is to say, such powers of agency when related solely to adaptation do not effect a spiritual transformation, the heart of man's being is therefore forgotten and ignored. The transformation brought about through the increases of power through technology become sources for the creation of a pseudo-solidarity among men. As a problem, this is everywhere evident in the psychotherapies, as we have noted before. Another element of Marcel's critique of functionalism is that it absorbs man in the world of desire and fear, an absorption that distracts and diverts attention from the world of mystery, which is foundationally more relevant to one's humanity.

Technological power also degrades the value of the human person by equating him totally with how much he produces; this is true even when people contend that increases in creativity are involved in such transformations. The idolization of functional adaptiveness deforms man's essential being:

The case is radically altered when technical knowledge begins to claim a sort of primacy in relation to modes of thinking . . . that concentrate on being rather than doing. It should be clear . . . that these remarks are a development of those I made about the notion of function, insofar as this contrasts with that of an actual grip on being, of any sort.

But what ought to strike us more than anything else about what I have called the emancipation of technique is the fact that what starts out as a collection of means put together to serve an end becomes . . . the center, the focus, of an obsessive cult (Marcel).⁽¹³⁶⁾

The critical position that Rieff addresses to contemporary psychoanalysis is that it abandoned Freud's liberationist work and has become a matter of faith; that Freud's work has become repressed once again through the misunderstanding introduced by the Adlerian psychologists, the neo-Freudians (Horney, Sullivan, etc.) and the apostolic successors, i.e., the ego psychoanalysts (Hartmann, Loewenstein, Kris).

Reviewing the revisionism of Freud's theory of the unconscious, Jacoby (1975, 41) notes:

Heinz Hartmann--probably the most important of the Freudian ego psychoanalysts--detached the ego, or part of the ego, from the unconscious and libidinal drives; he dubbed this the "conflict-free ego sphere". "Not every adaptation to the environment, or every learning and maturation process is conflict." The critical edge of Freud is blunted: the aim of psychoanalytic therapy is "to help men achieve a better functioning synthesis and relation to the environment."

Those who laud these theoretical developments within and outside psychoanalysis have told the unpleasant truth pleasantly, ego psychology grinds down the cutting edge of psychoanalysis in contemporary garb. Just as conflict is the central notion in Freud's work, adaptation is central in Hartmann's . . . Compared to Freud, Hartmann is another breed altogether, not a revolutionary, but a practical earth-bound traditionalist.⁽¹³⁷⁾

The author acknowledges the truly radical character of the early psychoanalytic formulation; but insists that contemporary ego psychology is a tamer and more "healthy-minded" quality. Some critics wonder whether psychoanalysis could have been as attractive to middle-class Americans. Ego psychology paves the way, not to a proper understanding of the ego, but to its idolization. This development ultimately led to the rehabilitation of the old-fashioned idea of the self, that is, the autonomous self of ego psychology.

Adaptation, accordingly, is a "corporealizing of the psyche", a processing of psychic energy into "unconscious automatic reactions". The reality principle asserts itself through a shrinking of the conscious ego in a significant direction. The development of the instincts is frozen, and their pattern is fixed at the childhood level. The reality principle is here revealed as the egoic agent of adaptation. One can more clearly see how narcissism constitutes the ground of the reality principle. As Jacoby says, "narcissism captures the reality of the bourgeois individual; it expresses the private regression of the ego into the id under the sway of public domination." Psychoanalysis understood in that way implies a psychology of conformity for its patients; we see more deeply also what adaptation means in psychoanalytic therapy.

FUNCTIONALITY/ADAPTATION:

SEPARATION FROM THE MYSTERY OF BEING

When human life is formed exclusively in accordance with the traditions of positivism or scientism, the human person may be overcome by a sense of loneliness and isolation, writes van Kaam (1986, 171), psychologist and master of spirituality. In the theory of spiritual formation, this author considers the deepest ground of the formation of life to be an ontological one:

The primary foundation of all formation is ontological; it refers to a forming direction of the universe and of humanity that cannot be controlled, manipulated, or exhaustively understood by means of clear and distinct concepts. This preformative direction does not make our formation responsibility superfluous. On the contrary, it demands that we explore its challenges, freely and wisely. We are free to deny this foundational direction at our own peril, or we may disclose and appraise it progressively (van Kaam).⁽¹³⁸⁾

In Foundations for Personality Study van Kaam describes the grounds of personality emergence and how the spiritual formation of life must there achieve its deepening:

Formation is the basic evolutionary process of the universe perceived as a formative energy field of constantly rising and falling forms. Each tends to realize, nuance, and maintain its own form potential in dialectical interaction with its formation field. Subhuman life forms give form in accordance with instinctual form directives. The human life form has to disclose and implement its own. In this process the personality is born. Personality is a unique movement of disclosure and tentative implementation of receptive and creative form directives and their corresponding formation fields. Foundational personality theorists are in search of form directives that can be scientifically appraised as foundational or universal. Their aim is the establishment of a foundational theory on which consensus can be reached eventually among a significant number of scholars in this field.⁽¹³⁹⁾

The inference to be derived is that personal emergence and maturity can be achieved only through a life formation that deepens to the extent that a person aspires to live in consonance with the forming mystery. Thus, personality is a unique movement that involves discovering and incarnating one's foundational life form, the true self as coming-to-be.

In that process formative directives need to be apprehended and appraised, which requires that the person become responsible for his own life direction through thoughtful apprehension and appraisal of what is discovered meaningfully to be inherent in interaction with the formation field or the unique personal world. Appraisal requires that one thoughtfully distinguish between dissonant and consonant life directives. Consonant directives that are affirmed can then be applied. In other words, personality is shaped by the acts of apprehension, appraisal, affirmation and application.

Personality is not understood here as guided by the reality principle. In this spiritual or distinctively human approach, self-direction is oriented by primordial acts of faith, hope and love. In this regard, van Kaam affirms transcendent life directives similar to the developmental emphases of the theory of Erik Erickson. These transcendent life directives--faith, hope and love--do not exist in the sphere of ego autonomy. Rather, they are one's spiritual openness to the irreducible ambiguity and contingency that characterizes everyone's interactive involvements with, and in, the formation field, our interactions with people, events and things.

In comparison, ego psychologies, humanistic psychologies, and developmental psychologies do not acknowledge the reality of the transcendent dimension of human experience. If such psychologies acknowledge any kind of transcendence, it is usually only the "quasi-transcendence" of some experiences in the vital and functional dimensions of life. They "go beyond" or transcended only in part, whereas in true experiences of transcendence "everything is left behind."

Life is understood as an exchange of polar energies in dynamic interaction. To live in faith or in hope always presupposes a polarity between these transcendent life directives and their opposites: contingency, unpredictability, insecurity. This dynamism is conflicted because our living is always to some degree dissonant, whereas its transcendence and integration dynamics tend toward consonance. The expanding movements of transcending require dissonance or the breaking up of established familiarities and securities which is necessary for outward and upward expansion (going beyond). The other pole of this expanding (transcending) movement is the dynamic of integration which acts to maintain or to regain its inner consonance.⁽¹⁴⁰⁾

Like pre-revisionist psychoanalysis, formative spirituality acknowledges conflict as ever-present in human life, that all growth and development emerge in the interaction of the polarities of dissonance and consonance. By the same token the science of formation disavows the idealization of conflict-free spheres and disavows the ideal of autonomy in its humanistic definition in ego psychology.

A distinctively human life is always a process of progressive emergence which has the structure of transcendence, of moving beyond. One should also say that a distinctively human life form emerges in the interaction between the polarities of life-death. This statement signifies that every person must continually die to past achievements as the precondition for going beyond or progressively transcending:

The human life-form is always emerging; it is never a finished life-form. This premise means that we are only on the way to a communal and unique form of life. Our empirical life-form can always be deepened, enhanced, and integrated, reaching out to new horizons. It belongs to the essence of human life never to be static or at a final stage (van Kaam).⁽¹⁴¹⁾

We are only on the way; one is always coming-to-be. The directional thrust of formation is focused not toward the mastery of reality, but rather around the dynamics of inwardness, of the intrasphere of life. Thus, van Kaam is cautious about the dominant world outlook of Western societies which have idealized the mastery of reality:

We live more and more as isolated functionaries who manage to survive. . . . Yet despite all our efforts, our restlessness may never be solved totally. It may keep seeping through the boundaries of our prefocal consciousness.⁽¹⁴²⁾

The orientation that favors mastery of reality and which implicitly deforms personal intraspheric development is similarly a concern in the critique of Erich Fromm in The Revolution of Hope:

The social machine works more efficiently if individuals are cut down to purely quantifiable units whose personalities can be expressed on punch cards. These units can be administered more easily by bureaucratic rules because they do not make trouble or create friction. In order to reach this result, men must be de-individualized and taught to find their identity in the corporation rather than in themselves.⁽¹⁴³⁾

In Fromm's view of the modern technological society, the mastery of reality is guided by two principles. The first is that something ought to be done because it is possible to do it; the second is that of maximum efficiency. The first principle when employed is inimical to life formation in that it may move by way of negation of all values because it ignores the primacy of man's deeper and real needs. For example, if it is possible to build more and more powerful nuclear weapons, then they must be built, even if the destruction of humanity may result. Once the principle that can implies ought is accepted, technological development becomes the prime value. As Fromm insists, once this principle of efficiency is invoked, what inevitably follows is de-personalization and de-realization because the conditions of life become progressively abstract and inhuman. But this de-personalization is evident only if we believe that underlying our personal emergence is a basic orientation that is exclusive for each of us. This unparalleled pattern is only gradually and in part disclosed to us during our ongoing dialogue with the successive fields of formation within which our personality unfolds. This disclosure of our uniqueness takes place mainly in the intrasphere of our life where the truth of one's being--a subject which is the essence of one's coming to be--is found disclosed. The displacement of being a subject, which occurs in the service of the efficiently working social machine, enables us to realize how murderous are its possibilities the more we give in to valuing the goals of mastering reality.⁽¹⁴⁴⁾

Another aspect of the efficiency principle is its equating of efficiency with quantity--thus the more efficient the plant, the greater the output. This principle leads to the phenomenon of over-production and the subsequent manipulation of the public in order to make it a docile market. Even the educational system is judged by the same criterion--the more college graduates the better, regardless of the quality of education. Indeed, few people ever seriously raise the question of quality or ask what an increase in quantity contributes.⁽¹⁴⁵⁾

The total effect of this technological organization is that man is transformed into homo consumens whose sole aim in life is to have more and to use more--the increase of the bourgeois man on the condition of the triumph of power, of reality mastery.⁽¹⁴⁶⁾

The prizing of efficiency leads to a new and excessive valorizing of quantity, production, and bureaucratic de-personalization which in the end transform humanity. Entangled in the production machine, man becomes a thing passively turning out things in which he is not interested and, when not producing, taking in whatever the boredom-preventing industry offers--liquor, movies, television, sports gadgets.⁽¹⁴⁷⁾

It is not necessary, however, to accept all that the critics of technology say or to agree with their descriptions of contemporary world conditions; it is sufficient to realize that they are faithfully recording certain aspects of reality which cannot easily be discounted. Man is in a world in which it is difficult to live humanly, especially since he is constantly being persuaded that the world is made possible by the valorization of efficiency, by quantity and production and by the seductive allure of consumerism as the best of possible worlds, and that which is at hand.

It is hard to discount the thesis that humanity is being transformed through human techniques. Everyone is absorbed in a non-spontaneous union, a union of the individual with the collectivity, where everyone has his punch card. This union, through its own dynamic, "dissolves" all that is unique in every human personality. The danger of the increasing pressures for adaptiveness lies in its de-personalizing effects. It destroys by increasingly emptying out human interiority and subjectivity, and thereby creating conditions unfavorable to a distinctively human or spiritual form of life. This union of the de-personalized individual with the collectivity is the most noteworthy result of techniques that man turns on himself.

This transformation and mutation of humanity has not been produced by a collectivist theory or by someone's will to power. The cause is much more profound, at once human and inhuman; inhuman because it is occasioned by things and circumstances, human because it answers to the heart's desire. The "rising expectations" evoked by technology are irreversible, yet we always come back to the reality that man, who is in fundamental discord with his world, must of necessity be restored to harmony with it. Any restorative action upon techniques appears impossible, yet we retain our freedom for thoughtful appraisal of human techniques. In view of the forces for de-personalization and de-realization our hope is an uneasy one but it is a hope nonetheless.

We have strongly emphasized a number of aspects and conditions that characterize the transformation of the individual and society through the application of human techniques. The effects resulting from this process or processes of transformation are very important for a proper understanding of the psychotherapeutic movement, especially as this presents itself as the new substitute for the historic symbol-systems of the faith traditions that predated the emergence of what Rieff calls the "psychological man".

On the general and global level, we have seen that the transformation of humanity favors the employment of techniques of adaptation. The danger here, as we have seen, is the conformity of the individual to the anonymous processes of production, the binding of persons under the requirements of efficiency and the reduction of human values or aspirations to consumerism. (It is not accidental that in the American psychotherapeutic world the people we serve are no longer referred to as patients or clients but commonly read as consumers.)

In the main, it is the third force in psychology and psychiatry that engages in critical theory and questioning of the fundamental issues of the psychotherapeutic movement. Reflection and appraisal of anthropological, sociological and psychological presuppositions are an essential mark of the existential-phenomenological enterprise.

Our intention has been centered around the problematics of the psychotherapies, since they are strongly pressured by the techniques of economics and political organization which make man the object of technology in the service of the social, organizational, economic and political processes in the culture. Everything in technological society favors processes which increase the pressures for adaptation. A psychology of conformity is increasingly brought into play thereby, with the result that the democratic spirit which gave high place and dignity to the individual is being displaced by the repressive power of a psychology of conformity.

To be true to its own visionary agenda, psychology conceived as a human science should be a force in moderating the deformations which do violence to the distinctively human under the impact of the anonymous processes initiated by the technical transformations to which we have alluded. The work of the human science psychologist should accordingly and rightly concern itself with the goals of restoration, for the repression of what is most distinctly human and transcendent in human life puts us at risk of forgetting these dimensions.

In the psychotherapies increasingly allied to ego psychology, there is a real need for alternative approaches which favor a more liberationist option, both at the level of theorizing and in praxis. In this regard, hope can be based in the movements of anti-psychiatry and transpersonal therapies. In addition, the meditation and contemplative techniques borrowed from Eastern cultures seem favorable alternatives to conformist psychotherapies of whatever type.

Here and there in the psychotherapeutic literature, one occasionally finds inspiration and is reassured that the ideal of what is distinctively human continues to burn brightly in the human heart:

People who present themselves for psychoanalysis are said to be alienated from the norm. Perhaps this is true, but that does not justify attempting to reinsert them in that norm. They are alienated because they have had a taste of something else, and once they have had that experience the norm does not seem to be worth the bother.⁽¹⁴⁸⁾

Duquesne University

Pittsburgh, PA