Writings/ essays
Please send us your published or unpublished texts/essays if you feel they align with our project. We would love to consider sharing them on the website.
The Quiet Crisis in Mental Health: The Medicalization and Deskilling of Psychotherapy
Darragh Sheehan
The medicalization of psychotherapy has undoubtedly been influenced by the psychiatric establishment’s “revolution” in 1980, marked by the release of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III). A manual barely known to the public before 1980 has since become a hegemonic force, shaping not only the practice of psychotherapy but also the broader cultural understanding of psychological suffering as “biomedical.”
DSM diagnoses are now widely accepted as “universal” and “fixed biomedical” disorders by both the general public and most mental health professionals. In reality, however, many of these so-called “disorders” reflect cultural and socio-political constructions of suffering, particularly specific to the United States. Even the DSM-IV committee chairman, Dr. Allen Frances, once admitted, “You cannot define mental disorders, it’s bullshit.”
This “bullshit,” however, dominates insurance reimbursement practices, requiring all mental health professionals—even those without medical degrees—to use DSM diagnoses as a medical framework for both billing and treatment. This biomedical model has fueled the rise of so-called “evidence-based” psychotherapies, which are promoted by insurance companies under the premise of “standardizing” care.
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The Hermetic
Theft
Plagiarism, Authorship, & Education in the Age of AI
Victor J. Kreps
Prelude
Something is shifting in the quiet rituals of academic life. The familiar coordinates—originality, authorship, mastery—no longer offer the certainty they once did. We find ourselves, as teachers and researchers, caught between two imperatives: to defend the integrity of thought, and to acknowledge that the very conditions under which thought takes shape have changed. This is not simply a matter of intellectual property or institutional policy; it is a crisis of individuation.
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An American Ambulatorium
ZaK Mucha
A pal of mine, a Zen Buddhist monk, was asked by a mid-level corporation to present a mindfulness workshop for staff because people were overworked and getting burned out. The monk said, “No, I can’t do a mindfulness workshop, but I’d be glad to talk about collective bargaining if you’d like.” The invitation was rescinded.
Psychoanalysis can embody more of that refusal, a refusal not dependent upon the offer, but one which recognizes a different measure of value. In her book, Persian Blues, psychoanalyst Gohar Homayounpour equates the origins of blues music and psychoanalysis as protests against the dominant culture, both holding their deepest purpose when at the margins of society. And she notes both, when mainstreamed, lose their reason to exist.
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A MAD SCIENCE
Carlos Padrón
Freud, following Schiller, writes that the uncanny arises when something that should have remained concealed is unconcealed— that is, when what we believe we understand about the world (the familiar) suddenly becomes unfamiliar and unsettling. These are the moments when the ordinary becomes extraordinary.
Freud observes that uncanny feelings emerge most strongly when we see madness in others because we sense that these forces also operate within us, hidden in the shadowy, often unacknowledged parts of what he calls our “normal personalities.” For psychoanalysis, there is something inherently disorienting and destabilizing about the other.
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Social
CHaracters
Lucas Ballestín
Times change, and with them psychic structures and illnesses. Psychoanalysis was invented to solve the big mystery of its times: the source and mechanism of the nervous diseases of the mind(neuroses), especially hysteria. And although its novelty and inscrutability might explain why some physicians of the late 1800s were so obsessed with the phenomenon of hysteria, I think it’s still fair to say it appears to have been much more common then than today. Psychoanalysts still diagnose patients as hysterics, but today the most commonly seen maladies increasingly relate to narcissism and so-called narcissistic deficiencies. Changes in incidence rates for physical illness might be explained by changes in diet or other environmental factors, but how about changes in mental illness.
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Healing
The Beauty
Way
M. Catalina Melo, M.D.
Coming from Latin America, I am no stranger to rituals involving the intangible, forces we cannot quantify, or forces that sometimes play a role beyond our simple understanding. We make offerings, promises, and sacrifices to a combination of magical and sanctioned entities and images in exchange for our well-being, for a cure. When I was four, I had a severe abdominal infection and needed emergency surgery for a ruptured appendix. The wound was left open to heal and drain in the meantime. I was taken to a hybrid healer saint, who was known to confer healing by touch. At the time, I had visions of this person every night or morning while still in slumber. I thought the healer was standing next to my bed. I recuperated, yet a large scar remains as a reminder.
To a great extent, medical school and psychiatry residency erased my beliefs in the magical and the ritual, in exchange for the “evidence-based.” I carried myself as a double through the years, the hidden me smiling at myself for the naivete of denying not the extraordinary, but the omnipresent forces that permeate throughout and timelessly thread through peoples, places, and occasions; while my outer self pretended to understand and see with transparency and accuracy.
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From Public Service to Private Practice
The Collapse of
The social work Profession
Darragh Sheehan
The social work profession was historically rooted in a mission of improving the lives of the vulnerable, the oppressed, and those living in poverty. Yet, the modern use of the social work license and degree as a quick path to private practice serving middle to upper-middle-class communities is oddly not questioned. This use of a social work master’s degree for private practice, primarily serving privileged communities, contradicts the profession’s code of ethics.
Social work is indeed a profession in collapse. This is due to broader social and economic changes, namely the shift away from welfarism towards neoliberal privatization, but also because of how social workers increasingly utilize the license.
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THE OPPRESSED
Carlos Padrón
Each time we call someone “the oppressed,” we oppress them.
(In writing this, I can't escape the paradox of oppressing “the oppressed”).
We oppress them by reducing the complexity of who they are to merely being “the oppressed.”
We oppress them by repeating “the oppressed” so often that the weight of our words pushes them down, pressing them like a well-folded shirt worn to look fashionable.
By repeatedly invoking 'the oppressed,' we may seek to reassure ourselves and others that we are definitely that we are unshakably aligned with them and the “right side of history:” that we are absolutely not one of the bad ones.
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Countercultural or Counterproductive? On Woke Culture's Uses of
“Mental Health”
Discourses
Darragh Sheehan
If R.D. Laing and Franco Basaglia could see the newest generation of “woke leftists” obsessed with psychology talk, identity classifications, and diagnoses, I imagine they would say “What in the countercultural hell is going on!?”
I echo their “What the hell?” and argue that we need to analyze why certain people influenced by woke culture – including contemporary psychotherapists, social media mental health influencers, and their tens of millions of followers – are obsessed with psychological lingo and psychiatric diagnoses. Digital-capitalism has undoubtedly fueled not only the rise of “pop psychology,” but also wokeism (which will be defined later) on social media, where diagnoses are casually tossed about. Yet, woke culture's use of psychological language undermines both leftist ideals and effective mental health care by depoliticizing systemic issues and reinforcing neoliberal individualism.
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PSYCHOANALYSIS
AND THE EXPERIENCE OF
HOMELESSNESS
Deborah Anna Luepnitz & DENNIS M DEBIAK
Psychoanalysis is often viewed as a practice relevant only to educated people of means. This article describes a project that matches psychoanalytically trained clinicians with unhoused and formerly unhoused adults in a large urban community. D. W. Winnicott’s ideas about impingement, the holding environment, fear of breakdown, and careful monitoring of the analyst’s interiority have proven to be most valuable theoretical and clinical tools. A decade-long case example demonstrates the challenges and healing potentials of the work.
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—> Author Bios
Note: This article was originally published in The Psychoanalytic Review Vol. 111, No. 2, June 2024. The authors have shared this article with the Center for Critical and Clinical Analysis for public sharing.
FREUD IN THE
FAVELA
Elizabeth Ann Danto & RaUl Araújo
Inside the third floor’s exhibition galleries, the works of young Brazilian artists focus on the ways in which representations of their experiences of colonialism overlap with the desire to maintain or resurrect indigenous art-making. Along the perimeter of the exhibition space and in adjoining rooms, as if looking over the community it anchors, the gallery’s floor-to-ceiling glass walls support and contain its center for art and psychoanalysis, São Paulo’s Favela de Psycanálise.
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Glittering Generalities &
Pop-leftist
“Psychotherapy Speak”
Darragh Sheehan
Modern psychotherapies are far removed from the anti-establishment ethos of their psychoanalytic ancestor; this is quite clearly related to market trends, e.g., the promotion of short-term, outcome-focused behavioral therapies and psychopharmacology. But what is less obvious is that the pop-leftist, mental-health speak meant to counter these trends may ironically play right into them.
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Spitting-off and
Outsourcing
the Social In Dollaria
Carlos PAdrón
Most American psychoanalytic institutes tend to encourage private practice as part of their pedagogical and organizational structure. It is an implicit or explicit expectation of candidates as their training is modeled by the way most experienced analysts work. This emphasis on the private parallels what elsewhere I have called a privatized model of subjectivity and of psychic suffering originating mostly in intra-psychic dynamics. This reality dissociates clinical practice from the constitutive social dimension of its process, from the ways in which social injustices are at the core of psychic pain, and from the immersion of the psychoanalyst into community work. The social undercurrent of psychoanalysis gets split-off from its institutions.
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The Mangrove
Notebook
Carlos PAdrón
1. Jean-Luc Nancy says that the individual is the residue of the erosion of community.
2. Nancy argues that two things negate community: l the idea of an individual that is taken to be the point of departure of the common which decays into the atomization and privatization of experience (liberal, capitalist democracies) l the idea of a fused collective body, which results in undifferentiation (real communisms).
Against these “betrayals of community,” he poses the thought that being in common has nothing to do with communion or individuals gathering to participate in a group of shared interests or characteristics.
Historically, these forms of organization have been based on a substantial, fixed identity of either the individual or the collective; the outcome has been different forms of totalitarian societies (past Soviet communism or contemporary fascist capitalism, for example). This phenomenon is what Édouard Glissant calls the “totalitarian drive of a single, unique root.”
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Annotations On A Philosophy
of Language for
Psychoanalysis
Carlos PAdrón
1. In Philosophical Investigations, Ludwig Wittgenstein famously said: “[T]o imagine a language means to imagine a life-form.”
Let’s observe the life-form that philosopher Stanley Cavell imagines when describing a scene in which a child learns a language; note the complexity he evokes:
When you say “I love my love” the child learns the meaning of the word “love” and what love is. That (what you do) will be love in the child’s world; and if it is mixed with resentment and intimidation, then love is a mixture of resentment and intimidation, and when love is sought that will be sought. When you say “I’ll take you tomorrow, I promise”, the child begins to learn what temporal durations are, and what trust is, and what you do will show what trust is worth. When you say “Put on your sweater”, the child learns what commands are and what authority is, and if giving orders is something that creates anxiety for you, then authorities are anxious, authority itself is uncertain. (The Claim of Reason)