As India liberalized its borders in the early 1990s, new desires and forms of subjectivation arrived and with them marched in the psy-disciplines. It is not surprising that the two co-appeared on the horizon of our possibilities; many have contended that Psychology essentially provides neoliberal capitalism with its functional logic (Roberts, 2020). I was their foremost champion and cheerleader.
Over the years, if I had not seen the mental health system fail miserably time and again, I would not be primed to understand what theory had to offer. By the time the replication crisis had started rolling in, I had gone through a clinical internship where fumbling psychiatrists were practicing trial and error on their patients. Physical restraints were liberally used, and I learned that sexual and physical abuse in psychiatric hospitals was commonplace (Campbell, 2018). A troubled friend had been diagnosed and discarded by the mental health system and was undergoing painful akathisia which I assumed was a hallucination. Before service users pointed out that akathisia can be brutal and excruciating, we were taught it was “just restlessness.” Friends and colleagues in other psychiatric hospitals complained about managed care and revolving doors, insisting that anyone who thought we had treatments or cures was deluding themselves.
My doctoral program was heavily invested in theoretical and philosophical approaches, and most importantly, had a critical edge. For part of my dissertation research, I used Foucault to trace the historicity of the schizophrenic position as an extreme rendition of the empirical-transcendental doublet, the cogito and the unthought and the ungrounding of language in the modern episteme. It was the theoretical analysis that exposed the schizophrenic as far more than a clinical entity and revealed why one of the most precarious categories in psychology (schizophrenia), despite decades of attacks on its validity, still managed to thrive. As my research entered rural India to study people hearing voices and seeing things which others didn’t, it came as no surprise that while the experience of hearing voices and seeing things was commonplace, the schizophrenic was nowhere to be found. Deleuze and Guattari’s discussions on desiring production were essential to a decolonial perspective as I formulated a theory of Indian subjectivity which was slippery and thrived in contradictions instead of being paralyzed by them.
The theories and philosophical writings of Foucault, Deleuze, and Guattari had already scrutinized many of the epistemological assumptions of psychology, whether it was by problematizing the triangulation of desire in a capitalist familial formation, or exposing the conditions of thought we took for granted in the study of manby man. Foucault had nothing to teach me about the Indian subject, and Deleuze and Guattari could not be applied to my culture, but they did offer alternative howsof thinking, and their emphasis on structures and historicity of thought predates our current awakening regarding the significance of structural determinants in mental health.
Deep theories and philosophy, in questioning conditions of knowledge and thought, have regularly deconstructed our most cherished ideas. They exhorted us to bracket second-order judgments and pay attention to words and visibilities. They warned us, but the psy-disciplines only have eyes for the empirical, and over those eyes, the glasses are fuchsia. Without a philosophical background, I would have conducted an analysis of hearing voices in rural India and found results which only corroborated my previous assumptions. I might have concluded that Indians were a collectivistic group which ensured social support in times of mental health crisis (thus erroneously individualizing and interiorizing the relational and social); I might have interpreted stories of deities, desire, and distress as psychogenic illnesses or called “locked leg” somatic symptoms (using an alien interpretive framework). I could have even gone down the path of romanticization of the local through a perverse form of narrative of progress. A strong theoretical background held me back and critical perspective showed the way. Had mainstream psychology paid attention to theoretical and philosophical concerns, they could have been saved some embarrassment. Humiliation often follows hubris. What follows is a short summary of that humiliation.
The attacks on the discipline are numerous and well-deserved. There is the notorious replication crisis which garnered significant media attention; claims that it was caused by different study populations has also been discredited (Owens, 2018). Additionally, our historical failures have followed us into the present. For e.g., while most are aware of psychology’s early racist days (Drapetomania, schizophrenia overdiagnosis amongst black men, eugenics, etc.), few are aware of how systemic factors still lead to different diagnoses based on race and socio-economic status, even when symptoms are the same (Hansen, 2019). The scandal around APA’s collusion with Bush-era torture is well-known but the links between positive psychology and military programs are less popular. More recently, even the highly fetishized Empirically Supported Treatments came under scrutiny as researchers found only mixed support for various ESTs which showed consistently questionable power and replicability (Sakaluk, Williams, Kilshaw, & Rhyner, 2019).
Cross-cultural and especially indigenous practitioners questioned our conceptualization of pathology and our prioritization of affective over somatic. They shunned the phrase therapeutic in creating forms of intervention, and even scrutinized how the Diagnostic and Statistical Manual (DSM)’s conceptualization of trauma and grief are decontextualized and inapplicable to native populations (Kopua, 2019; Langa & Gone, 2019; Kirmayer & Young, 1998). Most of all they challenged psychology’s positioning of indigenous groups as vulnerable; they objected to the violence inflicted on indigenous communities when they are repeatedly portrayed through statistical language as inherently broken, traumatized, and disordered. Through a decolonial lens, they challenged that groups are not simply vulnerable but are made so through systemic exploitation of their land and resources. Some even pointed to how psychology, through the trauma theory narrative, has allowed settler colonizers to maintain their hold and power by focusing on mental health issues while ignoring indigenous demands for self-governance (Million, 2020) – often under the garb of restorative justice and reparations.
Psychology’s deleterious effects in other countries ranged from dubious interventions to drugging of street children and even inculcation of guilt in and financial penalization of young girls when they didn’t live up to our standards (Cosgrove & Karter; 2018; Sweis, 2017; Adolfsson & Madsen, 2019). Cultural psychology revealed that fundamental attribution error is anything but fundamental, that universal perceptual illusions such as the Muller-Lyer are not universal at all, and that most of our studies are studies of psychology undergraduates (the WEIRD problem). We found our research, evidence, and even abstracts in papers to be riddled with bias (Jellison et. al., 2019). Industry corruption was shown to be rampant and doctors began raising concerns around polypharmacy (which is the norm for psychotropics).
Most importantly, it was the service user movement which recently made great strides and brought about policy-level change in recognizing that antidepressant withdrawal was debilitating and could last for more than a year, as opposed our earlier prescriptions that it lasts few weeks. Necessary changes were brought in the UK’s NICE guidelines and the Royal College of Psychiatry released resources for antidepressant withdrawal. Lastly, noted figures on the inside wrote about our past errors and critiqued our current ways, often at great personal cost.
The list is unending. So, where are we to go from here? Will these cracks in the psy-disciplines lead to a revolution? Maybe we could begin to scrutinize some of the most basic assumptions in our knowledge systems, as philosophers are known to do? Or will this get co-opted by the discipline offering lip service to systemic issues while looking for individual interventions, superficially addressing diversity concerns while practicing an inherently colonial model, using qualitative research not to subvert ideas of being, knowing, and knowledge but to produce the same jargon but with interesting quotes from participants?
I see two paths – on one hand as I read the cultural jargon produced by the current therapeutic fad of trauma theory, I am almost convinced that any revolutionary possibility will be absorbed by this narrative. On the other hand, when I read the contributions coming from other disciplines such as anthropology, literature, sociology, social work, linguistics, philosophy and more, I am heartened. The possibility of change, of an actual paradigm shift, is slim if criticism is superficial. We must go beyond context-sensitivity and examine our fundamentals around self and ethics if we are to escape this epistemic bardo.
This is where philosophers and theorists have always had an edge. Our teaching of history cannot be restricted to an undergraduate course; every concept must be situated, every theory seen as conditional. Inter-disciplinary as a buzzword must give way to a willingness to have other disciplines torture our flaws. We must hold to light Psychology’s crimes, and make no mistake, they are crimes. I for one am not holding my breath.
References
Hansen, H. (2019). Substance-induced psychosis: Clinical-racial subjectivities and capital in diagnostic apartheid. Ethos.https://doi.org/10.1111/etho.12223
Million, D. (2020). Trauma’s empty promise: indigenous death, economics, and resurgence. In D. Nehring, O.J. Madsen, E. Cabanas, C. Mills, & D. Kerrigan (Eds.), The Routledge International Handbook of Global Therapeutic Cultures (pp. 372-383). Routledge.
Owens, B. (2018). Replication failures in psychology not due to differences in study populations. Nature. Retrieved from: nature.com
Roberts, R. (2020). Psychology estranged: mind, culture, capitalism. In D. Nehring, O.J. Madsen, E. Cabanas, C. Mills, & D. Kerrigan (Eds.), The Routledge International Handbook of Global Therapeutic Cultures (pp. 372-383). Routledge.
About the Author
Ayurdhi Dhar is an assistant professor at Mount Mary University. She has taught psychology in the United States and in India, where she also worked as a therapist. She is the author of Madness and Subjectivity: A Cross-Cultural Examination of Psychosis in the West and India. Her interests include discursive practices sustaining the concept of mental illness, decolonial theory, schizophrenic subjectivity, and trauma and immigration. She is also a science news writer for Mad in America and loves dogs.