Editorial for the Special Issue of Clinical Psychology Forum, on a Draft Manifesto for A Social Materialist Psychology of Personal Distress

Why write a manifesto? And why one that is so critical of mainstream psychology? In the UK and throughout the developed world, psychologists, their teachings and above all their therapies - are flourishing as never before. Increasingly, they sit close to the centre of government, promoting individual treatments and techniques as the solution to every kind of human problem: from ill health, poverty and joblessness to workplace strife, poor parenting, depression and ‘unhappiness’(Epstein, 2013; Midlands Psychology Group, 2007; Moloney, 2013; Throop, 2009).

And yet there is a crisis at the heart of psychological explanation. Close scrutiny of the evidence base for talking treatments (and indeed for psychiatric drug therapies) shows neither of them to be anywhere near as effective as many practitioners - or the wider public - would seem to believe. On the other hand, strong indications that most mental health problems are caused or maintained by hostile environments have been accumulating steadily over the last century, and perhaps most rapidly in the last thirty years.

The manifesto presented by the Midlands Psychology Group draws upon a wide range of cross-disciplinary research in order to, first, demonstrate the reality of this overall situation; and second, to outline the beginnings of an alternative, social-materialist psychology, founded upon it. Instead of regarding human beings as disembodied information processors, as talking therapy sometimes does, the social-materialist approach puts our physicality, our feelings - and the situations that shape them - at the centre of its focus. It suggests that it is not faulty cognitions, lack of insight or motivation, but social and political inequalities and the widespread abuse of power that underlie the vast majority of the distress that clinicians attempt to understand, explain, and treat. The manifesto was created, not just as a scientifically grounded critique, but as an open-ended and evolving document: a draft, intended to invite reflection, debate and perhaps action. And so we come to the current issue of CPF, in which selected contributors from the worlds of clinical psychology and of mental health teaching and research were asked to comment upon this document. We envisage this as an early step in what we hope will prove to be a long and fruitful dialogue, aimed at the development of a more scientifically and ethically defensible psychology than the versions which hold sway at present.

It seems sensible, given the manifesto’s focus upon issues of power and the experience of distress, to start with the comments of the mental health service user and educator, Barbara Riddell. She sees within this document a call to arms against the damaging myths and practices that still drive so much of the mental health system. The manifesto suggests for Riddell an opportunity for clinical psychology to escape its historical enthralment to psychiatry, and to do full justice to its own ethical vision of itself. By contrast, Lynne Freidli, an independent health researcher and activist, likewise welcomes the manifesto, but finds within it fewer grounds for psychologists to congratulate themselves: especially in the application of their ideas and techniques to health promotion for the poor, and to ‘workfare’ for the jobless. Friedli suggests that social-materialist psychology constitutes a lens through which everyone can more easily see these claims of curative expertise as the politically and professionally expedient myths that they are. Nevertheless, Freidli suggests that, for all of its strengths, the social-materialist framework veers close to being one-dimensional when it comes to understanding the daily lives, aspirations, and creative struggles of the impoverished and the marginalised.

The commentary provided by The East Midlands Critical and Community Psychology Group (or EMCCPG), which is composed of clinical psychologists, bears striking thematic similarities to Freidli’s. They suggest that this document offers a useful reminder to all practitioners who need to ask more often on whose behalf they are really acting, and who should be working more closely with health service users and others for progressive change, both within the mental health system and beyond. Beginning along similar lines, the clinical psychologist Anne Cooke and her colleagues endorse the manifesto as a philosophically coherent guide for critical thinking and practice. However, they find that it is sometimes too sweeping in its criticisms of the ideas and research that underpin current psychological therapy and practice.

In line with the conversational theme of this special issue, Dave Harper was invited by Cooke and her colleagues to comment upon their response. Unlike Cooke and her co-authors, Harper does not believe that the manifesto represents a thoroughgoing rejection of traditional humanism. He suggests that it points toward the adoption of more socially grounded (and ethically secure) accounts of human agency, as found within the practice of narrative therapy and the writings of developmental psychologists, like Vygotsky.

In a welcoming but more testing vein, Jim Orford sees the manifesto as a needful act of rebellion against the heritage of clinical psychology, rooted in the medical tradition. He asks whether the authors might in fact be community psychologists after all, since the manifesto’s key claim that personal distress and its alleviation are largely social and political matters is the bread and butter of that discipline.

If the responses discussed so far have been, on the whole, supportive of the arguments in the manifesto, then this should not give the impression that the MPG were looking only for admirers. We had been hoping to receive vigorous criticism as a stimulus to the thinking and debate that we sought for this special issue. To this end we had approached representatives of psychiatry and prominent practitioners of CBT, none of whom, unfortunately, agreed to respond, a topic that might be worthy of more comment in itself. However, Jan Burns, in the final paper in this special issue, provides a decidedly critical retort. She argues that no competent practitioner seeks to detach the individual from their world or from their body in the way that the manifesto implies. For Burns, it is the manifesto’s neglect of what psychologists can and do offer in the way of alternatives to medical discourse that constitutes its other main failing.

Considered together, the papers in this special issue represent a reasonably wide range of responses to the Midland Psychology Group’s manifesto, and we hope that you will find them as interesting as we did. The seriousness and depth with which the contributors have engaged with the topic of social-materialism suggests two things. First, that clinical (and therapeutic) psychology is indeed in a state of crisis, whether this is widely recognised or not; and second that, as yet, the field is not quite in peril of sinking into a moribund orthodoxy.

Finally, we would like to say a big thank you to Tony Wainright for his hard work, judgement and timeliness in reviewing all the articles in this issue.

Midlands Psychology Group

February 2014

Bibliography

Epstein, W. (2013) Empowerment as Ceremony. New York: Transaction.

Midlands Psychology Group (2007) Questioning the Science and Politics of Happiness. The Psychologist. Vol 20, No 7, July 2007422 – 425.

Moloney, P (2013) The Therapy Industry, the Irresistible Rise of the Talking Cure, and Why it Doesn’t Work. London. Pluto.

Throop (2009) Psychotherapy, American Culture, and Social Policy: Immoral Individualism. London: Palgrave MacMillan.

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