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Philip Cushman. Constructing the Self, Constructing America: A Cultural History of Psychotherapy. Reading, Mass.: Addison-Wesley, 1995. xiii + 430 pp. $U.S. 27.50; $Can. 35.95.

Philip Cushman is a psychotherapist eager to develop a critical perspective on the cultural role of his craft in order to improve its practice. According to him, psychotherapists wrongly assume that they treat psychological problems that are inherent in human nature, rather than the consequences of particular historical, social, and economic circumstances. By failing to address the context of their clients’ problems, he argues, they are unwittingly complicit in the capitalistic culture of consumption that has alienated individuals from themselves and from each other. Cushman’s prescription for this predicament has two steps. First, he suggests that psychotherapists view the personal problems that clients bring to the fifty-minute hour in their social context. Second, he considers it imperative that psychotherapists recognize the historical and social role of their own practice. Constructing the Self, Constructing America provides examples of how both steps can be accomplished. Cushman believes that if his advice is taken seriously, psychotherapy will become part of the cure rather than the problem.

Cushman provides a history of psychotherapy from a critical Marxist-Foucauldian perspective, building on the work of T. J. Jackson Lears, Christopher Lasch, and Kenneth Gergen. He begins with an overview of American history, touching on such varied issues as the birth of the asylum, the Second Great Awakening, mesmerism, Christian Science, and the late-nineteenth-century rise of consumer culture. He then places the history of psychoanalysis in America within this context. He presents the American psychiatrist Harry Stack Sullivan as a hero whose views have been ignored.

Sullivan considered social issues such as racism, economic injustice, and nuclear war as prime topics for psychiatric research. He also advocated the in-volvement of psychotherapists in the critique and restructuring of society. Sullivan’s colleagues, in contrast, were enthralled with the object relations theory of Melanie Klein, Cushman’s villain. In Cushman’s view, Klein portrayed the growing child as a self-contained individual who consumes objects, be they persons or commodities, in order to achieve personal satisfaction. In doing so, he argues, she transformed psychoanalysis into a prime tool for fostering consumerism. [End Page 180]

This book should be read as a programmatic statement about the place of psychotherapy in American society, directed to fellow psychotherapists, rather than as a comprehensive historical study. Cushman’s aim is to make therapists politically conscious by promoting the constructionist agenda, which could correct the complicity of psychotherapy with the consumerist culture of capitalism. The book contains many intriguing suggestions as to how the history of psychotherapy could be made relevant for cultural historians. Unfortunately, as far as the historical part of the book is concerned, Cushman does not go much beyond the authors mentioned above.

Hans Pols
University of Pennsylvania
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