Journal for the Psychoanalysis of Culture and Society

Cushman, Philip. Constructing the Self, Constructing America: A Cultural History of Psychotherapy. Cambridge, MA: Perseus, 1995.

In his book, Constructing the Self, Constructing America, Philip Cushman reminds us that the social realm has a powerful impact on the configuration of the self, and he presents a sweeping hermeneutical analysis of how American culture has constructed the self since the Civil War. While most of the book is dedicated to situating the construction of the self within American historical and cultural contexts, the most challenging implications of his argument come in his critique of psychotherapy, particularly psychoanalysis, in America. It is in this critique of psychotherapy and psychoanalysis as an "objective," "apolitical" science dealing with "universal" and "ahistorical" selves that he persuasively argues that psychotherapy discourse is always about the moral and the political. The challenge, then, is to develop a subversive psychotherapy that refuses to unwittingly reinforce current configurations of the self (which, since World War II, Cushman characterizes as an "empty" self) through its theories and practices. This is not a small task, but Cushman provides an important piece of scholarship promoting the reintegration of the social, moral, and political into psychotherapy.

Influenced by Foucault, Gadamer, and Heidegger, Cushman argues that the self is always a product of the historical, cultural, and moral landscape and is constructed by those in power. The growing power of capitalism, the urbanization of America, and the increasing need to create consumers is kept at the fore throughout his analysis of the shifting configuration of the self in American history. The differing constructions of the self by those in power are well exemplified in his discussion of the differences between Europeans' and Americans' conceptions of the self during the Victorian age. Contrasting two "illnesses"—Freud's notion of hysteria with American neurologist George Beard's conception of neurasthenia—Cushman argues that Freud's notion of illness arising from uncontrolled sexual or aggressive impulses paralleled the European state's need to maintain a capitalistic economy in areas of limited resources while also controlling the population. That is, in Europe where the political solution was to dominate the population, the interior self was constructed as dangerous and dark and in need of self-domination. In America, on the other hand, Beard's conceptualization of neurasthenia as nervous exhaustion or lethargy paralleled the state's need to get its citizens to work hard, expand into the frontier, and take advantage of America's vast natural resources that could be used for capitalistic gain. Thus, the solution for Beard was to strengthen and liberate the self so that is could be free to find its fulfillment in work. Whereas the European self had too much inside and needed to be dominated, the American self had too little inside and needed to be strengthened and liberated.

The construction of the American self as having too little inside and needing liberation plays an important role for Cushman in the banalization of psychoanalysis in America. American psychiatrists latched on to Freud's idea of the unconscious after his visit to Clark University in 1909 because it offered an interior "frontier" that could be explored limitlessly, but promised pragmatic and liberating results. This allowed psychiatry to establish itself as a major player in the cultural landscape, giving creditability to a young profession and beginning the ethos of the "therapeutic." With this turn towards what Cushman terms the "enchanted interior," the unconscious became an important concept in the American capitalistic framework as it lent itself easily to a consumerist construction of the self.

In what is perhaps the most innovative piece of his hermeneutical analysis, Cushman discusses the ascent in America of psychoanalytic [End Page 165] object relations theory over and against Sullivan's interpersonal psychoanalytic framework. He uses Melanie Klein and Harry Stack Sullivan as examples of two different "roads" with which psychoanalysis was confronted. One "road," the interpersonal psychoanalytic theory of Sullivan, led to an evaluation of the social. Sullivan argued for understanding the impact of culture, ethnicity, and socioeconomic status on the creation of the self and was heavily interested in the political aspects of the self. For Sullivan, personal individuality was an "illusion" because individuality was always an interpersonal process. The other "road," the object relations theory of Melanie Klein, located the social inside the individual. For Klein, it is intrapsychic "objects" that reflect distorted and partial internalizations and come under the influence of the life or death instincts (understood as a universal condition) that generate experience. Thus, the social in Klein's model is not thought to be an important influence. Cushman argues that Klein and object relations theory won the day in psychoanalysis in America because of the threat Sullivan's theory posed to psychotherapy as a "science." If the self were a social construction, then attempting to legitimize a "scientific" discipline predicated on treating a "universal" self with a "universal" healing technology would be fruitless. Klein and other object relations theories also had an advantage because of the way those theories fit into the American construction of the self. Klein's self is constantly internalizing (consuming) and spitting out (projective identification), which provided a language and healing technology that made sense in an increasingly consumerist culture. For Cushman this shift is something to lament, as the potential of psychoanalysis to play a role in understanding the impact of the social has been banalized to an unwitting reinforcement of the construction of the empty self.

To drive home the point of psychoanalytic theory as both reflecting its historical and cultural context and then reinforcing the current construction of the "empty" self, Cushman critiques the object relations theory of Donald W. Winnicott and Heinz Kohut's self psychology. Common to the theories of both Winnicott and Kohut is the centrality of the self and the initial emptiness of the self that must be filled by "consuming" caregiver interactions. Rather then viewing this understanding as a reflection of a particular cultural and historical context, each of them understood the self to be universal and ahistorical. Through the universalizing of their theories and the emphasis within their therapeutic practices on consumption (internalizing the therapist's empathy), both Winnicott and Kohut end up reinforcing the configuration of the "empty" self. Cushman writes:

If psychotherapy theory accepts the empty self as the essential nature of human being, and if the emotional effects of our consumerized era are accepted as ahistorical illnesses, then we have no way of resisting consumerism. Psychotherapy then becomes just another voice implicitly encouraging compliance with the status quo. We are told by self psychology and object relations theory that the empty self is the natural configuration of human being, and its attendant problems, such as disunity and confusion, self-preoccupation, loneliness, acquisitiveness, and competitiveness, are caused by parental failure; that the drivenness to fill up one's interior emptiness by consuming psychological objects is essential, natural, healthy human activity; that the child naturally and normally experiences herself as the entitled, self-absorbed, omnipotent center of attention; that the essence of psychological growth is consumption, and that the natural way of relating is consuming, metabolizing, and then leaving the selfobject other. In other words, just as in other spheres of life, in the psychological realm the natural, proper process of human living is consuming and metabolizing. It seems impossible to imagine how these messages could not have the effect of reproducing the cultural terrain, and especially the consumerism, of our era. (273-274)

It is here that we see the full force of Cushman's argument come to [End Page 166] bear as he reminds clinicians that how we work therapeutically is part of the problem culturally and that a change to the configuration of the self requires a subversive psychotherapy with subversive practices. Psychotherapy is moral discourse, and it has political consequences.

In my opinion, the best part of Constructing the Self, Constructing America is the last two chapters, where Cushman begins to develop his ideas of how philosophical hermeneutics has shaped his own work as a therapist and how it might impact the field of psychotherapy in general. With a constructivist focus on language, Cushman discusses the importance of locating psychological processes between people rather then inside of people. By emphasizing the social (e.g., cultural, ethnic, socioeconomic, religious, familial, etc.) a person's life might be understood as reflecting a commitment to a certain moral framework that has become "sedimented" within the self and through which a "clearing" that illuminates and secludes various aspects of life may be created. An important aspect of the therapeutic process for the client is coming into contact with an alternative moral framework in the person of the therapist. Through the focus on the interpersonal elements of all of life, moral frameworks, and the "clearings" they engender, the client is presented with a language that suggests that a new "clearing" can be constructed. This process also confronts the client with the various ways they participate in the continuation of their old "clearings," which challenges notions of themselves as passive victims. Throughout these chapters, Cushman uses case examples to illustrate his point and present examples of how he uses philosophical hermeneutics to think about his clients and talk with them in the therapy session.

The primary contribution of this book for psychotherapy is in Cushman's deconstruction of the claim of psychotherapy as an "objective" and "ahistorical" method of treating "universal" selves and illnesses. By reminding us that even claiming status as an "objective" science is a political and moral act, Cushman confronts clinicians with our limitations in conceptualizing psychotherapy in any way other then in privatized, interiorized, individualized, and consumerist terms. His focus on the social, historical, and cultural allows us to realize that conceptions of the human person do matter and some conceptions are better then others. What Cushman seems to suggest is that alternative conceptions of the human person coupled with strong social practices that construct that alternative conception are needed within the psychotherapeutic community if we are to end the unwitting reinforcement of the cultural status quo. He suggests that a return to a civic tradition where mutual regard, economic justice, and a concern for the well being of citizens is needed. The difficulty with this, in my opinion, is that the strongest alternative conceptions of the human person lie in the ethical/religious traditions that have millennia of traditions and practices to draw upon, not in a civic language based in secular liberalism. Secular liberalism demands a discourse devoid of religious language, yet it is in religious/ethical language, traditions, and practices that strong, alternative conceptions of the person are embedded. On top of this, traditionally, psychotherapy has trained therapists to be critical of religious thought and to psychologize religious experiences. This will have to change to a large degree if clinicians are to begin to draw upon alternative conceptions of the human person. In fact, when viewed from this perspective it would seem to suggest that psychotherapeutic practice should flow from the moral community that provides the conception of the human person. Thus, what psychotherapy might need is for psychotherapists to understand themselves as situated within a particular moral community and to practice as a part of that community, utilizing the community's practices and traditions in presenting an alternative construction of the self. While this might not allow psychotherapy to be unified in the way it subverts the status quo, it would allow for various constructions of the self to emerge. Participating as a part of a moral community might also allow clinicians to understand the political and moral discourse that is always involved in psychotherapy in new ways.

Constructing the Self, Constructing America is a book that [End Page 167] pushes psychotherapy (and hopefully psychoanalysis) to the cusp of something new. Perhaps in the reminders of the way that psychological processes always happen between others, that is, in the social sphere, psychotherapists can begin to think of their work in political and moral terms. Once this begins to happen, perhaps new configurations of the self can be constructed within psychotherapeutic communities. While we are muddling our way through the shift from psychotherapy as "objective," "asocial," and individualized into new ways of practicing therapeutically, Cushman's analysis stands as a guidepost for us along the way.

 

Ronald W. Wright

Ron Wright is an Associate Professor of Psychology at Mount Vernon Nazarene University in Mount Vernon, OH. His research interests include the moral and philosophical foundations of contemporary psychoanalytic theory, social constructionism, and philosophical hermeneutics.