In Therapy We Trust: America's Obsession with Self-Fulfillment (review)

Eva S. Moskowitz. In Therapy We Trust: America’s Obsession with Self-Fulfillment. Baltimore, Maryland, The Johns Hopkins University Press, 2001. x, 342 pp., illus. $34.95.

Commentators have long noted the peculiarly American obsession with the psyche and faith in psychological cures. Eva Moskowitz’s engaging and comprehensive book examines this phenomenon from its first appearance in the nineteenth-century mind cure movement through to its contemporary manifestations in a wide range of popular and professional venues, from Oprah to Prozac. Surveying such diverse topics as marriage, war, housewifery, social protest, and the expressive self of the 1970s and 1980s, Moskowitz argues persuasively that the therapeutic gospel is not merely a perspective but, rather a program or faith, organized around three tenets. The first of these is that happiness should be an overriding goal of individual striving and public policy alike (Americans do well in this regard, scoring a 7.0 on the “happiness index” that has the rest of the world at a mere 6.85). The second tenet of this therapeutic faith holds that there are psychological—as opposed to more straightforwardly political or economic—roots to many if not all problems; and the third tenet is that these problems are treatable within the universe of solutions offered by the psychological and, further, that they should be addressed, by both individuals and society as a whole.

Rendered unexceptionable by its ubiquity, this therapeutic program, Moskowitz argues, infiltrates all corners of American life, transforming everything from business to politics, from sports to education, into grist for the amateur or professional psychologist’s mill. America is so awash in purveyors of self-help, consultants in self-esteem, and specialists in addiction—eating, driving, shopping, talk-show viewing—that it can be hard to imagine it was not always so. Moskowitz notes that the business of Americans’ emotional health is now a $69 billion industry that encompasses pharmaceutical companies and psychiatrists, bibliotherapists and remotivational therapists, cybershrinks and Internet counselors. Forty percent of American adults have joined support groups of one sort or another, and in any single year, 15 percent of adults and 21 percent of children visit mental-health professionals.

Moskowitz’s book is a useful antidote to those who would interpret the psychologizing of America as yet another symptom of national decline, rooted in the excesses of the 1960s and the narcissism of the baby-boom generation. The national proclivity for seeking quick and easy therapeutic solutions to intractable social problems has deeper, early-twentieth-century roots that were nourished and sustained by their location in a number of institutional settings—courts, prisons, schools, and hospitals among them. While some of the ground Moskowitz covers up to 1945 will be familiar to students of American culture, what follows is refreshingly original. The 1950s figure in her narrative as the apogee of the therapeutic gospel, a decade in which its core concepts were realized in a series of federal acts (the National Mental Health Act of 1946, for example) and bureaucracies, the National Institute for Mental Health (1949) foremost among them, a decade before the stirrings of antipsychiatry dimmed the gospel’s luster. The numbers of psychiatrists and psychologists alike increased fourfold over the course of the decade, due largely to government-sponsored training programs and dollars; hundreds of clinics were established as the federal government for the first time put its weight behind preventing “unnecessary unhappiness.” Terms such as “ego,” “unconscious,” and “self-esteem” entered the vernacular, offering everyone the language with which to discuss their particular sort of unhappiness. Meanwhile, advertisers, engaging in “mass psychoanalysis,” plumbed the consumer’s unconscious; their discovery that “the wish to appear naked or scantily clad” was common fueled the enormously successful “I Dreamed I Stopped Traffic in My Maidenform Bra” campaign, which featured a buxom woman wearing only a bra above the waist, stopping...