Cushman's book - a review

Lois Shawver (
Mon, 25 Mar 1996 12:50:47 -0800 (PST)

Someone here invited comments from therapists on Phil Cushman's book

Cushman, P. Constructing the Self, Constructing America:
A Cultural History of Psychotherapy. Addison-Wesley
Publishing Co. 1995.

I'm a therapist, so let me give you my reaction to it.

In this book, Phil Cushman deconstructs the concept of the self into
multiple voices as many people do today. I like this new postmodern
metaphor of the mind containing multiple voices, and I often use it
myself. I like the passages in Cushman's book that explain what is
compelling about this new metaphor. But then Phil Cushman draws a
conclusion from this deconstruction that is very different from my own.
It is always unfair to characterize a conclusion so briefly and
categorically, as I will here. But in the end, Phil Cushman's book came
together in my mind with a simple message that left me dismayed.

To my mind, Cushman wants to say that because the self can be
deconstructed into fragments, other voices, memories, ambitions, and so
forth, individual people do not deserve our respect as therapists. Since
the self as a unified center is a fiction, so the argument goes, then we
do not need to concern ourselves with our patients' individual desires and
miseries. And since each person is each constructed in a network of people,
through the political structuring of our society, what we need to concern
ourselves with in the therapy hour is the health of this network and its
political structure. This implies that what is most therapeutic is to
help people see their roles in this structure and move them towards
another role that would help constitute a better society. What Phil
Cushman sees as constituting a better society is not entirely clear
to me, but it has to do with increasing respect for multi-cultural
diversity, socially desirable gender role changes, and a shift towards
greater reliance on an economic socialism. All of this, however, is a bit
more subtle in Phil Cushman's phrases than my own. Here are a couple of
passages from his book that can allow you to see the kinds of text that I
am interpreting the way I do.

I believe the following questions are rhetorical ways Cushman has of
making the point that the political structure is the cause of our problems,
and that therapy as it is now conceived cooperates with the status quo:

Could the culprit be a sociopolitical system that is structured
in such a way so as to deprive the majority of the population
of the emotional guidance and security provisions it needs, and
then to convince people that what they need is to be found in
empty calories, new electronic gadgets, and glitzy clothes?
by conceiving of the self as a structure that can be properly
built by the proper parents, and by conceiving of psychotherapy
as the activity in which proper suppiles are offered or a
proper environment for the true self provided, are we unknowingly
providing a covert, compensatory solution to a political
problem best attacked directly? And by doing so are we
preventing our patients from understanding the political nature
of their distress and challenging the political structures that
cause it? (p. 349)

And the point in the next passage, as I take it, is that psycho-
therapy should be revised to serve these political purposes:

The task, in psychotherapy, is to confront our thrownness, discover
experientially and cognitively how we cooperate in constructing the
world the way we do, more fully experience the consequences of that
construction, explore whether we want to continue constructing it,
conceive of alternative configurations, and then develop ways of
letting a different world emerge. I do not mean that this process
is solely or even predominantly rational, calculating, cognitive,
or conscious. I do not mean that that this process is even entirely
possible--the concept of the clearing implies not only the potential
for change but also the very real limitations of givenness. But
perhaps there is also a place for thinking and choosing, for will as
well as feeling; a place for hope as well as resignation and
compromise. (p.310)

In contrast to Cushman, I believe that psychologists should champion their
beliefs about social practices in the public forum, not in the therapy
forum. I believe the fragmented self is as much a fiction as is the
unified self. Both are constructions of language that highlight some
aspects of experience and distract from others. Moreover, I believe that
appreciation of the metaphor of a fragmented self does not require us to
think of therapy as an arena for political enlightenment and that it is
better if we do not switch to thinking of therapy as a form of political

But why do I think this? My difficulty in explaining this is disturbing
to me. Why do I think that the therapist should not turn the therapy
session into political indoctrination of a sort that the therapist thinks
will foster a better world? A simple answer like "it would betray the
trust of the patient" is not good enough. Its a circular answer. Why
shouldn't we be utiliarians here and be willng to sacrifice the good of
the patient for the good of the many? On the grounds that the benefits
of society will come back to the patient in the long run?

I am fumbling here, but let me try to answer my questions: If a person
decides to enter therapy, it is likely to be because psychotherapy is
expected to be a safe, unpressured place for troubled people to go, a
place where people can focus their attention on their personal, private
issues. If patients go to therapists for this kind of self-reflection
only to find they are instructed in performing useful roles in society, it
would be like someone going to a dentist only to find the dentist was more
interested in saving their souls than their teeth. It would discourage
people with toothaches from going to dentists. And making therapy an
areana of political indoctrination would discourage people who were
troubled from going to therapists.

It would change therapy's image at a point in time that we are acquiring
the public faith that even if we do not have all the answers, even if we
each provide different answers, we can be trusted to provide people with
a thoughtful and private place to talk about their problems. If
Cushman's political version of psychotherapy were to replace the present
one, psychotherapy as an institution that invites people to its doors
rather than enforcing their presence, would, it seems to me, simply die.

So, although Cushman's book has much that is positive to offer, in the
end, his ideology dominates the book for me, shocks me and I reject his
conclusions as I interpret them.

Lois Shawver, Ph.D.