Review of "Psychotherapy As Praxis"

Psychotherapy as Praxis is a proposal for a radical reconceptualization of psychotherapy. The author wants to refute an interpretation of therapy in terms of science and presents the Aristotelian notion of praxis as a core concept that may provide new insights into the nature of a non-scientistic conception of psychotherapy. Berger is a psychotherapist with psychoanalytic training who draws extensively on philosophical writings mainly from the continental tradition (especially Heidegger).

In the following, I will focus on his ideas on the theory and praxis of psychotherapy. I will not address Berger?s use of philosophical theory, given that he presents himself explicitly as a non-philosopher. (Philosophically, there is much that could be disputed, including his idiosyncratic generalizations concerning the history of philosophy, his apparent view of rationality as deductive reasoning and especially the details of his interpretation of the notions of praxis and phronesis as Aristotelian notions.) Berger starts with a general critique of what he terms ?technological thinking?. According to Berger, it is characterized by a strong reliance on rationality and instrumental thought and a negative, if not outright eliminative attitude toward irrational elements of human experience. He sees this attitude as pervasive in contemporary psychotherapy, for example in the attempt to establish empirical proof for the efficacy of certain forms of therapies, especially in terms of symptom-reduction. Such therapy is thus understood as purely instrumental activity (?technotherapy?), a stance that Berger rejects as thoroughly inadequate. Instead, he proposes to understand therapy as praxis. Phronesis is then introduced as a specific non-theoretical form of knowledge that is acquired through individual experience and praxis as that kind of action that is based on this special kind of knowledge and is characterized by the absence of instrumental goals.

Accordingly, therapy practice should not be understood as deduced from therapy theories (these, Berger assumes, are never able to give sufficient guidance in specific therapy situations), but as based on the character and the individual experiential background of the therapist. Theories may play a role mostly in the sense of enriching the therapist?s background. Berger points out that psychoanalysis is a form of therapy that places much importance on the therapist?s character and individual therapy experience. In his opinion, this may qualify psychoanalysis as an approach with special significance for understanding clinical phronesis. However, Berger is aware that psychoanalysts today do not necessarily possess exemplary phronesis. He suggests that (in addition to the succession of incompletely analyzed analysts from Freud until today), this may be ultimately due to remaining ?technotherapeutic? elements in psychoanalysis and may disappear once an entirely non-instrumental form of psychoanalysis is adopted. Such a form of ?radical psychoanalysis? would be based largely on free-association (which for Berger represents a form of discourse fostering the recognition of rationality?s otherwise repressed ?other?), and shun those forms of action and interaction that are representative of rationality and the technological attitude. Instead of pursuing specific therapy goals, radical psychoanalysis would focus on the process itself as the goal. The therapist?s main task would apparently be to be a neutral and accepting listener. (Unfortunately, Berger does not elaborate on this point). Berger ends his book with an application of these ideas to wider social criticism.

Psychotherapy as Praxis presents itself as a radical manifesto that will surely be rejected by those who still cling to ?Cartesian? and ?technological? thinking. However, there are also other reasons why one might want to criticize it. First of all, there is Berger?s style of writing. He tends to make very general statements, presents issues extraordinarily briefly (and incompletely) and often draws very strong conclusions from weak, incomplete or exceedingly vague arguments. Instead of elaborating on his arguments or specifying his points, he frequently presents long lists of names or issues. These do not usually clarify the issue at hand, but mostly point to entire fields of discourse. Accordingly the reader is not encouraged to pursue the specific significance of points that might initially have appeared interesting.

I personally was disappointed by the book. For me, the use of the Aristotelian notion of praxis evoked the expectation of a theoretical engagement with the nature of therapy in the context of broadly ethical questions. However, Berger does not really engage with psychotherapy as it is practiced today; those psychotherapies that are presently practiced in the mental health system seem to be all subsumed under the label of ?technotherapies? and thereby judged as entirely unacceptable. Despite certain assertions of the author that values are a crucial part of therapy, they are mostly discussed negatively, namely as the (not further specified) implicit values that underlie the technocratic view. Even the values of radical psychoanalysis remain unclear ? are these restricted to the total absence of instrumentality and the acceptance and integration of irrationality, or are there any other values implicit in radical psychoanalysis? How about intersubjectivity and the therapeutic relationship, an issue that hardly receives any attention in Berger?s book while many contemporary psychoanalytic theoreticians consider it to be crucial for understanding the nature of therapy? And how about respect for the clients? own values, who usually appreciate at least some reduction in their symptoms? Is their attitude really nothing more than a sign of the pervasive influence of technological thinking ? or could humanism (which is apparently endorsed by Berger) have a word to say here as well?

With regard to possible readers, it seems to me that for most practicing therapists this book will prove rather unsatisfactory because of its radical rejection of all therapy as practiced today, except perhaps classical psychoanalysis. I assume this book may be most interesting for theoreticians with psychoanalytic and deconstructivist predilections and perhaps for those psychoanalysts whose primary interest are not the intersubjective aspects of psychoanalytic practice. It is a pity that Berger does not engage with a broader audience ? in my opinion, the question concerning the relation of psychotherapy to science is too interesting to be reduced to a dichotomy of (non-scientistic) radical psychoanalysis vs. all other (presumably equally and thoroughly scientistic and technocratic) psychotherapies.

 

© 2003 Heike Schmidt-Felzmann. First serial rights

 

Heike Schmidt-Felzmann holds graduate degrees in philosophy and psychology from the University of Hamburg, Germany. She is currently a doctoral candidate in philosophy and works on ethics in psychotherapy.