You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Farhad Dalal tells the story of a brazen heist that occurred in plain view. It is a tale of two influential men, one an economist, the other a cognitive psychologist, who, armed with what Dalal calls corrupt science, and with a sleight of hand known as “evidence-based practices,” changed the ethos of mental health provision in Britain’s National Health Service (NHS). The shift toward an econometric approach to mental health delivery, coupled with mandated “efficiencies” of manualized, time-limited therapy, has changed the NHS beyond recognition and dealt what is likely a death blow to widespread use of psychoanalytic, humanistic, existential, and other therapies that take human suffering seriously and that may harbor emancipatory conceptions of therapy as a lever for addressing social inequalities. With advances in digital therapeutics, underwritten by huge sums of venture capital, the likelihood is that in the future psychotherapy for the masses will be delivered by minimally skilled “clinicians” communicating via scripted text, until in due course they are replaced entirely by “intelligent” digital therapists. By no means confined to Britain, this healthcare “solution” is spreading rapidly across neoliberal western democracies.
For psychodynamically oriented clinicians, this book makes for grim reading. While individual analysts in major metropolitan centers will continue to carve out a living catering to an intellectual and wealthy elite, graduate training in psychoanalytic therapy or psychodynamic clinical psychology is declining rapidly. It is hard to leave Dalal’s book without the impression that psychoanalysis has lost the war to cognitive behavioral therapy (CBT). Buoyed though it may be by endorsements from twenty-five leading intellectuals, it is doubtful that this book will shift an insidiously entrenched CBT paradigm; indeed, it may serve more as an obituary for the practice of psychoanalysis than a call to action. Complementing Nancy Fraser’s (2016) “Con