Neoliberal Gaslighting

The term “analytic action” assumes new complexity when we use it to enhance meaningful discourse about our unsettling and turbulent political reality. It opens doors to the possibility of kindling a deeper connection to parts of our psychoanalytic heritage, such as Freud's free clinic movement. It brings to mind concerns expressed by early psychoanalysts Otto Fenichel, Wilhelm Reich, and Erich Fromm about the way sick societies produce troubled minds. Most importantly, it introduces two pressing questions. First, what issues occurring outside the consulting room demand analytic action? Second, what renders “action” outside the consulting room “analytic”?

With that in mind, I would like to share some ideas and experiences I hope constitute one example of a form of analytic action that enriches, but in no way forecloses, other understandings and approaches. The analytic action I would like to discuss highlights both an intervention and the dilemma that necessitates it. I conceptualize this dilemma as a unique case of gaslighting geared specifically toward us and our patients. The dilemma I am referring to is the neoliberal phenomenon known as evidence-based therapy (EBT).

Let me assure you, I am not saying EBT's stated goal of researching the effectiveness of mental health treatment is “fake news.” Nor am I implying that research demonstrating the benefits of non-psychoanalytic treatment should be dismissed as “alternative facts.” What is concerning is the way in which EBT has come to refer almost exclusively to short-term, symptom-focused, manualized treatments, such as cognitive behavioral therapy. This is the case despite the existence of a large body of scientific evidence demonstrating the clinical efficacy of psychoanalytic and psychodynamic treatment.1^,2

This misrepresentation of research outcomes is only the beginning of the problem.

The problem becomes clearer when we examine EBT in the context of its political economy. This expanded lens reveals how EBT comforta