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by Louis S. Berger Trafford, 2002 Review by Heike Schmidt-Felzmann on Jan 10th 2003 
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.
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