Psychotherapy and the Pursuit of Happiness
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Freudianism sits alongside Marxism and Darwinism in the pantheon of modern theories held to be so revelatory that they not only gained the adherence of Western intelligentsia but shaped the broader culture. During the first half of the twentieth century, an air of intrigue and mystery hovered around Freud’s newly anointed practitioners. Psychotherapists occupied a strange universe, speaking in a language so incomprehensible but seemingly authoritative that it alternately awed and scared the average man on the street.
Psychotherapy is no longer an intellectual movement today as it once was. But in the form of modern professional “caring,” it has assumed a new role, which is to provide a peculiar sort of substitute friendship — what we might call “artificial friendship” — for lonely people in a lonely age.
To understand why this occurred and what it means for American culture, we must study the fractious history of the mental health field over the last six decades. It is a complicated story, with a staggering variety of terms, schools, leaders, and techniques, so any overview must necessarily leave out many important details. But from even just a synopsis of the conflicts that gave rise to today’s culture of psychotherapy — battles over who would hold the truest title to physician of the mind, tensions between scientists and clinicians, academics and professionals, elites and the public — we can see more clearly how psychotherapy has profoundly shaped the American conception of what happiness is and how we can achieve it.
Disciplines in Conflict
A mental health crisis erupted in the United States after the Second World War, touching not just returning soldiers but people from all walks of life. Alcoholism and juvenile delinquency became rampant. The number of patients admitted to hospitals and outpatient psychiatric clinics for mental health problems began to climb rapidly. There were not enough trained mental health personnel — the nation then had only a few thousand clinical psychologists — to deal with the problem. So the federal government responded by passing the National Mental Health Act (NMHA) in 1946, leading to the establishment a few years later of the National Institute of Mental Health and the provision of funding to train more psychotherapists. The new policy represented a genuine attempt to handle the crisis, yet it also brought to the surface important subcurrents and divisions within the mental health community, including skepticism among both academic psychologists and medically trained psychiatrists toward an elevated role for less-trained psychotherapists.