Intended for healthcare professionals

Reviews Book

Therapy Culture: Cultivating Vulnerability in an Uncertain Age

BMJ 2003; 327 doi: (Published 27 November 2003) Cite this as: BMJ 2003;327:1293
  1. Raj Persaud, consultant psychiatrist
  1. the Maudsley Hospital, London

    Frank Furedi is professor of sociology at the University of Kent, Canterbury. He is also, perhaps, the nation's best known sociologist, partly as a result of popular books such as Therapy Culture, which has been extensively reviewed in the national press.

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    Frank Furedi

    Routledge, £16.99, pp 243 ISBN 0 415 32159 X

    In Therapy Culture he argues that the language and sentiment of psychotherapy have now spread outside the confines of the clinic, widely infecting society at large. As a result emotional vulnerability has become the defining feature of people's psychology, leading to a “unique sense of powerlessness.” Furedi questions the widely accepted thesis that psychotherapy as an ideology represents an enlightened shift towards emotions. But is it really the case that people didn't feel powerless before?

    We do, however, live in apparently peculiar times. Tony Soprano, head of America's favourite television gangster family, goes to a therapist. American girl scouts can now get a badge in being stress free. And it is now possible to buy pet insurance packages that provide counselling for those whose pets have died.

    Furedi also reports that an attempt to map the number of counselling encounters taking place in Britain in February 1999 concluded that there had been 1 231 000 such events that month. Following this startling testimony of how therapy is taking over our lives, he readably marshals a wide range of criticisms of how therapeutic thinking is influencing the wider culture.

    At first glance the book's extensive referencing seems to support the idea that Therapy Culture is an academically rigorous treatise. However, on closer inspection, it becomes clear that most of the references are to newspaper articles or websites. For example, Furedi's intriguing claim that by 1995 nearly half the US population had experienced some kind of psychotherapeutic intervention and that estimates suggest the figure is now 80% comes from the Montreal Gazette. In the first chapter, out of nearly 100 references I could find fewer than five that appeared to be to peer reviewed academic journals.

    Furedi accords to the preoccupations and contentions of the popular press the same status as one would give an academically rigorous gathering of data in a published study. To use journalism as a way of working out what is going on in society is a surprising strategy for anyone who straddles the worlds of both the media and academe, as Professor Furedi increasingly does. But he would probably soothingly argue that I am worrying too much and that therapy culture now means that I might even rashly claim to be traumatised by the experience of reading his book.

    That does not mean that there aren't some significant ideas here. It is interesting to note that while liberal society is not convinced that it should persuade us to believe in anything, other than tolerance for other beliefs, it is now preoccupied with how we should feel. It is also noteworthy that Western governments keen on re-election have begun to focus on how to improve a sense of well-being in the electorate, which raises the issue of who should take responsibility for our emotions.

    Doctors in general and psychiatrists in particular increasingly fear bureaucratic and public inquiries pointing the finger of blame if patients take their own lives or behave in some other way that might inflict suffering on others. Furedi is right that people nowadays seem to accept less responsibility for their feelings and instead increasingly load the burden on to professionals such as doctors. The medical profession will therefore welcome this searing analysis of the slippery slope towards a future when how patients feel, as well as their health, have become entirely our responsibility and not theirs.

    It is only by taking responsibility for themselves, their beliefs, and their emotions that people become truly free. Exactly how we got to the stage where therapy can imprison rather than liberate is enigmatic, and Furedi performs a valuable service in charting this journey. But his polemic misses the undeniable fact that some therapy has helped some people. Furedi seems to reject the reality of the genuine suffering that therapists work to ameliorate.

    Perhaps in future editions of Therapy Culture Furedi could acknowledge the growing work that “positive psychology” and other new fields are doing in pioneering resilience enhancement and self taught coping skills. But it is hard to imagine him doing this while he appears to reject any form of psychological thinking at all. If Furedi could embrace the fact that psychology is not synonymous with therapy, his work could become a more valuable resource for those wrestling with the genuine conundrum of whether to seek therapy or try the reliable alternatives that now exist.


    • Items reviewed are rated on a 4 star scale (4=excellent)

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