the ways in which the expansion of psychological and psychiatric knowledge in new networks of power has had uneven effects for individuals and groups in varying social strata. In The Rise of the Therapeutic State, Andrew Polsky employs a Foucauldian analysis, informed also by Thomas Szasz as well as the concerns of anti-psychiatry, in arguing that the therapeutic becomes a mechanism of normalization of marginal populations. He argues that both public and private therapeutic intervention generally operate as a means of support for the middle classes who are able to choose when to begin and when to end treatment: "By contrast, public therapeutic intervention aimed at marginal citizens proceeds from the assumption that they cannot govern their own lives. The state therefore seeks to 'normalize' them… Lower class clients do not seem to require merely a bit of support, like their middle-class counterparts, but instead wholesale personal and family reconstruction."66
Foucauldian analyses have provided important insights into the critical role of psy knowledges in the operation of power, notably through techniques and practices directed towards "the shaping of conduct."67 As a framework for theorizing the therapeutic, however, a governmentality approach is not without its problems—at least insofar as it has been deployed to date. As Anthony Elliott has forcefully argued, studies of governmentality inspired by Foucault have tended "to offer a dark, oftentimes a sinister, account of social processes."68 Not only does an inherent distrust of the routines of social life often emerge, but the model of personhood upon which such theorization hinges constitutes a fundamental weakness; it is highly individualistic, provides little attention to the workings of emotional life, and only a limited understanding the self in its relation with others. Moreover, as Elliott points out, both in Foucault's work and in Rose's extension of it, there is "no adequate account of human agency, since the self simply appears as the decentred effect of an analytics of governmentality … In short, inadequate attention is given to the active, creative struggles of individuals as they engage with their own social and historical conditions."69
The notion of selfhood that emerges from Foucauldian theory is thus deeply problematic. As Lois McNay argues, the "lack of a rounded theory of subjectivity or agency conflicts with a fundamental aim of the feminist project: to rediscover and re-evaluate the experiences of women."70 An associated problem concerns the inadequacy of Foucault's explication of the complex relation between "care for the self" and "care for others," which neglects the ways in which "care" has been socially assigned to women and construed as "feminine" and domestic.71 This raises particular problems for interpreting critical dimensions of the therapeutic society, particularly the ways in which gender and the therapeutic terrain intersect. As feminist theorizing of the ethics of care reminds us, human dependency is a central dimension of existence and there are moral values involved in caring for another, physically, psychologically, and emotionally.72 In spite of its limitations, the Foucauldian reading of the nexus of knowledge and power, especially as imbued in psychological and psychiatric knowledge, therapy and other therapeutic cultural forms, has provided a valuable critique of power and the regulation of disadvantaged social groups, including women. It has thus also informed some feminist approaches in theorizing the regulation of women in therapeutic culture.
The Myth of Women's Empowerment
While relations of power and control have informed many analyses of the therapeutic, the theoretical traditions so far considered have not explored the ways in which the social and cultural diffusion of psychological knowledges may register differently for men and women. In bringing the experiences of women to the centre of analysis, feminist critiques provide another lens through which to examine this pervasive cultural turn. The points of overlap and departure from other perspectives already discussed are particularly salient. For example, while Donzelot, suggested that women secured a degree of benefit from their acquiescence to and embrace of the psychological, feminists have largely interpreted psychological knowledge and practices as yet another means by which women have been controlled and disempowered. In Dana Cloud's view: "too great an emphasis on personal life—on consciousness, identity, and lifestyle—has hindered progress toward women's liberation … 'The personal is political' may not be a revolutionary challenge to the status quo but rather an unwitting collaboration with the forces of stability in contemporary capitalist culture."73
The practices of psychiatry, psychotherapy, and counseling have been subject to strong feminist critique. Psychiatry in particular has provoked much disquiet, interpreted as an especially pernicious agent of social control. Indeed, the construction of the psychologically unstable woman has been interpreted as a key way in which oppressive gender relations have been maintained under patriarchy through the male authority of the medical professions.74 In her classic text, Women and Madness, Phyllis Chesler contends that psychiatry is much like marriage, an institution that controls women through dependency and the reinforcement of ideals of femininity. Challenges to existing power relations are marginalized, discredited, or undermined, she argues, in the labeling of women as psychologically unstable. In Australia, Jill Matthews elaborated a similar thesis in her classic study of twentieth century femininity, Good and Mad Women, while Judith Allen revealed how psychological and psychoanalytic theory has historically been marshaled in the criminal justice system, often in defense of sex offenders and to the detriment of their victims.75 More recently, there has also been widespread disquiet about the medicalization of women's unhappiness, as evidenced by diagnoses of depressive disorders and the use of anti-depressants: women are twice as likely to be diagnosed with a depressive disorder and twice as likely to be prescribed psychotropic drugs.76
Rather than focusing on broader questions of cultural change, a key element of feminist accounts of the therapeutic has thus been a critique of the psy professions and associated clinical practices. Reflecting similar concerns to the critiques of therapy outlined above, Celia Kitzinger, for example, argues that while many women may be helped by therapy, it nevertheless personalizes the political by concentrating on the emotional realm and the inner life of women.77 Similarly, critiques of therapeutic cultural forms, notably self-help literature, strike a particularly strong chord in feminist accounts. As with therapy, they have been interpreted as a panacea for alienation and an impediment to social action.
According to American journalist Susan Faludi, popular psychology was instrumental in the anti-feminist "backlash" of the 1980s. In her view, the strategies of popular psychologists with prominent media profiles reinforced female isolation and pain, rather than helped to relieve it. The rhetoric espoused by self-help authors constituted, she argues, a discourse couched in the language of women's liberation, but constructed around various interpretations of the masochistic female psyche: "To the vast female readership of self-help manuals, the advice experts delivered a one-two punch. First they knocked down the liberated woman, commanding that she surrender her 'excessive' independence … Then, having brought the 'victim' of feminism to her feminine knees, the advice writers reaped the benefits—by nursing the backlash victim. In the first half of the 1980s the advice experts told women they suffered from bloated egos and a 'fear of intimacy'; in the second half, they informed women that atrophied egos and 'co-dependency' were now their problems."78
Other analyses of self-help advance similar concerns, especially in terms of its focus on introspection and healing rather than social action, and in the view that engagement with therapeutic texts offer only illusory cures for what are essentially social ills.79 Concerns have also been raised about the ways in which other therapeutic cultural forms construct notions of the feminine, and in particular, female distress. The self-disclosure typical of the television talk show, according to Franny Nudelman, "has confirmed and elaborated a certain construction of female subjectivity." In her view, we have come to believe that women "are prone to psychic pain."80 Embodying significant attributes of the therapeutic, television talk shows and self-help literature are important cultural artifacts to consider when assessing its impact, especially for women and for gender relations.81 For just as women have significantly higher utilization rates of therapy than men, it is also women at whom television talk shows and self-help books are primarily targeted.
Offering
