Counseling and the Therapeutic State

This book examines the nature and scope of counselling and psychotherapeutic practice in modern society. Although this entails a close analysis of the social organization of counselling within medicine, psychology and the helping professions, the book also looks at the persistence of the therapeutic ethos within American and Western culture more generally (that is, within the context of families, communities, schools, churches, the courts, and the mass media). In order to understand the rise and continuing persistence of the therapeutic welfare state, with its guiding concepts and metaphors of sickness, disease, syndrome, pathology, addiction and self-esteem, one must understand that the rise to prominence of medicine occurred concomitant to the broader transformation of western societies from agricultural to industrial (manufacturing-based) to postindustrial (information- and service-based) economies. Late industrialization and the postindustrial era, with its emphasis on service rather than manufacturing, produces a range of "experts" modelling themselves after the primordial professional classes of physicians and lawyers. The proliferation and continuing expansion of psychotherapeutic practice in modern society is a reflection of the power of the professional discourses of medicine and the assumptions of the disease model, which suggests that persons ought to "seek professional help" for even minor disturbances in their lives. This ideological hegemony works by turning greater and greater numbers of average citizens into "patients" or "clients" as they accept the assumptions of the disease model and turn to various "physicians of the