I have just finished reading a book by the British clinical psychologist David Smail (1938 – 2014), called “Power Interest and Psychology: Elements of a materialist understanding of distress”. My housemate bought Smail’s book after I complained that his opinions on mental health were out of date, because he was only reading books from half a century ago – by Foucault, Laing and others. Reading Smail’s book was our attempt to gain insight into a more modern perspective on mental health in our society.
I’m still confused as to how much of Smail’s book I agree with, so for this blog post I have attempted to summarise three of the main points raised (as far as I understood them), in the hope that others might come back to me with their own thoughts and opinions.
Point 1 from the book: We should take our focus away from individual psychology.
In psychology and psychiatry we aim to understand human emotional distress by understanding the mind and biogenetic makeup of the individual. Less attention is paid to what is going on in the world and the relationship between individuals and society. Smail argues that societal factors are just as important in influencing our emotional states, as “we are as much creatures of culture as of biology”.
In our current system we deem each individual’s emotional state to be “largely if not solely their own responsibility”. Smail suggests that “abandoning a self-centred psychology would increase freedom and dignity rather than diminish them” (this links back to a previous post on the blog by ). By continuing to blame individuals for their suffering within society, Smail warns that we are making it easy for the few individuals in power to exploit us for their own advantage…
“Smail argues that societal factors are just as important in influencing our emotional states…”
Point 2 from the book: The influence of distal powers.
Smail emphasises the role of external powers that are capable of altering our perceptions. These powers can be coercive, economic, or ideological – and they operate at varying distances from the person. Smail proposes a model called the ‘power horizon’, where the ‘self’ is at the centre and the largest, most influential powers (global powers and governments) lay out somewhere beyond the horizon, too far away for the self to see – where all sorts of things might be happening.
Distal powers can take hold of our proximal space via media manipulation or advertising, for example (see back to a previous post on this by Laurie Hannigan). One way that this has happened has been via the globalisation of the ‘free market’, which has resulted in the sale of ‘highly desirable’ consumer goods, which are actually the product of brutal exploitation of labour on the other side of the world – hidden from the consumers.
We are unconscious of these distal powers and it is difficult for us to comprehend their influence over us, because it is difficult for us to feel our conduct as anything other than our own creation. As a result, Smail suggests that we invest a disproportionate amount of belief in self-importance – which “bears upon us the self-conscious spotlights of guilt and anxiety”. Smail suggests that “when things go well we falsely credit ourselves with virtue, and when things go wrong we wrongly torment ourselves with blame”. In actual fact, “most things come out the way they do in accordance with the interests of the powerful”.
“… it is difficult for us to feel our conduct as anything other than our own creation.”
Point 3 from the book: Therapeutic aims should be shifted.
Smail proposes that lack of power is a major source of emotional distress. This, he argues, is “a material circumstance, not a psychological condition”. Smail proposes that the psychologist’s job should not be “to diagnose the ‘inner person’ but to explicate his or her relationship with the outside world”. This involves helping the individual to determine what is and isn’t possible for them to change with regards to their circumstances.
Smail uses this argument to denounce the practise of cognitive behavioural therapy (CBT). In his view, CBT wrongly “converts powerlessness into a ‘sense of disempowerment’ that can be ‘treated’ by persuading people to see things in a different light”. Smail suggests that we cannot find the cure to emotional distress at a personal level, because “along with seeing the need to change”, individuals “need the power to change”. By establishing the limits of individual responsibility and power, we may be able to lift a heavy burden of apprehension or guilt from those who are struggling with their mental state.
What we think should be inside ourselves is actually a false representation of humanity, which has been manipulated by distal powers. So in summary, Smail urges the reader to “take really seriously the fact that we are a society, not a collection of individuals, and that we live in a real world that is as impervious to optimism as it is to wishfulness”.
“Smail suggests that we cannot find the cure to emotional distress at a personal level…”
Having finished the book I am left wondering whether we are doing enough to accommodate this perspective in our research. How do the points raised by Smail relate to the theory behind therapy-genetics, or research on the intergenerational transmission of psychopathology? I’m still thinking about it!