The Erosion of Nuance
The insistence on simplistic narrative and the denial of nuance is not something new.
In the face of anxiety, distress and complexity, human beings have always had to guard against a tendency to withdraw into a state of denial. This tendency increases in the face of increasing anxiety. Any great change in external circumstances, that threaten to disrupt an established way of life, tends to increase anxiety. The first response to the intimations of great change tends to be denial.
Over the last twenty years such a state of denial seems to have become increasingly respectable, and more deeply entrenched in government policy. This impacts on many areas of specialism that explore worrying and unwelcome truths - from climate change to the causes of terrorism and the consequences of Brexit. For us, as psychoanalytic thinkers, it creates an increasingly hostile environment; regard for the unique aetiology of each individual’s emotional difficulties has been eroded, and there has been a corresponding devaluation of the importance of empathy and insight as clinical tools.
Within the public sector, this state of denial has been rationalised as a valid response to the need to save money: it takes time and resources to provide any talking treatment, and in particular the individually tailored treatments of traditional psychoanalysis. The financial requirements of the NHS, social services, and education, continue to escalate while budgets are cut. Successive governments have attempted to increase financial efficiency, so as to reduce the impact of this shortfall; and each government has assumed that it can best do this by delegating the control of these services to managers with business expertise. Such managers are thought to be more capable of driving a scientifically hard-nosed system than are professional clinicians, social workers and teachers.
Unfortunately, the application of a business expertise designed to achieve expansion of profit within a competitive market is not appropriate to these areas of work. Organisations offering social care, education and the provision of mental and physical treatments function as extensions of the family. That is, they exist primarily to promote learning, development and well-being,supplementing what a nuclear family is able to provide, and compensating for its deficiencies,through offering an expertise beyond that available to most families. They occupy the role we traditionally ascribe to the parental couple: they aim to provide an environment of emotional containment that allows for a necessary level of dependency in order to facilitate development, and to cure illness, injury and trauma - or if it cannot cure them, to ameliorate their impact.
If patients and clients are to benefit, they need to trust the integrity and motivation of teachers, social workers and clinicians. They need to believe that the professionals involved have no ulterior motive in recommending a particular course of learning or treatment.
Businesses, by contrast, fulfil the traditional role of the father who engages with other adults beyond the safe environment of the home, in order to provide the resources that will facilitate emotional containment. They are not there simply to fulfil the needs of their customers: they exist to make money, and customers are expected to take this ulterior motive for granted.
Customers understand that by paying for the goods or services that are on offer they provide the business with a profit; and they know that they buy at their own risk. They must make their own decisions about whether or not they want to spend their money on a particular service or commodity.
However, within a growth economy, managers tend towards a particularly aggressive type of business model: any large business has to satisfy its investors as well as its customers - and its investors will have the prior claim.
Globalisation has intensified the perceived need for a growth economy. A business model designed for this context, and applied without sufficient modification to the caring professions, is therefore bound to undermine the trust of its clients. It is also likely to demand a significantly different approach in its clinicians, teachers and social workers from that of a business that does not need to expand.
This in turn will impact upon the quality of service these workers are able to provide.
I want to spend a few minutes thinking about this, and about how growth economy business attitudes and approaches have impacted on the organisations designed to provide care.
Business models within a growth economy require growing investment. They assume that investors will need regular evidence of value for the money they invest. This evidence will be demonstrated through the achievement of specified targets, designed to show an increase in productivity, sales and profits, via numbers on spreadsheets. Investors will need to know that the product is being created as cheaply as possible in order to maximise profits, and that there is a possibility of further expansion.
Since the industrial revolution, the use of technology has facilitated standardisation and mass production, and this has in turn facilitated cheaper production costs and greater expansion of productivity.
Alongside the increase in productivity, investors will need reassurance that there is a supply of customers willing to consume the greater quantity of products on offer, and that there will be a corresponding expansion of sales.
This is usually achieved through marketing and advertising; efficient marketing and advertising costs money, but this expense will be defrayed through ever-increasing productivity and ever- expanding sales.
If the aim is to promote sales, in order to make profits, the product does not necessarily have to fulfil a recognised need. On the contrary, a need may have to be generated in order to sell the product. Customers have to be persuaded that the product that is on offer is something they want. As customers, we all know that advertising is not always grounded in truth: indeed, we don’t expect that it should be. It’s designed to entertain us and seduce us rather than to instruct us, and the better it does this the more successful it is likely to be.
At all stages, investors will require a review of the data that supports expenditure on all these activities. Provision of this data has been greatly assisted by digitilisation: computers excel at collecting, storing and sorting data and displaying the figures in a way that makes it possible to run an efficient business and will satisfy the needs of the investors.
So an effective business methodology, and the expertise it brings with it, involves:
- a need to demonstrate value for money;
- standardisation of production methods;
- marketing techniques to persuade consumers of the value of the products on offer;
- mass production in sufficient volume to defray the costs of production and advertising;
- evidence of growing productivity;
- an increased reliance on computerisable data.
I’m really stating the obvious here, but it’s worth giving some examples of how widely the attitudes that we take for granted within a business model have infiltrated the caring professions.
Teachers, social workers and mental health clinicians are all required to comply with tight regulations, and to provide evidence of digitalisable outcomes designed to demonstrate the achievements of targets that will satisfy investors - that is, politicians and bureaucrats.
In schools, the children’s exam and test results become the product, and their teachers are judged by whether or not these product targets are met.
Schools teach from textbooks designed to promote standardised learning. Pupils are coached to pass exams which are marked to protocols that insist that certain points are made during the course of an essay - which is judged accordingly. Marks are lost for any deviation from the norm, and no extra points are accrued for original thinking. This has an obvious impact on how teachers teach: there is less freedom to encourage creative thought, a stronger emphasis on exam technique, and greater pressure to conform. The marketable element here is the argument that this creates a level playing field: it does not depend on the individual judgement of the people who mark the exams.
Similarly, within mental health services, cases are divided into strict categories, and set on treatment pathways. There is an increased reliance on a medical model for conditions such as depression, bipolar affective disorder and ADHD, and these are routinely treated by medication. Within the talking therapies, CBT is regarded as the evidence-based treatment of choice. The doctrine behind these treatments can be succinctly described as ‘don’t look beyond behaviours for any but physical reasons,’ and ‘don’t think about anything that will upset you.’ This makes it easier to record a positive outcome in terms of client satisfaction for short-term work. What is marketed here is ‘evidence-based’ treatments, which are claimed to be ‘scientifically endorsed’.
The ‘scientific evidence’ on which these treatments rely is often deeply flawed. One evaluation of CBT in comparison with psychodynamic treatment, for instance, depended on an experiment in which some graduate students were given brief manualised coaching in CBT therapy and others were given brief manualised coaching in psychodynamic therapy. The two groups of students were then asked to test out the two methods on other graduate students brought in to role-play patients. This is rather like the old-fashioned advertising technique where actors impersonating housewives are asked to compare detergents and come out with a scripted response about the superiority of Brand X over Brand Y.
So we are perhaps being naive if we think that we can make much headway through the use of research that demonstrates the efficacy of long-term psychotherapy in an environment where research and evidence are recruited for the purpose of marketing affordable treatments on a growth- economy business model, that relies on economies of scale: that is, a model which means treatments that can be standardised, manualised and mass-produced, with outcomes that can be easily measured as digitalised data, and then described as positive.
Several of our colleagues have recognised this, and are indeed creating therapeutic methodologies that fit the mould of what can be advertised in this way. While this may be an admirably adaptive response to a situation that is unlikely to change any time soon, it is arguable that these methodologies militate against the application and development of psychoanalytic thinking. This is because once you start thinking in business terms, you have already sacrificed a psychoanalytic state of mind: you have an ulterior motive. You are hoping to derive a product from your patients that can be evidenced to a third party - successful outcome data for the investors - rather than exploring a relationship together in the hope of deriving joint insight for the benefit of the patient and the profession. And you make yourself vulnerable to the demands of business methodology.
I talked to an old colleague a few months ago, a senior psychologist, sympathetic to psychodynamic thinking, who runs a department within a well-known and well-respected NHS Trust. She described to me how her work in managing and supervising younger colleagues has been affected by the digitalised methodology demanded by her Trust. People’s jobs depend on meeting outcome targets, and these outcomes are measured by scores entered onto the computers. The computer programme requires that clinicians should tick a box to indicate each client’s presenting symptom, alongside other data to do with age, gender, ethnicity, background and so on - including intimate questions on sexual orientation and whether or not there is a history of sexual abuse. So all interventions begin with the clinician interviewing the client, and filling in an elaborate questionnaire, designed to align with the Trust’s computer programme. This is an artificial process in itself, as few clients fit neatly into any one category, and present with only one symptom. The clinician is only able to offer six sessions, and will select a symptom from a pre-determined list through which to categorise the patient’s problem. Unsurprisingly, the symptom tends to be selected in order to enhance the possibility of recording a successful intervention within the established time frame. The consequence is that the department is highly regarded for its achievements: it can produce data to demonstrate that a high percentage of patients have been cured within six sessions. The Trust can claim that they are achieving a faster throughput of patients, and that the treatments they offer now are far more effective than those they offered in the past, which took longer and resulted in fewer recorded cures.
My colleague finds all this troubling. Her own perception is that patients now go away after six sessions with their underlying problems unrecognised and untreated.
She feels guilty towards the patients, but she feels equally guilty towards her junior colleagues: she is aware that they are left with no encouragement to look beyond the superficial presentation of symptoms and explore the true causes of emotional distress. She feels that the services they provide are largely window-dressing: that the patients are being exploited in order to provide the Trust with positive outcome measures, and that her colleagues are failing to develop clinical sensitivity. But as a manager she is expected to maintain the morale of her staff and to support Trust policies. So she doesn’t feel able to voice any objections.
Here’s an example of the consequence of this kind of approach from my own supervisory practice. A sensitive young woman, Julie, came to me for supervision because she was interested in ‘psychodynamic thinking’, and was convinced that she used it in her work. At our first meeting, when I asked for an example, she told me about how she had successfully cured a little boy. He was eight years old and his foster mother couldn’t get him to dress himself in the mornings. He wouldn’t do up his shirt, and told Julie and his foster mother that it was because he was scared of buttons. The only reason he could give Julie for this was that he had once seen a film about someone with buttons on their face. Julie didn’t pursue this further but set about curing the boy of his phobia for buttons: she spent six sessions with him, sensitively helping him to hold first one, then two, then three buttons in his hands.
I suspect that the film he had seen was one called Coraline: the little girl heroine enters an alternative world where her mother has become a monster with buttons instead of eyes - and tries to get Coraline to exchange her own eyes for buttons, too.
(You can watch a trailer for this film here.)
You can see why Julie felt she had achieved a success she was proud of. It was good for the Trust’s statistics to record that she had helped this little boy to overcome a problem that could be categorised as a ‘phobia’. But her work hadn't helped him to get what I thought he needed most: sympathy and reassurance from his foster mother that might get him safely buttoned into his shirt to face the school day, or her understanding of his early experiences of terror about a mother too pre- occupied to offer him eye contact when he needed it, and incapable of providing emotional containment.
The system in which she was working encouraged Julie to ignore all of this in order to produce a satisfactory outcome for the spreadsheet: a tick in a box called ‘phobia’ so that the case could be described as cured within six sessions.
Social Care has comparable problems. Social workers have become brokers rather than case workers, commissioning and managing external services using set criteria based on cost and measurable outcomes rather than an informed understanding of what their clients need. In order to commission a service for a client, they have to demonstrate value for money to a Panel of Managers who will agree funding for that particular service through a list of predetermined protocols. If the service is to be extended beyond a standard short-term length, they need to submit reports with outcome measures to evidence why the work should continue, and how it provides value for money.
This is an area I know a good deal about because for the best part of twenty years I was the Clinical Director of a small business called Placement Support - I still retain a connection as an honorary consultant. Placement Support provides therapeutic interventions to Local Authority adoption and fostering services, and to their Children and Family departments. It is a registered Adoption Support Agency. So we have always worked very closely with Social Services, and value our long-term alliances with senior social workers.
The nature of the work has changed as the finances available have dwindled. We used to specialise in therapeutic interventions for children in foster care - but we now have very few referrals of this kind. Such children are instead referred to CAMHS - with variable results. What is on offer there is often purely behavioural and usually restricted by rigidly enforced time-limits. We are now increasingly asked to provide adoption support, instead.
Government policy for some time has been to move the maximum number of children from the care system into permanency - which translates as adoption wherever possible. This is marketed as ‘every child has a right to a family’. So one of the targets that Social Care departments have to meet is an increasing number of successful adoptions within a short time frame. This means that matching for adoption is often less careful than it should be. More and more children are adopted at a later age, as soon as adoptive parents can be found. Siblings are often separated in the hope that this will make the job easier - even though this can disrupt the only solid attachment a child has known. One child we work with, for instance, was ten years old when she was adopted out of a sibling group of five, and had had eight different foster placements since being removed from her family at the age of three. She lost one sibling after another, and was separated from the last one a year before her final adoption. Her middle-class adopters do not begin to have the skills or understanding to meet her needs, and have no concept of the importance of her siblings to her: they see them as a disruptive influence - which in a sense they are, as they preserve this little girl’s sense of herself and her identity as a member of her delinquent and dysfunctional birth family in contradistinction to the well-behaved little girl her adoptive parents require her to be.
Increasing the rate of adoption was a Government initiative that was intended to save money: on paper it looked a good solution to a problem. Once a child is adopted you don’t have to pay for foster care. But children like this cause chaos in ordinary families. Many adoptions disrupt, many marriages break down. And Local Authorities have had to spend money picking up the pieces: taking children back into care who are now more damaged than they were, or providing costly support to battered, furious families.
So in order to promote their initiative, the Government has recently created an Adoption Support Fund. It is run by bureaucrats, who have strict protocols about how the money is to be allocated: £5,000 per child per year, never mind the complexity of the case. The Fund has been inundated with requests - demand has been much heavier than was anticipated. So various bureaucratic devices have been put in place to slow things down. This year, everyone was instructed to reapply for funding at the start of the financial year - and as this caused a huge log-jam for the social workers making applications, and for the bureaucrats administering the fund, all treatments abruptly ceased for a few weeks after April 1st, until psychotherapists and counsellors could be given the go- ahead to start again - with dire results for many families.
Local Authority managers used to give an assessed package to finance late adoptions of kids with complex backgrounds. But they have used the existence of the Adoption Support Funds to cut their budgets for post-adoption support: this means that in practice families often get less financial support than they used to, and that social workers are further disempowered.
In the face of this, many old-fashioned social workers are looking for other employment; and because they have worked with us for so long, and know us well, they confide in us, and tell us why they’re going. They complain about the increasing bureaucratisation of their work, a lack of belief and confidence in their judgment as social workers, and the prioritising of budgetary concerns and tick-box solutions over the deeper needs of children and their families. We often find ourselves following senior social workers from one Local Authority to another, as they search for social care departments where restructuring has not yet taken a full hold, and they can still hope to do a worthwhile job.
In some Local Authorities, social workers who have remained where they are go to great lengths to hold on to our services for as long as they can, while their departments are restructured around them. One social work manager, who comes from Romania and grew up under Ceausescu’s regime, talked to us about the change in atmosphere after a new line manager had taken over the running of her department. She no longer feels trusted to make decisions based on her own judgment: instead she is required to comply submissively to bureaucratic commands, and to maintain the morale of her staff in obeying the protocols unquestioningly. She says she feels that she has returned to the kind of regime she grew up in, a dictatorship where there is no freedom of speech. She has so far succeeded in marketing our work consulting to foster carers as a ‘training’: we don’t know how long this will last.
I think it is interesting that the values of a growth economy business methodology applied inappropriately to a Social Care department reminded her so strongly of a repressive communist dictatorship. What both seem to have in common is an over-valuing of the machismo of autocratic control at the expense of collaboration with the maternal function of care for the individual.
This shouldn’t perhaps surprise us: a growth economy, after all, does depend on capitalism, and capitalism is a system that elevates the initial investment of finance above the subsequent contribution of labour.
Those of you familiar with Klein’s theories of child development will recognise that this is consonant with early infantile phantasies that accompany the stage of phallic narcissism: the process of insemination - the father’s contribution of sperm - is felt to demonstrate the superiority of the male and the rule of patriarchy. Through his act of penetration father has acquired ownership of the mother and obviated the potency of her contribution in carrying the foetus to birth, and feeding the baby at the breast. The infant feels that the mother who has allowed herself to be penetrated by this external other, and thus betrayed the mother/infant dyad, has proved herself weak, treacherous and unworthy. She has sacrificed all rights of ownership to the product of her labour, and deserves to be exploited.
Let me emphasise that this is an unconscious infantile phantasy - but it is a fundamental phantasy which has shaped human identities and impacted on the relationship between the genders throughout history.
In our private lives as adults, we hope to overcome this phantasy and create a good collaboration between male and female functioning. Where we don’t, it is a dynamic that can lead to gender stereotyping and domestic violence.
Some of the situations I am describing within public sector organisations would certainly be seen as domestic abuse if they were translated to a family situation: a bullying father, jealous of every extra penny spent on the children, and intimidating their mother into silent compliance, even when she knows that her children are being damaged. We would expect a good mother to leave such a partnership: and that’s what many teachers, social workers and clinicians within the public sector are doing.
But women within a situation of domestic violence can easily become bewildered, blaming themselves for what has gone wrong, colluding with the abuse, or giving credence to the abuser’s rationalisations. Members of the caring professions can find themselves similarly bewildered, collusive and credulous. After all, we would not want to argue with an exploration of physical causalities and with a limited use of medication, and we would certainly agree that CBT can have its uses. Some degree of marketing makes sense, where it is transparent and honest. And there’s nothing wrong with good business practice; it can be hard to define the point at which management becomes autocratic and bullying rather than firm and authoritative. So psychoanalytic thinkers try to make the best of the situation, maintain a depressive position state of mind towards their colleagues and managers, and carry on.
Even in its most benign form, wholesale adoption of the business methodology appropriate to a growth economy is bound to be unsympathetic to psychoanalytic thinking, because it relies on a model of standardisation, economies of scale, and the use of marketing. It favours compliance and conformity, so it will necessarily marginalise and at times disparage any methodology that is committed to exploring the complexity of the individual psyche. In addition, it encourages seductive advertising at the expense of a search for hard facts. This is at odds with the aims of any well-functioning educational, clinical or social care service, where professionals hope to offer pupils, patients and clients what they think is best suited to their individual needs.
An award-winning and much-celebrated advertisement campaign for mobile phones appeared in 2013. It carried the slogan ‘Be more dog’. Here are links to the first two in the series.
[Here are summaries, for those who cannot access the links. The first ad of the series showed a cat explaining how he ‘used to be a cat’. He was ‘aloof,’ he said, ‘coldly indifferent’: ‘every day was the same’. But then ‘it hit him’ - he could start chasing cars, fetching sticks, catching balls! He could be more dog! And we see him racing, excitedly, amongst the dogs in the park. In a sequel he goes on to say that when he was a cat ‘everything seemed out of reach’; he was ‘always wanting, never getting; life was so unfair. But now I’m a dog, it’s a whole different ballgame: I want, I get!’]
In other words, if you maintain your own identity rather than merging with the crowd, you will miss out. Consenting to a dog’s life will guarantee instant gratification.
As one marketing expert commented approvingly ‘The O2 ad takes a cat – an animal known for being lethargic and disinterested – and shows his decision to make a change in his life to become more like a dog, a species known for showing enthusiasm at an almost unbelievable level. . . . The thinking is that, through "being more dog", people will use more technology and services. Good news for O2’. [O2 is a telecommunications services provider in the UK owned by the Spanish multinational Telefónica]
But not necessarily good news for human beings. We love dogs because we see them as adoring infants, happy to follow us, their owners, loyally and unquestioningly. The enthusiasm they show is construed by us as a sign of their devotion to us - like the love of a happy baby towards its loving mother. We love cats, too. But cats, who are notorious for making their own judgments, are depicted by the advertisers as cynical, bored and boring, rather like sulky adolescents.
These ads illustrate nicely the link between computerisation and the mass production required by a growth economy. The imperative to woo customers into enthusiasm for the product co-incides neatly with the dependency relationship that we are invited to form with our electronic devices.
The philosophy proposed by this campaign trivialises the significance of personal identity, the need every human being has to be recognised for who they actually are, and to insist on their autonomy and their right to scepticism. Instead, we are invited to join the pack of eager consumers, and be ‘almost unbelievably’ enthusiastic about developing a dependency upon our computers rather than upon our relatedness to ourselves and to other human beings.
There can be no doubt about the convenience and usefulness of a computer. It acts as an administrator and a researcher, storing correspondence, filing documents, finding information. It answers questions that previously had to wait until we could consult a library, a friend or a colleague with specialist knowledge. It shops for us. We can buy whatever we need online instead of making a journey or talking to another human being: we simply press a button and it will be delivered to our door. It can offer us music to soothe us, books, videos and games to entertain us. It mediates our relationships with the world: through social media, it allows us to present ourselves as we wish to be seen, and to engage with other people closely or at arms’ length, depending on how we’re feeling. And it is a personal possession, password protected, available only to its owner.
In all these ways our computers can seem to operate like an ideal mother towards her small child. But they replicate a dissociated, narcissistic or emotionally passive mothering which ultimately leaves children feeling lost, angry, and unintegrated: a button-eyed mother. Computers cannot offer containment for our infantile omnipotence, our sadism and our consequent paranoid phantasies. Our dependency on computers needs to be balanced by our dependencies on fellow human beings, who will register our own emotional states: other human beings will notice when we get lost in a fantasy world, or when we are taking logic to an extreme that neglects the world of feeling, and results in dissociation. At these times they will find us disturbing, boring or downright mad; and whether or not they tell us so, we will have some intuitive awareness of their reactions to us. In contrast, our computers will follow us uncritically, in any direction, without comment or judgment.
And as well as liberating us from the friction of coming up against other people and their opinions of us, our computers will shelter us from the projections of other human beings: their needs, quirks, and emotional sensitivities. We can now avoid many areas of human contact - administrators, librarians, local shop-keepers - contacts that might in the past have offered some corrective to our own more paranoid/schizoid states of mind, or required us to be alert and sensitive to those states of mind in other people.
But while it has become commonplace to worry about the effect of digitalisation on young people, closeted in their rooms with their computer games, we do not yet worry sufficiently about its impact on our policy makers. The recent scandals about how computer platforms can feed propaganda content to targeted audiences is only one aspect of the problem. It is not only the content but the nature of the thinking represented by Artificial Intelligence that is disturbing: the fact that by ‘being more dog’ we may find ourselves in projective identification with the devices that provide us with information. That is, on the one hand we expose ourselves to the power of creative advertising and the myth-making of propaganda, in an environment that offers no human corrective to infantile phantasy; and on the other hand we make an unquestioning assumption that the kind of data that can be stored and calibrated on a computer represents the sum of scientific knowledge. We become either the infant or the dissociated, button-eyed mother.
The business managers to whom our public sector organisations have been entrusted, and the politicians who have assigned this responsibility to them, have succumbed to a phantasy that equates the containment offered by a thinking mind with the statistical information offered by a spreadsheet, and the marketing opportunities offered by those statistics.
Here are some symptoms of their identification:
- minimising the importance of the irrational in determining human behaviour (computers are not irrational)
- a diminution of guilt about requiring endless availability from services and service providers (computers are always available and never make you feel guilty)
- a decreasing valuation of empathy for nuance and uncertainty (computers need a binary form of programming and a clear formulation of every question)
- a consequent over-valuation of logical reasoning derived from false premises (computers don’t argue about how you programme them or what questions you put to them)
- a tendency to compartmentalise (computers don’t expect that any one app should work collaboratively with any other)
- a dismissive attitude towards the importance of psychic truth (computers do not have a psyche).
This ignores the essential difference between the business of making money and the task of maintaining education, health and welfare services for the good of the community, and disregards the unbridgeable difference between human beings and machines. At a political level, this leads to policies that put advertising slogans fed by inaccurate statistics above meaningful action, and an indifference to the distress of the electorate.
The maternal function of containment has been corrupted and perverted in the service of phallic aggression: economic expansion. This resonates for all of us with an infantile phantasy of the combined object: a flaccid, dissociated mother penetrated by a monstrous, exploitative and murderous father; a mother with buttons instead of eyes. It is no wonder that misogyny and bigotry thrive, and that we find ourselves living in a mistrustful, disaffected and fragmented society, thirsty for containment and vulnerable to extremism.
As psychoanalytic thinkers, we believe that a benign and differentiated parental couple is crucial to the achievement of mental health and emotional well-being. This is as true for communities as it is for individuals. We need to hold on to our thinking in the face of societal pathology, and to withstand attacks on mature emotional functioning. We have a responsibility to collaborate in finding an appropriate and authoritative intervention, and in taking appropriate action. And this responsibility entails careful observation and individuated thinking.
Be more cat!
Jenny Sprince
References
See this link: https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2013.12081125 - re testing of psychodynamic treatment! These were psychologists and psychiatrists who had been trained in a manualised form of psychodynamic psychotherapy (they presumably had not had their own analysis!)
Comments
neoliberalism
I thought I'd just add to Jenny's great and imaginative paper -- not too catty, I hope :-)
The great neoliberal race started with Milton Freudman's article in the New York Times in 1970 https://web.archive.org/web/20060207060807/https://www.colorado.edu/studentgroups/libertarians/issues/friedman-soc-resp-business.htm
Reagon liked it so much he got Friedman the Nobel Prize, and started reagonomics. Thatcher gushed by his side.
The only reason for business is to make money -- and give it to investors.
Bob Hinshelwood