With my thesis I have sought to challenge the profession of which I really have been looking forward to become a part for these last six years. I have attempted to provide an answer to the very complex question of whether the relation between psychotherapy and mental illness should be considered alleviating or maintaining. To accomplish this task, I have ventured to characterise both the practice of psychotherapy and aspects of the societies in which it is practised.
In considering Danish society I have found it to be one which reveres the narrative of scientific progress and one which strives for material wealth. These two inclinations combine to form demands for evidence-based practise as natural-scientific methods are assumed to bring about certainty of effects and thereby the state’s economic investments. A reason for this interest appears to be that a significant part of the Danish populace finds itself in the unfortunate position of either being in general discontent or having a costly diagnoseable mental health condition. I have also argued that these state-level concerns extend beyond Danish borders.
In considering the practice of psychotherapy, I have found it to be highly regarded by the decision-makers of Denmark and viewed as one of the main ways in which to solve mental illness on the scale of society. In accordance with this view, psychotherapy does also seem very apt in treating mental illness. The view of how psychotherapy alleviates illness on the part of the decision-makers, however, seems to be technique even though research cannot back this up. In contrast, research centrally accentuates the human relation between therapist and client as curative. What the professionals and non-professionals, however, have in common seems to be a view of mental illness as fundamentally individual. In opposition to the preceding view on psychotherapy I have provided research which argues that structural – economic, cultural, power-related – issues can be significant factors in predicting individual illness. Seen from this perspective, I make the case that psychotherapy to a significant degree can make contextual problems seem particular to individuals.
Taking this abstract critique to a more concrete level, I discussed at length Cognitive Behavior Therapy and more briefly Eye Movement Desensitization and Reprocessing. While I found both these therapies to be commendable, I also found them in their alleviation of mental illness to be overly technical, individualising and pacifying. I then sought to argue that the proposed problems with CBT and EMDR are more generally representative of the various practises of psychotherapy. Penultimately, I turned towards society once more to make the case that the individualisation and pacification of the suffering has the potential to mask structural issues. This enables these to be neither addressed nor challenged whereby the pressures on individuals to some degree can persist.
In conclusion I have found that the relation between psychotherapy and mental illness ought to be characterised as dual. In the short term, psychotherapy is an effective way to harmoniously treat individual illness and return the suffering to societal productivity. In this view psychotherapy is ameliorative. In the long term, a large proportion of those treated for depression experience relapse-recurrence partly due to factors which might be attributed to the structural conditions under which they live. In this view psychotherapy does to some extent maintain mental illness by not addressing structural factors impactful to mental health.
As an alternative, I have proposed ways of relating to mental illness on the hand of psychotherapists that might partly counter the perceived faults of therapy. There are 1) being able to identify structural issues and cultivate an awareness of these in the suffering, 2) helping them to find community with other people with comparable struggles, and 3) making it an option for our clients to engage and try to make a difference in the socio-political sphere. I made the case for these moves as awareness might lessen the burden of perceived individual faults, because regular people in communities do hold ameliorative potentials for each other and taking action against structural pressures might also in itself be both empowering and thereby partly ameliorative.