John Waters said: “If you go to his house and he doesn’t have books, don’t throw them away.” Today a new one has emerged, even more demanding: “If he doesn’t go to therapy, don’t go to bed.” It’s not just a joke. Now that therapy has flooded everything, it is also something that, according to American media such as The New York Timesappears in Tinder bios as an indicator that someone is up to date and emotionally responsible.
Today many references in everyday language come from therapeutic language: expressions such as “red flag”, “gaslight” or “trauma” refer directly to the consultation of a psychologist. Even rappers have incorporated this universe into his songs and Jay-Z mentions his therapist in songs like 4:44, while Kendrick Lamar went one step further by structuring his album Mr. Morale (2022) as a series of sessions. Also Drake, in Churchill Downsa collaboration with Jack Harlow, alludes to the traumas of abandonment that he would be treating in consultation.
It would be easy to relate this rise in therapy to the culture of self-absorption that has proliferated in recent years: the successes of the selfie in contemporary art, of autofiction in literature or of the autobiographical in music (did someone say Taylor Swift ?) would reinforce the thesis that we love to talk about ourselves. But therapy goes one step further, because it addresses real suffering and symptoms that often constitute mental illnesses.
Victims or sick?
The appearance of these symptoms in millions of young people, almost simultaneously and during an economic cycle marked by pessimism and precariousness (the so-called “mental health epidemic”), makes many authors think that we are facing a collective malaise and widespread that, in the words of the philosopher Amador Fernández-Savater, author of libidinal capitalism (Ned, 2024), it would be a “discomfort due to overflow caused by a triple collapse: psychological, social and ecological.” The questions in an emergency like this are whether the person suffering from it is going to therapy and if the therapy they go to is well focused. The North American example is not encouraging: studies have appeared there that warn that the increase in mental health treatments is not translating into an increase in the psychological well-being of citizens. Quite the contrary.
Psychiatry is the most controversial discipline within medicine. Historically it has been seen as a double-edged sword because in certain contexts (especially political) it has functioned as a device to control patients instead of relieving their pain and its foundations are still debated. Recently, Dutch psychiatrist and scientist Jim Van Os explained to EL PAÍS: “There is too much heterogeneity and variation for people to fit into a diagnosis.”
Specialists have been searching for neurobiological markers for mental illness for decades; markers that would allow them to be assimilated to other diseases and would confirm the suitability of standardized pharmacological treatments. However, so far this evidence is resisting and the behavior of patients continues to be what weighs most in making a diagnosis. “For the vast majority of mental health conditions, no biological markers have been found, so we do not have any biological test to verify any type of psychiatric diagnosis,” explained British psychologist James Davies to EL PAÍS in 2022.
This leads us to another great contemporary paradox about therapy: when it has more presence in our lives and terms such as “anxiety”, “trauma” or “red flags” become more popular, it is just when some consider the psychoanalysis that Freud developed to be outdated. and, somewhat later, Lacan. At least, this is what has happened in certain environments such as hospitals and university departments, which have been relying on cognitive-behavioral therapy and drugs for years. In a column published in EL PAÍS in 2023, psychiatrist and biologist Cristian Llach asked himself: “Will the day come when psychiatrists will stop interpreting subjectively, improvising and functioning through trial and error? These are questions that are managing to leave their traditional ivory towers: laboratories, universities and research circles. But will they ever be able to reach mental health clinics?”
Sigmund, analyze this
Psychoanalysis influenced the culture of the last century almost like no other current of thought. His legacy extends from the works of Proust to today’s cultural press, in which television critics exclaim “Freud was right!” if at the end of a plot it is discovered that what moved the characters was sex. However, it is a discredited practice in many sectors.
“The discredit of psychoanalysis and the place from which it is considered a pseudoscience is above all academic,” explains Manuel González Molinier, psychiatrist. “The reason is obvious: both the cognitive-behavioral method and the neurobiological explanations of mental illness are experiencing a moment of certain failure, which makes them see their spheres of power threatened and attack with more violence the only discipline that bets for working with the unique factors of each case. Psychoanalysis has never lent itself to a kind of manualization that is easily sold by American insurance companies, that ‘you apply twenty sessions, talk about these things and you will cure the patient in those twenty sessions.’ “It is not a drug.”
Precisely, the defenders of psychoanalysis are the most critical of the trivialization of therapy and argue that, as it has been practiced in recent years, it frequently becomes self-help. “We are moving towards a society hyperpsychologized, but we psychoanalysts think that the fundamental issues are not addressed,” says González. He also recognizes that “what Freud proposes is still controversial or unfriendly because it appeals to childhood traumas and defends that there are a lot of unconscious factors that we do not control. But the truth is that in consultation we continue to take into account the existence of unconscious processes and working with words continues to be essential. “You have to make an individual suit with the biographical factors of each patient, paying close attention to childhood.”
Jara Pérez, psychologist, also practices psychoanalysis and believes that this is one of the few forms of therapy that makes the patient take responsibility for the process. She does not believe that the culture of therapy is giving rise to egocentric or selfish individuals, as the cliché suggests, but, rather, to lazy people in search of immediate solutions: “I find it very problematic that we are constantly looking for people to help us.” I solve the problem: I go to a psychologist to give advice, I go to a nutritionist to teach me how to eat, I go to a personal trainer to teach me how to play sports… thus a large part of the autonomy is lost. And what psychoanalysis does is put that autonomy on the table.”
Therapy or union
“What is labeled today as depression is rather a generalized dropout,” says Fernández-Savater. “Thousands of people ask for leave due to depression and, in reality, their low mood has to do with bad working conditions, meaningless work, a shitty job as David Graeber says.” It is common to read in “What this alternative means,” explains Fernández, “is that the evils are objective-structural. I believe that the situation is more complex: the discomfort not only has objective causes, but also comes from a relationship with the world, with the internalization of the logic of performance and competitiveness.” González gives a concrete example: “Sometimes the patient needs both things because the reason why he cannot get out of his helplessness has elements of the unconscious. For example, in the case of Nevenka Fernández, a psychoanalyst was needed so that she could see what was obvious to others: that she was being a victim of sexual harassment. In the end, a psychiatrist refers her to a psychoanalyst and the psychoanalyst works with her until she can take charge of her own body, get out of depression and, when that awakening occurs, report it.
Pérez is blunt and believes that there is no incompatibility between political activism and therapy, quite the opposite: “Everything is done in a place: what I work on in therapy has to do with how the structure has developed my subjectivity, but in The union does something else, the social struggle is something very different. Another issue is that therapeutic culture has become a control device, with that I totally agree, because therapy mainstream, cognitive-behavioral has a lot of ‘it’s not what happens, but how you see it’, since it works with thoughts and behaviors. There is a sense of guilt there.”
So, is this therapy that is everywhere, precisely the most harmless for the system and the least useful for delving into patients’ problems? “Indeed,” the psychologist responds. “The therapy mainstream In the end what it does is adjust you so that you continue producing and it is completely harmless to change the system, because it does not help you analyze reality.” Faced with this, Fernández-Savater proposes recovering the Freudian concept of “sublimation” and collectivizing it. The philosopher concludes: “Freud called sublimation knowing what to do with discomfort, converting what harms us into energy for transformation. He reserved it for artists and geniuses and that seems like a mistake to me. Collective action is not only transformative, but it is also possible for everyone and, in that sense, therapeutic.” Maybe that could be put on Tinder too.
You can follow ICON on Facebook, x, instagram,or subscribe here to the Newsletter.