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• Sociology has built its reputation on causing trouble. The ‘sociological imagination’ inspires scepticism about what are otherwise taken for granted notions, whether the subject is ethnicity, love, or McDonald’s. But I’m not just a troublemaker: I’m an angry troublemaker. The physical world is deteriorating, global society is in disarray, and humanity debased.Sociologists and therapists have a social responsibility to rage against such a mess.
  
  The existence of this mess and the lack of radicalism in the social sciences (which includes sociology, psychology and therapy) make me very angry. This is not anger I need a therapist to help me ‘come to terms with’, displace or sublimate. I want my anger. It is an affirming not a destructive emotion. I wish more fellow social scientists possessed such anger and that this anger would promote productive activism aimed at tackling the mess. Not to feel rage and enact this rage is both immoral and irrational.

  Therapy and sociology should be in the business of understanding humans and societies and/or of repairing individual lives, but also of working dynamically in the production and implementation of radical social policies. Too much time and energy is spent on the minutiae of institutional and personal agendas, rather than on what really matters. What really matters is tackling directly and virulently human suffering and social injustice globally.

  In my book, The Trouble with Therapy,¹ j’accuse the enterprise of therapy* of having seven specific defects: it is dysfunctional, arrogant, selfish, abusive, infectious, insane, and deceitful. Overall, however, my argument is that the enterprise of therapy* is an immature occupation, and paramount to this immaturity is a lack of social awareness, social contextualising, and social responsibility. The ‘asocial’ condition of therapy I suggest is therapeutically counterproductive, intellectually defective and morally reprehensive. My proposal to remedy these defects is for therapy to embrace sociology.

  My intention with regard to therapy is to be constructive not destructive. That is, I do not want to disassemble the therapy enterprise*, but wish to contribute positively to its social evolution.A sociology ‘of’ and ‘in’ therapy is my intended contribution. Hence I am not ‘against therapy’ but wish for a socially enlightened form of therapy.

  Authentic empowerment
  Empowerment is claimed to be at the heart of therapy.² But the ability of an individual to change his/her personal circumstances through therapy is dictated, limited, or moulded by ‘social power’. Social power is external to and beyond the influence of the client. Potent factors in the manufacture of social power on the individual include the influence of close family and friends, but are primarily the physical environment, general attitudes and prejudices, organisational allegiances and, crucially, the actions of those in government, those who run global corporations, and those who head up military oligarchies. To give the client (whether therapy is conducted in USA, Brazil, or Zimbabwe) the impression that he/she has the power to overcome these socially generated obstacles is as futile as giving aspirin or homeopathy to cure cancer (except for their possible placebo and placating effects).

  Rather than the enterprise of therapy having the function of empowerment in society it is, in effect if not by design, an agency of social control. It does this in two ways. Firstly, therapy conducts social control by closing the social space between the twin controlling measures in post-liberal society of selfregulation (individuals monitoring and controlling their own behaviour) and demonisation (the targeting and punishing of certain groups which do not self-regulate). Secondly, therapy socially controls through its direct and indirect contribution to the ‘sick role’ (the way in which society monitors and manipulates the social deviance of sickness), and its consequential ‘normalising’ influence.

  Therefore, therapy is unlikely to encourage revolutionary fervour amongst its clientele or to challenge those with excessive structurally embedded social power (other than very slowly and ineffectively through personal change) – for example, the owners and operators of global corporations and financial institutions, national politicians, and military dictators. Nick Totton3 believes that therapists should willingly and actively enter politics. For him an individual’s psychological distress cannot be disconnected from social power. That is, the cause of much of human suffering has social origins. Moreover, I agree with George Monbiot^{4, 5} that the globalisation of society requires a globalised solution to globally orchestrated and globally structured abuses. So, therapy offers ‘emotional offsetting’.⁶ As such, it is merely diverting attention from effective social action to deal with mass psychological distress.

  Emotional offsetting refers to the equivalent within therapy of ‘carbon offsetting’ within ecology. The practice of carbon offsetting provides absolution for those governments and corporations whose practices pollute and cause global warming. But, for Monbiot,⁷ the planting of trees, erection of windmills, or attachment of methane-capturing equipment to the hindquarters of cows and pigs, does not deal effectively with the essential causes of global warming.

  Similarly, in therapy the displacement of psychological distress through selfhelp programmes or professionalised helping imparts absolution for those governments and corporations that seriously pollute the mind (through encouraging rampant consumerism and not acting to stop social and health inequalities), and does not deal with the essential causes of a malfunctioning global society.

  Public issues
  Therapy has an institutionalised, reckless unconcern for what is happening in global society and how this shapes individual behaviour, thinking, and emotions. In order to gain the required in-house knowledge, skills, and attitudes (the supposed qualities of the ‘good therapist’), there is little time and scant motivation to persuade students to raise their gaze from their own navels and see the ‘bigger picture’ of world events concerning human suffering. Yes there are ‘social therapies’, but in the main these pay attention only to the narrow picture of the individual’s family and personal networks, not how global society operates. Indeed therapies such as cognitive-behaviourism deliberately confine their focus to the ‘faulty thoughts’ of the client not the faulty performance of his/her society.

  For the sociologist, humans are not unitary organisms operating in a social vacuum, they are inexorably connected to the social setting in which they live out their daily lives, and to the broader (ultimately global) society to which they belong. Human problems, for the sociologist, are an outcome of the individual’s reflexive interaction with society, or they are determined fully by society. But during therapy the focus is on the individual rather than society. Therapy, as with other epistemologies/ disciplines such as biology and medicine, is reductionist. C. Wright Mills (1959) pointed to the connection between ‘private troubles’ and ‘public issues’. However we perform as individuals (what we feel, how we act, and what we think), there is always a connection to our social surroundings. From a sociological viewpoint, seemingly exclusively personal states such as happiness, misery, self-identity, empowerment, madness, and sexuality, are linked inexorably to social factors.

  For example, the private trouble of being diagnosed with heart disease is also a public issue. Either directly or indirectly, such a diagnosis relates to health policies and resources, which in turn are connected to economic programmes and political decisions. A greater political will at a local and national level to improve the physical environment, more money ploughed into relevant research and treatment rather than, for example, conducting warfare, help to prevent malfunctioning circulatory systems. Governmental legislation to tackle the high fat, high sugar, and high salt content produced by food manufacturers, will affect the prevalence of heart disease. The private trouble of depression (‘misery’) and anxiety (‘stress’) is a public issue in the sense that this ‘internal’ condition may have been precipitated by alienating and dehumanising social circumstances associated either with the exigencies of global capitalism and/or living in poverty, violence, and disease. Even the private trouble of committing murder (as well as suffering the devastation as the consequence of a loved one being murdered) has social connotations.

  A society that revels in violence sets the stage for such seemingly volitional acts as taking, with malice aforethought, someone’s life. Governments, criminal justice systems, the mass media, crime writers, and aggressive sports, orientate the individual’s personal potential to kill.⁸
  
  Sociological enlightenment
  So the major trouble with therapy is that it is ‘asocial’. That is, the therapeutic enterprise ignores or pays only tokenistic attention to the mess in global society. Whilst there are a few politically active therapists, and a few therapy organisations aligned with issues of human rights, overall the therapeutic enterprise is untroubled by the mess.

  Social and health inequalities are worsening within countries and between countries. Whilst the majority of people in the world struggle with poverty and disease, and die at an early age, a minority is getting richer, becoming less diseased, living much longer, but paradoxically appear not to be much happier. Moreover, the natural world is tipping towards catastrophic collapse, the international system of trade and finance is in danger of disintegration and has had to be reconfigured drastically, and the system of global food distribution is failing. ^{4, 9, 10, 11} Under these circumstances, human civilisation itself is threatened.10 The majority of people in the world are acutely aware that the world is in a mess because they live in the midst of the mess. For them dealing with food crises, seeking clean water, and not succumbing to sickness, is their life. At least a billion people in the world (many of whom are children) are living in terrible squalor, are malnourished, or vulnerable to brutality. ^{8, 12, 13, 14} Therapy in the face of these critical public issues (especially the ‘quick-fix’ varieties) is either an irrelevance or emollient.

  The sociological imagination invites a broader appreciation of human problems than has traditionally been forthcoming from therapy. Humans and their social environment cannot be detached. Human problems, for the sociologist, are either born of society or have a strong connection to society – whether that society is messy or tidy. Stucturalist sociology challenges therapists to do much more than engage in interpersonal navel gazing. For the stucturalist there is a patent need to see the individual as a part of a social system, and increasingly as belonging to a global village. Ultimately, the stucturalist takes the view that society has to be altered, perhaps radically, before many human problems can be resolved.

  The interactionist sociologist also pays homage to the power humans have as individuals to make their own meanings about their lives rather than having it thrust upon them from society. It is they who make up society, and have the power to infl uence society (more plausibly when they act rather than the other way around). But there is still a society in which interaction takes place, and which sets the scene for the type of script which individuals can improvise.

  Constructionist sociology, and its extremist off spring postmodernism, attempts to debunk reality by suggesting that there are an infi nitive number of realities. Humans therefore can either celebrate their liberty to create a personalised lifestyle, self-identity, and belief system, or degenerate into a condition of downright nothingness, hopelessness, and cynicism. The realist sociologist wants to mend epistemological fences.

  For the realist there really is a reality, a truth, and facts. However, we await the methods (scientifi c or otherwise) that will eventually expunge completely the cultural attributes that are attached to reality, truths, facts, and free will. When (and if) this happens – when the real, truthful and factual nature of human problems is exposed – then therapy can be appropriately redesigned.

  Enlightenment about how society aff ects human performance is obtained from whichever sociological perspective is embraced. For example, an individual’s feelings of insecurity and rejection cannot be divorced from the social (and physical) environment in which he/ she exists. But, how potent the eff ect of society is considered to be on an individual, and the perceived ability of that individual to manage him/herself in society, will be dependent on which perspective is selected. But, even after embracing sociology for 30 years (and in doing so applying it to psychological distress in various ways), I do not have the perfect solution to the mess of the world, nor of how to make therapy mature and become ‘psycho-social’ rather than only ‘psycho’. However, below are some suggestions that may lead both in that general direction.

  Tidying up the mess of the world
  • ‘Global Government for Global Society’ (with representation from: national and cross-national ethnic, religious/spiritual, humanist, humanitarian, environmental, media, sporting, leisure/entertainment, and animal rights, groups; and international scientifi c/academic and occupational disciplines).
  • ‘Health not Wealth’ (the driving ideology for humanity should be its physical, emotional, spiritual, cultural, and environmental wellbeing; whilst respecting cultural diversity, moral universals are defi ned and propagated; ‘wealth’ becomes a consequence of, not catalyst for, civilised human life).
  • ‘From Social Atavism to Social Actualisation’ (the present time warp of social life to be given a momentous jolt, firstly by accepting that it still is ‘uncivilised’, and secondly by recognising that achieving personal or social satisfaction is not trouble-free – humans have to strive to thrive).

  Fixing the faults in therapy
  • A shift away from ‘the self’ as the only locus of attention during therapy towards a dialogue with the client’s ‘social self’ (that is a self that includes due deference to personal and social factors, and interventions are thereby sociologically informed).
  • All therapy training curricula to include a thorough explication of sociological knowledge about socially produced/ infl uenced psychological distress.
  • Therapy must be de-coupled from the commercialisation of human (un)happiness.
  • The legitimisation of rigorous and forthright debates about society to be held at every opportunity (for example, in all therapy conferences).
  • ‘Impossibilism’ to be tackled (that is, the notion that nothing can be done about global suff ering should be challenged); vigorous and committed alignments made between agencies of therapy and ethical causes with the express aim of alleviating global misery; therapy and sociology to align strategically for the benefit of both, and engage in political analysis and action.

• The Trouble with Therapy: Sociology and Psychotherapy by Peter Morrall is published by Open University Press/ McGraw-Hill at £21.99. Readers can obtain a 20 per cent discount by ordering online at www.openup.co.uk/morrall and quoting ref TT9. This offer expires 31 March 2009.

  * I use ‘therapy’ as a generic and generalised term for psychotherapy and counselling. The term ‘therapy enterprise’ is used to describe the institutions, personnel, and discourses of therapy.

• References:
  

  1. Morrall P. The trouble with therapy: sociology and psychotherapy. Maidenhead: Open University Press/McGraw-Hill; 2008.
  2. McLeod J. An introduction to counselling (3rd edition). Maidenhead: Open University Press; 2003.
  3. Totton N (ed). The politics of psychotherapy: new perspectives. Maidenhead: Open University Press; 2006.
  4. Monbiot G. 2009. www.globalising.org
  5. Monbiot G. The age of consent: a manifesto for a new world order. London: Blackwell; 2007.
  6. Tischner I, Morrall P. Emotional off setting. University of the West of England, Bristol/ University of Leeds, Leeds; 2007. Personal communication between the authors.
  7. Monbiot G. Heat: how to stop the planet burning. London: Allen Lane; 2006.
  8. Morrall P. Murder and society. Chichester: Wiley; 2006.
  9. Ranson D. The road to meltdown: financial Crisis. New Internationalist. 2008; 418:23-24.
  10. Brown LR. Plan B 3.0: mobilizing to save civilisation. New York: Norton; 2008.
  11. World Wildlife Find. Living planet report 2008. http://assets.panda.org/downloads/living_planet_ report_2008.pdf
  12. Collier B. The bottom billion: why the poorest countries are failing and what can be done about it. Oxford: Oxford University Press; 2007.
  13. Morrall P. Sociology and health: an introduction. London: Routledge; 2009.
  14. United Nations Children’s Fund. The state of the world’s children 2008 report (executive summary). New York: United Nations; 2008.