[Le Devoir de philo] The triumph of therapeutic culture

Twice a month, The duty challenges enthusiasts of philosophy and the history of ideas to decipher a topical issue based on the theses of a prominent thinker.


The obsession with mental health, and health more broadly, has peaked in recent years, in part because of the pandemic we are going through. But this obsession took hold after a long journey and a cultural change with serious consequences.

The author who can best help us understand this cultural change is the American sociologist Philip Rieff. Little taught today, he nevertheless described with finesse the rise ofpsychological man and the triumph of a therapeutic culture. The latter was forged in restricted social circles (bourgeoisie, cultural elite) before the 1960s, but it has since triumphed to the point of becoming a kind of unique thought, disseminated by the medical system, the big media, multinational companies , the advertising industry, our governments and Hollywood. This culture disseminates small maxims as simple and effective as they are insignificant: “today, I choose myself”, “take care of yourself”, “listen to your body”, “cause for the cause”, “why suffer? »…

In 1950, a young professor of sociology, Rieff fell in love with a brilliant student: Susan Sontag. Ten days after their meeting, they get married. During this decade, Sontag supported Rieff in writing his first great book, Freud: The Mind of a moralist. The essay offers a pessimistic reading of civilization and provides a central concept to Rieff’s theory: thepsychological man.

The hospital as a cathedral

Rieff had created a luminous maxim, which sums up our cultural history: “The hospital succeeds the parliament and the cathedral as the archetype of Western culture. This cultural history rests on a succession of social types: the politician, the religious man, the economic man, the psychological man. The first type is dominant during Antiquity; it is idealized in the thought of Plato and Aristotle. The politician is the one who affirms his identity in public activities. He frequents the Agora, goes to the Areopagus, in short, he engages in what we call civic life.

In the Middle Ages, the politician gave way to a second type, the religious man. The latter develops his identity on the occasion of religious activities: attending mass, celebrating religious festivals, taking part in processions, going on pilgrimages.

Then, at the beginning of the modern age, as industrialization progressed, the economic man replaced the religious man. The individual is absorbed in productive activities such as work, trade, production, etc. This third figure is however unstable and transient. It simply announces the birth of a fourth type: the psychological man. The latter does not assert its identity by opening up to the outside, in social activities, as is the case for the three previous types. On the contrary, he is led to tirelessly explore the smallest corners of his inner life. Obsessed as he is by a furious quest for well-being, his feelings dictate his actions.

Endless self-examination

Rieff’s great book was published in 1966: The Triumph of the Therapeutic. According to him, culture is mainly defined by what it prohibits. It sets out prohibitions, attitudes deemed unacceptable. This view has institutional implications. The vitality of a culture depends on its ability to assert its authority through its institutions.

Until the middle of the XXand century, recalls Rieff, culture opens individuals to the outside world. By participating in social activities, the individual develops his identity. Thus, identity was inculcated and learned; the individual did not create it or choose it. The culture was greater than the individual; it preceded him, and made him a social being.

However, the rise of the psychological man gave birth, during the 1950s and 1960s, to a new culture, the therapeutic culture. It is based on authors who claim that society oppresses the individual through its institutions. The new therapeutic culture aims to cure the neuroses manufactured by society.

The psychological man is not open to the outside like the previous three types. He is committed to himself. His life, from morning to night, is an endless examination of himself. Thus, the old hierarchy has been reversed. From now on, the institutions are summoned to serve the individual, to provide for his well-being and, in particular, for his mental health.

In the past, institutions were places where individuals were trained. They prepared us to inhabit society and contribute to it; since the triumph of therapeutic culture, institutions have become platforms where one can give a performance, put on a show; in short, they have become spaces where individuals are invited to give free rein to their moods, to express what they feel inside. At work, at the bistro, in our social relations, we are all invited to confess, to monologue, to reveal our little secrets, as if we were competitors on a reality show where we compete in authenticity.

Three Disciples: Wolfe, Allen, Lasch

Rieff was not writing for the general public. His texts were difficult, mysterious, hermetic. He refused to be a public intellectual. He saw himself as a monk, and revered the teaching profession and its natural habitat, the classroom. He forbade his students to take notes during his presentations. Sentence by sentence, he dissected and commented on the great works, the starting point for dialogue with the students. One session was Weber, another was a text by Durkheim or Lenin.

Outside the academy, his thesis inspired daring popularizers. In the cinema first, Woody Allen built part of his work around the torments of the psychological man. Journalist and novelist Tom Wolfe, for his part, has produced legendary analyzes of the most zany expressions of therapeutic culture that have marked the ” Me Decade “. The writer’s reports and novels present characters who share in the cult of the individual and the liberation of impulses and desires. The new therapies that mark the 1970s revolve, in its analyses, around the obsession consisting in talking about nothing but oneself.

This posture, directed towards the exploration of our anxieties and our small wounds, has long been the preserve of the privileged classes; however, it was democratized after World War II. This quest, formerly, furnished only the moments of leisure. By a curious Orwellian reversal, it is now encouraged in all walks of life, even workplaces, companies that have understood the value of treating, even healing consciences… “Tell me what is on your heart, dear employee. I’m listening to you… “

The definitive analysis of therapeutic culture was provided by Christopher Lasch in The culture of narcissism, in 1979. Claiming to be Rieff, he showed that the narcissistic personality shaped by therapeutic culture was not, as assumed, selfish and imbued with excessive self-love. She was more of an anxious, nervous soul, in survival mode, seeking to please at all costs. This personality was deprived of the essential landmarks to access emancipation or more simply to maturity. He agreed with Rieff’s conclusion: the therapeutic age, for all its verbiage about human potential and self-realization, was ultimately anti-therapeutic, producing increasingly bitter, anxious, depressed, and frustrated humans moving forward in life with a deep sense of emptiness.

Among the lasting effects of the triumph of the therapeutic culture, we discern the birth of a religion of health, the meteoric expansion of the medical system and the rise in prestige of doctors (and more broadly of therapists). The pandemic did not create these trends; she simply magnified them.

In his analyzes of the Me Decade Tom Wolfe had brilliantly depicted the duplicity and snobbery of the chic radical, this living room rebel evolving in the cultural sphere, who had quickly swapped the class struggle for the more harmless fight of “personal liberation”. On the occasion of the pandemic, the therapeutic culture has today given birth to a new figure, the “medical chic”. This influencer, dressed in a lab coat, a graduate of health sciences, who comments on the stock market ratings of viruses, lecturing on Twitter the “toothless” who grumble against the multiplication of health measures.

Thus, the constitution of a “therapeutic society” allows a new social divide to emerge, alongside the left-right divide and the nationalist-globalist divide. This split is structured around the new hegemony of the medical system. On the one hand, a growing number of people violently oppose this hegemony; on the other, a growing number of people are unable to face the slightest test of life without submitting to medical (and pharmaceutical) assistance. Fortunately, there are still a good number to camp an intermediate space, between these two extremes. In the coming years, they will have to show patience and take part in social debates to defend the values ​​that have made our civilization advance.

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