A quick note on the death of David Smail, a clinical psychologist whose writing I admired very much and whose death in August I have only recently learned about. I came to Smail's work by a fortunate accident years ago, long before I decided to become a therapist. I was at Waterstone's on Picadilly and sat down in an armchair and found a stack of books at my elbow. The book at the top was a dual text edition that contained two titles, Why Therapy Doesn't Work and Taking Care. Intrigued, I began to read the book and was quickly taken by the case he made. Therapy doesn't work, he argued, because it promises certainty based in objective evidence which we as embodied subjects cannot possess. Moreover, by locating the source of people's problems inside their minds, therapy overlooked and tacitly excused the actual living conditions that caused them to suffer psychologically. Indeed, by ignoring the social context of mental illness, psychotherapy was guilty of blaming the victim for their problems and abetting the social forces that were truly to blame. For me, the echo of Laing could be heard loud and clear in Smail's argument. Smail was in fact, an admirer of Laing, but there was much that separated their work. Laing, surely the more adventurous thinker, sought to plumb the depths of the psyche and saw psychotic breakdown as a legitimate means of breaking free of repressive norms. Smail offered a more modest and perhaps more compelling argument. Can't we as a society see that it is socially sanctioned cruelty that is most responsible for making people's lives a misery?
In fact, much of Smail's thinking drew from his work in the 1980's as an NHS psychologist dealing with people who suffered from the emergence of Free Market capitalism as a new social ethic. In a backhanded tribute to Thatcher, he credited her for teaching him the most about the misuse of political power as a source of widespread psychological suffering. But Smail offered something other than a standard leftist critique of the abuses of capitalism. Above all, he insisted on the moral necessity of recognising our common humanity. It was, he thought, the abandonment of compassion as an essential psychological value and the celebration of power as a positive psychological value in its own right that were most responsible for the distress that people suffered. Kindness, he seemed to suggest, was what mentally ill people really needed to find dignity and their well being.
It would seem Smail had little time for exploring the more hidden dynamics of the psyche. Certainly, many people might question raising social criticism above self formation as a concern of psychotherapy. But research (such as that which can be found in Richard Wilkinson and Kate Pickett's excellent The Spirit Level) tends to confirm Smail's conviction that is the gross inequality caused by rampant and unchecked capitalism that lies behind a host of social ills, including mental illness. Smail did not shy away from the political implications of his thinking, and this too may have caused unease among some observers. In fact, therapists do not possess any special insight into politics and their political opinions deserve no particular respect. At the same time, it must be recognised that there are pernicious psychological influences within a society that preserves the interests of the powerful and wealthy and organises a vast industry of deception to do so. In a previous post I cited Smail's remark that consumerism--free market capitalism's cunning master of propaganda--seeks to convince that love is always in short supply and that only the wealthy, the successful and the well- adjusted deserve to get it. We only begin to appreciate the scale of such deception and the cultural corruption that ensues from it when we consider the amount of time people spend watching television and other forms of popular entertainment---amusing ourselves to death, in Neil Postman's memorable phrase. Smail was surely right to point out that there was a relation between the values society promotes and the mental agony that society's "losers" suffer.
For all of my admiration for him, I am not an expert on Smail and I am not competent to discuss his work in any depth. But I credit him as an influence in my own thinking and think back to that day at Waterstone's when I first encountered his books as a pivotal moment towards my decision to become a therapist.