At 10:25 PM 7/11/96, "Gabriel Ash" <Gabriel.Ash.1@xxxxxx> wrote:
[Quotation from my prior post deleted]
>What you say is very interesting and important [re: managed care,
psychotherapy, and disciplinary power], and as you say, somehow 'predictable',
>it reminds me of Lacan's quarrel with the French psychoanalytic
association, which peaked
>over the question of the 'variable-time session'. Would it appeal to you to
think about
>the question of managed psychotherapy in terms of of Lacan's psycho-analysis?
>Then, could you see place for organised professional opposition to this
disciplining? You don't
>have to espouse all of Lacan's ideosincretic baggage, but his work could
provide some arguments
>against this tendency: the insistance on the primacy of speech, on the
discourse between the
>subjects, etc. principles that would preclude some levels of
standartization as
>therapeutically counter-productive.
>
>
>
>-------------
>Gabriel Ash
>Notre-Dame
>-------------
>
I must confess to not having been able to penetrate Lacan's thinking,
despite a couple of short-lived efforts to do so. Your comments do bring to
mind some thoughts that I hope are related to what you were suggesting.
I believe that some of the success of managed care in general rests upon the
perception of it attacking and bringing to heel the powerful entity of
institutionalized medicine. This would include the practitioners of
psychotherapy insofar as they present themselves as working within or trying
to emulate the medical model. Foucault's comments about how psychiatry and
the human sciences in general have grown up along side the spread of the
disciplinary techniques are relevant to this popular sentiment. Managed
care in the arena of mental health is seen as accomplishing a leveling of
formerly powerful groups and institutions. From the perspective of putting
together a profitable network of mental health care providers, the
guild-like institutions of psychiatry, psychoanalysis, psychology, and
clinical social work are irrelevant to the process of fitting clinicians
into an organization of uniform care delivery. I think that they will be
more concerned with making sure that they are not excluded rather than
actually resisting the process, itself. The point I wanted to get to is
that I doubt that these institutions can be counted on to provide any
effective resistance to the totalizing power of managed care. I think that
they will be more concerned with making sure that they are not excluded
rather than actually resisting the process, itself. I suspect that
resistance to managed care will be found in minority-oppositional
perspectives, in other words that which is not institutionalized. Lacan
seems to have represented a point of counter-power or resistance to the
institutionalization of psychoanalysis, especially as it took the form of
ego psychology in this country. His and other less organized points of view
may eventually provide points of resistance to the industrialization of
mental health care, as well. I think that even psychoanalytic perspectives,
in general, insofar as they have fallen so out of favor because of the
emphasis on short-term treatment methods, will also provide a point of
resistance. Not as an institutional power, but re-constituted as another
minority perspective.
John Sproule
Knoxville, TN
[Quotation from my prior post deleted]
>What you say is very interesting and important [re: managed care,
psychotherapy, and disciplinary power], and as you say, somehow 'predictable',
>it reminds me of Lacan's quarrel with the French psychoanalytic
association, which peaked
>over the question of the 'variable-time session'. Would it appeal to you to
think about
>the question of managed psychotherapy in terms of of Lacan's psycho-analysis?
>Then, could you see place for organised professional opposition to this
disciplining? You don't
>have to espouse all of Lacan's ideosincretic baggage, but his work could
provide some arguments
>against this tendency: the insistance on the primacy of speech, on the
discourse between the
>subjects, etc. principles that would preclude some levels of
standartization as
>therapeutically counter-productive.
>
>
>
>-------------
>Gabriel Ash
>Notre-Dame
>-------------
>
I must confess to not having been able to penetrate Lacan's thinking,
despite a couple of short-lived efforts to do so. Your comments do bring to
mind some thoughts that I hope are related to what you were suggesting.
I believe that some of the success of managed care in general rests upon the
perception of it attacking and bringing to heel the powerful entity of
institutionalized medicine. This would include the practitioners of
psychotherapy insofar as they present themselves as working within or trying
to emulate the medical model. Foucault's comments about how psychiatry and
the human sciences in general have grown up along side the spread of the
disciplinary techniques are relevant to this popular sentiment. Managed
care in the arena of mental health is seen as accomplishing a leveling of
formerly powerful groups and institutions. From the perspective of putting
together a profitable network of mental health care providers, the
guild-like institutions of psychiatry, psychoanalysis, psychology, and
clinical social work are irrelevant to the process of fitting clinicians
into an organization of uniform care delivery. I think that they will be
more concerned with making sure that they are not excluded rather than
actually resisting the process, itself. The point I wanted to get to is
that I doubt that these institutions can be counted on to provide any
effective resistance to the totalizing power of managed care. I think that
they will be more concerned with making sure that they are not excluded
rather than actually resisting the process, itself. I suspect that
resistance to managed care will be found in minority-oppositional
perspectives, in other words that which is not institutionalized. Lacan
seems to have represented a point of counter-power or resistance to the
institutionalization of psychoanalysis, especially as it took the form of
ego psychology in this country. His and other less organized points of view
may eventually provide points of resistance to the industrialization of
mental health care, as well. I think that even psychoanalytic perspectives,
in general, insofar as they have fallen so out of favor because of the
emphasis on short-term treatment methods, will also provide a point of
resistance. Not as an institutional power, but re-constituted as another
minority perspective.
John Sproule
Knoxville, TN