A Foucault analysis of the psychotherapy industry

[Jodistrict]

Traditional psychoanalysis was replaced by Cognitive Behavioral Therapy (CBT) during the 1980s and 1990s in alignment with Neoliberalism and its preference for cost-effective therapy and productivity-oriented care. 

While psychoanalysis involved years of deep internal work, CBT offered quick returns, enabling individuals to return to the workplace in weeks or months.   By focusing on external actions rather than internal states, CBT provided quantifiable results that suited capitalist requirements for emotional regulation and workplace compliance.

CBT is considered the gold standard of therapy.  It delivers quick and quantifiable results. It trains patients to self-monitor and police their own thoughts, which functions as a form of "soft power" that benefits the system by reducing the need for external management.

 CBT shifts the burden of blame for systemic issues onto individuals by acting as a form of compliance training that targets internal reactions rather than external conditions. Instead of addressing structural problems—such as exploitative labor, lack of safety, or economic hardship—CBT encourages individuals to perform the following:

Question their own perception: Patients are taught to reframe their thoughts and view their distress as a cognitive distortion or a personal failure rather than a rational response to an unhealthy environment

Internalize control: By focusing on individual breathing exercises, cognitive restructuring, and mindset shifts, the therapy keeps the broader system invisible and uninterrupted, effectively training individuals to become their own "jailers"

Avoiding system critique: The framework discourages looking for external causes of suffering, which protects the status quo by ensuring that the individual is solely responsible for their ability to function within the capitalist order.

Imagine your hand is on a burning hot plate.   CBT therapy does not ask if the plate should be turned off or moved. Instead, it assumes the plate is correct and teaches you to reframe your thoughts about the burning or change how you feel about the pain, effectively keeping the system that caused the harm invisible and uninterrupted.

When someone fails to thrive—not due to their own lack of grit, but due to systemic issues like structural poverty or workplace exploitation—the system flips the switch and labels the patient as the "scapegoat" or the problem.

CBT doesn’t make you a happier person.  It makes you an obedient person.   It maintains the power structure by shifting blame from systemic failure to you the "scapegoat".

 

 

 

Edited August 21 by Jodistrict
typo

[Joseph Maynor]

 

[Ulax]

Definitely agree

[Judy2]

yes, the big problem with CBT is that it mostly targets symptoms and behaviours while completely ignoring root causes which often necessitate the return of the exact same behaviours and symptoms. telling an alocoholic to "just stop drinking", telling an anorexic to "just eat and restore weight", telling a person with OCD/GAD to "just confront their fears", telling a depressed person to "just get up and do something", ....

maybe there is a time and place for CBT and deliberate behavioural changes to help stabilise some patients by teaching them certain techniques (as DBT does), but stable does not mean healed, by any means. although sometimes stability (sobriety, nourishment, skills to regulate your nervous system when experiencing a strong emotional reaction, being able to stop showering for 5h/day, being able to get out of bed and clean your room) are requirements, or at the very least useful, to even have the cognitive resources to work on proper healing.

Edited yesterday at 04:26 AM by Judy2

[Judy2]

On 21/08/2026 at 7:47 PM, Jodistrict said:

When someone fails to thrive—not due to their own lack of grit, but due to systemic issues like structural poverty or workplace exploitation—the system flips the switch and labels the patient as the "scapegoat" or the problem.

CBT doesn’t make you a happier person.  It makes you an obedient person.   It maintains the power structure by shifting blame from systemic failure to you the "scapegoat".

i especially agree with this last section

Edited yesterday at 04:24 AM by Judy2

[Verdesbird]

Resume:its all b.s

[Leo Gura]

It is hard to justify investing years into therapy. Most people don't have the time or money for that.

Years of therapy is such a bourgeoisy concept.

Edited 4 hours ago by Leo Gura

[Basman]

Healing and therapy itself can become an endless rat race. I'm wary of therapy culture and this incessant focus on what's wrong with your personal life (besides it being quiet classist $$$). There's a reason why the stereotypical therapy client/new age healing people are middle-upper class women. Gotta keep em busy somehow.

In my opinion, you'll gain more self-autonomy by developing your talents in life. I think it's more common that something external is keeping you down in most cases. Besides, you can accomplish a bunch through just journaling. 

[Judy2]

some of you may not know this, but in some countries, public health insurance covers certain therapies....so it's essentially "free" for those who need it. in Germany, this includes CBT (and sub-forms such as DBT and schema-therapy), systemic therapy and psychoanalysis/modern versions of this.

the question is, is it effective? and i think, unfortunately, in most cases the answer is no, or it's usually just to stabilise people to some extent, but they stay miserable or relapse pretty quickly.

but what are our alternatives? if CBT doesn't actually resolve mental illness at its core, and idk if any of you have ever tried classic psychoanalysis but that stuff isn't necessarily great, either.

what are our options here as a society to provide effective help to all who need it? is 1:1 therapy even ideal, considering there are year-long waiting lists? what therapeutic approach(es) actually, reliably help people?

[Leo Gura]

One psychedelic trip is worth 6 months in therapy.

[Judy2]

@Leo Gura

not if you are on your own and have a mental illness. for some people it can be that straightforward, but definitely not for all.

so if anything, we'd need centres with trained professionals to accompany psychedelic therapy sessions.

Edited 1 hour ago by Judy2

[Leo Gura]

7 minutes ago, Judy2 said:

not if you are on your own and have a mental illness

Yes, that's valid. But therapy doesn't really solve mental illness either.

[Judy2]

Just now, Leo Gura said:

Yes, that's valid. But therapy doesn't really solve mental illness either.

agreed. 

do you have any insights into what could/what does?

wisdom? experience? emotional awareness? what is the essence of mental illness and how can it be healed?

[Leo Gura]

5 minutes ago, Judy2 said:

agreed. 

do you have any insights into what could/what does?

wisdom? experience? emotional awareness? what is the essence of mental illness and how can it be healed?

It's a difficult issue. Some conditions just can't be cured.

Medication is probably the most reliable method, as long as there exists a medication for it. But medications have their own set of problems.

It's all on a case-by-case basis. There is no generic solution.

But for stuff like healing trauma, which requires deep introspection, psychedelics are amazing.

Edited 1 hour ago by Leo Gura

[Judy2]

@Leo Gura ok

[CosmicExplorer]

"In psychotherapy, practically the only consistent finding is that whatever kind of psychotherapy the person running the study likes is most effective. Thirty different meta-analyses have confirmed this"

https://slatestarcodex.com/2014/04/28/the-control-group-is-out-of-control/

https://jonathanshedler.com/wp-content/uploads/2018/05/Shedler-2018-Where-is-the-evidence-for-evidence-based-therapy.pdf

[Leo Gura]

I promise you psychedelic therapy will be the most effective.

But it has to be done seriously.

[Michal__]

6 minutes ago, Leo Gura said:

I promise you psychedelic therapy will be the most effective.

But it has to be done seriously.

One guy on this forum blasted himself out of schizophrenia with weed.

I wonder whether that would work in my case or at least make the hallucinations I get sober more beautiful.

Edited 45 minutes ago by Michal__

[Leo Gura]

8 minutes ago, Michal__ said:

One guy on this forum blasted himself out of schizophrenia with weed.

That is not what I am suggesting. That will likely make you more unhinged. So please be careful.

Schizophrenia usually requires anti-psychotics, which is the opposite of weed.

Edited 40 minutes ago by Leo Gura

[Michal__]

1 minute ago, Leo Gura said:

That is not what I am suggesting. That will likely make you more unhinged. So please be careful.

Sure thing. Although in my experience psychedelics in reasonable doses make zero difference with schizophrenia. At least the non visual ones like 5 meo.

Edited 38 minutes ago by Michal__