Sociologists have offered varied critiques of psychology, psychotherapy, and psychiatry. Some have viewed their effects as extremely negative, while others have taken a more moderate view of the effects of psychotherapy (e.g., Scull, 2022). Illouz argues that psychology increases suffering in various ways by obscuring social aspects and creating “psychological failures” that are particularly burdensome because individuals are simultaneously held responsible for their situation (Illouz, 2008). Sociologists who have researched this area, however, have often been critical and have identified negative effects of what is frequently described as the hegemony of psychology and psychiatry since the breakthrough of psychoanalysis (Cohen, 2016). Some criticism of psychotherapy and psychiatry is part of a broader critique of modernity and/or capitalism.
My view of sociologists’ criticism of psychology is that they often underestimate the debate that exists within psychology itself. There is a tendency to treat certain psychological approaches, as representative of the entire field of psychology. This leads to overlooking how much of the criticism has already been addressed by psychologists themselves. Sociologists also often rely on research conducted by psychologists themselves, which some explicitly acknowledge, Scull, for example, serves as a prime example here (2022). At the same time, sociologists’ theories have been used primarily by “critical” psychologists. There is also a tendency among some sociologists to focus more on problematizing and criticizing than on creating an alternative. Those sociologists who have taken an interest in these issues have often stopped at criticism and have been unwilling to devote energy to research programs involving their own applied research that goes beyond policy at levels other than the macro level.
There is a common criticism of psychology from sociology, namely psychology’s overreliance on an individualistic perspective and its overly one, sided reliance on experiments that are inevitably too reductionist and lack ecological validity. Sociologists have repeatedly analyzed how psychology has been used for ideological purposes, both in state propaganda and in corporate advertising (Cabanas & Illouz, 2019). Psychology has also been used as a means to control, categorize, and subjectivize people, to create “psy, selves” and “psy, citizens” who largely conceive of themselves as psychological beings (Cabanas & Illouz, 2019; Rose, 1999; Davies, 2015). In addition to general criticism, sociologists often voice more specific criticisms that vary among them, with some being more critical of particular schools of thought. Reiff, for example, hails Freud as a genius (1986) after several sociologists, primarily within the Frankfurt School, employed Freud within a Freudo, Marxist paradigm (Fromm, Marcuse, Adorno, & Horkheimer), while Cabanas and Illouz are critical of positive psychology and happiness research (2020), and Morrall (2008) is generally critical of all forms of psychotherapy; Ecclestone and Hayes have been critical of CBT and positive psychology, especially in a school context (2019), and Bauman has noted how CBT has been a form of therapy that is symptomatic of and reinforces individualization in “liquid modernity.”
Sociologists have much in common with research that incorporates social and cultural factors into psychology. However, sociologists are not satisfied when psychologists incorporate social factors. For example, Cabanas and Illouz are critical of positive psychology for incorporating social factors in a way that obscures how individualistic it actually is, and for instrumentalizing a sense of “meaningfulness” to promote an unproblematized and simplified understanding of “happiness” (2019). Another criticism is that when social factors are incorporated, cultural factors are lost, leading to the reification of the social as something fixed and one, dimensional, where more “positive” relationships are the goal. When the social dimension is often incorporated in a depoliticized manner or without a political context, where more of the social is considered good, it fails to recognize that different forms of sociality can have a strong negative effect, for example, by being oppressive.
A dividing line often seen between psychologists and sociologists is their view of human agency, where, for example, CBT, positive psychology, and existentialist psychology often hold a strong belief in agency, while other branches, such as biologically oriented psychology with genetic research and twin studies, psychodynamic and social psychologists, consider human agency to be much lower and more contested. Sociologists have often adopted a position in which the individual is strongly socialized, which, according to some sociologists, has led to an over, socialization of the subject (Wrong, 1961; Paulsen, 2013, 20).
The “therapeutization” of society, in the form of the spread of psychotherapy as an ideology, practice, and discourse, has been argued to lead to atomization (Furedi, 2019, Illouz, 2008), introspective leveling (Paulsen, 2020), cultural narcissism (Lasch, 2018), and the responsabilization of the subject, which leads to “psychological failures” (Illouz, 2008, Rose, 2019), an excessive focus on health in the form of “wellness syndrome” (Cederström & Spicer, 2015), the subjectification of the individual as a psychological being through various “psy, technologies” (Rose, 2019), the suppression of critical thinking and civic engagement, and instead the individualization and atomization of problems (Cabanas & Illouz, 2019), increased fragility and risk aversion (Furedi, 2004, 2019), an instrumentalization and demoralization of emotions (Cabanas & Illouz, 2019), and a means of domination and the creation of a “cruel optimism” that fosters an unrealistic hope for change (Berlant, 2011; Becker, 1973, 269).
According to these thinkers, this “therapization” thus creates fragile and even neurotic subjects, vulnerable subjects who need help, which shapes our perspective on society; for example, the idea that we need to do something about the climate is framed within a highly therapeutic discourse through the introduction of the concept of “climate anxiety” (Ecclestone, 2016). Ecclestone argues that there is now a feedback loop, in which the neurotic subject seeks more therapy in order to protect themselves even further.
Another criticism of psychology is that it has allowed itself to be used, and continues to be used, for ideological reasons to control and manipulate the population through marketing research and psychological research, in order to better manage organizations and create a “happiness industry” that turns happiness into a fetish and an object to be pursued, divorced from its moral content, and to be consumed (Davies, 2015; Illouz, 2018). Bourdieu views psychotherapy as a form of symbolic manipulation that reduces the pressure to politicize society. Psychotherapy can be seen as a field with its own set of rules, where the pursuit of power, and psychotherapy itself, is influenced by other fields that dominate it (Bourdieu). Psychotherapy can also be viewed as a form of civic manipulation as opposed to civic control. Society is dysfunctional, yet what is offered is therapy aimed at adaptation (Morrall, 2008; Moloney, 2013; Paulsen, 2020). If society is miserable, a certain degree of misery and unhappiness is important as a signal, and that signal should not be suppressed (Morrall, 2008). There is a focus on positivity as an illusion in a sea of injustice, oppression, and misery, which is harmful to society’s progress.
Another criticism of therapy is that it has overestimated the importance of conversation in generating solutions based on a therapeutic dialogue, a conversation that is not politicized (Moloney, 2013). Part of this depoliticization is that patients’ voices are often systematically neglected; instead, the focus is on listening to the body itself. This is done based on various assessments and self, assessments that are highly reductionist and, for example, leave no room for political discourse (Davies, 2015; Moloney, 2013).
Left, leaning therapeutic interventions are seen as a path forward for creating “moral change” (Fromm, 1993) with an emancipatory goal (Cohen, 2019). Marxist theory posits that class society has effects on socio, psychological constellations, noting a correlation between class and various diagnoses, as well as the degree of inequality in society (Cohen, 2018, 46; Roger & Pilgrim, 2003; Davies, 2013; Cockerham, 2017). Diagnoses can also be viewed as contributing to false consciousness, since one’s self, understanding is influenced by a medicalized discourse that purports to be free of politics and based entirely on science (Cohen, 2016).
Some Marxists argue that psychiatry and psychotherapy are effective tools of social control that maintain the status quo (Cohen, 2016). These diagnoses protect the system, which has historically pathologized various forms of resistance: escaped slaves as suffering from “drapetomania,” suffragists as “hysterical,” the civil rights movement as “schizophrenic,” and the pathologization of homosexuality, as well as today in the form of ADHD and borderline personality disorder, according to certain sociologists (Cohen, 2016, 2018, 49). This does not necessarily rule out the existence of differences at the brain level, but the fact that these differences are linked solely to a discourse of diagnoses and biology, rather than being seen as making a person more sensitive to aspects of society, means, for example, that a “sociological imagination” cannot develop. For example, there are significant differences in the diagnosis of ADHD between countries and regions within countries (Cohen, 2016).
This Marxist interpretation contrasts with a more Weberian interpretation, in which it is the collective of psychotherapists and psychiatrists that competes for power and status against other expert groups in society, and in which psychotherapists do not work for capitalists but for themselves as a status group (Szasz, 2010, in Cohen, 2019, 49). Ulrich Beck recognized this early on as part of the risk society’s constellation, in which experts such as psychiatrists individualize social risks (Cohen, 2018, 50). The control society has been replaced by the performance society (Han, 2015; Davies, 2015), which makes it more reasonable to speak of a “depressive competition syndrome” (Davies, 2015), but such diagnoses do not exist; instead, there is still a distinction between anxiety and depression as diagnoses, even though there is a very high rate of comorbidity (Scull, 2022; Cohen, 2019; Morall, 2008; Paulsen, 2020).
This politicization has also been highlighted in the fields of positive psychology and “happiness research,” where an uncritical view of the concept of “happiness” is treated as something easily quantifiable, which can then be measured, set as a goal (such as the Gross Happiness Product), and compared (Cabanas & Illouz, 2019). At the same time, the basis for this quantification relies on self, report questionnaires that are susceptible to several sources of error, such as self, enhancement bias and the difficulty of assigning a numerical value to one’s assessment of one’s own life (Cabanas & Illouz, 2019). This is linked to a broader trend of quantification, cross, national ranking, and a practice of valuing numbers more highly than the voices of populations, a trend thus driven by a strongly technocratic approach (Cabanas & Illouz, 2019).
Psychotherapy, as it is currently practiced, lacks the ability to mobilize local communities around an individual, a task that is structurally difficult today because psychotherapy is practiced in mass societies. Morrall argues that this constitutes a form of deception, as focusing on intra, psychological aspects obscures social aspects (Morrall, 2008).
Sociologists have examined how psychotherapy relates to morality, noting that psychotherapy both moralizes behavior by holding the individual accountable and, at the same time, demoralizes behavior, thoughts, and feelings by treating them as disconnected from moral signals. Demoralization occurs, for example, through the pathologization of life, rather than viewing it as a moral project (Cabanas & Illouz, 2019; Illouz, 2018). This makes us more vulnerable while simultaneously cutting us off from a historical consciousness in which previous generations managed great risks and uncertainty in their lives based on moral and various narratives (Furedi, 2019). Therapy focuses on the individual and their thoughts, disconnected from a moral life, which increases the focus on one’s own happiness and benefit, a focus that, in turn, reinforces the risk of self, absorption, introspection, and rumination. Demoralization can also be viewed in light of this quote from Freud: “In other words, it is not so much a question of whether we are able to cure a patient, whether we can or cannot, but whether we should or should not” (Freud cited in Becker, 1973, 265). A demoralized therapy can sidestep this question.
A counterargument is that psychotherapy actually fosters moralization; the therapy instills morality in the individual and causes them to internalize it, so that the blame is placed on the individual’s own insufficient will to make an effort and stay healthy, thereby creating a “psychological failure” (Illouz, 2008). External problems in society are internalized by the individual, who, for example, sees themselves as to blame for not finding a job, even though there are not enough jobs for everyone. Criticism of society is absent, and therapy is part of a process of conformity and a form of manipulation (Illouz & Cabanas, 2019). In Science and Technology Studies (STS), Arnstein, in his participatory ladder for citizens, has placed therapy at the very bottom of an 8, step ladder, where therapy ranks even below manipulation, with the highest step being citizen control (Arnstein, 1969 in Sundqvist & Soneryd, 2020). Political scientist Wendy Brown has touched on a similar theme, noting that “therapization” creates a moralizing discourse in which systemic criticism is absent (2015). This “therapization” is also reflected in the changing nature of political participation, where therapeutic discourses and victim narratives are more prevalent and take center stage. Paradoxically, some political actors balance the attempt to bring about change with a partial portrayal of themselves as vulnerable individuals, to whom others and society must adapt (Ecclestone, 2016; Illouz, 2008; Furedi, 2011). Interwoven with “therapeutization” are the processes of “medicalization” and “pathologization.” Pathologization involves labeling various social phenomena as illnesses, drawing legitimacy from a medical understanding of these phenomena, which reinforces the impression that agency does not exist and that moral language is pushed aside even further (Furedi, 2019; Svenaeus, 2013). In the pathologization of suffering, for example, the phenomenon of “concept creep” has been highlighted: everything can become an expression of the multifaceted and vague term “psychological ill, health” or “mental ill, health,” as well as more specific concepts such as anxiety, stress, depression, trauma, and aggression (Furedi, 2019; Ecclestone, 2019).
Eva Illouz argues that “therapeutization” should be viewed in relation to what she terms “emotional capitalism,” in which emotions have been commodified to such an extent that they can be seen as commodities that are central to contemporary capitalism (Cabanas & Illouz, 2019; Illouz, 2018). Individualization and the rationalization of emotions are merely an extension of the order in which emotions are the focus of so much attention, where, through emotional reflexivity, one attempts to achieve self, understanding, which is difficult or impossible because emotions are embedded in a capitalist logic (Illouz, 2018).
Ecclestone and Furedi, in their critique of the emotionalization of the world through therapy, make the mistake of taking such a hard line in asserting that emotional restraint - a stiff upper lip, stoicism, is always better. It is likely that a balance between emotional restraint and the ability to listen to emotions is part of reasonable emotional reflexivity (Holmes, 2010). Therefore, their critique of psychotherapy is not entirely accurate because it takes a stoic ideal as the benchmark, an approach that is not supported by research in the field, to which they themselves actually refer. One example that serves as a strong argument against Furedi’s de, emotionalized conception of a good life is Randall Collins’s theory of emotional energy, which demonstrates how central a feeling such as pride is to a good life (2004).
Psychotherapy has been regarded by many as a religion, a civil religion, or a practice with religious traits (de Groot, 1998). Others argue that psychotherapy is a weak, powerless religion that gives people too much hope, hope that cannot be fulfilled in a modern, fragmented society (Reiff, 2006). The psychiatrist as priest has become a cliché that obscures the nuances suggesting that psychotherapy is best described as having religious similarities and traits (de Groot, 1998). Psychotherapy does not unite people in a moral community (Reiff, 2006) and can instead be viewed as an “anti-religion” that actually fuels “cultural narcissism” (Lasch, 2018). Some, however, view psychotherapy as a modern version of shamanism, while others see it more as a form of priesthood, with a “pastoral power” that subjectifies the client in certain ways: individualization, belief in secular salvation, the cultivation of sensitive souls in need of constant care, and the creation of a truth about the individual (Foucault, 1978 in de Groot, 1992). Psychotherapy becomes a substitute for methods of achieving salvation in place of the clergy, which has been displaced within religion (Abbot, 1986 in de Groot, 1998). Psychotherapy can also be seen as an effect of the secularization of the self, and it first gained prominence in the United States, where moral communities had first disappeared (de Groot, 1998; Morall, 2008). Pastoral care, like shamanism, relied on symbols and the role of evil spirits to activate or mobilize the community to care for an individual and provide them with attention and support (de Groot, 1998). Psychotherapy’s salvation is individualized; it is also disconnected from moral actions, or rather, it establishes other prohibitions and commandments, a commandment to make time for oneself and to enjoy life.
Psychotherapy can be viewed both as part of a broader trend toward “disenchantment,” in which the body and the psyche are treated as something that can be fully understood and controlled, and as a form of “enchantment” of the individual, the belief that there are great, almost magical powers within a person that can be brought to the surface. This form of enchantment is even more prevalent in self, help literature, which can foster a “cruel optimism”, an overconfidence that everything can be solved and all suffering can be eliminated through a particular psychological method (Berlant, 2011).
Sociologists have criticized cognitive behavioral therapy for individualizing and internalizing difficulties, as well as contributing to the pathologization of suffering (Bauman, 2013). Added to this is the criticism that it creates a self that is rationally calculating, objectifying emotions in a way that separates them from their moral claims (Cabanas, 2018). It is the commodification and commensuration (making measurable) of emotions and thoughts that help reinforce an individualized, responsabilized, and neoliberal subject (Illouz, 2018). One criticism has been that meaning is lost and that “feeling good”, such as being happy, becomes an overriding goal, rather than living a meaningful and moral life (Furedi, 2019).
Sociologists have criticized psychology and psychotherapy for focusing one-sidedly on self, insight, turning inward to find the answer to why one feels bad (Illouz & Cabanas, 2019; Cederström and Spicer, 2015; Davies, 2015; Paulsen, 2020). This exacerbates the narcissistic culture that is the root cause of why we feel lonely, isolated, and alienated from one another (Lasch, 2018). I believe some aspects of this criticism accurately identify problems within CBT, but other criticisms miss the mark. CBT aims to foster an outward perspective to move away from self, centered rumination and hypervigilance. Metacognitive therapy seeks to identify and counteract various thought patterns that lead to introspective rumination. Cognitive therapy is primarily intended to increase functionality, not to pursue happiness as an end in itself. However, this “functionality” is limited to an individualized form of what is “functional,” which need not include, for example, being a good ethical citizen, something that could be described as central to being considered “functional.” For instance, behavioral experimentation is a technique used in CBT to expose the patient to things they have irrational fears of. Behavioral experimentation could be a practice that might continue as part of living a generally experimental and exploratory life, but it often ends at a minimum level where anxiety has decreased enough to allow one to live a “normal” life with a good level of “functionality.”
Third, wave CBT, such as ACT, advises the client to work on acceptance and then engagement with the surrounding world, rather than a general pursuit of a de, moralized form of “happiness”, which the therapy’s founder, Stephen Hayes, explicitly opposes, and instead leans toward a Buddhist understanding of happiness and suffering. The criticism directed at Hayes is that he is part of a process in which Buddhist ideas are taken out of their intellectual tradition, which is strongly individualistic, Westernized, and the political and social connections inherent in Buddhist thought are rendered invisible (Purser, 2019). One pillar of ACT is commitment to various “life values.” A key criticism is that while this could serve as a foundation for a more outward, looking therapy, it fails to address political issues that quickly arise when discussing life values. These life values can be ill, considered, individualistic, trivial, and even unethical because they have not been subjected to critical reflection; rather, these life values are intended primarily to increase “functionality” and reduce suffering (Paulsen, 2020).
Positive psychology has been criticized both within and outside the field of psychology for methodological flaws, problematic assumptions, measurement issues, an unclear epistemological foundation, and vague concepts such as “happiness,” which is uncritically attempted to be quantified based on self, report questionnaires (Cabanas & Illouz, 2019). One problem with positive psychology is that “meaningfulness” is instrumentalized for an unclear definition of “happiness” (Cabans & Illouz, 2019). However, this criticism is not entirely fair, since Seligman uses the concept of flourishing instead of happiness (Seligman, 2013), which is a eudaimonic view of happiness. A sharper criticism, however, is that while Seligman claims to advocate a eudaimonic view of happiness, in practice positive psychology is used in ways that call this into question, for example, in the U.S. military (Ehreinrich, 2010). Positive psychology, much like mindfulness, has become instrumentalized and disconnected from the ethical tradition (Purser, 2019).
Positive psychology, however, has a tendency to be also outward looking. There are techniques such as “moral elevation,” which is based on the assumption that rumination stems from self, focus. Therefore, one should begin to think about other people and adopt their perspectives (McGuire & Mignogna, 2020). Jonathan Haidt and Barry Scott Kaufman are two prominent psychologists who place a strong emphasis on the good life in their research and practice. Kaufman builds upon Maslow’s work, noting that self, actualization as a concept has an outward focus and a strong social dimension, as Maslow himself advocated, but he also added that the highest value on the hierarchy of needs is “transcendence,” which is entirely outward, focused (Kaufman, 2020). Positive psychology also includes techniques centered on generosity to foster greater well, being, which align closely with Aristotle’s idea that pleasure follows good actions. Illouz’s critique is that meaningful actions are instrumentalized for the sake of happiness as the ultimate goal. I find Illouz’s own philosophical foundation to be unclear. Does she advocate a deontological ethics? Some have argued that Kant’s deontological ethics takes an unrealistic view of human behavior, linking willpower to reason and underestimating the necessity of emotions, which can then be seen as “instrumentalizing” or as tainting ethical actions with emotions and self, interest.
One criticism that has been raised is that the focus on self, actualization, which Maslow viewed as the highest level in his hierarchy of needs, is primarily a form of self, realization (Cabanas & Illouz, 2018). This criticism is misleading because Maslow believed that those who achieved self, actualization did so with an eye toward various values (truth, beauty, and justice) and problems to solve; furthermore, later in his career, he also viewed transcendence as a stage beyond self, actualization and held a very social vision (Kaufman, 2020). An important criticism, then, may be how humanistic psychology is applied in, for example, organizations, where certain elements are selected and others are overlooked, such as an upside, down hierarchy of needs, resulting in psychology being “captured,” as Cabanas and Illouz write (2018).
A key criticism of humanistic psychology is its focus on trying to find an authentic self. Authenticity can be seen as one of several different identity technologies that do not necessarily lead to the best outcomes in terms of well, being and a good life, but rather result in a burdensome identity fundamentalism and are fraught with various paradoxes that make it impossible to achieve “pure” authenticity (Moehller & D’Ambrioso, 2021). Hochschild, for example, has advocated the notion that there is something authentic beyond the social. However, this is a weak form of authenticity, given that we are still influenced by what we think and feel constitutes an authentic self (Hochschild, 2012; Taylor, 1991).
An offshoot of humanism that became a movement was the self, esteem movement. Sociologists have done a great job of criticizing this focus on self, esteem. Sociologist Thomas Scheff, for example, has examined research on self, esteem and discusses the shortcomings of that research (Scheff & Fearon, 2004). However, self-esteem as a concept and an important factor has been defended when viewed in a more dynamic and indirect way (Strandell, 2017; Scheff & Fearon, 2004).
Psychiatry today is a practice, discourse, and ideology that wields significant influence, so much so that it can be viewed as a hegemonic discourse (Cohen, 2016, 2018). At the same time, several researchers argue that psychiatry is in the midst of an ongoing crisis, manifested in strong skepticism and uncertainty regarding the validity and reliability of diagnoses, Deinstitutionalization did not lead to better care in the “community” but rather to the continued neglect of these individuals, albeit in a more “responsibilized” form, an overreliance on psychotropic medications that is institutionalized in places such as the United States (Scull, 2022). Psychiatric diagnoses have validity issues: measurement, construct, and prognosis/predictability (Scull, 2022). Other problems include intersubjectivity (psychiatrists making the same diagnosis of the same case), test, retest reliability, a lack of etiology, and a lack of treatment specificity (Scull, 2022). Psychiatry’s reliance on the medical model, with its focus on neurochemical processes to understand human beings, can be seen as the subjectification of the “neurochemical subject” (Rose, 2019). This is part of the criticism that mental illness can only be viewed as a metaphor if there is no clear link to biological markers. Others, however, argue that this connection is clear and that mental illness can be viewed as a brain disorder or, more recently, even as a gut disorder (following links between gut flora and depression). Nikolas Rose has been critical of how the “psy, self” is constructed but nevertheless believes that a neurological foundation, combined with social and sociological aspects, offers a way forward (2013). Psychiatry and psychotherapy can be viewed as a form of biopower that shapes “conducts of conduct”, that is, how categorizations, measurements, and control are carried out in a society (Foucault, 1991 in Fullagar, 2017). Part of this involves viewing oneself more as a neurochemical subject that competes with or complements a psychological subject (Fullagar, 2017). These discourses linked to this biopower make it difficult to know what constitutes a placebo, but it is likely that it is precisely these discourses and subjectifications in the encounter with psychiatry that create the placebo effect (Fullagar, 2017). Subjectification also involves becoming a consumer who consumes subjective well, being and health, rather than being a citizen (Fullagar, 2017).
Psychiatry and psychiatrization are viewed by some sociologists in food studies as a form of oppression (sanism, mentalism) that perpetrates various forms of “psy-violence” and dominates different subjects through epistemic injustice and can be seen as colonizing certain bodies and their psyches (Mills, 2014; Cohen, 2018).
Medicalization is a process in which various ailments and problems are treated as medical issues within the medical model (Conrad, 2007). In psychotherapy and, above all, psychiatry, this model has been strongly dominant, but has faced competition from other relational and psychosocial models. The pharmacological revolution has had mixed effects: while certain medications are used to meet a great need and have saved lives, others have been prescribed for conditions that could have been treated in other ways, leading to an overreliance on the medical model in psychiatry (Scull, 2022). While this can help destigmatize mental health issues, it can also obscure certain discourses, such as discourses of resistance and political discourses (Morrison, 2005). However, these processes have led to discourses and practices of resistance, as people come to see themselves as “survivors”, and that this is part of sanism and psy, violence (Morrison, 2005; LeFrancois, 2019). The overuse of psychotropic drugs is a recurring problem, according to critics (Gotzsche, 2013; Healy, 2007; Angell, 2004; Whitaker, 2015; Morall, 2018; Rose, 2019).
According to several researchers in the field of psychiatric research, psychopharmacology is in a crisis, as evidenced by the fact that little progress has been made in developing new medications, and that the momentum that once existed has diminished so much that several major, influential companies that led the psychopharmacological revolution have reduced their investments in the development of new drugs, leaving the “pipeline” of new drugs empty (Rose, 2019, 130; Scull, 2022). The situation is controversial, with other researchers insisting that progress is being made. The crisis is exacerbated by problems with the methods used, which are often applied poorly and contain multiple sources of error (e.g., the degree of blinding is insufficient), but also by the inherent limitations of using randomized controlled trials (RCTs), in which it is relatively easy for both those administering and those receiving psychopharmaceuticals to know whether they are receiving a placebo or not (Kirsch in Rose, 2019, 122). Psychopharmacology has also suffered from several recurring scandals involving key researchers and practitioners who have served as “key opinion leaders/thought leaders”; in ADHD research, for example, this has led to warnings from Harvard regarding prominent researchers who, in order to secure research funding from Johnson & Johnson, promised positive results for Johnson & Johnson’s own ADHD medication (Scull, 2022). One of the most extreme cases in this regard is the scandal surrounding opioids, which were aggressively marketed to doctors, with the use of these potent and addictive drugs repeatedly expanded, a contributing factor to the phenomenon of “deaths of despair” in the United States (Scull, 2022).
When sociologists critique therapies, they often employ discourse analysis, examining manuals, books, and the language used. Sociologists have conducted far fewer studies (if any at all) on how therapists actually practice (Morrall, 2008). There is some research showing, for example, that therapists become more eclectic the more experienced they are, and that the better a therapist is at demonstrating empathy, the better the therapeutic outcomes (Miller, 2015). Therapists may also resist various aspects of how clinical psychology has evolved. Therapists can be highly critical of medicalization, overdiagnosis, and the pathologization of clients