Analyzing Psychotherapy: A Social Role Perspective

Wayne State University, Dec 1994

By Nancy A. Naples, Published on 01/01/94

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Analyzing Psychotherapy: A Social Role Perspective

Analyzing Psychotherapy: A Social Role Perspective Nancy A. Naples 0 Recommended Citation 0 University of California , Irvine , USA - right to receive humane care and to participate in treatment decisions. These basic assumptions are prevalent as discrete but powerful messages throughout the book to confirm the magnitude of its importance. Melvyn Fein has written a book that flies in the face of contemporary postmodern critiques of grand narrativesand totalizing discourses. No therapeutic perspective is missing from his broad reach as he argues that a role-problem/role-change paradigm turns out to be a useful instrument. In the best tradition of science, it brings order to enormous diversity. It permits a grand synthesis that demonstrates the connections between apparently antagonistic perspectives, (p.207) Fein's overall goal is to demonstrate that "a social-role framework can enable competing therapists to integrate what have seemed to be antagonistic worldviews and will help them make further advances in developing effective helping technologies," which will also lead to "a greater utilization of sociological knowledge" (p.vii). He outlines the relevance of role theory to psychotherapy in Chapter One, further describes the role change process in Chapter Two, then broadly compares and contrasts diverse therapeutic specialties in Chapter Three. One of the basic problems with Fein's analysis is his broad definition of roles: "Indeed, for every social task we can distinguish, there exists a corresponding behavior pattern that can be labeled a role" (p.16). To begin with, Fein never addresses who determines the content of the behavior patterns appropriate to certain social positions. Next, roles discussed range from family position (mother, husband, daughter) to job (doctor, artist) to such diverse personal characteristics or experiences as caretaker, free spirit, winner or loser, the leader, the martyr or scapegoat, and the fat one. Since Fein views the goal of therapy as one of fostering role change, the unreflexive inclusion of categories such as careers or family positions is problematic. This approach obscures how power is imbedded in these social positions. For example, a term frequently associated with sociological role theory is role conflict. Women are likely to experience a conflict between the role of mother and the role of worker. These are structural tensions best alleviated BOOK REVIEWS 297 through increased valuation of women's paid and unpaid labor and material changes in the gender division of labor. In other words, the solution may not be located within the individual or even between role partners. Chapters Four through Seven further explore the usefulness of role theory for evaluating different psychotherapies. By presenting such a wide ranging set of therapeutic approaches, frequently lumping divergent perspectives under one broad category, Fein often truncates and misrepresents them. Consequently, his approach may function inadvertently to undermine his overall goal. Chapter Four applies role theory to psychoanalysis. The sweep of Fein's project is most apparent in Chapter Five where he considers cultural therapies. Combined together in this chapter are "those who brought social insights to their critique of Freud," including Alfred Adler, Erich Fromm, Karen Horney, Harry Stack Sullivan, Heinz Hartmann, Ronald Fairbairn, Edith Jacobson, Rene Spitz, Heinz Kohut, and Margaret Mahler (p.98). In Chapter Six, Fein turns his attention to ecological therapies: family therapy, group therapy, labeling theory, social reform, sociotherapy/milieu therapy, community psychiatry, temperamental fit, and alcoholism counseling. In this chapter, he considers Alcoholics Anonymous (AA) alongside what he terms "alcohol therapies." Given the decentralization of AA and its avowed resistance to systematic research, Fein's bold assertions about the philosophy and practice of AA are troublesome. Chapter Seven covers what Fein calls "romantic" modalities. Therapies included under this term are: "client-centered, gestalt, primal-scream, and existential therapies, and also transactional and Jungian analyses" (p. 143). Fein criticizes these therapies for sharing "an overly simple view of human nature and interpersonal relations." Chapter Eight addresses itself to academic modalities; behavior modification; cognitive, affective, and eclectic behavioral strategies. Chapter Nine presents so-called "antitherapies": medical interventions which rely upon pharmacotherapy, strategic therapy and hypnotherapy; reality therapy; and vocational therapy. Fein's terse presentations and dismissal of many therapeutic frameworks could serve to alienate the audience he most wishes to convince. His book highlights two significant and unavoidable obstacles to developing a broad-based theoretical framework for psychotherapy. First, fundamental premises that undergird divergent social and psychological perspectives cannot be ignored (...truncated)


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Nancy A. Naples. Analyzing Psychotherapy: A Social Role Perspective, Wayne State University, 1994, Volume 12, Issue 1,