A chip off the old block

A child who has ‘made it’ in the world might want to forget the parents who no longer match its self-image, even demonstrating a blind spot about its heredity.

There is, however, nothing secretive about the fact that clinical psychology was born out of an alliance of convenience with an older and more established profession. As Hans Eysenck stated it in 1950: That a strong, respected and highly competent profession of psychiatry is essential for the growth and flourishing of clinical psychology appears obvious: it is perhaps no less true to say that the existence of well trained, competent, and friendly clinical psychologists can be of the utmost value to psychiatrists.1

There has been a substantial redrawing of the boundaries since 1950, with new alliances, antagonism as well as cooperation, and new power structures to deal with. Applied psychologists have now decided to march under the banner of ‘evidence-based practice’, confident that ‘the facts’ will win out in its competition with other professions. American psychologists have looked on with admiration at the UK government’s decision to invest in a psychological therapy service provided by the NHS (IAPT), while in their own country they seem to be losing the battle against the promotion of psychotropic drugs on an overwhelming scale.According to market researchers, the global depression drug market alone will reach $16.8 billion by 2020.3

Gaudiano and Miller2 view the current situation facing the advocates of a psychosocial approach as serious and challenging. It appears to them that in the global market place, ‘evidence-based’ and sound ‘value-for-money’ psychosocial interventions are losing out. What they fail to fully recognise is their own allegiance to a concept of mental illness that sets the rules of the game. They are chips off the old block. They refer to the over-medicalizing of mental health problems and define medicalization as the practice of defining and treating non-medical problems as if they were such conditions. But in the same article, they endorse the idea of improving public attitudes about mental illness, mention recovered patients relapsing after treatment, and note the importance of reducing the burden of mental illness at a population level.

Professionals who provide ‘psychosocial interventions’ are in business too, but when they share a medical inheritance, they constrain the defining characteristics of the ‘market’ of their potential consumers. By adopting the trope of health, illness, treatment, and cure, psychosocial means whatever their competitors want it to mean, and what their competitors have already persuaded the consumer to believe it should mean.

According to Gaudiano and Miller: This tendency within psychology to fail to put forward a unified front has left room for other professions to wage aggressive media campaigns to change public thinking in ways that argue against psychology and ultimately do a disservice to consumers and their families.

What would doing a service to consumers (and their families) actually amount to? Not, in my view, sharing the mythology of mental illness.


  1. Eysenck, H J (1950) Function and training of the clinical psychologist. Journal of Mental Science, 96, 710-725. Cited by Burton, M and Kagan, C in British clinical psychology in historical perspective: The genesis of a profession,(1983, unpublished). www.compsy.org.uk/listkb.html
  2. Gaudiano, B A and Miller, I W (2013). The evidence-based practice of psychotherapy: Facing the challenges that lie ahead. Clinical Psychology Review, 33, 813-824.
  3. Market Research Store.            https://globenewswire.com/news-release/2016/05/10/838292/0/en/Global-Depression-Drug-Market-Poised-to-Surge-from-USD-14-51-Billion-in-2014-to-USD-16-80-Billion-by-2020-MarketResearchStore-Com.html

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