Tuesday, January 5, 2010

Therapist Reform

Economics Inquiry

In this inquiry we are starting from the situation of therapy. In this situation of therapy we will consider that a therapist, and a client or patient, is getting the therapy from the therapist. Let us further imagine that within this situation the patient asks a particular question of that therapist.
And what the patient asks is: "Why do you want to help me?" I am therefore conceptualizing an inquiry that concerns motivation. My concern in particular is in whether this motivation is in deference to some aspect of economics. Maybe the motivation is in terms of society's needs, or maybe the motive exists in relation to some boss under whom (and also I think with whom) the therapist works. Maybe motive just in the purist-capitalist style of selfishly just wanting money. On the other side, maybe it is the therapist's altruism that is involved --- a true desire to help and with no other factor there. All of those are possiblities. All spring to mind, but which motivates the therapist in truth? Which obtain and which do not?

Let us also ask what is the use of the enquiry. What is the point of setting up this situation? But I am not setting it up. It's there. Do I need a reason? We have a situation; where I'm interested. No one is going to stop me if I am interested. And I am. It seems important to me to understand the answer the question of a fictional patient to a therapist. So there. Let us proceed with the operation, gentleman, and cut up the patient. If we don't the patient might die. It's a little thing called compassion.

What is the therapist motivated by? We shall first of all rule out pure altruism. It just seems far-fetched. I do not think that is what a therapist does. With that eliminated, other options are left, from which list we can also rule out the very opposite, which is that there is no aim other than that possessed by the therapist to wind up having more cash then she had going in. So both those are out. True, I would suggest that there must be something like altruism. True, but there must be (other) social roles, etc. For example, consider the institution the therapist works for (alternatively, with). All kinds of considerations can file into this space. Maybe the therapist, and some do thinks like this, thinks that it is in "society's interest" to have well-adjusted persons and not maniacs walking around loose. So they are working for society. Maybe they just want to lower the prison population, or prevent crime. Many do see it like that. I do not but some do.

Another possibility is that the therapist does not see herself as primarily a social utilitarian or policeman-janitor as in the case above, but rather has a mixture of economic and humanitarian motivations. This possibility as already been referred to here. The therapist needs to have a career, fed her kids, have a life of her own, etc., but also has perhaps a love for humanity, and wants to be of service, etc. It is a mixture, then.

What the outcome of our little inquiry is for economic analysis, then, is that economics is not anything singular, but it is, when it works, always a combination. Human motivation in a capitalist society is balanced between two or more motives. There is a desire to benefit others, or altruistic desire. That is there. But in any institutional or professional therapist's world this could scarcely act alone. There is also a more utilitarian desire to do one's job in society as an economic actor. The desire to just get money exists, just as the desire to be a good person exists. We may also speak of an individual's simple need to find his or her place, in a world of markets and trade like the mysterious world in which we exist, that is called "capitalism," or "modern life," etc. In this situation, one is forced, increasingly I might add, to accept that there exist these practices involving "how to get money." Giving this kind of help we call "therapy" to others only in expectation of the money is a bit disgusting. But also, giving one's service only out of altruism is a bit ridiculous. It has got to be a mixture, and perhaps that tells us something about economics, as well as economic theory. The idea is that economics exists as combination, not singularity. Economic theory, in this sense of the word "economics" at any rate, is not just about money but it is rather about how money flows in the stream, the stream being social life. Economics exists within the life of a society. It is not purely the individual's need for the substance understood as "money." A river is not just about water, but also about the banks of the river that hold the water as other things, things often intangible.
Not only this aspect of life in modernity, which is a highly monetized affair, but all aspects of economic life or modern life can be understood in the same way. One behaves, or should behave, in a way that is moral and decent, or helpful towards the needs of others. This is not necessarily "economic," in the more narrow sense of the term, but, as well, one has to "monetize," or find one's way in the economy that is life.
The monetary side becomes ritualized. Charging for one's services is very like a ritual. The therapist knows she has the right to ask for money; the client knows he or she is supposed to pay. There is no need to establish the monetary side of the matter by anything deeper than this ritualized expectation of a monetary arrangement as a perfectly acceptable tool; these are socially-endorsed behaviors. On the other hand, the actual work of rendering service to others is not just a ritual but would have other distinct characteristics. It would probably be more creative. It would probably not be a blind ritual but rather it would contain more human considerations that could never be monetized, as such. Money works somehow by integrating into the "flow" of the process of life that the therapist and client are already existing within. Money has to be involved because os human weaknesses, not because of human genius. The exchange of money does not work all on its own, merely because we somehow recognize the money value of a thing like therapy and assign the correct market price. It is not regulated by some kind of invisible hand. Therapy is, or ought, to be something other than a blind ritual or a mechanical transfer of funds in return for a service. Somehow, both sides of the economics of therapy, the helping and the pecuniary or monetaristic, seem to operate together. And if they cannot, that constitutes a problem. The motivation of a therapist, in providing therapy to a patient, is not explainable through money. Money is a part of the equation, along with other, more human things. Somehow these have to operate both together, at the same time. This is not always an easy trick.

This is my general take on capitalism where I mean, by "capitalism," our world according to our current social arrangements. It is not, as arch-capitalist purists, or right-wing conservative rationalizers of capitalism would try to tell us, totally about generating profit or payment such that the only thing we have to consider is the profit itself, in which view the "self-interested" individual is regarded as sacred choice agent. Instead, we may capitalism see it as a method, designed to do some kind of good, in the aim of getting monetary considerations to flow with and into all the other human activities. Money is channeled into the flow of human activities. But it does not somehow replace the human activities and it does not somehow explain the human activities, and it not, in some equally mysterious way, an excuse for the activities. Neither is it that the human activities do not exist. Nor that they are not human but rather mechanical, as if life must become like some French Enlightenment fantasy about what machines should be able to accomplish. Rather we can understand modern life, with its use of money, as a phenomenon in which the rationality of payment and self-interest has to work together with the flow of human life and life's activities.
Much of the more conservative kind of theories of economics try to say that the logic of markets, or of money (e.g. M. Friedman) replace human behavior, or replace the explanation of it, or replace other explanations of it. Or the economic theories constitute the explanation or logic of what humans do. This is all to be rejected. In each case there are "rules" they think they are discovering about the rationality of markets that become the whole of the object itself.
This is totally wrong, totally absurd. Money is not an end unto itself. I think a real explanation, or a real economics, considers that human society is imperfect in itself, first of all. Given these problems and deficiencies, money or economics is a tool, a means to an end, used to channel and organize these imperfect societies. If that is the case, it is only natural that, at times, various economic reforms have to be enacted.

No comments: