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Culture War Roundup for the week of March 27, 2023

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I also get the impression that both psychoanalysis and root cause thinking for social problems are popular with the same crowd for the same reasons.

I'm part of that "crowd", to an extent*, so I'd be curious to hear what your reasons are.

Psychoanalytic thinking is not opposed to taking action. It merely tries to get a holistic understanding of problems before making recommendations; it stresses that, when you decide to take action, it should be the right kind of action, taken for the right reasons.

A simple psychoanalytic case study I once came across in the literature: man comes to an analyst and says that he has trouble getting to work on time. Frequently he oversleeps, but even when he wakes up early enough, things seem to get in his way and he ends up being chronically late. Someone who's too deep into the "practical problem solving" mindset might say: set your alarm clock earlier, go to bed earlier, switch to taking a different train line closer to your house, keep a journal for two weeks about your habits and what time you arrive to work, then report back.

The analyst, instead of immediately recommending a course of action, takes a step back and asks: how are you feeling about work, in general? Are you happy at work? Are you chronically late to other things, or is it just your job? You're never late to your kid's softball practice, but you are late to work? Why do you think that is? What is the difference?

Eventually it comes out after multiple sessions that the man never really wanted to be in the career he was in in the first place; he felt forced into it because he wanted to live up to his father's expectations (yes yes, stereotypical I know; it doesn't always have to be your parents when it comes to psychoanalysis, but, given the central importance of the relationship with one's parents in one's early formative years, it often is). After psychoanalysis, the man got the courage to quit his job and transition into a career that was more aligned with his own personal goals and values, rather than the goals that his father wanted to project onto him.

So you can see that there was no aversion to action here. The man actually ended up taking a much more radical action than what the naive bulldog "git 'er done" approach would have suggested: quitting his job and pursuing a new career, rather than making superficial adjustments to his daily routine. But he was only able to understand that that was the appropriate course of action after he took a minute to breathe and analyze, well, the root causes.

Even with "obvious" deficiencies like social anxiety, I think there can be much to question and analyze. You say you experience fear and anxiety - can you articulate what you're afraid of, exactly? Why do you want to talk to more people? What is it that you really want to get from being more social, what is it that you hope to gain? Maybe you're just not meant to be a social butterfly, in the same way that not everyone is meant to be a pro athlete - it's worth exploring. Perhaps your anxiety actually benefits you in some way? Fear does serve an evolutionary purpose after all. I don't think the answer to any of these questions is obvious; they will vary on a case by case basis.

** (I won't make any strong claims about the clinical efficacy of psychoanalytic methods vs conventional methods; I have no technical expertise here. I can say that I find the concepts of psychoanalysis to be fascinating though, and I enjoy reading the writings of psychoanalysts. Whether any of it is "real" or not is up for debate, but if I were God and I could mold human psychology in whatever way I wanted, I would make it like that.)

Oh I also love hearing stories from psychoanalysts. I also like talking and speculating about the motives and reasons of both me and other people in a similar manner to psychoanalysts/dynamics. My wife studied psychology and originally planned to become a therapist, and her sister is currently almost finished with her education for becoming a systemic family therapist. We all love talking about this stuff. But that's the thing: Psychoanalytics/-dynamics is maximized for interesting-ness and/or pleasantry and very easily degenerates into a stagnant pattern were the patient just likes talking to the therapist (usually complaining about their parents or partners, we all love complaining about our parents or partners) and doesn't really want to change anything. The housewife who has been going to the same therapist for 30 years is not a meme without a reason.

Using more practical approaches (systemic family therapy is another more practical approach for example) doesn't forbid thinking about the bigger scope (calling career choices into question is an all-time favorite in all therapy styles), but actually asking the patient to "do stuff" makes the therapy less pleasant, tends to rock the patient(s) out of complacency and in general doesn't devolve into this particular failure mode. As you mention Psychoanalytics isn't opposed to action, but it also doesn't require it, which is important. Some high-motivation low-introspection people really do only need someone to force them to introspect and re-consider their live choices and then will go on to make the needed radical choices themselves, but many people not only need some practical directions on "what to do now" on top, they also need a push to actually do it.

And there is also the other direction. A push can not only help you achieve something, it can also trigger the opposite reaction. You may even go as far as saying that good therapy needs a certain baseline of hostility, basically amounting something like this: "You claim you want X? Well then, here are simple steps on how to get X. Now go out and DO IT. If you don't, we can devise a new strategy next week or we will talk whether this is really what you want". This forces the patient to put some skin in the game, which in turn makes it easier to realize what you really want. It's easy to claim that you always wanted to become an author, but if someone manages to get you 1 extra free hour per day through re-organization and prioritizing, asks you to actually start and even gives you some practical hints, you may realize that you have been fooling yourself. Or you may become an author. Either way you're better off.

Furthermore, the incremental changes favoured by practical approaches tend to give patients more breathing room. For the example of soxial anxiety, having appropriate coping strategies will expand your capabilities and make you more functional. In general, CBT favors making the patient more functional first. You can still decide afterwards that you're introverted and want to minimize social contact, but you can't entirely avoid it and need to handle the situations you can't avoid. This then makes bigger changes more easy and less likely to fail completely. An appropriate CBT can be the difference between a programmer working in home office most days and a totally dysfunctional unemployed shut-in. I have much less confidence in Psychoanalytics here, since shut-ins usually are poster boys for "need clear directions and lots of pushing" to get them out of their comfort zone.

For your chronically late example, it is the same: If you're already struggling at your current work, preparing for a career switch is a lot harder. I can tell you that from experience. But if you first are helped so that you struggle less at your current work, you then have more time you can dedicate to prepare for the switch. If you are more functional, you will have more spare time, you will have an easier time prioritizing, and so on. You can then use that extra slack as you please. Note how your example basically assumes a functional & decently motivated person; Someone who can just switch jobs and do fine, someone who needs no practical step-by-step guides, no pushes nor nudges.

Again, to be clear, I'm not opposed to thinking about the bigger scope or calling fundamentals into question. A good therapist will always do that. But since most people come to therapy mildly to severely dysfunctional, it is best to first start making them more functional, and then they can make bigger changes. And even once you're not (as) dysfunctional anymore, you will still profit from viewing everything in practical incremental steps, no matter how radical your goal is. And traditional psychoanalytics/dynamics often massively fails on these two accounts in practice, either talking endlessly about things in the past you can't change anymore or proposing radical changes that are almost guaranteed to fail if you can't get your shit together first.