Mike Phipps reviews Personal Responsibility, Inc: How Psychotherapy Turns Society’s Problems into Yours, by Julie Tilsen, published by OR Books.

One of the features of neoliberalism is the individualisation of social responsibility, which leads to “all forms of social crisis being perceived as individual crises and all inequalities being made the responsibility of individuals,” as Pierre Dardot and Christian Laval put it in their 2013 book, The New Way of the World.

This applies especially to psychotherapy, argues therapist Julie Tilsen – it increasingly functions as an arm of free market ideology, reinforcing its imperatives of personal responsibility, individualism and relentless self-improvement, compelling people to search inwardly for solutions to problems created by the system itself. There may be very sound material reasons why nearly half of US adults in 2024 were reported to be feeling more anxious than in the past, yet this is often portrayed as a personal failing.

Therapy may not be the answer to this collective anguish. In fact, it “often functions as an agent of social control, a tool of compliance and conformity,” advising people to build more “resilience” to “endure more and more shit.” A lack of this resilience is seen as a personal weakness, based on assumptions – false – of ‘rugged individualism’, the theory of human society favoured by the American right.

Tilsen shows from a number of real examples drawn from her own experience how therapy might be reimagined to provide meaningful responses to people’s suffering, cultivating approaches that individuals, families and groups with shared experiences and values can engage in collectively. This helps decentre therapy as the go-to ‘solution’, creating instead a social response to the problems caused by neoliberalism’s perpetuation of competitiveness and resultant social isolation.

Neoliberalism not only creates a demand for psychotherapy: it corners the market. The ‘mental health screening’ test offered in a variety of US environments may well be written by a pharmaceutical company and end up prescribing a drug produced by that company.

Social media also helps privatise societal problems, “by decontextualizing them and pathologizing individuals.” The US Bureau of Labor Statistics estimates that from 2024 to 2034 the employment of mental health professionals will grow up to six times faster than other jobs.

Tilsen is heartened by an increasing recognition from ordinary people that a struggle against oppression is important for our mental wellbeing. As someone who took part in the defence of their community in Minneapolis when it was occupied by federal ICE agents said, “I know this is traumatic and I will deal with the impact of it probably all my life, but I also know it would be bad for my mental health to just go about my life and not pitch in.”

It’s a recognition, says the author, that what are presented to us as personal problems, such as anxiety or depression, need to be solved as social problems that are manufactured and perpetuated by neoliberalism. And that means moving from the internalization of personal responsibility to developing practices of collective solidarity. As for therapy, it should not be an end in itself but a pathway to change.

This is a livelier, funnier and more rambling book than a short review can convey. But it’s also full of hope, because as Brazilian educator Paulo Freire said, “Without a minimum of hope, we cannot so much as start the struggle.”

Mike Phipps’ book Don’t Stop Thinking About Tomorrow: The Labour Party after Jeremy Corbyn (OR Books, 2022) can be ordered here.