There’s a strange connection between an idea that Karl Marx used to explain the relationship between labour and capital, and an idea that is central to CBT.
The idea, which Marx used in his 1867 work Capital and elsewhere, is that of mystification. In the context of Capital it is the way in which our understanding of economics is socially and historically determined, limiting our ability to make sense of our situation.
Marx got the idea from earlier writers. For example, P-J. Proudhon, (in The Philosophy of Misery, 1846) explains it well (my italics):
It is said that the people, naming its legislators and through them making its will known to power, will always be in a position to arrest its invasions; that thus the people will fill at once the role of prince and that of sovereign. Such, in a word, is the utopia of democrats, the eternal mystification with which they abuse the proletariat.
But will the people make laws against power; against the principle of authority and hierarchy, which is the principle upon which society is based; against liberty and property? According to our hypothesis, this is more than impossible, it is contradictory.
Mystification is the practice of deliberately making things mysterious, outside the realm of reason. It is utopian, in that it is used to promote an idealized vision of reality; it is an abuse, in that it causes harm; and it makes certain things impossible even to think.
Around a century later, British psychiatrist R.D. Laing picked up this idea and translated it into the realm of family dynamics. Contributing a chapter, Mystification, Confusion & Conflict in the 1965 book Intensive Family Therapy, he writes (original italics):
To mystify, in the active sense, is to befuddle, cloud, obscure, mask whatever is going on, whether this be experience, action, or process, or whatever is “the issue.” It induces confusion in the sense that there is failure to see what is “really” being experienced, or being done, or going on, and failure to distinguish or discriminate the actual issues. This entails the substitution of false for true constructions of what is being experienced, being done (praxis), or going on (process), and the substitution of false issues for the actual issues.
The state of mystification, mystification in a passive sense, is possibly, though not necessarily, a feeling of being muddled or confused. The act of mystification, by definition, tends to induce, if not neutralized by counteraction, a state of mystification or confusion, not necessarily felt as such.
Laing notes that mystification in a family often has the function of maintaining the status quo and supporting rigid roles, avoiding certain kinds of disturbing conflict (although mystifying families are not necessarily free of all conflict). One or more family members can be harmed (becoming schizophrenic), and certain things become impossible even to think:
The mystified person is operating in terms that have been misdefined for him. This definition is such that, without realizing it or without understanding why he may perhaps intensely but vaguely feel it to be so, he is in an untenable position…
So Laing’s use of the term mystification closely parallels Proudhon’s. His chapter, Mystification, Confusion & Conflict, with its thought-provoking case studies, is well worth reading.
Laing is often presented as a kind of lone looney whose wacky ideas had little relation to the rest of psychiatry, but in this chapter he makes the strong relationship between his thinking and that of other researchers very plain. He also makes it plain that his understanding of the role of mystification in schizophrenia was developed from his understanding and treatment of real schizophrenic patients.
For example, a recent blog post by Peter H. Donnelly dismisses Laing’s ideas as a theory about chaotic, disorderly, or disturbed communication. This misses the point that families of schizophrenics communicate in ways that are purposeful and effective in promoting their ideals and excluding aspects of reality. Their communication is not dysfunctional. Rather, it functions exactly as intended, and the resulting schizophrenia is just an unintended consequence.
The Philadelphia Association in London continues to provide psychotherapy and training based on Laing’s methods and ideas, providing a focus for the work of a few dozen psychotherapists, and operating households for patients:
The experience of forty years has demonstrated that personal crises or seemingly inescapable distress and confusion, as well as experiences of “stuckness” with intractable “problems”, may for many people best be negotiated in…therapeutic households.
What’s curious is how very close the approach is to the CBT approach, though the terminology is different.
Laing, strikingly, uses innocent-souding words like “muddle” to describe distortions of reality that have severe though unintended consequences (and recalling, perhaps not entirely appropriately, Chouette’s SimpleHarmonicMuddle blog). He describes himself and his colleagues as “investigators.” A look around websites of some members of the Philadelphia Association today suggests that they seem to use similarly low-key descriptions of their work.
CBT practitioners would say that they aim to correct “cognitive distortions” or “maladaptive beliefs”, and they call themselves “therapists,” implying a more stongly curative role.
But the focus of the work for both kinds of practitioner is arriving at a shared understanding with the patient of those well-established patterns of thinking that are not aligned with the way things really are.
In CBT with a very wide range of patients, as in Laing’s work with schizophrenics, it often turns out that the underlying misalignment is an unintended consequence of purposeful and effective mystification by other family members (one of the causes of the effect I described in Partners).