Mental(izing) Health: How Do You Feel about Emotions?

Newsletter, #62

Provoked, terrified, outraged, and overwhelmed: you name it, I’m feeling it. Every day my emotions traverse vast territories, never lingering for long in one feeling, but piercing in their intensity. However desirable it might be to experience a multitude of emotions, in this case, there is a sense of foreboding, an underlying state of mind that is distraught, bewildered, and where greater intelligibility seems out of reach.

So much for emotion regulation. Emotion dysregulation prevails, from those in power, all the way down. My question for this month’s newsletter is: how can our understanding of emotions help us to negotiate the current crisis? Or maybe I ought to rephrase that more tentatively: can our understanding of emotions help us to negotiate the current crisis?

There has been a profusion of interest in emotions across almost all academic disciplines—the humanities, social sciences and the sciences. There has been less metathinking about what this means. In psychoanalysis, the interest in emotions served as a breakthrough, overcoming the never-ending debates about the primacy of drives. Even CBT has jumped on the bandwagon with emotions: given that “c” has already been added for cognition, why not go all the way, and add an “e” for emotion? In psychology proper, the related paradigms of emotion regulation and emotional intelligence have commanded much attention with tons of research, applicable to development, cognition, neuroscience, not to mention the clinical realm and beyond (parenting, sports, and business).

Not everyone is enamored with emotions. As I have discussed in a previous newsletter, some thinkers have weighed in with concerns about how “therapeutic culture” has come to dominate our understanding of social issues (https://elliot4cc.substack.com/p/mentalizing-health-2e1). A recent book by the UK based sociologist Ashley Frawley, Significant Emotions: Rhetoric and Social Problems in a Vulnerable Age, stresses the point that emotions have been embraced in a way that obscures, rather than supports efforts to grasp and solve social problems.[i] I do not entirely agree with Frawley’s take on emotions or therapy, but she presents arguments that are challenging and well worth pondering.

Let’s take a closer look. Frawley’s position is that the proliferating interest in emotions is an attempt to solve social and political problems by directing our attention to human subjectivity and thereby deflecting our attention away from material reality. In engaging with our emotions, our focus turns to the internal world as the domain of change, rather than external reality (p. 178). Frawley makes the intriguing point that Maslow’s hierarchy of needs is turned upside down, and she ultimately argues that material reality “is pushed gradually out of bounds” (p. 187). Frawley traces the emergence of therapeutic culture which features emotions, from the time of the Enlightenment, which had a more optimistic take on humans as rational, free-willed and possessing self-governing agency and which served as the basis for the model of liberal society in which our relationship to others was minimal, if we successfully monitor ourselves. With the modification that occurs in neo-liberal society, our obligations to one another decrease further, and we are discouraged from seeking help from others, like employers or the government, generating and deepening the crisis that therapeutic culture then attempts to solve, taxing the individual even more. Frawley follows various manifestations of therapeutic culture: the self-esteem movement in the 70s and 80s, followed by the emphasis on happiness in positive psychology in the 90s and 00s, and up to the the current fascination with mindfulness and well-being.

Here’s the key part: therapeutic culture suggests that our emotions are out of control and require us to manage them, ideally with the help of therapy or therapeutic practices. The autonomy promoted by the Enlightenment shifts to seeking and depending upon help from experts and gurus. As Frawley maintains, emotional well-being is seen as under threat, rather than being celebrated. In addition, “seemingly mundane and banal discomfort” is elevated “as a potential source of illness” (p. 147). Therapeutic culture, in this account, sets forth the problems and then attempts to provide the solutions. It’s not that Frawley regards the problems as non-existent; it’s that therapeutic culture does not live up to its promise.

Lots of questions can be posed about Frawley’s assertions. She never clarifies what emotions are, and she ignores social emotions that are a direct response to the external world. Frawley also misses the opportunity to link her arguments to recent approaches to emotions, like Feldman Barrett’s constructivist theory, which affirms how our understanding of emotions fits various cultural priorities.[ii] There is an ambiguity in Frawley’s account of emotions that can be glimpsed in her subtitle, which refers to our age as “vulnerable.” On the one hand, she wants to argue that we are less vulnerable than therapeutic culture encourages us to believe; on the other hand, she maintains that neo-liberalism has worsened our overall condition.

The term therapeutic culture is invoked with no specific effort to define its meaning. Frawley refers to related notions of “therapeutic culture,” “therapeutic vocabularies,” and a “therapeutic paradigm,” attributing to the latter a central impulse as “the depoliticization and individualization of social problems” (p. 21). Frawley is not invested in distinguishing therapeutic culture, as propagated by popularizers versus every day, hard-working clinicians, who are down in the trenches, and certainly understand the pressures that are generated from the world outside of therapy. Faddish technological versions of therapy can be completely at odds with how a well-trained professional would act (https://www.nytimes.com/2025/02/24/health/ai-therapists-chatbots.html). No mention is made of mental health professionals for whom connecting the internal with the external is a concern—like most practicing social workers, counseling psychologists, feminist and multicultural therapists, and relational psychoanalysts. As an overarching category, therapeutic culture obscures as much as it reveals.

In Frawley’s account, “conceptual entrepreneurs” figure prominently: people who develop, spread and profit from their therapeutic inventions. She cites the ludicrous sounding claim of Martin Seligman who declared that positive psychology chose him, he did not choose it, likening the experience to Moses and the burning bush (p. 61). Frawley investigates the example of mindfulness closely, especially how Jon Kabat-Zinn created a model that blended science, ancient wisdom and intuition, to enormous success. Frawley questions the evidence that exists in support of mindfulness as well as other controversial issues, like the spread of therapeutic culture into universities, including forging the claim about an alleged crisis in mental health, which she questions. She is astute in discerning how universities have made mental health central to their missions, shifting from away from freeing the minds of students to providing safety for them.

Frawley’s focus is more on various appropriations of therapy than on therapy in and of itself. She registers some awareness of this in referring to “therapeutic fads,” although she provides no counterexamples of therapeutic integrity. Hucksterism ought to bother us: there are many new iterations of therapy that are, in fact, money-making operations. Nevertheless, this should not obscure that psychotherapy has evolved to be more self-aware of how it dwells within culture, and more sensitive in dealing with minoritized patients for whom belonging is a loaded expectation.

For Frawley, dwelling on managing emotions is preoccupying and gets in the way of recognizing how neo-liberal society rewards people who belong to the dominant culture at the expense of others. She is right to signal how therapeutic culture can be unwittingly deployed to reinforce the success of the few over the many. I would agree that there is a liability, for example, in our constructs of emotional intelligence and emotion regulation as normative ways for privilege to be reinforced. However, I am not convinced that therapeutic culture necessarily fails and makes things worse, as Frawley suggests (p. 185). In any case, although Frawley’s book was published as recently as 2024, the world has been transformed in 2025 since the new administration has come into office in the US.

As I have written in previous newsletters, it is unclear what the stance of the Trump administration will be toward mental health (https://elliot4cc.substack.com/p/mentalizing-health-keeping-up-with). We can predict that the attitude will not be curious, generous or fair-minded. My suspicion is that antagonism toward therapeutic culture will increase, and that the administration will not see therapeutic culture as serving to further their aims. Here I should acknowledge that Frawley’s case is made primarily with the UK in mind, where the threat of authoritarianism is not as immanent, as in the US.

Frawley makes a point of noting the shift away from the affirmation of autonomy and self-reliance in the Enlightenment to the heteronomy of therapeutic culture, where we are encouraged to look to experts and gurus to tell us how to live. However, there is different connotation of heteronomy, which suggests an openness to value the input of others, an affirmation of relatedness, that does not have to entail either a rejection of autonomy or a subordination to others. Valuing both autonomy and relatedness explicitly lies at the heart of psychotherapy, as the work of Sid Blatt emphasizes.[iii] The foundational principle of psychotherapy is that others can see things about a person that the person fails to see. At the same time, all forms of psychotherapy support the expansion of agency as part of their aim. I am sure I am not alone in helping patients to develop a sense of agency that leads them to engage the external world more passionately and productively. Retreating from the world can be a means to the end of returning to engage the world in a rejuvenated spirit.

Although Frawley elaborates upon variations amongst Enlightenment thinkers, she does not consider the critique that is found in Horkheimer and Adorno, who turn to psychoanalysis to discern how the defense of rationality by Enlightenment thinkers has an underbelly of unacknowledged irrationality.[iv] The failure to acknowledge irrationality in the form of anti-Semitism was dangerous and turned lethal. Irrationality is inescapable for humans, regardless of the fate of therapeutic culture. We can grant Frawley that caring only about emotions is problematic; yet without ample consideration of emotions, we risk self-deception and disturbing outcomes.

The sins of neo-liberalism have produced our current reality that has become substantially worse under a law-breaking regime for whom nothing exists beside self-interest. Our emotions, no doubt, are confusing now, as we both knew and did not know what would ensue. Staying with our emotions, and riding out their vicissitudes, though, is a noble effort that requires space for inward reflection but that, we can hope, will lead us back to engage the social and political world.

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[i] A. Frawley (2024). Significant Emotions: Rhetoric and Social Problems in a Vulnerable Age. Bloomsbury.

[ii] L. Feldman-Barrett (2017). How Emotions are Made: The Secret Life of the Brain. Mariner.

[iii] S. Blatt, (2008). Polarities of Experience: Relatedness and self-definition in personality development, psychopathology, and the therapeutic process. APA.

[iv] M. Horkheimer and T. Adorno (1944/1972). Dialectic of Enlightenment. Continuum.