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ReviewofGeneralPsychology2014,Vol.18,No.3,208–215©2014AmericanPsychologicalAssociation

1089-2680/14/$12.00http://wendang.chazidian.com/10.1037/gpr0000012

CriticalPsychiatry,CriticalPsychology,andtheBehaviorism

ofB.F.Skinner

UniversityofNewBrunswick

Criticalpsychiatrysuggeststhatthecurrentlydominantmedicalmodelinpsychiatryoverstatesinternaldisturbanceandunderstatesenvironmentalstressorsasimportantcausalfactorsinpsychologicaldistress.Criticalpsychologysuggeststhatwhenindividualsexperienceproblemsinaculture,psychologyemphasizesindividual,ratherthancultural,change.ThisarticleprovidesabriefoverviewofcriticalpsychiatryandcriticalpsychologyandoutlineshowbothmovementsshareimportantepistemologicalsimilaritieswiththewritingsofB.F.Skinner,thefounderofradicalbehaviorism.Keywords:criticalpsychiatry,criticalpsychology,radicalbehaviorism,B.F.Skinner

MurrayJ.Goddard

ThisdocumentiscopyrightedbytheAmericanPsychologicalAssociationoroneofitsalliedpublishers.Thisarticleisintendedsolelyforthepersonaluseoftheindividualuserandisnottobedisseminatedbroadly.

Lossesdisguisedaswins(LDWs)arecommoninmodernvideoslotmachinesthatencourageplayerstobetonmultiplepaylinesandfollowanywinningcombinationwithflashinglightsandhigh-fidelityaudio,evenwhentheamountwonislessthantheamountwagered(Harrigan,Dixon,MacLaren,Collins,&Fugel-sang,2011).Asoneelderlygentlemannoted,“Ieventuallyreal-izedthatifIkeptonwinning,Iwasgoingtogobroke”(Dixon,Harrigan,Sandhu,Collins,&Fugelsang,2010,p.1824).

TheconceptofLDWsprovidesasalientillustrationofhowcriticalpsychiatry,criticalpsychology,andthebehaviorismofB.F.Skinnersharecommonground.Forexample,criticalpsychi-atrychallengesthedominantmedicalmodelbysuggestingthatproblematicgamblingmayhavelesstodowithinternal“pathol-ogy”andmoretodowiththeenvironmentalcircumstancespro-motinggambling(Reith,2007).Criticalpsychologyemphasizesthat,byfocusingonalteringproblematicgamblinginanindivid-ual,psychologypreservesthestatusquoanddeflectsattentionawayfromculturalpracticesthatmayencourage,andpromote,gambling(Griffiths,Parke,Wood,&Parke,2006).Finally,Skin-nerusedgamblingtoillustratethepowerofreinforcementsched-ulestomaintainbehavior,andhenotonlyresentedthegamblingindustrybutwasalsoangeredbypoliticianswhoraisedmoneythroughgamblinginitiatives(Knapp,1997;seealsoFantino,2008).Inanarticle,withuncharacteristicsarcasm,Skinner(1978b)suggestedthatperhapsthewealthycouldavoidpayingtaxesaltogether,iflotterieswereintroducedinGrade1classroomsandtherewardschedulewasgraduallyreducedinmagnitudeovertime.

ThepresentarticlefirstbrieflyoutlinesSkinner’sradicalbehav-iorism,withaparticularemphasisonthoseaspectsmostrelevanttosubsequentdiscussionsofcriticalpsychiatryandcriticalpsy-chology.Second,criticalpsychiatry’shistoryandconceptualfoun-dationsarebrieflyoutlinedbeforehighlightingtheepistemologicalsimilaritieswithSkinner’swritingsand,third,asimilarapproachfollowsforcriticalpsychology.Finally,thearticleconcludeswithasummarysection.

RadicalBehaviorism

Skinner’sradicalbehaviorismemphasizesafunctionallevelofanalysis(orselectionism)thatmaybecontrastedwithmain-streampsychology’semphasisonessentialism.Forexample,Schlinger(2003)discussedhowintelligencemaybeconceivedofasarelativelyfixedquantitythatindividualspossess(essen-tialism)orasasetofbehaviorsthatarisegivenaparticularsetoforganism–environmentinteractions(selectionism).Skinnerconsistentlyemphasizedthepragmaticadvantagesofselection-ism,aligningpsychologywithboththenaturalsciencesandDarwin’stheoryofnaturalselection(Skinner,1971;seealsoOyama,Griffiths,&Gray,2001).Further,essentialismhastheinherentdangersofcircularreasoningandreification,andmaycurtailinquiry,becauseessentialpropertiesaretreatedasgiv-ens,requiringnofurtherexplanation(Skinner,1950,1963).Essentialismmayalsoleadtotheproliferationofadditionaltheoreticalconstructs,particularlymentalisticconstructsthatarehypothesizedtoresidewithinautonomousman(Skinner,1971).Forexample,whenanessential-likestructure(e.g.,short-termmemoryoracademicintelligence)isunabletoexplaindivergentdata,additionalmemoriesorintelligencesareoftenadded,leadingtoendlessdebatesaboutwhetheraparticularbehavioris“really”evidenceforaparticulartypeofmemoryorintelligence(Palmer&Donahoe,1992;Schlinger,2003).Notably,youngchildrenrou-tinelyengageinessentialistthinking(Gelman,2004),andessen-tialismiscommonwhenordinarypeopleexplainhumanbehavior;forexample,unsavorybehaviormaybeexplainedbysayingthatapersonisa“pervert”(Malle,2004,p.162).

InarecentextensionofSkinner’sradicalbehaviorism,FieldandHineline(2008)notedthatpsychologicalphenomenaareintrinsi-208

MurrayJ.Goddard,DepartmentofPsychology,UniversityofNewBrunswick.

SupportedbyasabbaticalleavefromtheUniversityofNewBrunswick,SaintJohnandtheNaturalSciencesandEngineeringResearchCouncilofCanada(Grant42025).IthankVanceMacLarenforhisinsightsonmodernvideoslotmachinesandMarilynMacLeodforhersupport.

CorrespondenceconcerningthisarticleshouldbeaddressedtoMurrayJ.Goddard,DepartmentofPsychology,UniversityofNewBrunswick,SaintJohn,NB,Canada,E2L4L5.E-mail:

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callytripolar,involvinganorganism,theenvironment(bothpres-entandpast),andwhatanorganismdoes(theorganism’sbehav-ior).Typically,psychologyprivilegesorganism-based(ratherthanenvironment-based)explanationsofbehaviorthatpreservetheprincipleofcontiguouscausationcharacteristicof17thcenturyscience.Toalignwithcontemporarydevelopmentsinscience,psychologymustabandon“dispositioning”andfocusontheen-vironmentalsideoftheorganism–environment?behavioraltriad,asemphasizedinSkinner’sradicalbehaviorism(Field&Hineline,2008).

GivenSkinner’sfocusontheenvironmentalcontributionstobehavior,Skinneralsoadvocatedforculturalchangetoimprove.

humanwelfare.Forexample,SkinnerdiscussedthedesignofayldabettercultureandtheproblemofcontrolinScienceandHumanorbBehavior(Skinner,1953)andspeculatedaboutautopiansocietyindeWaldenTwo(Skinner,1976;seealsoAltus&Morris,2009).taniFurther,Skinner(1986)describedfivedetrimentalculturalprac-meticesin“WhatisWrongWithDailyLifeintheWesternWorld?”ssidandaddressedpsychology’sfailuretoinstituteculturalchangeinebboth“WhyWeAreNotActingtoSavetheWorld”(Skinner,to1987b)and“AreWeFreetoHaveaFuture?”(Skinner,1978a).tonUnfortunately,althoughSkinnerwasinitiallyoptimisticaboutthesipowersofbehavioralanalysistosolvethemajorproblemsfacingdnahumanity,hebecamelessoptimisticlaterinlife(Chance,2007).resCriticalpsychologyalsoadvocatesforculturalchange,andtheulastepsusedbycriticalpsychologytoadvanceculturalchangeudisometimesshowstrikingsimilaritieswithSkinner’sradicalbehav-vidiorism.

niethfoCriticalPsychiatry

esulaPsychiatryisprobablyuniquewithinthehealthcaresystemofnogeneratingextensivescholarlycriticisminadditiontoangerandsrepoutragefromthepeoplecontactingpsychiatricservices,someofewhomidentifyas“psychiatricsurvivors”(Bracken&Thomas,thro2009).Inpart,thiscriticismandangermaybetracedbacktothefyl1980publicationoftheDiagnosticandStatisticalManualofeloMentalDisorders,ThirdEdition(DSM-III),inwhichbehavioralsdesymptomsweretransformedfrombroadfailurestoadapttothedneenvironment(thatwerecontinuouswithnormality)toentitiestnireflectinganunderlyingdiseaseprocess(Mayes&Horwitz,2005;siseealsoConrad&Barker,2010).NotethatthepublicationofelciDSM–IIIusheredinatransformationfromaperspectivethattraresembledSkinnerianselectionismtoaperspectivethatresembledsihTpsychologicalessentialism.

AlthoughDSM–IIIradicallytransformedmentalhealth,psychi-atryhadbeenthetargetofextensivescholarlycriticismlongbeforeDSM–III(Double,2002).Forexample,http://wendang.chazidian.coming(1965)suggestedthatdysfunctionalrelationships(ratherthanbiology)werecriticalinmentalhealthand,inastudyresemblingaSkin-nerianfunctionallevelofanalysis,LaingandEsterson(1970)foundthathighexpressedemotioninafamily(consistingofhostility,emotionaloverinvolvement,andcriticism)likelycontrib-utedtothedistressanddisorderedbehaviorinapersonsubse-quentlylabeledwithschizophrenia(seealsoModrow,2003).Dysfunctionalfamilyrelationshipsmayalsobeexpressedinin-formalnurse’scomments,suchas“Ithinkwe’vegotthewrongoneinhere”(Johnstone,2000,p.75).

InadditiontoLaing,ThomasSzaszwasalsoarelentlesscriticofpsychiatry(Szasz,1970,1974).Forexample,Szasz(1974)suggestedthat,intheabsenceofabiologicalmarker,“mentalillness”waslikelyametaphorand(echoingSkinner’sfocusonorganism–environmentinteractions)suggestedthat“problemsinliving”wasamoreaccurateandusefulmetaphor(seealsoJoseph,2011;Sarbin,1990).Szasz(1970)alsocomparedcurrentbeliefsintherealityofpsychiatriclabelswithmedievalbeliefsintherealityofwitchcraft.

Today,criticalpsychiatryemphasizesthatnobiologicaltestcanconfirmanypsychiatriclabelandtheformerchairoftheDSM–IVTaskForcehaspredictedthattheincorporationofbiologicaltestsinpsychiatricdiagnosiswillapplytoonlyasmallpercentageofindividuals(Frances&Widiger,2012).Withonlyasmallpercent-ageofindividualshavingabiologicaldysfunction,thiswouldexplainwhytheevidencesupportingageneticbasisformanypsychiatriclabelsisweak(Joseph,2006)andwhydimensionalstructuredifferencesbetweenclinicalandnonclinicalrespondents,onpublisheddatafromseveralpersonalityandpsychopathologyinventories,weresorarethat“onewouldbehardpressedtoargueagainsttheoverallpatternofsimilarity”(O’Connor,2002,p.974).Giventhatonlyasmallpercentageofindividualsmayhaveabiologicaldysfunction,criticalpsychiatryemphasizesthatemo-tionaldistressanddisorderedbehaviorpredominantlyarisefromenvironmentalfactors,likeincomeinequality(Albee,2005),andthatthelargenumberoftherapistsinWesternculturesmaybeasignofaculturaldefect(Pande,1968).ThisisconsistentwithSkinner’spositionthatemotionaldistressanddisorderedbehaviorpredominantlyarisefromenvironmentalfactorsandthattherapistsshouldexploreenvironmentalfactorsfirstwheninstitutingtreat-ment(Skinner,1961b).Evenunusualbehaviors(likehearingvoices)mayresultbecause“positivereinforcementforvoicehear-ingincludescompanionship,comfort,positiveguidance,andspir-itualenlightenment”andnegativereinforcementincludes“remov-ingresponsibilityorthestressofhavingtomakeindependentdecisions”(Boyle,2006,p.196).ThepossibleinvolvementofpositiveandnegativereinforcementinhearingvoicesconvergeswithSkinner’spositionthatunusualbehaviorsmaybe“simplytheresultofahistoryofreinforcement”(Skinner,1961b,p.198;seealsoFlora,2004;Richelle,1993,p.156).

Notealsothatsomepsychiatriclabels(e.g.,compulsivebuyingdisorderorpyromania)resemble“dispositioning”andhaveadis-tinctlyessentialistflavor(Haslam&Ernst,2002).Consequently,psychiatriclabelsmaybesocialconstructionsratherthantrueentitiesreflectinganunderlyingbiologicaldysfunction(Horwitz,2002).Notably,Guerin(1992)presentedabehavioranalysisofsociallyconstructedknowledgethatwasbasedonSkinner’s(1957/1992)functionalanalysisofverbalbehavior.Thatis,becauseculturaltermsmayarisefrominteractionswithotherpeople(ratherthanfromthenonsocialenvironment),thereisagreatpotentialformodernsocietiestomaintaincounterfactualknowledgebecausebehaviorisbecomingmoreverbalandthecontrolsonverbalbehaviorarebecomingdetachedfromnonsocialenvironmentalcontrols.

Guerin’s(1992)behavioranalysisofsociallyconstructedknowledgeisrelevanttocriticalpsychiatry.Forexample,inastatementthatmighthavebeenmadebySzasz(1970),theculturaldominanceofmedicalmodelsmakesitdifficultformanypeopletothinkoutsidethem:“ratherlikeaskingmedievalEuropeansto

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thinkaboutaworldwithoutkingsorqueens”(Boyle,2006,p.191).Konner(2008)hasalsosuggestedthatpeoplemayhaveagreatdealofresiliencybecausehumanevolutionaryhistorywaslikelycharacterizedbydisease,animalattacks,famine,andhomi-cide.However,mentalhealthinterventions,whichareroutinelyencouragedafterapotentiallytraumaticexperience,mayinadver-tentlyconveytopeoplethatrecoveryovertimeisnotatypicalhumanresponsetotrauma(Konner,2008).Finally,Watters(2010)haspresentedevidencethatpharmaceuticalcompanieshaveat-temptedtoreplaceindigenousunderstandingsofmentalhealth,withWesternmedicalmodels,thatmorereadilytranslateintoprofitabledrugtreatments.

.

LikeSkinner,criticalpsychiatryalsoemphasizesthedangersofyldreification,thatis,thedangersofbelievingthatanypsychiatricaorlabel(includingschizophrenia)mustbeanentityhavinganinde-bdpendentexistence(Jacobs&Cohen,2010;seealsoBarrett,1996;etanBoyle,2002;Romme&Escher,2000;Sarbin&Mancuso,1980).imeAspreviouslynotedinthesectiononRadicalBehaviorism,Skin-ssiner(1950)waswellawareofthedangersofreificationanddebcautionedthatpsychologistsfrequentlypostulate“eventstakingtoplacesomewhereelse,atsomeotherlevelofobservation,de-tonscribedindifferentterms,andmeasured,ifatall,indifferentsidimensions”(p.193).Further,Skinner(1961c)expressedconcernsdnthathypothesizedinnerentitiesinpsychiatry“abandonthetech-areniquesofmeasurementwhichwouldotherwisebeanaturalheri-sutagefromearlierachievementsinothersciences”(p.210).

laudCriticalpsychiatryalsosuggeststhattheexpandednumberofivipsychiatriclabels(fromabout100inDSM-Itoabout400indniDSM-5)raisesthepossibilitythatpsychiatriclabelsareinventedethratherthandiscovered(Houts,2002;seealsoMarecek&Hare-foMustin,2009;Pérez-Álvarez&García-Montes,2007).Recallthatesuanexpandednumberoftheoreticalconstructswasalsoaproblemlanwiththeessential-liketermsthatwerecommoninintelligenceandosrmemoryresearch(Palmer&Donahoe,1992;Schlinger,2003).epSimilarly,Skinnernotedthat“Freuddidnotdiscoverthementalethapparatusbutratherinventedit”(Skinner,1961a,p.186),androfSkinnercautionedthat“psychotherapyisrichinexplanatoryfic-yletions.Behavioritselfhasnotbeenacceptedasasubjectmatterinlositsownright,butonlyasanindicationofsomethingwrongdesomewhereelse”(Skinner,1953,pp.372–373).

dneCriticalpsychiatryalsoemphasizesthatdifferencesinpower,tnibetweenpsychiatristsanddistressedpeople,mayresultinmis-sietreatment(Rosenhan,1973;seealsoGoddard,2011).Skinnerlcit(1974)alsoemphasizedthatdifferencesinpowermayresultinrasmistreatment,particularlymistreatment“oftheveryyoung,oftheihTaged,ofprisoners,ofpsychotics,andoftheretarded”(pp.210–211).Forexample,prepubertalyouthmaybereceivingasmanyassevenconcurrentpsychiatricdrugs,althoughtherearelimiteddataondrugsafetyandefficacy,becausestudiestypicallyuseadultsamples(Safer,Zito,&dosReis,2003).Previouslydistressed,butfullyrecovered,adultshavealsoreportedthatpsychiatristserro-neouslypredictedtheywouldlosecustodyoftheirchildren,wouldneverholdajob,orwouldbeonmedicationforever(Hagen&Nixon,2011).

Cliniciansmayalsonotbeoverlyfamiliarwiththe400(orso)hypothesizedpsychiatriclabels;forexample,inasampleofmentalhealthprofessionals(thatincluded20licensedpsychiatristsand20licensedpsychologists),onlyabout22disorderscouldberecalledbyatleast25%ofparticipants(Ahn,Proctor,&Flanagan,2009).Finally,accuratediagnosismaynotnecessarilyevenbenefitdis-tressedpeoplebecausepsychiatristsmight“debatethefinepointsaboutthecorrectdiagnosisforadisturbedclient,butalwayswouldprescribeHaldolregardlessoftheoutcomeofthediagnosticde-bate”(Kirk&Kutchins,2008,p.235).

Skinner(1953)wasalsocriticaloftheuseofdrugsorelectricshockinpsychiatrythatwerenotfarremovedfromtheideathat“theDevilorsomeotherintrudingpersonalityisintemporary‘possession’ofthebody”(p.374).Skinneralsoexpressedcon-cernsthatshocktherapymayhavebegunasaversivecontrol(seeEpstein,1980,pp.6–7),supportingevidencethat,althoughshocktherapywasaterrifyingexperience,somepeoplewerefearfulthatexpressinganymisgivingsmightannoytheirpsychiatristandprolongtheirconfinement(Johnstone&Frith,2005).SkinnerandVaughan(1983)alsonotedthatalthough“Americantakebillionsofpillseveryyear...drugsthatmakeyoufeelbettercankeepyoufromattackingtheconditionthatmakesyoufeelbad”(p.118;seealsoFlora,2007).

CompareSkinner’scriticismstorecentevidencethat,althoughpsychiatrypromotesthemetaphorthatdrugsareliketakinginsulinfordiabetes,drugsmayactuallybeliketakingalcoholforsocialanxiety(Moncrieff,2009).Further,“themisconceptionthatmentalillnesscanbecuredbydrugsdiscouragestheprovisionofdecentservices”(Moncrieff,2009,p.240;seealsoWhitaker,2010).Drugcompaniesmayalsosuppressdatashowingharmfulsideeffects(Breggin,2006),andtheremaybeconflictsofinterestinpsychi-atry.Forexample,someshocktherapyresearchershaveheldsharesinthecompaniesthatmarketedtheshockmachines(Andre,2009).TheformereditorofTheNewEnglandJournalofMedicinenotedthatbecausetheU.S.FoodandDrugAdministrationre-quiresonlythatanewdrugshowshort-termbenefitrelativetoplacebo,thelong-termdrugeffectsareoftenunknownandthereisagenuinepossibilitythatanewdrugmaybeinferiortoanolderdrugortreatment(Angell,2005).Inastudythatcomparedthreenewbloodpressuredrugswithagenericdiuretic(thathadbeenonthemarketforover50years),thenewdrugswerenomoreeffectivethanthediureticatloweringbloodpressure,andtheyhadmoredangeroussideeffects(Angell,2005,p.96;seealsoHealy,2012).

Asisgenerallywellknown,Skinner(1938,1963)alsoadvo-catedwithin-individualdesignsthatintenselystudiedafewsub-jectsratherthanthemultiple-subjectdesignsthatarecommoninpsychology(O’Donohue,Callaghan,&Ruckstuhl,1998).InSkin-ner’s(1966)words“insteadofstudyingathousandratsforonehoureach,orahundredratsfor10hourseach,theinvestigatorislikelytostudyoneratforathousandhours”(p.21).

Similarly,standardpsychiatricstudies,usingmultiple-subjectdesigns,mayignoreindividualpatient’saccountsoftheirlivedexperiences(Hornstein,2009).Althoughthereareover600first-personaccountspublishedinEnglishalone,first-personaccountshavebeenlargelyignoredbypsychiatricresearchers(Adame&Hornstein,2006).First-personaccountsmayalsochallengemed-icalmodels;forexample,in-depthinterviewsshowthatdepressioninwomenmaybeaproductofsocial,political,andinterpersonalrealities,ratherthanaproductofneurochemicaldysregulation(Lafrance,2009;seealsoStoppard,1999,2000).Onepsychiatristcandidlyadmittedthatheactuallyknewverylittleabouthispatient’slivesbecausemosttherapysessionsconsistedofa15-min“medcheck”(Carlat,2010,p.11).Consequently,psychiatricprac-

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ticemaymakeitlesslikelythatanallianceformswithanempa-thetictherapistthatmaybecriticalfortherapeuticprogress(Wampold,2001).

Finally,understatingenvironmentalstressorsinpsychiatrymaybedueto“culturalassumptionsabouttheprimacyoftheautono-mousindividual”(Boyle,2011,p.34).Further,becauseadiseasereferstoaprocesswithinthebodyofanindividual,psychiatricsymptomsare“conceivedtobeapartofasystemofbehaviorthatislocatedentirelywithinthepatientandthatisindependentofthesocialcontext”(Scheff,2007,http://wendang.chazidian.comparethesecommentswithSkinner’sviewthatascienceofhumanbehaviorproceedsby“questioningthecontrolexercisedbyautonomousman”(Skinner,.

1971,p.19)andthatanexperimentalanalysis“shiftsthedeter-yldaminationofbehaviorfromautonomousmantotheenvironment”orb(Skinner,1971,p.205).

detanimCriticalPsychology

essidCriticalpsychologysuggeststhatcurrentculturalpracticesmayebbedetrimentaltohumanwell-beingandthatpsychologistsmaytotpreservethestatusquobyfocusingonindividual,ratherthanoncultural,change(Fox,Prilleltensky,&Austin,2009).CriticalsidpsychologybuildsonFromm’s(1965)dualconceptionoffreedomnaasbeingfreefromsocialandpsychologicaloppressionandbeingresufreetopursueimportantlifegoals(Austin&Prilleltensky,http://wendang.chazidian.comTherootsofcriticalpsychologymayalsobetracedtotheudivFrenchphilosopherMichelFoucault,whofamouslyarguedthatidnknowledgewasintimatelyconnectedwithpowerandthatapow-ieer?knowledgenexusdetermineswhatbehaviorsaredesired,howthfoobjectsandpeoplearetobeunderstood,andhowdeviantindivid-esualsaretobecorrectedanddisciplined(Foucault,1980).NotetheulasimilaritybetweenFoucault’sideaswithpreviouslydiscussedev-noidence,intheCriticalPsychiatrysection,thatthepowerfulphar-srepmaceuticalindustrymaybealteringindigenousunderstandingsofementalhealthforfinancialgain(Watters,2010).Foucault’sdis-throcussionofpoweralsosharessomesimilaritywithSkinner’scon-fylceptofcountercontrol,inwhichindividualsmayopposeaversiveelocontrolthroughnegativereinforcement,suchasbyescaping,at-sdetacking,orpassivelyresisting(Skinner,1974).Foucault’sideasarednealsorelevanttoevidencefromcriticalpsychologythatsomepio-tnineersinintelligencetestingmayhavebeenmotivatedbyracialsiprejudice(Kamin,1974)orthattheacademiccontributionsofelcifemalepsychologistshadbeenneglectedinstandardpsychologytratextbooks(Scarborough&Furumoto,1987).

sihTCriticalpsychologyemphasizesthatacademicworkinpsychol-ogyisnotwellalignedwithaction-orientedsocialjusticeinitia-tives,andcriticalpsychologyoftenasksthequestion“Whatispsychologytodo?”(Prilleltensky,2012,p.617).Criticalpsychol-ogyalsonotesthatculturalchangemayrequirebehavioralchangebecause“changingbeliefswithoutaccompanyingbehaviorsisfutile”(Prilleltensky,2012,p.622)andthat“awarenessisgood,butactionisbetter”(Fox,2003,p.299).Further,ifpeopleaskwhatreinforcesthemtoparticipateinculturalchange,peoplecanimprovetheireffortsby“analyzingantecedents,behaviors,andconsequences”(Prilleltensky,2012,p.621).Criticalpsychologyalsosuggeststhatbecauseourownsocietymayfallshortofhistoricalandtheoreticalalternatives,itisevenhelpfulto“spec-ulateaboututopiansocieties”(Fox,1993,p.239).

AspreviouslydiscussedintheRadicalBehaviorismsection,thereislittledoubtthatSkinneradvocatedculturalchangetoimprovehumanwell-being(Skinner,1953)andSkinnerspeculatedaboutautopiansocietyinWaldenTwo(Skinner,1976).Skinnerwouldalsoagreewithcriticalpsychology’sfocusonbehavioral(ratherthanbelief)changesbecause“changingamind...isanineffectivewayofchangingbehavior”(Skinner,1971,pp.91–92)and“psychologyhasremained...primarilyasearchforinternaldeterminers”(Skinner,1987a,p.780).Ofcourse,criticalpsychol-ogy’semphasisonbehavioralchangebyanalyzingantecedents,behaviors,andconsequenceswasSkinner’sbasicunitofanalysisandSkinner’sconstantsearchforwaystochangehisownbehaviorwas“alifestyle”(Epstein,1997,p.547;seealsoBjork,1993;Smith,1992;Vargas,2004).

Asmightbeexpected,theremayalsobeacertaindegreeofoverlapbetweencriticalpsychiatryandcriticalpsychology.Forexample,aconsumerculturethatcreatesanethosofwinnersandlosers,coupledwithincomeinequalityandparentaldivorce,maypartlycontributetoincreasedchildhooddistress(Timimi,2010).Medicalizingthisdistresswithalabel(likeattention-deficit/hy-peractivitydisorder[ADHD])may,however,bemoreofaquick-fixsolutionthatisencouragedbydrugcompanies(Timimi,http://wendang.chazidian.commondrugtreatmentsforADHD(usingpsychostimulantslikemethylphenidate[Ritalin])mayalsocauseadverseneuronalchangesinhumans(Andersen,2003)andprolongedmemoryim-pairmentsinrats(LeBlanc-Duchin&Taukulis,2007).Thus,ADHDmaybeasocialconstruction(asnotedbycriticalpsychi-atry),butincreasedlabelingmayreflectgenuineincreasesinchildhooddistresscausedbydetrimentalculturalpractices(asnotedbycriticalpsychology).

CriticalpsychologyisperhapsmostconcernedwithaNorthAmericanindividualisticworldview,encouragingcompetitivenessandconsumerism,whichmaybeharmfultohumanrelationshipsandasustainableplanet(Fox,Prilleltensky,&Austin,2009).Skinnersharedtheseconcerns,suggestingthatcompetitivenessandconsumerismmayleadtowar,overconsumption,and,poten-tially,humanextinction(Skinner,1971).“Thatmanypeoplehavebeguntofindarecitalofthesedangerstiresomeisperhapsanevengreaterthreat”(Skinner,1987b,p.1).

Skinnersuggestedthatbecausepeoplearepredominantlysocialcreatures,socialcontrolmaybeexercisedbydirectface-to-facecontactwhenallindividualshaveessentiallythesamepower(Skinner,1978c).Researchshowingthatconformityandsocialinfluencepowerfullyaffecthumans,possiblyoutsideintrospectiveawareness(Pronin,2008),supportsSkinner’sposition.However,Skinner(1978d)notedthatbecausepowerisconcentratedinthosewithmoney,anintroductionofamaximumwagelaw(incombi-nationwithaminimumwagelaw)maybeprudent.EchoingtheconcernsofFoucault(1980),Skinner(1987b)wasparticularlyconcernedaboutpowerfulfinancialinterestsinfluencinggovern-mentpolicy“fortheirownaggrandizement...inconflictwiththefutureofthehumanspecies”(p.7).SharingSkinner’sconcerns,Chomsky(2003)alsoarguedthattheU.S.governmenthas“per-sistedinundermininginternationaleffortstoreducethreatstotheenvironmentthatarerecognizedtobesevere,withpretextsthatbarelyconcealedtheirdevotiontonarrowsectorsofprivatepower”(p.3).

Inaddition,consistentwithSkinner’sviewthat“behaviormaybeextensivelymodifiedbyvariablesofwhich...thesubjectis

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neveraware”(Skinner,1963,p.957),therearenowalsomanysurprisingfindingsofhumanbehaviorsunconsciouslyinfluencedbyenvironmentalfactors(Goddard,2009).Ascriticalpsychologyexpandsintoareaslikehealth,social,andpersonalitypsychology,criticalpsychologistsmaybenefitfromanappreciationthatenvi-ronmentalfactorscaninfluencehumanbehavioroutsideconsciousintrospectiveawareness.

Forexample,eatingmaybeunconsciouslyinfluencedbyadver-tising(Harris,Bargh,&Brownell,2009)andthefoodindustryspendsapproximately$10billionannuallytopromoteprimarilyunhealthyfoodstochildrenandyouth(Brownell&Horgen,2004).Further,becausefoodcostsarelow,relativetolaborandprocess-.

ing,competitionencourageslargerportions,orvalue-sizepricingyld(alowerpriceperunitforlargerportions),toincreasemarketshareaor(Young&Nestle,2012).Smallincreasesindishwaresizemaybdalsoincreasecaloricintake(Pratt,Croager,&Rosenberg,2012)etanandtraditionalsocietiesundergoingWesternizationroutinelyshowimeweightgain(Brown&Konner,1987).Artificialsweeteners(likessisaccharine)mayalsoparadoxicallycauseweightgainbydisrupt-debingfundamentalhomeostaticprocesses(Swithers&Davidson,to2008).Thus,consistentwithSkinner’semphasisthatenvironmen-tontalfactorspowerfullyinfluencehumanbehavior,anappreciationsithatunhealthyeatingmaybepowerfullyinfluencedbyenviron-dnmentalfactorshelpstoredressmainstreamhealthpsychology’sarehighlydispositionalapproach(Chamberlain&Murray,2009;seesualsoWansink,2013).

laudAconsumerculturemayalsocreatehumanneedsratherthanivifulfillthem(Leatherman&Goodman,2005).Forexample,salesdniwerepoorwhenblackpearlswerefirstintroduced,butsalesethincreasedwhenpricesweresubstantiallyraised,possiblybecausefoonlywealthyconsumerscouldthenaffordthecommodity(seeesuAriely,2008,pp.23–25).Skinneralsoexpressedconcernsthatlanpeoplearepreparedtodealwithcoerciveculturalpractices,butosrmaynotobjecttoother,possiblymorepowerfulanddangerous,epbehavioralcontroltechniques,suchasmediainfluences(Rogers&ethSkinner,1956).InastatementthatmighthavebeenmadebyrofFoucault(1980),ChomskyalsosharedSkinner’sconcernsas“theylemediaserve,andpropagandizeonbehalfof,thepowerfulsocietallosintereststhatcontrolandfinancethem”(Herman&Chomsky,de2002,p.xi).Guerin(1992)alsoemphasizedthemedia’sabilitytodnemaintaincounterfactualknowledge,intheabsenceofasocialtnigroup(seealsoPollay,1986),andcriticalpsychiatryhasexpressedsieconcernsabouttheaccuracyofpharmaceuticaladvertisementsonlcittelevision(Achamallah,2011)andinleadingmedicaljournalsras(Valenstein,1998,pp.197–199).

ihTFinally,capitalistassumptionsthatcertainabstractconcepts(likegrossdomesticproduct[GDP])mirrorhumanwell-beingmaybemisleading,becauseGDPriseswhentherearemorecarcrashes(Anielski,2007).Thepotentialproblemofabstractconcepts(likeGDP)wasalsopointedoutbySkinner,whonotedthatabstractconceptscanleadtooversightsanderrors,particularlywhentheabstractionsareseparatedfromtheoriginal,specific,concretereferents(Grant,2012).

GiventhatmanypsychologistsmayalsobeimmersedinaNorthAmericanindividualisticworldview,perhaps,inhindsight,itshouldcomeaslessofasurprisethatsometheoriesinpsychologycontainanimplicitassumptionofhumanautonomy(Baum&Heath,1992).Skinneralsospeculatedthat,althoughaculturemayhaveinitiallygainedagreatdealbyemphasizingthatindividuals

areincontroloftheirbehavior,itispossiblethatsuchaphilosophy“hasremoteconsequenceswhichwillprovetobedangerous”(seeCatania&Harnad,1988,p.487).

Further,someempiricalresults,likethecommonfactors(or“Dodobird”)effectintherapy,maybequitedifficultformanypsychologiststoaccept(Wampold,2001).Surely,ifadistressedpersonwaslikeacarthatneededtobefixed,somemethodsofrepairwouldbebetter(orworse)thanothers?Whatpsychologistsmaybemissingisthatahumanmayactuallybeaveryoddcarthatmayfailtostartproperlyunlessyouparkitinthevicinityofothercars.Empiricalevidencethathumanverbalbehaviorisuncon-sciouslyinfluencedbysocialrewards(likesmilingorattention)isalsodifficulttoaccommodateinaworldviewwithanimplicitassumptionofhumanautonomy(Krasner,1958;seealsoGuerin&Miyazaki,2006;Schlinger,2008;Skinner,1957/1992).

SummaryandConclusion

Criticalpsychiatrysuggeststhatpsychiatriclabelsmaybesocialconstructionsandthatpsychiatryoverstatesinternalpathologyandunderstatesenvironmentalstressorsasimportantcausalfactorsinemotionaldistress.Similarly,Skinnersuggestedthatpsychiatricla-belsmaybe“explanatoryfictions”andthatemotionaldistressmaybeaproductofextremeenvironmentalconditions.CriticalpsychiatryalsosharesSkinner’sconcernsthattheuseofdrugs(orelectricshock)maybeharmfulandthatdifferencesinpower(betweenpsychiatristsanddistressedpeople)mayresultinmistreatmentandinsufficientattentiontoindividuallifecircumstances.

Criticalpsychologysuggeststhatpsychologymustbetteradvo-cateforculturalchangeandthatspeculationaboutautopiansocietyishelpful.Similarly,SkinnerwasapowerfuladvocateforculturalchangeandspeculatedaboutautopiansocietyinWaldenTwo.CriticalpsychologyalsosharesSkinner’sconcernsthaten-vironmentalfactorspowerfullyinfluencehumanbehaviorandthatcompetitionandconsumerismmayharmhumanrelationshipsandasustainableplanet.

Finally,whatarethepossiblebenefitsofalertingacademicstotheextensiveoverlapbetweenSkinner’sradicalbehaviorismandcriticalpsychiatryandcriticalpsychology?First,behavioranalystsmaybeencouragedtoparticipateincriticalpsychiatry’seffortstoreformDSM-5.Indeed,theobjectionstopsychiatricdiagnosisarenowsowidespread(andwellrehearsed)thatthemainchallengeforsocialscienceistoexplainhowandwhypsychiatricdiagnosishasmanagedtosurvive(Pilgrim,2007).

Second,criticalpsychology’seffortstochallengedetrimentalculturalpracticesmaybeimprovedbyincreasedfamiliaritywithSkinner’swritingsandtheextensivebehavior-analyticliterature.Behavioranalystsmayalsobealertedtorelevantresearchincriticalpsychologythatmaynotbepublishedinstandardbehavioranalyticjournals.Persistent,andharmful,culturalpracticesmayhaveagreatdealofinertia,andthecollaborationbetweenbehavioranalystsandcriticalpsychologistsmaybehelpfulininstitutingmeaningfulculturalchange.

Third,althoughmanyacademicsmayconsiderSkinner“history,”thisviewmaybefundamentallyalteredwhencomparisonsshowstrikingepistemologicalsimilaritiesbetweenSkinner’swritingsandcontemporarytopicsthatareofinteresttomanypsychologists.Forexample,Skinnerianbehaviorismsharesimportantsimilaritieswithpositivepsychology(Adams,2012)andcurrentempiricalresearchin

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