Critical Psychiatry, Critical Psychology, and the Behaviorismof B. F. Skinner

    Murray J. GoddardUniversity of New Brunswick

    Critical psychiatry suggests that the currently dominant medical model in psychiatry overstates internaldisturbance and understates environmental stressors as important causal factors in psychological distress.Critical psychology suggests that when individuals experience problems in a culture, psychologyemphasizes individual, rather than cultural, change. This article provides a brief overview of criticalpsychiatry and critical psychology and outlines how both movements share important epistemologicalsimilarities with the writings of B. F. Skinner, the founder of radical behaviorism.

    Keywords: critical psychiatry, critical psychology, radical behaviorism, B. F. Skinner

    Losses disguised as wins (LDWs) are common in modern videoslot machines that encourage players to bet on multiple pay linesand follow any winning combination with flashing lights andhigh-fidelity audio, even when the amount won is less than theamount wagered (Harrigan, Dixon, MacLaren, Collins, & Fugel-sang, 2011). As one elderly gentleman noted, “I eventually real-ized that if I kept on winning, I was going to go broke” (Dixon,Harrigan, Sandhu, Collins, & Fugelsang, 2010, p. 1824).

    The concept of LDWs provides a salient illustration of howcritical psychiatry, critical psychology, and the behaviorism ofB. F. Skinner share common ground. For example, critical psychi-atry challenges the dominant medical model by suggesting thatproblematic gambling may have less to do with internal “pathol-ogy” and more to do with the environmental circumstances pro-moting gambling (Reith, 2007). Critical psychology emphasizesthat, by focusing on altering problematic gambling in an individ-ual, psychology preserves the status quo and deflects attentionaway from cultural practices that may encourage, and promote,gambling (Griffiths, Parke, Wood, & Parke, 2006). Finally, Skin-ner used gambling to illustrate the power of reinforcement sched-ules to maintain behavior, and he not only resented the gamblingindustry but was also angered by politicians who raised moneythrough gambling initiatives (Knapp, 1997; see also Fantino,2008). In an article, with uncharacteristic sarcasm, Skinner(1978b) suggested that perhaps the wealthy could avoid payingtaxes altogether, if lotteries were introduced in Grade 1 classroomsand the reward schedule was gradually reduced in magnitude overtime.

    The present article first briefly outlines Skinner’s radical behav-iorism, with a particular emphasis on those aspects most relevantto subsequent discussions of critical psychiatry and critical psy-chology. Second, critical psychiatry’s history and conceptual foun-dations are briefly outlined before highlighting the epistemologicalsimilarities with Skinner’s writings and, third, a similar approachfollows for critical psychology. Finally, the article concludes witha summary section.

    Radical Behaviorism

    Skinner’s radical behaviorism emphasizes a functional levelof analysis (or selectionism) that may be contrasted with main-stream psychology’s emphasis on essentialism. For example,Schlinger (2003) discussed how intelligence may be conceivedof as a relatively fixed quantity that individuals possess (essen-tialism) or as a set of behaviors that arise given a particular setof organism– environment interactions (selectionism). Skinnerconsistently emphasized the pragmatic advantages of selection-ism, aligning psychology with both the natural sciences andDarwin’s theory of natural selection (Skinner, 1971; see alsoOyama, Griffiths, & Gray, 2001). Further, essentialism has theinherent dangers of circular reasoning and reification, and maycurtail inquiry, because essential properties are treated as giv-ens, requiring no further explanation (Skinner, 1950, 1963).

    Essentialism may also lead to the proliferation of additionaltheoretical constructs, particularly mentalistic constructs that arehypothesized to reside within autonomous man (Skinner, 1971).For example, when an essential-like structure (e.g., short-termmemory or academic intelligence) is unable to explain divergentdata, additional memories or intelligences are often added, leadingto endless debates about whether a particular behavior is “really”evidence for a particular type of memory or intelligence (Palmer &Donahoe, 1992; Schlinger, 2003). Notably, young children rou-tinely engage in essentialist thinking (Gelman, 2004), and essen-tialism is common when ordinary people explain human behavior;for example, unsavory behavior may be explained by saying that aperson is a “pervert” (Malle, 2004, p. 162).

    In a recent extension of Skinner’s radical behaviorism, Field andHineline (2008) noted that psychological phenomena are intrinsi-

    Murray J. Goddard, Department of Psychology, University of NewBrunswick.

    Supported by a sabbatical leave from the University of New Brunswick,Saint John and the Natural Sciences and Engineering Research Council ofCanada (Grant 42025). I thank Vance MacLaren for his insights on modernvideo slot machines and Marilyn MacLeod for her support.

    Correspondence concerning this article should be addressed to Murray J.Goddard, Department of Psychology, University of New Brunswick, SaintJohn, NB, Canada, E2L 4L5. E-mail: [email protected]

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    Review of General Psychology © 2014 American Psychological Association2014, Vol. 18, No. 3, 208 –215 1089-2680/14/$12.00 http://dx.doi.org/10.1037/gpr0000012

    208

    cally tripolar, involving an organism, the environment (both pres-ent and past), and what an organism does (the organism’s behav-ior). Typically, psychology privileges organism-based (rather thanenvironment-based) explanations of behavior that preserve theprinciple of contiguous causation characteristic of 17th centuryscience. To align with contemporary developments in science,psychology must abandon “dispositioning” and focus on the en-vironmental side of the organism– environment�behavioral triad,as emphasized in Skinner’s radical behaviorism (Field & Hineline,2008).

    Given Skinner’s focus on the environmental contributions tobehavior, Skinner also advocated for cultural change to improvehuman welfare. For example, Skinner discussed the design of abetter culture and the problem of control in Science and HumanBehavior (Skinner, 1953) and speculated about a utopian society inWalden Two (Skinner, 1976; see also Altus & Morris, 2009).Further, Skinner (1986) described five detrimental cultural prac-tices in “What is Wrong With Daily Life in the Western World?”and addressed psychology’s failure to institute cultural change inboth “Why We Are Not Acting to Save the World” (Skinner,1987b) and “Are We Free to Have a Future?” (Skinner, 1978a).Unfortunately, although Skinner was initially optimistic about thepowers of behavioral analysis to solve the major problems facinghumanity, he became less optimistic later in life (Chance, 2007).Critical psychology also advocates for cultural change, and thesteps used by critical psychology to advance cultural changesometimes show striking similarities with Skinner’s radical behav-iorism.

    Critical Psychiatry

    Psychiatry is probably unique within the health care system ofgenerating extensive scholarly criticism in addition to anger andoutrage from the people contacting psychiatric services, some ofwhom identify as “psychiatric survivors” (Bracken & Thomas,2009). In part, this criticism and anger may be traced back to the1980 publication of the Diagnostic and Statistical Manual ofMental Disorders, Third Edition (DSM-III), in which behavioralsymptoms were transformed from broad failures to adapt to theenvironment (that were continuous with normality) to entitiesreflecting an underlying disease process (Mayes & Horwitz, 2005;see also Conrad & Barker, 2010). Note that the publication ofDSM–III ushered in a transformation from a perspective thatresembled Skinnerian selectionism to a perspective that resembledpsychological essentialism.

    Although DSM–III radically transformed mental health, psychi-atry had been the target of extensive scholarly criticism longbefore DSM–III (Double, 2002). For example, R. D. Laing (1965)suggested that dysfunctional relationships (rather than biology)were critical in mental health and, in a study resembling a Skin-nerian functional level of analysis, Laing and Esterson (1970)found that high expressed emotion in a family (consisting ofhostility, emotional overinvolvement, and criticism) likely contrib-uted to the distress and disordered behavior in a person subse-quently labeled with schizophrenia (see also Modrow, 2003).Dysfunctional family relationships may also be expressed in in-formal nurse’s comments, such as “I think we’ve got the wrongone in here” (Johnstone, 2000, p. 75).

    In addition to Laing, Thomas Szasz was also a relentless criticof psychiatry (Szasz, 1970, 1974). For example, Szasz (1974)suggested that, in the absence of a biological marker, “mentalillness” was likely a metaphor and (echoing Skinner’s focus onorganism– environment interactions) suggested that “problems inliving” was a more accurate and useful metaphor (see also Joseph,2011; Sarbin, 1990). Szasz (1970) also compared current beliefs inthe reality of psychiatric labels with medieval beliefs in the realityof witchcraft.

    Today, critical psychiatry emphasizes that no biological test canconfirm any psychiatric label and the former chair of the DSM–IVTask Force has predicted that the incorporation of biological testsin psychiatric diagnosis will apply to only a small percentage ofindividuals (Frances & Widiger, 2012). With only a small percent-age of individuals having a biological dysfunction, this wouldexplain why the evidence supporting a genetic basis for manypsychiatric labels is weak (Joseph, 2006) and why dimensionalstructure differences between clinical and nonclinical respondents,on published data from several personality and psychopathologyinventories, were so rare that “one would be hard pressed to argueagainst the overall pattern of similarity” (O’Connor, 2002, p. 974).

    Given that only a small percentage of individuals may have abiological dysfunction, critical psychiatry emphasizes that emo-tional distress and disordered behavior predominantly arise fromenvironmental factors, like income inequality (Albee, 2005), andthat the large number of therapists in Western cultures may be asign of a cultural defect (Pande, 1968). This is consistent withSkinner’s position that emotional distress and disordered behaviorpredominantly arise from environmental factors and that therapistsshould explore environmental factors first when instituting treat-ment (Skinner, 1961b). Even unusual behaviors (like hearingvoices) may result because “positive reinforcement for voice hear-ing includes companionship, comfort, positive guidance, and spir-itual enlightenment” and negative reinforcement includes “remov-ing responsibility or the stress of having to make independentdecisions” (Boyle, 2006, p. 196). The possible involvement ofpositive and negative reinforcement in hearing voices convergeswith Skinner’s position that unusual behaviors may be “simply theresult of a history of reinforcement” (Skinner, 1961b, p. 198; seealso Flora, 2004; Richelle, 1993, p. 156).

    Note also that some psychiatric labels (e.g., compulsive buyingdisorder or pyromania) resemble “dispositioning” and have a dis-tinctly essentialist flavor (Haslam & Ernst, 2002). Consequently,psychiatric labels may be social constructions rather than trueentities reflecting an underlying biological dysfunction (Horwitz,2002). Notably, Guerin (1992) presented a behavior analysis ofsocially constructed knowledge that was based on Skinner’s (1957/1992) functional analysis of verbal behavior. That is, becausecultural terms may arise from interactions with other people (ratherthan from the nonsocial environment), there is a great potential formodern societies to maintain counterfactual knowledge becausebehavior is becoming more verbal and the controls on verbalbehavior are becoming detached from nonsocial environmentalcontrols.

    Guerin’s (1992) behavior analysis of socially constructedknowledge is relevant to critical psychiatry. For example, in astatement that might have been made by Szasz (1970), the culturaldominance of medical models makes it difficult for many people tothink outside them: “rather like asking medieval Europeans to

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    209CRITICAL PSYCHIATRY

    think about a world without kings or queens” (Boyle, 2006, p.191). Konner (2008) has also suggested that people may have agreat deal of resiliency because human evolutionary history waslikely characterized by disease, animal attacks, famine, and homi-cide. However, mental health interventions, which are routinelyencouraged after a potentially traumatic experience, may inadver-tently convey to people that recovery over time is not a typicalhuman response to trauma (Konner, 2008). Finally, Watters (2010)has presented evidence that pharmaceutical companies have at-tempted to replace indigenous understandings of mental health,with Western medical models, that more readily translate intoprofitable drug treatments.

    Like Skinner, critical psychiatry also emphasizes the dangers ofreification, that is, the dangers of believing that any psychiatriclabel (including schizophrenia) must be an entity having an inde-pendent existence (Jacobs & Cohen, 2010; see also Barrett, 1996;Boyle, 2002; Romme & Escher, 2000; Sarbin & Mancuso, 1980).As previously noted in the section on Radical Behaviorism, Skin-ner (1950) was well aware of the dangers of reification andcautioned that psychologists frequently postulate “events takingplace somewhere else, at some other level of observation, de-scribed in different terms, and measured, if at all, in differentdimensions” (p. 193). Further, Skinner (1961c) expressed concernsthat hypothesized inner entities in psychiatry “abandon the tech-niques of measurement which would otherwise be a natural heri-tage from earlier achievements in other sciences” (p. 210).

    Critical psychiatry also suggests that the expanded number ofpsychiatric labels (from about 100 in DSM-I to about 400 inDSM-5) raises the possibility that psychiatric labels are inventedrather than discovered (Houts, 2002; see also Marecek & Hare-Mustin, 2009; Pérez-Álvarez & García-Montes, 2007). Recall thatan expanded number of theoretical constructs was also a problemwith the essential-like terms that were common in intelligence andmemory research (Palmer & Donahoe, 1992; Schlinger, 2003).Similarly, Skinner noted that “Freud did not discover the mentalapparatus but rather invented it” (Skinner, 1961a, p. 186), andSkinner cautioned that “psychotherapy is rich in explanatory fic-tions. Behavior itself has not been accepted as a subject matter inits own right, but only as an indication of something wrongsomewhere else” (Skinner, 1953, pp. 372–373).

    Critical psychiatry also emphasizes that differences in power,between psychiatrists and distressed people, may result in mis-treatment (Rosenhan, 1973; see also Goddard, 2011). Skinner(1974) also emphasized that differences in power may result inmistreatment, particularly mistreatment “of the very young, of theaged, of prisoners, of psychotics, and of the retarded” (pp. 210 –211). For example, prepubertal youth may be receiving as many asseven concurrent psychiatric drugs, although there are limited dataon drug safety and efficacy, because studies typically use adultsamples (Safer, Zito, & dosReis, 2003). Previously distressed, butfully recovered, adults have also reported that psychiatrists erro-neously predicted they would lose custody of their children, wouldnever hold a job, or would be on medication forever (Hagen &Nixon, 2011).

    Clinicians may also not be overly familiar with the 400 (or so)hypothesized psychiatric labels; for example, in a sample of mentalhealth professionals (that included 20 licensed psychiatrists and 20licensed psychologists), only about 22 disorders could be recalledby at least 25% of participants (Ahn, Proctor, & Flanagan, 2009).

    Finally, accurate diagnosis may not necessarily even benefit dis-tressed people because psychiatrists might “debate the fine pointsabout the correct diagnosis for a disturbed client, but always wouldprescribe Haldol regardless of the outcome of the diagnostic de-bate” (Kirk & Kutchins, 2008, p. 235).

    Skinner (1953) was also critical of the use of drugs or electricshock in psychiatry that were not far removed from the idea that“the Devil or some other intruding personality is in temporary‘possession’ of the body” (p. 374). Skinner also expressed con-cerns that shock therapy may have begun as aversive control (seeEpstein, 1980, pp. 6 –7), supporting evidence that, although shocktherapy was a terrifying experience, some people were fearful thatexpressing any misgivings might annoy their psychiatrist andprolong their confinement (Johnstone & Frith, 2005). Skinner andVaughan (1983) also noted that although “American take billionsof pills every year . . . drugs that make you feel better can keep youfrom attacking the condition that makes you feel bad” (p. 118; seealso Flora, 2007).

    Compare Skinner’s criticisms to recent evidence that, althoughpsychiatry promotes the metaphor that drugs are like taking insulinfor diabetes, drugs may actually be like taking alcohol for socialanxiety (Moncrieff, 2009). Further, “the misconception that mentalillness can be cured by drugs discourages the provision of decentservices” (Moncrieff, 2009, p. 240; see also Whitaker, 2010). Drugcompanies may also suppress data showing harmful side effects(Breggin, 2006), and there may be conflicts of interest in psychi-atry. For example, some shock therapy researchers have heldshares in the companies that marketed the shock machines (Andre,2009). The former editor of The New England Journal of Medicinenoted that because the U.S. Food and Drug Administration re-quires only that a new drug show short-term benefit relative toplacebo, the long-term drug effects are often unknown and there isa genuine possibility that a new drug may be inferior to an olderdrug or treatment (Angell, 2005). In a study that compared threenew blood pressure drugs with a generic diuretic (that had been onthe market for over 50 years), the new drugs were no moreeffective than the diuretic at lowering blood pressure, and they hadmore dangerous side effects (Angell, 2005, p. 96; see also Healy,2012).

    As is generally well known, Skinner (1938, 1963) also advo-cated within-individual designs that intensely studied a few sub-jects rather than the multiple-subject designs that are common inpsychology (O’Donohue, Callaghan, & Ruckstuhl, 1998). In Skin-ner’s (1966) words “instead of studying a thousand rats for onehour each, or a hundred rats for 10 hours each, the investigator islikely to study one rat for a thousand hours” (p. 21).

    Similarly, standard psychiatric studies, using multiple-subjectdesigns, may ignore individual patient’s accounts of their livedexperiences (Hornstein, 2009). Although there are over 600 first-person accounts published in English alone, first-person accountshave been largely ignored by psychiatric researchers (Adame &Hornstein, 2006). First-person accounts may also challenge med-ical models; for example, in-depth interviews show that depressionin women may be a product of social, political, and interpersonalrealities, rather than a product of neurochemical dysregulation(Lafrance, 2009; see also Stoppard, 1999, 2000). One psychiatristcandidly admitted that he actually knew very little about hispatient’s lives because most therapy sessions consisted of a 15-min“med check” (Carlat, 2010, p. 11). Consequently, psychiatric prac-

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    210 GODDARD

    tice may make it less likely that an alliance forms with an empa-thetic therapist that may be critical for therapeutic progress(Wampold, 2001).

    Finally, understating environmental stressors in psychiatry maybe due to “cultural assumptions about the primacy of the autono-mous individual” (Boyle, 2011, p. 34). Further, because a diseaserefers to a process within the body of an individual, psychiatricsymptoms are “conceived to be a part of a system of behavior thatis located entirely within the patient and that is independent of thesocial context” (Scheff, 2007, p. 180). Compare these commentswith Skinner’s view that a science of human behavior proceeds by“questioning the control exercised by autonomous man” (Skinner,1971, p. 19) and that an experimental analysis “shifts the deter-mination of behavior from autonomous man to the environment”(Skinner, 1971, p. 205).

    Critical Psychology

    Critical psychology suggests that current cultural practices maybe detrimental to human well-being and that psychologists maypreserve the status quo by focusing on individual, rather thancultural, change (Fox, Prilleltensky, & Austin, 2009). Criticalpsychology builds on Fromm’s (1965) dual conception of freedomas being free from social and psychological oppression and beingfree to pursue important life goals (Austin & Prilleltensky, 2001).

    The roots of critical psychology may also be traced to theFrench philosopher Michel Foucault, who famously argued thatknowledge was intimately connected with power and that a pow-er�knowledge nexus determines what behaviors are desired, howobjects and people are to be understood, and how deviant individ-uals are to be corrected and disciplined (Foucault, 1980). Note thesimilarity between Foucault’s ideas with previously discussed ev-idence, in the Critical Psychiatry section, that the powerful phar-maceutical industry may be altering indigenous understandings ofmental health for financial gain (Watters, 2010). Foucault’s dis-cussion of power also shares some similarity with Skinner’s con-cept of countercontrol, in which individuals may oppose aversivecontrol through negative reinforcement, such as by escaping, at-tacking, or passively resisting (Skinner, 1974). Foucault’s ideas arealso relevant to evidence from critical psychology that some pio-neers in intelligence testing may have been motivated by racialprejudice (Kamin, 1974) or that the academic contributions offemale psychologists had been neglected in standard psychologytextbooks (Scarborough & Furumoto, 1987).

    Critical psychology emphasizes that academic work in psychol-ogy is not well aligned with action-oriented social justice initia-tives, and critical psychology often asks the question “What ispsychology to do?” (Prilleltensky, 2012, p. 617). Critical psychol-ogy also notes that cultural change may require behavioral changebecause “changing beliefs without accompanying behaviors isfutile” (Prilleltensky, 2012, p. 622) and that “awareness is good,but action is better” (Fox, 2003, p. 299). Further, if people askwhat reinforces them to participate in cultural change, people canimprove their efforts by “analyzing antecedents, behaviors, andconsequences” (Prilleltensky, 2012, p. 621). Critical psychologyalso suggests that because our own society may fall short ofhistorical and theoretical alternatives, it is even helpful to “spec-ulate about utopian societies” (Fox, 1993, p. 239).

    As previously discussed in the Radical Behaviorism section,there is little doubt that Skinner advocated cultural change toimprove human well-being (Skinner, 1953) and Skinner speculatedabout a utopian society in Walden Two (Skinner, 1976). Skinnerwould also agree with critical psychology’s focus on behavioral(rather than belief) changes because “changing a mind . . . is anineffective way of changing behavior” (Skinner, 1971, pp. 91–92)and “psychology has remained . . . primarily a search for internaldeterminers” (Skinner, 1987a, p. 780). Of course, critical psychol-ogy’s emphasis on behavioral change by analyzing antecedents,behaviors, and consequences was Skinner’s basic unit of analysisand Skinner’s constant search for ways to change his own behaviorwas “a lifestyle” (Epstein, 1997, p. 547; see also Bjork, 1993;Smith, 1992; Vargas, 2004).

    As might be expected, there may also be a certain degree ofoverlap between critical psychiatry and critical psychology. Forexample, a consumer culture that creates an ethos of winners andlosers, coupled with income inequality and parental divorce, maypartly contribute to increased childhood distress (Timimi, 2010).Medicalizing this distress with a label (like attention-deficit/hy-peractivity disorder [ADHD]) may, however, be more of a quick-fix solution that is encouraged by drug companies (Timimi, 2009).Common drug treatments for ADHD (using psychostimulants likemethylphenidate [Ritalin]) may also cause adverse neuronalchanges in humans (Andersen, 2003) and prolonged memory im-pairments in rats (LeBlanc-Duchin & Taukulis, 2007). Thus,ADHD may be a social construction (as noted by critical psychi-atry), but increased labeling may reflect genuine increases inchildhood distress caused by detrimental cultural practices (asnoted by critical psychology).

    Critical psychology is perhaps most concerned with a NorthAmerican individualistic worldview, encouraging competitivenessand consumerism, which may be harmful to human relationshipsand a sustainable planet (Fox, Prilleltensky, & Austin, 2009).Skinner shared these concerns, suggesting that competitivenessand consumerism may lead to war, overconsumption, and, poten-tially, human extinction (Skinner, 1971). “That many people havebegun to find a recital of these dangers tiresome is perhaps an evengreater threat” (Skinner, 1987b, p. 1).

    Skinner suggested that because people are predominantly socialcreatures, social control may be exercised by direct face-to-facecontact when all individuals have essentially the same power(Skinner, 1978c). Research showing that conformity and socialinfluence powerfully affect humans, possibly outside introspectiveawareness (Pronin, 2008), supports Skinner’s position. However,Skinner (1978d) noted that because power is concentrated in thosewith money, an introduction of a maximum wage law (in combi-nation with a minimum wage law) may be prudent. Echoing theconcerns of Foucault (1980), Skinner (1987b) was particularlyconcerned about powerful financial interests influencing govern-ment policy “for their own aggrandizement . . . in conflict with thefuture of the human species” (p. 7). Sharing Skinner’s concerns,Chomsky (2003) also argued that the U.S. government has “per-sisted in undermining international efforts to reduce threats to theenvironment that are recognized to be severe, with pretexts thatbarely concealed their devotion to narrow sectors of privatepower” (p. 3).

    In addition, consistent with Skinner’s view that “behavior maybe extensively modified by variables of which . . . the subject is

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    211CRITICAL PSYCHIATRY

    never aware” (Skinner, 1963, p. 957), there are now also manysurprising findings of human behaviors unconsciously influencedby environmental factors (Goddard, 2009). As critical psychologyexpands into areas like health, social, and personality psychology,critical psychologists may benefit from an appreciation that envi-ronmental factors can influence human behavior outside consciousintrospective awareness.

    For example, eating may be unconsciously influenced by adver-tising (Harris, Bargh, & Brownell, 2009) and the food industryspends approximately $10 billion annually to promote primarilyunhealthy foods to children and youth (Brownell & Horgen, 2004).Further, because food costs are low, relative to labor and process-ing, competition encourages larger portions, or value-size pricing(a lower price per unit for larger portions), to increase market share(Young & Nestle, 2012). Small increases in dishware size mayalso increase caloric intake (Pratt, Croager, & Rosenberg, 2012)and traditional societies undergoing Westernization routinely showweight gain (Brown & Konner, 1987). Artificial sweeteners (likesaccharine) may also paradoxically cause weight gain by disrupt-ing fundamental homeostatic processes (Swithers & Davidson,2008). Thus, consistent with Skinner’s emphasis that environmen-tal factors powerfully influence human behavior, an appreciationthat unhealthy eating may be powerfully influenced by environ-mental factors helps to redress mainstream health psychology’shighly dispositional approach (Chamberlain & Murray, 2009; seealso Wansink, 2013).

    A consumer culture may also create human needs rather thanfulfill them (Leatherman & Goodman, 2005). For example, saleswere poor when black pearls were first introduced, but salesincreased when prices were substantially raised, possibly becauseonly wealthy consumers could then afford the commodity (seeAriely, 2008, pp. 23–25). Skinner also expressed concerns thatpeople are prepared to deal with coercive cultural practices, butmay not object to other, possibly more powerful and dangerous,behavioral control techniques, such as media influences (Rogers &Skinner, 1956). In a statement that might have been made byFoucault (1980), Chomsky also shared Skinner’s concerns as “themedia serve, and propagandize on behalf of, the powerful societalinterests that control and finance them” (Herman & Chomsky,2002, p. xi). Guerin (1992) also emphasized the media’s ability tomaintain counterfactual knowledge, in the absence of a socialgroup (see also Pollay, 1986), and critical psychiatry has expressedconcerns about the accuracy of pharmaceutical advertisements ontelevision (Achamallah, 2011) and in leading medical journals(Valenstein, 1998, pp. 197–199).

    Finally, capitalist assumptions that certain abstract concepts(like gross domestic product [GDP]) mirror human well-being maybe misleading, because GDP rises when there are more car crashes(Anielski, 2007). The potential problem of abstract concepts (likeGDP) was also pointed out by Skinner, who noted that abstractconcepts can lead to oversights and errors, particularly when theabstractions are separated from the original, specific, concretereferents (Grant, 2012).

    Given that many psychologists may also be immersed in a NorthAmerican individualistic worldview, perhaps, in hindsight, itshould come as less of a surprise that some theories in psychologycontain an implicit assumption of human autonomy (Baum &Heath, 1992). Skinner also speculated that, although a culture mayhave initially gained a great deal by emphasizing that individuals

    are in control of their behavior, it is possible that such a philosophy“has remote consequences which will prove to be dangerous” (seeCatania & Harnad, 1988, p. 487).

    Further, some empirical results, like the common factors (or“Dodo bird”) effect in therapy, may be quite difficult for manypsychologists to accept (Wampold, 2001). Surely, if a distressedperson was like a car that needed to be fixed, some methods ofrepair would be better (or worse) than others? What psychologistsmay be missing is that a human may actually be a very odd car thatmay fail to start properly unless you park it in the vicinity of othercars. Empirical evidence that human verbal behavior is uncon-sciously influenced by social rewards (like smiling or attention) isalso difficult to accommodate in a worldview with an implicitassumption of human autonomy (Krasner, 1958; see also Guerin &Miyazaki, 2006; Schlinger, 2008; Skinner, 1957/1992).

    Summary and Conclusion

    Critical psychiatry suggests that psychiatric labels may be socialconstructions and that psychiatry overstates internal pathology andunderstates environmental stressors as important causal factors inemotional distress. Similarly, Skinner suggested that psychiatric la-bels may be “explanatory fictions” and that emotional distress may bea product of extreme environmental conditions. Critical psychiatryalso shares Skinner’s concerns that the use of drugs (or electric shock)may be harmful and that differences in power (between psychiatristsand distressed people) may result in mistreatment and insufficientattention to individual life circumstances.

    Critical psychology suggests that psychology must better advo-cate for cultural change and that speculation about a utopiansociety is helpful. Similarly, Skinner was a powerful advocate forcultural change and speculated about a utopian society in WaldenTwo. Critical psychology also shares Skinner’s concerns that en-vironmental factors powerfully influence human behavior and thatcompetition and consumerism may harm human relationships anda sustainable planet.

    Finally, what are the possible benefits of alerting academics tothe extensive overlap between Skinner’s radical behaviorism andcritical psychiatry and critical psychology? First, behavior analystsmay be encouraged to participate in critical psychiatry’s efforts toreform DSM-5. Indeed, the objections to psychiatric diagnosis arenow so widespread (and well rehearsed) that the main challengefor social science is to explain how and why psychiatric diagnosishas managed to survive (Pilgrim, 2007).

    Second, critical psychology’s efforts to challenge detrimentalcultural practices may be improved by increased familiarity withSkinner’s writings and the extensive behavior-analytic literature.Behavior analysts may also be alerted to relevant research incritical psychology that may not be published in standard behavioranalytic journals. Persistent, and harmful, cultural practices mayhave a great deal of inertia, and the collaboration between behavioranalysts and critical psychologists may be helpful in institutingmeaningful cultural change.

    Third, although many academics may consider Skinner “history,”this view may be fundamentally altered when comparisons showstriking epistemological similarities between Skinner’s writings andcontemporary topics that are of interest to many psychologists. Forexample, Skinnerian behaviorism shares important similarities withpositive psychology (Adams, 2012) and current empirical research in

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    psychology (Goddard, 2012), suggesting that there may be a very realopportunity for reintegrating Skinnerian behaviorism with main-stream psychology (Overskeid, 2008). The present article joins theseefforts by showing that Skinnerian behaviorism also shares importantsimilarities with critical psychiatry and critical psychology. Althoughsome North Americans might presume that the increased pharmaceu-tical treatment of emotional distress (and worldviews emphasizingconsumerism) demonstrates human progress, Skinner might suggestthat they are LDWs.

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    Received June 26, 2014Accepted August 1, 2014 �

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    215CRITICAL PSYCHIATRY

    • Critical Psychiatry, Critical Psychology, and the Behaviorism of B. F. Skinner
      • Radical Behaviorism
      • Critical Psychiatry
      • Critical Psychology
      • Summary and Conclusion
      • References

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