Article Critique

Critical Psychiatry, Critical Psychology, and the Behaviorism of B. F. Skinner

Murray J. Goddard University of New Brunswick

Critical psychiatry suggests that the currently dominant medical model in psychiatry overstates internal disturbance and understates environmental stressors as important causal factors in psychological distress. Critical psychology suggests that when individuals experience problems in a culture, psychology emphasizes individual, rather than cultural, change. This article provides a brief overview of critical psychiatry and critical psychology and outlines how both movements share important epistemological similarities 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 video slot machines that encourage players to bet on multiple pay lines and follow any winning combination with flashing lights and high-fidelity audio, even when the amount won is less than the amount 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 how critical psychiatry, critical psychology, and the behaviorism of B. F. Skinner share common ground. For example, critical psychi- atry challenges the dominant medical model by suggesting that problematic 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 emphasizes that, by focusing on altering problematic gambling in an individ- ual, psychology preserves the status quo and deflects attention away 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 gambling industry but was also angered by politicians who raised money through gambling initiatives (Knapp, 1997; see also Fantino, 2008). In an article, with uncharacteristic sarcasm, Skinner (1978b) suggested that perhaps the wealthy could avoid paying taxes altogether, if lotteries were introduced in Grade 1 classrooms and the reward schedule was gradually reduced in magnitude over time.

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

Radical Behaviorism

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

Essentialism may also lead to the proliferation of additional theoretical constructs, particularly mentalistic constructs that are hypothesized to reside within autonomous man (Skinner, 1971). For example, when an essential-like structure (e.g., short-term memory or academic intelligence) is unable to explain divergent data, additional memories or intelligences are often added, leading to 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 a person is a “pervert” (Malle, 2004, p. 162).

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

Murray J. Goddard, Department of Psychology, University of New Brunswick.

Supported by a sabbatical leave from the University of New Brunswick, Saint John and the Natural Sciences and Engineering Research Council of Canada (Grant 42025). I thank Vance MacLaren for his insights on modern video 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, Saint John, NB, Canada, E2L 4L5. E-mail: [email protected]

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

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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 than environment-based) explanations of behavior that preserve the principle of contiguous causation characteristic of 17th century science. 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 to behavior, Skinner also advocated for cultural change to improve human welfare. For example, Skinner discussed the design of a better culture and the problem of control in Science and Human Behavior (Skinner, 1953) and speculated about a utopian society in Walden 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 in both “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 the powers of behavioral analysis to solve the major problems facing humanity, he became less optimistic later in life (Chance, 2007). Critical psychology also advocates for cultural change, and the steps used by critical psychology to advance cultural change sometimes show striking similarities with Skinner’s radical behav- iorism.

Critical Psychiatry

Psychiatry is probably unique within the health care system of generating extensive scholarly criticism in addition to anger and outrage from the people contacting psychiatric services, some of whom identify as “psychiatric survivors” (Bracken & Thomas, 2009). In part, this criticism and anger may be traced back to the 1980 publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), in which behavioral symptoms were transformed from broad failures to adapt to the environment (that were continuous with normality) to entities reflecting an underlying disease process (Mayes & Horwitz, 2005; see also Conrad & Barker, 2010). Note that the publication of DSM–III ushered in a transformation from a perspective that resembled Skinnerian selectionism to a perspective that resembled psychological essentialism.

Although DSM–III radically transformed mental health, psychi- atry had been the target of extensive scholarly criticism long before 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 of hostility, 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 wrong one in here” (Johnstone, 2000, p. 75).

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

Today, critical psychiatry emphasizes that no biological test can confirm any psychiatric label and the former chair of the DSM–IV Task Force has predicted that the incorporation of biological tests in psychiatric diagnosis will apply to only a small percentage of individuals (Frances & Widiger, 2012). With only a small percent- age of individuals having a biological dysfunction, this would explain why the evidence supporting a genetic basis for many psychiatric labels is weak (Joseph, 2006) and why dimensional structure differences between clinical and nonclinical respondents, on published data from several personality and psychopathology inventories, were so rare that “one would be hard pressed to argue against the overall pattern of similarity” (O’Connor, 2002, p. 974).

Given that only a small percentage of individuals may have a biological dysfunction, critical psychiatry emphasizes that emo- tional distress and disordered behavior predominantly arise from environmental factors, like income inequality (Albee, 2005), and that the large number of therapists in Western cultures may be a sign of a cultural defect (Pande, 1968). This is consistent with Skinner’s position that emotional distress and disordered behavior predominantly arise from environmental factors and that therapists should explore environmental factors first when instituting treat- ment (Skinner, 1961b). Even unusual behaviors (like hearing voices) 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 independent decisions” (Boyle, 2006, p. 196). The possible involvement of positive and negative reinforcement in hearing voices converges with Skinner’s position that unusual behaviors may be “simply the result of a history of reinforcement” (Skinner, 1961b, p. 198; see also Flora, 2004; Richelle, 1993, p. 156).

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

Guerin’s (1992) behavior analysis of socially constructed knowledge is relevant to critical psychiatry. For example, in a statement that might have been made by Szasz (1970), the cultural dominance of medical models makes it difficult for many people to think 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 a great deal of resiliency because human evolutionary history was likely characterized by disease, animal attacks, famine, and homi- cide. However, mental health interventions, which are routinely encouraged after a potentially traumatic experience, may inadver- tently convey to people that recovery over time is not a typical human 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 into profitable drug treatments.

Like Skinner, critical psychiatry also emphasizes the dangers of reification, that is, the dangers of believing that any psychiatric label (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 and cautioned that psychologists frequently postulate “events taking place somewhere else, at some other level of observation, de- scribed in different terms, and measured, if at all, in different dimensions” (p. 193). Further, Skinner (1961c) expressed concerns that 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 of psychiatric labels (from about 100 in DSM-I to about 400 in DSM-5) raises the possibility that psychiatric labels are invented rather than discovered (Houts, 2002; see also Marecek & Hare- Mustin, 2009; Pérez-Álvarez & García-Montes, 2007). Recall that an expanded number of theoretical constructs was also a problem with the essential-like terms that were common in intelligence and memory research (Palmer & Donahoe, 1992; Schlinger, 2003). Similarly, Skinner noted that “Freud did not discover the mental apparatus but rather invented it” (Skinner, 1961a, p. 186), and Skinner cautioned that “psychotherapy is rich in explanatory fic- tions. Behavior itself has not been accepted as a subject matter in its own right, but only as an indication of something wrong somewhere 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 in mistreatment, particularly mistreatment “of the very young, of the aged, of prisoners, of psychotics, and of the retarded” (pp. 210– 211). For example, prepubertal youth may be receiving as many as seven concurrent psychiatric drugs, although there are limited data on drug safety and efficacy, because studies typically use adult samples (Safer, Zito, & dosReis, 2003). Previously distressed, but fully recovered, adults have also reported that psychiatrists erro- neously predicted they would lose custody of their children, would never 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 mental health professionals (that included 20 licensed psychiatrists and 20 licensed psychologists), only about 22 disorders could be recalled by 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 points about the correct diagnosis for a disturbed client, but always would prescribe 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 electric shock 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 (see Epstein, 1980, pp. 6–7), supporting evidence that, although shock therapy was a terrifying experience, some people were fearful that expressing any misgivings might annoy their psychiatrist and prolong their confinement (Johnstone & Frith, 2005). Skinner and Vaughan (1983) also noted that although “American take billions of pills every year . . . drugs that make you feel better can keep you from attacking the condition that makes you feel bad” (p. 118; see also Flora, 2007).

Compare Skinner’s criticisms to recent evidence that, although psychiatry promotes the metaphor that drugs are like taking insulin for diabetes, drugs may actually be like taking alcohol for social anxiety (Moncrieff, 2009). Further, “the misconception that mental illness can be cured by drugs discourages the provision of decent services” (Moncrieff, 2009, p. 240; see also Whitaker, 2010). Drug companies 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 held shares in the companies that marketed the shock machines (Andre, 2009). The former editor of The New England Journal of Medicine noted that because the U.S. Food and Drug Administration re- quires only that a new drug show short-term benefit relative to placebo, the long-term drug effects are often unknown and there is a genuine possibility that a new drug may be inferior to an older drug or treatment (Angell, 2005). In a study that compared three new blood pressure drugs with a generic diuretic (that had been on the market for over 50 years), the new drugs were no more effective than the diuretic at lowering blood pressure, and they had more 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 in psychology (O’Donohue, Callaghan, & Ruckstuhl, 1998). In Skin- ner’s (1966) words “instead of studying a thousand rats for one hour each, or a hundred rats for 10 hours each, the investigator is likely to study one rat for a thousand hours” (p. 21).

Similarly, standard psychiatric studies, using multiple-subject designs, may ignore individual patient’s accounts of their lived experiences (Hornstein, 2009). Although there are over 600 first- person accounts published in English alone, first-person accounts have 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 depression in women may be a product of social, political, and interpersonal realities, rather than a product of neurochemical dysregulation (Lafrance, 2009; see also Stoppard, 1999, 2000). One psychiatrist candidly admitted that he actually knew very little about his patient’s lives because most therapy sessions consisted of a 15-min “med check” (Carlat, 2010, p. 11). Consequently, psychiatric prac-

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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 may be due to “cultural assumptions about the primacy of the autono- mous individual” (Boyle, 2011, p. 34). Further, because a disease refers to a process within the body of an individual, psychiatric symptoms are “conceived to be a part of a system of behavior that is located entirely within the patient and that is independent of the social context” (Scheff, 2007, p. 180). Compare these comments with 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 may be detrimental to human well-being and that psychologists may preserve the status quo by focusing on individual, rather than cultural, change (Fox, Prilleltensky, & Austin, 2009). Critical psychology builds on Fromm’s (1965) dual conception of freedom as being free from social and psychological oppression and being free to pursue important life goals (Austin & Prilleltensky, 2001).

The roots of critical psychology may also be traced to the French philosopher Michel Foucault, who famously argued that knowledge was intimately connected with power and that a pow- er�knowledge nexus determines what behaviors are desired, how objects and people are to be understood, and how deviant individ- uals are to be corrected and disciplined (Foucault, 1980). Note the similarity 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 of mental 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 aversive control through negative reinforcement, such as by escaping, at- tacking, or passively resisting (Skinner, 1974). Foucault’s ideas are also relevant to evidence from critical psychology that some pio- neers in intelligence testing may have been motivated by racial prejudice (Kamin, 1974) or that the academic contributions of female psychologists had been neglected in standard psychology textbooks (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 is psychology to do?” (Prilleltensky, 2012, p. 617). Critical psychol- ogy also notes that cultural change may require behavioral change because “changing beliefs without accompanying behaviors is futile” (Prilleltensky, 2012, p. 622) and that “awareness is good, but action is better” (Fox, 2003, p. 299). Further, if people ask what reinforces them to participate in cultural change, people can improve their efforts by “analyzing antecedents, behaviors, and consequences” (Prilleltensky, 2012, p. 621). Critical psychology also suggests that because our own society may fall short of historical 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 to improve human well-being (Skinner, 1953) and Skinner speculated about a utopian society in Walden Two (Skinner, 1976). Skinner would also agree with critical psychology’s focus on behavioral (rather than belief) changes because “changing a mind . . . is an ineffective way of changing behavior” (Skinner, 1971, pp. 91–92) and “psychology has remained . . . primarily a search for internal determiners” (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 analysis and Skinner’s constant search for ways to change his own behavior was “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 of overlap between critical psychiatry and critical psychology. For example, a consumer culture that creates an ethos of winners and losers, coupled with income inequality and parental divorce, may partly 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 like methylphenidate [Ritalin]) may also cause adverse neuronal changes 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 in childhood distress caused by detrimental cultural practices (as noted by critical psychology).

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

Skinner suggested that because people are predominantly social creatures, social control may be exercised by direct face-to-face contact when all individuals have essentially the same power (Skinner, 1978c). Research showing that conformity and social influence powerfully affect humans, possibly outside introspective awareness (Pronin, 2008), supports Skinner’s position. However, Skinner (1978d) noted that because power is concentrated in those with money, an introduction of a maximum wage law (in combi- nation with a minimum wage law) may be prudent. Echoing the concerns of Foucault (1980), Skinner (1987b) was particularly concerned about powerful financial interests influencing govern- ment policy “for their own aggrandizement . . . in conflict with the future 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 the environment that are recognized to be severe, with pretexts that barely concealed their devotion to narrow sectors of private power” (p. 3).

In addition, consistent with Skinner’s view that “behavior may be 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 many surprising findings of human behaviors unconsciously influenced by environmental factors (Goddard, 2009). As critical psychology expands into areas like health, social, and personality psychology, critical psychologists may benefit from an appreciation that envi- ronmental factors can influence human behavior outside conscious introspective awareness.

For example, eating may be unconsciously influenced by adver- tising (Harris, Bargh, & Brownell, 2009) and the food industry spends approximately $10 billion annually to promote primarily unhealthy 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 may also increase caloric intake (Pratt, Croager, & Rosenberg, 2012) and traditional societies undergoing Westernization routinely show weight gain (Brown & Konner, 1987). Artificial sweeteners (like saccharine) 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 appreciation that unhealthy eating may be powerfully influenced by environ- mental factors helps to redress mainstream health psychology’s highly dispositional approach (Chamberlain & Murray, 2009; see also Wansink, 2013).

A consumer culture may also create human needs rather than fulfill them (Leatherman & Goodman, 2005). For example, sales were poor when black pearls were first introduced, but sales increased when prices were substantially raised, possibly because only wealthy consumers could then afford the commodity (see Ariely, 2008, pp. 23–25). Skinner also expressed concerns that people are prepared to deal with coercive cultural practices, but may 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 by Foucault (1980), Chomsky also shared Skinner’s concerns as “the media serve, and propagandize on behalf of, the powerful societal interests that control and finance them” (Herman & Chomsky, 2002, p. xi). Guerin (1992) also emphasized the media’s ability to maintain counterfactual knowledge, in the absence of a social group (see also Pollay, 1986), and critical psychiatry has expressed concerns about the accuracy of pharmaceutical advertisements on television (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 may be misleading, because GDP rises when there are more car crashes (Anielski, 2007). The potential problem of abstract concepts (like GDP) was also pointed out by Skinner, who noted that abstract concepts can lead to oversights and errors, particularly when the abstractions are separated from the original, specific, concrete referents (Grant, 2012).

Given that many psychologists may also be immersed in a North American individualistic worldview, perhaps, in hindsight, it should come as less of a surprise that some theories in psychology contain an implicit assumption of human autonomy (Baum & Heath, 1992). Skinner also speculated that, although a culture may have 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” (see Catania & Harnad, 1988, p. 487).

Further, some empirical results, like the common factors (or “Dodo bird”) effect in therapy, may be quite difficult for many psychologists to accept (Wampold, 2001). Surely, if a distressed person was like a car that needed to be fixed, some methods of repair would be better (or worse) than others? What psychologists may be missing is that a human may actually be a very odd car that may fail to start properly unless you park it in the vicinity of other cars. Empirical evidence that human verbal behavior is uncon- sciously influenced by social rewards (like smiling or attention) is also difficult to accommodate in a worldview with an implicit assumption 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 social constructions and that psychiatry overstates internal pathology and understates environmental stressors as important causal factors in emotional distress. Similarly, Skinner suggested that psychiatric la- bels may be “explanatory fictions” and that emotional distress may be a product of extreme environmental conditions. Critical psychiatry also shares Skinner’s concerns that the use of drugs (or electric shock) may be harmful and that differences in power (between psychiatrists and distressed people) may result in mistreatment and insufficient attention to individual life circumstances.

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

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

Second, critical psychology’s efforts to challenge detrimental cultural practices may be improved by increased familiarity with Skinner’s writings and the extensive behavior-analytic literature. Behavior analysts may also be alerted to relevant research in critical psychology that may not be published in standard behavior analytic journals. Persistent, and harmful, cultural practices may have a great deal of inertia, and the collaboration between behavior analysts and critical psychologists may be helpful in instituting meaningful cultural change.

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

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212 GODDARD

psychology (Goddard, 2012), suggesting that there may be a very real opportunity for reintegrating Skinnerian behaviorism with main- stream psychology (Overskeid, 2008). The present article joins these efforts by showing that Skinnerian behaviorism also shares important similarities with critical psychiatry and critical psychology. Although some North Americans might presume that the increased pharmaceu- tical treatment of emotional distress (and worldviews emphasizing consumerism) demonstrates human progress, Skinner might suggest that they are LDWs.

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