No Problem With Determinism
The problem of determinism is a deep one, and I think that neither scientific nor folk psychology have come to grips with it. In scientific psychology, there is constant friction between deterministic theories, such as behaviorism (or any other theory describing "mechanisms") and theories stressing human agency. What academic psychology seems to be telling us is that human behavior follows scientifically detectable laws and that at the same time we have the power to choose and change apart from these laws.It's crucial to see that determinism doesn't conflict with genuine human agency, including the power to change ourselves. Human beings, though caused in each and every respect, are just as real as the causes that shaped them, and they still have real causal powers to pursue their goals, including those set by psychotherapy. We can't logically attribute causal power to the factors that create human agents and yet deny it for the agents themselves (see Avoiding demoralization by determinism).
Were there some part of a human being independent of determining influences, it would have no reason to choose one way or another, since it wouldn't be affected by, and thus responsive to, its own motives and reasons. Any exemption from determinism wouldn't give us a freedom (or responsibility) worth wanting, as philosopher Daniel Dennett puts it, only a random factor introduced into behavior. So we don't need, and indeed shouldn't want, a power to choose that's independent of "scientifically detectable laws."
As it turns out, there are now psychiatrists and therapists who are coming to grips with a deterministic, and more broadly, naturalistic understanding of behavior. Dr. Ron Pies, clinical professor of psychiatry at Tufts University in Boston, is one - see his papers on what he calls "psychiatric naturalism" in Psychiatric Times: Hume's Fork and Psychiatry's Explanations: Determinism and the Dimensions of Freedom and Psychiatric Naturalism and the Dimensions of Freedom: Implications for Psychiatry and the Law. (Pies responds to Krueger at the blog.)
In a therapeutic setting, seeing that one's behavior and that of others is fully caused works to reduce shame, blame (of self and others), anger and other responses predicated on the idea that we could have done otherwise in a situation. Indeed, Krueger recognizes a thorough-going determinism might make us more compassionate and self-compassionate, since, as he puts it, "We acted the way we did because we did our best and really couldn't have acted differently."
The cause-and-effect understanding of ourselves not only generates compassion, but gives us control, since we won't suppose that any part of us escapes being shaped by our circumstances, internal and external. Instead, we'll look at the actual causes of behavior, and thus be in a much better position to design and target effective interventions. So the insight that we don’t have contra-causal free will can be a key tool in achieving therapeutic objectives. Far from causing trouble, determinism - the reliable patterning of events and actions - can serve us well in navigating the world.
Further reading: Worldview Cognitive Therapy