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:: Against Therapy by Jeffrey Moussaieff Masson
Against Therapy by Jeffrey Moussaieff Masson
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In this ground-breaking and highly controversial book, Jeffrey Moussaieff Masson attacks the very foundations of modern psychotherapy from Freud to Jung, from Fritz Perls to Carl Rodgers. With passion and clarity,
addresses the profession's core weaknesses, contending that, since therapy's aim is to change people, and this is achieved according to therapist's own notions and prejudices, the psychological process is necessarily corrupt. With a foreword by the eminent British psychologist Dorothy Rowe, this cogent and convincing book has shattering implications.
This is a book about why I believe psychotherapy, of any kind, is wrong. Although I criticize many individual therapists and therapies, my main objective is to point out that the very idea of psychotherapy is wrong. The structure of psychotherapy is such that no matter how kindly a person is, when that person becomes a therapist, he or she is engaged in acts that are bound to diminish the dignity, autonomy, and freedom of the person who comes for help.
I began training to become a psychoanalyst at the Toronto Psychoanalytic Institute in 1970. Eight years later, in 1978, I was admitted to the International Psychoanalytic Association as a psychoanalyst. In the course of my training at a classical, orthodox psychoanalytic institute, much of it in the theory and technique of what is termed “dynamically oriented psychotherapy,” I was beset with doubts that I assumed were typical: Did any of this make sense? Was I really helping people during therapy? Was I any better off than my so-called patients? As part of my training, I was in analysis five days a week for five years; my “patients” were also in analysis five days a week for five years. Couldn’t we easily have changed places? Did I really understand “emotional problems of living” any better than anybody else, including people who had absolutely no training or background? Was I learning anything that had any practical application? Were there “skills” that could be acquired, e.g., learning to listen, learning to be “empathic” or merely sympathetic, learning to suspend judgment, and so on? If so, was I acquiring them? These doubts were fairly typical of my colleagues at the initial stages of psychoanalytic training. But I still had these doubts after eight years of training.
I saw three possibilities: there was something wrong with me; there was something wrong with the particular training I was undergoing; or there was something wrong with the theory and the practice. I chose to believe the second, and least threatening, explanation, and decided that once I graduated from Toronto and gained a wider acquaintance with the world of psychoanalysis both in the United States and in Europe, I would be able to resolve my doubts concerning psychotherapy.
I moved to California in order to start a psychoanalytic practice. My doubts persisted; in fact, they increased. I realized that until I felt clearer about these issues, it would be better for me not to practice. I turned my energies to historical research. The issue that most intrigued me was Freud’s abandonment of the so-called seduction theory. As a psychoanalytic student I had been taught that Freud initially believed the women who came to him for therapy when they said they had been sexually abused as children, often by members of their own family. Then he made what he thought to be a momentous “discovery”: What he heard from these women were not genuine memories; they were, Freud said, fabricated stories, or madeup fictions. They were fantasies, not memories. Or they were memories of fantasies. They were, Freud believed, important, but they were not real; they referred to internal, not external, events. The implications of this “discovery”—it never occurred to Freud that it was only a point of view—were enormous. It has affected the course of psychoanalysis and therapy in general from that time on, and has caused incalculable suffering for patients who were in fact sexually abused. Therapists accepted Freud’s belief that the best judge of what really happened is not necessarily the person to whom it happened. In therapy, the person’s account of a traumatic event is not to be taken literally, as referring to something real that happened in the real world. It may be no more than a symbol, a sign pointing to an obscure internal area of confused desires and fantasies, a nest of unacknowledged needs, impulses, drives, and instincts said to be hidden in the heart of every human being.
To find out what happened, in this view, requires an external, objective source, a person trained in a demasking procedure: the therapist. Freud’s views became the testing ground for the training of a later generation of therapists. The therapist thought he knew when patients were confusing internal fantasy with external reality because he had the previously analyzed experiences of the patients of the founder of psychoanalysts to serve as a guidepost. Many people believed that a major breakthrough in the alleviation of human suffering had been achieved: If people could so confuse inner with outer reality that they could mistake an obscure (and never conscious) desire with a frightening and vivid memory of having been sexually assaulted, then how much else might they have distorted in their lives? How could they be trusted to know the real intricate relationship they had with their mothers, their fathers, their siblings, even their spouses? The idea that only the analyst can judge whether something is real or merely a fantasy became standard doctrine, and the very foundation of psycho-analytically oriented psychotherapy. I was taught during my psychotherapeutic training that statements about relationships should always be regarded as no more than an account of wishes, fantasies, desires, and projections. They could not be taken at face value any more than could accounts of sexual assault in childhood. Thus, when I began my investigation of Freud’s momentous about face, I was not investigating some obscure corner of psychoanalytic history that held no more than antiquarian interest for a small number of historians. I was examining one of the cornerstones of psychoanalytic therapy.
The results of my investigation were initially received by the psychoanalytic profession with somewhat less than cordial and objective interest. I should not have been surprised that when my book The Assault on Truth: Freud’s Suppression of the Seduction Theory appeared in early 1984, the attention of reviewers was riveted on the character of the author rather than on an examination of the issues. I had assumed that the implications for psychoanalytic therapy of the new documents I had found—for example, previously unpublished letters by Freud, new material from the Paris morgue about child abuse, unknown pages from Ferenczi’s private diary—would be pursued by members of the profession with more clinical experience than I had. I was entirely mistaken. Instead, wherever I lectured, even in France, Italy, Spain, and Holland, the discussions focused on my physical appearance, my clothing, my motivation in researching child abuse, my relationship with my father, my mother, my analyst, Anna Freud, and others. It seemed that neither the findings nor their implications could be regarded with any dispassion. I learned that people who criticize establishment dogmas are not accorded a serious hearing. I took some comfort in the recognition that the pain I felt over the personal attacks against me was due to my political naiveté.
But if psychoanalysts, academics, and some members of the public sympathetic to psychoanalysis were not prepared to deal with the issues, another vocal and important part of the public was: the feminists. Many women were interested in the historical material and documentation I had gathered. Feminist writers, including Florence Rush, Judith Herman, Diana Russell, and Louise Armstrong, commented favorably on the research. My book joined a long line of recent works exposing the reality of sexual abuse of girls and women, the most recent of which is the excellent book by Diana Russell, The Secret Trauma: Incest in the Lives of Girls and Women.
I received many letters in response to an article on the history of sexual abuse in the March 1984 issue of the Atlantic and another in Mother Jones in December 1984 about my findings. These letters, almost all from women who had been sexually abused in childhood, showed me that many of the facts I uncovered as a result of my archival research were correct and relevant today.
The purely intellectual satisfaction I experienced with the publication, in 1985, of The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904 and the largely favorable reviews it received helped restore some of my faith in the value of pure research. But I think this is only because most reviewers did not see the relevance of these letters, which contain the most elaborate exploration we have of Freud’s fluctuating views on sexual assault in childhood, to the issues I raised in my earlier book. No review looked at sexual abuse in the light shed by these letters. I believe the letters make it clear that Freud had considerable clinical evidence, material from his own patients, that the abuse he later repudiated as fantasy was, in fact, real.
I had yet to come to terms with one important point: Why would I expect that Freud or Fliess would behave any differently toward their patient Emma Eckstein than they did? Freud had handed her over to Fliess, who “diagnosed” her to be suffering from a “nasal reflex neurosis” and performed an experimental operation on her nose. She nearly died when she hemorrhaged as a result of surgical gauze Fliess left in the wound he created. Freud later told Fliess that her bleeding was “hysterical”—psychological, and not the consequence of Fliess’s incompetence. This was to be expected, some feminists told me, because the whole legacy of medicine and surgical intervention on women was a violent one. Was this true? Official psychiatric histories presented the nineteenth century as the age when psychotherapy as we know it today was born. Many authors had argued that this official history omitted the violent aspects of nineteenth-century psychiatry. But by and large most confined their research to material available in English. The materials for exploring this in any depth for German and French psychiatry, so influential in England and America, were hard to come by. My knowledge of the primary literature was limited to what I knew from my readings in preparing the Freud/Fliess letters for publication. To place the controversy over sexual abuse in a wider historical context, it was necessary to spend the next few years examining the nineteenth-century psychiatric, pediatric, and gynecological periodical literature in some depth. The result was A Dark Science: Women, Sexuality and Psychiatry in the Nineteenth Century, a reader of the horrors inflicted on women in the name of “mental health.”
Feeling my historical obligations at an end, I have one task remaining to do justice to my many years of psychoanalytic training. Most of that training was not theoretical, but practical—as psychiatrists like to say, clinical. During my training, I was much too close to psychotherapy, either being in it myself or dispensing it, to be able to examine it critically. Now I was unencumbered by any need to protect the profession or my place in it. Perhaps the response of the profession to my findings about child abuse in Freud’s time and by implication today was so obtuse, vicious, and self-serving that it would prejudice me against therapists in general. There is some truth in this. Nevertheless, I no longer feel the personal bitterness I once felt. I am left with a strong need to examine what I learned about practicing therapy on “patients,” and to examine the theoretical assumptions of psychotherapy in general more critically than I feel has yet been done.
This book, then, fulfills my obligation to the reading, the training, and the preoccupations of the last sixteen years of my life. Now these years feel like an intellectual detour. I became fascinated with what appeared at the time to be the intellectual beauty of psychoanalytic theory. Perhaps the more profound lesson I learned is that investigation of psychoanalysis was not really a detour at all. Had I studied medicine, or law, or philosophy, the kinds of discoveries I have made would have been duplicated in those fields. I learned something, in the end, about the pretensions to knowledge. I learned something of the frailty of our ability to help another person who is in emotional distress, and especially about the pretensions to this ability. I learned about power, and hierarchies, and dominance, the rationalizations for abuse, and the inability of many people to comprehend the suffering they cause others.
Perhaps it was not a detour after all. When I began my psychoanalytic training, I was a Sanskrit scholar who had become disillusioned with the notion that life could ever provide a guru, a person with unique insights into the internal life of another person. I thought this claim was unique to Indian culture, one that had caused people a great deal of unhappiness, though no doubt many would claim that it had also brought them great happiness, even joy and bliss (just as some people who have had electroshock claim that it did them a great deal of good). I wrote an unpopular book on this theme in 1980, The Oceanic Feeling: The Origins of Religious Sentiment in Ancient India. And yet, here I was, eight years later, coming to the same unhappy conclusion about psychotherapy: There are no gurus. Maybe I was touching on one of the characteristics of the human animal, the need to seek somebody apparently stronger, wiser, better, happier, from whom guidance could be sought.
Some who have listened to my ideas have agreed that I may be right, but have then asked a question. Granted that psychotherapy is flawed, what would I put in its place that would be better?
In reply I would note that, as one feminist friend put it, nobody thinks of asking: What would you replace misogyny with? If something is bad, or flawed, or dangerous, it is enough if we expose it for what it is. It is almost as if once it has been determined that something exists, we decide it must be there for a reason (undoubtedly true) and then slide into the false position that it must be there for a good reason, which is undoubtedly not true. Or it is as if we believed that if we finally rid ourselves of something heinous (like apartheid), then we must replace it with something similar in nature. The truth is we do not know all the wonderful things that could happen once something hateful is abolished. Anyone who has ever oppressed another human being invariably asks what will happen once the oppression is over. What will happen to children once we stop beating them in schools? What will happen to slaves when they are freed from the plantations? What will happen to animals when we stop slaughtering them for food? What will happen to women when we stop subordinating them? What will happen to nonconformists when we do not incarcerate them in psychiatric institutions? What will happen to the wife when her husband no longer beats her? These questions are not real questions at all. What is required is a shift of focus, to the people who do these things, the aggressors, not their victims. Why do men hunt? Why do psychiatrists torture people and call it electroshock therapy? Why do men rape? And, perhaps just as important, why does society tend to blame the victim for all these acts of violence? Why do psychologists search for what they think to be the flaw in the victim that caught the attention of the predator?
I have some ideas about how people could live without psychotherapy or psychiatry. I am thinking of self-help groups that are leaderless and avoid authoritarian structures, in which no money is exchanged, that are not grounded on religious principles (a difficulty with Alcoholics Anonymous and similar groups, since not all members share spiritual or religious interests), and in which all participants have experienced the problem they come to discuss. I know that some women who have been sexually abused have been helped by getting together with other sexually abused women to share experiences, survival strategies, political analysis, and just their own outrage. What we need are more kindly friends and fewer professionals.
Published by: Untreed Reads
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