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Therapy's Delusions: The Myth of the Unconscious and the Exploitation of Today's Walking Worried Hardcover – April 16, 1999


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Product Details

  • Hardcover: 288 pages
  • Publisher: Scribner (April 16, 1999)
  • Language: English
  • ISBN-10: 0684835843
  • ISBN-13: 978-0684835846
  • Product Dimensions: 8.8 x 5.8 x 1.1 inches
  • Shipping Weight: 1 pounds
  • Average Customer Review: 3.5 out of 5 stars  See all reviews (13 customer reviews)
  • Amazon Best Sellers Rank: #1,176,825 in Books (See Top 100 in Books)

Editorial Reviews

From Publishers Weekly

Following Making Monsters, their much-discussed attack on recovered memory therapy, Watters and Ofshe offer a rigorous critique of talk therapy of the Freudian variety and its many offshoots. In a broadside as withering as those by anti-Freudian critic Frederick Crews (Memory Wars; Unauthorized Freud), the authors assail psychoanalysis as a convoluted system of assumptions and anachronistic beliefs. Using cases from the psychoanalytic literature, they find troubling evidence of analysts' arbitrary diagnoses, misogyny, hubris and pretense of scientific authority. Ofshe, a sociology professor (UC-Berkeley), and freelance journalist Watters observe that with the psychotherapy profession in defensive retreat from its claim to reveal the secrets of unconscious minds, talk therapists have increasingly allied themselves with social movements and cultural trends, spawning feminist therapy, body/mind therapy, care of the soul (e.g., Thomas Moore's books) and so forth. The authors reject these approaches as fundamentally flawed because, in their view, Freud's notion of a dynamic unconscious that influences our everyday lives is nothing more than a culturally supported myth. The "biogenetic approach" they favorAcombining pharmacotherapy, research into brain dysfunction and rehabilitative behavioral/cognitive therapyAhas already made progress in treating schizophrenia and mood disorders. Ultimately, however, their wholesale rejection of the existence of an unconscious, and of the roots of mental illness in developmental or childhood factors, seems an article of faith as debatable as the exaggerated claims of talk therapists. Nevertheless, their provocative analysis of what happens in therapy sessionsAthe patient internalizing the life story that he or she creates in tacit collusion with the therapistAwill challenge patients and practitioners alike. An appendix dismantles the upbeat conclusions of an influential 1995 Consumer Reports survey, "Does Therapy Help?" Agent, Bonnie Nadell.
Copyright 1999 Reed Business Information, Inc.

From The New England Journal of Medicine

The concept of an unconscious mind is an old one, going back to speculations in the 12th century and articulated clearly by a Professor W.B. Carpenter of London in his lectures 25 years before Freud ever wrote his papers on the topic. Without reading a scientific article on the subject, anyone who has made an embarrassing slip of the tongue is well aware that our minds function outside our awareness.

Freud's contribution was to use the knowledge of these forces in the treatment of psychological difficulties. His explorations did for our understanding of the mind what Spallanzani did for biology in the 18th century and what Pasteur did a century later. They showed that there was no spontaneous generation but that things arose from causes. In other words, our mental functions do not result from random neuronal discharges from the cerebral cortex; instead, they have meanings of which we may not always be aware. This concept may be among Freud's most lasting contributions, and it has given rise to what is called psychodynamics -- the understanding of the meaning of mental life.

Written by a journalist and a sociologist, Therapy's Delusions attempts to prove that the concept of an unconscious is a delusion and that psychodynamic therapy is therefore a fraud. The authors cite stories of incompetent treatment, wild interpretations made years ago by analysts, recent forms of spiritual treatment, and even alien-abduction therapy -- all of which, for some reason, they include under the rubric of psychodynamic therapy. They constantly repeat the phrase "the myth of the unconscious," as though the repetition itself served as a proof.

The authors insist that because we have learned so much about the brain, the psyche is irrelevant in the treatment of psychological difficulties. However, although it is obvious that the brain mediates all mental functioning, in our present state of knowledge we cannot explain how it does so. Even major psychoses have not yet been explained in terms of brain function. For example, when schizophrenia develops in a monozygotic twin, in only 50 percent of cases will the same condition develop in the remaining twin, even though the twins have identical genes. This finding has been cited by geneticists as evidence that environmental, nongenetic factors play a part in the disease. We have a long way to go before we can be certain of the causes of psychological difficulties.

Although Freud founded psychoanalysis, many of his ideas have been enlarged, changed, and discarded by analysts, just as in any medical discipline. However, the importance of unconscious mental functioning is universally recognized, both within and outside the field.

In the field of psychiatry, the past 100 years have been marked by a conflict between psychiatrists who view all mental illness as caused by brain pathology and psychiatrists who focus on psychological issues. This either-or dichotomy is arbitrary and restricting -- it has been called "mindless versus brainless psychiatry." Clearly, both neuroscience and psychology contribute to our understanding of how the mind works and are certainly not contradictory. There is evidence that not only can brain difficulties affect psychological functioning, but also psychological events can alter brain structures and bodily functions.

Recent advances in neuroscience have shed much light on mental functioning, and some psychoanalytic training institutes have started to give courses in neuroscience and its relation to the mind. The authors complain that those in the field of psychodynamics do no research into their subject, but a great deal of sophisticated research is being carried out, much of which is sponsored by the major psychoanalytic associations.

Many books have been published recently that are critical of psychodynamic psychiatry, and some have been written by thoughtful investigators. I am afraid that Therapy's Delusions is not one of them. It is more a polemic than a serious study and is selective and slanted in its presentation. For the knowledgeable reader, it adds nothing new on the subject.

Reviewed by Richard S. Blacher, M.D.
Copyright © 1999 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.


More About the Author

Ethan Watters is the author of Crazy Like Us: The Globalization of the American Psyche. Before that he authored Urban Tribes, an examination of the mores of affluent "never marrieds" and coauthored Making Monsters, a groundbreaking indictment of the recovered memory movement. A frequent contributor to The New York Times Magazine, Discover, Men's Journal, Details, Wired, and PRI's This American Life, he has appeared on such national media as Good Morning America, Talk of the Nation, and CNN. He is a co-founder of the San Francisco Writers' Grotto, a cooperative writing workspace in San Francisco.

Customer Reviews

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Most Helpful Customer Reviews

46 of 50 people found the following review helpful By Todd I. Stark VINE VOICE on April 21, 2000
Format: Hardcover
This isa "debunking" style book that can be summarized very simply: (1) Freud was a fraud, (2) most talk therapies are based on Freud's ideas, (3) most talk therapies are a fraud.
The argument is fleshed out along the way by several main themes. There is a negative interpretataion of psychotherapy outcome research, showing that most therapies are effectively interchangeable (an old argument with some validity), and that most outcomes are equivalent to placebo (also having some validity, though perhaps not as far as the authors take it).
There are also several useful chapters explaining why clients (incorrectly) believe they are being helped, why therapists (incorrectly) believe they are helping, and why we continue to believe in things that don't really work. Those chapters are so good, in fact, that one wonders why the authors don't realize that some of their own beliefs could probably be explained away in similar terms, if that was all that was required to debunk a topic.
The authors' rhetorical purpose is pretty clear, to dismantle the immense tree of modern psychotherapies at its roots, leaving only a vague sort of professional counseling service involving a straightforward short-term comforting of the distressed, and perhaps some of the better validated forms of cognitive and behavioral therapy. The long term therapy whereby the client spends months or years seeking out childhood stories to explain their current difficulties is attacked thoroughly and without mercy.
Do the authors succeed in their task ?
Ofshe and Watters borrow heavily from Frederick Crews and other modern critics of Freud to make a persuasive case that Freud didn't know as much about his patient's minds, or even cure them as effectively as he claimed.
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20 of 24 people found the following review helpful By "slwheelock" on September 14, 1999
Format: Hardcover
"Therapy's Delusions" is the second critique of the mental health community by the same two authors. The first book, "Making Monsters" was a well-defined argument regarding a specific issue (sexual abuse) and how the psychological community, specifically unqualified therapists, had become negatively influenced by cultural myths and fears.
"Therapy's Delusions" is their attempt to critique the entire field of psychology, or what they refer to as "talk therapy". The argument is overgeneralized and not well-defined. There are many forms of therapy, a multitude of illnesses and many different types of therapists. The authors do not attempt to explain differences, but rather make blanket statements which are often inaccurate and are used to mislead the reader. For example, they discuss the 'myth of the unconcious' and 'psychoanalysis' as if they are an integral part of the current treatment of mental illnesses... which, in reality, may be considered historical ideas and for the majority of clinicians are not a significant part of treatment of major mental illnesses in the late 1990's.
While the authors make very compelling statements that incite anger towards the mental health community (e.g., the need for scientific research rather than just 'intuition'), their logic and argument is so generalized that it is unclear where the anger could be most effectively directed to cause change. For example, they discuss the merits of understanding the biological underpinnings of mental illness & the necessicity of rehabilitation therapy. They refer to these as if they have found the panacea for "cures".
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13 of 16 people found the following review helpful By A Customer on August 11, 1999
Format: Hardcover
This book forced me to rethink many ideas about psychotherapy and even 20th Century culture. Calling for increased accountability for psychotherapists, the authors document how psychotherapeutic techniques have damaged mentally ill individuals. They also present the process of psychotherapy as one of manipulation and delusion - storytelling that deliberately encourages the confusion of fiction with fact.
A critique focused on behalf of mentally ill and so-called "walking worried" individuals, Therapy's Delusions may prove difficult for functional people in crises (the walking wounded?) who need no reminder of the complexities of the human mind. Compelling, and challenging to many 20th Century assumptions, the book raises fascinating questions, for example whether it's a fool's game for humans to even attempt to understand themselves.
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7 of 8 people found the following review helpful By Ms. L. R. Fisher on April 8, 2005
Format: Hardcover
After three years of therapy and several years of reflection I achieved an insight: I'd been sold a theory that I didn't subscribe to. Namely, that all my present problems were caused by incidents in my distant past that I'd forgotten. Once I'd remembered these incidents, my present problems would go away. I was also angry that my therapist seemed indifferent to serious problems I was facing in the present. I achieved another insight: that you can use your conscious mind to seek a solution to your problems. I enjoyed this book, because it supported these conclusions, and gave a lot of historical background. It is also good on the way people follow the herd and justify decisions after they've made them, the way people invent a self-narrative that will meet with their peers' approval. The only flaw is a serious lack of copy editing. Sentences ramble without making a point, modifiers dangle, apostrophes come and go and spelling is random. No doubt after another 20 years' work on my anal tendencies I will learn to live with the authors' bad grammar.
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