Customer Reviews

Therapy's Delusions: The Myth of the Unconscious and the Exploitation of Today's Walking Worried

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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. I found their case compelling, also, (though not original) that psychoanalysis was never a scientific discipline in the sense that analysts once seemed to claim. So much for the Freudian roots of long term therapy.

However, the authors don't make the argument as convincingly that all of the many therapies are really so reliant on Freud specifically. Afterall, as the authors point out, so much of our culture has been influenced by the psychodynamic model that it is difficult to even identify the influences today. The aspects of Freud that the authors consider the biggest problem are (1) the unconscious mind that affects us while being hidden from view, (2) the way the unconscious mind is supposed to affect us through childhood trauma and (3) the privileged knowledge of therapists to uncover the unconscious mind. To the degree that therapies claim privileged access to the unconscious mind, Ofshe and Watters' critique probably applies to some extent. To the degree that therapies rely on uncovering hidden childhood trauma, likewise the critiques seem to apply.

The problem I had with this book's line of reasoning is the cases where therapies are not reliant in any straightforward way on psychoanalytic thinking. Some of these other forms of therapy have a growing body of empirical data behind them. The authors seem to dismiss all therapies in the same sweeping argument, even though the research they review clearly shows that some therapies are more effective than others for specific things. While pointing out the positive research results for various cognitive and behavioral therapies, the authors seem to dismiss the positive results with some therapies as unimportant because it isn't explained in a satisfactory way by current medical theories.

The weaknesses of the book are twofold. For one thing, the authors, whose background is social sciences rather than biology, hold an untenable and archaic view of human biology as solely chemistry and biology. Their assumptions are based on an older dualism, finding no relationship between thoughts and feelings and beliefs one hand and physiological processes on the other hand. In contrast, most modern biologists who specialize in human beings seem to find that information processing in humans is in fact a pertinent factor in how the brain and body regulates themselves. Thoughts, feelings, and beliefs are not irrelevant to health, they are simply not relevant in the bizarre way postulated by the Freudians. So the Freudian therapies may all be equally silly in some sense, as the authors suggest, but they apply their admonitions much more broadly than that, claiming that therapy never really influences more serious problems, which is demonstrably false, even within the data surveyed by Ofshe and Watters.

The second problem is that the authors' interpretation of psychotherapy research is consistently biased, to the point of rejecting data that most other independent reviewers consider either positive or ambiguous. The authors are so intent on showing that therapy can't work that they ignore a wealth of data showing that cognitive therapy, for example, and drugs can work equally well in a number of kinds of serious mental health problems, such as major depression. The authors posit a very simplistic model of mental illness, which (ironically) follows Freud's own model, separating serious illness (Freud's psychosis) from simple daily distress (Freud's neurosis). They claim that somatic treatments (drugs, surgery, shock) are more appropriate for the serious category, and that it doesn't matter what we do for the non-serious category. Not only is that kind of clear distinction not entirely supportable, but the overlap of treatments effective with both categories shows that the _treatments_ do not fall into such cleanly distinct categories either.

Giving the effective drugs, surgery, and shock treatments their due, we shouldn't limited by Ofshe and Watters' failure to consider the information processing dimension of human self-regulation. But I think we can certainly heed their admonitions about the fallacies we accept too easily about ourselves. They make a number of good points about how people form beliefs about their own problems that are not only not necessarily accurate but also may not have much to do with effective treatment.

However they dismiss the clear evidence that "simply" how we interpret our situation is actually a factor in mental health. They make the reasonable point that this interpretation can also go astray in a number of ways, without every being particularly therapeutic or accurate, and that is the strength of this book.

"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". The majority of the psychological community have long realized the strengths of understanding the importance of biology, medication, and rehabilitation. However, they do not offer cures as the authors state. Major mental illnesses are very complex and are still being studied. Often medication offers stabilization, not cures.

The authors inaccurately attempt to make arguments and relationships between major mental illnesses (e.g., schizophrenia, psychotic disorders, major depression) and other reasons people enter therapy (e.g., marriage conflicts, loss issues, personal growth). They misguide the reader to believe that therapy approaches these difficulties with similar treatments (e.g., their focus on Freudian psychoanalysis is an example of their ill-defined argument and lack of knowledge of the variety of treatments).

Overall, the authors have attempted to critique a very broad field and ignored the differences that are a part of the field. The generalizations used could definitely mislead readers who have no other knowledge regarding the issues addressed in this book. When reading this biased argument, readers need to realize that the authors have taken their biases and painted over all the issues to the point that they have lost any valuable and logical argument. Rather, their attempt has clarified their agenda to discredit the mental health and psychological community based on generalizations, misinformation, and ignorance.

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.

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.

Does dysfunction have specific causation in the mind which is curative merely by exposing it? That's a psychotherapeutic promise roundly criticized in this book. "Therapy's Delusions" is an insightful scrutiny of an institution overdue for critique.

A particularly telling chapter, "Why Therapists Believe," explores how therapists buy into their own publicity as magic healers. Here they are compared with psychics who shore up their self-mythology by conveniently overlooking the many times they are wrong. There's lovely discussion how psychotherapists explain away patient anger or therapeutic failure as negative transference, and their own misconduct as countertransference. (Wonder how many times psychotherapists have employed these as legal maneuvers in licensing board hearings or malpractice defenses.)

I disagree however with this book's final destination: reliance on psychopharmacology as key to alleviating psychic suffering.

For who exited psychotherapy feeling like they have been conned by side-show charlatans, there is much confirmation in "Therapy's Delusions."

This is an important, well written, well argued, and devastating critique of psychotherapy. If it's wrong, the points made need careful refuting. If it's right, it's a substantive contribution to better understanding how we think and should have consequences in the worlds of medicine and law.

It's curious that there've been no reviews of "Therapy's Delusions" yet in amazon.com. This is a highly charged issue and I'd expected to see a lively debate here. Perhaps this review will encourage (incite?) submissions.

My short version of the basic premise is that people do not always think rationally, that we can be influenced by others to believe things that are simply false (actually, of course, we don't need others for this), and that this is much of what goes on in the forms of therapy they critique.

They have gotten ahold of an important idea and are continuing to make very good use of it. Ofshe and Watters have previously written a book alleging serious damage done by advocates of recovered memories. "Therapy's Delusions" is a continuation of the arguments raised in their "Making Monsters". Also, not mentioned in "Therapy's Delusions" is work done by Ofshe in finding and freeing people convicted of crimes they confessed to but did not commit; this is basically the same premise applied to another field.

One criticism: Ofshe and Watters use modern medicine as their example for how to go about doing things right. They have too high a regard for its accountability and capabilities. There are studies suggesting that medical malpractice kills about 100,000 people a year in this country.

This book is essential to anyone who currently is in therapy or who is thinking about entering therapy. The author will talk you out of it, and rightly so. For those of you who have already completed therapy (as I had when I read the book), be prepared to be very angry. You've been the victim of a hoax, and partially it is your (our) fault, for in order to enter and continue with therapy you have to subscribe to the presumptions of psychoanalysis and not question them. Once released from these assumptions (after you read "Therapy's Delusions") you will at least be thankful that you might never be fooled again. As Milton said, "Tomorrow to fresh woods, and pastures new."

This book illustrates to all what many who have been involved in the, highly speculative and sometimes dangerous, psychotheraputic system have experienced. This is not a psychology book and never pretends to be (one author is a Professor of Social Psychology UCB and the other an independent journalist). It is a book about psychotheraputic methodology and its efficacy. Many who have been unfortunate enough to sit through sessions with one of the psuedo-scientists commonly known as tharapists, will immediately identify with what this book has to say.

Here are my personal opinions which are completely supported by this book:

1. If you are not mentally ill - then make a concerted effort solve your own problems with the help and support of family and friends. The solutions you find will be more appropriate to your own life situation than those any therapist can manufacture.

2. If you ARE mentally-ill then seek out medical attention and stay on your medications as long as you need them.

You wouldn't advise a diabetic to try to go off their meds and switch to talk-based therapy. Don't make people who require drug therapy feel guilty about ther reliance on medication - THEY ARE ILL!

Our society needs to seriously revise the manner in which psychological discomfort and mental illness are dealt with. This book will provide readers with the necessary dose of skepticsm and food for thought that will be necessary if such a social revolution is to ever be undertaken.

the core purpose of this book is to "debunk" psychodynamic therapy, but the definition of psychodynamic therapy that the authors use is fundamentally incorrect. they also lump virtually all talk therapy into one category and call it psychodynamic which is also incorrect.

yes, many of Freud's theories are/were flawed and not empirically supported, and most psychologists realize this. most psychologists do not base their practice and theory on Freud alone. True psychoanalysis is still around, but psychoanalysis is not psychodynamic therapy.

the only thing i liked about this book is the fact that it supports pharmacotherapy. however, pharmacotherapy and talk therapy of some variety is really the way to go. if you are considering therapy, don't look to this book for help--find a book with a more balanced approach.

If you really want to know what this book is about, just read the New England Journal of Medicine review above. Bear in mind that Watters and Ofshe have no formal training in medicine, psychology, neuroscience, or any other clinical discipine. After a couple of efforts at debunking recovered memory, Watters and Ofshe have become intoxicated by the "high" of taking on a popular belief. The result is this misguided polemic. In some ways, their effort is reminiscent of the scientific integrity inquisitions of Stewart and Feder at the N.I.H. some ten years ago. It's not enough to want to get off on trashing a popular discipline; there has to be some validity to the arguments. I know of whence I speak because I read this book a few years ago and I can say without hesitation that it has no relevance to "psychodynamic" treatments as they are practiced today. The cases Watters and Ofshe dig up are of the most extreme and ridiculous sort. They make no effort to examine the theoretical underpinnings of the discipline they are attacking, nor do they attempt to give any balance to their account. In short, they just don't know what they are talking about.