Reviewed by Mira de Vries
“But Mira, you don’t believe in anything,” is an accusation oft hurled at me, as though I am guilty of psycho-atheism, a grave sin in our highly medicalized society. In Jeffrey Masson, an ex-psychoanalyst, I have found a kindred spirit, a fellow non-believer.
Traditionally, psychiatrists have debunked psychotherapy, pointing out its meager accomplishments and unscientific basis, although nowadays many are content to delegate the unpleasant business of listening to patients to psychotherapists. On the other hand, traditionally, psychotherapists have debunked psychiatry, pointing out its devastating damage to the mind and body, though nowadays many clamor for the right to prescribe psychiatric drugs.
Masson debunks both, without pardon, and without yielding to the temptation of producing an alternative model. So many excellent books have already been written on the cruelty of psychiatry, such as by Thomas Szasz and by many psychiatric survivors, that Masson chooses to focus on exposing the cruelty of psychotherapy. His main contention is that the therapeutic relationship is intrinsically abusive. The powerful person, the therapist, even when he resists physically abusing his powerless patients, still imposes himself on them mentally by defining himself as the proper judge of their behavior. Because the patients are considered sick, their viewpoints are automatically invalidated. Anything the therapist claims about them is accepted by third parties as correct, and anything the therapist does to them is accepted as defensible.
The first chapter of Against Therapy focuses on the mid-19th century writings of an involuntarily incarcerated French woman who was beautifully articulate, and able to express very well the indignities and injustices inflicted upon her. Masson believes her early writings are unique. Though no doubt rare, I have seen similar writings, for instance by the Dutch psychiatric victim Johanna Stuten-te Gempt, also from roughly the same time period. This does not detract from Masson's point that the core business of psychiatry and psychotherapy has always been and still is domination and fraud.
Next Masson picks apart the contentions of Sigmund Freud, a subject on which he is an authority, as two of his earlier books were totally devoted to Freud. Freud dealt with “voluntary” patients (apparently all women). Initially he listened to them and accepted their viewpoints, according to Masson, but later Freud allowed professional pressures to influence his interpretations of their tales. By deliberately misinterpreting his patient’s stories of sexual abuse as fantasies, he was callous, and the women worse off.
Sándor Ferenczi was Freud’s much loved disciple, who invented the idea of mutual analysis. Ferenczi recognized the truth of patients’ stories, and their legitimate need to be believed. This led to Ferenczi himself being disbelieved and disgraced by fellow psychoanalysts. Although Masson also criticizes Ferenczi, for instance for things he said to his patients according to his diary, he believes Ferenczi might have come around to recognizing the basic illegitimacy of psychiatry if he had lived long enough.
Carl Jung was not interested in patients’ pasts, but in dreams, to which he ascribed predictive qualities. Masson suspects that Jung’s disinterest in the past was related to his need to forget his own past of alleged collaboration with the nazis. The absence in Jung’s writings of any reference to concentration camps, along with the absence of references to other traumas such as sexual assault, child abuse, battering, torture, and other forms of violence, leads Masson to conclude that Jung was not interested in these aspects of his patients’ lives.
John Rosen, inventor of “Direct Psychoanalysis” even though he never had any psychoanalytic training, is much lauded in conventional circles still today. This is in spite of his being compelled to surrender his medical license in 1983 due to many and gross abuses of patients, which Masson describes in nauseating detail. (Rosen's book is available to medical students at the university in my town, without any mention of this.) Rosen’s disciple, Honig, continued in Rosen’s vile footsteps.
Carl Rogers, founder of Humanistic Psychology, is described by Masson as kind and benevolent. But a benevolent despot is still a despot, says Masson. Furthermore, Rogers was guilty of not actively interfering with psychiatric abuses he saw and knew about. The attention he paid to inmates of institutions was of no use to them, because it did not lead to their release, as those inmates themselves told him.
It is strange that Masson claims that Szasz, though an excellent critic of psychiatry, has failed to criticize psychotherapy. Szasz published an article called 'The Myth of Psychotherapy' in 1974, fourteen years before Masson’s Against Therapy, and in 1978 Szasz published a book by the same name. Szasz’s Sex by Prescription published in 1980 is also a stinging critique of the folly of psychotherapy.
In his last chapter before the brief conclusion, Masson discusses Family Therapy, Gestalt Therapy, Feminist Therapy, Incest-Survivor Therapy, Ericksonian Hypnotherapy, and Eclectic Therapy, which means “a little bit of everything.” The problem with all these therapies is the same as with the previously described therapies: the imbalance of power; the assumption that the therapist has superior insight and wisdom, and is thus justified in imposing his views on the other; and gross discordance between stated aims and actual results. Psychotherapy cannot be reformed, Masson concludes, it must be abolished.
The edition of Against Therapy I borrowed from the library was printed in Britain, and has a foreword written by Dorothy Rowe. Like in her foreword some years later to the British edition of Peter Breggin’s Toxic Psychiatry, she misses the point.