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A Basic Theory of NeuropsychoanalysisA Cursing Brain?A Dream of Undying FameA Map of the MindAfter LacanAgainst AdaptationAgainst FreudAn Anatomy of AddictionAnalytic FreudAndré Green at the Squiggle FoundationAnger, Madness, and the DaimonicAnna FreudAnna Freud: A BiographyApproaching PsychoanalysisAttachment and PsychoanalysisBadiouBecoming a SubjectBefore ForgivingBerlin PsychoanalyticBetween Emotion and CognitionBeyond GenderBeyond SexualityBeyond the Pleasure PrincipleBiology of FreedomBoundaries and Boundary Violations in PsychoanalysisBuilding on BionCare of the PsycheCarl JungCassandra's DaughterCherishmentConfusion of TonguesContemporary Psychoanalysis and the Legacy of the Third ReichCrucial Choices, Crucial ChangesCulture and Conflict in Child and Adolescent Mental HealthDarwin's WormsDesert Islands and Other Texts (1953-1974)Dispatches from the Freud WarsDoes the Woman Exist?Doing Psychoanalysis in TehranDreaming and Other Involuntary MentationDreaming by the BookEnergy Psychology InteractiveEqualsErrant SelvesEthics and the Discovery of the UnconsciousEthics Case Book of the American Psychoanalytic AssociationFairbairn's Object Relations Theory in the Clinical SettingFed with Tears -- Poisoned with MilkFeminism and Its DiscontentsForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFour Lessons of PsychoanalysisFratricide in the Holy LandFreudFreudFreudFreudFreudFreudFreud and the Question of PseudoscienceFreud As PhilosopherFreud at 150Freud's AnswerFreud's WizardFreud, the Reluctant PhilosopherFrom Classical to Contemporary PsychoanalysisFundamentals of Psychoanalytic TechniqueGenes on the CouchGoing SaneHans BellmerHappiness, Death, and the Remainder of LifeHate and Love in Psychoanalytical InstitutionsHatred and ForgivenessHealing the Soul in the Age of the BrainHeinz KohutHeinz KohutHidden MindsHistory of ShitHope and Dread in PsychoanalysisImagination and Its PathologiesImagine There's No WomanIn Freud's TracksIn SessionIn the Floyd ArchivesIntimaciesIntimate RevoltIrrationalityIs Oedipus Online?Jacques LacanJacques Lacan and the Freudian Practice of PsychoanalysisJung and the Making of Modern PsychologyJung Stripped BareKilling FreudLacanLacanLacanLacan and Contemporary FilmLacan at the SceneLacan For BeginnersLacan in AmericaLacan TodayLacan's Seminar on AnxietyLawLearning from Our MistakesLove's ExecutionerMad Men and MedusasMale Female EmailMelanie KleinMemoirs of My Nervous IllnessMental SlaveryMind to MindMixing MindsMoral StealthMourning and ModernityMovies and the MindMurder in ByzantiumNew Studies of Old VillainsNocturnesNoir AnxietyOn Being Normal and Other DisordersOn BeliefOn IncestOn Not Being Able to SleepOn the Freud WatchOn the Way HomeOpen MindedOpera's Second DeathOvercoming Destructive Beliefs, Feelings, and BehaviorsPhenomology & Lacan on Schizophrenia, After the Decade of the BrainPhilosophical Counselling and the UnconsciousPractical Psychoanalysis for Therapists and PatientsPsychiatry, Psychoanalysis, And The New Biology Of MindPsychoanalysisPsychoanalysis and Narrative MedicinePsychoanalysis and NeurosciencePsychoanalysis and the Philosophy of SciencePsychoanalysis as Biological SciencePsychoanalysis at the MarginsPsychoanalysis at the MarginsPsychoanalysis in a New LightPsychoanalysis in FocusPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychotherapy As PraxisPutnam CampQuestions for FreudRe-Inventing the SymptomReading Seminar XXReinventing the SoulRelational Theory and the Practice of PsychotherapyRelationalityRepressed SpacesRevolt, She SaidSecrets of the SoulSerious ShoppingSex on the CouchSexuationSigmund FreudSoul Murder RevisitedSpectral EvidenceSpirit, Mind, and BrainStrangers to OurselvesSubjective Experience and the Logic of the OtherSubjectivity and OthernessSubstance Abuse As SymptomSurrealist Painters and PoetsTaboo SubjectsTalk is Not EnoughThe Art of the SubjectThe Brain and the Inner WorldThe Brain, the Mind and the SelfThe Cambridge Companion to LacanThe Challenge for Psychoanalysis and PsychotherapyThe Clinical LacanThe Colonization Of Psychic SpaceThe Condition of MadnessThe Couch and the TreeThe Cruelty of DepressionThe Dissociative Mind in PsychoanalysisThe Dreams of InterpretationThe Examined LifeThe Fall Of An IconThe Freud EncyclopediaThe Freud FilesThe Freud WarsThe Fright of Real TearsThe Future of PsychoanalysisThe Gift of TherapyThe Heart & Soul of ChangeThe Knotted SubjectThe Last Good FreudianThe Letters of Sigmund Freud and Otto RankThe Mind According to ShakespeareThe Mystery of PersonalityThe Mythological UnconsciousThe Neuropsychology of the UnconsciousThe New PsychoanalysisThe Power of FeelingsThe Psychoanalytic MovementThe Psychoanalytic MysticThe Psychoanalytic Study of the ChildThe Psychoanalytic Study of the ChildThe Psychodynamics of Gender and Gender RoleThe Puppet and the DwarfThe Real World Guide to Psychotherapy PracticeThe Revolt of the PrimitiveThe Seminar of Moustafa SafouanThe Sense and Non-Sense of RevoltThe Shortest ShadowThe Social History of the UnconsciousThe Surface EffectThe Symmetry of GodThe Tragedy of the SelfThe Trainings of the PsychoanalystThe UnsayableThe World of PerversionTherapeutic ActionTherapy's DelusionsThis Incredible Need to BelieveThoughts Without A ThinkerTo Redeem One Person Is to Redeem the WorldTrauma and Human ExistenceTraumatizing TheoryUmbr(a)Unconscious knowing and other essays in psycho-philosophical analysisUnderstanding Dissidence and Controversy in the History of PsychoanalysisUnderstanding PsychoanalysisUnfree AssociationsWalking HeadsWay Beyond FreudWhat Does a Woman Want?What Freud Really MeantWhen the Body SpeaksWhere Do We Fall When We Fall in Love?Whose Freud?Why Psychoanalysis?Wilhelm ReichWinnicottWinnicott On the ChildWisdom Won from IllnessWittgenstein on Freud and FrazerWittgenstein Reads FreudWorld, Affectivity, TraumaZizek

Related Topics
Therapy's DelusionsReview - Therapy's Delusions
The Myth of the Unconscious and the Exploitation of Today's Walking Worried
by Ethan Watters and Richard Ofshe
Simon & Schuster, 1999
Review by Natalie Simpson
Sep 30th 1999 (Volume 3, Issue 39)

The aim of Therapy's Delusions is to show that psychodynamic psychotherapy is unscientific, wasteful, ineffective and dangerous. The term "psychodynamic psychotherapy" is defined as "any talk therapy that claims to have the power to cure mental illness or derives its status from that claim or from its relation to the theory of the mind promoted by Freud" (p.13). In the introduction, the authors clearly describe how they intend to present their case, and promise that they will show that there is no scientifically credible evidence for repression of memories, and that there is no evidence that psychotherapists have any means of breaking through the repression barrier. They aim to show that both patient and therapist are profoundly influenced by cultural factors, and by each other's beliefs, and also that talk therapy in general can make little claim to cure mental illness.

The book is written in a clear and readable style without jargon or unnecessarily technical language. However, its overall structure and plan of campaign are unclear, and the arguments are presented as conclusions, with little evidence to back them up. The bias of the authors against psychodynamic psychotherapy is so obvious that it detracts from the credence of their statements. For example, a published case study of a successful outcome in psychoanalysis is discussed as though it were a myth, saying that the patient was "supposedly able to walk, unaided" (p. 74). On the other hand, a case study of an unsuccessful outcome in psychoanalysis is discussed sympathetically without doubting any of its claims (pp. 94-99). There does not appear to be any scientific reason for the difference in treatment of the case studies.

To show that there is no evidence for the validity and efficacy of psychodynamic theories is not enough. Discrediting a theory requires either the production of evidence that contradicts the theory, or the demonstration that an alternative theory is "better" in some way. There are numerous case studies that appear to support psychodynamic psychotherapy; if these are to be shown to be invalid, then they must be examined carefully and objectively, and other explanations for the apparent success of the therapy must be proposed and backed up with other evidence. To reject psychodynamic explanations on the grounds that they are "bizarre" and "not compelling", as in the case of the interpretations of the analyst Harold Boris (pp. 168-170), is no more scientific than it would be to support them on the grounds that the patient apparently believes in them.

The principal alternative explanation for reported successes in psychoanalysis is that patients believe their therapy is successful because they are influenced by their therapists and the culture supporting therapy, and that therapists in turn build up their beliefs because of the patients' confidence in their interpretations. When this loop of positive feedback has completed many iterations, the therapist's professional reputation is assured. Although the power of the therapist to influence the patient is generally well known, the effect of the patient's beliefs feeding back to the therapist is less appreciated, and the chapters on "Why patients believe" and "Why therapists believe" are perhaps the most important parts of the book. Once again, however, it would have been helpful if the authors had drawn more evidence from the vast supply of social psychology experiments that show how easily people can be influenced without even being aware of it.

A book which aims to discredit a form of therapy many people hope will solve their troubles would be incomplete, even irresponsible, not to suggest an alternative. The authors' favoured alternative is a biomedical approach to reduce or remove the most crippling symptoms, together with cognitive behavioural therapy to help the patient cope with the day-to-day aspects of living. These treatments do indeed have much more empirical support than does psychodynamic therapy. However, such treatments usually offer management of symptoms, not a cure. Psychodynamic therapy offers, in contrast, the promise of gaining insight and understanding of the origin of symptoms and a permanent release from them with no further effort for maintenance. It is not hard to see why, despite the plethora of books and papers debunking Freud's theories, patients are still attracted to psychoanalysis. The authors recognise this, and offer the hope that when symptoms become more controllable, patients will have less need to develop dramatic narratives to provide an emotional cause for their illness. Perhaps they are right. Until then, however, no attempt to discredit psychodynamic therapy, including this book, will have the power to stem the demand for it from patients.

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