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

Very interesting information about theme

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 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.

A good reminder for clients and conscientious therapists about the harmful realities of therapy.

Rather too naively wedded to the biological model of mental illness and makes assertions about diagnoses which have subsequently been proved to be wrong.