Purchase Item

Manufacturer: Amazon Remainders Account
List Price: $25.00
Our Price: $9.18

incorrect at the core

Useful but diffuse

Brave and Brilliant

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.

A Failure

Tackling Freud while claiming to have tackled all of healing

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.

Book Description

From the critically acclaimed authors of Making Monsters, a no-holds-barred critique of talk therapy that will forever change your view of the couch.

In this clearheaded and courageous book, Ethan Watters and Richard Ofshe expose the pseudo-science behind the twentieth century's most enduring myth -- Freud's theory of the psychodynamic mind. Despite the lack of credible evidence for a powerful unconscious that controls our behavior, a huge number of therapists continue to base their practice on the idea that only they can uncover their patients' unconscious motivations, luring thousands of Americans, from the mildly demoralized to the seriously ill, down dangerous and arbitrary paths of treatment.

Therapy's Delusions reveals how, over the years, talk therapy has masqueraded as a scientific discipline and has cost patients time, money, and their mental well-being. Waters and Ofshe demonstrate how patients, therapists, and society alike are fooled by the stories created in therapy. This back-and-forth belief-building process has popularized countless faddish and speculative notions, some of the most aberrant of which have popped up in recent years, including the recovered memory trend the authors exposed in Making Monsters.

Therapy's Delusions also makes a decisive case for the biomedical approach to mental health care. In addition to the celebrated success of drugs like Prozac, revolutionary advances are being made in genetic research and in the field of cognitive and behavioral counseling. This book is a powerful call to action for reforming the poorly regulated mental health profession, so that no more patients are misled by a myth that has held sway over American minds for far too long.

Talk therapy's tight grip on both its patients and practitioners is exactly why it deserve close examination. Brilliantly argued, Therapy's Delusions is a crucial addition to the dialogue about Freud's legacy and essential reading for anyone considering taking his or her troubles to a psychodynamic therapist.