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--------------------- text of forwarded message ----------------------- >Date: Sun, 28 Nov 1993 20:06:28 -0500 (EST) >From: MILLARD@ZODIAC.BITNET Jeff: We may end up reaching an aporia of metaphors here: you've described my antipsychoanalytic position in terms of hobbyhorses and blind alleys, while I've described the Freudian edifice as having a Tinkertoy foundation. To each his own trope, I guess, but I remain suspicious of any field grounded in writings that make elementary mistakes in logic. Freud posited the very things he set out to prove, and thus discovered nothing. Whatever later psychoanalytic writers have done, they have not broken with the whole cumbersome and unverifiable apparatus of repression, transference, family romance, ad nauseam. Until someone can demonstrate that these things have a material existence (and are not implanted in vulnerable, suggestible, even gullible minds by the unaccountable and unassailable authority of a therapist), I see no particular reason to grant psychoanalysis the status of a true intellectual discipline. It is possible to write with complexity, even eloquence, about how many reaction formations can dance on the head of a pin, but does this differ from other tautological, unverifiable discourses (phrenology, Christian fundamentalism, Scientology, the works of Mary Baker Eddy, etc.) in ways anyone can observe and communicate to other fields of study? Psychoanalysis claims an explanatory power that can be justified only in the terms of psychoanalysis. It finds Oedipus just as reliably as the Salem inquisitors found witches. One way to measure the value of a tautological discourse might be to look for practical clinical effects. Do the patients actually get better? Medicine tries to answer this question for any new treatment through controlled studies, but psychoanalysis has somehow managed to carry on for 90 years or so without subjecting itself to any of those. Other psychotherapies, whose practitioners are a bit less shy of reality testing, have taken this leap, and certain methods do in fact outperform placebo. Cognitive and behavioral therapies, in particular, have a record to stand on. Psychoanalysis simply does not. This is not to say that no one has ever had clinical improvement while working with a Freudian -- though, as Crews reminds us early in his review, it might be useful to try to distinguish a convert (in the religious sense) from someone actually cured. But isolated case studies are no substitute for quantitative science. I hold a daytime job writing for a medical journal, and I was recently assigned an article on the diagnosis and treatment of depression; the research for this project involved interviews with leaders in psychiatry, psychology, and internal medicine. They unanimously dismissed long-term psychotherapies of any flavor, particularly the psychoanalytic, as valid treatments for major depressive disorders. Extensive meta-analysis of the psychiatric and psychological literature supports the clinical common-sense principle that when an approach doesn't work after a couple of months, you switch to something else. Psychoanalysis simply doesn't work, and in holding forth the never-realized promise of a slow, gradual resolution to deep-seated conflicts -- a miracle cure -- it precludes the possibility that a patient will undertake an approach with a reasonable chance of success. I won't quote my interviewees here, as they spoke to me for a particular project and didn't intend their remarks for other contexts, but I can describe their account of Freudianism as scathing. Perhaps devotees of psychoanalysis prefer to remove that discourse from the clinical setting entirely and account for it merely as a belletristic discursive practice. They're welcome to whatever readings they care to produce using these methods; personally, I've never run across one that refutes Nabokov's recurrent description of them as banal, reductionist, and abusive. Perhaps some people have had positive personal experiences with the practice, and they're welcome to those as well; I remain unconvinced that the lucrative professionalization of conversational functions that were performed by people's family, friends, and community members for centuries before Freud ever came along represents any true improvement over those older, informal discursive forms. People doubtlessly have relieved some personal tensions by going to Roman Catholic confession or talking at length to bartenders, but I don't think it follows that the Catholic cosmology has grounds for truth claims or scientific status (or that a central nervous system depressant is a wise choice when what exacerbates one's interpersonal problems is an imbalance of brain chemistry). Anecdotal evidence just isn't the stuff of which a science is made; this isn't meant to disparage your personal experience, Jeff, but only to call psychoanalysis's claim to scientific status and curative power into question. When someone finds a way to measure how reliably the Freudian methods can truly benefit a patient -- and compares that measurable benefit with the long history of abuses such as the Dora or Wolf Man cases, let alone the myriads of cases where people have been maintained in a prolonged state of neurosis or worse, placing faith in their therapists' mystical power to the exclusion of other methods with known effects -- then psychoanalysis might begin to assemble a credible defense of its social privilege. As these analysts continue to duck the challenge of controlled trials, though, I remain as skeptical toward their theory as I am toward the supernatural, "free-market" economics, Leninist millennialism, or Shirley MacLaine's assertions that she can channel dead royalty. I'll stoop as low as a pun here: If it ducks like a quack, it's probably a quack. And it's by no means as harmless as MacLainism. It's an ideological state apparatus in Althusserian terms, driving people's consciousness ever inward away from the social realm; it produces excellent little capitalist subjects, solipsistically focusing on their feelings and resentments, modeling all human interactions after murderous infantile rages, rejecting the observable material causes of phenomena in favor of the obscurantist and the perverse, amplifying the tensions of families into the grim, hateful lockstep of the Oedipal ur-family. Most damagingly, it blurs the boundaries that separate the real from the imaginary from the implanted, leading to the kind of real-world results chronicled in Lawrence Wright's "Remembering Satan" (_New Yorker_ May 17 & May 24, 1993). Never having personally observed it having any effect on anyone but to make them unhappier, more cultishly intolerant, more self-absorbed, and more resistant to the kinds of therapies or beliefs that could actually help them, I can only view psychoanalysis as a device for encouraging everything selfish, competitive, bitter, and unhealthy in a person's mind. Narcissism is precisely the point: psychoanalysis (particularly Alice Miller's brand of it) manufactures narcissism. We need less of this, not more. Ecrasez l'infame. Flamingly, and at much greater length than I intended... but, hey, this is serious stuff, since it's capitalism's most powerful tool for invading your head... -- Bill Millard