Monday, December 17, 2007

Jeffrey Masson - Against Therapy (1990)

Though I read them some time ago, I was a big fan of Masson's books on emotions in animals, Dogs Never Lie About Love (despite the fact that I'd be lying if I said I was a dog lover), and When Elephants Weep. However, when I got to The Nine Emotional Lives of Cats, I felt that he was relying far too heavily on the, in my opinion dubious, claims of evolutionary biology to explain the emotions in animals. What I didn't realise was that Masson has a whole other history in the field of psychoanalysis (not to mention Sanskrit studies).

Masson is a fascinating character. A youthful savant, he was originally a sanskrit scholar before moving into the field of psychoanalysis. He quickly rose to the heights of editing an archive of Freud's letters, which had until then been kept from the public, held by Kurt Eissler, a man devoted to maintaining Freud's posthumous reputation; but Masson soon became disillusioned with Freud as an admirable person, and with psychoanalysis in general, and a massive falling-out ensued. Janet Malcolm describes this in her wonderful book In The Freud Archives, originally a New Yorker article; but, when she quoted Masson as having aimed to change the archives into a place of "women, sex and fun" he sued her for libel, and the ensuing case took a decade before finally being found in Malcolm's favour. Masson, disappointed by the lack of purchase gained by his work on therapy and psychoanalysis, then turned to writing about emotions in animals.

All this is by way of introducing Masson's self-explanatorily titled work, Against Therapy. Masson's position is that all one-on-one therapy is inherently deeply flawed, and that one-on-one therapy should be abandoned as a practice. This is because the therapist is inevitably in a position of great power, as an expert and as someone with the social power to determine sanity and insanity, normality and abnormality, while the patient (or client) is inherently vulnerable; because the therapist imposes his or her own belief systems on the patient in order to shape the patient into a more 'healthy' person, and in doing so, the individual is always considered the problem in need of change, rather than the nature of the society around that individual. Anyone who says that they have been helped by therapy (or by other psychologically-aimed interventions such as electroshock treatment) is either deluded, having been brainwashed into accepting the therapist's understanding of the world (a view which in itself could be seen as denying these individuals agency and telling them that 'the expert knows better' about you than you do yourself); or else has been helped in the same way that conversations with a close friend would help someone in distress, but at a much greater financial cost in a much less equal relationship. In order to expose this, Masson traces individual abuses by therapists, from Freud to modern feminist and radical psychoanalysis.

In some ways, Masson's points are well taken. Classical psychoanalysis is indeed a repressive institution, as its history demonstrates; to my mind, it is a fascinating and productive system of understanding, but of little use as a therapeutic tool. The abuses he details are indeed hideous, and difficult to believe, particularly those which take place in more recent times; and they do indeed support his thesis, that the role of the therapist is to force the individual to submit to the norms of society (particularly with regard to gender and sexuality), as dictated by the therapist, whose own prejudices are shaped by that milieu. Masson rejects the argument that the examples he gives represent a few 'bad apples'; rather, he says, power, of the kind possessed by a therapist, is almost always abused. As well as this, he notes that the psychotherapeutic establishment has done little or nothing to publicise or decry such abuses, and that it has a tendency to protect and make excuses for its own; and that therapists have an interest in maintaining good social networks (given that they rely on other therapists for referrals), and a financial interest in the general practice of psychotherapy, and, on the individual level, of not turning away clients who they might feel they are unsuitable to work with. All of these arguments are well received, and hold some truth.

Nonetheless, Masson's work is problematic. His argument, as outlined above, is never really clearly established; rather, it is pieced together over the episodes he describes. He fails to distinguish between people who are functional but who have issues around their own identity and behaviour that they would like to address, people who are functional but have mental illnesses, and people who are non-functional (to be fair, the lines between these states can be very difficult to draw). Rather, he takes the extreme position that 'mental illness' is nothing more than a label used for those who do not fit into social norms (another well-known exponent of this concept is Thomas Szasz, whom Masson mentions often, though not always, with approbation). Furthermore, although he mentions modern, non-psychoanalytic forms of therapy (which, of course, have their roots in psychoanalysis inasmuch as they involve a one-on-one 'talking cure'), he fails to clearly distinguish between psychonalytic and non-psychoanalytic forms; rather, the sins of psychoanalysis, which are many and varied, stand for the whole.

To my mind, however, the biggest problem with his argument is his solution to the problems of individuals who do not like or accept oppressive social norms and structures: that they should work to change them. This is very much in the vein of seventies radical politics: 'don't change yourself, change society' (and the introduction to the work, by Alice Miller, also champions this idea). In theory, this concept has a lot going for it. However, it ignores the fact that there are many aspects of society which change very slowly. While we work against patriarchy, for example, in our lifetimes we cannot escape a patriarchal society; even separatists must work with the norms and issues instilled in them from childhood. Given this, we need both strategies to change society, and strategies to deal with our encounter with a hostile and oppressive external social reality. The two are not mutually exclusive.

Despite these flaws, however, this work is well worth reading for anyone with an interest in psychoanalysis, therapy, concepts of sanity and insanity and their relationship to power and social control, or gender politics. Not being au fe with developments in therapies since 1990 (when this book was published; there was also a revised edition, published in 1993) I can't say whether they address any of the criticisms made by Masson; however, given his stance against any kind of one-on-one therapy, I'd think the answer would be, for the most part, negative. It's also inspired me to hunt down another work of Masson's, Dark Science: Women, Sexuality and Psychiatry in the Nineteenth Century. Overall, for all its problems, this is a compelling and often-horrifying work which is a welcome, if over-extreme, riposte to the grandiosities, hypocrisies and cruelties of psychoanalysis in particular, and therapy in general.

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