Madness on the Couch
Blaming the Victim in the Heyday of Psychoanalysis
by Edward Dolnick When Freud had a friend operate on a patient of his in the hopes of curing her neuroses, the patient almost dies of hemorrhage. Freud was deeply troubled, until he came up with an explanation- the patient had almost died because she wanted Freud's attention! She did not want to recover. On a similar vein, Freud warned against attempting to treat schizophrenics- he said that they were not open to recovery. Thus began the grand psychoanalytic claim that victims of psychological disorders
chose to be ill. Unfortunately, Freud's followers did not heed his warning. They attempted to use psychoanalysis to treat schizophrenia and autism, which Freud refused to touch.
With schizophrenia and autism, the psychoanalysts saw external factors as the only possibly cause. Therefore they blamed the families of schizophrenics and autists, thereby depriving these people of their most likely advocates. They attempted to remove schizophrenics and autists from the families they were sure had abused them. And when parents did not fit their models, they assumed that parents were very good at subterfuge. But in the late 1960s, studies proved the heredity of schizophrenia by studying adopted schizophrenics and the adopted children of schizophrenics. They showed that the children of schizophrenics are as likely to be schizophrenic whether or not they are raised by their parents. With autism, no such studies are shown, and autism's link to psychoanalysis is vague at best; Dolnick never states that Bettelheim had any thoughts of Freud. Instead, he shows Bettelheim to be the fraud he has been known as in the decades since his death. He describes Bettelheim's claims and their effects, quoting extensively from
The Sound of a Miracle in which Annabel Stehli describes how she was treated as the parent of an autistic girl. He also describes Bernard Rimland's rebuttal of Bettelheim, although he presents Rimland's theory simplified and in an early form.
To hammer the nail in the coffin of psychoanalysis on the not-so-normal, Dolnick covers the psychoanalytic
mistreatment of a disorder Freud approved of: Obsessive Compulsive Disorder. Freud had claimed that OCD was caused by guilt, and that compulsions were caused by symbolically acting to correct the guilt. Freud claimed to be able to cure OCD; he claimed as exhibit A of his psychoanalytic skills. His followers refused to accord it even that level of difficulty; they claimed to be able to cured OCD in six months. But their claims were false, and with the coming of drugs which could cure many cases of OCD, psychoanalysts who had claimed to treat OCD were sued. OCD was even shown to be curable in dogs with the same medication that cures OCD in humans, making it unlikely that Freud's speculation held any truth: dogs suffering from guilt over masturbation? Yeah, right!
This is a criticism not on psychoanalysis but on psychoanalysis as treatment of brain disorders. As such it is a sound critique. Dolnick spends part 1, about a ninth of his narrative, on Freud. But only his section on OCD, which is even smaller than the section on Freud, seems to be about work descended from his. The work with schizophrenics was a break from orthodox Freudianism, and psychoanalysts were not shown to be to blame for the refrigerator mother theory of autism. The "heyday" of psychoanalysis is taken to be the American heyday, during the 1950s and 60s. I don't like Dolnick's portrayal of autism. He cites as common knowledge that 80% of autists are retarded. Dolnick uses footnotes and endnotes copiously, although his endnotes are not the sort with numbers by the citations. I was a little bit startled when I recognized one of the first quotations in this book as being from
Welcome To My Country, which I had just read. Also unusual, all of the positives takes on this book shown on the back cover are from authors cited in this work!
Cautious/ indignant reading.
