This section covers critiques and debates in psychology and therapy.
The author's argument is straightforward: psychotherapy is so inherently time consuming and costly, and takes so much work, that its overall impact on the mental health of the population is miniscule.
This contains the famous exchanges with Skinner, Buber, Bateson and others.
This initial attack on psychoanalysis, based on Freud's personal reluctance to acknowledge child sexual abuse in public -- and his revised 'theory' that his patients memories of rape and seduction were mere fantasies -- was just the first round in a battle which continued with Masson (1988) and Masson (1990).
Masson views psychotherapy as inherently prone to distort another person's reality and, therefore, as inherently abusive. While Masson rightly condemns many figures in the history of psychotherapy, his particular contention that the acceptance and understanding at the heart of person-centred work is 'mere artifice' strikes me as a blunt instrument in an area where some genuine but carefully targeted criticism undoubtedly is in order. For an empirical look at the effectiveness of counselling and psychotherapy, see Bergin and Garfield (1994). See Masson (1990) for the third volume of what is effectively a trilogy (and is described as such in the preface of Masson (1990)) that began with Masson (1984).
This scathing critique of Freudian psychoanalysis begins in full heat on the very first page: "until now it has been almost impossible to get an internal view of the workings of this 'men's club' with its initiation rites; expectations of membership loyalty over truth; pressures to accept concepts handed down by the leader, no matter how irrational; xenophobic banding together against outsiders; and the punishment of anyone who poses questions or finally wants out" (p. 1). I was already highly skeptical of psychoanalysis, but even for someone who places great credence in the approach, this book must give some cause to stop and question. While this is the most full-blown critique of them all, Masson's critical look at the field began with Masson (1984) and continued with Masson (1988).
This is one view that private practice is unethical and exploitative, on the grounds that people who are already vulnerable or distressed should not be further compromised by being charged. Also see Rowan (1992).
See Shlien (1984) entry for notes on Rogers's reply.
The counter to Pilgrim (1992), Rowan notes that the costs of institutional counselling are very real but simply hidden from the client. Rowan also observes an ambiguity in the public sector, one absent in the private sector: namely, the question of for whom the counsellor is really working.
Shlien, J.M. (1984) 'A Countertheory of Transference', in Levant and Shlien (1984), pp. 153-81.
This is Shlien's celebrated (and entertaining) attack on the theory of transference at the heart of the psychoanalytic tradition, a theory he dubs "a fiction, invented and maintained by the therapist to protect himself from the consequences of his own behaviour" (p. 153). As Shlien summarizes it, after quoting from Freud's writings on the subject, "So, the analyst is not responsible, the situation is not responsible... Transference is a neurotic peculiarity. Whether it is a normal (common) trait is also unclear, but the transference neurosis is a feature of analysis -- that is certain" (p. 164). Despite the assault, however, it should be noted that it is not necessarily transference itself which is in question, but the special treatment accorded transference within psychoanalysis -- both in terms of releasing analysts from responsibility and in terms of how analysts respond specially and deliberately to transference. In his own commentary on Shlien's article, Rogers (1987) strongly supports Shlien and notes that within the person-centred approach, distinguishing transference and projections from therapist-caused reactions is of merely theoretical interest: all the client's attitudes and feelings should be nonjudgementally understood and accepted. In particular, dependent feelings can be accepted without allowing the type of dependence relation to develop which is so central to psychoanalysis.
The 'countertheory' of Shlien's contribution rests on the notion that "understanding is a form of love-making" (p. 171), and he summarizes it succinctly: "the therapist is responsible for two fundamental behaviors -- understanding and misunderstanding -- which account for love, or for hate, and their associated affects" (p. 177); later, "love does not heal. Understanding heals" (p. 178).
This was the original book to put the cat among the pigeons in terms of society's view of mental illness and the practice of psychiatry. The exceedingly controversial book has been read in many different ways: for some, it is a straightforward refutation of the so-called 'medical model', which Szasz views as institutionalized persecution of those who are different; for others, it is an admonition to those suffering with 'mental illness' just to get over their 'problems of living' and sort themselves out; while for others still, the book amounts to a dangerous abject failure to appreciate the genuine distress and needs of those who suffer from mental illness and who may benefit from assistance. Perhaps the truth involves some portion of each of these.
This page was last reviewed by Dr Greg Mulhauser, Friday, 10 December 2010.
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