Monsieur Freud
So someone has finally told France – psst, Freud kind of got things wrong. Tiens! Sans blague?
A war of words has erupted among French psychiatrists after the publication of a “black book” that lambasts the teaching of Sigmund Freud and blames his followers for setting back mental health care in France by decades. In a country that is one of the last redoubts of pure Freudian psychoanalysis, the book has been like shock treatment for many in the white-coat establishment who accuse the authors of grovelling to the “Anglo-Saxon” trend towards behaviour-based mental therapy. The news magazine Le Nouvel Observateur, which published extracts of the 800-page work last month, was bombarded with letters charging it with “fascist rhetoric” and leading a “communist-style” propaganda campaign. One leading psychoanalyst described the book as a “fanatical chargesheet placed firmly in the camp of the revisionists”, while another accused its authors of “scientism” – an excessive belief in the power of science.
Scientism! Oh no! Anything but that. Guesswork, intuition, aura-manipulation, healing touch – anything.
In France, around 70% of French psychiatrists base their treatment of depression, phobias and other mental ailments on Freudian theory. Most countries now use of cognitive behaviour therapy (CBT) – which works by helping a patient understand and overcome patterns of behaviour. Pure French Freudians see this as a superficial mechanism designed to return patients to usefulness in the results-based societies of “le monde Anglo-Saxon”.
Results-based! God, is that philistine or what. Those stupid empirical pragmatic Anglo-Saxons, actually wanting results when they’re mentally ill – actually wanting to get better and not feel depressed or phobic. How superficial. How trivial. How shallow. How utilitarian, returning patients to ‘usefulness’ – so much better and more authentic for them to be miserable and unable to function. Imagine, wanting to be useful – for instance to your children if you have them, to your friends, to the people you work with and for – if you’re a teacher, for instance, or a doctor, or a scholar, or a poet. Why would people like that want to be useful? So much better for them to curl up in a corner whimpering.
France is the world’s biggest per capita consumer of anti-depressants and tranquillisers as the result, the authors claim, of the failures of the couch-and-notebook school and the lack of any alternative. One section of the book entitled “Victims Of Psychoanalysis” contains painful accounts from French mothers of autistic children. Freudian theory had it that autism was caused by the mother’s “unconscious wish that the child should not exist”. A Swiss doctor accuses the French mental health authorities of being responsible for the deaths of more than 10,000 heroin addicts up to the mid-1990s by refusing to countenance methadone treatment. This was deemed by Freudians as a crude way of suppressing the symptoms of the problem, rather than addressing the inner cause.
Oh dear. So they kept addressing the inner cause until…oh dear.
According to the book, only last year Freudians persuaded the health ministry to suppress a report from the National Medical Research Institute which attested to the effectiveness of cognitive behaviour therapy. In the view of the critics, Freudian psychoanalysis is not a science but a hermetic cult “immunised against proof” which has inflicted untold damage on the nation’s mental health by opposing treatments that are known to work and by enforcing a politically correct “pensee unique” across the country.
Pensée unique. I like that – good phrase.
But the Freudians see the book as an attempt to introduce new-fangled American theories into France. Treatments such as cognitive behaviour therapy – they say – are dehumanising, merely conditioning the patient to overcome his symptoms and render him “productive” again. Freud, they argue, recognises human complexity.
But even if not feeling miserable does make one ‘productive’ again, which no doubt it does, one, that’s not the only thing it does, and two, being productive is not necessarily a bad thing, is it. It’s not just being Charlie Chaplin in ‘Modern Times’ or Dilbert. It could mean being an effective mental health doctor, for one thing. An artist, a dancer, a singer, a dentist, a gardener, a farmer. Furthermore, even if Freud does recognise human complexity, here’s a news flash: he’s not the only one who does. And a lot of the ‘complexity’ he recognises is his own invention. I’d rather just treat the symptoms, thanks.
You’re only bashing Freud because you’re mad at Dad. Tell me, how long have you had these feelings?
A good Freud bashing is always fun. And almost always well deserved. The only bit of this I don’t understand is the very high use of antidepressants in France. Usually, therapists using analysis and such are anti-medication.
Suicide rates, which increasingly move with antidepressant use (inversly of course), are about the same as the West Europe average, though higher than the UK.
I wonder if psychoanalysis has become a form of recreation in france (as it seems to be for some in the US) rather than a treatment for mental illness.
Anybody know?
>Pure French Freudians see this as a superficial mechanism designed to return patients to usefulness in the results-based societies of “le monde Anglo-Saxon”.< Reminds me of the apocryphal story of the words of a French academic:
“Yes, it works in practice, but does it work in theory?”
Behave like the French when in France!!!
Cheers for that. Some of the letters sent to the Nouvel Obs really cracked me up. I know I ought to cry rather than laugh, but seeing these complete cranks published in a serious newspaper tends to have that effect on me. Here, for instance, is what Antoine Courban, M.D., surgeon, had to say:
‘The current controversy over psychanalysis is an extremely serious debate where the image that man has of himself is at stake. […] A newspaper as serious as yours easily understands the implications, notably political, of this major anthropological debate.
On one side, we have the “anti-psychanalysts”, the cognitive circles which convey a portrait of man reduced to an arrangement of molecules and where thought is explained away as an emergent property of the secretory activity of an organic tissue itself infinitesimally reduced to matter. Hence, thought would have the same status as saliva, bronchial mucus, intestinal secretions, etc […]
But the portrait of man they convey is not in accordance with the elementary values of our culture’.
A fine example of proof by necessity. Makes me want to attempt suicide by overdose of homoeopathic medicine, another French speciality. Or perhaps I should just go back to Molière. He knew a quack when he saw one.
Ah, yes, the infamous Anglo-Saxon. The killer argument. This is Anglo-Saxon, Anglo-Saxon, Anglo-Saxon. I’ve never met any Anglosaxonians. Euphemism, of course, for American. It pains me to still see knee-jerk anti-Americanism published almost daily in French papers. And they all do it!
Autism is one area where psychoanalytical ideas (and similar ones, like the “refrigetaror mothers” of the 70s) caused enormous grief.
Anyway, what is someone who believes in “scientism”? A “scientist”? With “scientific” ideas?
Oh, but to shoot down your good mood, OB: a communal health service in the Netherlands is now going to officially adopt alternative holistic therapies and “healing” and all that. Hmmmm… Come to think of it, anyone who would try to perform “therapeutic touch” on me if I were in the hospital is going to get a “therapeutic whack”.
“Autism is one area where psychoanalytical ideas (and similar ones, like the “refrigetaror mothers” of the 70s) caused enormous grief.”
Definitely. Another area is the whole (huge, consequential) field of putative repressed and recovered memory, as Frederick Crews pointed out in the NY Review of Books, to be greeted with a ‘torrent d’encre’ as the Nouv Obs called the response to their dossier. Another of course is female subordination; another is the complexities of the seduction theory; another is the attribution of physical trauma (closed-head injury, for example) to ‘hysteria’ – and on and on. It’s a pretty dang long list of grief.
Martin Gardner has written several articles for The Skeptical Inquirer over the last 25 years on the decline in Freud’s reputation as a scientist (at least outside France). In his collection of essays “The Night is Large” he reprints one – a bizarre tale called “Freud,Fliess, and Emma’s Nose”.
Oh, it’s bizarre all right. What those two did to Emma Eckstein…is painful to read.
There’s also, come to think of it, a slightly veiled reference to what those two did to E.E. in the Dict. of Fash Nons.
Just looked up the Emma Eckstein event… Yikes.
I have been thinking (too much time on my hands, says my daughter) about Freud, ID and such.
It seems to me that ID and even creationism do not do much harm. No behavior flows from a person’s belief or otherwise in those things.
But religious beliefs that prevent immunization, blood transfusions or other medical treatment (scientology?) do result in harm.
And a belief in Freud also may do harm if it prevents or delays treatment. That’s why I wonder if the French are treating depression and such with SSRIs and CBT (the state of the art) or relying on analysis.
An interesting subject for another day might be the bad rap ECT gets. It is still the quickest and often the most effective treatment for depression.
Another day…
“It seems to me that ID and even creationism do not do much harm”
They probably don’t do much direct, immediate harm. But by discouraging science education and cutting funding for scientific research they contribute to the dumbing down of our society and the loss of lives through retarding medical progress.
Your assuming, Karl, that everyone gets the dumbed down education. I bet there’s not too much Young Earth Creationism or its ilk at Andover, Friends’ School, or, for that matter at Yale or Harvard. Theocracy is fine, however, for the plebes and cannon fodder. It’s Levi Strauus??? in action.
“Your assuming, Karl, that everyone gets the dumbed down education”
No, not everyone. But eventually enough will. What’s the tipping point? I dunno, and I don’t wanna find out. And if funding for scientific research gets cut, scientists will go elsewhere–outside the US. This is already starting to happen to stem-cell research.
And now creationists are showing up at museums and wasting everyone’s time by asking rapid-fire stupid questions in an aggressive manner and not listening to the answers.
The ‘people of faith’ are gathering. I don’t think they’re the lest bit harmless.
Ophelia: none of us are harmless, but we must pick the things and people we are going to get really upset about. Time wasting is not a serious sin. I am sure I have been guilty of it.
I think the “pof” are causing harm on stem cells, abortion but not creationism and ID.
And with a bit more hesitation, I belive that all this will pass. People will wake up and realize that the world is more complicated and more exciting than the New Testament says.
But then, I have reached the age of optimism.
“Time wasting is not a serious sin.”
It is if they’re wasting a lot of our precious time. Why should scientists have to waste their time defending firmly established scientific principles from relentless attacks by aggressive Know Nothings?
“I think the “pof” are causing harm on stem cells, abortion but not creationism and ID.”
The same know-nothing virulence that underlies creationism and ID also underlies opposition to stem cell research and birth control, along with a whole host of other issues you might consider important. Attacking ignorance and fanaticism in all their manifestations gets at the root of the problem.
Ken,
“but we must pick the things and people we are going to get really upset about.”
Yes – and I do. This is one of them.
“Time wasting is not a serious sin. I am sure I have been guilty of it.”
That depends. For one thing, on whether it’s one’s own or other people’s time that is being wasted, and for another thing, what the wasted time would otherwise be used for. If you waste the time of a rescue worker who is on the way to save someone from rising floodwaters, then it is a serious – bad thing to do.
We just disagree, that’s all. I think the people of faith are causing harm, by shutting down criticism, by inhibiting disagreement, by confusing issues, by applying pressure where it shouldn’t be applied, by encouraging emotion to over-rule reason, by making atheism ever more marginal, by making rationality a ‘sin’, and by making all of us more stupid.
ken nielsen wrote:
‘An interesting subject for another day might be the bad rap ECT gets. It is still the quickest and often the most effective treatment for depression.
then?
OK, where is your evidence for that?
|
Jim: It is well accepted among psychiatrists these days. I cannot off hand quote a source, but I believe most psychiatrtists will confirm it.
Many will say they would prescribe it more often, but for the bad press it has had.
It is prescribed for pregnant women because SSRIs are not considered safe.
PS Here is one reference
http://www.medscape.com/viewarticle/450436
It’s ironic if French psychoanalysts see cognitive behavioural therapy (CBT) as somehow coldly ‘Anglo-Saxon’ and the various Freudian orthodoxies as, presumably, something else (Latin? Levatine? Another bit of non-European peasant wisdom?). Like Somoza and several other unpleasant dictators, psychoanalysis would probably not have prospered without American support and I suspect more psychoanalysis arrived in France from across the Atlantic than from across the Rhine or the Alps.
As for their home-grown Lacanian version, here’s what Jean Thuillier, a bemused French contemporary, remembered of a Lacan lecture in the 1950s. “…the charm worked little by little on the whole audience, who were first seduced, then in ecstasy, and finally bewitched by the play of a most magic style. … For Lacan’s sentences had the prodigious quality of being perfectly constructed, with all the logical constituents of speech, but with so many ramblings and antinomies, that comprehension was lost between the subject and the complement, the verb and the object.” Thuillier felt “the impossibility of understanding any of the verbiage” but was “anguished to see the audience was hanging on his lips”. (Thuillier J. Ten years that changed the face of mental illness. Trans. G. Hickish. Martin Dunitz, London 1999, p.126)
‘Explanations’ of suffering can be quite comforting (for both parties) especially if they’re true and even if they’re wildly wrong but here’s a simple test. Ask patients if they prefer explanation without relief to relief without explanation. Not many will prefer the former. In any case, one of the best and biggest comparative studies of psychoanalysis vs CBT (Sloane et al c.1975, from memory) found that the chilly CBT therapists, as well as being more effective, were no less liked by the patients than the cuddly Freudians.
Perhaps the best hope for French patients is that since their health system is in big financial trouble, the government will prefer CBT’s time-limited and cost-effective approach to the open-ended or interminable nature of psychoanalysis.
A preference for ‘relief without explanation’ might also lead one to prefer heroin–rather than, say, political activism.
Hmmyes – and similarly, a preference for ‘relief without explanation’ might also lead one to prefer ibuprofen after having a wisom tooth pulled, rather than, say, reading poetry. A preference for ‘relief without explanation’ might also lead one to prefer an effective antibiotic to treat a raging infection, rather than a lovely walk along the beach. A preference for ‘relief without explanation’ might also lead one to prefer a doctor to set one’s broken arm, rather than, say, tickets to ‘Hamlet.’ This is not to say that poetry, walks on the beach, ‘Hamlet’ are not all fine things – it is merely to mock the logic of the idea above.
Nice bit of mockery! Not entirely successful though:
my.webmd.com/content/article/111/109938.htm – 39k – 24 Sep 2005
Yes it is, it’s entirely successful. If you want to argue, argue – just dropping a url doesn’t do it.
Nonsense, other people here drop in urls all the time; why single me out?
Next time I break a bone, my local A&E will be the place for me. When infection rages within my body, to antibiotics I shall turn. A wisdom tooth removed? Ibuprofen? Not for me thanks! Ever heard of hypnotism?
It’s not the url-dropping, it’s the url-dropping all by itself. You have to do some of the arguing yourself!
So, okay, A&E for broken bone but not ibuprofen for pain. How does that link up with the heroin-political activism dichotomy?
If you’re saying pain-relief is not enough and that we need meaningful work too, I certainly don’t disagree. But that wasn’t clear from that post.
I’m saying that psychic pain is qualitatively different from physical pain. Heroin makes both types of pain tolerable. A physical injury may heal and remove the necessity of analgesia. A psychic injury may be the result of historical oppression (whether personal or political; in such a circumstance, identifying the cause of the pain may be more useful–in the long run– than removing the pain by pharmacology.
“A psychic injury may be the result of historical oppression”
It may be – or it may be the result of physical physical problems in the brain. Surely this is exactly the issue: that it’s neither helpful nor reasonable to assume that all psychic pain is the result of human agency – of experience of any kind, as opposed to being the result of physical accident.
Freud didn’t know what closed-head injuries were, so he labeled some paralysis etc that was the result of head trauma as ‘hysteria.’ That wasn’t profound or complex, it was just a mistake.
Even if psychic pain is due to historical oppression, it shouldn’t need psychoanalysis to find that out. Someone might need help to realise that it’s reasonable for them to suffer psychologically as a result of their current or past situation but Freudians are likely not best placed people to do this–consider Freud’s notoriously silly ideas about women, for example. But any attempts to recover any causes beyond those the patient is already aware of seems likely to succeed in nothing other than implanting false memories.
I get the impression–from reading Overcoming Low Self-Esteem by Melanie Fennel, which is a reliable-looking do-it-yourself-CBT book–that CBT does deal with causes of psychological problems but that it trusts the patient to come to his own conclusions rather than forcing the therapists’ upon him. CBT aims to correct non-useful thought patterns; it seems difficult to do this without considering the causes of the trauma.
It seems probable that that trust in the patient’s own perceptions stems from a lack of emphasis on the unconscious mind, which, if Daniel Dennet is correct, doesn’t even exist.
‘…it’s neither helpful nor reasonable to assume that all psychic pain is the result of human agency – of experience of any kind, as opposed to being the result of physical accident.’
I hold no such assumptions. How about you–do acknowledge that in some cases, the converse of what you assert above might also be true?
‘…the unconscious mind, which, if Daniel Dennet is correct, doesn’t even exist.’
In Dennet’s book (Consciousness Explained) he asserts, baldly, that true hallucinations are ‘very rare’. He’s obviously wrong about that. He’s also wrong about the unconscious mind.
Well, sure, Jim. You mean do I acknowledge that some psychic pain is caused by oppression? Well of course!
Dang, if I didn’t, why would I give a shit about all these oppressed women cluttering up the place?
‘…do I acknowledge that some psychic pain is caused by oppression? Well of course!’
Would you also acknowledge, OB, that one prevalent form of oppression is sexual abuse (whether against males or females)?
Would you also acknowledge that any trauma subsequent to sexual abuse can be alleviated by fairly simple methods–ones applicable to other forms of trauma, also?
If you can acknowledge the verity of the two propositions above, can you go further and acknowledge that a (psychic)trauma occuring in infancy would be just as disabling as it is for an adult, but far more difficult to recover from–given the developing neurolinguistic status of the victim?
“Dang, if I didn’t, why would I give a shit about all these oppressed women cluttering up the place?”
Ah, but you don’t “give a shit”, as you so quaintly put it. Not really. You are only projecting your own frustrations (stemming from your infantile oral fixations) onto the “oppressive” world at large. A truly healthy person, you see, doesn’t give a fig about the suffering of others, particularly those far away.
By the way, your use of the expression “give a shit” is very revealing. Were your parents very strict about toilet training? I zink ve are getting somevhere now.
Oops. Hour’s up. That’ll be $400, please.
Jim, no. And you’re wearing out the word ‘acknowledge’ – which is a rhetorical word that presupposes the truth of whatever proposition you’re seeking ‘acknowledgement’ of. If the proposition is self-evident enough, such as that oppression can cause psychic pain, I don’t always object, but if it’s not, I do.
‘Oops. Hour’s up. That’ll be $400, please.’
One travesty calls for another:
Is there no alternative treatment, doctor?
Vell, there is! It doesn’t work for very long; but I get a free UBS, and a ball-point pen, off the drug rep.
OB words don’t wear out; and rhetoric is a double-sided sword. Do I understand you rightly–are you saying you do not accept the reality of PTSD?
Jim, words do wear out. They get overused and underquestioned until people no longer notice (if they ever did) how manipulative they are. Words like ‘spiritual’ or ‘faith’ for example.
I’m saying that this bit –
“acknowledge that a (psychic)trauma occuring in infancy would be just as disabling as it is for an adult, but far more difficult to recover from–given the developing neurolinguistic status of the victim?”
is highly speculative and contentious.
‘..words do wear out. They get overused and underquestioned until people no longer notice (if they ever did) how manipulative they are.’
Lacan’s “empty signifiers”?
‘highly speculative and contentious’
A fair enough judgement. I can live with that.
“Lacan’s “empty signifiers”?”
Or like Orwell’s dead metaphors. Frequent overused, vague terms are a telling sign of writing lacking thinking.
Are “empty signifiers” really Lacan’s?