Therapy is all talk

A new book argues that psychotherapy is better at recycling cultural myths than figuring out what's in your head.

Published April 6, 1999 5:22PM (EDT)

In 1994, freelance writer Ethan Watters and UC-Berkeley professor of
sociology and Pulitzer Prize-winner Richard Ofshe published "Making Monsters,"
a full-throttle attack on one of the most controversial issues in
psychology: recovered memory syndrome. In "Therapy's Delusions: The Myth of
the Unconscious and the Exploitation of Today's Walking Worried" (Scribner), released this month, they take on a larger subject -- what they see as the fraud of talk therapy. Almost a century after
Freud told his first patient to lie down on the couch and start talking,
they say that psychotherapy doesn't work -- and never has.

Watters and Ofshe say the dozens of types of therapy practiced today all
share a "lineage of mistakes" dating back to Freud. Talk therapy's
fundamental belief is that we are all at the mercy of unconscious mental
forces outside of our awareness, which we cannot by ourselves name or tame.
Freud believed mental illnesses had developmental causes, most often
stemming from childhood. He believed that trained analysts could understand
these in a way that could ultimately tame them, bringing
self-understanding, an end to problem behaviors and -- the grandest claim -- a cure for major mental illnesses.

The scientific and pharmacological breakthroughs of the last few decades
have left most therapists with an entirely new client base, the
non-mentally ill: average "walking worried" people looking for answers and
receiving simplistic explanations from therapists selling the myth that
therapy is the best means to self-knowledge.

Salon talked with Watters recently near his office in San Francisco.

What was the genesis of your new book?

In "Making Monsters" we exposed the myth of recovered memory
syndrome. But the fundamental problems that allowed recovered memory to
"bloom" were still present. There are no checks on the system -- no checks on
therapy, no checks on the myth-making potential of the therapy encounter.

We felt there was a bigger book here -- about the history and practice of
psychotherapy. We made one good argument in "Making Monsters"; the bigger
story was another book.

Have you been in therapy?

No; there's room for one book from people outside therapy. Our argument
lends itself to an outsider. We saw our job to be the outsider -- to connect the
dots in the history of psychotherapy. I'm a journalist, and I don't think
it's necessary for me to have been in therapy to write about it.

This isn't meant to be the end-all book about psychotherapy, but it's an
attempt to expose the conceptual murkiness in the therapeutic system. And
we show how Freudianism took hold in the United States, and how
psychoanalysis and psychotherapy became a sort of secular religion.

What is the myth of psychotherapy?

For generations, therapists have been claiming that they could cure mental
illness with a small set of techniques that would work for everyone. And
they can't. Most psychiatrists aren't even on the cutting edge -- they've
ceded that to the neurologists and other brain scientists. That's where the
real work is being done, developing medications that can successfully treat
major mental illnesses.

Why do so many of us go into therapy?

We've believed the therapist's claim that it's the best way to
self-understanding. It's not.
We've been led to believe it's the highest calling, but I think that's the
problem. The human mind is not well designed to understand itself -- it sees
out, not in. Therapy's claim to be the best mode to understanding yourself
is a false one. I think there are ways to understand the human creature,
but they often come at you obliquely, through music or art or
literature -- ways of understanding our brains in a very non-direct way.
Those things have more claim to leading you to self-understanding than
therapy does.

Therapy sells the ability to know yourself, even though there are no provable
results. If you look over the entire course of psychotherapeutic
literature -- not that I've read every bit of it -- but if you read every
generation of therapists, and the stories that have come out of therapy,
the patient's accounts and the therapist's accounts, you have to say they
believed such stupid, simple myths.

Like the idea that "bad mothering" caused autism or schizophrenia?

Exactly. It's based on a certain kind of cultural misogyny. Women were
told penis envy was the cause of their depression. The broader the claim,
the more suspect it is. After it's passed, we see the cultural myth
manifested in someone's belief. But since we share the same myths, we don't
recognize them as myths until the myth has passed us by.

What you're likely to get out of therapy is a sharing of whatever social
narrative has currency at the time. Often, that's what accounts for the
"Aha!" feelings people get in therapy. Aha! I knew my father was a molester
or my mother was domineering. It's not from matching your memories or
coming to a better understanding of yourself. The "Aha!" comes from matching the cultural currents of the times. The connection is with the
society around you -- not with your past or the interior of your brain.

There's the idea that therapy is the way to deep knowledge. In most
instances, therapy is the way to the shallow end of the pool.

What's your response to the people who say that "therapy changed my life"?

When someone says, "Therapy changed my life -- therapy made all the
difference," I don't necessarily disbelieve them. People can be helped. But
I'm also saying that when they say that, it's proof of nothing, because
that kind of belief is built into therapy. Therapy includes mechanisms to
build the client's devotion to the therapy. The devotion people feel
towards therapy is not a defense of therapy.

Are most therapists well-intentioned?

Absolutely well-intentioned, but operating in an environment with very
few checks on what they're doing, or what they can do. Their work is
highly influenced by the cultural phobias that both they and the client
bring with them. It's the people who think they are doing good who have to be
watched the closest.

Much of psychotherapy is based on accessing and exploring our memories,
but most people would admit that memory is a very iffy thing. Can we
accurately remember something that happened 20 or 30 years ago?

Studies show that the vast majority of people do believe that everything
that ever happened to them is stored somewhere in their mind.

The mind as a giant filing cabinet?

Yes. That idea comes from the fact that every now and then we have a memory
and absolutely no idea where it came from. That sensation makes us think
it's all there. If that moment's there, the next moment must be too! A
psychiatrist likened it to renovating your attic, pulling up an old
floorboard and finding a copy of the New York Times from 1938. Your
reaction wouldn't be to tear up all the floorboards and expecting to find
every other issue of the Times there as well.

What we do know about memory is that so much of our existence is lost to
us. But we hold to our other belief that everything is still
there -- somewhere -- because the knowledge of losing so much of our existence is
terrifying to us. We want to believe it's still all there. People recoil at
the idea of the unconscious as a myth.

Is Freud responsible for the idea of an unconscious mind that includes

A Freudian-derived construct is that everything is there. Therapists who use
guided visualizations frequently tell their clients that it's all
there -- that you just have to relax and access it.

But it's gone?

You remember the things you go over in your mind or have a reason to
remember. The more you go at it directly, the more you find that you're not
excavating memory -- you're tearing it apart and building something new. And
that's the classic mode of therapy, rehashing and rehashing and rehashing
memory. And when you do that, you often end up creating narrative truths.
Narrative truths aren't necessarily bad -- even when they're myth-based. It's
said that they at least have the ability to relieve the sense of anxiety
people have about losing their memories. Even if they're bad memories, like "my
father raped me when I was a child," it doesn't mean that it doesn't cause
a whole number of other problems that hugely outweigh the small benefit of
having a "reason."

For example, a person with some mild depression spends a year or two in
therapy, creating a narrative around it. The person's still mildly
depressed, but doesn't want to abandon the narrative that explains it. If he
takes Prozac and loses the depression, that fundamentally undermines the
narrative. And the narrative has nothing to do with his level of seratonin.
But the narrative is usually a very complex story.

What gives therapists and their patients the motivation to continue?

The therapy half of the myth is that you can access the unconscious.
That's the equivalent of fortune telling. Therapists are loosed within the
therapeutic setting to spin the dialogue in whatever way it goes. And the
narratives created in therapy have momentum. Stories, once begun, aren't
easily abandoned. Patients and therapists usually don't take a right turn
after a year.

Patients have an investment of time, money and emotion, don't they?

Yes, and it's hard to admit you were wrong. But I don't think that's the
worst part. The worst part is abandoning a narrative that explains your
life -- or that you believe explains your life. That comes at a tremendous
cost. You put yourself right back where you were at the beginning of
therapy, with very little understanding of yourself.

In therapy you get the sensation of understanding. But this sensation
doesn't necessarily have anything to do with the truth. You think: The more
I feel this is true, it will be true. But that's just not true. Things in
therapy can make a lot of sense to you and be absolutely myth-based.

Isn't part of the problem that therapists call themselves scientists,
but refuse to quantify their results? You can't quantify happiness or
self-awareness or functionality.

But you can quantify functionality. Say someone has a phobia and is
afraid to get out of bed because they think there are snakes under the bed.
If therapy helps them get out of bed, that's an easy result to quantify.
But the more amorphous the claim, the less I think therapy helps, and I
don't think the mental health profession should be claiming it does.

I think the important thing to remember is if any therapist tries to sell
you the idea that they're creating the actual truth of your life, then
you're in a bad situation. With a book like this, people tend to think I'm
against self-awareness, since so many of us bought into the notion that
therapy is the best means to self-awareness. And they ask how we can be
against this manifest good -- this reaching out to other people and helping
them with their problems. I'm not against that. If you want to pay another
person to do something like therapy, or be a daily coach, do it. My problem
is in all the ways this technique has been set up in a way that allows for
waste of communal resources, all the way to the potential destruction of lives.

Most important, talk therapy's a dumbing-down of people's lives, and it
pretends to cure something when it can't. If people are informed -- if they
understand that therapy is an enterprise based on narrative creation, not
narrative truth, and they understand what's going to happen to them, go for it.
It's a free country. Do it if you think it's going to help you.

Therapists market themselves these days. They all seem to have catchy
titles: spatial counseling, shamanistic healing, Y2K phobias, Internet

Therapy itself has lost its credibility, so simply presenting yourself
as a psychotherapist has no credibility. When I was writing the book I
responded to therapists' ads and asked them what they did that was
different. They'd say, "Therapy can focus on so many things -- your spirit,
your mental health problems, your relationship, your soul -- and we can do it
with all these fantastic techniques. Isn't this a wonderful time? We're
living in the golden age of therapy!" My case is that we are living in the
era of the death of therapy. Therapy is doing what a supernova does before
it blows itself up. Look at any social movement, and you'll see a therapist
attaching himself to it.

I look at the pictures of these therapists [he points to a "Common Ground"
catalog] and see their "genuine and sincere" looks -- photos that were chosen
to give the "I'm the most meaningful person you'll ever talk to" look -- and it
makes me a little angry. Because, for the most part, these people are
offering simplistic stories about people's lives, and they're offering them
to people who need more help than that.

I have a belief system -- if this qualifies as a belief system -- that your brain and the world are both phenomenally complex. Your brain isn't up to the challenge of understanding the world in its full complexity, or of understanding itself completely. I find tremendous wonder and solace in that. I find it compelling the same way other people find a spiritual belief system compelling. It draws me into the world and makes me want to understand what I can understand -- and the knowledge that I'll never come close to it draws me in.

I get upset with systems of belief that narrow people and make them believe everything is simpler than it is.

Americans want to believe you can be happy every single day of your life.
The most you can hope for is to work hard and find some level of
satisfaction -- and that only comes through a real engagement with life. And I
don't think therapy is a real engagement with life. It's talking.

By Joy Rothke

Joy Rothke is a health writer in San Francisco.

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