Talk Therapy with a Forked Tongue

Therapy's Delusions: The Myth of the Unconscious and the Exploitation of Today's Walking Worried
by Ethan Watters and Richard Ofshe

The Goodread review:

In this clearheaded and courageous book, Ethan Watters and Richard Ofshe expose the pseudoscience behind the twentieth century's most enduring myth - Freud's theory of the psychodynamic mind. Despite the lack of credible evidence for a powerful unconscious that controls our behavior, a huge number of therapists continue to base their practice on the idea that only they can uncover their patients' unconscious motivations, luring thousands of Americans, from the mildly demoralized to the seriously ill, down dangerous and arbitrary paths of treatment. . . . This book is a call to action for reforming the poorly regulated mental health profession, so that no more patients are misled by a myth that has held sway over American minds for far too long

Finally someone is willing to come out and say it.  Much of what passes as psychotherapy is not based in empirical science and is quite often unhelpful or even worse.  This book is a wry yet disturbing romp through the cultural history of psychoanalysis from its birth out of the forehead of Freud, through it’s explosive captivation of the American pop psyche, and finally up to the present day accumulation of psychotherapy methods (the intellectual grandchildren of Freud’s) that are trademarked, patented and hocked to practitioners at carnival-like trade shows.  It is a must read for anyone who has questioned the Great Oz of the Ego/Id/Superego Trinity and wants to know who the man behind the curtain is.

While there has been a virtual Gatling Gun of  criticism of the biomedical model from psychosocial adherents, there has been very little in recent memory in the way of criticism of psychotherapy.  In that sense, Therapy’s Delusions is a breath of fresh air.  My only gripe with Watters and Ofshe is their implicit assumption that the biomedical model is more objective and has more to offer consumers of mental health.  While both theoretical arenas contain elements of empirical knowledge, they are also both driven by ideology and consumer-capitalism.  It is quite well known now that the pharmaceutical industry drives bio-psychiatry forward as a commercial enterprise.  The authors fail the test of objectivity by ignoring this plain fact.  However, they have done us a service by highlighting the equally disturbing but lesser known fact that psychosocial based therapy is also a capitalist endeavor made up of many entrepreneurs and businesses both large and small.  Every peddler of treatment models and every practitioner of psychotherapy has a profit motive hidden, undeclared, under the surface of their brand.

What’s wrong with that, you ask, it’s the American Way, is it not?  Yes, it is.  And it is not so wrong except that it is denied and hidden.  It is lurking in the id of the mental health industry, you might say.  Hidden from view, who can say when and how often the profit motive trumps the best interest of consumers of mental health care?  Don’t expect a straight answer from your therapist, especially if their house is underwater, as we say these days.