Psychotherapy is big business. America employs perhaps a half million professionals and paraprofessionals (psycho therapists, psychiatric technicians, drug/alcohol counselors, clinical social workers, clinical psychologists, psychiatrists and psychiatric nurses, family therapists) in the field, and the talk therapy industry as a whole is worth about $17 billion. Yet many scholars and laymen are uneasy at the sight of the tower of psychobabble. Himself a psychiatrist and philosopher, Garth Wood has written a fascinating book, which is at once a critique of psychoanalytic therapy (and theory) and a sketch of an alternative form of therapy Wood calls “moral therapy.”

To help the reader see the difference between real mental illness and phony “disorders” and “neuroses,” Wood pro vides a detailed appendix which helps you decide whether or not you are truly psychotic. (As he notes, chances are good that if you worry about being insane, you aren’t insane.) Moreover, Wood does not criticize all forms of therapy—he readily concedes that some forms of behavioral therapy are quite effective in modifying undesirable behavior. But he denies that either “talk” therapy (Freudianism and all its descendants) or drug therapy (“mind candy”) are effective. His critique of those standard psychiatric therapies is both philosophic and scientific.

On the scientific side, Wood lays out the evidence against psychotherapy and psychoanalytic theory in detail. Wood reviews the classic theoretical criticisms of Freudian theory by Sir Karl Popper and Sir Peter Medawar. Even supporters of Freudian theory such as Adolf Grünbaum (the eminent philosopher of science) and Arnold Cooper (past president of the American Psychoanalytic Association) admit that its theoretic underpinnings are weak. A number of empirical studies have likewise shown psychoanalytic therapy to be ineffective and even harmful. One early critic, Hans Eysenck, analyzed 19 reports on the effects of psychotherapy and discovered that the patients who had no psychiatric therapy improved the most, those with “eclectic” (non-Freudian) therapy improved less, and the patients with Freudian therapy did the worst. Wood concludes bluntly that the therapeutic claims of psychotherapists no longer have scientific or moral credibility and that practitioners are shamelessly “taking money from the gullible.” 

Wood’s criticisms ring true, especially if you have ever known someone who has been “in analysis” for years. Wood is caustic on this point: 

[Psychoanalysis] may be rubbish, but it is dangerous and demeaning rubbish, tending to rob us of our natural belief that we are in control of our mental and physical behavior, fostering the illusion of our lack of responsibility, of our passivity. As the tentacles of this pernicious doctrine reach out to embrace the arts, politics and education, nothing remains untouched by the poison of its determinism as it degrades creativity, debases ambition and reduces the value of human aspiration.

More philosophically, Wood criticizes the whole concept of neurosis. He puts forward the view, so obvious that it has escaped the masters of arcane psychiatry, that aside from clear cases of psychotic illness, much of what passes for “mental illness” is in fact not illness at all. So called “neuroses” and “personality disorders” are just pseudoscientific terms for behavior that is self destructive, self-centered, imprudent, eccentric, noble, or evil. Thieves and murderers must not be stigmatized as “evil men” but treated as mentally ill “sociopaths.”

When Wood turns from his trench ant critique of psychotherapy to pro pounding his own method of “moral therapy,” things are less satisfactory. The goal of the moral therapist (friend or priest) is to help the other person gain self-respect. The doctor/patient relationship gives way to friendship be tween equals, and “therapy” can take place at the ball park or bar as we”ll as in an office or hospital. The moral therapist helps his troubled friend grow in self-respect in three ways: (1) recognizing and living up to his own value system; (2) confronting problems squarely; (3) exercising.

The problem lies in getting past the first step, which sounds suspiciously like the “values clarification” strategy now touted by too many professors of education. Wood goes so far as to tell us that if a mentally troubled man’s own ideals lead him to acts that society would regard as “terrorist,” then the “individual’s mental health” should take priority over “the standards and rules of society.” Sending one letter bomb may indeed provide as much catharsis as several hours on the couch, but does Wood really want to replace Freud with Sorel?

Perhaps the problem is simply that Wood has spent so much time demolishing Freudianism that he hasn’t worked out his own views enough. Currently at work on a new book, Wood may yet help us escape both the ersatz professionalism of the psychoanalyst and the chummy relativism of the “moral therapist.”


[The Myth of Neurosis, by Garth Wood; New York: Harper & Row]