This is a book for anyone who has
ever felt the slightest discomfort of doubt about psychotherapy.  It’s sure to
raise the ire of practitioners and patients who believe in the infallibility of
the ever-evolving Diagnostic and Statistical Manual of Mental Illnesses (DSM). 
But it’s also guaranteed to find a friend in anyone who considers the critics
of psychotherapy, like Thomas Szasz, to be on the right track.  

Laurence Simon vigorously joins the
ranks of those who condemn what psychotherapy has become.  But while he details
the internal political agenda, the profit-making motivation, and the
methodological madness that form the foundations of the field, he does not
argue for a total abandonment of the entire enterprise.  In fact he makes it
clear that during the almost three decades he has been a practitioner he has
come to appreciate just how much psychotherapy has to offer when it’s done
properly, that is, when it’s not corrupted by internal politics, when it’s not
sustaining the profit margin of some giant pharmaceutical company, and when it
doesn’t try to imitate biology or medicine.

The book consists of nine chapters
that carry a dominant underlying theme.  In fact the author admits that there
is a certain amount of overlap.  In general these chapters deal with what it is
that psychology has to do with human relationships–which the author reminds us
is always political, how religion and science are historically relate to
psychology, how psychiatry and psychoanalysis have produced a convincing myth
which they call mental illness, and how mental illness is a form of political
oppression of those individuals who see the world differently than either the
majority or the mental health professionals.  Simon’s main point is that the
global consensus has it that democracy is the most humane and humanistic political
system available today, but that psychotherapy is practiced in a totalitarian
manner.  This makes it not only democracy’s exact opposite but downright
harmful to patients.  In the last chapter the author gives words of wisdom
about what good therapy should be like, along with an admission of his own
shortcomings early on in his professional career as a clinician.  I found this
chapter particularly commendable in that Simon turns the critical gaze he has
been directing at the entire field of psychotherapy back on himself in a
demonstration of his belief that the psychotherapist’s criticism of others
should always also include an honest look at himself.  This is exemplary
democracy.

There are thought-provoking
passages throughout, such as  "Mental illness is modernity’s dishonest and
confused name for sin"  ([because Simon sees mental illness as a moral
judgement rather than a medical condition] p.6),  "Psychology has gone
forward with great confidence in creating one image of humanity after another
that degrades and undermines its human subject matter"  ([by making
individuals seem like animals or machines]  p.63),  "The peculiar politics
of psychology states that negative results are not to be accepted for
publication in mainstream psychology journals"  ([I didn’t know this, but
it’s good to know]  p.75),  "…the drugs provided by psychiatrists and
other nonpsychiatric physicians correct no chemical imbalances in anyone’s
brain and cure or ameliorate no known problems in brain functioning.  Rather
they work in general ways affecting the mentally ill and the mentally healthy
in highly similar ways"  ([the pharmaceutical companies have worked very hard
to keep this from becoming public knowledge]  p.101),  "…psychology and
the self are not reducible to the laws of other fields" ([meaning that
emotional distress should not be defined in medical terms]  p.177), and  "I
no longer try to cure mental diseases but teach individuals how to understand
and better deal with their own unique way of seeing the world"  (201).  It’s
passages like these that make this book hard to put down.

Simon’s approach to the critique of
psychotherapy is both empirical–he refers to studies that have revealed
serious flaws in twin research that claimed to have proven the genetic origin
of schizophrenia–and very philosophical.  He talks about how important it is
for both the patient and the therapist to use critical thinking, and about how
the therapist is, and must be, a teacher rather than a totalitarian expert to
the patient.  But it becomes painfully evident that Simon is not a trained
philosopher when he says "morality is based solely on opinion and any
adult’s opinion is as equally valid as any other" (127).  This is the sort
of belief in the subjectivity of morality I often hear from my undergraduate
students that I wouldn’t have expected from a professor and author in his
mid-sixties.  This again shows how important it is for therapists of all
persuasions to gain a solid background in philosophy before going into
practice.

This book is easy to read and very
informative.  I highly recommend it.  I can see it being an inspiration to all
those who have doubted their own doubts about psychotherapy.  I have only two
minor complaints:  the book suffers from a number of typographical errors that
the word-processing spell-checker couldn’t recognize, and it offers only a
superficial index.

© 2003 Peter B. Raabe

Peter B. Raabe teaches
philosophy and has a private practice in philosophical counseling in North Vancouver, Canada. He is the author
of the books Philosophical
Counseling: Theory and Practice (Praeger, 2001) and Issues
in Philosophical Counseling (Praeger, 2002).

Categories: Psychotherapy, Psychoanalysis, Philosophical