Theodore Dalrymple begins this anti-psychology polemic with a quote from the great 17th-century memoirist François de La Rochefoucauld: “In the misfortunes of our friends, there is something not entirely unpleasing.” Dalrymple cites this shrewd and biting insight into the complexities of the human heart for two reasons. First, it serves as a reminder that psychological understanding long predated Sigmund Freud, B. F. Skinner, and other 20th-century chieftains of the “science” called psychology. Older insights into the mind and heart were often as perceptive as modern pseudoscientific explanations, if not more so. They were also considerably less excusing and rationalizing.
It is the latter tendency in modern life at which Dalrymple, a psychiatrist himself, takes steady aim. Though he acknowledges that psychology has made some modest contributions to the alleviation of suffering, he offers that the following is, at best, an open question: “If all the antidepressants and anxiolytics . . . were thrown into the sea,” “all textbooks of psychology were withdrawn and pulped,” “all psychologists ceased to practice,” and “all psychological terms were excised from everyday speech, would Mankind be the loser or the gainer”?
That Freud was at best a philosopher and at worst a fraud is now pretty widely acknowledged. His work was completely unscientific — that is, unmeasurable, untestable, and founded upon nothing more than speculation enforced by dogma. Freud debunkers have filled whole bookshelves. The id, the ego, penis envy, the Oedipus complex — all have been consigned to the intellectual trash. Still, because the man Vladimir Nabokov dismissed as “that Viennese quack” has cast such a long shadow over our times — W. H. Auden said that Freud was not just a man, but “a whole climate of opinion” — Dalrymple attends to filleting him with a few swift strokes. Freud was a “self-aggrandizing mythologist and a shameless manipulator of people. . . . He was the founder of a doctrinaire sect and a searcher-out and avenger of heresy . . . who called down anathema on infidels as intolerantly as Mohammed.”
Though Freud was “undoubtedly brilliant,” Dalrymple rejects utterly the notion that he originated such concepts as ambivalence, projection, and unconscious motivation. A quick glance at Shakespeare undermines Freud’s pretensions, and Dalrymple deploys King Lear to good effect:
Why dost thou lash that whore? Strip
thine own back.
Thou hotly lust’st to use her in that
For which thou whipp’st her.
Worse than Freud’s lack of scientific foundation, and much more significant than any of his personal shortcomings, was the effect his odd and baseless theories had on our civilization. Though Freud didn’t necessarily intend this result (he was personally quite conventional in most respects), the effect, Dalrymple writes, was to “loosen Man’s sense of responsibility for his own actions, freedom from responsibility being the most highly valued freedom of all.” Freud’s message, warped to be sure by oversimplification, became profoundly subversive. Dalrymple explains: “That desire, if not fulfilled, will lead to pathology makes self-indulgence man’s highest goal. It is a kind of treason to the self, and possibly to others, to deny oneself anything.” The author quotes one of his patients, a murderer: “I had to kill her, doctor, or I don’t know what I would have done.”
So psychoanalysis was bunk — and culturally destructive bunk at that; but what of the more scientific branches of psychology? Did they too help to undermine morality?
The behaviorists dispensed with the unconscious and infantile sexuality, but in its place they erected a new theory that was supposed to explain with one blinding insight all of the complexity of human experience. It was, according to John B. Watson, B. F. Skinner, and others, all a matter of stimulus and response. “What started as methodology became ontology,” writes Dalrymple, in one of the dozens of memorable aphorisms that enliven nearly every page of this book. While behaviorism (unlike psychoanalysis) could claim some clinical successes, such as treating phobias, it proved absurdly reductionist as a guide to understanding human behavior as a whole. The behaviorists treated human beings as laboratory animals, whose thoughts and conduct could be controlled by the correct administration of food pellets and electric shocks.
Dalrymple allows that cognitive behavioral therapy has helped some, but he cannot help wondering “whether many conditions . . . such as eating disorders . . . spread in proportion as they are known about.” Surely the pharmaceutical companies that advertise cures for such conditions as “overactive bladder,” “premenstrual dysphoric disorder,” and “low T” are counting on creating as much as discovering sufferers.
Writing of the “Werther effect” — which was named for the rash of suicides that followed the publication of Goethe’s The Sorrows of Young Werther, and refers to the predictable copycat acts that follow the suicides of celebrities — Dalrymple notes that human beings are awfully susceptible to suggestion. “No statement that a psychological disturbance has such-and-such a prevalence in such-and-such a population should be taken at face value, especially when it is a plea, as it so often is, explicit or implicit as the case may be, for more resources to treat it, the supposed prevalence having risen shockingly in the last few years. It is not merely that epidemiological searchers in this field can find what they are looking for; it is that they can provoke what they are looking for.”
While psychology diligently (and not selflessly) creates more and more categories of illness — the latest Diagnostic and Statistical Manual lists some 300 maladies — the social-welfare and tort systems in America and other countries encourage and reward victim status. Many bad behaviors, such as alcoholism or drug abuse, are labeled as mental illnesses and thus placed beyond moral censure. “There can be nothing morally to choose between the disordered conduct of a person with a brain tumor or dementia on the one hand, and a person who has intoxicated himself with drugs on the other.” Also, once the apparatus for diagnosing and treating self-reported psychological ailments is in place, with caregivers and sufferers alike benefiting financially, the “virtue of resilience or fortitude” becomes a “sworn enemy.”
This approach has bizarre consequences:
The expansion of psychiatric diagnoses leads paradoxically and simultaneously to overtreatment and undertreatment. The genuinely disturbed get short shrift: Those with chronic schizophrenia, which seems most likely to be a genuine pathological malfunction of the brain, are left to molder in doorways, streets, and stations of large cities, while untold millions have their fluctuating preoccupations attended to with the kind of attention that an overconcerned mother gives her spoiled child with more or less the same results.
Psychology’s code is roughly that of the French proverb: “To understand all is to forgive all.” Psychology has served up one excuse after another for bad behavior — our terrible childhoods, our genes, our neurotransmitters, our addictions. In each case, and often with extremely unscientific reasoning, we are offered absolution. None of us is really responsible for our behavior. The whole psychological enterprise, Dalrymple argues, has had the effect of excusing poor choices and bad character. “Virtue is not manifested in one’s behavior, always so difficult and tedious to control, but in one’s attitude to victims.”
It’s a powerful argument, studded throughout with chiseled gems of observation and reflection.
Admirable Evasions is actually an indictment of modern culture, with its moral laxity and sloppy thinking. It may be a little too hard on psychology and psychiatry. Though it is beyond question that psychological thinking has damaged our culture by elevating non-judgmentalism to the highest plane, it isn’t clear, at least to me, that mankind would truly be better off without anti-psychotic drugs, antidepressants, and other mood-altering substances. Animals are now commonly trained with rewards (positive reinforcement) rather than punishments, and so, in many cases, are children (with punishment as backup). That seems to be a humane advance. And while many therapists may deliver nothing but warm sympathy to their clients (which probably does no harm), some are able to help their patients attain true insight — the kind that requires painful honesty about one’s actions.
I would not chuck the entire corpus of psychology and all the psychotropic drugs into the sea. But I would recommend that anyone interested in where the field, and our culture, has frequently gone wrong read this incisive little book.