Analysis, Not Prescription

The Ethics of Psychoanalysis, by Thomas S. Szasz. Basic Books, $5.50 This is an altogether admirable book—one of the most concise, precise, and lucid expositions of the nature, possibilities, and limitations of psychoanalytic treatment to be found anywhere. Dr. Szasz places much welcome emphasis on the distinction between psychoanalysis (or autonomous psychotherapy) and treatments which coerce patients by institutional means or by the assumption on the part of the therapist of the role of moral authority or agent of society. The analyst, Szasz points out correctly, is simply the patient’s agent; he does not make choices for the patient nor even tell him the “right” choices, but merely analyzes what the patient tells him. Unlike the physician, the analyst prescribes neither medicine nor behavior; he only helps the patient to understand his behavior and to choose it more freely.

We all are indebted to Dr. Szasz for his previous books, which cogently and courageously called attention to the use of psychiatry and of psychiatric hospitals for the confinement of people who have annoyed their families, social workers, or officials. All too often therapists, sometimes in good faith, have lent themselves to such commitments. In the present book, Dr. Szasz sheds some light on what leads therapists to confuse behavior they or the law disapprove of with illness. I have nothing but admiration for the substance of his argument. However, there are some formulations which unnecessarily obscure the points Dr. Szasz has done so much to clarify. Thus Szasz insists that psychoanalysis is a moral enterprise—but only means that analysts are morally committed to analyze their patients.

EH

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Ernest van den Haag

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The Ethics of Psychoanalysis, by Thomas S. Szasz. Basic Books, $5.50 This is an altogether admirable book—one of the most concise, precise, and lucid expositions of the nature, possibilities, and limitations of psychoanalytic treatment to be found anywhere. Dr. Szasz places much welcome emphasis on the distinction between psychoanalysis (or autonomous psychotherapy) and treatments which coerce patients by institutional means or by the assumption on the part of the therapist of the role of moral authority or agent of society. The analyst, Szasz points out correctly, is simply the patient’s agent; he does not make choices for the patient nor even tell him the “right” choices, but merely analyzes what the patient tells him. Unlike the physician, the analyst prescribes neither medicine nor behavior; he only helps the patient to understand his behavior and to choose it more freely.

We all are indebted to Dr. Szasz for his previous books, which cogently and courageously called attention to the use of psychiatry and of psychiatric hospitals for the confinement of people who have annoyed their families, social workers, or officials. All too often therapists, sometimes in good faith, have lent themselves to such commitments. In the present book, Dr. Szasz sheds some light on what leads therapists to confuse behavior they or the law disapprove of with illness. I have nothing but admiration for the substance of his argument. However, there are some formulations which unnecessarily obscure the points Dr. Szasz has done so much to clarify. Thus Szasz insists that psychoanalysis is a moral enterprise—but only means that analysts are morally committed to analyze their patients.