Madness on the Couch: Blaming the Victim in the Heyday of Psychoanalysis

Extensively researched but depressingly mean-spirited, journalist Dolnick's debut chronicles the American midcentury's full-out embrace of psychoanalysis and willingness to apply it with impunity. Theorists such as Frieda Fromm-Reichmann, R.D. Laing and Bruno Bettelheim broadened Freudian theory to treat not only anxiety and neurosis, Dolnick explains, but also more severe mental illnesses such as schizophrenia, autism and obsessive-compulsive disorder. As Dolnick shows, these neo-Freudians quickly came to dominate the psychiatric industry. They shared with ur-Freudianism an emphasis on talk therapy for even the most disturbed patients and, most damningly in Dolnick's eyes, a vision of the home as nest of pathology; it was in this era that the term ""refrigerator mother"" was coined to designate the mother of a schizophrenic. Today, these theories have receded into the background of psychiatry because of their apparent clinical inefficacy and the emergence of powerful (but hardly problem-free) drug therapies. In an ill-focused j'accuse, Dolnick, a contributing editor of Health magazine, charges the neo-Freudians with sloppy science, moral laxness and intellectual infirmity. Above all, he faults them for ""hubris,"" because they failed to conduct double-blind experiments in testing theories (although in the epilogue he admits that such trials were not even invented until 1948, nor widely in use until long after). He also pins the blame for an entire generation's demonization of domestic life squarely on the shoulders of this small band of therapists. In sentence after sentence brimming with accusatory hauteur, Dolnick shifts his moral critique from anecdote to anecdote, now sympathizing with the patients, whose symptoms he details with distasteful breathiness, now with the hard-working but sadly befuddled psychoanalysts in the trenches, and now with the unfairly blamed parents. While this book can be seen as yet another case of hindsight Freud bashing, it lacks the intellectual subtlety that would make it a genuine contribution to such historical revisionism. (Oct.)