AND Assault on the Couch Step/Jen Seligrnan critics have drawn their arguments from a wide spectrum of viewpoints. For defenders of traditional conceptions of privacy, talking about inner dilemmas is a breach of family and personal boundaries. Men who ask for help are often regarded as weak, and emotional self-disclosure is relegated to a depreciated world of women. In public life, consultation with a therapist carries the stigma of ?mental instability.? (Michael Dukakis?s prompt denial of accusations that he had suffered from depression emphasizes this prejudice.) The complexities of self-exploration ?y in the face of a widespread desire for quick, practical solutions to personal and social problems, no matter how entrenched or subtle these problems may be. Thus, for example, the experiences and environments of those who abuse drugs are responded to with the banality of just saying no. Leftists and feminists have also been among the skep- tics. While af?rming the value of probing beneath the surface to challenge conventional modes of thought and communication, they indict the mental health system for controlling the powerless and diverting attention from the true sources of individual distress?political and economic injustice. From this point of view, Freudian mysti?es and reproduces a destructive social order rather than promoting the conditions for chang- ing it. Recently, one aspect of Freud?s thinking?the ?seduc- tion hypothesis? ?has been the subject of a particularly heated debate. Early in his work, Freud turned away from the unearthing of actual childhood events that caused overwhelming injury and began to analyze his patients? fantasies in order to discover the sources of their distress. Contemporary critics have interpreted this shift as a thinly veiled strategy of victim- blaming, citing current research showing that child abuse?especially the sexual abuse of girls by their fathers and other male relatives?is much more common than was previously believed. Freudians are accused of In the century since invention, its Step/yen Seligman teacher in the department of at tlre University of California, San Francisco, and is on the faculty at New College of California. He practices adult, child, and infant-parent reproducing the initial conditions of abuse under the guise of offering a cure?inviting trust and exposure and then assaulting the disclosure of truth as nothing more than a distorted fantasy. Jeffrey Masson has been in the forefront of this critique. Until ?red in 1981 as projects director of the Sigmund Freud Archives, Masson unearthed previously suppressed material that documented Freud?s departure from the hypothesis that his female patients had been seduced as girls. Although a storm of controversy fol- lowed Masson?s expos?, his work has served, together with a general recognition of the frequency of child abuse and the writings of such feminists as Diana Russell, Alice Miller, and Judith Herman, to spur a subtle re- orientation among many Therapists are now more likely to inquire about the possibility of such incidents and to encourage patients? expressions of anger and protest rather than to analyze the dis- tortions or motives that affect memories of abuse. Although some critics have misused the new revelations to discredit the entire edi?ce, Masson?s passionate scholarship has contributed to a critical recognition of the variety of injuries in?icted on children that have so often been overlooked by those appearing to help them. In Against Therapy: Emotional Tyranny and t/ae of Healing (1988), Masson has extended his attack to cover as a whole. Now, nothing but abolition will do. He argues that therapy inevitably reproduces the power inequalities that are the true sources of individual suffering; it thus conceals the fundamental political realities that bring people to therapy in the ?rst place. Even the most politically aware therapists, he maintains, cannot help but oppress their patients. Sandwiched between two brief theoretical polemics, the bulk of Masson?s book details, at length, a series of abuses of power. These abuses range from the dreadful con?nements of rebellious women in nineteenth-century European asylums, through Freud?s famous Dora case, to reports of abuses by recent stars of the galaxy??including the ?humanist? Carl Rogers; Fritz Perls, the founder of 49 Gestalt therapy; and Milton Erickson, a charismatic ?grand old man? of family therapists. Masson also in- cludes a chapter on Carl Jung?s Nazi sympathies. Al- though unable to conclude whether Jung was motivated by conviction or expediency, Masson cites numerous examples of the Swiss analyst?s participation in the organizations of the Third Reich. asson?s attack, while impassioned, doesn?t make his case stick. The news that Freud mis- treated Dora is quite old by now, and the reports of others? atrocities, while chilling, do not prove that therapy always harms its patients. Similarly, knowing about Jung?s flirtation with the Nazis may raise questions about the most extreme implications of his sometimes romantic and mythologically oriented but it does not discredit the entire edifice any more than Martin Heidegger?s nazism dis- credits all of phenomenology or Werner Karl Heisen- berg?s efforts on behalf of Hitler?s war discredits all of theoretical physics. Masson?s theoretical arguments are even less compel? ling. They recall the more reflexiver antiauthoritarian positions of the New Left and neglect the extensive and subtle discussions of personal power and domination that have emerged from the left and feminist intellectuals. His opinion that the therapeutic relationship is essentially an arena for domination and exploitation rests on two arguments?a class analysis and the commonly held view that power inequalities are inevitably corrupt. As members of a professional group whose privilege is derived from the suffering of its patients, therapists, he argues, cannot help reinjuring their patients. The intrinsic limitations of the therapist- patient hierarchy thwart the best of intentions. This stance does raise an issue that is often neglected in everyday practice. But when Masson declares his lack of interest in the fact that sometimes does provide relief and the possibility of change, he displays a cynical ignorance of how conscien- tious individuals manage to do humane, progressive work under adverse political circumstances. Radical social theorists have discussed the multiple and contradictory effects of ?helping? professions such as social work, psy- chotherapy, and medicine; these professions meet some immediate human needs while also stabilizing inequitable social systems. Although such efforts do not in them- selves challenge the oppressive features of the political system, they do not always conceal them. When therapy encourages patients to trust their own instincts and helps give them the con?dence to pursue their own goals, it can encourage confrontation with harsh social and sexual realities. Personal insight and self?esteem are not in- trinsically opposed to political awareness and activity. 50 TIKKUN VOL. 4, No. 4 Impediments to social consciousness often present themselves in the form of individual feelings of in- adequacy and alienation. A lesbian woman in therapy with one of my colleagues sought to reassure herself that she was correct in thinking that her colleagues were indeed homophobic. But she first had to sort out the ways in which her own self-hatred led her to agree with her tormentors. Other patients have been able to stop oppressive sexual practices when they become aware of how inner scars compel them to manipulate others in order to preserve their own sense of emotional safety. Although many therapists do exert a variety of subtle and not-so-subtle pressures on the side of con- formity, is a more open form than Masson would have us believe. In those situations where political and cultural op- pression are clearly at the root of the problem, therapy can be equally helpful. Many victims of child abuse could not endure the painful process of remembering and re?ecting without the protective support of a con- cerned therapist. This includes children who report severe forms of abuse only after carefully determining whether the therapist can be trusted to help them in this most sensitive of self?disclosures. And what would Masson say to those victims of torture and those wit- nesses of political murder in Central America and else- where who suffer from nightmares, persistent anxiety, and other crippling associated with their terrifying memories? from throughout the Americas have enabled such people to gain some control over their haunting images by helping them review their experiences at a pace slow and deliberate enough to avoid the overwhelming pain that merely remembering traumas brings on. would be easy to dismiss Masson?s book as no more than a supplement to the already impressive historical record of abuses. However, the issues he raises do deserve attention; the same elements that give the therapeutic relationship its extra- ordinary power are those that intensify the risks of abuse. The secluded intimacy of the relationship and the fact that the patient approaches the therapist in a state of need do create possibilities for exploitation that are paralleled only in the parent-child relationship and in other situations more overtly characterized by domination and oppression. For example, although sexual relationships between patients and therapists are already subject to severe professional sanctions, they are currently so frequent that some organizations of are demanding they be criminalized. In addition, the private nature of conventional therapy? re?ecting the general isolation of individual conscious- ness from collective life?makes it easy for both therapist and patient to omit social factors. Therapy does some- times function as a ?haven in a heartless world,? which veils our sense of collective powerlessness by allowing for a bit of individual change. These realities account for the considerable appeal that views such as Masson?s have engendered among many patients in as well as among therapists struggling to integrate their clinical practice and their political values. These therapists include many feminists, supporters of the radical therapy movement, and people who have called attention to the widespread abuses of such practices as shock treat- ment, and involuntary hospitalization. Many self-help groups, often using the addiction-oriented ?twelve-step? model of Alcoholics Anonymous, also criticize conven- tional as authoritarian; AA meetings typically proceed with little formal structure or leader? ship. This antiauthoritarian sentiment is also re?ected in those left organizations that attempt to change authority structures in the belief that such structures reproduce the very conditions activists want to change. Self-help groups and such egalitarian therapeutic forms as peer counseling can indeed support and even transform their participants, encouraging many of the same personal changes as does traditional However, they are not without problems. Painful tensions may arise over competition and attempts at leadership. The strain of listening to others? problems may prove overwhelming for those who are in acute crisis or who are chronically needy. Even, as in peer counseling, when one-to-one attention can be provided, both conscious and unconscious personality patterns can impede even the most compassionate and carefully conceived efforts to provide nonprofessional assistance. People who deeply mistrust those upon whom they depend and who retreat from all offers of help demonstrate that the circle of internalized alienation cannot be broken by good inten- tions alone. When Masson reports that repeats the destructive dynamics of individual histories and cultural systems, he is describing a phenomenon that is not exclusive to therapy; the repetition of past experi- ence occurs throughout our personal and social lives. And, with a trustworthy therapist, the peutic relationship can ful?ll some of its promise. It can offer a person in emotional pain an opportunity to learn about past abuses without having to suffer them passively. As the relationship deepens, the patient can feel increasingly free to re?ect on problematic ideas, emotions, and self-images, and can begin to play them out in the therapeutic context. Instead of merely re- enacting the patient?s disappointments and deprivations, the careful therapist can interrupt the patient?s distress by linking it to earlier wounds. The personal focus may constrain the exploration of social issues, but, in return, it allows for a deeper recognition of the earliest child- hood in?uences, which indeed represent some of the culture?s most profound incursions into the developing self. When therapists are aware of the social nature of all individual experience, personal exploration need not exclude or obSCure that truth. When therapy encourages patients to trust their own instincts and helps give them the con?dence to pursue their own goals, it can encourage confrontation with harsh social and sexual realities. For one young man I treated, who had been brutally ordered around by his parents, personal history and social factors converged in the context of his therapy. His adult behavior re?ected the obsequiousness he had developed as a child to avoid his parents? abusive taunt- ing. When his boss insisted he work overtime on a routine basis, the man told me that he would have to stop therapy because he would never be free during regular clinic hours. I considered making special arrangements to see him after hours. But before doing so, I explored his reluctance even to attempt to negotiate a more reasonable work schedule. As a result, he concluded that he was repeating his accommodating style from childhood instead of demanding his rights under the union contract. He then ?led a successful grievance and began to understand further how his feelings about his earlier experiences in?uenced his everyday behavior. Even in cases where therapists are guided by the often controversial assertion that it is sometimes useful to maintain a posture of restraint and authority in order to promote greater insight, many therapists are ?exibly supportive toward their patients. One such case with which I?m familiar involved a di- vorced man who told his therapist that his son?s child care teachers were concerned about the boy?s compulsive and persistent habit of showing his genitals to other children. The therapist?s inquiries about whether this behavior could possibly re?ect sexual abuse led the father, who had been somewhat detached from his son, to discover that his ex-wife?s new boyfriend had indeed been sexually inappropriate with the youngster. As the father proceeded to take the necessary steps to protect his son during the subsequent period of therapy, the therapist again returned to his more ?neutral,? explora- tory stance. Although the father often demanded that AND 51 the therapist be as directly helpful as he had been in raising the issue of abuse, the therapist maintained an analytic distance and interpreted these feelings in the context of the patient?s experiences of his own father, in whom he was frequently disappointed. The father . was soon able to see how his own distance from his son repeated his relationship with his distant father, and he was able to increase his own capacity to be available to the boy. Although some still adhere to the view that patients become more self-aware only when therapists frustrate their desires, most therapists View exploration and support as part of a single process. Thus, in everyday practice, the therapist?s authority is not uniformly oppressive but provides a ?exible template through which the patient can experience hierarchy in a variety of ways?ranging from protection, nurturance, and understanding, to deprivation, threat, and abuse. This situation corresponds to the child?s complex ex- perience of the parent, and the capacity to evoke the multiplicity and depth of this experience is what gives therapy some of its special power. Similarly, social authority is not uniformly destructive, despite its pro- found and sometimes crushing costs. Cultures and families offer a variety of human possibilities, and the therapeutic situation provides a microcosm of such potentials in a speci?c historical context. Masson?s ab- solute equation of authority and abuse isolates only the most destructive of these experiences and projects them onto the whole. He thus ignores the more benign aspects of both therapy and society, and paints a picture of both that lacks all subtlety. af?rm the potential of is not to dismiss its pitfalls and dangers. In fact, Masson?s emphasis on horror stories diverts attention from the more mundane abusers?those therapists who en- courage an unrealistic hope for quick and complete relief from profoundly rooted suffering, and those therapists who use the therapeutic relationship to pursue their own narcissistic agendas. are not immune to the same personal and historical forces that have distorted their patients? lives. 52 TIKKUN VOL. 4, No. 4 Faced with such challenges, many therapists monitor their reactions more or less continually, attempting to avoid re-creating the patient?s and their own oppressive experiences. This process helps them to re?ne their awareness of how their own personalities and power interact with their patients? inner worlds. Such self- re?ection is increasingly part of standard training and practice, and it has spawned an expanding body of literature about ?countertransference.? In this way, the therapist works to establish and main- tain an unconventional, asymmetrical relationship in service of a fundamental goal: that the patient feel ade- quately protected from the conscious and unconscious risks associated with desires, such as those for intimacy, recognition, sexuality, and power. The therapist?s relative inaction and self-discipline promote an atmosphere in which the wounds of the past?whether individually or socially registered?can be understood rather than actually re-experienced or re-created. Ideally, patients learn to appreciate the value of memory and imagination rather than to de?ect them anxiously; they can better discriminate between past and present, can realign blame and self-destructiveness, and can conceive of new, more autonomous, and truly connected forms of power, need, and desire. Less ambitiously conceived, is a valu- able source of support for people who cannot turn elsewhere. At its worst, it is a casual tampering with the tender and profound, an arena for the abuse of the already wounded, and an apology for oppression. has indeed become, for some, nothing more than one of an array of balms that we apply to the gaps and scars left by a culture that provides increasingly limited opportunities for community and human con- nectedness. But in the age of postmodern nihilism, when the pressures to avoid historical and introspec- tive consciousness have become increasingly potent, the ideal?that ?nding out the truth about ourselves will make us freer?supports the hu- manistic struggle to maintain authenticity and hope. Simply to abandon this idea], at a time when larger movements for liberation offer little hope for redemp- tion, is to neglect wounds that may be soothed and even healed, however imperfectly.