Is Psychoanalysis Harmful?

Many articles and books have been written which purport to show that psychoanalysis is an ineffective form of psychotherapy. Behavior therapists, existentialists, physical scientists, rational philosophers, Marxists, and many other kinds of thinkers have held that psychoanalytic therapy rests on unverified assumptions and that it is largely a waste of time. Relatively few critics, however, have objectively pointed out some of the actual harm that may occur if an individual enters classical psychoanalysis or even undergoes intensive psychoanalytic psychotherapy.

To give and to document all the main reasons why virtually any form of truly psychoanalytic therapy is frequently injurious to clients would take a sizable book; and someday I may write it. For the present, let me briefly and inadequately outline some ways in which analysis does more harm than good.

SIDETRACKING

Probably the greatest harm that psychoanalysis does is its tendency to sidetrack clients from what they had better do to improve and to give them a "good" excuse not to work hard at helping themselves. What disturbed people preferably should do is fairly simple (although it is not at all easy); namely, to understand precisely what are the self-defeating irrational ideas they firmly believe and to vigorously contradict them, both verbally and actively. Thus one of the main senseless notions they usually hold is, "Unless I am remarkably competent and popular, and unless I am superior to others, I am rather worthless as an individual." They can strongly contradict this philosophy by asking themselves, "Why am I no good just because many of my performances are poor? Where is the evidence that I cannot accept myself if others do not like me? How is my self-acceptance really dependent on external criteria?" And they can actively work against their self-defeating attitudes by performing, even when they may not do very well; by risking social disapproval when they want to achieve a desired goal; and by experimenting with potentially enjoyable pursuits in spite of the possibilities of failure and rejection.

Psychoanalysis sidetracks health-seeking individuals verbally by encouraging them to concentrate on innumerable irrelevant events and ideas: such as what happened during their early years, how they came to have an Oedipus complex, the pernicious influence of their unloving parents, what are the meanings of their dreams, how all-important are their relations with the analyst, how much they now unconsciously hate their mates, etc. These may all be interesting pieces of information about clients. But they not only do not reveal, they often seriously obscure, their basic irrational philosophies that originally caused, and that still instigate, their dysfunctional feelings and behavior. Being mainly diagnostic and psychodynamic, analysis is practically allergic to philosophy, and therefore often never gets around to the basic ideological assumptions and value systems with which humans largely create their symptoms.

To make matters much worse, psychoanalysis is essentially a talky, passive, insight-seeking process which encourages clients mainly to lie on their spine or sit on their behinds in order to get better. Sensible unorthodox analysts frequently supplement this passive procedure by giving advice, directing the clients to do something, helping them change their environment, etc.; but they do so against psychoanalytic theory, which stoutly insists that they do otherwise. Meanwhile, the poor analysands, who probably have remained disturbed for most of their lives largely because they will not get off their asses and take risk after risk, are firmly encouraged, by the analytic procedure and by the non-directive behavior of the analyst, to continue their avoidant behavior. They now, moreover, have the excuse that they are "actively" trying to help themselves by being analyzed; but this, of course, is a delusion if anything like classical procedures are being followed; and they consequently tend to become more passive, and possibly even more disturbed, than before.

DEPENDENCY

Most clients are overly-dependent individuals who are afraid to think and act for themselves and to risk being criticized for making mistakes. Psychoanalysis is usually a process which greatly fosters dependency. The sessions are often several times a week; they continue for a period of years; the analyst frequently forbids the clients to make any major changes in their life during treatment; a positive transference between the analyst and analysand is usually encouraged; the clients are constantly brainwashed into accepting analytic interpretations, even when they seem to have a far-fetched relationship to the facts of their lives; and in analytic group therapy, a family-like setting is often deliberately fostered and maintained. While many forms of therapy also abet the patient's being dependent on the therapist, classical analysis is surely one of the worst, and psychoanalytically-oriented psychotherapy one of the second-worst modes, in this respect. Several activity-directed forms of therapy, on the other hand -- such as assertive therapy, rational-emotive therapy, and structured therapy -- urge clients, as soon as feasible, into independent action and teach them how to think clearly for themselves.

EMPHASIS ON FEELINGS

Because it heavily emphasizes free association, dream analysis, and the involvement of the client and therapist in transference and counter-transference relations, psychoanalysis inevitably puts a premium on the expression of feelings rather than the undermining of neurotic ideas. A good deal of the improvement in analytic therapy seems to come from clients' feeling better, as a result of catharsis and abreaction, and because they believe that the analyst really understands and likes them. This tendency of clients to "feel better," however, frequently sabotages their potentiality to "get better."

Thus, the analysand who is terribly depressed about his being refused a job and who gets these feelings off his chest in an individual or a group session will often come away relieved, and feel that at least his analyst (or the group) heard him out, that someone really cares for him, and that maybe he's not such a worthless slob after all. Unfortunately, in getting himself to "feel good," he forgets to inquire about the self-defeating beliefs he told himself that maintain his depression: namely, "If this employer who interviewed me today doesn't like me, probably no employer will; and if I can't get a very good job like this one, that proves that I'm incompetent and that I don't really deserve anything good in life." The expressive, cathartic-abreactive method that is such a common part of analysis doesn't encourage this client to stop and think about his philosophic premises; instead, it enables him to "feel good" -- at least momentarily -- in spite of the fact that he strongly retains these same premises, and in spite of the fact that he will almost certainly depress himself, because of his holding them, again and again.

In the expression of hostility that psychoanalysis encourages, the situation is even worse. Starting with the assumption that it is bad for the client to feel hostile and to hold in her hostile feelings -- which is a fairly sensible assumption, since there is empirical evidence to support it -- psychoanalysts usually derive from this view another, and rather false, assumption: that the expression of hostile feelings will release and cure basic hostility. Nothing of the sort is probably true; in fact, just the opposite frequently happens. The individual who, in analytic sessions, is encouraged to express her hatred for her mother, husband, or boss may well end up by becoming still more hostile, acting in an overtly nasty fashion to this other person, engendering return hostility, then becoming still more irate, etc.

Expression of hostility, moreover, is one of the best psychological cop-outs. By convincing herself that other people are awful and that they deserve to be hated, the client can easily ignore her own maladaptive behavior and self-loathing and can nicely avoid doing anything to look into her own heart and to change her irrational thinking and her dysfunctional feelings and acts. One of the main functions of an effective therapist, moreover, is to help the client minimize or eliminate her hostility (while keeping her dislike of unfortunate events and nasty people, so that she can do something to solve her problems connected with them). Psychoanalysis, because it falsely believes that present hostility stems from past occurrences (rather than largely from the individual's philosophic attitude toward and consequent interpretations about those occurrences), has almost no method of getting at the main sources of hatred and eradicating them. By failing to show the client how to change her anger-creating views and by encouraging her to become more hostile in many instances, it tends to harm probably the majority of analytic clients (or should we say victims?).

BOLSTERS CONFORMISM

The main reasons why most human beings feel sufficiently disturbed to come for therapy are their misleading beliefs that they need the love and approval of others, that they can't possibly be happy at all when they are alone, and that unless they are successful they are no damned good. Because psychoanalysis is essentially non-philosophic, and because it does not show clients how to distinguish clearly between their wanting and their needing to be approved and successful, most analysands wind up, at best, by becoming better adapted to the popularity- and achievement-demanding culture in which they live rather than becoming persons in their own right who give themselves permission to think and to enjoy themselves in unconforming ways. Psychoanalysis basically teaches the client, "Since your parents were overly-critical and therefore made you hate yourself, and since you are able to see that I, your analyst, uncritically accepts you in spite of your poor behavior, you can now accept yourself." And also: "Since you have been achieving on a low level because you were afraid to compete with your father or your brother, and I have helped you gain insight into this reason for your doing poorly, you can now compete successfully with practically anyone, and make the million dollars you always wanted to make."

What psychoanalysis fails to teach the individual is: "You can always unqualifiedly accept yourself even if I, your analyst, do not particularly like you, because your value to yourself rests on your existence, on your being, and not on how much anyone approves you." And: "There are several reasons why succeeding at vocational or avocational activities is usually advantageous; but you don't have to be outstanding, ultra-successful, or noble in order to accept yourself. The main purpose of life is not achievement but enjoyment."

[Actually, the bible teaches that the main purpose in life is to serve God which leads to inner happiness and fulfillment. Enjoyment in life outside of this is fleeting]

Because analysis is largely concerned with historical events in people's lives rather than their ideological reactions to these events; because it encourages passivity and dependency; because it over-emphasizes the personal relationship between the analyst and analysand -- for these and other reasons it often encourages clients to be more successful conformers rather than ever-growing, courageously experimenting, relatively culture-free persons. The analyst himself, rigidly-bound as he often is by the orthodox rules of the therapeutic game he is playing, and self-condemned by following these rules to be a non-assertive, undaring individual himself, tends to set a bad example for the client and to encourage her or him to be a reactor rather than an actor in the drama that we call life.

STRENGTHENS IRRATIONALITY

Clients' basic problems often stem from assuming irrational premises and making illogical deductions from these premises. If they are to be helped with their basic disturbance, they had better learn to question their assumptions and think more logically and discriminate more clearly about the various things that happen to them and the attitudes they take toward these happenings. In particular, they'd better realize that their preferences or desires are not truly needs or demands and that just because it would be better if something occurred, this is no reason why it absolutely should, ought, or must occur.

Instead of helping clients with this kind of cognitive, semantic and logical analysis, psychoanalysis provides them with many unverified premises and irrationalities of its own. It usually insists that they must be disturbed because of past events in their lives, that they need to be loved and have to become angry when thwarted, that they must have years of intensive analysis in order to change significantly, that they must get into and finally work through an intense transference relationship with their analyst, etc. All these assumptions -- as is the case with most psychoanalytic hypotheses -- are either dubious or false; and analysands are given additional irrationalities to cope with over and above their handicapping crooked thinking with which they come to therapy. In innumerable instances, they become so obsessed with their analytic nonsense that psychoanalysis becomes their religious creed and their be-all and end-all for existing; and though it may somewhat divert them from the nonsense with which they first came to therapy, it does not really eliminate it but at best covers it up with this new psychoanalytic mode of "positive thinking." Rather than becoming less suggestible and more of a critical thinker through analysis, they frequently become worse in these respects.

ABSORBS AND SABOTAGES HEALTH POTENTIALS

When clients come for psychoanalysis, they are usually reasonably young and have considerable potential for achieving mental health, even though they are now disturbed. Psychoanalysis, particularly in its classical modes, is such a long-winded, time-consuming, expensive process that it often takes many of the best years of clients' lives and prevents them from using these years productively. To make matters much worse, analytic therapy leads in most instances to such abysmally poor results that analysands are often highly discouraged, are convinced that practically all the time and money they spent for analysis is wasted, that there is no possibility of their ever changing and that they'd better avoid all other types of psychotherapy for the rest of their lives and adjust themselves, as best they may, to living with their disturbances. An untold number of ex-analysands have become utterly disillusioned with all psychological treatment because they wrongly believe that psychoanalysis is psychotherapy, and that if they received such poor results from being analyzed nothing else could possible work for them. If the true facts in this regard could ever be known, it is likely to be found that analysis harms more people in this way than in any of the other many ways in which it is deleterious. The number of people in the United States alone who feel that they cannot afford any more therapy because they fruitlessly spent many thousands of dollars in psychoanalysis is probably considerable.

WRONG THERAPEUTIC GOALS

The two main functions of psychotherapy, when it is sanely done, are: (1) to show clients how they can significantly change their disordered thinking, emoting, and behaving and (2) to help them, once they are no longer severely disturbed, to lead a more creative, fulfilling, growing existence. Instead of these two goals, psychoanalysis largely follows a third one: to help people understand or gain insight into themselves and particularly to understand the history of their disturbances.

Humans -- in contradistinction to the analytic assumptions -- do not usually modify their basic thoughts and behaviors by insight into their past, by relating to a therapist, or even by understanding their present irrational assumptions and conflicting value systems. They change mainly by work and effort. They consequently had better be helped to use their insights -- which usually means, to concretely understand what they are believing and assuming right now, in the present, and to actively challenge and question these self-defeating beliefs and assumptions until they finally change them. They also had better be helped to act, to experiment, to accept discomforts, and to force themselves to do many things of which they are irrationally afraid, so that their actions effectively depropagandize them to give up their dysfunctional beliefs.

[Scripture says to obey God's Word]

Psychoanalytic therapy, instead of devoting much time to encouraging and teaching clients to dispute and act against their self-defeating thoughts, feelings, and behaviors, takes them up the garden path into all kinds of irrelevant (though sometimes accurate) insights, which gives them a lovely excuse to cop out from doing the work, the practice, the effort, the self-deprivation by which alone they are likely truly to change their basic self-sabotaging philosophies of life. Even if it were a good method of psychological analysis (which it actually is not), it is an execrable method of synthesis. It does not notably help people make themselves whole again; and it particularly does not show them how to live more fulfillingly when they have, to some degree, stopped needlessly upsetting themselves. Because it implicitly and explicitly encourages people to remain pretty much the way they are, though perhaps to get a better understanding of themselves (and often to construct better defenses so that they can live more efficiently with their irrational assumptions about themselves and others), it frequently does more harm, by stopping them from really making a concerted attack on their fundamental disturbances, than the good that well might come to them if they received a non-analytic form of psychotherapy or even if they resolutely tried to help themselves by reading, talking to others, and by doing some hard thinking.

SUMMARY

Psychoanalysis in general and classical analysis in particular are fundamentally wrong in their assumptions about why human beings become emotionally disturbed and what can and should be done to help them become less anxious and hostile. Consequently, analytic therapy largely wastes considerable time teaching clients often-mistaken theories about themselves and others. Although these theories are frequently highly interesting and diverting, they at best may help the client to feel better rather than to get better.

The one thing that analysis usually insures is that analysands will not understand the philosophic core of their disturbance-creating tendencies and consequently will not work and practice, in both a verbal-theoretical and active-motor way, to change their basic assumptions about themselves and the world and thereby ameliorate their symptoms and make themselves less disturbable. Although ostensibly an intensive and ultra-depth-centered form of psychotherapy, analysis is actually an exceptionally superficial, palliative form of treatment. Because it deludes clients that they are truly getting better by following its rules and because it dissuades them from doing the difficult reorganizing of their underlying philosophical assumptions, psychoanalysis usually (though, of course, not always) does more harm than good and is contraindicated in the majority of instances in which it is actually used.

My rather biased opinion is that analysts frequently help people by sneaking non-analytic or anti-analytic forms of treatment into their "psychoanalysis." But the closer they stick to truly psychoanalytic theory and practice, the more harm they tend to do.

REFERENCES

Bernard, M.E. (Ed.) (1991). Using rational-emotive therapy effectively. New York: Plenum.

Bernard, M.E. (1992). Staying rational in an irrational world. New York: Carol Publishing.

Ellis, A. (1962). Reason and emotion in psychotherapy. Secaucus, N.J.: Citadel.

Ellis, A. (1975). How to live with a "neurotic." North Hollywood, CA: Wilshire.

Ellis, A., & Becker, I. (1982). A guide to personal happiness. North Hollywood, CA: Wilshire.

Ellis, A., & Dryden, W. (1987). The practice of rational-emotive therapy. New York: Springer.

Ellis, A., & Dryden, W. (1990). The essential Albert Ellis. New York: Springer.

Ellis, A., & Harper, R.A. (1975). A new guide to rational living. North Hollywood, CA: Wilshire.

Ellis, A., & Velten, E. (1992). When AA doesn't work for you: Rational steps to quitting alcohol. New York: Barricade.

Freud, S. (1965). Standard edition of the complete psychological works of Sigmund Freud. New York: Basic Books.

Walen, S., DiGiuseppe, R., & Dryden, W. (1992). A practitioner's guide to rational-emotive therapy. 2nd ed. New York: Oxford.

Albert Ellis, Ph.D. is President of the Institute for Rational-Emotive Therapy in New York City, and for the last 50 years has been practicing psychotherapy and marriage and family counseling. He is a Fellow and has been an officer of the American Psychological Association and several other professional associations, has won many scientific and social service awards, and has published over 700 articles and more than fifty books, including Reason and Emotion in Psychotherapy, A New Guide to Rational Living, The Practice of Rational-Emotive Therapy, and The Art and Science of Rational Eating.