Why do some people still choose psychoanalysis-Freud's so-called talking cure-when numerous medications are available that treat the symptoms of psychic distress so much faster? Elisabeth Roudinesco tackles this difficult question, exploring what she sees as a "depressive society": an epidemic of distress addressed only by an increasing reliance on prescription drugs.
Far from contesting the efficacy of new medications like Prozac, Zoloft, and Viagra in alleviating the symptoms of any number of mental or nervous conditions, Roudinesco argues that the use of such drugs fails to solve patients' real problems. In the man who takes Viagra without ever wondering why he is suffering from impotence and the woman who is given antidepressants to deal with the loss of a loved one, Roudinesco sees a society obsessed with efficiency and desperate for the quick fix.
She argues that "the talking cure" and pharmacology represent not just different approaches to psychiatry, but different worldviews. The rush to treat symptoms is itself symptomatic of an antiseptic and depressive culture in which thought is reduced to the firing of neurons and desire is just a chemical secretion. In contrast, psychoanalysis testifies to human freedom and the power of language.
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Elisabeth Roudinesco teaches at the École des Hautes Études en Sciences Sociales in Paris. She is the author of twelve other books, including Jacques Lacan (Columbia 1999) and Revolution and Madness: The Lives and Legends of Theroigne de Mericourt.Rachel Bowlby is a professor of English at the University of York. She has written Carried Away: The Invention of Modern Shopping(Columbia 2001); Feminist Destinations and Further Essays on Virginia Woolf; Just Looking: Consumer Culture in Dreise, Gissing, and Zola; Still Crazy After All These Years: Woman, Writing, and Psychoanalysis; and Shopping with Freud.
It is interesting and instructive to read Roudinesco's eloquent defense of psychoanalysis in an era when psychopharmacology and cognitive science--not to mention managed-care cost cutters--deny the value of the "talking cure." The author, a French psychoanalyst, historian, and critic, labels the contemporary West "the Depressive Society." This, she argues, is a world in which physicians prescribe drugs to eliminate psychic symptoms without inquiring into their origin; cognitive scientists reduce both Mozart's artistry and schizophrenia's delusions to neurons and chemicals; and depression has replaced the hysteria of Freud's time as "the psychical epidemic of democratic societies." Roudinesco examines "The Great Quarrel over the Unconscious" and speculates on "The Future of Psychoanalysis," offering valuable insights into the nature of psychoanalysis and the profession's development in different countries. But her greatest contribution is her insistence that the human subjectivity at the heart of psychoanalysis is ignored and defeated by the scientific approaches dominant today. Mary Carroll
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These two books defend the professional treatment of psychological problems by listening and responding in the Freudian manner, and they deplore the current dominance of neuroscience, pharmacology, and behaviorism. In Why Psychoanalysis?, French psychoanalyst, historian, and critic Roudinesco refers to our "depressive society" and our loss of subjectivity in the era of individuality. She fiercely defends Freud against "fanatical" opponents, even claiming that he was not antifeminist. Roudinesco will appeal to scholars of Freud and Jacques Lacan, of whom some knowledge is assumed. Unfortunately, though Roudinesco wants psychoanalysis to be a science, she often waxes polemical when a clear, objective evaluation of Freud is needed. For that, a general audience will be better served by Elio Frattaroli's Healing the Soul in the Age of the Brain (LJ 8/01). For a more readable presentation of the cultural nexus of psychiatry, Julian Leff's The Unbalanced Mind (LJ 11/15/01) is outstanding. In The Gift of Therapy, Yalom (psychiatry, emeritus, Stanford) writes for both the professional and the lay reader a good idea, since educated consumers help bring professionals into the real world. He favors some self-disclosure by therapists, home visits, meeting with significant others, nonsexual touching, and time for reflection on each session. In 85 short chapters, he presents little pearls of ideas shaped from 35 years in practice. Yalom's view that the therapist is also healed in the process reminds this reviewer of James P. Carse's philosophy. Yalom's latest is essential for therapy trainers and fine for general libraries with psychology and self-help collections. For a general selection of this respected psychiatrist's earlier work, including fiction, consider The Yalom Reader (Basic Bks: Perseus, 1998). E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC
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