[Talk delivered at Balliol College, Oxford, May 1996]

Psychotherapy: Illusion with no Future?

Having spent nearly half this century involved in and thinking about therapeutic psychology, I find myself, with some embarrassment I must say, ever more firmly coming to the view that for much of that time I, along with so many others, have been pursuing an illusion. Therapeutic psychology, I'm afraid, may just prove to be the great red herring of the twentieth century, a master-stroke of ideology which has managed to obscure from our view the full significance for our emotional suffering of the workings of material reality. Instead of seeing with absolute clarity that what makes people happy or sad, triumphant or despairing, lucid or confused, is a function of what happens to them in the real, material world which lies beyond their skin, it is as if our view has become clouded by a haze congealing all too easily into a mirage of personal responsibility and control, deceptively convincing us that mastery of our fate is a matter of the deployment of our psychological resources as private individuals.

Not everyone, of course, has succumbed to this illusion, and it may have been much more dominant in the capitalist West than in the - until recently - communist East. I was struck that, despite the cultural breadth of his view, Eric Hobsbaum makes absolutely no mention in his absorbing account of the 'short twentieth century' of psychology and psychotherapy1. Freud doesn't appear in the index to Age of Extremes, nor do any of the other psychological architects of our notions of self. In some ways this must, I think, be regarded as an oversight on Hobsbaum's part, but in another it is an excellent indication of the importance of psychological ideas for the actual events of the time. The century which Sir Isaiah Berlin characterized as the 'most terrible in Western history' unrolled through the operation of powers scarcely glanced at by the likes of Freud and Jung, Rogers, Perls or Berne.

And yet if psychological notions have been largely irrelevant to the actual course of events of the last hundred years and have failed to have any significant impact on the suffering which they have occasioned, in some ways this could still be called the Century of Psychology. Certainly in the so-called liberal democracies, there can be hardly anyone who hasn't derived a view of self, and ideas about the scope of personal responsibility, from the kind of 'dynamic' psychological approach whose origins are attributed to Sigmund Freud.

Freudianism has enjoyed a remarkable revival in Britain over the past twenty years, and even within academic psychology, traditionally most suspicious of Freud's ideas, there have been signs here and there of greater respect. In America, of course, Freud has had a strong following right from the early years of the century.

If one regarded Freud's contribution as being simply about founding a system of therapy for the relief of psychological distress, his success would be hard to explain, because the evidence for the effectiveness of psychoanalysis as a therapeutic medium is so slender. Non-existent, really. Rather, I think, Freud has to be regarded as the great ideologue of the Western World (Marx, of course, being his counterpart in the East). I don't suppose Freud would have been terribly happy to think that he might come to be seen in this role, but there is something about his ability as a psychological sophist; his genius for performing the conceptual conjuring tricks which can turn black into white, reality into imagination (and vice-versa); his literary skill in fudging arguments and obscuring the stuffy bourgeois morality underlying them, which makes him the ideal person to provide an intellectual backing for the capitalist world. For this world depends for its survival on a huge, docile consumership instantly internalizing manufactured needs and exquisitely vulnerable to endless cycles of changing fashion, and psychoanalysis is a marvellous medium for making 'all that is solid melt into air' while convincing those driven to distraction by the process that somehow it is all their own fault.

I do not for an instant want to suggest that Freud was some kind of evil genius deliberately weaving woolly notions to pull over the eyes of the masses, but rather that, inevitably caught up himself in the inescapable net of capitalist socio-economic relations, he was drawn quite without noticing into constructing some of the most influential conceptual foundations for it. And if I seem to be giving particular prominence in what follows to Freud's writing, it is not because psychoanalysis is necessarily the most widespread psychotherapeutic system in operation today, but because Freud, in constructing the philosophical and moral framework of therapeutic psychology, was intellectually streets ahead of his professional successors who, though they have quarrelled endlessly over details of therapeutic practice, have hardly questioned at all the fundamental tenets of the therapeutic enterprise.

What Freud did was:-

a) detach the person from the noxious influences of a real, material world, and render the causes of their suffering imaginary

b) remove from people the right to judge the significance of their own actions, while at the same time affirming their personal moral responsibility for the ills befalling them

These two processes combine to establish a comprehensive psychological privatism which all but destroys the possibility for credible political understanding and action. Let me try to give some substance to these allegations.

My claim that Freud rendered the causes of suffering imaginary might seem to be refuted by his oft-quoted view that 'hysterical misery' is but a perverted form of 'common unhappiness'. What he actually wrote was as follows:-

'Why, you tell me yourself that my illness is probably connected with my circumstances and the events of my life. You cannot alter these in any way. How do you propose to help me, then?' And I have been able to make this reply: 'No doubt fate would find it easier than I do to relieve you of your illness. But you will be able to convince yourself that much will be gained if we succeed in transforming your hysterical misery into common unhappiness. With a mental life that has been restored to health you will be better armed against that unhappiness.'2

For me, the most significant aspect of the view Freud articulates here - a view with which I have some sympathy - is that it was one he shortly afterwards abandoned. It was in fact written in 1895, very much towards the beginning of Freud's development of his ideas, and reflected his experience that the so-called neurotic symptoms of his mainly young, female patients seemed surprisingly often to be related to sexual traumata that had befallen them in childhood (that 'sexual abuse', especially by members of their family, happens to children disturbingly frequently is something that we have of course re-discovered in much more recent times).

At this stage, then, Freud seemed to have embarked upon the thesis that psychological disturbance in later life was likely to be the consequence of actual injuries sustained earlier on in infancy and childhood. He quickly discovered, however, that this was not a popular view, and, as has been documented very persuasively by Jeffrey Masson in his The Assault on Truth3, Freud very soon revised his view fundamentally, suggesting instead that the sexual assaults and seductions which seemed to lurk behind his patients' distress were in fact the products of their own wishful fantasy. Far from being the result of painful and damaging abuses of power, his patients' symptoms were thus transformed into events that they guiltily wished to have happened.

One can see that this revision of his theory must have brought Freud considerable relief: quite apart from mitigating some of the odium in which he had found himself with colleagues, it no doubt made it easier for him to make a living. Freud himself never seems seriously to have considered as psychologically important the kinds of material necessities which form such a prominent part of the motivation of the great mass of humanity, but there is no doubt that he was at this time of his life greatly preoccupied with the need to make ends meet, and it must have been easier for him to persuade the senior male members of his patients' households to pay his bills if they were not at the same time being accused of incestuously assaulting their offspring.

I can't resist at this point quoting a passage written by Freud in a letter to his friend Wilhelm Fliess around this time, as it demonstrates how acutely aware Freud was of material necessity in his personal circumstances while insisting in his writings on the primacy of fantasy for everyone else.

A patient of mine with whom I have been negotiating, a 'goldfish', has just announced herself - I do not know whether to decline or accept. My mood also depends very strongly on my earnings. Money is laughing gas for me. I know from my youth that once the wild horses of the pampas have been lassoed, they retain a certain anxiousness for life. Thus I have come to know the helplessness of poverty and continually fear it. You will see that my style will improve and my ideas will be more correct if this city provides me with an ample livelihood.4

So there was nothing very reflexive about Freud's psychology: goose and gander had distinctly different diets, and while Freud himself worried constantly about money, power and influence, the world for those who were the objects of his study was collapsed into the contents of their 'psyches'. What made them tick was the largely morally repugnant contents of their 'Unconscious', which for the sake of their psychological health had to be 'interpreted' by a psychoanalyst such that 'id' was 'transformed' into 'ego'. What was actually going on in the world around people, together with what had actually taken place in their past, were explicitly ruled out as irrelevant to their mental state by psychoanalysis, which insisted instead on the fundamental significance of the individual's psychic apparatus, which in turn could be understood and influenced solely through the carefully guarded and esoteric arts of psychoanalysis itself.

Not the least important aspect of this process was the morality it espoused. Responsibility for their predicament lay squarely with patients themselves. True, they would not be considered by most psychoanalysts to be exactly in control of their own fate (that privilege would depend on how far they were able to make use of the benefits of analysis), but they would certainly be held responsible for it, and somewhere buried in the middle of the technical verbiage is, as in my view there is in pretty well all brands of psychotherapy which have been concocted since, an extremely naive view of 'will power'. Essentially, this encompasses the view that once someone sees the reasons for their conduct (as revealed, in the case of psychoanalysis, by 'insight' gained from the interpretations of the analyst) they may be expected to adjust their previously 'neurotic' conduct by means of an act of will.

Freud was of course always at pains to invoke the authority of 'science' for his position and it was doubtless his scientific aspirations which led him to develop the notion of 'psychic determinism' as a means of rendering human conduct amenable to the technical operations of psychoanalysis. But the result seems to me to be merely cosmetic. In fact 'psychic determinism' seems to mean little more than the shifting of culturally everyday ideas about blame and responsibility and the operation of will power from one mental sphere (the conscious) to another (the unconscious). For example, modestly claiming 'a triumph for the interpretative art of psychoanalysis' in revealing the origin of 'parapraxes' such as slips of the tongue, etc., Freud wrote that such events were 'strictly determined' and 'revealed as an expression of the subject's suppressed intentions' or 'a clash between two intentions, one of which was permanently or temporarily unconscious'5. All that seems to have happened here, however, is that Freud has transferred the processes of will from the conscious to the unconscious mind; 'unconscious mental acts' come about in exactly the same way as conscious ones, apart, of course, from the individual's not knowing about them.

That Freud was unable to free himself from a very mundane - one might be tempted to say petit bourgeois - conception of morality is in my view demonstrated particularly clearly in his treatment of the Oedipus legend. In a fascinating passage in one of his Introductory Lectures, written, interestingly, only a year or two before the outbreak of the First World War6, Freud chides Sophocles for the 'amorality' of his treatment of the Oedipus legend. I've often wondered how Freud managed to derive his version of the 'Oedipus Complex' (in which the male child wishfully fantasizes the sexual conquest of his mother and the destruction of his father) from Sophocles's tragedy (in which Oedipus is fated to fulfil the oracle's prediction that he will murder his father and marry his mother). But this passage makes it plain: Freud simply dismisses the tragedian's concern with the relation between Oedipus and powers (the gods) greater than and outside himself, and wrenches the structure of the work into a form which will support his own, entirely contrary notion of internalized will and unconscious morality. Completely disregarding the fact that Oedipus is overtaken by his fate despite the best efforts of all to avoid its coming to pass, and tries, desperately and unsuccessfully, to discharge his duty by obeying the dictates of superior power, Freud maintains instead that there is a 'secret sense and content of the legend' to which the auditor reacts.

He reacts as though by self-analysis he had recognized the Oedipus complex in himself and had unveiled the will of the gods and the oracle as exalted disguises of his own unconscious. It is as though he was obliged to remember the two wishes - to do away with his father and in place of him to take his mother to wife - and to be horrified at them. And he understands the dramatist's voice as though it were saying to him: You are struggling in vain against your responsibility and are protesting in vain of what you have done in opposition to these criminal intentions. You are guilty, for you have not been able to destroy them; they still persist in you unconsciously.' And there is psychological truth in this. Even if a man has repressed his evil impulses into the unconscious and would like to tell himself afterwards that he is not responsible for them, he is nevertheless bound to be aware of this responsibility as a sense of guilt whose basis is unknown to him.

To arrive at this interpretation, Freud has positively to mutilate Sophocles's play in order, like a cuckoo, to install within it his own brain-child. The tragic inevitability of Oedipus's innocent fulfilment of the Oracle's prophecy, and his horror at the discovery that it has indeed come to pass, are turned by Freud, as of course were the violations of his patients by their male relatives, into matters of personal responsibility. Instead of the kind of objective analysis of the working on individuals of powers beyond their control which might lead to a compassionate solidarity with them (much more Sophocles's point, of course), we are offered an account in terms of 'evil impulses' for which 'we like to tell [our]selves afterwards that [we] are not responsible' more typical of the kind of moral bigotry which likes to make rape victims complicit in the crime which has been perpetrated upon them. Indeed, this is moralism with knobs on: the individual is placed in a kind of moral double-Nelson. Not only are we to be held responsible for our conduct, but we are also guilty of 'repressing' knowledge of that responsibility so that it has to be elucidated for us by a professional expert (the analyst) before we have an opportunity for atonement.

In fact, the kind of social philosophy which underlay Freud's moralism is all too clear, and expressed quite unashamedly in his The Future of an Illusion. It's all a question of ignorant masses and enlightened leaders. The masses, he writes:

are lazy and unintelligent; they have no love for instinctual renunciation, and they are not to be convinced by argument of its inevitability; and the individuals composing them support one another in giving free reign to their indiscipline. It is only through the influence of individuals who can set an example and whom masses recognize as their leaders that they can be induced to perform the work and undergo the renunciations on which the existence of civilization depends. All is well if these leaders are persons who possess superior insight into the necessities of life and who have risen to the height of mastering their own instinctual wishes. There is a danger that in order not to lose their influence they may give way to the mass more than it gives way to them, and it therefore seems necessary that they shall be independent of the mass by having means to power at their disposal. To put it briefly, there are two widespread human characteristics which are responsible for the fact that the regulations of civilization can only be maintained by a certain degree of coercion - namely, that men are not spontaneously fond of work and that arguments are of no avail against their passions.7

Freud goes on in this short work to pour scorn on religion as a means of containing and disciplining the masses, but certainly does not notice that in proffering psychoanalysis as the 'scientific' answer to social understanding he is simply trying to replace one opiate with another. From where we stand now, it is much easier, I think, to see that more than merely criticizing religion, he was competing with it. In fact, over the first three decades of this century, what Freud did was to lay the foundations of a psychotherapeutic ideology which has, whether explicitly or not, underpinned pretty well all subsequent approaches in the field. To summarize:-

a) Psychological distress arises not from the injuries inflicted by a material social environment, but from the desires and fantasies of individual sufferers themselves.
b) Although such desires and fantasies are largely unconscious, the rules of conventional morality still apply: people are 'responsible' for their distress, and guilt over its causes is not inappropriate, even if the way to expiation is only likely to be found through engagement in the formal process of psychoanalysis.
c) The functioning of civilization requires that for the mass of ordinary people some kind of disciplinary procedure is necessary if their natural inclination to indolence and anti-social conduct is to be contained. In contrast to the illusory and increasingly discredited rules and dogmas of religion, psychology offers the scientific means of achieving this discipline.

We do not of course have to be aware of the conceptual underpinnings of our practice, and the fact that 99% of psychotherapists would probably dissent emphatically from so blunt a statement of this basic therapeutic creed does not in my view invalidate its influence. The whole manner and context of the practice of psychotherapy betrays its most basic assumptions: i.e., that people are responsible for their suffering and that in the final analysis its up to them to will the appropriate changes to their lives. The fact that these assumptions are clearly false, and that, moreover, there is not a shred of evidence for the effectiveness of the therapeutic practices which are based upon them, further betrays the fundamental rationale of psychotherapy: to represent social damage as personal failure and to transmute potential political dissent into an anxious concern with individual adjustment.

The only way we can explain the continued existence - indeed the positive flourishing - of psychotherapy since the serious doubts which were raised about its efficacy (particularly by H.J. Eysenck) in the middle of this century, is through the recognition that it serves some purpose other than the therapeutic. Psychotherapy has of course had its scientific apologists, and there is a truly vast literature on the supposedly objective measurement of its apparent benefits, but even these justify no more sanguine conclusion than that psychotherapy, in the safest and most experienced hands, is only marginally more effective than the healing passage of time. However, William Epstein, an American sociologist, has recently launched a spanner into the psychotherapeutic works which could prove even more destructive than Eysenck's efforts in the 1950s.

In his book called The Illusion of Psychotherapy, published last year8, Epstein systematically demolishes the pro-psychotherapy research literature in a way which, though it scarcely disguises his own partiality, leaves very little comfort to anyone wishing to claim that, on any conventional understanding of 'evidence', the practice of psychotherapy can be justified by its demonstrable results. More bluntly and boldly than any other writer I've encountered, Epstein states that the reason for the continued thriving of psychotherapy despite its woeful ineffectiveness is precisely its political expediency. He suggests that psychotherapy:

is an immensely attractive strategy for a society that is reluctant to allocate substantial funds to address its problems. If it were effective, then psychotherapy would offer efficient, low-cost remedies. Yet, even apart from the issue of its effectiveness, psychotherapy still provides a useful vehicle to proselytise the ideology of social efficiency in evading more productive and expensive approaches to social problems...

and again that:

The ideology of therapeutics is ... consistent with a conservative social ideology that is unwilling to accept broad-based social expenditures to provide greater social equality through government action.

I myself have never been a great fan of the squabblings which go on amongst those who practise the methodology of positivistic social science and the kind of ratty irritability to which it so easily gives rise, and one has to acknowledge that Epstein is undoubtedly a paid-up member of this club. His achievement, nevertheless, is to hoist the psychotherapy researchers by their own petard and leave the official apologetics of psychotherapy in tatters. Even if the profession manages to get away with treating Epstein with disdainful silence, his book nevertheless demonstrates that the future of an essentially illusory psychotherapy industry is vulnerable to exactly the kind of analysis by means of which it has sought to justify itself.

But I also think there are other, personally more compelling, reasons for questioning the efficacy of psychotherapy, not least of which is that, in my case anyway, thirty years' practice of psychotherapy reveals precisely the opposite of what is usually theoretically claimed for it: people are not responsible for their distress, cannot 'change' themselves from the inside, but are, so to speak, held in place by the social powers enveloping them.

Working in a publicly funded health service with people whose resources - or rather lack of them - leave them very few options when it comes to their deciding how to order their lives makes it all the more obvious how 'choice' and 'will power' are the epiphenomena of material advantage rather than the kind of innate moral potentialities which, explicitly or not, psychotherapy suggests they are. I have too often come across people who have perfect insight into the reasons for their distress and are absolutely desperate to change things, who struggle with enormous courage against all the odds, only in the end tragically to succumb to the overwhelming influences which have damaged them in the past or oppress them in the present - I have as I say come across such people too often to believe any more in the potency of psychotherapeutic magic.

Certainly, well-educated, relatively affluent, relatively socially well-connected people may make use of the opportunity for reflection on their situation afforded by psychotherapy to redeploy their assets or formulate strategies to better their lot. The richest may buy a five-times-a-week psychoanalyst to act as a kind of personal confidant, providing solidarity in their troubles for as long as they can afford to pay. But for ordinary people what shapes their lives and, too often, causes them pain, are powers and influences well beyond their own or any therapist's ability to control. Epstein is in my view absolutely right to point out that the ideology of psychotherapy serves principally to divert our gaze from the real causes of our troubles in the outside environment to a moralistic appraisal of so-called 'inner worlds' which we deludedly hope will fuel feats of will power, flashes of insight and engineerings of attitudes which 'adjust' us to a reality taken as given and immutable (presumably the 'real world' so frequently used as a kind of disciplinary instrument by oppressors over the oppressed).

A psychological analysis of personal distress must in my view diagnose not individuals, but their environments. What we need is not the moral crusade of psychotherapy, in which our ills are made a matter of 'responsibility', but the patient laying-bare of the social and material structures through which oppressive power is transmitted and which end up impinging on the individual's body as the sensation of pain. What we then do about these structures is not a matter for psychology, but for politics; the last thing I would like to see is that psychologists represent themselves as the architects of an ideal civilization (some, like the behaviourist B.F. Skinner, did of course succumb to that temptation).

As it is, most people, conditioned by over a century of 'dynamic psychology' in one form or another, have very little understanding of the origins of their own distress and are profoundly mystified as to its nature and significance. The commonest reactions to distress are probably panic and guilt, at once a terror of 'abnormality' and an intimation of responsibility for it. Let me give you as an example a description of a predicament which might well feel fairly close to home for some of you, since it is particularly a difficulty for people who have grown up during the past couple of decades and crops up, in my experience, quite frequently in the student population.

The subjective experience is primarily one of anxiety, but not about anything specific. Rather there is a pervasive uncertainty about whether what one is feeling and thinking are appropriate, whether one is 'like' other people or seems strange to them, and this uncertainty flares from time to time into seemingly uncontainable panic - 'freaking-out', as it is often put. The interesting thing from a psychologist's point of view is that the degree of subjective suffering attached to this state seems out of all proportion to the person's actual ability to cope. Sufferers are often intelligent, competent students able to cope well with the intellectual demands made on them (though exams can become a serious obstacle) and even functioning socially quite effectively - they have friends, etc., and seem outwardly well adapted to student life. And yet under this surface there is really quite profound doubt and anxiety about the validity of their own experience which at its worst looks very like the uncontrolled terror and distress of an abandoned baby.

Another interesting feature of this group is what I can only call an impairment of desire. People often say that they have absolutely no idea of what they really want. Whether it's a question of courses of study, prospective jobs, choices of girl- or boy-friend, outside-work activities or even food, there seems to be no internalized arbiter of taste, no flash of lust, no gut feeling to guide their conduct. So that choices have to be arrived at by some kind of, so to speak, prosthetic device. I asked one young man to imagine being really hungry in a wonderful restaurant, money no object - what would he choose from the limitless menu? He wrestled with this for some time. 'I really don't know,' he said. 'I suppose I'd have to choose the most expensive.'

The things which particularly 'freak out' people suffering in this way are very often experiences which are the unavoidable lot of human beings as they grow up. One of the most frequent is, put at its simplest, love. In this way I have encountered several students, young men and women, who are panicked to the point of incapacity by meeting someone they are seriously attracted to. Casual relationships are fine (and taken or left), but the experience which used to be referred to as 'falling in love' may be simply unhandlable. The feelings which invade their body are experienced as alien, utterly confusing, frightening; the obsession with the beloved felt as an intolerable form of derangement. It is as if they had never come across any understanding of this condition in the culture, read no novel nor seen any film which made intelligible the experience of falling in love. Again, the beloved is not experienced as desired, but as dangerous, even terrifying.

It is extremely difficult in my experience to shift people who find themselves in this condition from a view of themselves as personally and morally defective ('I'm such a sad git; why can't I get a grip on myself' would be a fairly typical response) to seeing that they are perfectly intact individuals whose lack of understanding about the nature and origins of their experience is the result of deprived environments. To give a full account of the nature of this deprivation, one would have to go beyond immediate factors such as parental influence (or, perhaps better, lack of parental influence) to the socio-economic setting which in turn shaped those factors.

Just to hint at what some of these influences might be, many of the students I'm talking about seem to have been brought up in homes where parents (often but not always professional people from working-class backgrounds) were struggling with the aspirations of upward mobility, the insecurity consequent upon threats to their jobs, an almost irresistible belief in the importance of 'image' and the consumerist philosophy surrounding it. Preoccupied by their own struggle for survival and difficulties in 'relationship' generated by profound changes in the job market and, consequently, male and female roles, the parents did not realize that their children needed instruction in what it is to be a human being. The closest to a meaningful relationship some of the, in particular, boys got was with the computer their parents were so keen to provide them with. You pick up a good sense of binary logic from playing with computers for hours, but not much of an idea of desire and what to do with it! A significant proportion of this generation, it seems, were in this way brought up with a kind of crude, bottom-line instrumentality, the basic kit for survival in a 'real world' consisting of a disorientating combination of hostile competition and consumerist fantasy, but very little appreciation of the warm flesh and blood of embodied humanity.

When it comes to the conduct of our lives in the present, the cultural message we are given, heavily endorsed by the psychotherapy industry, is that our survival and success depend on our personal initiative and ability to exercise our responsibility (precisely the attributes so stifled, we are led to believe, by the 'outmoded' welfare state). This in fact fails entirely to recognize that what enables us to live reasonably comfortably in the social world is the kind of exoskeleton provided by its institutions - we cannot hold ourselves together psychologically just by our own internal structures.

There needs to be a world of which a young person can become part, and by 'world' I mean, among other things, the provision of a range of valued social roles. As it is, the young, as increasingly the old, find themselves a sort of impediment to social worth. Far from being beckoned into a society which has need of them, even the relatively advantaged young are grudgingly loaned the means of an education which is seen as a personal privilege of dubious value rather than a social need, and at the end of their period of study they are left to cobble together the means of their livelihood with very little in the way of social approbation - unless, that is, they have a vocation for banking, finance or business administration. Understandable enough, in circumstances such as these, to feel lost and panicky.

There is in fact no form of psychological distress that I have encountered which is not best understood as damage done to people by the world they inhabit, past and present. We will make no impact on their distress by holding them responsible for it and/or trying to tinker with the psychological processes through which the world is experienced. We need to detach ourselves from the illusory promises of psychological therapy and turn our attention to making the world a more comfortable place for people to live in.

I've gone on long enough. I don't know how much longer the hotch-potch of 'postmodern' make-believe and crude business pragmatism which constitute present-day culture can maintain their symbiotic relationship with the ideology of psychotherapy. As far as I'm concerned, the sooner reality intrudes, the better.

Notes
1 Hobsbaum, Eric. 1994. Age of Extremes. The Short Twentieth Century 1914-1991. Harmondsworth: Michael Joseph, Penguin Books.
2 Pelican Freud Library, Vol. 3, Studies on Hysteria, 1974, 393.
3 Masson, J.M. 1985. The Assault on Truth. Harmondsworth: Penguin Books.
4 Masson, J.M. (ed). 1985. The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887-1904. Cambridge, Mass. & London: Harvard University Press. Letter of 21.9.1899.
5 From the first of Freud's 'Two Encyclopaedia Articles' in Vol 15 of The Pelican Freud Library - Historical and Expository Works on Psychoanalysis, pp 136-7.
6 Freud, S. 1973. Introductory Lectures on Psychoanalysis. Vol I, p. 374. Harmondsworth: Penguin Books.
7 S. Freud. The Future of an Illusion, originally published 1927.
8 Epstein, William. 1995. The Illusion of Psychotherapy. New Brunswick & London: Transaction Publishers. Both quotes p. 6.

David Smail
Oxford, May 1996.

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