Book Review : Assault on Psychiatric Establishment

A Dark Science by Jeffrey Moussaieff Masson (Farrar Straus & Giroux: $15.95)

“A Dark Science” is a continuation of Masson’s guerrilla warfare against the psychiatric Establishment, a mission that began with the 1984 publication of “The Assault on Truth: Freud’s Suppression of the Seduction Theory.” Brought to wide public attention by Janet Malcolm’s series of New Yorker articles, that book thrust Masson into the august company of iconoclastic psychiatrists including Thomas Szasz, Wilhelm Reich and others whose theories have departed radically from Freud’s. In “The Assault on Truth,” Masson presented evidence that after Freud had developed his thesis that many psychoses in adult women could be traced to childhood sexual abuse, he capitulated to pressure from colleagues and recanted his discoveries, offering in their stead the notion that such accounts were mere fantasy, the products of disordered minds. By this convoluted reasoning, the victim of abuse could be seen as the perpetrator.

In her fiercely impassioned preface to “A Dark Science,” Catherine A. MacKinnon explains further. “The doctors say that the victims imagine sexual abuse, which is fantasy, not real, and that their sexuality caused it. In fact, it is the doctors, who, because of their sexuality, imagine that sexual abuse is a fantasy when it is real . . . Psychoanalysis . . . has been used to legitimize pornography, calling it fantasy; and pornography has been used to legitimize psychoanalysis, to show what women really are. Pornography presents itself as the answer to Freud’s query: this is what women want.”

She presents the entirely reasonable hypothesis that as male analysts listened to women’s accounts of child abuse, they became aroused and attributed their arousal to the child who is now a woman. Logical though this interpretation may be, the contemporary heirs of the psychiatric pioneers have strenuously resisted accepting it. To convince them, Masson has done extensive research in 19th-Century psychiatric literature to buttress his case against those who continue to dismiss reports of abuse as fiction, an issue with urgent current implications.

Though Masson is credited as the author of this profoundly disturbing book, in fact he has written only 32 pages, presenting and explaining his findings, wisely allowing the devastating material to speak for itself. After reading and translating hundreds of articles in 19th-Century publications and examining the archives of mental hospitals, he has selected nine monographs written between 1865 and 1900 by leading physicians of the time--gynecologists and pediatricians as well as the early psychiatrists, to find the sources of the entrenched beliefs about female sexuality still distorting present-day attitudes towards assault, pornography and incest.

Though the names of these doctors may be unfamiliar to the layman, their work and the case histories they recorded have formed the foundations of modern psychiatric theory and practice. Building upon this flawed structure, psychiatry has constructed a tower of ideology tragically inimical to the interests of the woman patient and plaintiff; a century-old bastion of deceit, self-deception and bias which Masson is determined to demolish.

The individual pieces in the book are gruesome, all the more obscene for the lofty detachment and patronizing omniscience with which they are written. Misogyny seeps through the formal prose, poisoning every phrase. In drawing up his indictment, Masson has not selected the moderates. The extremes are here; the doctors who cauterized and sterilized women and girls, who drugged and lobotomized them, starved and imprisoned them, chained them to walls, and then wrote about the treatment, congratulating themselves on their innovations.

In an 1882 essay by the then-respected physician Dmetrius Alexandre Zambaco on his treatment of a child of 4, for masturbation: “She howls like a wild beast when she hears me come; I give her some violent and extremely painful shocks on her genitals with a Clarke machine.” Though this child was eventually removed from Zambaco’s care, others were not so fortunate. The “remedies” applied were even more atrocious.

The points are made immediately and overwhelmingly. There’s little to choose between pornography and the medical literature of the 19th Century. The most outrageous tortures can be justified in the name of therapy, thereby establishing a horrendous precedent permitting crimes against humanity to masquerade as scientific research. Grim, appalling and persuasive, “A Dark Science” may well arouse even more consternation than “The Assault on Truth” and have ramifications far beyond the psychiatric community.