Should we put an end to psychoanalysis? The truths about a French passion – L’Express

It’s a lunch with some of the most influential publishers in Saint-Germain-des-Prés. At dessert time, these fine scholars begin to enthusiastically discuss the “four pillars” of the couple as set out by the Lacanian Juan-David Nasio (“sexuality, mutual admiration, rituals and role mobility”). “You should definitely consult him,” we are advised. It’s also a Parisian evening watered with spritz that turns into a brawl when the subject of psychoanalysis comes up in the conversations.

Anyone who dares to question Freudian theories on the phobia of snakes or spiders, respectively associated with a phallic symbol or the wicked mother, is accused of “repression”. It is, again, a recent cover of a weekly, “What the shrinks say about them”, which puts our political leaders on the couch. In the file, the psychoanalyst Jean-Pierre Winter says he hears in the word dissolution “ten solutions”, while his colleague Roland Gori detects in Emmanuel Macron an “absence of fear of castration”…

There is no doubt that we are in France, a country where it is easier to calmly debate the Israeli-Palestinian conflict than the scientific relevance of psychoanalysis. Born in Vienna at the end of the 19th century, the discipline was first historically established in German-speaking and then Anglo-Saxon nations, but it has been in sharp decline there for several decades in favor of other psychotherapies. In our country, it remains a French passion, essential in the media, hospitals, universities and even the courts. As confirmed by psychoanalyst and philosopher Clotilde Leguil, France is its “nerve center”. Only Argentina, whose capital Buenos Aires holds the world record for shrinks per square meter, can today challenge this title.

Dolto, Lacan, the origins of a cultural exception

A singularity which is largely explained by the figures of Jacques Lacan and Françoise Dolto. Breaking with the international psychoanalytic association, the first created his own school in the 1960s, generously granting the title of psychoanalyst to people who were neither psychologists nor psychiatrists. Philosophers (Octave Mannoni), Jesuits (François Roustang) or Maoists (Gérard Miller) have then found a new vocation. The other achievement of Lacan, brilliant orator, jargon-filled theorist and eccentric dandy, is to have bewitched the intellectual and media circles of his time, from Michel Foucault to Françoise Giroud, co-founder of The Express.

“Moreover, the French are prepared for psychoanalytic discourse by the philosophy course taken in high school. The unconscious is one of the obligatory themes and Freud is often praised there. Michel Onfray has well recounted how his students were more interested in psychoanalysis than in Kant, Descartes or Plato”, believes the Belgian Jacques Van Rillaer, former psychoanalyst and professor emeritus of psychology at the University of Louvain, who has become the most ferocious critic of the discipline in the French-speaking world.

Freud, a new Darwin?

Even today, many media outlets present psychoanalysis as a science. On the 85th anniversary of the death of the founding father Sigmund Freud, The world for example, publishes a special issue which takes up, without any hindsight, the argument developed by the Viennese during the First World War: psychoanalysis would represent, after heliocentrism and the theory of evolution, the third – “and the most stinging” – narcissistic wound inflicted on humanity by science. In other words, Freud placed himself on the level of the giants, Nicolas Copernicus and Charles Darwin.

An argument that Elisabeth Roudinesco, guardian of the Freudian temple in France, also opposes to us when we asked her for this critical report. “Do we make a case for or against Darwin? We are no longer there,” the historian and psychoanalyst answered us sharply, who does not hesitate to use the heavy accusations of “negationism” and “anti-Semitism” as soon as someone dares to tickle the statue of the commander a little too much.

However, Sigmund Freud’s theories have aged much less well than those of Copernicus and Darwin. His basic concepts, such as the unconscious, the Oedipus complex or the castration complex, have the value of dogma in psychoanalysis, but have never been scientifically validated. Even in France, psychoanalysts know that they are far from their omnipotence of the 1960s and 1970s, when Lacan called the shots among the French intelligentsia.

In the meantime, there was the publication of the Black Book of Psychoanalysis in 2005, with contributions, in particular, from the critical historian Mikkel Borch-Jacobsen, the psychiatrist Jean Cottraux and Jacques Van Rillaer. A bestseller followed in 2010 by the Twilight of an Idol by Michel Onfray, a violent attack on Sigmund Freud. Above all, the discipline has suffered considerably from the rise of scientific psychology and a medicine based on facts. The all-psychic model advocated by psychoanalysis has, for decades, been refuted by the discoveries of genetics and neuroscience.

The Autism Fiasco

Under the influence of Bruno Bettelheim in particular, psychoanalysts have accused mothers of being responsible for their child’s autism, even though we now know that this neurodevelopmental disorder (NDD) has multifactorial causes, partly genetic. In 2012, The High Authority for Health (HAS) has excluded psychoanalysis of its recommendations for the treatment of autism. Despite this fiasco, the discipline continues to have an influence in child psychiatry. “I’ll spare you the many letters I receive from mothers who have been told, for example, that if their child was autistic, it was because they had experienced incestuous rape of which they were unaware,” laments Etienne Pot, interministerial delegate for the national strategy for neurodevelopmental disorders (autism, ADHD, dys disorders, DID, etc.), who does not mince his words: “For me, psychoanalysis has no place in the field of NDD. I challenge psychoanalysts to prove to us that they have helped autistic children progress. I ask that everyone stick to their field of expertise, the stakes are too high: guaranteeing each person with NDD the best support in accordance with scientific data.”

This public health doctor points out the “new clothes” of pro-psychoanalysts who, under an apparently more modest discourse, now highlight the complementarity of “organic” and Freudian approaches. In June, the public channel LCP broadcast a debate on autism, bringing together mainly supporters of psychoanalysis, such as Alain Vanier, trained at the Freudian School of Paris, or the psychiatrist and psychoanalyst Pierre Delion, who defends the practice of “packing”, a treatment consisting of temporarily wrapping a patient in cold, damp cloths, also banned by the HAS in 2012. Lobbyist Elisabeth Roudinesco denounced a “war” against psychoanalysis, believing that “we need all approaches”.

It took psychiatrist Raphaël Gaillard, director of the university hospital center at Sainte-Anne hospital, to step in to remind us of the “catastrophic effects” of psychoanalytic discourse in the field. “There is still this idea that parents are the cause of the disease through their behavior. It’s terrible,” the academic snapped, before emphasizing that in medicine, on the contrary, it was necessary to prioritize approaches based on levels of proof. For Dominique Campion, hospital psychiatrist at the CHR in Sotteville-lès-Rouen and author of The Freudian Unconscious: Is There Anything to Save? (Odile Jacob), “human beings need to believe in things like psychoanalysis to give meaning to their lives, which is not reprehensible, because it is at the heart of the human being. But when it comes to applying it to children who have asked for nothing, it becomes a problem, and we must sound the alarm.”

The sofa made in France

Despite these errors and a very mixed assessment in terms of effectiveness in adults according to meta-analyses, Psychoanalysis still has a bright future in our country. For two seasons, France Inter broadcast the show The Unconscious. On a public radio station, Juan-David Nasio was thus able to affirm, without any contradiction, that “people suffering from phobias” were “traumatized in their childhood or adolescence by the sudden loss of a loved one”. Child psychologist Caroline Goldman, who claims to be a psychoanalyst, has also hosted 40 shows on the most listened to radio station in France, provoking the anger of psychiatrists and researchers following her comments on childhood depression or attention deficit hyperactivity disorder (ADHD).

As for the psychoanalyst Claude Halmos, she has a bi-monthly column in The world. According to an analysis carried out in 2018 by Joël Swendsen, former professor of clinical psychology at the CNRSout of 26 French universities responsible for training clinical psychologists, half provided substantial psychoanalytic training and 9 offered an exclusively psychoanalytic approach. On the cultural level too, the couch remains an imposed figure on the screens, like the hit series In Therapy by Eric Toledano and Olivier Nakache on Arte.

“Since the 1960s, France has been the European country where Freudianism has been most widely disseminated. The number of psychoanalysts per capita is much higher than elsewhere,” observes Jacques Van Rillaer. However, our nation is also distinguished by its pessimism, even by Western standards. “According to a survey by Claudia Senik in 2014, it is one of the European countries where negative emotions and psychological disorders are most frequent. Freud wrote that “the spread of psychoanalysis would reduce the number of various neuroses in the masses.” This is clearly not the case…