Frederick Crews writes in 1993:
* That psychoanalysis, as a mode of treatment, has been experiencing a long institutional decline is no longer in serious dispute. Nor is the reason: though some patients claim to have acquired profound self-insight and even alterations of personality, in the aggregate psychoanalysis has proved to be an indifferently successful and vastly inefficient method of removing neurotic symptoms. It is also the method that is least likely to be “over when it’s over.” The experience of undergoing an intensive analysis may have genuine value as a form of extended meditation, but it seems to produce a good many more converts than cures. Indeed, among the dwindling number of practicing analysts, many have now backed away from any medical claims for a treatment that was once touted as the only lasting remedy for the entire spectrum of disorders this side of psychosis.
…Without significant experimental or epidemiological support for any of its notions, psychoanalysis has simply been left behind by mainstream psychological research. No one has been able to mount a successful defense against the charge, most fully developed in Adolf Grünbaum’s meticulous Foundations of Psychoanalysis (1984), that “clinical validation” of Freudian hypotheses is an epistemic sieve; as a means of gaining knowledge, psychoanalysis is fatally contaminated by the inclusion, among its working assumptions and in its dialogue with patients, of the very ideas that supposedly get corroborated by clinical experience. And Grünbaum further showed that even if Freud’s means of gathering evidence had been sound, that evidence couldn’t have reliably yielded the usual constructions that he placed on it. We cannot be surprised, then, by Malcolm Macmillan’s recent exhaustive demonstration that Freud’s theories of personality and neurosis—derived as they were from misleading precedents, vacuous pseudophysical metaphors, and a long concatenation of mistaken inferences that couldn’t be subjected to empirical review—amount to castles in the air.
Nevertheless, Freudian concepts retain some currency in popular lore, the arts, and the academic humanities, three arenas in which flawed but once modish ideas, secure from the menace of rigorous testing, can be kept indefinitely in play. There psychoanalysis continues to be accepted largely on faith—namely, a faith in Freud’s self-description as a fearless explorer, a solver of deep mysteries, a rigorously objective thinker, and an ethically scrupulous reporter of both clinical data and therapeutic outcomes.
* Dostoevsky was an unlucky man in several ways, but he did have the good fortune to have died without presenting his troubles in person to Sigmund Freud and his epigones.
