The transformation of psychoanalysis from one of the core emancipatory doctrines of twentieth-century modernism into a reviled, reactionary “pseudoscience” is certainly one of the signal events of recent cultural history. Kurt Jacobsen's book traces one important aspect of this transformation: American psychiatry's successful onslaught against its erstwhile Freudian master. A volume in “Polemics,” the lively new series of short, disputatious books edited by Stephen Eric Bronner for the now-legendary “general reader,” Freud's Foes is important, accurate, and informative. In a brief compass, it lays bare the tenacious and pullulating power of supposedly neutral or objective “outcome studies” to overtake and consume a matter as close to a culture's core needs as the study of the human mind. Its special contribution lies in explicating and critiquing the illusions that underlie the current faith in pharmacology, high-tech solutions, brain research, and other wonders. Jacobsen's story raises broad, general questions concerning the place of science in society, as well as the need to restore the line not so much between science and falsehood as between the kinds of questions that can be answered in a causal and deterministic manner, and the kind that require self-reflection, democratic deliberation and cultural exploration.

In order to more fully address these questions, it is helpful to begin with a definition of psychoanalysis itself, something Jacobsen fails to do. Psychoanalysis was an intervention in the long-standing modern project of understanding the nature of the human mind. Its predecessors did include nineteenth-century brain neurologists like some of Freud's mentors, Ernst Wilhelm von Brücke, Theodor Meynert and Jean-Martin Charcot. But it also encompassed Enlightenment philosophy, especially Kant's conception of the human subject; literature, including theatre, with all of its explorations of motivation and character; Darwin's extraordinary work, which described the evolution of the mind as well as the brain; and even forms of folk knowledge, such as those linked to hypnotism, which lay at the basis of popular healing. The result was not an amalgam but a genuinely new, unified, and brilliant theory. This theory was scientific—a new science—but a science of a particular character, one that studied the mind not as one studies chemical or geological phenomena, that is from the outside, but rather from within, as part of a process of self-study. As readers of Perspectives on Politics will understand, then, psychoanalysis was a critical theory, a Wissenschaft, and not a natural science per se, although it contained natural science elements.

Psychiatry, Jacobsen's main concern, was only a small part of psychoanalysis. Indeed, one of the great advantages of the psychoanalytic worldview lay in the way in which it problematized the psychotherapeutic model, and especially the medical as well as moral/religious assumptions that so often infused it. It is also true, however, that psychoanalysis, especially in the United States, became part of psychiatry, and in that way became part of an official system of power/knowledge, losing its critical dimensions. Jacobsen fails to describe the power wielded by American psychoanalytic psychiatrists in the 1950s, 1960s and 1970s, their sexism, their prejudices concerning gays, their ignorance even of their own history, and their overweening sense of self-importance. This development set the stage for the anti-Freudians, who were not interested in a balanced view of psychoanalysis, which would save the baby while discarding the bath water, but rather in using the most discreditable aspects of analysis to characterize the whole.

The attack on psychoanalysis that began in the seventies offers a textbook model in the deployment of power. At its heart lay the cost-cutting and profit-expanding program of the dominant forces in American society—the drug companies, big medicine, and government-sponsored science. Presenting themselves as underdogs battling against the Goliath of psychoanalysis, these poor, ill-funded babies had only the slingshot of truth to defend themselves against the mendacious tyrant, Sigmund Freud, and his equally duplicitous epigones. The fact that Freud's American practitioners had indeed become part of the establishment meant that they would offer little, if any, resistance. Of indispensable help to the giant corporations was their ability to bond with the contemporaneous feminist and gay movements. One marvels at the chivalrous stance adopted by big medicine, historically among the most vicious enemies of gays and women.

Of course, large corporations rarely, if ever, speak for themselves in public. Rather, intellectuals make their arguments for them. Writers such as Jeffrey Masson, Peter Swales, and Frederick Crews understood that the prerequisite for establishing a new psychological regime lay in destroying the figure of Freud. His peculiarities did affect the later history and are worth understanding. However, what Freud's foes unleashed was not understanding but a series of great lies: cocaine addiction, sex addiction, the driving of various followers to suicide, the behavior of a con man, a crook, and a sexist. For Crews, Freud was the force behind the calamitous recovered-memory movements of the nineties, movements that claimed widespread child abuse, even though Freud abandoned his “seduction hypothesis” in part because he could not believe that abuse was that widespread. For Kate Millett, Freud was the worst misogynist of all time, who could have been saved if only he had been exposed to a few feminists, even though psychoanalysis featured a higher percentage of women than any other profession of the time, and Freud's co-workers included Karen Horney and Joan Riviere. Through such arguments, Freud became one of those great villains whose downfall certified the progressive character of the present moment, thus making present-day knowledge seem inevitable and eliminating any reason for self-critique.

The destruction of a supposedly malevolent past was accompanied by the creation of a set of new gods, new ways of thinking about the mind. These however, lacked the element of self-reflection that had been critical to psychoanalysis. According to the new worldview, we can know the mind objectively by understanding the chemistry, neurology, and physiology of the brain. In other words, we don't have to understand our minds from within; scientists will understand it for us, and they will explain it to us in fascinating lectures on Charlie Rose and other forms of mass dissemination. If we have a disturbing thought or a strange dream, we could speculate that it's a wrinkle in the amygdala or a bit of protein imbalance in the hypothalamus, but we really don't have to because a doctor can adjust the chemical mix for us; self-reflection (“navel gazing”) belongs to a previous epoch. What drops out of the new dispensation is not only self-reflection, but any general approach to the problem of human motivation, that is, to a dynamic theory of the psyche, the very quality that had distinguished psychoanalysis from the brain psychiatries that preceded it.

Jacobsen does not attempt a full understanding of the cultural transformation through which motivation and self-reflection were replaced by brain science, but he does make the medical or psychiatric part of the story clear. He describes the lobbies, the legislation, the drug “breakthroughs,” the hype, and the pseudoscience that destroyed what remains, with all of its limits, of our best, overall working conception of the individual mind. He shows how axe-wielding “intellectuals” used the language of rebellion and critique to advance a neoliberal agenda, in all but name. Viewed from the vantage point of U.S. history after the 1970s, Jacobsen's study implies that the decimation of psychoanalysis was a vanguard maneuver, initiating a long period of corporate rationalization in every area of the economy. Once the experiment of destroying psychoanalysis worked, the same rhetoric of “outcome studies,” cost–benefit analysis, an orientation to results, diagnosis and cure, and the like has been used to cut public spending on education, culture, and, of course, other forms of health care. Given the fact that the present administration, more than any previous one, speaks the language of outcome studies, Jacobsen's book is all the more welcome.