Therapy Or Coercion?: Does Psychoanalysis Differ From Brainwashing?

R.D. HINSHELWOOD Therapy or Coercion? Does Psychoanalysis Differ from Brainwashing? KARNAC BOOKS THERAPY OR COERCION R. D. Hinshelwood THERAPY OR COERCION Does Psychoanalysis Differ from Brainwashing? R. D. Hinshelwood London KARNAC BOOKS First published in 1997 by H. Karnac (Books) Ltd, 118 Finchley Road, London NW3 5HT Copyright © 1997 by R. D. Hinshelwood The rights of R. D. Hinshelwood to be identified as the author of this work have been asserted in accordance with §§ 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. N o part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. British Library Cataloguing in Publication Data Hinshelwood, R. D. Therapy or coercion: does psychoanalysis differ from brainwashing? 1. Psychoanalysis 2, Medical ethics I. Title 150.Γ95 ISBN 978 1 85575 143 9 Edited, designed, and produced by Communication Crafts Printed in Great Britain by BPC Wheatons Ltd, Exeter 10987654321 For all the deeper, of support that go beyond and more personal encouragement the merely to kinds Anna intellectual, CONTENTS PREFACE ix Introduction 1 PART ONE THE UNITY OF THE PERSON 1 Freedom or force 15 2 Medical ethics 20 3 Rationality and irrationality 25 4 The divided mind 34 5 Psychoanalytic evidence 46 6 Primitive phenomena in psychoanalysis 52 7 The primitive phenomena in everyday life 69 vii Viii CONTENTS PART T W O THE PROBLEMS OF AUTONOMY 8 Resolving conflicts: repression and splitting 81 9 Splitting and informed consent 89 10 Psychoanalytic paternalism 97 11 Integration 107 12 Self-reflection 116 PART THREE THE ETHICS OF INFLUENCING 13 Professional practices 129 14 The verdict on psychoanalysis 146 15 Professions and power 160 PART FOUR PERSONS A N D SOCIETY 16 Identities 177 17 Objects and ownership 187 18 Freedom and coherence 195 19 Coercion: induced splitting 200 20 Social health 209 REFERENCES 221 INDEX 239 PREFACE T his book has been a long time developing. Perhaps it goes back to the 1960s, w h e n the age of permissiveness w a s upon us, and I found myself both strongly identifying w i t h those aspirations and, at the same time, as a young psych­ iatric doctor, helping nurses to struggle physically to get reluctant patients into the E C T room. That kind of conflict, between freedom and force, went rather deep, and it has taken a long time to come to terms with it—to come to terms with bridging the contra­ dictions, w h i c h