To the Editor:

Leslie H. Farber’s article does justice neither to the arguments of the protagonists he has selected for his barbs, nor to the complexities of the moral issues posed by psychoanalysis or any other psychotherapeutic procedure [“Psychoanalysis & Morality,” November 1965]. One may take exception to the positions of Dr. Szasz and Dr. London, but their viewpoints deserve to be fairly stated.

I share Dr. Farber’s response to the therapist’s rejection of responsibility . . . with respect to such . . . questions as abortion and suicide; but moral behavior also involves less dramatic matters like divorce, sexual behavior, obligations to children and parents, . . . and it is the therapist’s role in regard to issues like these that concerns Dr. Szasz. It is easy to reject the extreme implications of Dr. Szasz’s arguments, just as it is easy to agree that freedom of speech does not imply the freedom to shout “fire!” in a crowded theater. The difficult problem, however, and one which Dr. Farber conveniently ignores, is whether the therapist can participate in the decision process with all its moral ramifications without restricting the patient’s freedom and—this is the heart of the matter—without engaging in manipulation of the patient. . . .

Professor London has shown that the position which Dr. Szasz favors is fundamentally untenable, that the values of the therapist must inevitably influence and shape the nature of the psychotherapeutic interchange and outcome. He argues that the therapist cannot escape the moral responsibility inherent in a relationship involving personality and behavior change, and that it behooves the therapist to be explicit not only as to the patient’s goals but also as to his own objectives. To illustrate his argument, he contrasts insight and behavior therapy approaches. While he clearly favors the latter, the book was not intended to be an argument for the superiority of action or behavior therapies.

I happen to be less sanguine than Professor London about the ultimate utility of the so-called behavior therapies. However, that question is an empirical rather than a moral issue except insofar as empiricism implies a moral commitment. If a patient dreads crowds, or is mutilating himself through head banging, or is committing suicide through refusal to eat, I do not see how we are making him into an “experimental animal” by eliminating these symptoms through conditioning procedures. Not all human problems and conflicts are existential. Some are due to ignorance, some to lack of resources, and others to poor or fortuitous training. The behavior therapies have been applied with great ingenuity and skill to a variety of problems—autism in children, mental deficiency and certain schizophrenic symptoms—that have been unresponsive to other therapeutic procedures.

The failure of psychoanalysis, either in its existential or orthodox Freudian garb, to cope with psychosis, is patent. Its success, when applied to less severe emotional problems, has been difficult, if not impossible, to demonstrate. Considering the extent of human psychopathology, and the limited effectiveness of current psychotherapeutic practices, it seems to me far more irresponsible and “morally obtuse”—to borrow Dr. Farber’s phrase—to dismiss a therapeutic procedure as wicked because it has its roots in animal experimentation than to eliminate crippling, albeit restricted fears, sexual impotence, enuresis, and schizophrenic isolation through the use of such experimental procedures.

Seymour Feshbach
Department of Psychology
University of California
Los Angeles, California

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To the Editor:

Dr. Farber’s criticisms of “action therapy” seem very unsound. To begin with, he claims that “human anxiety (unlike animal anxiety) always portends a moral issue whose claim may be disowned or distorted or acknowledged.” But he offers no evidence to support this statement (which he calls a “fact”) and it seems to be prima facie false. What was the moral issue portended by little Hans’s fear of horses, for example, or by the common anxiety people feel in the presence of snakes? . . .

Dr. Farber then goes on to criticize the techniques of behavior therapy . . . although he offers no evidence that they do not work. . . . He thinks they may result in aftereffects . . ., that, following this kind of therapy, the patient will be like an automaton with no control over his own life, but, again, he gives no evidence, . . . arguing from a priori grounds. . . . The case studies I have read, however, do not support Dr. Farber’s view. On the contrary, they show that once freed of their anxieties and neurotic symptoms, patients seem to have reached a point, at last, where they are in control and are able to realize their potentialities. They also report that they feel much better, which I, for one, do not consider irrelevant. Of course, there is a great danger, as with all powerful instruments, that the techniques of behavioral therapy can be used for evil as well as for good. But less effective instruments . . . do not even have the potentiality for good.

Marshall Missner
Chicago, Illinois

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To the Editor:

. . . Dr. Farber’s revulsion at the methods of the behavioral psychologists (curing anxiety by “conditioning” . . .) is, I think, shared by most of us, but is the explanation he gives of that revulsion adequate? He writes, “Human anxiety . . . always portends a moral issue. . . . To shock . . . or coax a human being out of anxiety as though it were mere bad behavior is to rob him of the moral potentiality to contend with his painful lot.”

. . . Following Dr. Farber’s reasoning, one is led to the conclusion that the use of tranquillizing drugs, or, indeed, any means that do not include a conscious confronting of the “moral issue” allegedly always at the heart of an anxiety neurosis, is immoral. . . . But why must we assume that every anxiety portends a moral issue? Might not some, at least, be symptoms of a chemical imbalance or other somatic cause . . .? Or even granting a moral cause, why must the patient be cured only by confronting it? Is not Dr. Farber’s insistence on this point itself a moral judgment: that the cure ought to involve the punishment of unraveling the dilemma, often a very difficult one, that caused the suffering in the first place? I would hesitate to make that judgment on all patients, especially since, as anxiety neurotics, they have probably already suffered immensely.

Surely the correct criticism of the behavioralists’ methods cannot be that they work too easily. I admit I am at a loss to pin down precisely why their methods are wrong, which leads me to wonder whether the revulsion I share with Dr. Farber does not just stem from fear that the behaviorists may be right—we are just animals. . . .

David Slawson
Washington, D.C.