Simone Beauvoir On Psychotherapeutic Healing As Mutilation

In Simone de Beauvoir‘s The Mandarins (WW Norton, New York, 1954; 1999, pp. 64), Anne Dubreuilh, a practicing psychoanalyst wonders:

Why does healing so often mean mutilating? What value does personal adjustment have in an unjust society?….My objective isn’t to give my patients a false feeling of inner peace; if I seek to deliver them from their personal nightmares, it’s only to make them better able to face the real problems in life.

It is a matter of some interest that Beauvoir does not place scare quotes around “real” in the passage above; given the worries about her practice that Anne has just expressed, such a distancing might well be considered appropriate.  The doubt that Anne directs at her apparent ‘healing’ of her patients is an acute one: Is the patient being ‘cured’ or merely subjected to a form of psychotherapeutic cosmetic surgery to make them fit better into the contours and constraints of an entirely unreasonable world? Their nightmares are not only of their own making; a nightmarish world should induce such visions even in our sleep. Perhaps it is the world that is out of joint, not the sufferer on the couch; but we cannot cure the world, so we cure our patients instead.

In his Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self (Viking Press, New York, 1994), Peter Kramer had expressed a similar worry: perhaps anti-depressants were a form of chemical cosmetic surgery–“cosmetic pharmacology”–deployed to round off and smoothen the rough edges of depressed and neurotic patients, the ones that did not allow them to fit into, to conform with, the world around them. We cannot respect and cherish the oddity, the idiosyncrasy, the ‘depressed’ or ‘neurotic’ person brings with them; they do not sit comfortably with this world’s required characteristics, the attributes it has granted preeminence in its table of values. (Kramer balances these claims with a sensitive appreciation of the suffering of the depressed thus addressing the perfectly reasonable claim that some kinds of mental health situations cry out for chemical intervention if only to prevent severe harms from being visited on the patient or those around them.)

The language of ‘cosmetic pharmacology’ and ‘mutilation’ suggests then, uncomfortable resonances with the oldest feminist critique of psychiatric healing directed at women: their supposed ‘mental illness,’ their ‘hysteria,’ was an entirely appropriate response to a sexist and patriarchal world. (These critiques would find particularly pointed form in Phyllis Chesler‘s 1972 Women and Madness.) If they were mad, they had been driven so; but that madness was a divine one, for it was touched with visions that the society around them was blind to. An ‘adjustment’ to this society was to take on its madness instead; it was to participate in its ‘unjust’ structures and arrangements.

This then, was the ‘unjust society’s’ final addition of injury to insult for those who could not, would not, conform: a labeling as ‘defective,’ and a prescription for modification. Come back when you’re different and are ready to play; we’ll still be here.