A critical appraisal of a best-selling book that originated in the realm of science-fiction and became the basis for a new cult
Dianetics is the title of a book (and a "science") which, for many months, held its place as a best seller in the non-fiction field. According to its originator and to thousands of dianetics adherents, it is "the new Modern Science of Mental Health." Dianetic research institutes have been founded in many cities, with the dual purpose of studying mental and psychosomatic ills in the light of dianetic theories, and of training potential practitioners or "auditors" to treat sick people by dianetic techniques. For about $500 anyone can take a month's course in dianetics practice, leading to "professional certification," and qualifying him to treat persons with mental and physical disability. For $350 each, a team of two "co-auditors" can enroll for a series of 15 lectures and case instruction.
The dianetics movement has grown so rapidly that it has challenged the attention of the American Medical Association, the American Psychiatric Association and other professional, medical and social welfare organizations. Spokesmen and disciples of dianetics are convinced that dianetics will bring to the millions relief from their burden of mental and physical ailments. Psychiatrists and other physicians are equally convinced that attempts by laymen or persons who lack proper training in and understanding of mental disorders to treat emotionally disturbed people are either futile or dangerous.
According to the creator of dianetics, Mr. L. Ron Hubbard, "The creation of dianetics is a milestone for man comparable to his discovery of fire and superior to his inventions of the wheel and arch . . . with the techniques presented in this handbook, the psychiatrist, psychoanalyst and intelligent layman can successfully and invariably treat all psychosomatic ills and inorganic aberrations. More important, the skills offered in this handbook will produce the dianetic 'clear,' an optimum individual with intelligence considerably greater than the current normal, or the dianetic 'release,' an individual who has been freed from his major anxieties or illnesses. The release can be done in less than 220 hours of work and is a state superior to any produced by several years of psychanalysis, since the release will not relapse."
One looks in vain in "Dianetics" for the modesty usually associated with announcement of a medical or scientific discovery. This lack of modesty does not of itself prove that dianetics is not comparable to the discovery of fire, or superior to the invention of the wheel and arch. Indeed if it is true that dianetics can "successfully and invariably treat all psychosomatic ills and inorganic aberrations," then it is unquestionably superior to all current methods of medical and psychological treatment, and no one would be disposed to dispute Mr. Hubbard's evaluation of his creation. Unfortunately, neither the book nor a study of the activities and publications of the dianetics Institutes and auditors sustains the hope that a new and invariably successful science of mental health has been discovered.
This history of medicine shows that years, and often generations, pass before an important discovery becomes an accepted part of medical theory and practice. This was true of the germ theory of disease, of the practice of vaccination and immunization, of advances in surgical techniques and others. It is particularly true of psychological innovations. Experimentation, case reports and statistical studies, made not only by the original discoverer, but by dozens of other observers are required before a technique or idea can become an integral part of medical practice.
Psychoanalytic theory, for example, became an integral part of psychiatric thought and practice because of careful case studies by Sigmund Freud and his followers, and the unquestionable improvement obtained in the treatment of some nervous ills, particularly the neuroses. But the acceptance of psychoanalytic theory by psychiatry required almost 50 years of work, and even now it is still not accepted by a significant percentage of the medical profession.
The partisans of dianetics may very properly assert that similar consideration must be given to dianetics, particularly since it is so strikingly opposed to current medical orthodoxy. To a certain extent this argument is unanswerable, and to be fair, one would be disposed to wait a generation and see before criticizing. But dianetics is not a concept and technique being applied experimentally on a few well selected patients by a small band of careful scholars. Hundreds of "auditors" have been and are being trained to actively treat sick people. Thousands of sick people are submitting to their ministrations. It is entirely proper and necessary, therefore, that some estimate be made at the present time of the nature and value of these skills and the effect that they will have on the mental and physical well-being of people.
The claims are broad
In a study of L. Ron Hubbard's text, one is impressed from the very beginning by a tendency to generalization and authoritative declarations unsupported by evidence or facts. To cite one example, from Chapter 2: "Hearing, in addition to other perceptics, varies organically over a wide range. Calcium deposits, for instance, can make the ears 'ring' incessantly. The removal of aberrations permits the body to readjust toward its reachable optimum, the calcium deposit disappears, and the ears stop ringing." Now ringing in the ears is a common symptom of acute or chronic infections or degenerative processes within the ear. Sometimes it may be a symptom of aging. The exact cause is often difficult to determine. The symptom may come and go, apparently without any relation to the treatment given. It has never been proved, moreover, that calcium deposits themselves are responsible for hearing disorders. But if calcium deposits can be made to disappear by the application of a psychological method such as dianetics, then it is a fact of enormous importance, not only for the treatment of ringing in the ears, but for other disorders in which abnormalities in calcium metabolism occur. One looks in vain, however, for case reports or statistical studies that would sustain the therapeutic claims.
The terminology of dianetics is made up of words and concepts borrowed from psychiatry and psychoanalysis, mixed with language derived from physics, mathematics, engineering and "cybernetics," plus a few created by Hubbard: pre-clear, clear, release, aberree, valence and engram are some examples.
The engram is the culprit
Special mention must be made of the term engram, for it is fundamental to the entire concept of dianetics. The engram is defined as "a cellular trace of recordings impinged deeply into the very structure of the body itself." The engram is "the single source of aberration and psychosomatic ills," and, according to dianetics, it has to be dissolved or erased by treatment. The most important engrams are those formed in the "basic" or "basic-basic" area, that is, the pre-natal period. Activities and incidents during pre-natal life and even the act of conception itself are recorded in the unborn child, and are said to produce aberrations. In the context in which they are described, post natal engrams -- less important than prenatal engrams -- are recognizable to the student of modern psychotherapy as a crude approximation to the psychoanalytic "unconscious," which operates below the level of awareness.
Full instructions are given
By following the standard procedures on treatment outlined by Mr. Hubbard in the "Dianetics Auditor Bulletin," it is possible to get some idea of how the auditor works his art on the patient. First the patient is "started on straight line memory to recover data about incidents which may contain grief, as of deaths, or about engrams of physical pain, as in accidents, illnesses or operations." The patient usually lies on a couch and goes into a dianetic "reverie" in the presence of the auditor. The auditor is admonished to be silent or passive, except when he wants the patient to "go back" on his "time track" or return to the present. Then the auditor calls the patient's attention to various periods of his life and tells him, not to remember or to associate freely as in psychoanalytic practice, but to "go there," which, presumably, the patient does on his time track. The object of moving on the time track is to detect an engram recording a forgotten pre-natal or post-natal experience and to remove it.
"One should not expect a pre-clear to simply wander into the basic area. He must be sent . . . the engrams on conception and conception itself are the earliest part of basic area. The first missed menstrual period is the latest part of basic area. This area is the most vital in the case and every effort should be made to reach and reduce or erase engrams in it. . . . Conception is run off as the sperm and then as the ovum with all the details it contains. Moments a little earlier as the sperm or ovum have been found engramic and when conception has pain and will not erase after many, many runs, look earlier. Conception does not always have pain, and if not, it should be run a few times to be sure, and thereafter neglected."
In a footnote Mr. Hubbard states: "The subjective reality of conception cannot be questioned. The objective reality, the validity of the experience, has not been thoroughly checked as have prenatal engrams in general." Nowhere, however, does one find sound evidence of the validity of the idea of prenatal engrams.
Dianetics, its creator insists, "is an exact science comparable to physics and chemistry but simpler and is really essentially an engineering science. The theory is basically the theory of mechanical calculators. It assumes that the mind is incapable of error, that any person -- aberrated or clear . . . computes perfectly from the data stored and perceived."
Later in the book, Mr. Hubbard again states, "Dianetics has no relationship with past mental treatments. It is entirely mechanistic and works with engineering precision."
It is possible that cybernetics and engineering may explain some of the mechanisms of communication and memory in the nervous system of man. But cybernetics presents no evidence that machines think creatively, even though they can compute accurately on the basis of the data fed into them. Nor do machines hold the key to why we behave like human beings. Computing machines illustrate the fact that some problem-solving operations which human beings perform, machines can perform also, and that there are some processes common to mechanical calculation and brain functioning.
The mind is complex
The human mind is more than a computing or a remembering machine. Instinctual drives, feelings, consciousness, will, ambition and all sorts of sublimations are part of the human mind and have so far defied the efforts of our best minds in medicine, psychology and physics to reduce them to quantitative terms or units. Psychiatry as a specialty of medicine is more concerned with these elements of the mind than with its computing or memory assembling properties. Present day psychiatry can hardly be called an exact science. Mixing up psychiatry with terminology and concepts borrowed from physics, chemistry, mathematics and engineering doesn't make it more exact.
If some of the formulations of dianetics are incomprehensible to the modern physician, the reason for its success, the reason why it has caught on so with all sorts of people in all walks of life is not incomprehensible. As Mr. Hubbard states, "Even professors of biology, political science, sociology, psychology and physics who have given dianetics a fair and impartial survey . . . discovered in it some of the answers for which they have long sought." Emotional disturbance and mental illness afflict both the sophisticated and the naive, the learned and the ignorant. It is undoubtedly true that there are some persons who have been helped by dianetics. When an auditor devotes time, interest and sympathy to an individual with worries, tensions and anxieties, he provides an opportunity for the ventilation of these problems. Ventilation is an old and successful method of reducing emotional tension. The relationship between auditor and patient will be particularly successful if the patient has been lonely or misunderstood or scolded. Furthermore, information or discussion about sexual matters always has considerable therapeutic value, at least temporarily. Reassurance, discussion, sympathy, suggestion and opportunity for ventilation have been the stock-in-trade of the practicing physician and of the successful mental therapist since primitive time.
In mild tension states where the symptoms are not too severe, these methods may be successful for a variable period in relieving or diminishing distressing symptoms. But in severe neuroses or nervous ills, the kinds of mental disorder that affect so many people in our society, the superficial methods of psychotherapy have a very limited value. Sometimes they may even be harmful, particularly in the hands of a person without much training.
A sign of our times
It is indeed a sign of our times that a movement like dianetics should gain so many thousands of enthusiastic supporters. Irrespective of whether psychiatry today is more art than science, the fact remains that as practiced by physicians it has failed to meet the needs of our population. The family doctor and the internist who are most conscious of emotional disturbances in their patients and whose practices consist largely of psychosomatic ills, often haven't the training or competence to treat the disorders. Or when they do they find that the patient cannot afford to pay for frequent long sessions. The difficulty of payment is even more true of skilled psychiatric treatment, for its costs are far beyond the financial resources of the average person. Mental hygiene clinics for middle- and low-income families have been developed in a few medical schools and hospitals of our larger cities, but they too are completely inadequate in meeting the demands of the population.
In the absence of rational organization of psychiatric resources and in view of the enormous deficiency of psychiatric personnel and facilities, it is little wonder that irrational cults have flourished. The popularity and commercial success of some of these cults are eloquent testimony to the enormous need of the people for help for chronic anxiety states and mental sicknesses and the failure of society to meet these needs.
It is also remarkable that society permits persons without any medical training to undertake to treat persons with every kind of mental and physical illness. How can an auditor determine whether the patient has an organic disease with emotional symptoms, or an inorganic functional disorder, such as a neurosis or a psychosis? This is a task that is sometimes difficult even for the trained psychiatrist. But it is obviously of great importance in determining the correct treatment.
It is also necessary to emphasize the harm that can occur when an auditor untrained in medicine or psychiatry attempts to influence the mental mechanisms of a person with a mental or a psychosomatic disorder. There is, furthermore, possibility of serious harm resulting from the abuse of intimacies and confidences associated with the relationship between auditor and patient. This is a danger that has occurred with other psychotherapies. The risk is obviously greater in a cult without professional traditions.