Cultic Studies Review, Vol. 5, No. 2, 2006, Page 98
Interviewing) are the treatments of choice for young and older drug abusers (Miller, 1989
Miller &Rollnick, 2002 Miller, Zweben, DiClemente, &Rychtarik, 1995 Project Match
Research Group, 1997). We now understand that the ―shock and awe‖ approaches used by
highly confrontational addictions and delinquency treatment programs are ultimately
unsuccessful at best and often harmful at worst.
Chapters seven and eight are largely devoted to a fascinating and disturbing recounting of
Lulu Corter‘s civil suit against KIDS of Bergen County, successfully prosecuted by New
Jersey attorney Philip Elberg. (Elberg currently serves as president of the International
Cultic Studies Association.) Rather than attack KIDS as a ―cultic‖ organization, Elberg took
the innovative approach of claiming malpractice. In essence, Elberg convinced the jury that
KIDS had violated established and well-known guidelines for the competent and ethical
practice of medical and psychiatric treatment. Nevertheless, according to Szalavitz, the jury
concluded that ―KIDS was more a cult than a clinic—and that such treatment had no place
in a healthcare system‖ (p. 246).
Szalavitz ends her book with a useful appendix, ―For Parents of Troubled Teens,‖ which
contains information about how to obtain appropriate treatment for defiant, oppositional,
antisocial, and addicted youth. The information is presented in a reasoned, undramatic
manner with references to several well-known Websites for additional information. One
section is an especially helpful ―questions parents should always ask‖ format that is concise
yet reasonably comprehensive.
Szalavitz is understandably puzzled that residential treatment for children (TTI) is a
multibillion-dollar industry, while proven treatments such as multisystemic family therapy
(MSFT), motivational interviewing (MI), and cognitive-behavior therapy (CBT), ―which are
actually cheaper than long-term residential care ...are largely unavailable‖ (p. 259). She
notes that the United States also has a gross shortage of child psychiatrists. While I agree
with her general points here, Szalavitz neglects to mention the harsh reality that, while
MSFT, MI, and CBT have indeed been proven to be significantly more effective than other
treatments, including residential treatment, the success rates for these interventions are
still disappointingly low.
This minor failing aside, Help At Any Cost is still a must-read for those interested in
adolescent treatment in general, and in how an iatrogenic therapy program can degenerate
into a therapy cult.
Note
[1] Of course, similar statistics apply to those who are exposed to, experiment with, and eventually
participate in, cultic movements. Contemporary cult interventionists (exit counselors and thought-
reform consultants) now realize that noncoercive, empathy-based interventions, as lacking in
immediate impact as they may seem, ultimately work best with cultists. The information-based and
psychoeducational approaches used by thought-reform consultants, or the strategic-interaction
approach advocated by Steven Hassan—while typically slow, methodical, and undramatic intervention
strategies—appear to be the best choices in the long run for intervening with cultists.
References
Miller, W.R. Increasing motivation for change. In: Hester, R.K., and Miller, W.R., eds.
Handbook of Alcoholism Treatment Approaches: Effective Alternatives. New York,
Pergamon Press, 1989. pp.67-80.
Miller, W.R., and Rollnick, S. (2002). Motivational interviewing: Preparing people for
change. New York: Guilford Press.
Miller, W. R. Zweben, A. DiClemente, C. C., and Rychtarik, R. G. Motivational
Enhancement Therapy Manual: A Clinical Research Guide for Therapists Treating
Individuals With Alcohol Abuse and Dependence. Project MATCH Monograph Series,

Cultic Studies Review, Vol. 5, No. 2, 2006, Page 99
Vol. 2. NIH Pub. No.94-3723. Rockville, MD: National Institute on Alcohol Abuse
and Alcoholism, 1995.
Project Match Research Group. (1997). Matching alcoholism treatments to client
heterogeneity: Project MATCH Posttreatment drinking outcomes. Journal of Studies
on Alcohol, 58(1), 7-29.
Steve K. D. Eichel, Ph.D., ABPP
Madness and Evil—A Review of The Sullivanian Institute/Fourth Wall
Community: The Relationship of Radical Individualism and
Authoritarianism
Amy B. Siskind, Praeger: Westport, Connecticut, 2003. 170 pages. $62.95
I recently played, for a psychoanalytic study group of which I am a member, a comedy
sketch, recorded ages ago, in which Elaine May and Mike Nichols portray a psychoanalyst
and her patient. Having had a good laugh each of the numerous times I have listened to
this sketch over the years, I gleefully, and as I now know naively, imagined my typically
serious and scholarly group uncharacteristically doubled over, wiping tears of laughter from
their eyes, enjoying a good joke on us all. In the sketch, the patient (Nichols) informs May,
his analyst, that in the following week he will have to miss the last of his five sessions per
week, since it is Christmas Eve and he plans to be with his family that day. Instantly
shattered by the news of her patient‘s plan to desert her, May attempts to maintain her
analytic stance and mask her spiraling self-fragmentation by demanding that her patient
explore, be curious about, reflect on and associate to his need to miss his session. In the
face of his insistence that he just wants to be with his family on Christmas Eve, the analyst
begins to weep quietly, then to sob in despair, then to scream with rage. Unable to help her
recompensate, the patient quietly retreats, wishing her a Merry Christmas, as the analyst
continues to unravel. When I turned off the recording, I faced a silent group, with some
members finally confessing to a sense of excruciating anxiety while listening. There was
little further discussion. We moved on quickly to the material we had planned to discuss. In
showbiz parlance, I had bombed. Though unable to articulate at the time why the sketch
repeatedly cracks me up, I can now say that for me, it helps to laugh about the ever
present, always not fully analyzed narcissism of the psychoanalyst—that is, to laugh at it,
but not to laugh it off.
Narcissism is a problem for our patients, but it is just as much a problem for the profession
of psychoanalysis and for every psychoanalyst. It is a problem that has shadowed our
profession from the beginning, and it is a problem that our profession still struggles to
address adequately. Freud formulated his conceptualization of narcissism in 1914, and
proceeded to enact some of its more problematic aspects: he deemed himself the only
analyst not in need of an analysis by another analyst he set up a book of rules for the
analytic process, which he exempted himself from following and he marginalized innovative
followers and favored those whom he could more easily control. Authoritarian control and
suppression of dissent may have seemed, at the time, like necessary means to the crucial
end of establishing psychoanalysis as a profession, but in the long run these methods have
not proven effective. To the contrary, Balint‘s (1968) portrayal of the banishment of
Ferenczi from the analytic community as a trauma to the profession remains relevant still,
decades after he made it. Although it is increasingly more likely in our professional
publications and conferences to see rival psychoanalytic schools seeking common ground,
years of rampant factionalism and internecine power struggles, along with authoritarian,
incestuous training systems (see Levine and Reed, 2004), have substantially contributed, I
believe, to the embarrassing fact that the majority of the public no longer has a clue as to
what we mean when we say ―psychoanalysis.‖