The creation of the myth of Bruno Bettelheim begins in the American Midwest during the Second World War. A recent immigrant from Nazi Europe, Bettelheim applied for a position at Rockford College in Illinois, using an impressive, and in those years unverifiable, curriculum vitae. It said he had studied for 14 years at the University of Vienna, earning summa cum laude doctorates in philosophy, art history, and psychology. He had done original work under the leading artists at the Vienna Kunstgewerbeschule; had excavated Roman antiquities; had run the art department of Lower Austria’s library; assisted at the Kunsthistorisches Museum; and published two books in the field. Bettelheim claimed this much and a good deal more (music studies under Arnold Schoenberg!) to land a two-day-a-week post in a small-college art department. By the time he aimed for the University of Chicago, the resume had been further improved with training in psychology, experience raising autistic children, and personal encouragement from Sigmund Freud.
There were snatches of truth in the tall tale, but not many. Bettelheim had earned a non-honors degree in philosophy, he had made acquaintances in the psychoanalytic community, and his first wife had helped raise a troubled child. But from 1926 to 1938 — the bulk of the “14 years” at university — Bettelheim had worked as a lumber dealer in the family business.
Lumber dealer or no, Bettelheim was a true Viennese intellectual. Though dishonest, the fabricated c.v. was an apt way of communicating to Americans, with their focus on credentialing. Bettelheim proved to be as advertised: the most cosmopolitan faculty member Rockford College had ever seen and a charismatic teacher. As for Bettelheim’s subsequent career as a “psychologist, ” he brought a comprehensive knowledge of the Freud canon, a talent for identifying salient issues in the profession and in individual lives, and a passionate dedication to the care of mentally ill children. Given his remarkable competency, there is something at once pathetic and grandly funny in Bettelheim’s forging (in both senses) an identity. Here was someone who understood America, a credulous nation where a man can remake the self.
The more serious issue is the use Bettelheim made of this new self. He became a man of parts. In such popular books as The Informed Heart, The Children of the Dream, and Love Is Not Enough, he weighed in on everything from the character of concentration camp victims to parenting styles on kibbutzim and in American families. Bettelheim’s standing arose from his renown as the wise and forbearing principal of the University of Chicago’s Orthogenic School, a residential facility for disturbed children that he ran from 1944 until the early 1970s.
The Bettelheim myth suffered after his suicide in 1990. Former patients came forward to testify to his violence toward children under his care. Now the journalist Richard Pollak has interviewed over 250 witnesses and read reams of documents in a painstaking effort to demolish every element of the legend. In The Creation of Dr. B, Pollak charges that Bettelheim was an inveterate liar, bully, plagiarist, and hypocrite. Pollak’s brother Stephen died in 1948 while on leave from the Orthogenic School; Bettelheim arbitrarily labeled the death a suicide and blamed the boys’ mother for Stephen’s mental illness. A proposed memoir about Stephen turned into a catalogue of Bettelheim’s acts of duplicity. Pollak succeeds in his main task; he proves that Bettelheim mistreated children and misled the public on numerous issues. Still, Pollak is so unsympathetic to his subject — he is, for example, not at all amused by Bettelheim’s outlandish CV — that he may inadvertently push readers back into admiration for Bettelheim, who was a survivor as well as a fraud.
Bettelheim reorganized the Orthogenic School on lines influenced by psychoanalysis and his own profound experience as a prisoner in concentration camps. In 1938 and 1939, Bettelheim had spent over ten months interned at Dachau and Buchenwald. Pollak denigrates Bettelheim’s standing in the hierarchy of sufferers: These camps were not yet death factories, and Bettelheim was protected by bribes paid by his family. But even Pollak concedes that Bettelheim’s experience was “hellish.”
Bettelheim’s reputation as a psychologist began with the publication in 1943 of his observation of behavior in the camps, “Individual and Mass Behavior in Extreme Situations.” Bettelheim contended that his survival had been due to his psychological skills, particularly his ability to continue to see his captors as individuals. At the same time, he concluded that regression was a normal response to overwhelming trauma that threatens the integrity of the self.
Drawing a parallel with his concentration-camp experiences, Bettelheim understood schizophrenia and autism to arise from extreme situations within the family. To counterbalance these noxious influences, he placed children in a “therapeutic milieu” — a permissive setting built on empathic understanding of their behavior. A child who provoked by taking a bite out of one sandwich after another was not punished; he would discover that freedom to enact psychic needs is more important than the enforcement of good manners. A wild child who toppled furniture might return to his room to find the tables and chests bolted to the floor, a creative solution meant to prevent him from doing harm without punishing or restraining him.
Pollak attacks Bettelheim as a Svengali who created his therapeutic milieu by dominating impressionable young women counselors through “dynamic supervision” — in essence, requiring staff to take on the role of patient. Bettelheim did hire a cohort of inexperienced women at the Orthogenic School; it is they who would spend long hours with difficult children. A number of those women went on to positions of leadership in the helping professions.
Dynamic supervision is very susceptible to abuse; but such supervision, whose goal is to make caregivers aware of their own blind spots, was once standard in psychoanalytically oriented institutions. Bettelheim believed that a counselor could respond effectively to disturbed children only if she grasped their motivation through the methods of psychoanalysis and a new tool: empathy.
Bettelheim understood empathy much as psychotherapists do today — as vicarious introspection, a way of knowing the other through examining the self. When he was good at teaching empathy, Bettelhelm was very good. Bettelheim would get a counselor to respond not to her own feelings but the child’s, even when the child had smeared feces on the counselor’s blouse. Empathy is so common a concept today that it is hard to appreciate the novelty of Bettelheim’s approach. In his 24 volumes of writing, Freud made only one substantive comment on empathy, and that comment is ambiguous. It was Bettelheim and, more vigorously, the psychologist Carl Rogers who brought empathy to center stage.
Though it has precursors, the therapeutic milieu was also innovative. Bettelheim looked past Freudian drives to the patient’s actual experiences — again, this is the concentration camp history put to use. The real parents counted, as did the real rehabilitative setting. The emphasis on the social ” surround” puts Bettelheim in a tradition of American and American immigrant theorists — such as Harry Stack Sullivan, Karen Horney, Erich Fromm, Viktor Frankl, and Erik Erikson — who created a line of psychotherapy that attends as much to social reality as to unconscious fantasy. To sustain the milieu, Bettelheim worked tirelessly as an administrator, raising funds, building, conceptualizing. His success was grounded in a personality style common among successful administrators: energetic, arbitrary, demanding, and not a little sociopathic.
In the service of fund-raising — and self-promotion — Bettelheim misdiagnosed patients and then inflated his therapeutic success rates. The Ford Foundation was willing to underwrite innovative treatments for autistic children, so Bettelheim labeled his children autistic. Few actually met the definition of the newly minted syndrome. But at mid-century, medical diagnosis coexisted with a psychoanalytic system that relied on broad categories — psychosis and neurosis. Bettelheim considered madness a universal capability; he was, after all, a man who claimed to be able to empathize with his tormentors at Dachau and who required his staff to discover what was autistic within themselves. Nor were psychoanalytic outcomes behavioral. Success was measured in terms of enhanced self- understanding, which was presumed to offer protection from further injury. This method had grave problems; but it was the system that would have been most familiar to an art historian-philosopher after World War II. That being said, Pollak demonstrates that Bettelheim gave an impression of the school’s efficacy that no subsequent examination has supported.
Bettelheim’s contributions — his celebration of empathy and his insistence that the social environment matters — create a standard that makes inexcusable his violence toward patients. Pollak’s account leaves no doubt that behind closed doors Bettelheim could be explosive. He hit children to control them in the midst of self-destructive acts, and he hit them when he himself was out of control. Residents describe episodes of slapping, punching, kicking, hair-pulling, and verbal attacks. Pollak reports accusations by two women who claim that, when they were at the school in their teenage years, Bettelheim fondled their breasts as he apologized for inflicting beatings. In Pollak’s account, Bettelheim, who lectured mothers on the harm that violence does, was the perfect hypocrite.
All along, Bettelheim’s colleagues had found his descriptions of the Orthogenic School hard to believe; in their experience, treatment of profoundly disturbed children sometimes required physical coercion. In private correspondence, Bettelheim said that force — slapping around — has a role in child-rearing: “Of course I cannot afford to say that out loud, because it runs against all child psychology. But I know: boy does it feel good to be once in a while mistreated by a parent.” He believed he needed to overstate the case against violence in order to make an impression on American parents. In this limited sense, Bettelheim was aware of and comfortable with his hypocrisy.
To Pollak, Bettelheim’s violence completes the picture of the (ersatz) psychologist as monster, and this conclusion may seem the only one possible. But much the same ground was covered by the French journalist Nina Sutton, to quite different effect. Sutton’s Bettelheim, which appeared in English last year, has a political-psychoanalytic agenda that may seem strange to American readers. But Sutton, more than Pollak, seems intent on wrestling with Bettelheim’s contradictions. She sees the violence as a tragic flaw in a man with heroic qualities.
Sutton is painstaking in documenting instances when Bettelheim attacked children merely because he felt insulted; some former patients claim to have been crushed by Bettelheim’s tyranny. Sutton interviewed others who were hit by Bettelheim but still consider the Orthogenic School a magical place. Before reading either book, my impression, based on stories that circulated in the profession, was that Bettelheim could lose control and hit children, but that he was not systematically cruel. Sutton’s conclusions are along these lines; Pollak’s are harsher. But even Pollak tells of interviewers who seem to have benefited from Bettelheim’s combination of empathy and authoritarianism.
What are we to make of the grand old men of psychoanalysis? Jung takes a patient as a mistress, Freud ignores patients’ accounts of incest, Ferenczi cannot decide which patient to marry, the mother or the daughter. Bettelheim’s case is ongoing — three additional biographies are rumored. Surely these will need to take into account Pollak’s monumental research. Pollak does a service by demonstrating how dangerous heroworship and psychoanalysis are in combination.
But, finally, Pollak’s book seems to me part of an unhelpful trend, self- congratulation masquerading as mature judgment, vendetta in the guise of biography. Pollak layers accusation and innuendo; the reader barely has time to consider one failing of Bettelheim’s before another is piled on. The accumulation creates a picture of a habitual liar who preys on others while aggrandizing himself. This view may not be wrong — certainly there are witnesses who saw Bettelheim in just this way. But there is a peculiar a historical quality to the presentation of the evidence. Often Bettelheim is judged according to the scientific or social standards of a subsequent era. Bettelheim’s genuine contributions are never gathered together. The well- documented abusive behaviors are put on the table with other less easily verified charges, like the sexual molestation. In the end, while it is clear that Bettelheim was no saint, it is hard to have confidence that the figure Pollak depicts resembles the man under study.
To my taste, the exercise lacks any wistfulness, any sense of what is lost. Because along with Bettelheim’s reputation, his contributions are in eclipse. In the era of brief hospital stays, few psychiatric institutions can maintain a therapeutic milieu. These milieux were liable to abuse (in particular, long and unjustified stays for rebellious adolescents) but with the right leadership they could be powerful tools for redirecting the course of an illness. In general, there remain few settings in which the expectation is that great effort and cleverness will be applied to the problems of disturbed children. For the most part, the helping professions have given up on remaking damaged personalities, except for those aspects of temperament that respond to medication.
Nina Sutton is keenly aware of the loss. She notes reforms at the Orthogenic School: Physical violence and dynamic supervision are banned, autistic children are not admitted. She asks:
But in this new irreproachable institution, what had happened to psychoanalysis, to empathy, to the fantasies and phantoms that made living so unbearable for the children? To those awkward, not-so-presentable feelings? . . . Once Bettelheim had left, the Orthogenic School stopped seeking out and confronting hidden “killers.” Instead, it tried to lull them to sleep.
Sutton condemns the new conformity as “covert violence,” presumably to children’s authentic or potential selves. This argument may sound a bit over- the-top. But even on the most pragmatic level, there are reasons to limit our self-satisfaction at the toppling of the icons.
With the therapist’s loss of authority and grandeur, psychoanalysis has become safer, but it has also lost much of its power to perturb. Even empathy has been degraded. The term once referred to a resonance with every aspect of a person, even what is most shameful and disturbing; in the brief psychotherapies available in modern health care, empathy has been reduced to niceness and general encouragement — cheerleading. And in our consciousness, as members of the post-Freudian culture, the human potential for violence is ignored or marginalized; it has become a pathological trait that appears in sick “abusers.” One does not have to be a devotee of analysis to wonder whether, as regards the darker aspects of human nature, our society and its caregivers are not in a self-righteous state of denial.
Bettelheim is a figure who ought to inspire wonder, at the juxtaposition of genius and fraudulence, wisdom and lack of control, public good and private shame. The effort to understand those dichotomies might be part of a larger project, to make sense of the confusing legacy of psychoanalysis, a movement that has shaped much of our culture, from the way we raise children to the way we demand forthrightness of one another, but whose history appears to be peopled almost exclusively by tainted giants.
Peter D. Kramer, the author of Listening to Prozac, is clinical professor of psychiatry at Brown University. His next book, Should You Leave?, will be published in September.
