John Heaton is, amongst others, a practising psychiatrist and psychotherapist, a regular lecturer on the Advanced Diploma in Existential Psychotherapy programme at Regent’s College, London, and a long- and some-time editor of the Journal for Existential Analysis.

This is Heaton’s third book with Wittgenstein in its title. In it, he applies the great philosopher’s insights to the psychotherapeutic process in all its forms. Heaton’s principle thesis is that many of our deepest and most intractable problems find their roots in linguistic confusions and limitations, and are resolved not by the search for causes inherent in the various pseudo-scientific doctrines and theories of the mind (such as those of Freud and Klein), but by careful attention to the use of language. This is particularly true in neurosis and psychosis in which language is used not so much to clarify and to communicate as to deceive and to obfuscate.

Like all the best things, the talking cure has its roots in ancient Greece with such luminaries as Socrates and Diogenes the Cynic (see my post on Diogenes here). Upon being asked to name the most beautiful of all things, Diogenes replied ‘parrhesia’ (free speech, full expression), and his intransigently courageous and sometimes delightfully shocking behaviour consistently accorded with this, his, truth. The self-understanding that underlies parrhesia is revealed not in reductionist propositions based on questionable pictures of the mind, but in the singular use of language – both by the expression and by its truthfulness. In short, it is revealed not in causes, but in reasons, with all their multiplicities and particularities.

For Wittgenstein as for Heaton, the talking cure is, like philosophy itself, a battle against the bewitchment of intelligence by means of language, for it is not knowledge but understanding that is needed to live an integrated, productive, and, dare I say it, happy, life. To date, this important, indeed, devastating, critique has had little or no impact on psychotherapeutic practices, and Heaton’s revolutionary book requires and deserves to be read not only by psychotherapists and psychiatrists but by every mental health professional. Although the book is not difficult to leaf through, she with little more than a scientific background may find it difficult to understand, accept, or come to terms with certain concepts. As Lichtenberg tells us, ‘A book is like a mirror: if an ape looks into it an apostle is hardly likely to look out … he who understands the wise is wise already.’

Neel Burton

NB: This review has also been published in the September issue of the British Journal of Psychiatry.