First Do No Harm (Book Review)

Editors:  Adrienne Harris and Steven Botticelli Routledge
Publisher:  Relational Perspective Book Series
Reviewed By:  Stephen Hartman, PhD

The Paradoxical Encounters of Psychoanalysis, Warmaking, and Resistance

With lingering sadness and humility, the 18 authors in First Do No Harm tell stories that describe how, after bearing witness to war, either as combatant or psychoanalyst, as Francoise Davoine writes, there is no going home again. It takes years to comprehend what happened, perhaps generations. This exemplary collection of essays, edited with grit and grace by Adrienne Harris and Steven Botticelli, chronicles this dilemma.

For soldiers, for their families, for prisoners of war, for the psychoanalysts who are leading the struggle to bring honor to the American Psychological Association, going home after facing war has many enduring effects that teach us about the overwhelming complexity of roles that we (as citizens and psychoanalysts) occupy at any moment. Does one return home outraged or crushed, emboldened or indifferent? Can one pick up where one left off? Or does one soldier on? And how?

I’m not going to take on the Herculean task of representing the wealth of experiences shared in this book nor of the gems found in each chapter. Most of the authors are readers of this newsletter, and I can’t do justice to each of their inquiries (See the Table of Contents on page 9.) What I hope to capture here is the personal nature of the authors’ and editors’ contributions and the transformative role that writing played in the gift that they have given to psychoanalysis. To my mind, First Do No Harm sets the standard both as exemplar of analytic social responsibility and as a primer on psychoanalytic writing.

Home: the word doesn’t appear in the index, and yet the concept of home is central to just about every essay. If “who are you?” is the question that we and our patients ask as treatment progresses (Gaudillière, p. 25), “am I at home here?” is a question that begins on day one. Suddenly deracinated by the threshold I have traversed, I ask: Is this home safe? Is it honorable? Is it indeed mine? Am I at home in my nation, in my professional organization, in my class? In First Do No Harm, these questions are elicited through writing in a way that captures the essence of resistance to war-making. Lynne Layton reflects, “committed as I am to social justice, I have never been able to revel in open rebellion, and I still can’t”

(p. 359) Yet, Lynne’s voice in print is a force to reckon with. Perhaps the betrayals of home have always given psychoanalysis its subject. In this collection of outstanding memoirs, historical inquiries, and theoretical initiatives, writing one’s way home gives psychoanalytic text its political heft.

In 1978, at seventeen, I returned to landlocked suburbia after an exchange student year in Johannesburg, South Africa. Initially, when I was placed in a family and school there, (having set my sights on learning Arabic or Swedish), I felt as if I had been drafted: sent as a teen ambassador to the Apartheid state that I had, already as a high school student, begun to protest. I went anyway, much as I imagine many young men my age went to Viet Nam, later Afghanistan and Iraq: ambivalent about my assignment, but glad just to escape home.

Of course, I was not a soldier sent to combat, and I would never conflate the two experiences. I’d seen racism at home in Cleveland. But, at the peak of Apartheid’s cruelty, witnessing oppression daily, and anticipating the inevitable raid by the security police on our home (an occasional station on an underground railway), I saw war. Sue Grand captures the eros of it; it was horrific and exciting in equal measure. When I returned to Ohio, my high school friends and I spoke a different language. I never found my way among them again. I spent the night of my high school graduation watching the revelry with a mix of disbelief and envy, and I decided to go to college in Canada.

The struggle to describe the complex positions that one occupies on going home from war, as Davoine notes, forces a writer to imagine alternate ways of telling stories in the hope that the reader will truly hear the trauma, and that the writer will capture him or her without inflicting his trauma upon the reader for personal gain (a condition that Donald Moss describes with great empathy). As psychologists and psychoanalysts, this should seem an obvious element of working in the countertransference but, as the history of wartime complicity between the military and members of our profession shows, it is not.

What leads some of us who are committed to human development to assist in torture and others to expose it? How does one witness terror and then return to friends, to a country, or to a profession that stands aloof to war? If, when, and how does one disclose the personal transformation that led to political activism? From Wikipedia, I recently learned that Sheldon Wolin (1965), intellectual mentor to the Berkeley student revolt in the sixties, had been a bomber pilot during World War Two. This detail was never discussed with or among his students when I was his dissertation advisee and teaching assistant in political theory. What makes this particularly striking for me is that Wolin articulated one of the most profound historical accounts of the theorist as witness: yet, at least in the work that I am aware of, his critique of wartime complicity does not include what we analysts call countertransference reverie. The kind of soul-searching that we analysts do—and share—is striking by comparison. The authors in First Do No Harm demonstrate the painful and heroic parallel process that is endured when solider and analyst face the enemy within our own ranks. As Harris and Botticelli write, “one cures with contaminated tools” (2010, p. xxi). The care of the self becomes one’s text, as Harris (2009) elaborates elsewhere. Yet, particularly when one is caught in media res, post-9/11, post-war trauma, bearing outrage and shame, acting against one’s own home, it is not always possible to assimilate this paradox. It is simpler to assail injustice than to occupy power’s multiple roles.

Harris and Botticelli built this complexity of roles into the book’s structure. First Do No Harm is divided into four parts: psychoanalysis and antiwar work; psychology’s militarism; war and militarism deconstructed; and resistance. This conceptual framework, much like a psychoanalytic frame, allows a more private set of dialogues to flourish within and among texts at the level of authorial voice. It invites a kind of textured layering of dialogic speech within any one author’s voice that, after M.M. Bahktin (1985), is the discursive operation that grants what we psychoanalysts call thirdness to narrative. It is a commitment to viewing an an utterance as an action.

On close reading, each chapter in First Do No Harm examines torture both as monologic form and as dialogic narrative through a play of discursive tropes. There is a remarkable play of third-person and first-person voices in each essay, rendering the uneasy conflict with a professional selfobject analytic text. Each author deploys a self-circumspect collision of narrative styles (a kind of writing that Bahktin called heteroglossia) to bring the reader to the front – and home again. Home being found in a position of resistance.

Witness the editorial voice, the contextualizer, the facilitator, and the op-editor. As authors move among voices, we read histories of ideas that circle among histories of political advocacy. The case write up is activated as a form of professional theatre. Sometimes the words speak for themselves, telling it like it is, doing and being the violence that was done. Other times, the case write up bears the irony and tension of the author’s expertise. The same occurs when autobiographical narrative is used to reveal the self as instrument of both interrogation and resistance. The perverse pleasure of writing well about something awful captures what Eyal Rozmarin deftly names living in the plural. Historical examples reverberate in contemporary scripts where matters of being at home in one’s convictions become political enigmas. Documentary approaches reveal the subtleties of listing crimes and undermining them as craft. As in the still unsolved case that Errol Morris documented in The Thin Blue Line, the facts of complicity with torture that are presented throughout First Do No Harm take on the moral authority of narratives that can no longer be presented as factual. To write about bold truths with clarity in this ambivalent way requires the kind of razor sharp ear with which Neil Altman pens his one-person play (p. 146): “Hold your horses! Listen to your tone of voice.”

We can choose to hear the contradictions, the paradoxes, the underlying defenses—or, not. We can reveal our own struggles, motives, agendas, contradictions—or, not. To this end, I want to note that every chapter in the book pits complicity and resistance in a dialectical tension without casting them in what Jessica Benjamin calls a doer and done-to complementarity. This is achieved by an unstated ruse that sounds something like: I could have written about it this way, but I wrote about it another way. It helped me find my way. And I feel that I must share it with you. The end result is a heroic text that brings the reader to the battlefield and home again so that we may understand the role of soldier as well as those of historian, activist, and psychoanalyst.

Table of Contents

Part I: Psychoanalysis and Antiwar Work: Healing

1. Where Is the “Post” in Posttraumatic Stress Disorder? First Impressions Working With Iraq and Afghanistan Soldiers, by Tom McGoldrick
2. Men Learn from History that Men Learn Nothing from History, by Jean-Max Gaudillière
3. The Psychoanalytic Politics of Catastrophe, by Ghislaine Boulanger
4. Whose Truth? Inevitable Tensions in Testimony and the Search for Repair, by Nina Thomas

Part II: The Paradox: Psychology’s Militarism

5. Psychologists Defying Torture: The Challenge and the Path Ahead, by Stephen Soldz
6. From Resistance to Resistance: A Narrative of Psychoanalytic Activism, by Steven Reisner
7. Torture and the American Psychological Association: A One-Person Play, by Neil Altman
8. Violence and American Foreign Policy: A Psychoanalytic Approach, by Frank Summers

Part III: War and Militarism Deconstructed

9. Psychoanalysis, Vulnerability, and War, by Eli Zaretsky
10. Casus Belli, by Françoise Davoine
11. Combat Speaks: Grief and Tragic Memory, by Sue Grand
12. War Stories, by Donald Moss
13. Notes on Mind Control: The Malevolent Use of Emotion as a Dark Mirror of the Therapeutic Process, by Ruth Stein
14. The Gendering of Human Rights: Women and the Latin American Terrorist State, by Nancy Caro Hollander

Part IV: Resistance

15. Living in the Plural, by Eyal Rozmarin
16. The Politics of Identification: Resistance to the Israeli Occupation of Palestine, by Steven Botticelli
17. Dread is Just Memory in the Future Tense, by Adrienne Harris
18. Resistance to Resistance, by Lynne Layton


Bakhtin, M.M. (1981), The Dialogic Imagination. Minneapolis: University of Minnesota Press.

Harris, A. & Botticelli, S. eds., (2010). First Do No Harm. New York: Routledge. Harris, A. (2009). You must remember this. Psychoanalytic Dialogues, 19:2-21.

Wolin, S. & Lipset, S.M.eds., (1965). The Berkeley Student Revolt: Facts and Interpretations. Garden City, NY: Anchor Books.

* All citations are to chapters in Harris and Botticelli (2010) unless otherwise noted.


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