Imagine that you have been experiencing a deep and persistent depression for the last few months and you realize that it is time to seek professional help. But first you decide to do a little research and search the Internet for the best treatment for your condition. A Web site catches your eye, promising “Permanent Relief from Depression and Anxiety in Minutes.” You learn of a self-anointed “revolutionary” new treatment that can eliminate depression and anxiety in a matter of minutes without dangerous medications. The Web site informs you that your depression is caused by an energy “perturbation” in your “thought field” that can be corrected easily through simple techniques. In fact, all that you have to do is tap on certain body points as directed to “rebalance” your energy and your mood. You find out that you may not even have to leave your house, as the Web site claims that a therapist can talk to you over the phone, diagnose your specific energy disruption by looking at a visual display of your voice, and come up with a tailored tapping “algorithm” that will eliminate your problems in a matter of moments. You decide to give it a try.
Sound far-fetched? This scenario actually is more common than most people realize. In a previous article, (”Can We Really Tap Away Our Problems? A Critical Analysis of Thought Field Therapy,” by B.A. Gaudiano and J.D. Herbert, July/August 2000) I discussed the treatment described above, called Thought Field Therapy (TFT). Of course, it possesses no more scientific validation now than it did when I originally reviewed it, but the so-called "energy” psychology movement sparked by TFT continues to grow. Unfortunately, TFT is only one of a long and growing list of therapies currently being marketed to a public in search of quick relief from mental health problems and possessing little empirical support of safety or efficacy. The list of questionable treatments is becoming quite long indeed: Eye Movement Desensitization and Reprocessing, Critical Incident Stress Debriefing, Rebirthing Therapy, Emotion Freedom Techniques, Be Set Free Fast, Touch and Breathe, Neurolinguistic Programming, Auditory Integration Training, Dolphin-Assisted Therapy, Facilitated Communication, Past Life Therapy, Recovered Memory Therapy, and Alien Abduction Therapy, just to name a few.
It is within this context that psychologists Scott Lilienfeld, Steven Jay Lynn, and Jeffrey Lohr present Science and Pseudoscience in Clinical Psychology. Social psychologist Carol Tavris contributes the foreword, and sets a somewhat pessimistic (but necessary) tone as she briefs readers as to why both professionals and laypersons need to pay attention to the public health threats caused by unscientific treatment approaches. She proposes a possible impetus for the growth of pseudoscience within clinical psychology--the long-lamented scientist-practitioner gap. Tavris asserts that fundamental deficiencies exist in the training of clinicians, where the practice of psychology is often divorced from the science of psychology. This science-practice gulf produces therapists easily duped by sham treatments in the quest to earn a respectable living in an age of managed care.
In Chapter 1, the editors present a more optimistic analysis of the situation and state that the book aims to assist readers of various backgrounds with the “important task of distinguishing techniques in clinical psychology that are scientifically supported or promising from those that are scientifically unsupported or untested.” Even though they concur that the state of affairs within the field at times can look rather grim, they assert that this is not an intractable problem and suggest education as a possible remedy.
The editors point out that nonvalidated therapeutic techniques can actually be dangerous and even lethal. The 2000 death of a girl in Colorado at the hands of her therapists using “rebirthing” therapy is but one example. The editors note that unscientific practices are harmful in other ways as well. For example, individuals may get discouraged after trying several treatments without success, and this can keep them from trying an empirically supported therapy that might actually be beneficial.
Each of the book’s five sections represent major areas of controversy. Part I discusses questionable assessment practices and diagnostic entities. This includes critiques of common “projective” tests such as the Rorschach Inkblot Test, and of controversial diagnoses such as Multiple Personality Disorder (MPD). Part I also provides some understanding of why clinicians may fall prey to errors in judgment, leading to erroneous beliefs like the diagnostic power of the Rorschach or the validity of MPD. Howard Garb and Patricia Boyle review the evidence from a wealth of experimental studies showing just how poor our judgment can be when based solely on experience. Many cognitive biases cloud our interpretations, requiring the use of objective methods and controls. Clinicians are no more immune from these biases than laypersons. Psychologist Paul Meehl put it this way: “It is absurd, as well as arrogant, to pretend that acquiring a Ph.D. somehow immunizes me from the errors of sampling, perception, recording, retention, retrieval, and inference to which the human mind is subject.”
The next three parts of the book cover controversies in psychotherapy and treatment. A host of respected scholars, including memory researcher Elizabeth Loftus, present discussions on recovered memories. The authors conclude that the inappropriate use of techniques such as hypnosis and guided imagery can foster false memories in vulnerable patients. Much harm has been done by practitioners who have unwittingly promoted false claims of abuse based on supposedly recovered memories. Another chapter includes a review of the countless sham treatments for autism and other developmental disorders. Facilitated Communication is but one example of a discredited technique for autism.
Perhaps the worst victims of pseudoscience are those who were actual victims of a life-threatening traumatic event and who continue to suffer from the residual effects of that experience. Chapter 9 reviews some of the most popular but controversial treatments of the “trauma industry,” including Eye Movement Desensitization and Reprocessing, Thought Field Therapy, and Critical Incident Stress Debriefing (CISD). CISD was originally developed as a brief group intervention with the laudable goal of preventing the development of posttraumatic stress disorder after a traumatic event. However, several controlled trials of CISD suggest that the treatment is inert at best and harmful at worst when conducted as originally proposed (Lancet 360 [9335]: 766-771, 2002). Issues involving the efficacy of trauma treatments have become increasingly urgent in the wake of terrorism acts and threats in recent years.
The final part of the book focuses on pseudoscience in the media, including the self-help movement. Nona Wilson provides a cogent argument for better representation of the mental health field to the public. Little wonder that the public is ill-informed about empirically supported treatments when most of their knowledge of mental health issues comes directly from the likes of “Dr. Phil” McGraw, radio show host “Dr. Laura” Schlessinger (whose doctorate is in physiology and not psychology or psychiatry), relationship “expert” John Gray (who holds no professional license), and motivational guru Tony Robbins (a practitioner of the pseudoscientific Neurolinguistic Programming).
The editors have presented the evidence in as fair and balanced a way as possible. They urged contributors to remain objective and dispassionate in their presentations, attempted to provide constructive criticism, and chose not to only debunk these techniques when necessary, but also to discuss techniques that are scientifically supported. Furthermore, each chapter contains a glossary of terms to aid the reader in the sometimes dense terminology. Although the book is accessible to the nonprofessional, the volume is most appropriate for the mental health professional or student.
The editors conclude with recommendations for combating the current state of pseudoscience in the field through increased educational and professional efforts. This book is the first major volume devoted to a discussion of science and pseudoscience within the field of clinical psychology, and hopefully can help guide both professionals and patients toward valid treatments. If the patient is clinical psychology and the disease is pseudoscience, this book is part of the treatment.
