Tuesday, July 17, 2007

More on McScience.

Consider this a somewhat more studious rendering of yesterday's post about the similarities between junk food and self-help.

Reader John Curtis, whose own debunking site is selfhelpfraud.org, tipped me to an article that appeared in a special issue of The Scientific Review of Alternative Medicine devoted to junk science in the mental-healing arts. Though this was back in 2001—before SHAM was so much as a gleam in my agent's eye—I hadn't seen it before, and I'm grateful to Curtis for bringing it to my attention. Its title pretty much says it all: "Fringe Psychotherapies: The Public at Risk."

The author, Canadian psychology professor Barry L. Beyerstein, comes out swinging. "From Hippocrates to the present," he opens the piece, which later became the keynote address to the 2002 Annual Convention of the Canadian Psychological Association, "the first duty of the helping professions has been 'Do No Harm.' Unfortunately, a widening gap between science and the further reaches of psychotherapy has allowed certain practices to flourish that have the potential to do much harm." A few points here. Beyerstein intended his treatise primarily as a broadside against pseudo-therapists: that is, under-credentialed private-practice shrinks who tout the various untested, faddish regimens that he labels collectively as "neurobabble." ("For example," he writes, "there are well-known psychiatrists...who advocate treating current maladjustments by encouraging patients to 're-live' mental trauma that supposedly occurred in utero, during birth, or even in previous incarnations.") He also concedes that even at best, formal psychotherapy remains an evolving science with a spotty success rate. Serious-minded professionals do not shy away from such truths, and their profession's limitations, as I myself learned when I delivered a keynote address to a convention of psychologists last fall.

But that's all the more reason why consumers must guard against falling under the spell of today's "fringe" practitioners, Beyerstein argues: "Cult-like pseudo-therapies can prey upon the dependency needs of vulnerable people while extracting unconscionable sums of money." Further, he writes, "inadequately trained therapists may fail to recognize early signs of serious psychopathologies that, left untreated, could prove disastrous"; even in less serious cases, such practitioners may "encourage their clients' delusions." Needless to say, he adds, "bad advice could exacerbate rather than alleviate clients' complaints."

All of these criticisms could be lodged with (at least) equal weight against mainstream self-help, as the author notes: "With the growth of the 'New Age' movement, the market has been flooded by a growing cadre of therapists with little formal training but an immense investment in pop-psychology and 'post-modernist' psychobabble." Many of these self-appointed gurus, he writes, set up shop under such labels as "New Age guide, relationship advisor, mental therapist, etc."

Beyerstein concedes that it's not beyond the realm of possibility that a troubled individual might find some solace in the words of a "kind, empathetic" psychobabbler (though, I might add, an equally sympathetic ear may be found among friends and/or loved ones, and without the self-help price tag). Still, he continues, even if we give the psychobabblers the benefit of the doubt, "there remains the danger that they will divert clients from treatments that would help them more."

In closing, I quote from Beyerstein's own conclusion: "As long as people refuse to think critically and to put psychotherapy methods to hard-nosed empirical tests, bogus treatments will continue to flood the market. It continues to amaze me that many people who demand extensive, impartial evaluations of automobiles or televisions before making a purchase will put themselves in the hands of psychotherapists with little or no prior investigation of their credentials, theoretical orientations, professional affiliations, or their records of successfully helping their clients in the past."

That last line, to which I've added emphasis, applies in spades to SHAMland, and is as incisive a comment as has ever been written about modern-day self-help, its clientele, and the strange, symbiotic relationship between the two.


RevRon's Rants said...

I find it telling that the hustledorks' typical response to suggestions that a process is less than viable is the suggestion that the doubter *buy* the book/dvd/workshop and see for themselves. I'd bet that used car salesmen would love it if this approach worked for them!

"I don't need to start the car to show you how well it performs. You probably wouldn't believe me, anyway. So why don't you just *buy* the thing, and you'll see for yourself!"

Judging by their sales numbers, the phrase commonly credited to P.T. Barnum is true. "There *is* a sucker born every minute."

Cosmic Connie said...

What Ron said.

And hey, happy SHAMblog anniversary, Steve!

RevRon's Rants said...

BTW Steve -
Just thought I'd wish you a happy 2nd anniversary of SHAMBlog. It is my belief that objective evaluation of the Self Help "gurus" & hustledorks will be around long after their 15 minutes are up. Unfortunately, there are so damn many of them, even at 15 minutes each, the collective might well outlive both of us.

Resistance is futile. You will be assimilated! :-)

Steve Salerno said...

Thanks, guys. Geez, who tracks this stuff? I knew it was just about two years...but you're telling me this is the actual day?

And Ron, funny you should broach the Assimilation Theory--because I was just approached about whether I'd be willing to give a corporate talk about the kind of training that DOES work, or at least offers better odds of self-improvement. Which I guess would sort of obliquely/indirectly make me part of the SHAMscape...huh?

Mary Anne said...

This post reminds me psychology itself has become a form of religion. I know so many who have spent years with various therapists. They can now explain their disorders and phobias in detail, which are worn as badges of honor. Therapy, like self-help, can be another form of drug. This post also reminded me that my mother's psychiatrist committed suicide. Psychiatrists have the highest rate of suicides among doctors, which makes me wonder-at least most mechanics can fix their own cars.

RevRon's Rants said...

Not if the process you describe is firmly based in the user's own genuine experiences, and tempered with a good dose of common sense.

Ultimately, the highest form of aspiration - be it spiritual or more physically based - is that which wrings every last drop of joy out of the individual's life, without resorting to fantasy or ludicrous ritual. To "just sit," wherever you find yourself, and find both contentment and yearning, each flowing in and out of and nurturing the other. By ignoring the "there" we seek, we truly enjoy the journey. Might not be particularly cosmic, or make us feel particularly clever, but I think it's the best way to live whatever life we're given.

Keep in mind, however, that I'm usually as full of it as a Christmas Turkey! Fortunately, I find my delusions quite satisfying! :-)

Steve Salerno said...

Mary Anne, I'd be careful about throwing around extreme statements on the suicide rate among psychiatrists, which--based on a quick Google I just did--appears controversial. It certainly also appears, however, that their suicide rate is on the high side of "normal." I think we'd do well to remember what someone (I'm thinking acd?) once pointed out--that it's often troubled and/or confused people who are so fascinated by the workings of the mind, and who therefore go into the so-called mental arts in the first place.

Anonymous said...

yep - there is a very fine line between the psycho and psychotherapist.

happy Shamblog anniversary, Steve

a/good/lysstener said...

Steve, I don't think there's as much separating formal therapy from SHAM-style therapy as you do. That is certainly the message I get from reading the actual article in full. (This is the kind of reading I have to do all day long once school starts of course). But I agree with your point that if it's all suspect then you might as well concentrate on the things that are the least suspect. If that makes sense.

Steve Salerno said...

The key point is your last one, Alyssa. If we can't exactly ensure that we're going to do NO harm, then at least let's be sure we do as little harm as possible, or take every reasonable precaution to that end. Formal, credentialed psychiatry and psychology may be evolving sciences...but they're sciences, which is more than we can say for mainstream self-help.

moi said...

I don't agree with anonymous' comment that there's fine line between the psycho and psychotherapist. That's a cheap shot at a profession that has done a lot of good for a lot of troubled people. Of course, there are a ot of bad therapists, but it doesn't invalidate the profession.
The comment, however, may apply to the shamscape.

Anonymous said...

moi, you obviously haven't had any psychotherapy training because if you had, you would have seen first hand the concept of the wounded healer.

Its become a case of physician heal thyself!

Steve Salerno said...

Let's not try to be too thin-skinned here, folks, especially when you consider that (a) this is a blog, where people don't always have the time and/or inclination to explain their positions at great length, and (b) sometimes people say things metaphorically or for other rhetorical effect that are not meant to be taken literally as ironclad judgments or verdicts. I suspect that anon's "fine line" comment was in that category. I don't think it was intended to "invalidate the profession"; rather, just to point up one of the foibles and ironies of the mental-healing arts, and with catchy phrasing. If you're still out there, anon, am I correct?

moi said...

I agree Steve, I also didn't have much time to write the comment so it probably came off a little too strong. I just don't feel it is right to label people who go into the field of psychotherapy as being somehow inferior healers because they may have had deep personal problems of their own. I haven't heard of the concept of the wounded healer, but it would seem that a therapist who has experienced personal trauma and 'issues' and then worked through them successfully would be a better healer than someone who had an easy life.
Of course, there are therapists who haven't worked through their problems well, and do harm to others.
In the shamscape, the problem must be worse. The people who call themselves 'healers' probably have little or no understanding of transference and counter transference, hence they can do a lot of harm.

RevRon's Rants said...

Good point, moi. From my experience, all too many of the male self-help gurus get into it for one of 2 reasons: to get rich or to get laid... some seek both. And both can be interpreted as arising out of a feeling of low self-worth. The more desperate their need for validation, the more fame, wealth, and accolades they demand (or claim to have).

Anonymous said...

Absolutely correct Steve.

Mary Anne said...

I am not making an extreme statement about psychatrists having a high suicide rate. Doctors (MDs) have higher suicide rates than the general public. Female doctors even higher rates. A 2005 Harvard University study cited this. As for my statics for psychatrists, this was cited in the New England Journal of Science in 2005. It is also cited in "Suicide by Psychiatrists 1967-1972" in the Journal of Clinical Psychology, August 1980. It actually has become somewhat of a macabe joke with people who study psychology. I was making the observation that if you are a psychatrist and know you have a problem, why not trust the therapy and medication you prescribe others? Why not get help from a trusted colleague? Also, so much of therapy is subjective to each individual. Yes, there are people who are helped by therapy, but that might be true of self-help too depending on the individual. I just find a lot of psychatrists are a bit hyprocritcal about their profession. I see a link between them and the self-help explosion, which means that they did contribute to it inadvertently.