Discredited Psychological Treatments

[David Baxter PhD]

Discredited Psychological Treatments
Dr. Will Meek
July 25, 2010

The psychological treatment marketplace is filed with all kinds of approaches and theories. Some of these have been able to withstand the rigor of scientific testing (all major schools of talk therapy for example: cognitive-behavioral, humanistic-existential, psychodynamic), proving their value to patients, while others come and go like pet rocks (Orgone therapy, primal scream) or occasionally things that really harm people (frontal lobotomy, rebirthing).

There are a number of reasons these things continue to exist including clinicians not adequately trained in cognitive science, private practice counselors looking to get an edge in the market by advertising their ability to do the cool new thing, the difficulty in studying psychological change and the counseling process, and people who are quick to make money by selling the new fad through workshops and the speaking circuits. The most important might be the demand for help from people that feel like existing treatments don't help at all, or don't help fast enough with big enough results.

The treatments themselves also usually have similar properties to them. First, they claim to offer incredible results beyond what is traditionally known for credible approaches like talk therapy (sometimes instant and near miracle like results are promised). Second, they almost always come from some kind of private industry or fringe charismatic inventor. Third, they are often rejected by scientific understanding or research, and continue to be taught through workshops rather than in universities.

Here in the northwest, we collectively operate on a different wavelength than other parts of the nation, and are usually more interested in alternative treatments and methods. I think this is wonderful, as long as there is evidence to back it up. If not, people end up spending a lot of money on treatments that are not effective, or are simply a lot of smoke and mirrors covering up a very basic psychological principle that is easily applied in more direct ways. The most common of these at the current time are Eye Movement Desensitization Reprogramming (EMDR), Neuro-linguistic Programming (NLP), and the Emotional Freedom Technique (EFT).

EMDR
This approach is very widely practiced and for some period of time was accepted as a mainstream treatment approach. It might be the most successful of these things of all time. The theory is that when we experience something traumatic and do not process the experience and memories properly, we are left with a variety of symptoms, including post-traumatic stress disorder (PTSD). In EMDR the patient is asked to watch the therapist's hand (or a light machine) move back and forth while discussing the traumatic memories. The belief was that this eye movement helps "reprogram" the brain, and early results showed people felt a lot better after doing some EMDR.

However, recent research has proven the critics right: the eye movements are not necessary at all, and what was really happening was that just the talking and sharing of the experience was the therapeutic element. This "exposure" is one of the most robust findings in all of psychological change research, and can be accomplished with a close friend over coffee or with a fancy light machine. Either way people feel better. This has even resulted in the Veterans Administration recently revising their website on PTSD treatment (see it here). The good news is that EMDR does help, but you could get the same effect or even better results with a more traditional approach.

NLP
This is one of the growing fad treatments but has been around since the 70s. Essentially, it is a collection of basic ideas about communication repackaged and given a fancy new name that sounds "science-y". Research throughout the 80s and 90s discredited NLP and it has been rejected by the mainstream psychological community for many years. However, special workshops and a cottage industry continues to profit on NLP.

The most interesting thing about NLP is that it is nearly impossible to find out exactly what it is. Almost every free resource dedicated to it will not give any specific techniques or ideas. This is always a red flag because real treatments are widely taught to everyone willing to listen in credible institutions, not just by salespeople in expensive hotel workshops.

EFT
The Emotional Freedom Technique is also very well named. Who doesn't want to free themselves from the shackles of painful emotions? EFT is the latest wave of a type of approach that involves tapping on your body while you say things. The belief is that tapping on specific "nodes" such as the space between your eyes, the space under your nose, and under your arm will help properly reorganize "energy fields" around the body to relieve symptoms. While doing the tapping, people repeat phrases over and over like "I am going to have a good day today" and "I am a good person". Big surprise here: when people do this they feel better.

Again we see a basic helpful process (giving yourself positive affirmations) repackaged with some other false explanation and technique. There is no research to support EFT, and the tapping is has never had enough credit to even be discredited, but there is some to support telling yourself positive things. Just go ahead and do this without the tapping on yourself.

Caveat Emptor / "Buyer Beware"
My advice is that as you look for a therapist (or are already working with one), and something tells you that what you are doing feels strange, makes your uncomfortable, or does not seem to make much sense, then question it and get more information. Doing this research ahead of time can save you a lot of time and money, and may help you direct yourself toward someone that is offering a more credible solution.

I'd suggest that if you are looking for help, give a more traditional approach a try. I have some advice for how to choose a therapist here. If that hasn't worked, consider trying someone with a different style of traditional approach or experience level, or moving to medication if you have more severe symptoms. I also have a list of alternative techniques with some credibility here.

 

[Pheonix]

Yep, NLP and EFT are the therapies my previous psychologist used with me and in group. Tap tap tap. I think she still does it. Something inside told me it was bullshit, the same way I find audiences of perfectly sane ordinary people gasping at TV psychics, claiming to be talking to their dead relatives. I looked it up on the internet and found its EFT founder discredited but I was afraid to say anything because she was intimidating and I was the outsider in her community/country. a lot of talk about energies and power transmissions etc. What miffed me was when I talked about my schizotypal, (rare but vivid) hallucinatory experiences it was psychosis, when she talked about feeling the magnetic forces and transferring energy fields etc.. blah, blah, blah, it was therapy and perfectly sane. I ditched therapy and it jaded my view for quite a while about psychologists, I even blamed myself and felt like a failure. I became much more critical of people claiming to be mental help professionals. Too many people stand in awe of a degree and a "Dr" tag like I once did. I wondered how all the psychologists and psychiatrists writing articles, books or blogging on the internet seemed so well informed and the ones I met in real life seemed so clueless. My next therapist got ran through a list of rigorous questions before I even allowed myself believe she had professionally qualified skills to help me. Hey, its great if your therapist is a specialist in everything but that unrealistic, just one who has a good grasp of all theories and is good enough with skills will do, not one who fills in gaps of incomplete education with religion, magical thinking and new agey fads. Every client must become an informed and empowered patient so they can screen out the good therapist from the incompetent ones. Its well worth it, its a matter of healing or not.

 

[locrian]

Another type of therapy that may eventually be added to the list is attack therapy:

Attack therapy - Wikipedia, the free encyclopedia

 

[Xelebes]

Another type of therapy that may eventually be added to the list is attack therapy:

Attack therapy - Wikipedia, the free encyclopedia

I've been reading a lot about it and from what I hear, that stuff is amongst the scariest stuff in psychiatry since the days of the asylums.

 

[Xelebes]

I've talked with survivors of institutions that used attack therapy. Apparently there is a lot of mess when you mix charismatic leaders who rise out of peer-based therapy, government funding and a McCarthyist panic (Commie Scare and the ensuing Druggie Scare.)

 

[locrian]

What's interesting is that the U.S. military has resorted to similar techniques in boot camp. A former co-worker, an ex-navy Seal, explained that the process is to break down the ego before building it back up. My co-worker joined the navy when he felt that his life was out of control and he needed discipline in his life. He looks on his military service as a positive experience.

That said, it's probably about the last thing that I would want for myself.

 

[Banned]

I think a key difference as well between the military using similar techniques and a therapist using them is that usually people who are going in to therapy are broken, vulnerable, and have whatever issues brought them to therapy. From what I understand, the military specifically screens those people out. I think the article did say that it is "more effective" on people with higher self-esteem but I just see it as inhumane treatment, no matter what your self-esteem is. There are just so many better ways to get better results.

 

[Xelebes]

Doing more research on "Confrontation Therapy" and "Attack Therapy", it seems it grew out of the Canadian Residential Schools (yes, those schools) and American Anti-gang efforts in Chicago in the 1930s. The basic principle behind it is to "convert" the patient - and we know the tragedy behind conversion. Attachment therapy may have similar roots but probably has more psychological flapdoodle behind it.

 

[David Baxter PhD]

Neuro Linguistic Programming: Mental health veterans therapy fear

Neuro Linguistic Programming: Mental health veterans therapy fear
BBC News
October 22, 2013

Week In Week Out's Tim Rogers spoke to soldiers who claimed to feel worse after treatment

Armed forces veterans struggling with mental health issues are being put at risk from a therapy used by a Welsh charity, a BBC investigation has found.

Healing the Wounds in Porthcawl has been asked to stop using Neuro Linguistic Programming (NLP), which tries to change people's patterns of mental and emotional behaviour.

It is not regulated or approved and can make patients worse.

The charity said it is gathering data to prove its treatment is effective.

But two veterans interviewed for the BBC's Week In Week Out programme claim it was the therapy they received at Healing the Wounds that made them feel suicidal. Both men, one of whom went undercover for the programme, said they felt worse after their treatment.

Dr Neil Kitchiner, head of the NHS All Wales Veterans Health and Wellbeing service, said he has not seen evidence of the treatment working. "None of them are cured as far as I've seen, after three days treatment," he said. "Some have been made very unwell as a result of going there and have needed a lot of support from NHS and veterans' charities. We have asked them to stop it. We have shown the evidence from the NHS and from the NICE (National Institute for Health and Care Excellence) guidelines, we've shared our concerns with them and yet they continue to operate in the way they do."

Healing The Wounds was set up by Bridgend couple Kevin and Carol Richards and has raised almost ?500,000 in the last three years. They insist it is offering a safe and effective alternative therapy for veterans.

'Feeling suicidal'
But on the programme some describe feeling even worse after a three-day residential course during which veterans are sent to a hotel overnight.

One veteran, who did not want to be identified, said the course of therapy left him feeling suicidal. "I did two full days and on the third I left and my wife came to collect me," he said. "When she came through the doors it was such a relief, I was left feeling worse than when I first went into Healing The Wounds."

The undercover veteran, who does not have post-traumatic stress disorder (PTSD) but described suffering some of the symptoms, was told by Carol Richards during therapy that it had taken her just 20 minutes to help one soldier who had seen many of his colleagues killed.

No attempt was made to contact the undercover veteran's GP to check his physical or mental health before therapy began.

Prof Neil Greenberg, co-director of the Academic Centre for Defence Mental Health at Kings College London, said: "If this group who are not medically qualified and don't know a person's whole treatment history, because they haven't got that, that could cause some real problems, it could be quite dangerous."

Healing the Wounds said it is collecting data to prove its treatment is effective, but Prof Greenberg says unless NLP is subjected to what are known as randomised clinical trials it cannot be established as an appropriate treatment for PTSD.

He added: "NLP has not been investigated by proper scientific trials to show it works. The key point is, just because someone feels good at end session, there is no guarantee they're going to feel good in the future. And given the fact we know psychological therapies have potential to harm we need to do those trails."

The programme also discovered that regulators have investigated the qualifications of a counsellor who had falsely been described as a clinical psychologist and a paramedic while helping vulnerable veterans for the charity. John Yandle from Blaenavon claims Healing The Wounds did not check his qualifications before he began counselling people with PTSD who had turned to it for help. The Health and Care Professions Council which polices the appropriate use of job titles including paramedic and clinical psychologist has ordered him not to use the titles in future. Mr Yandle, who does have counselling qualifications, denied deliberately misleading people and says the charity had mistakenly referred to him as a paramedic on its website.

Better regulation
Darren Millar, chair of the Welsh assembly's cross-party group on the Armed Forces, is calling for better regulation of charities offering mental health services to veterans.

He said: "Because there is no regulation anybody can set up as an NLP practitioner and the quality of their work is not monitored by anybody so that puts potential risks out in the field for anybody accessing those sorts of services."

"What we need is some proper arrangements for oversight of the quality of the work being done by any charity that is giving some support to veterans. What is important is to measure the outcomes when any organisation is offering this sort of service to see if it is making a real difference in the lives of the people who contact it."

The Charities Commission has confirmed it is investigating Healing the Wounds and its links to The Forces Aid Foundation - set up by Kevin Richards and wrongly described as a charity on its website. Mr Richards thanked the programme for pointing out the error and said it would amend its website.

The Welsh government said it has spent ?500,000 on the All Wales Veterans Health and Well Being Service. A spokesman added: "We are clear that where any body offers treatment for any condition, they should ensure that these are in line with evidence based guidelines. This is a stipulation for the NHS but an expectation for general good practice more broadly."