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The Case Against Psychotherapy
by Lawrence Stevens, J.D.
"What we need are more kindly friends
and fewer professionals."
- Jeffrey Masson, Ph.D.,
a psychoanalyst,
in his book Against Therapy
(Atheneum, 1988, p. XV)
The best person to talk with about your problems in life usually
is
a good friend. It has been said, "Therapists are expensive
friends." Likewise, friends are inexpensive "therapists".
Contrary to popular belief, and contrary to propaganda by mental
health professionals, the training of psychiatrists, psychologists,
and other mental health professionals does little or nothing to
make them better equipped as counselors or "therapists".
It might
seem logical for formal credentials like a Ph.D. in psychology
or
a psychiatrist's M.D. or D.O. degree or a social worker's M.S.W.
degree to suggest a certain amount of competence on his or her
part. The truth, however, is more often the opposite: In
general,
the less a person who is offering his or her services as a
counselor has in the way of formal credentials, the more likely
he
or she is to be a good counselor, since such a counselor has only
competence (not credentials) to stand on. Generally, the
best
person for you to talk with is a person who has worked himself
or
herself through the same problems you face in the nitty-gritty
of
life. You usually will benefit if you avoid the "professionals"
who claim their value comes from their years of academic study
or
professional training.
When I
asked a licensed social worker with a Master of
Social Work (M.S.W.) degree who shortly before had been employed
in
a psychiatric hospital whether she thought the psychiatrists she
worked with had any special insight into people or their problems
her answer was a resounding no. I asked the same
question of a
judge who had extensive experience with psychiatrists in his court-
room, and he gave me the same answer and made the point just as
emphatically. Similarly, I sought an opinion from a high
school
teacher who worked as a counselor helping young people overcome
addiction or habituation to pleasure drugs who both as a teacher
and as a drug counselor had considerable experience with psychia-
trists and people who consult them. I asked him if he felt
psychi-
atrists have more understanding of human nature or human problems
than himself or other people who are not mental health profes-
sionals. He thought a few moments and then replied, "No,
as a
matter of fact, I don't."
In his
book Against Therapy, a critique of psychotherapy
published in 1988, psychoanalyst Jeffrey Masson, Ph.D., speaks
of
what he calls "The myth of training" of psychotherapists.
He says:
"Therapists usually boast of their `expertise,' the `elaborate
training' they have undergone. When discussing competence,
one
often hears phrases like `he has been well trained,' or `he has
had
specialized training.' People are rather vague about the
nature of
psychotherapy training, and therapists rarely encourage their
patients to ask in any detail. They don't for a good reason:
often
their training is very modest. ... The most elaborate and
lengthy
training programs are the classic psychoanalytic ones, but this
is
not because of the amount of material that has to be covered.
I
spent eight years in my psychoanalytic training. In retrospect,
I
feel I could have learned the basic ideas in about eight hours
of
concentrated reading" (Atheneum/Macmillan Co., p. 248).
Sometimes
even psychiatrists and psychologists themselves
will admit they have no particular expertise. Some of these
admissions have come from people I have known as friends who
happened to be practicing psychologists. Illustrative are
the
remarks of one Ph.D. psychologist who told me how amazed members
of
his family were that people would pay him $50 an hour just to
discuss their problems with him. He admitted it really didn't
make
any sense, since they could do the same thing with lots of other
people for free. "Of course," he said, "I'm
still going to go to
my office tomorrow and collect $50 an hour for talking with
people." Due to inflation, today the cost is usually
higher than
$50 per hour.
In his
book The Reign of Error, published in 1984,
psychiatrist Lee Coleman, M.D., says "psychiatrists have
no valid
scientific tools or expertise" (Beacon Press, p. ix).
Garth
Wood, M.D., a British psychiatrist, included the
following statements in his book The Myth of Neurosis published
in
1986: "Popularly it is believed that psychiatrists have the
ability
to `see into our minds,' to understand the workings of the psyche,
and possibly even to predict our future behavior. In reality,
of
course, they possess no such skills. ... In truth there
are very
few illnesses in psychiatry, and even fewer successful treatments
... in the postulating of hypothetical psychological and biochem-
ical causative processes, psychiatrists have tended to lay a
smokescreen over the indubitable fact that in the real world it
is
not hard either to recognize or to treat the large majority of
psychiatric illnesses. It would take the intelligent layman
a long
weekend to learn how to do it" (Harper & Row, 1986, p.
28-30;
emphasis in original).
A cover
article in Time magazine in 1979 titled
"Psychiatry's Depression" made this observation: "Psychiatrists
themselves acknowledge that their profession often smacks of modern
alchemy - full of jargon, obfuscation and mystification, but
precious little real knowledge" ("Psychiatry on the
Couch", Time
magazine, April 2, 1979, p. 74).
I once
asked a social worker employed as a counselor for
troubled adolescents whose background included individual and
family counselling if she felt the training and education she
received as part of her M.S.W. degree made her more qualified
to do
her job than she would have been without it. She told me
a part of
her wanted to say yes, because after all, she had put a lot of
time
and effort into her education and training. She also mentioned
a
few minor benefits of having received the training. She
concluded,
however, "Most of the things I've done I think I could have
done
without the education."
Most mental
health professionals however have an
understandable emotional or mental block when it comes to admitting
they have devoted, actually wasted, several years of their lives
in
graduate or professional education and are no more able to
understand or help people than they were when they started. Many
know it and won't, or will only rarely, admit it to others. Some
cannot even admit it to themselves.
Hans J.
Eysenck, Ph.D., is a psychology professor at the
University of London. In the December 1988 issue of Psychology
Today magazine, the magazine's senior editor described Dr.
Eysenck
as "one of the world's best-known and most respected psychologists"
(p. 27). This highly regarded psychologist states this conclusion
about psychotherapy: "I have argued in the past and quoted
numerous
experiments in support of these arguments, that there is little
evidence for the practical efficacy of psychotherapy...the evidence
on which these views are based is quite strong and is growing
in
strength every year" ("Learning Theory and Behavior
Therapy", in
Behavior Therapy and the Neuroses, Pergamon Press, 1960,
p. 4).
Dr. Eysenck said that in 1960. In 1983 he said this: "The
effectiveness of psychotherapy has always been the specter at
the
wedding feast, where thousands of psychiatrists, psychoanalysts,
clinical psychologists, social workers, and others celebrate the
happy event and pay no heed to the need for evidence for the
premature crystallization of their spurious orthodoxies"
("The
Effectiveness of Psychotherapy: The Specter at the Feast",
The
Behavioral and Brain Sciences 6, p. 290).
In The
Emperor's New Clothes: The Naked Truth About the
New Psychology, (Crossway Books, 1985) William Kirk Kilpatrick,
a
professor of educational psychology at Boston College, argues
that
we have attributed expertise to psychologists that they do not
pos-
sess.
In 1983
three psychology professors at Wesleyan
University in Connecticut published an article in The Behavioral
and Brain Sciences, a professional journal, titled "An
analysis of
psychotherapy versus placebo studies". The abstract
of the article
ends with these words: "...there is no evidence that the
benefits
of psychotherapy are greater than those of placebo treatment"
(Leslie Prioleau, et al., Vol. 6, p. 275).
George
R. Bach, Ph.D., a psychologist, and coauthor
Ronald M. Deutsch, in their book Pairing, make this observation:
"There are not enough therapists to listen even to a tiny
fraction
of these couples, and, besides, the therapy is not too successful.
Popular impression to the contrary, when therapists, such as
marriage counselors, hold meetings, one primary topic almost
invariably is: why is their therapy effective in only a
minority of
cases?" (Peter H. Wyden, Inc., 1970, p. 9; emphasis in original).
In
his book What's Wrong With the Mental Health Movement,
K. Edward Renner, Ph.D., a professor in the Department of
Psychol-
ogy at the University of Illinois at Urbana, makes this observation
in his chapter titled "Psychotherapy": "When control
groups are
included, those patients recover to the same extent as those
patients receiving treatment. ...The enthusiastic belief
expressed
by therapists about their effectiveness, in spite of the negative
results, illustrates the problem of the therapist who must make
important human decisions many times each day. He is in
a very
awkward position unless he believes in what he is doing"
(Nelson-
Hall Publishers, 1975, pp. 138-139; emphasis in original).
An example
of this occurred at the psychiatric clinic at
the Kaiser Foundation Hospital in Oakland, California. Of
150
persons who sought psychotherapy, all were placed in psychotherapy
except for 23 who were placed on a waiting list. After six
months,
doctors checked on those placed on the waiting list to see how
much
better the people receiving psychotherapy were doing than those
receiving none. Instead, the authors of the study found
that "The
therapy patients did not improve significantly more than did the
waiting list controls" (Martin L. Gross, The Psychological
Society,
Random House, 1978, p. 18).
In the
second edition of his book Is Alcoholism
Hereditary?, published in 1988, Donald W. Goodwin, M.D., says
"There is hardly any scientific evidence that psychotherapy
for
alcoholism or any other condition helps anyone" (Ballantine
Books,
1988, p. 180).
British
psychiatrist Garth Wood, M.D., criticizes modern
day "psychotherapy" in his book The Myth of Neurosis
published in
1986 with these words: "These misguided myth-makers have
encouraged
us to believe that the infinite mysteries of the mind are as
amenable to their professed expertise as plumbing or an automobile
engine. This is rubbish. In fact these talk therapists,
practitioners of cosmetic psychiatry, have no relevant training
or
skills in the art of living life. It is remarkable that
they have
fooled us for so long. ... Cowed by their status as men
of
science, deferring to their academic titles, bewitched by the
initials after their names, we, the gullible, lap up their preten-
tious nonsense as if it were the gospel truth. We must learn
to
recognize them for what they are - possessors of no special
knowledge of the human psyche, who have, nonetheless, chosen to
earn their living from the dissemination of the myth that they
do
indeed know how the mind works" (pp. 2-3).
The superiority
of conversation with friends over
professional psychotherapy is illustrated in the remarks of a
woman
interviewed by Barbara Gordon in a book published in 1988: "For
Francesca, psychotherapy was a mixed blessing. `It helps,
but not
nearly as much as a few intense, good friends,' she said. `...I
pay a therapist to listen to me, and at the end of forty-five
minutes he says, `That's all the time we have; we'll continue
next
week.' A friend, on the other hand, you can call any hour
and say,
`I need to talk to you.' They're there, and they really
love you
and want to help." In an interview with another woman
on the same
page of the same book, Ms. Gordon was told this, referring to
pain
from losing a husband: "Good shrinks can probably deal with
it; the
two I went to didn't help" (Barbara Gordon, Jennifer Fever,
Harper
& Row, 1988, p. 132).
The June
1986 issue of Science 86 magazine included an
article by Bernie Zilbergeld, a psychologist, suggesting that
"we're hooked on therapy when talking to a friend might do
as
well." He cited a Vanderbilt University study that
compared
professional "psychotherapy" with discussing one's problems
with
interested but untrained persons: "Young men with garden
variety
neuroses were assigned to one of two groups of therapists. The
first consisted of the best professional psychotherapists in the
area, with an average 23 years of experience; the second group
was
made up of college professors with reputations of being good people
to talk to but with no training in psychotherapy. Therapists
and
professors saw their clients for no more than 25 hours. The
results: "Patients undergoing psychotherapy with college
professors
showed ... quantitatively as much improvement as patients treated
by experienced professional psychotherapists" (p. 48). Zilbergeld
pointed out that "the Vanderbilt study mentioned earlier
is far
from the only one debunking the claims of professional superiority"
(ibid, p. 50).
Martin
L. Gross, a member of the faculty of The New
School For Social Research and an Adjunct Assistant Professor
of
Social History at New York University, has argued that "the
concept
that a man who is trained in medicine or a Ph.D. in psychology
has
a special insight into human nature is false" (quoted in
"And ACLU
Chimes In: Psychiatric Treatment May Be Valueless", Behavior
Today,
June 12, 1978, p. 3).
Implicit
in the idea of "psychotherapy" is the belief
that "psychotherapists" have special skills and special
knowledge
that are not possessed by other people. In making this argument
against "psychotherapy", I am arguing only that conversation
with
psychotherapists is no better than conversation with other people.
In his defense of psychotherapy in a book published in 1986, psy-
chiatrist E. Fuller Torrey makes this argument: "Saying that
psychotherapy does not work is like saying that prostitution does
not work; those enjoying the benefits of these personal
transactions will continue doing so, regardless of what the experts
and researchers have to say" (Witchdoctors and Psychiatrists:
The
Common Roots of Psychotherapy and Its Future, Jason Aronson,
Inc.,
p. 198). If you really are desperate for someone to talk
to, then
"psychotherapy" may in fact be enjoyable. However,
if you have a
good network of friends or family who will talk to you confiden-
tially and with your best interests at heart, there is no need
for
"psychotherapy". Just as a happily married man
or a man with a
good sexually intimate relationship with a steady girlfriend is
unlikely to have reason to hire a prostitute, people with good
friendships with other people are unlikely to need "psychotherapy".
What
if you need information about how to solve a problem
your family and friends can't help you with? In that case
usually
the best person for you to talk to is someone who has lived through
or is living through the same problem you face. Sometimes
a good
way to find such people is attending meetings of a group organized
to deal with the kind of problem you have. Examples
(alphabetically) are Alcoholics Anonymous, Alzheimer's Support
groups, Agoraphobia Self-Help groups, Al-Anon (for relatives of
alcoholics), Amputee Support groups, Anorexia/Bulimia support
groups, The Aphasia Group, Arthritics Caring Together, Children
of
Alcoholics, Coping With Cancer, Debtors Anonymous, divorce
adjustment groups, father's rights associations (for divorced
men),
Gamblers Anonymous, herpes support and social groups such as HELP,
Mothers Without Custody, Nar-Anon (for relatives of narcotics
abusers), Narcotics Anonymous, Overeaters Anonymous, Parents Anony-
mous, Parents in Shared Custodies, Parents Without Partners,
Potsmokers Anonymous, Resolve, Inc., (a support group that deals
with the problems of infertility and miscarriage), Shopaholics
Ltd., singles groups, Smokers Anonymous, The Stuttering Support
Group, women's groups, and unwed mothers assistance organizations.
Local newspapers often have listings of meetings of such organi-
zations. Someone who is a comrade with problems similar
to yours
and who has accordingly spent much of his or her life trying to
find solutions for those problems is far more likely to know the
best way for you to deal with your situation than a "professional"
who supposedly is an expert at solving all kinds of problems for
all kinds of people. The myth of professional psychotherapy
training and skill is so widespread, however, that you may find
people you meet in self-help groups will recommend or refer you
to
a particular psychiatrist, psychologist, or social worker. If
you
hear this, remember what you read (above) in this pamphlet and
disregard these recommendations and referrals and get whatever
counselling you need from nonprofessional people in the group
who
have direct experience in their own lives with the kind of problem
that troubles you. You will probably get better advice and
-
importantly - you will avoid psychiatric stigma.
In their
book A New Guide To Rational Living, Albert
Ellis, Ph.D., a New York City psychologist, and Robert A. Harper,
Ph.D., say they follow "an educational rather than a psychodynamic
or a medical model of psychotherapy" (Wilshire Book Co.,
1975, p.
219). In his book Get Ready, Get Set...Prepare to Make
Psycho-
therapy A Successful Experience For You, psychotherapist and
psychology professor Harvey L. Saxton, Ph.D., writes: "What
is
psychotherapy? Psychotherapy is simply a matter of reeducation.
Reeducation implies letting go of the outmoded and learning the
new
and workable. Patients, in one sense, are like students;
they need
the capacity and willingness to engage in the process of relearn-
ing" (University Press of America, 1993, p. 1). In
their book When
Talk Is Not Cheap, Or How To Find the Right Therapist When You
Don't Know Where To Begin, psychotherapist Mandy Aftel, M.A.,
and
Professor Robin Lakoff, Ph.D., say "Therapy...is a form of
educa-
tion" (Warner Books, 1985, p. 29). Since so-called
psychotherapy
is a form of education, not therapy, you need not a doctor or
therapist but a person who is qualified to educate in the area
of
living in which you are having difficulty. The place to
look for
someone to talk to is where you are likely to find someone who
has
this knowledge. Someone whose claim to expertise is a "profes-
sional" psychotherapy training program rarely if ever is
the person
who can best advise you.
THE AUTHOR, Lawrence Stevens, is a lawyer whose practice has
included representing psychiatric "patients". His
pamphlets are
not copyrighted. You are invited to make copies for distribution
to
those who you think will benefit.