The Death of Psychotherapy: From Freud to Alien Abductions

244 Pages·2000·0.76 MB·English

by  Donald A. Eisner

THE DEATH OF
PSYCHOTHERAPY
THE DEATH OF
PSYCHOTHERAPY
From Freud to Alien Abductions
DONALD A. EISNER
Foreword by Tana Dineen
LibraryofCongressCataloging-in-PublicationData
Eisner,DonaldA.,1943–
Thedeathofpsychotherapy : fromFreudtoalienabductions /
DonaldA.Eisner ; forewordbyTanaDineen.
p. cm.
Includesbibliographicalreferencesandindex.
ISBN0–275–96413–2(alk.paper)
1. Psychotherapy—Evaluation. 2. Psychotherapy—Philosophy.
I. Title.
RC480.5.E365 2000
616.89'14—dc21 99–22138
BritishLibraryCataloguinginPublicationDataisavailable.
Copyright(cid:1)2000byDonaldA.Eisner
Allrightsreserved.Noportionofthisbookmaybe
reproduced,byanyprocessortechnique,without
theexpresswrittenconsentofthepublisher.
LibraryofCongressCatalogCardNumber:99–22138
ISBN:0–275–96413–2
Firstpublishedin2000
PraegerPublishers,88PostRoadWest,Westport,CT06881
AnimprintofGreenwoodPublishingGroup,Inc.
www.praeger.com
PrintedintheUnitedStatesofAmerica
TM
Thepaperusedinthisbookcomplieswiththe
PermanentPaperStandardissuedbytheNational
InformationStandardsOrganization(Z39.48–1984).
10 9 8 7 6 5 4 3 2 1
To Ardyne, Danielle, and Courtney
Contents
Foreword by Tana Dineen ix
Introduction xi
1. Science and Fiction in Psychotherapy 1
2. Psychoanalytic Psychotherapy 21
3. Cathartic Therapies: From Primal to est 45
4. Recovered Memory Therapy 67
5. Humanistic Psychotherapy 95
6. Behavioral and Cognitive Therapy 117
7. Strategic Family Systems Therapy and Neurolinguistic
Programming 143
8. Spiritual Therapy 163
9. From Buddha Psychotherapy to Alien Abductions 185
10. The Death of Psychotherapy: Conclusions 205
Selected Bibliography 227
Index 229
Foreword
A fundamental assumption, which has become almost a cornerstone of
American society, is that psychotherapy, however it is packaged and sold, is
somehow good for us. Recent statistics indicate that upwards of half of the
U.S. population, at some point in their lives, turn for help to a psychother-
apist.
As a business enterprise, psychotherapy appears to be thriving. People
have come to rely on it in their pursuit of comfort, good feelings, success,
andhappyoutcomes.Butisthereanyproofthatthesecustomersaregetting
what they pay for?
Severalyearsago,whenIwasfirststartingtovoicethisquestionoutloud,
I submitted a proposal to the American Psychological Association, suggest-
ing that a mock trialbeheldattheirannualmeeting.Thetitlefortheevent
was to be ‘‘Psychology on trial: Can the profession survive and should it?’’
I had assembled a panel of prominent lawyers, sociologists, and psycholo-
gists.Ouragendawasclear.Wewantedpsychotherapyexaminedandjudged
in the cold light of scientific evidence. Not surprisingly, the proposal was
turned down: the ‘‘powers that be’’ were not willing to bring this issue
under public scrutiny.
These same ‘‘powers that be’’ will not take kindly to Don Eisner’s book
for, in many ways, he has done what we had hoped to do, and he has done
itwell.Meldinghisextensiveknowledgeofpsychotherapy,gleanedfromhis
education and experience as a psychologist, with his training and skill as a
lawyer, he has put psychotherapy on trial.
In The Death of Psychotherapy he has carefully and meticulously presented
the evidence. Chapter by chapter, he looks at the popular varieties of psy-
chotherapy and shows that, despite the claims and supportive studies, they
x Foreword
all lack the essential proofofeffectiveness.Hedoesn’tdenythatsome,even
many, people feel better after talking to a therapist. But he does challenge
that this is due to anything special or specific to any of the treatments.
For centuries, placebos or sugar pills have made people with physical
problems feel better. Early in this century, Emil Coue´ gained fame by en-
couragingpeopletotellthemselvesthat‘‘everydayineveryway,I’mfeeling
better and better.’’ As Don Eisner suggests, without proof of an active in-
gredient,psychotherapyshouldberecognizedasnothingmorethanasugar
pill or an expensive Coue´ism.
He makes a good case for concluding that there is no active ingredient.
While I expect that the organizations which promote psychotherapy will
make every effort to ignore or dismiss the evidence, people deserve to be
given the facts. At the very least, consumers should have the opportunity to
weigh the information for themselves.
Consumer protection is a familiar term. Before important shopping trips,
we tend to seek out information about how products have been tested and
to find out whether or not there is any support for the claims made by
advertisers.
Recently one of the most trusted sources of such information, Consumer
Reports, addressed the topic of psychotherapy. In a survey of thousands of
its readers it asked, ‘‘does therapy work?’’ One would have assumed that,
given their approach to toasters and cars, they would have examined each
type or model, describing their strengths and weaknesses. Not so! They
lumped them all together and concluded that therapy helps simply because
thepeoplewhochosetofilloutaquestionnaireclaimedthattheyfeltbetter.
TheDeathofPsychotherapydoeswhatConsumerReportsmighthavedone.
It looks at the different therapies offered to consumers and tells them what
they need to know. Before spending their money on any type of psycho-
therapy,peoplewouldbewelladvisedtoexaminetheevidenceofferedhere.
Tana Dineen
Author of Manufacturing Victims:
What the Psychology Industry Is Doing to People
Introduction
I entered the field of psychology in 1970. In the 1980s, I began law school
and became a practicing attorney in 1988. This book emerged from the
confluence of the two disciplines. My specialization in law was psychother-
apy malpractice. What I began to notice as I took the depositions of both
the defendants and the plaintiffs’ treating therapists was the inexactness of
the therapy that was provided. Many therapists testified that their approach
was eclectic.
Thus, a major impetus for this book originated with the observation that
many therapists did not adhere to a specific type of therapy but seemed to
proceed on an ad hoc basis with the justification that adjustments or mod-
ifications were made in order to better treat the patient.
A second significant inspiration was Masson’s Against Therapy. His dia-
tribe against psychotherapy is cited in the text that follows. What I derived
from Masson’s book was that therapists do not practice what they preach.
At that point, I began a preliminary survey to assess whether there wereany
empirical and well-validated studies that supported the efficacy of psycho-
therapy. What emerged is an evaluation of many of the popular present-day
therapies.
Thanks are due to: a former client, who permitted me to quote a part of
her journal; Matt Maibaum, Ph.D., for his comments on an earlier draft of
portionsofthisbook;FrederickCrews,Ph.D.,whomadeincisivecomments
on chapters involving psychoanalysis and recovered memory therapy; Susan
Kennedy,fortypingandeditingthefirstdraftofthemanuscript;JohnDon-
ohue, project editor, and Betty Pessagno, copy editor, who made the book
readable; and Nita Romer, acquisitions editor at Greenwood Publishing
Group, for her support of the project.
Chapter 1
Science and Fiction
in Psychotherapy
Since virtually the beginning of human existence, individuals have been suf-
fering from emotional problems and difficulties with everyday living. It has
only been in the last several hundred years or so, however, that formal at-
tempts have been made to deal with emotional problems. A type of treat-
ment that has evolved over the last 100 years is called psychotherapy.
Psychotherapyisatechniqueinwhichoneperson(thepsychotherapist)gen-
erally engages in a verbal interaction with another person (the patient).
Interestingly, psychotherapy cannot be precisely defined. In California,
psychotherapy is defined as ‘‘the use of psychological methods in a profes-
sional relationship to assist a person or persons to acquire greater human
effectiveness or to modify feelings, cognitions, attitudes and behavior which
are emotionally or socially ineffective or maladjustive.’’1 A similar definition
relates to the amelioration of distress in cognitive, affective and behavioral
functioning.2
Whatexactlyarethepsychologicalmethodsorprinciplesthatproducethe
improvement in human effectiveness? Corsini and Wedding assert that the
therapist should have ‘‘some theory of personality origins, development,
maintenance and change along with some method of treatment logically
related to the theory.’’3 The California Business and Professions Code (sec-
tion 2903) states that the procedure producing improvement in cognitive,
affectiveandbehavioralfunctioning‘‘involvesunderstanding,predictingand
influencing behavior.’’
As is obvious, the procedures, techniques or theories as to how psycho-
therapy is performed are never defined. Not too surprisingly, different ther-
apists may not agree as to what is considered psychotherapy.4 Apparently,
psychotherapy is something psychotherapists do. Corsini and Wedding es-
2 The Death of Psychotherapy
timate that as of 1994, there were over 400 different systems of psycho-
therapy.5 There is no line of demarcation or guidepost distinguishing
mainstream psychotherapy from ‘‘fringe’’ psychotherapy, let alone outright
quackery.
Neither the California Business and Professions Code nor the definition
in Corsini and Wedding indicates whether a particular technique needs to
be scientifically verified.6 Thus, there is no requirement that psychotherapy
needs to meet any minimal standard of scientific scrutiny or verifiability. If
a method or principle is psychological in nature and is performed by a psy-
chotherapist, then the procedure qualifies as psychotherapy. Under this
vague and amorphously contoured definition, the following is considered
psychotherapy, for example: In psychoanalysis, metaphorical unconscious
mental contents are examined. It is theorized that neurotic symptoms may
be due to ‘‘undischarged emotional tension connected with the repressed
memory of a traumatic childhood sexual experience.’’7
Cognitive Behavior Therapy, on the other hand, evaluates how a person
thinks and attempts to reduce maladaptive self-views by problem-solving
strategies and reality testing.8 Listed as separate psychotherapeutic tech-
niques are meditation and Yoga. Meditation focuses on training attention
in order to bring one’s mental processes under greater voluntary control.9
Yoga refers to an area that includes ‘‘ethics, lifestyle, body posture, breath
control and intellectual study.’’10
Similarly, informing a client that he or she was abducted by aliens or
fomenting this belief as causally related to current mental functioning is
within the ambit of psychotherapy. Even astrologically oriented psycho-
therapy would seem to qualify under this rubric if performed by a psycho-
therapist. In contrast to exploring unconscious determinants, a
psychoastrological analysis uses a fixed point in time to describe and explain
human behavior.
In The Myth of Psychotherapy, Szasz argues that psychotherapy is not a
medical treatment. He reasons that psychotherapy is simply a rhetorical ap-
proach wherein one person engages in conversation with a second person.
‘‘Virtuallyanythinganyonemightdointhecompanyofanotherpersonmay
now be defined as psychotherapeutic.’’11 What is needed in order to qualify
as psychotherapy are proper credentials and a gullible audience. In a some-
what more therapist-friendly view, Frank states that therapeutic techniques
and concepts are ‘‘primarily rhetorical devices to persuade or convince the
patients of the therapist’s healing power’’12 and that the efficacy of ‘‘most
psychotherapeutic methods depends...on how successfully the therapist is
able to make the methods fit the patient’s expectations.’’13
The question remains: Where is the factual basis for psychotherapy? If
thereisnoscientificbasisunderlyingpsychotherapy,thenSzaszisessentially
correct. Namely, the so-called therapist and the so-called patient are merely
indulging in a mutual exchange of myths in which the psychotherapist at-