Unjustified Psychiatric Commitment In The
U.S.A.
by Lawrence Stevens, J.D.
The Case Against Psychotherapy
by Lawrence Stevens, J.D.
"What we need are more kindly friends
and fewer professionals."
- Jeffrey Masson, Ph.D.,
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 courtroom, 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 psychiatrists and people who consult them.
I asked him if he felt psychiatrists have more understanding of human nature
or human problems than himself or other people who are not mental health
professionals. 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 biochemical 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 possess.
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 Psychology 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 pretentious 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, psychiatrist 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 confidentially
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
Anonymous, 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 organizations. 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 Psychotherapy 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 relearning" (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 education" (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 "professional"
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.
Say
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