The Loose Screw Awards
Projective tests, recovered memories, correctional boot camps --
psychology's top 10 misguided ideas.
By: Robert Epstein
The mental health fields have, now and then, spawned and nurtured some
completely crazy ideas. Physicians in the 18th and 19th centuries, for
example, inflicted strange and extremely cruel treatments on their mentally
ill patients based on equally bizarre theories of human nature. To try to
shock schizophrenics into "regaining consciousness of the true self," for
example, doctors bled them until they fainted, or blindfolded them and
allowed them to fall through a trapdoor into cold water -- the so-called
"Bath of Surprise." It's unlikely that such techniques had any therapeutic
value.
Our own era has also produced theories and techniques of dubious worth. In
the 1990s, for example, practitioners by the thousands began "facilitating
communication" with nonverbal children by strategically guiding their
clients' hands over keyboards. Some of these children appeared to claim that
they had been sexually abused, and one even wrote a novel this way. A
barrage of research soon demonstrated that the technique was nonsense; all
of the ideas came from the facilitators, not the children. Unfortunately, no
matter how persuasive the evidence, people often cling to bad ideas,
including facilitated communication.
Here are 10 faulty concepts from the mental health professions that have yet
to disappear. Sometimes their effects have been benign; other times, put
into practice, such ideas have harmed many people.
1. The Jackson Pollock Prize for Ambiguity
Projective Tests
In the 1930s behaviorist B.F. Skinner -- known mainly for his work with rats
and pigeons -- invented the verbal summator, a device that undoubtedly made
some psychoanalysts salivate. A 78-rpm record played ambiguous, muffled
phrases, and listeners interpreted the sounds. If you heard a strange
hissing sound like mzher bsss, mzher bsss, mzher bsss, what words would
occur to you? Mother's breast? My abyss? Wide-mouth bass? Psychoanalysts
believed that responses on a projective test of this sort -- that is, a test
that forces people to interpret ambiguous cues -- could give insights into a
patient's unconscious mind. After all, someone who answered "my abyss" would
presumably have far different things on his or her mind than someone who
said "wide-mouth bass."
Skinner's test never caught on, but others are legendary. The most famous is
the series of symmetrical inkblots developed early in the 1900s by Swiss
psychiatrist Hermann Rorschach to assess personality characteristics. Even
the old word-association test, in which the therapist asks for quick
reactions to common words, can be considered a kind of projective test.
Early evaluations of such tests praised them as "foolproof X-rays" of
personality, but eventually it became clear that responses on projective
tests varied considerably with the situation, the instructions and the
scorer. If different lab technicians produced dramatically different X-rays,
we'd abandon that test, but projective tests are still widely used by
therapists -- even in life-changing situations like child-custody disputes.
A recent review of research on projective tests suggests that they rarely
reveal information that can't be obtained in other, more practical ways --
like asking the client!
2. The Idea That Launched a Thousand Suits
Recovered Memories
While under treatment for depression in the mid-1980s, Patricia Burgus made
a horrible discovery. Her psychiatrist, employing both hypnosis and
medication, helped Burgus remember that she had been a victim of horrendous
abuse as a child -- torture, cannibalism, even participation in ritual
murders. She also learned that she had more than 300 alternate
personalities. Burgus was hospitalized for more than two years, often in
leather restraints.
Eventually she began to doubt the validity of her many "recovered" memories.
She sued her therapist, his associate and the hospital where they practiced
and ultimately won a settlement of $10.6 million.
Burgus was one of many swept up in the "recovered memory" craze of the
1980s. Zealous therapists encouraged clients to recall repressed memories of
childhood abuse, leading to more than 800 lawsuits against alleged abusers
between 1985 and 2000. Many of these resulted in incarcerations. A few led
to suicides.
In most cases there was no corroborating evidence, and many accusers later
recanted. But if the memories were inaccurate, where did they come from, and
why did patients accept them as real?
Laboratory research by Elizabeth Loftus of the University of California,
Irvine, provides a clear answer. Her studies of eyewitness testimony
demonstrate that memory is remarkably susceptible to suggestion. Ask
subjects who have just seen photos of a crime scene to describe the stop
sign in the image, and many will "remember" the stop sign -- even though it
was never there.
In other words, the source of many of the recovered memories was the
therapist. Leading questions, especially when combined with drugs, hypnosis
and suggestive dream interpretation, can easily produce false memories that
seem quite real to patients.
In recent years, dozens of recovered-memory "survivors" have won settlements
or judgments against their former therapists, but according to the director
of the False Memory Syndrome Foundation, recovered-memory therapy is still
being practiced.
3. Meanest
Correctional Boot Camps
In the late 1970s, government leaders were desperately seeking remedies for
the nation's soaring crime rate. One solution, inspired in part by the tough
love message coming from mental health professionals, was to establish
military-style boot camps where harsh discipline and strict regimens would
set people straight. The first adult camps were established in 1983, and by
the end of the decade, at least 15 states had opened or were developing
similar camps for either adults or juveniles.
Although initial reports were encouraging, by the mid-1990s troubling
stories began to appear about abuse and sadism at the camps. In 1998 five
staff members at a boot camp in Arizona -- including the camp nurse -- were
indicted in connection with the death of a 16-year-old inmate. At the time
of his death, his body was covered with cuts and bruises -- 71 in all. The
camp was eventually shut down, and 16 of its staff members were added to the
state's registry of child abusers.
The biggest problem with boot camps, however, is that they just don't do the
job. Recidivism of 60 percent or more is common -- as high as, or higher
than, recidivism rates generated through more benign programs. Experts on
learning have long known that harsh discipline mainly teaches people to be
harsh themselves -- and to hate their abusers -- but that message is getting
through only belatedly to the boot camp advocates. As the head of a National
Institutes of Health panel that studied "get tough" programs nationwide
summed it up a few months ago: "All the evaluations have shown [the
programs] don't work."
4. Most Over-Rated
The Cult of Self-Esteem
Humorist Garrison Keillor is famous for his stories about the fictitious
Lake Wobegon, "where all the women are strong, all the men are good looking
and all the children are above average." Statistically speaking, however,
all children can't be above average -- unless, that is, they're raised in
self-esteem-obsessed America.
Feeling good -- as opposed to behaving well -- came into vogue in the 1960s,
driven in part by books like Nathaniel Brandon's Psychology of Self-Esteem.
By the 1980s, many schools were spending upwards of three hours a week on
counseling and self-esteem classes, and at some schools all students were
made "Student of the Month." Curriculum programs such as educational
psychologist Michele Borba's Esteem Builders stimulated the development of
more than a thousand off-the-shelf exercises like "I Love Me," in which
students complete sentences like "I am" with words such as "gifted" or
"beautiful" and then memorize the sentences.
But hundreds of studies have failed to show that self-esteem training
produces lasting positive results. To put this another way, merely feeling
good about yourself doesn't necessarily make you more effective. What's
more, recent studies suggest that self-esteem training may be harmful --
that it leads many students to overestimate their abilities, for example.
One study even shows that people with high self-esteem are more likely to be
violent or racist.
5. Most Likely to Make Good People Feel Bad
Codependency, Enabling and Tough Love
Love and support are generally seen as good things, but in the 1980s, some
substance-abuse writers and counselors claimed that the family members of
alcoholics "enabled" alcoholism by being too loving. "Tough love," they
insisted, was the only solution. What's more, they said, "co- dependent"
enablers were themselves almost certainly victims of sexual abuse when they
were children. The abuse lowered their self-esteem, which made them more
likely to love and support someone unworthy of their attention. Some also
insisted that all adult problems were the result of child abuse, and
co-dependency was sometimes defined so broadly that almost any act of love
or self-sacrifice could fit the definition. Best sellers like Melody
Beattie's Codependent No More and Robin Norwood's Women Who Love Too Much
thrust these ideas into the public consciousness, where they remain to this
day.
Considerable evidence suggests that the codependency idea is dead wrong. In
a comprehensive analysis of alcoholism treatment published in 1990, for
example, Stanford University psychiatrist Rudolf Moos and his colleagues
came to the obvious conclusion that family support helps ex-alcoholics stay
sober. Abandoning a substance abuser in the name of "tough love" can
sometimes provoke a relapse, and it's certainly hard on family
relationships.
As for the child-abuse idea, it too contradicts the evidence. Not everyone
who suffers from emotional or behavioral problems as an adult was abused as
a child, and not everyone who is abused as a child necessarily develops
psychological problems in adulthood.
6. The P.T. Barnum Medal for Mass-Market Potential
Mozart Babies
All parents want the best for their children, which is presumably why
millions of moms and dads have played Mozart for their babies over the past
decade -- especially the Sonata for Two Pianos in D Major. In 1993,
researchers Frances Rauscher and Gordon Shaw announced that playing this
piece for college students temporarily increased their "spatial reasoning
ability." To be precise, some of the students were better able to make
judgments about how pieces of paper would look after they were folded and
cut in certain ways. The researchers suggested that the music of Mozart (but
not of other composers) had a positive impact on the brain.
From this modest study a large industry has grown, driven in large part by
musicologist Don Campbell, who trademarked the phrase "the Mozart Effect"
and published a best-selling book about the idea in 1997.
Although there is evidence that intensive training in music may produce some
general cognitive benefits, there is virtually no evidence that merely
listening to music -- even to Mozart -- produces any significant or lasting
effects. Even the original Rauscher and Shaw study has proved suspect;
attempts to replicate it -- including a careful 1999 study -- have failed.
Meanwhile, hospitals around the country give out Mozart CDs to new parents,
and the governors of Tennessee and Georgia have made this practice mandatory
in their states.
7. Most Bureaucratic
Stages of Dying
Elisabeth Kübler-Ross has some very specific ideas about death. I saw her
lecture just once. It was an unforgettable experience, in part because she
chain-smoked during the entire two-hour talk -- on life after death, no
less. Kübler-Ross, who died in 2004, is best known for her theory that
terminally ill people go through five distinct stages of dying: denial,
anger, bargaining, depression and acceptance, introduced in her 1969 book On
Death and Dying.
Her theory does sound good: First we tell ourselves that we're not really
going to die, then we get angry, and so on, until we finally accept the
inevitable. Her theory spread widely, and caregivers were soon pushing dying
patients along this pathway, inferring from Kübler-Ross's book that any
deviation from her five-step path was detrimental to the patient.
The problem is that Kübler-Ross based her stages on interviews with
terminally ill people. The universality of her model was never actually
tested.
As early as 1980, hospice chaplain George Fitchett published an article
insisting that dying patients actually decline in their own unique ways.
More recently, Michele Chaban of Toronto's Mount Sinai Hospital has claimed
that many of the patients Kübler-Ross interviewed didn't even know they were
dying, which could explain why these very sick people were angry or in
denial: They were being lied to about their ailments by hospital staff,
including Kübler-Ross herself.
8. Most Twisted
Rebirthing Therapy
Ten-year-old Candace Newmaker suffered, we're told, from "reactive
attachment disorder" -- an inability to form close personal attachments. In
April 2000, her adoptive mother brought her to a professional "rebirther,"
who promised to help Candace by staging her rebirth. The technique was
spawned in the 1960s by New Age guru Leonard Orr, author of the recent book
Breaking the Death Habit. More than 100,000 people have been trained in
Orr's technique, which mainly involves breathing in ways that supposedly
allow people to return to the moment of their birth.
The rebirthers handling Candace used a creative adaptation of Orr's highly
questionable methodology: Four adults pressed on Candace while she was
surrounded by pillows and wrapped in a blanket -- a makeshift womb. The idea
was for the girl to emerge through the simulated birth canal into her new
life with her adoptive family. Instead, she suffocated, and her adoptive
mother and the four rebirthers were charged with her murder.
While rebirthing is not even on the fringes of legitimate therapy, sometimes
legitimate therapists, like licensed counselor Kim Waters-Rose of Atlanta,
adopt such techniques to add to their therapeutic tool kit. By using
rebirthing, "therapy goes a lot faster" for some clients looking for
"personal growth," Waters-Rose says. She also offers "group rebirthings."
In 2002, the American Psychiatric Association said the technique "is not
therapeutic and can even be fatal." But as long as therapists use it, and so
long as clients don't object, rebirthing is unlikely to disappear.
9. The Breakfast Club Award
Adolescent Angst
With so many bad ideas around, it's certain that some of psychology's worst
have yet to be exposed. Adolescent angst is a good example. The idea that
adolescence is necessarily a time of emotional turmoil was introduced by
pioneering psychologist G. Stanley Hall in 1904 and has been widely accepted
ever since. It still provides a rationale for America's massive and deeply
troubled juvenile justice system, which handles more than 1.5 million teens
a year, and it is also at the heart of a wide range of therapeutic
treatments for teens.
But Hall based his concept of adolescence on a faulty theory from biology --
"recapitulation theory," according to which each individual creature, as it
develops, relives the evolutionary stages of its species. Hall conjectured
that teens were reliving a time of "savagery" in our distant past -- "an
ancient period of storm and stress." By the 1930s, recapitulation theory had
been completely discredited, but this had no effect on Hall's theory, which
had by this time taken on its own life.
Teen turmoil, it turns out, is far from inevitable. In a recent review of
186 contemporary preindustrial societies, researchers found that more than
half had no sign of it. Yet the idea that teen angst is unavoidable is
pervasive in our culture.
Hall's theory has probably set a vicious cycle in motion: Society responds
to teen problems (drinking, drug use, pregnancy and so on) with restrictive
laws and treatments, which in turn cause more teens to act out and rebel.
The tumultuous stage of life we call "adolescence" is, without doubt, a
creation of modern culture, not an inevitable stage of human development,
and our own culture has produced far more of it than has any other culture
in the world -- in part, perhaps, because of a faulty idea from psychology.
10. The Sound and the Fury Award
Catharsis
The idea behind catharsis is that current psychological pain is the result
of pent-up energy left over from unresolved trauma. Like a fluid trapped
under high pressure, energy is vented when someone relives an old experience
while expressing intense emotion. In the 1960s, when extreme self-expression
was all the rage, therapies in which people screamed (primal-scream therapy)
or were goaded into states of near-panic (implosive therapy) became
mainstream. Most people still believe that anger is some sort of force that
can be "bottled up," and that it's healthy to "vent" or "let go."
But in the 1970s and '80s, prominent psychologists like Elliot Aronson
suggested that expressing your pent-up anger could make you even more angry,
and recent studies by Iowa State University's Brad Bushman and others seem
to bolster this viewpoint.
The catharsis idea is highly suspect, but the case against it is not
airtight. No one is entirely sure just when venting frustration or rage is
helpful and when it's not, but for some clients, expressing anger during
therapy can help them learn about and control their negative emotions.
Similarly, some studies show that expressing anger through athletic
activities helps people stay calm.
This is just the short list, of course. The mental-health fields have
generated a dizzying number of bad ideas, many of which still affect us.
Even when an idea is discredited, it's rarely abandoned; it just moves to
the fringes of the field, where needy people are only too happy to adopt it.
And that's the heart of the problem: We want solutions now, and we'll take
what we can get. When therapists or behavioral scientists offer us even the
most preliminary ideas for improving our lives, we grab them and hope for
the best. PT
source:
psychologytoday.com/articles/index.php?term=pto-20050119-000004&print
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