Discussion in 'Other Health News and Research' started by Esther12, Sep 21, 2013.
I think these 4 are especially relevant to CBT/GET practitioners:
IMO, so much of what we deal with living with this curse of a disease is Kafkaesque; somewhat like the quote in your signature, @Valentijn. It also applies to what is sometimes unintentionally harmful psychotherapy, @disequilibrium1. A fellow ME patient, Samuel Wales, has a good blog titled The Kafka Pandemic.
This is from a 1991 New York Times article --
The Essence of 'Kafkaesque'
By IVANA EDWARDS
"I had to be very familiar with the psychological and psychoanalytic doctrines so that I could apply them. Kafka without a psychological approach is not Kafka."
Wikipedia has a good page on Franz Kafka. Reportedly he had a dry sense of humor. --
@Roy S I enjoyed the Sunday Times article which started me thinking. I'm amused that someone has to do a categorical exploration of why psych practitioners resist scientific research. I would be far more colloquial and less kind why therapists resist scientific evidence. (A couple of statistics-fluent correspondents on my blog have raised issues about the validity evidence studies in general.)
My other mental tangent is around the discussion on this board vs. the reaction my blog received on psych patient discussion boards. The psych clients largely were provoked, furious and seemingly destabilized at the mere suggestion that therapy doesn't work for everyone. They didn't want information; they wanted reinforcement of their faith. Psych treatment is the only mainstream practice I know where evidence gathering follows application.
This is especially apparent in their support of CBT/GET for ME/CFS. The one constant is that they will insist that CBT/GET is the cure. Then they work backwards to create a rationale to support their conclusion. As their rationale is repeatedly disproven, they will replace it with a new one, never questioning whether it's their pre-determined conclusion which is faulty.
As such, they can't decide if we're deconditioned, or psychosomatic, or too passive, or too active, or too pampered, or have unrealistic expectations of what we should be able to do, etc, etc. They end up cycling through the options as each is disproven, but cling to their ultimate faith that CBT/GET are the key to recovery, even when that belief is directly disproven (FINE, PACE, Wiborg, etc).
"A solution looking for a problem" as they say.
The solution is to make the patient repent their (alleged) sins.
Is psychology some sort of atheistic religion?
Also pertinent are the parallels between psychiatry and inquisition. Isn't the case of Justina Pellettier really a battle of faith?
In my area there is a surprising level of the combining of Christianity and psychotherapy. It seems to be increasing. The latest thing I've seen is an area wide group practice adding a subspecialty of psychotherapy for ministers.
Some people really like being able to have faith in a special group who have power over them. To some extent, psychiatry might be innately biased towards their interests, as it does seem that it's very hard to do psychological research in a way which avoids selection bias towards those who are instinctively deferential towards authority, or respectful of the expertise of psychiatrists. A lot of people see the whole think as a bit of a joke, and are thus less likely to cooperate with research.
Writings from avid psych clients convey a worshipful obedience to their therapist/priests/parent figure, and a submission to the duty of therapy, as if it were some penance or purification that anoints them into a selective inner circle of evolved species. Defectors, more like heretics, are viewed as lacking the trust to submit to these priests and the bravery to excavate their wounds and woes.
Yeah - I don't want to ignore the possibility that some therapists are just really good, wise and insightful, but there does seem to be a bit of a weird power/worship thing for some people. Also, I think that some people are really troubled by the complexities of life, and like the idea of a socially respected figure whose guidance is to be followed: "I should not be criticised for doing this, because it is what my therapist said I should do". I think that similar things can happen with doctors (and any other authority figure: teachers, priests, bosses, Milgram?). When the moral demands of personal responsibility are so contested and uncertain in society, that sort of submission can be really appealing.
This is probably verging on the sort of bold psychosocial speculations that we should be wary of... but fortunately, we're not in positions of authority over others, so can get away with it!
Just read up on the Justina Pellettier case. Yikes. Bad enough the mental health industry reduces some worried well to rock groupies, disciples and dependent children. Their unfounded notion they can psych away illness, the somatoform diagnosis, is an entirely different level of mayhem and damage. And unlike medical doctors, psychiatrists can pull conclusions out of their hats. (I'm being polite; substitute human anatomy metaphor if you'd like.)
The mito condition is rare, but research and treatment are conducted by the venerable Muscular Dystrophy Association. There are tests. No brainer. Think I get it now. I can extrapolate how the psych industry can arrogate control when diagnosis/treatment are difficult.
*I did some of this to myself. Convinced my fatigue must be emotional, I postponed real thyroid treatment for years.
There are some surprising improvements in therapy outcomes stated in this article I found through reading disequilibrium1's blog -- like twice the effectiveness % and half the deterioration %.
Feedback Improved Therapy
The evidence is now compelling that feedback improves therapy. This new approach is called Feedback Improved Therapy, FIT (elsewhere, it is called CDOI). It is simple to incorporate into a psychotherapist’s work with clients. In each session, client’s complete very brief (1-minute) forms assessing psychological distress and therapeutic alliance, and the results are analyzed by computer. The computer generates graphs to indicate if clients are progressing as expected, or if therapy needs to be adjusted. This session by session feedback markedly improves the quality of therapy for clients.
more heresy --
client directed outcome informed (CDOI) therapy
the CDOI approach utilizes two brief, distinct scales, one given at the start and the other given just before the close of each session which take a total of two or three minutes
There are several papers in the reference section
Gaslighting, the Double Whammy, Interrogation and Other Methods of Covert Control in Psychotherapy and Analysis
In treatment, the psychotherapist is in a position of power. Often, this power is unintentionally abused. While trying to embody a compassionate concern for patients, therapists use accepted techniques that can inadvertently lead to control, indoctrination, and therapeutic failure. Contrary to the stated tradition and values of psychotherapy, they subtly coerce patients rather than respect and genuinely help them.
Cliff Notes, anyone?
Psychobabble: Exploding the myths of the self-help generation
published December 2012
from the cover --
Exposing the self-help myths that make us all more miserable. This is what your psychologist would really tell you-if he thought you could handle it! This is the kick up the backside the self-help genre needs: an intelligent, provocative and thought-provoking expose of the modern myths that we're told make us happier, but in reality screw us up. Clinical psychologist, Dr Stephen Briers shines a light into the dark corners of self-help and explodes the myths, false hopes, quack philosophies and unrealistic expectations it routinely advocates. It is a refreshing antidote to the 'same old same old' approaches, offering a radical re-think of the way we approach problems in our lives, offering empowering new perspectives and expert advice on avoiding the biggest life traps. Dr Briers questions the perceived wisdom, shakes up the status quo, and encourages us to think again.
I wonder if the author acknowledges how much of this psychobabble is in the practice of psychotherapy.
by Jeffrey Masson
From the Back Cover
In this ground-breaking and highly controversial book, Jeffrey Masson attacks the very foundations of modern psychotherapy from Freud to Jung, Fritz Perls to Carl Rogers. With passion and clarity, 'Against Therapy' addresses the profession's core weaknesses, contending that, since therapy's aim is to change people, and this is achieved according to therapists' own notions and prejudices, the psychological process is necessarily corrupt. With a foreword by the eminent British psychologist Dorothy Rowe, this cogent and convincing book has shattering implications for the world of psychotherapy today.
"A dynamic attack on one of the century's great creeds"
"A brilliant and courageous expose of the damage that unavoidably occurs in the name of 'psychotherapy'…essential reading"
MIKE LAWSON, Vice-Chairman, 'Mind'
"Clear and demystifying…we have much to thank Masson for"
NIGELLA LAWSON, 'Guardian'
"'Against Therapy' is a humane, insightful, and amazingly gentle argument. Masson's commitment to human dignity suffuses every part of his thesis"
"A guru against gurus"
D M THOMAS, 'Observer'
This is part of one of the comments by Jana Sherber: "Masson admits in an interview that if he dismisses the experience of those who have found therapy beneficial, he is being as authoritarian and dismissive as the practitioners he attacks."
Crazy like Us: The Globalization of the American Psyche
by Ethan Watters
From Publishers Weekly
If you thought McDonald's and strip malls were the ugliest of America's cultural exports, think again. Western ideas about mental illness-from anorexia to post-traumatic stress disorder, schizophrenia, general anxiety and clinical depression-as well as Western treatments have been sweeping the globe with alarming speed, argues journalist Watters (Urban Tribes), and are doing far more damage than Big Macs and the Gap. In this well-traveled, deeply reported book, Watters takes readers from Hong Kong to Zanzibar, to Tsunami ravaged Sri Lanka, to illustrate how distinctly American psychological disorders have played in far-off locales, and how Western treatments, from experimental, unproven drugs to talk therapy, have clashed with local customs, understandings and religions. While the book emphasizes anthropological findings at the occasional expense of medical context, and at times skitters into a broad indictment of drug companies and Western science, Watters builds a powerful case. He argues convincingly that cultural differences belie any sort of western template for diagnosing and treating mental illness, and that the rapid spread of American culture threatens our very understanding of the human mind: "We should worry about the loss of diversity in the world's differing conceptions of treatments for mental illness in the same way we worry about the loss of biodiversity in nature."
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
During the last quarter-century, America’s cultural influence on foreign countries has become all too visible, with a McDonald’s opening on Tiananmen Square and remote African tribes sporting jeans and T-shirts. Perhaps less obvious, but no less worrisome, is the American exportation of mental illness documented in this unsettling expose by the coauthor of the recovered-memory critique, Making Monsters (1996). Watters emphasizes that different cultures have long had their idiosyncratic ways of handling stress that don’t necessarily conform to descriptions provided by the American Psychological Association (APA). Yet, because the APA’s treatment guidelines are increasingly being subscribed to and Western medicine’s recommended drugs prescribed by other countries’ health-care workers, such illnesses as anorexia and post-traumatic stress disorder (PTSD) are appearing in cultures previously unfamiliar with them. In making his case, Watters provides four carefully dissected case studies, those of anorexia in Hong Kong, PTSD in Sri Lanka, schizophrenia in Zanzibar, and depression in Japan. Ultimately, Watters argues, the loss of cultural diversity consequent upon this peculiar form of Americanization will be keenly felt. --Carl Hays
I don't think psychology is religion, nor even psychiatry. However I think, as did Richard Webster, that Freudian psychology was close to a religion, and so are its descendants in the psychosomatic movement.
PS. But then there is this.
"It would be easy to go on. In every case, the intention was benevolent – cure people, prevent dysfunction, control illness, or secure a better seat in heaven. The means were promoted by well-intentioned people who genuinely believed that they were doing something positive. The results were disastrous. One can only wonder whether if the people involved believed just a little less in themselves and in the power of their good intentions, perhaps fewer people’s lives would have been ruined."
"One of my interests in recent years has been the negative impacts of the mental health system. Although mental health services are intended to contribute toward mental health, unexamined assumptions often seem to result in unintended harm. A friend and colleague of mine once remarked that he felt the majority of his time was spent trying to undo the damage of previous mental health care."
"Although well-intentioned, our efforts may create more misery than they relieve."
"Unfortunately, as a field, we have done a poor job of publicizing these facts - that both effective and iatrogenic (harmful) treatments exist - and several of the treatments that appear on Lilienfeld's list are likely to surprise both the general public and practitioners."
Since most of the things I have been posting in this thread were found on your blog, I'd like to try to return the favor. I think you would be interested in the psychobabble on this previous thread.
You can also try a Google Site Search
Separate names with a comma.