Discredited Psychological Treatments

07/25/10: The psychological treatment marketplace is filed with all kinds of approaches and theories. Some of these have been able to withstand the rigor of scientific testing (all major schools of talk therapy for example: cognitive-behavioral, humanistic-existential, psychodynamic), proving their value to patients, while others come and go like pet rocks (Orgone therapy, primal scream) or occasionally things that really harm people (frontal lobotomy, rebirthing).

There are a number of reasons these things continue to exist including clinicians not adequately trained in cognitive science, private practice counselors looking to get an edge in the market by advertising their ability to do the cool new thing, the difficulty in studying psychological change and the counseling process, and people who are quick to make money by selling the new fad through workshops and the speaking circuits. The most important might be the demand for help from people that feel like existing treatments don’t help at all, or don’t help fast enough with big enough results.

The treatments themselves also usually have similar properties to them. First, they claim to offer incredible results beyond what is traditionally known for credible approaches like talk therapy (sometimes instant and near miracle like results are promised). Second, they almost always come from some kind of private industry or fringe charismatic inventor. Third, they are often rejected by scientific understanding or research, and continue to be taught through workshops rather than in universities.

Here in the northwest, we collectively operate on a different wavelength than other parts of the nation, and are usually more interested in alternative treatments and methods. I think this is wonderful, as long as there is evidence to back it up. If not, people end up spending a lot of money on treatments that are not effective, or are simply a lot of smoke and mirrors covering up a very basic psychological principle that is easily applied in more direct ways. The most common of these at the current time are Eye Movement Desensitization Reprogramming (EMDR), Neuro-linguistic Programming (NLP), and the Emotional Freedom Technique (EFT).

EMDR
This approach is very widely practiced and for some period of time was accepted as a mainstream treatment approach. It might be the most successful of these things of all time. The theory is that when we experience something traumatic and do not process the experience and memories properly, we are left with a variety of symptoms, including post-traumatic stress disorder (PTSD). In EMDR the patient is asked to watch the therapist’s hand (or a light machine) move back and forth while discussing the traumatic memories. The belief was that this eye movement helps “reprogram” the brain, and early results showed people felt a lot better after doing some EMDR.

However, recent research has proven the critics right: the eye movements are not necessary at all, and what was really happening was that just the talking and sharing of the experience was the therapeutic element. This “exposure” is one of the most robust findings in all of psychological change research, and can be accomplished with a close friend over coffee or with a fancy light machine. Either way people feel better. This has even resulted in the Veterans Administration recently revising their website on PTSD treatment (see it here). The good news is that EMDR does help, but you could get the same effect or even better results with a more traditional approach.

NLP
This is one of the growing fad treatments but has been around since the 70s. Essentially, it is a collection of basic ideas about communication repackaged and given a fancy new name that sounds “science-y”. Research throughout the 80s and 90s discredited NLP and it has been rejected by the mainstream psychological community for many years. However, special workshops and a cottage industry continues to profit on NLP.

The most interesting thing about NLP is that it is nearly impossible to find out exactly what it is. Almost every free resource dedicated to it will not give any specific techniques or ideas. This is always a red flag because real treatments are widely taught to everyone willing to listen in credible institutions, not just by salespeople in expensive hotel workshops.

EFT
The Emotional Freedom Technique is also very well named. Who doesn’t want to free themselves from the shackles of painful emotions? EFT is the latest wave of a type of approach that involves tapping on your body while you say things. The belief is that tapping on specific “nodes” such as the space between your eyes, the space under your nose, and under your arm will help properly reorganize “energy fields” around the body to relieve symptoms. While doing the tapping, people repeat phrases over and over like “I am going to have a good day today” and “I am a good person”. Big surprise here: when people do this they feel better.

Again we see a basic helpful process (giving yourself positive affirmations) repackaged with some other false explanation and technique. There is no research to support EFT, and the tapping is has never had enough credit to even be discredited, but there is some to support telling yourself positive things. Just go ahead and do this without the tapping on yourself.

Caveat Emptor / “Buyer Beware”
My advice is that as you look for a therapist (or are already working with one), and something tells you that what you are doing feels strange, makes your uncomfortable, or does not seem to make much sense, then question it and get more information. Doing this research ahead of time can save you a lot of time and money, and may help you direct yourself toward someone that is offering a more credible solution.

I’d suggest that if you are looking for help, give a more traditional approach a try. I have some advice for how to choose a therapist here. If that hasn’t worked, consider trying someone with a different style of traditional approach or experience level, or moving to medication if you have more severe symptoms.