Crazy Therapies: Would You Submit To This Treatment?

Martin H. Ritchie, Ed.D., LPC

The University of Toledo

In the past two decades counselors have made prodigious strides toward professional recognition. Counselor training has evolved from 30 semester master’s to 48 and 60 hour programs. Over 125 counselor training programs are nationally accredited. Counselor licensure first granted in Virginia in 1976 is now a reality in 46 states. Counselors are making resolute gains at being recognized and reimbursed by third party health insurers. Research, modest as it is, continues to demonstrate that counseling can and often does work with a variety of client problems. And yet, there are those therapists who subject their clients to techniques which have no discernible, verifiable theoretical or empirical validity. There are the charismatic gurus who train others in these dubious methods and demand a loyal following from the naive therapists ever willing to believe in miracle cures. When these crazy therapies are exposed it causes great harm to the counseling profession, but even greater harm to the clients who have been denied proper treatment. The recent rash of therapists claiming to uncover repressed memories of incest is one example, the accusations and convictions of child care workers for satanic, ritualistic abuse is another. Both of these examples have left counseling and psychotherapy with a black eye to say nothing of the suffering of innocent victims and, as a result, the increased difficulty in real victims of abuse being believed.

Why does this happen? How is it that trained therapists, graduates of accredited programs, holding certifications and licenses engage in unethical practices? I will try to shed some light on these questions. I will share with you some current practices which I think are at best crazy, and at worst destructive. And finally I will suggest how you can avoid falling prey to these crazy treatments, protect your clients and provide best practice.

When clients come to us they are troubled and vulnerable, sometimes desperate. They want to believe in us. They want to believe we can help them. Sometimes they believe anything we tell them and will do whatever we ask them to do, no matter how silly. They want a label for their troubles, an explanation that removes them from being responsible for the mess they are in (e.g., "It’s not my fault, I’m codependent; My son’s not disobedient, he has attention deficit disorder; You can’t blame me for the mess I am in, I was molested as a child").

Because, as helpers, we are caring and want to help our clients we too are vulnerable. We feel so helpless at times. If only we were more powerful therapists, if only we could find the silver bullet, the miracle cure that would free us from the frustratingly slow process of therapy. This mix of vulnerable clients and hopeful counselors can lead to quick fixes and quackery. "Intoxicated by models and a penchant for complex but mostly vacuous psychological theories, clinicians often accord their beliefs the status of clinical reality" (Miller, Duncan, & Hubble, 1997, p. 21). Let me share some true stories of therapists and their clients as documented in Singer and Lalich’s recent book Crazy Therapies.

Rose, thirty-seven, married with two teenage daughters, saw a psychologist’s poster advertising that patients would attain dramatic personal transformation, learn long-forgotten events, and achieve emotional intensity that would revitalize their lives. Women--Prepare for the New Century Through Rebirthing and Reparenting, the poster proclaimed. Rose was intrigued and called for an appointment. (Singer & Lalich, 1996, p. 23)

Rose continued these sessions for several months before her husband, who had noticed a steady deterioration in her condition, persuaded her to stop. Singer and Lalich cite several similar cases where the harm to the clients led to lawsuits against the therapists. In one such case, "The patient said she was induced to suck on the therapist’s nipple and on nursing bottles, to change her name, to address one therapist as "Mommy" and another as "Aunt Gail," and to buy a teddy bear that the therapist sprayed with her perfume as a reminder of her for the patient" (p. 37). The authors go on to detail cases where patients were regressed into remembering past lives, "progressed" into revealing future lives, uncovered "repressed memories of ritualistic, satanic abuse, and abduction by aliens.

But not all crazy therapies are this wild. Let’s look at some more mainstream family therapy. What follows are from passages from an article in a recent issue of The Family Journal, the official journal of the International Association of Marriage and Family Counselors, an organization I co-founded in 1985 with Dr. Tom Sweeney. The article is entitled "Including the body in couple therapy: Bioenergetic analysis" and it appeared in the July 1996 issue of journal.

"Bioenergetic analysts working with couples focus on aiding them in developing a supportive relationship wherein they actually help each other learn to increase their capacity for tolerating a higher degree of sexual pleasure. . ." (Astor, 1996, p. 258).

Astor illustrates his therapy by relating a recent case.

The husband and wife come to the therapist, each complaining about the other. The wife believes that the husband needs individual therapy because he has a low sex drive, takes no pleasure in life, is not in touch with his feelings, and has no outside interests except for his work. The husband angrily denies these accusations, feeling that the wife denigrates him and never shows appreciation for the fact that he is an excellent provider. Furthermore, he believes that she has been involved with other men when he has traveled out of town. (p. 259).

"In bioenergetic terms, the therapist diagnosed the husband as schizoid and masochistic. . . Furthermore, he was obsessive-compulsive and had for many years deadened his capacity to feel any deep emotions" (p. 259). "The wife was diagnosed as a psychopathic narcissist. She had very high energy and was extremely manipulative. She ‘wore the pants’ in the family and was in full control of its members" (p. 260). Never mind that neither client’s description includes the necessary criteria for making these diagnoses. And as for wearing the pants in the family, I am not sure which mental disorder that represents. Nevertheless, Astor plods on to describe his unique brand of therapy with this couple.

While working with the husband, the therapist emphasized exercises that would lead to grounding, self-possession, contact, and self-expression. Grounding exercises involved getting the client to stand properly on his own two feet and to learn literally to resist being a pushover. These exercises also taught him to take energy up from the ground by pushing himself up straight from a squatting posture. This served to strengthen his leg muscles as well as to bring energy up through his legs and into his entire body. . . He was encouraged to express his rage and frustration through kicking and hitting. In fact, he eventually bought a heavy punching bag, which he installed and used at home. While hitting the bag, he was encouraged to grunt, groan, yell, and make whatever kinds of early, natural, primitive sounds that arose along with his feelings. (p,. 260).

The wife was also treated on a body level. She was asked to do difficult, painful exercises that would lead to both frustration and exhaustion. Thus, she was denied immediate gratification and was not allowed to fall back into her characteristic narcissistic mode. Her exercises included standing on one leg, knee deeply bent, with the other leg held high in the air. She stood this way for an indefinite time, until she collapsed. Another exercise required that she stand with her back to the wall, then sit down in an invisible chair, until she finally fell to the floor. These difficult and painful exercises served to help break up her old rigidities. . . Their problems, needless to say, were not changed overnight. (p.260).

It never ceases to amaze me what some therapists will do to their clients in the name of therapy. Do you think they would allow themselves to be treated this way? I believe this sort of treatment as taking advantage of what I call the "bootcamp" or "basic training" phenomenon, which is an application of Leon Festinger’s "Cognitive Dissonance." In other words, if you allow yourself to be physically hurt and emotionally humiliated then you decide that it must have been for a worthwhile cause. The armed forces have used this kind of treatment in the basics training for centuries, secure in the knowledge that those soldiers who survive the ordeal will decide that being part of the regiment is terribly important to them. Some university fraternities and gangs in the U.S. also make use of this phenomenon to increase the loyalty of their members. But is it therapy? Is it best practice? I think not. And there’s more.

Here’s another one from The Family Journal entitled "Neuro-Linguistic Programming (NLP): Changing Points of View". The author, who is not cited as a therapist but as a trainer and consultant, claims to have a an almost instant cure for phobias. In fact, he boasts that he has done so many phobias that he is bored with them. He describes the process by recounting experiences of participants in his workshops. He explains:

Years ago, it took me an hour to work with a phobia. Then we learned more about how a phobia works, we announced the 10-minute phobia cure--more than 15 years ago! Now I’ve got it down to a few minutes. Most people have a hard time believing that we can cure a phobia that fast, which is really funny, because I can’t do it slowly. I can cure a phobia in 2 minutes, but I can’t do it in a month, because the brain doesn’t work that way. (Andreas, 1999, pp. 26-27)

So how does this miracle cure work? It’s all done through imagery in a process he calls dissociation. Say you are afraid of dogs. Now imagine sitting in the middle of a movie theater and up on the screen you see a black-and-white snapshot of a dog. Now I want you to float out of your body up to the projection booth where you can see yourself watching the snapshot of the dog. Now make the snapshot into a black-and-white movie and watch yourself come into the picture with the dog. Then stop the projector and run it backwards so you can see yourself walking backwards away from the dog. You should be cured.

He shares another variation which he claims works. Recall a memory of something exquisitely pleasurable, exciting, and humorous from your past, and see what you saw at the time that it occurred. Turn the brightness up a little bit. Now keep that picture and have the dog come running right through the middle of the picture and as it does make the picture a little bit brighter. That’s it you should be cured.

I am not sure that the people he "works" with at his training seminars are really suffering from phobias. I have a friends who is phobic to helicopters from his traumatic experiences in Vietnam. Somehow, I don’t think that asking him to imagine a helicopter gunship sailing through a pleasant scene would produce the miracle cure the author claims. In fact, I think it would be cruel and unethical.

As an explanation for how this miracle works, he suggests that it takes away feelings through dissociation. He elaborates, "Someone experiencing a phobia associates into an unpleasant memory. Grief is the exact inverse of this. Someone who is grieving is dissociating from a pleasant memory (p. 28)." Got that?

Not all fringe therapies involve physical and emotional torture. Some are just plain silly. Here’s a crazy one: it’s called Thought Field Therapy (TFT) and it’s all the rage. I am not only going to describe TFT to you, based on an article by its founder, Gregory Nicosia (1997), but I am going to let you experience its miraculous powers. But first let me give you the theoretical basis for this latest miracle cure. According to Nicosia (1997, p. 24):

Thoughts and emotions are energy expressions of human consciousness. As such, it seems reasonable that the most efficient form of therapeutic intervention to cure disturbances in our thoughts and emotions should operate at the same quantum level. The body’s energy system and the meridians through which the Chi or "subtle energy" flows were discovered approximately 5,000 years ago by the Chinese. Yet, it was only 16 years ago when Dr. Roger Callahan, using the ‘therapy localization’ of applied kinesiology, discovered psychological problems could be successfully treated by utilizing that same energy system. Unlike traditional acupuncture that modulates the body’s energy system to affect changes at the molecular level, fully two quantum levels below the treatment’s origin (energy-atoms-molecules), thereby diluting its efficacy, Thought Field Therapy’s (TFT) effects are virtually immediate, astoundingly powerful and easy to engender.

TFT is based on the idea that a thought field is a psychological field distinct from the fundamental matter, gravitational and electromagnetic fields of quantum physics. Fields are not a form of matter, rather, matter is energy bound within fields.

Thought fields, like other fields, carry information, have memory and can be perturbed causing mental disquietude. The perturbation or disruption of energy within the thought field is seen to be the fundamental cause of all negative emotions and is the target of TFT’s energy balancing interventions.

The author claims that by redirecting or reversing these energy flows that the fundamental causes of their mental or emotional disorders can be alleviated. He claims to be able to diagnose the precise order of energy meridians to be stimulated by using algorithms or a voice technology which can determine the correct treatment sequence through the analysis of speech.

The author goes on to claim, among other things, that mind and matter are interchangeable, that reversing negative thought fields eliminates the chemical, neurological, and cognitive corollaries of negative emotions, and that "TFT has been used to successfully treat hundreds of individuals suffering from a variety of traumatic experiences including victims of accidents, crimes, rapes, war and various sorts of sudden loss" (p. 24). The author claims that clients are usually stunned by the rapidity of relief, a phenomenon he refers to as the "Apex Problem." And he challenges the reader to try it for themselves. So we will. Are you ready?

Here is the actual protocol for TFT taken from Nicosia’s article. Please, everyone follow these directions:

1. Think about a specific trauma or painful memory and rate the level of discomfort on a scale from 0 to 10.

2. While thinking about the trauma, tap your finger five times:

At the edge of the eyebrow above the bridge of the nose.

Directly under the center of the eye on the bony orbit.

On the side approximately four inches below the armpit.

Directly under either collarbone next to the sternum, between the clavicle and first rib.

3. Re-evaluate your discomfort level. If it is better, proceed to Step 5.

4. Assuming no improvement, perform a gentle karate chop with one hand onto the palm of the other hand repeating aloud three time, "I deeply and profoundly accept myself even though I am upset with this memory." Repeat Step 2.

5. Tap the GAMUT spot between the 4th and 5th metacarpals above the knuckles (i.e., on the back of the hand in between the bones going to the ring finger and pinkie [little finger]) while simultaneously closing your eyes, then opening your eyes and looking with your eyes (head still) down to the right, then looking down to the left, circling your eyes clockwise all around the visual field, circling your eyes counter-clockwise, humming a few notes of a tune, counting to five, and finally humming a few more notes. Be sure to keep tapping the back of your hand as instructed throughout all these activities." (p. 25)

So are you better yet? The remaining steps involve re-evaluating the discomfort level and repeating the exercises.

This is a perfect example of the kind of nonsense that can give counselors and their profession a bad name. There are plenty of other dubious psychotherapy treatments out there with hundreds of dedicated followers: Neurolinguistic Programming or NLP, which despite a thorough debunking by Christopher Sharpley of Monash University and others, lives on among its faithful along with its more recent knockoff, EMDR, Eye Movement Desensitization and Reprocessing, which claims to rid patients of stress and trauma be waving fingers in their face. This is reminiscent of Franz Anton Mesmer, who in the late 18th century became the sensation of the European aristocracy with his ability to throw young women into hypnotic trances by his mere presence. He claimed to be able to mesmerize not only women, but inanimate objects such as water and trees through his channeling of animal magnetism, a sort of European version of the Chinese Chi. He was eventually disgraced when he failed to demonstrate his abilities in a scientific experiment under controlled conditions which was overseen by Benjamin Franklin, on assignment in France, and one Joseph Guillotine.

A more recent incarnation of Mesmer’s animal magnetism is therapeutic touch whose adherents claim that they can sense the energy field imbalances of patients and correct them by waving their hands over the patient’s body. This technique was brilliantly debunked by a 12 year old who set up a simple experiment. The practitioners stood behind a barrier with holes for their arms so they could wave their hands over the patients but could not see the patients. This adolescent demonstrated that not only were practitioners not able to detect whether or not the patients were ill, they detected energy fields from patients when the bed was. There are many other therapies and therapists which prey on the hope and desperation of their clients. They are easy to spot because they tend to have common characteristics (Beyerstein, 1997).

1. They claim miraculous results beyond what can be explained by accepted scientific methods.

2. They claim to be effective with a wide variety of unrelated mental and emotional disorders.

3. They are usually loosely associated with some scientific or pseudo scientific principle, such as Eisenberg’s uncertainty principle, or Chaos Theory, or Chi, although the exact nature of the connection or causation is either incorrect or remains a mystery.

4. They can only be effective when administered by adherents to the approach.

5. In order to become an adherent you most often must obtain expensive training which can only be offered by a chosen few.

6. They are not receptive to being tested by scientific method involving double blind controls. In fact, sometimes they claim to be beyond scientific scrutiny because they are supernatural.

Do some of these therapies seem to work, some of the time, with some people? Yes. So what, you may ask, is wrong with these so called "miracle cures" if patients believe they have been helped by them, and in some cases, actually demonstrate improvement? I would offer the following list of reasons, which is by no means exhaustive:

1. The failure to diagnose a real medical, emotional, or mental disorder could lead to serious complications which could otherwise have been avoided.

2. Some therapies rely on hypnosis or regression techniques which have not only been shown to be unreliable, but have been shown to cause deterioration of the clients’ condition. Some of these therapies result in client abuse: emotional, physical, and/or sexual.

3. When these therapies don’t work the therapist often blames the client or the client’s family, not the therapy. In addition, the client becomes disillusioned with therapy in general and may not seek help elsewhere.

4. Therapists who adhere to some of these therapies may begin to believe their own potency and cease to consider alternative treatments or referrals.

5. A loss of the public trust and a further tarnishing of the professional image of counseling.

6. And finally, where it is starting to really hurt, use of unsubstantiated therapies is resulting in law suits against the therapists. In fact, my mental health insurance specifies in bold letters that it will no longer cover anyone who uses hypnosis or regression therapy to uncover repressed memories of sexual abuse.

So what’s an ethical counselor to do? Trust your instincts. If a therapy seems to be too good to be true, it probably is. We must be skeptical, but not cynical. We can be cautious yet open to new treatment techniques. In order to provide the best treatment to your clients consider these steps:

1. Work within your scope of practice or professional boundaries. If clients present problems you have not been trained to deal with refer them to a more qualified professional. For Guidance Officers this often presents difficulties, particularly in country areas where there may not be other professionals to refer your clients.

2. Inform you clients of their rights and tell them what to expect in treatment. If you are working with minors you should convey this information to their parents.

3. Write out treatment plans. Because you know what you are doing you should be able to write it down and you should not be ashamed to show it to your clients or other professionals. If you can’t write it down, or as one family therapist once told me, "I can’t tell you what I’m going to do until I do it, I just get a feeling and go with it," then my advice is to go into acting or politics.

4. Consult with colleagues and other professionals on a regular basis. The notion of your family physician, or for that matter your auto mechanic, never consulting others is positively frightening, yet we sometimes operate this way.

5. Keep up with the professional literature. Read professional journals. Join professional associations. Go to professional conferences and workshops, and don’t believe everything the presenter tells you.

6. Evaluate your work and allow your clients to evaluate you. If you are effective you have little to fear.

7. And finally, do not lose faith in yourself or in counseling. It is slow, it is emotionally draining, but it works.

References

   Andreas, S. (1999). Neuro-Linguistic Programming (NLP): Changing points of view. The Family Journal, 7, 22-28.

   Astor, M. (1996). Including the body in couple therapy: Bioenergetic analysis. The Family Journal, 4, 257-261.

   Beyerstein, B. L. (1997, September/October). Why bogus therapies seem to work. Skeptical Inquirer, 29-34.

   Campbell, T.W. (1994). Beware the talking cure : Psychotherapy may be hazardous to your mental health. Boca Raton, FL: Upton Books.

   Dawes. R. (1997). House of cards: Psychology and psychotherapy built on myth. New York: Free Press.

   Dineen, T. (1998). Manufacturing Victims : What the psychology industry is doing to people. Montreal : R. Davies Publishing.

   Nicosia, G. J. (1997, Winter). TFT: A quantum leap in psychotherapy. Treatment Today, 24-25.