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Answer to Quote Quiz

August 20, 2011

Here is the answer to the quote quiz, I posted earlier. What therapy was this quote referring to?

I am a sensitive observer, and my conclusion is that a vast majority of my patients get better as opposed to worse after my treatment.

The answer is:

Yes, that’s right. The doctor who made this statement was referring to the prefrontal lobotomy, perhaps the most brutal, damaging treatment ever invented in the history of mental health treatments, yet this person was so sure of his powers of observation, that he thought he could trust his judgment and anecdotal “clinical” evidence even though this procedure was utterly lacking in scientific support.

Sound familiar? It should. I posted the link to my question on my facebook page and someone responded that the quote could be about just about any therapy, the sentiment is so common.

I thank Scott Lilienfeld for bringing this quote to my attention. He uses it in a PowerPoint presentation he gives on pseudoscience to make a point about naive realism, the philosophy that we can simply look and take what we see at face value without critically evaluating it. His concluding thoughts are:

Students need to understand that subjective observation and “gut feelings” can play helpful roles in clinical practice and research, but that they must be tempered by rigorous hypothesis testing
Learning how we can be fooled by bogus psychotherapeutic techniques may improve the quality of clinical practice
“The scientific method” is largely a toolbox of procedural safeguards designed to combat naïve realism

The example of the lobotomy used by Scott Lilienfeld and now by me, comes from Robyn Dawes book, House of Cards.

Think about that, next time someone offers an intervention that has no well designed, published research to support its safety and efficacy and instead offers testimonials and anecdotes or worse, says trust me, I’m an expert or words to that effect.

It is interesting to look at some of the claims being made by those I have expressed concerns about on this blog, in light of this quote. In essence, this seems to be the same argument that proponents of interventions aimed at internationally adopted children are using that advocate outdated prone holds (banned in a number of states in institutions because they have been shown to be dangerous), isolation, hard labor, humiliation and other highly questionable practices. Click here for quotes of some of these proponents. Mental health professionals and others who engage in these practices appear to be making the argument that based on their observation, they do more good than harm. Some compare it to chemotherapy, but where is the evidence? If you had cancer, would you undergo chemotherapy that was claimed to be effective, based only on the observation of the doctor or would you want scientific evidence? While it is true that sometimes cancer patients do agree to undergo experimental treatments with very unpleasant side effects, in those cases full informed consent is given, the treatment is clearly labeled experimental and used only after well-tested treatments, if any, have been tried and failed and no unwarranted claims are made. Another key difference is that clinical trials for cancer are very strictly monitored and overseen, with each and every patient known and accounted for. Not so for the therapist in private practice offering what are essentially experimental treatments, who all too often, makes claims that are not based on any kind of systematic study and have not been independently tested, much less verified. Those who drop out and/or fail are explained away and often blamed.

Not so for therapies some professionals are asking people to engage in with their children (and themselves), many of which claim high success rates without basis. Sadly, all too many therapies fall into this category and my own survey of LCSWs, accepted for publication in a peer reviewed journal, has indicated that 75% of my respondents engaged in such practices. Some of the practices are known to be harmful and others, while not known to be directly harmful, can be indirectly harmful if they deter people from seeking well tested therapies. Obviously, something needs to change in the way mental health professionals are educated.

The only response I’ve had from the smear campaigners,who it is evident from the content of their postings over the last 2+ years are at the very least, supporters of those I have criticized and questioned, was a defamatory posting calling me an incest porn dealer, accompanied by obscene inferences about me and the late Robyn Dawes, claiming I “stole” from him (no, reference to his work as Scott Lilienfeld has also done and presented to psychology students in a similar manner, is not “stealing”). Normally I wouldn’t link to these things, but just to document the sort of irrationality and downright libel that is occurring, here it is.

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One Comment
  1. I thought it had to be either lobotomy or bloodletting, but wasn’t sure which one.

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