argument from authority, Castlewood Treatment Center, eating disorders, Informed Consent, Internal Family Systems, Lisa Nasseff, Lori Galperin, Mark Schwartz, mental health practice, Monica Pignotti, Nancy Albus, parts therapy, Richard Schwartz
Update on Castlewood Treatment Center Lawsuit: Other Ex-Patients Come Forward to the Press
According to St. Louis Today (stltoday.com), other ex-patients of Castlewood Treatment Center are now coming forward to the press, with their own allegations corroborating some of the allegations in the complaint filed November 21, 2011 by Lisa Nasseff against Castlewood and its Director Mark Schwartz. Additionally, some former patients at Castlewood posted comments on the article, also corroborating Lisa Nasseff’s allegations. A 28 year old former patient stated that “Satanic ritual abuse was talked about a lot in group therapy” but yet ironically she felt that Castlewood seemed like a cult to her. Another woman who reports she was at the center at the same time as Lisa Nasseff, maintains that “Schwartz told the other residents she had returned to her cult.” and she saw several women “screaming and shaking” having flashbacks of abuse and hearing other patients saying they would die if they left.
It is most encouraging that other St. Louis mental health professionals such as Dr. Lynne Moritz have the courage to take a stand in challenging the “parts” therapy, Internal Family Systems, that is the main treatment offered by Castlewood. Unfortunately, all too often, mental health professionals are reluctant to publicly criticize their own. I can personally attest that this can frequently result in shunning and accusations of being “mean” spirited. However, what I consider “mean” is standing by and saying nothing when a therapist is engaging in potentially harmful therapies and making unsupported claims. It is a refreshing change to see St. Louis therapists who are not afraid to speak out.
Mark Schwartz is no longer making comments to the press. This is not surprising, as most lawyers advise clients involved in lawsuits not to comment publicly. However, Executive Director Nancy Albus is continuing to publicly defend the center and Schwartz. In an all too familiar refrain, she stated that Schwartz is an “internationally respected in the field of eating disorders.” However, at this point, arguments from authority are simply not enough. Really all that does is to provide evidence he is considered a public figure, but the question remains, respected by whom and what has he done to deserve it?
In an earlier paper that he coauthored, posted on his website, with the founder of IFS, Richard (Dick) Schwartz and Castlewood clinical co-director Lori Galperin, they are honest enough to admit that “Unfortunately, no well-constructed outcome studies testing the IFS model and methods have been completed…” they assert that “the best evidence of IFS is from empirical observations in the clinician’s office.” (p. 7-8) I would have to beg to differ with them that this is valid evidence, especially given the heavy investment that ISF therapists have made in the training itself, which would render them far from unbiased. The most basic level, Level 1 alone, according to the IFS website training brochures, costs $3400. Level 2 is $2500 and Level 3 is $1500 which comes to a total of $7400 and that doesn’t include additional expenses such as travel, lodging and textbooks. There are many reasons (which I have outlined elsewhere in my writings) why it is unwise to make claims based only on clinical successes and why it is premature, in my opinion, to be marketing such trainings when published well designed outcome studies are lacking.
Schwartz, Schwartz and Galperin also maintain in that same paper, that “Until the results of these studies are in, skeptical clinicians are left to test these assertions within their own practices.” What does this mean? Are clients being informed that they are test subjects, basically guinea pigs? Have they consented to what is essentially an experimental treatment? I see nothing about suggesting this on any of the IFS sites I have read. Instead, what I see are suggestions on how to introduce IFS to a client, with no mention that it is experimental. What I do see instead are unsupported claims based not on independent research, but on the clinical experience of therapists who have a big investment in the treatment. Even without such an investment, human beings, including clinicians are subject to confirmation bias, which is the tendency to focus on successes and ignore or explain away failures.
When we read client success stories on websites of novel unsupported therapies, we don’t hear about the failures and the clients who quietly dropped out of treatment who were too polite to tell their therapists that they got nothing from it or worse, clients who were harmed. As this lawsuit unfolds, if it continues into the discovery and trial phases, we may be hearing evidence from the Plaintiff and possibly others who consider that they were harmed. Since some clinicians don’t seem to have understood the importance of using well tested therapies or at the very least, if none exist or existing ones did not work for a particular client, to provide full informed consent to the client that the treatment is experimental, perhaps this lawsuit will provide an example of what the consequences of such practice may be.
Some recent anonymous commenters have given testimonials of positive experiences at Castlewood. Although this may be the case, given that Castlewood uses a number of different types of therapies, some better supported than others, this in no way takes away from those who have come forward, several now who have used their real names, reporting bad experiences. Although there is nothing wrong with sharing a positive experience, one of the positive commenters also proceeded to trash one of the whistleblowers, saying she was “defiant to to treatment”. I say, good for her! Defiance to the treatment described is, I would say, a very healthy response.
The positive testimonials being offered reminds me of the Conrad Murray trial where in his defense, he offered several witnesses who were former patients of his who had nothing but the highest praise for him, maintaining that he saved their lives. While this is most likely true, their positive experiences did nothing to change the facts of the gross malpractice against Michael Jackson when Dr. Murray engaged in reckless, dangerous and ultimately deadly practices that were gross deviations from the standard of care. Thankfully, the jury and judge recognized this and found Murray guilty and the judge gave him the maximum sentence.
Additionally, one of the commenters appears to be woefully misinformed on the research on recovered memory. Although he repeated the assertion “research shows” a number of times in the response, it actually does not show what he claims. “Research” does not show it is nearly impossible for therapists to implant false memories of abuse in people. On the contrary, there are now studies showing that people were led into highly improbable memories of having been abducted by UFO aliens, so unless he wants to believe in that, the research shows how easy it is to not only suggest false memories, but also to create distress about those memories. The participants who had been led into believing they had been abducted, had physiological responses that were the same as those who had been through very real war trauma. The research is overwhelming, that for the most part, severe child sexual abuse is most often continuously and well remembered, something the victims would like to forget, but cannot. For some actual citations, see Richard J. McNally’s book, Remembering Trauma that reviews all the research and also shows what is wrong with many of the studies that claim to prove repression of memories exists when actually there were other more plausible explanations. For example, in one of the studies, the children had been struck by lightening and so brain damage could not be ruled out as a cause for inability to remember the trauma. In another study, the children in question were under age 3. It is very normal for people not to remember events that happened prior to the age of 3 that have nothing to do with trauma or repression.
To refute some of the ridiculous assertions that are now being made by some of the defenders of Castlewood, click here for a list of a large number of “nationally and internationally prominent psychiatrists, psychologists and behavioral scientists, Federal grant recipients, private foundation grant recipients, members of professional journal editorial boards, journal reviewers, recipients of national research awards, collectively publishers of thousands of peer-reviewed scientific journal articles, and/or licensed clinical health care practitioners” that signed an Amicus that strongly challenges the kinds of claims being made by some people who are posting here implying that their “experts” are the only ones and making highly questionable interpretations on what “the research” shows. Anyone who doubts who is in the mainstream should have a look at these names. It is obvious that there will be no shortage of qualified experts to testify for the Plaintiffs.