Stop casualties of pop therapy

Martha A. Churchill

"Stay in there with the poop and vomit," ordered the therapist, Connell Watkins, moments before her young patient died. Watkins, a Denver area therapist, held her face close to the little girl's and shouted at her repeatedly while the girl messed her pants, begging for air.

Candace Newmaker, age 10, was the subject of "rebirthing" therapy intended to cure behavior problems with her adoptive mother. For more than an hour, the girl was rolled into a flannel blanket while four therapists, including Watkins, pushed on her with pillows or sat on her to simulate birth contract-ions.

Candace did not die quietly. "I'm going to die. Now!" she called out from under the pillows, choking for air.

"Go ahead and die," Watkins retorted. By the time therapists unwrapped Candace, the girl's face was blue, and she had no pulse. She died the next day of asphyxiation.

Watkins and one assistant, Julie Ponder, both received guilty verdicts for child abuse resulting in death more than a week ago, after prosecutors played a videotape of the rebirthing session for jurors. The two face possible prison terms of 16 to 48 years.

The taped rebirthing session was chilling. "You said you would give me oxygen," Candace was heard crying. "You gotta fight for it," Watkins shot back, pressing harder on the couch pillows.

But the really chilling thing about the "rebirthing" casualty is the pop psychology, fad-of-the-day culture among many therapists, including some in Michigan. Unproven, dangerous practices spread around a national grapevine of irresponsible mental health practitioners. Certain ones latch on to a particular idea, like converts to a new religion, and won't let the facts get in the way of their beliefs.

Candace was brought to a Denver-area therapist from Durham, N.C. Promoting a risky treatment like rebirthing did not make Watkins an oddball among therapists. It gave her a national reputation, so the girl's mother traveled across country for this treatment.

Even after literally killing a child, Watkins was unrepentant. "I do it because it works," she declared from the witness stand. And her attorney lined up therapists from all over the country, attesting to the wonders of this miracle cure, although no scientific study has ever found the technique safe or effective.

Michigan has plenty of crusading therapists, using treatment methods just as questionable as rebirthing. Rather than testing their ideas in double-blind studies, these therapists throw around buzz words, especially "healing," "faith" and "spirituality."

Psychotherapists are not required to use only scientifically proven methods, such as cognitive behavioral therapy, or medications. The responsible ones choose treatments that withstand scientific scrutiny; others use whatever fad happens along.

Junk treatments are easy to spot. You hear testimonials from grateful patients who say breathlessly "My therapist saved my life!” Soon, someone is making a buck teaching the latest psycho fad. Therapists without scientific training assume that if a treatment method is taught at a seminar, it must be valid.

A popular junk therapy in the Ann Arbor area involves eye movement, which supposedly cures traumatic stress disorder. This therapy has a nasty side effect, in that it is hypnotic. So the subject may absorb whatever is suggested during the eye movement session and come away with mistaken memories of childhood abuse.

Recovered memory therapy has fallen into disrepute among the scientifically oriented, but certain therapists in Michigan and elsewhere still cling to it as gospel. Patients must come up with memories of childhood abuse, and no one checks to see if the events really happened.

Memory therapists use different jargon these days, such as "dissociation," to make it sound scientific. Another change: a younger clientele. Fewer adult women seek out this treatment method for themselves, while more children of divorce accuse one of the parents of abuse after visiting the other parent's therapist.

"Thought field therapy" is another fad. It's easy; the therapist simply taps certain spots on the person's body. This supposedly works on depression, phobias and anxiety. Don't have time? Try "voice technology.” Tap yourself, based on advice by the therapist over the phone.

Let's not forget wind prayer. This "treatment" involves going outdoors and praying on a windy day. Patients actually pay money for this approach.

Colorado just passed a law against rebirthing. But with the junk- therapy culture alive and well, this type of law is nearly useless. Prosecutors simply cannot chase after every fad therapist, even when a patient or family is harmed. Some patients end up sicker on account of their therapy, but won't complain because they "believe in" the treatment.

Harmful mental health practices can be stopped, but only if insurers refuse to pay for treatments that are not proven safe and effective.

From The University of Arkansas

Seeking recovery from emotional distress and traumatic experiences, millions of people have turned to a new psychological therapy that promises miraculous results in a matter of weeks. But a University of Arkansas psychologist claims this miracle treatment is based on inadequate scientific evidence and is no more effective than existing treatments.

It's called Eye Movement Desensitization and Reprocessing (EMDR), and it first entered the field of clinical psychology in the late 1980s. Since its intro-duction, more than 25,000 mental health professionals have been trained in the procedure. It has been applied to millions of people worldwide and promoted as a "paradigm shift" in psychological treatment. It has also been shown to be scientific-ally and theoretically inadequate, according to Jeffrey Lohr, professor of psychology. "EMDR is being touted as a breakthrough therapy, practically a miracle cure for post-traumatic stress disorders," Lohr said. "But as more and more objective scientific testing is performed, the treatment proves less and less effective."

Lohr knows how to spot bogus therapies. For the past four years, he has dedicated his expertise to identifying and debunking pseudosciences, particularly in the field of psychology. He acts as president of the Science and Pseudoscience Review Special Interest Group of the Association for Advancement of Behavior Therapy and has published several articles on pseudoscientific treatments. His latest article, co-authored by James Herbert of MCP Hahnemann University and Scott Lilienfeld of Emory University, is titled "Science and Pseudoscience in the Development of EMDR: Implications for Clinical Psychology" and appears in the latest issue of Clinical Psychology Review. The article takes a skeptical look at the development and promotion of EMDR and concludes that practitioners of the therapy cloak it in scientific trappings while disregarding the scientific evidence against it.

That's because the theory behind EMDR is not scientific at all, says Lohr. The creators of EMDR developed the therapy based on research which showed that rapid eye movement aided in the processing of memories during sleep. They theorized, therefore, that inducing rapid eye movements while a patient remembered a traumatic event would help the subject more quickly process and come to grips with that memory. To facilitate this, the therapy consists of three components: prescribed eye movements (EM), in which the patient's eyes are to follow the therapists fingers in specific patterns; desensitization (D), or the ebbing of emotional distress through the repetitious remembering of trauma; and reprocessing (R), in which the patient reinterprets negative experiences in a benign way, free from self-blame.

In order to qualify as a new form of therapy, a treatment must consist of unique components, and each of the components must be essential to the outcome of the treatment. EMDR meets the first criterion but not the second, Lohr states.

In their article, Herbert, Lilienfeld and Lohr cite numerous scientific experiments, which compared patients treated with the traditional EMDR protocol to patients treated with the EMDR protocol, sans eye movements. Both groups showed similar relief from trauma. Further, other research has reported that removing the reprocessing component from EMDR made no impact on the outcome of treatment. "Basically, the research says you can take the EM and the R out of EMDR," Lohr said. "All that leaves is D-desensitization - and desensitization is the same sensible form of treatment that psychologists have been practicing for over 30 years." As a result, the eye movements and reprocessing techniques do not represent a therapeutic innovation, as EMDR proponents claim. Rather, they amount to little more than sales gimmicks that can be used to market the therapy.

And the marketing tactics - rather than scientific evidence - are responsible for the widespread use and glowing reputation of EMDR, said Lohr. Promoters have given the therapy an illusion of scientific veracity by creating a specialized terminology for its procedures, by instituting training and certification requirements, and by referring to case studies in which the treatment produced seemingly fast and effective results.

This effort to appear scientific is part of what qualifies EMDR as pseudoscience rather than outright bunk. It's also partly the reason that so many mental health clinicians have chosen to adopt the treatment. Lohr points out that the mental health field has experienced a boom over the past three decades, producing more and more psychologists and therapists who must now compete for clients. Offering a treatment that claims to produce significant therapeutic results in record time made good business sense to many practitioners. Furthermore, because patient testimonials seemed to support the efficacy of EMDR and because rigorous scientific testing was slow to refute these claims, many psychologists and therapists had no reason to doubt that EMDR worked. However, now that the empirical data is in, many of these same therapists seem reluctant to abandon the treatment. This makes little sense to Lohr. "The fact that some psychologists-who are supposedly trained in scientific methodology-are disregarding scien-tific evidence and continuing to offer an inef-fective treatment does not bode well for the integrity of our profession or for the public's perception of psychology as a science," he said.

Though the continued use of EMDR may result in a loss of reputation for the mental health profession, Lohr is quick to assert that the therapy does not constitute criminal fraudulence, nor does it pose a health risk to patients. "The only danger I perceive is that patients who receive an ineffective therapy now will be less likely to seek out effective treatment later," Lohr said. "Over the long haul, that may just aggravate their problems."

OHIO ASSOCIATION OF RESPONSIBLE MENTAL HEALTH PRACTICES

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