Key Takeaways
1. Mental Health's Credibility Crisis: Politicization and Economic Pressures
Psychology and mental health have veered away from scientific integrity and open inquiry, as well as from compassionate practice in which the welfare of the patient is paramount.
A troubling deviation. The mental health field, once dedicated to scientific integrity and patient welfare, has been significantly compromised. This shift is largely due to the pervasive influence of political correctness, intrusive ideologies, and economic pressures that distort its core mission. The result is a profession that often prioritizes agenda over evidence, diminishing its credibility and potentially harming those it aims to serve.
Erosion of trust. The American Psychological Association (APA), for instance, has been criticized for choosing ideology over science, eroding its authority. This is evident in instances where advocacy is based on political stances rather than scientific data or demonstrable professional experience, turning psychology into "another opinionated voice shouting to be heard in a vast arena." Such actions undermine the public's trust in psychology as a reliable source of factual and evidence-based insights.
Economic drivers. The economic landscape, particularly the rise of managed care, has further exacerbated these issues. With a surplus of practitioners and shrinking reimbursement for traditional psychotherapy, there's been a "pseudoeconomic expansion" through the invention of new syndromes. This approach prioritizes financial gain over genuine patient needs, leading to questionable diagnostic practices and a focus on what is reimbursable rather than what is truly effective.
2. The Perilous Rise of "Feel-Good" Diagnoses and Victimhood
The intent of this book is to acquaint the reader with the often well-meaning, but frequently self-interested destructive trends that have permeated the mental health professions, threatening harm to the patients who seek their help, and betraying the society they are sworn to serve.
The victimhood culture. Mental health has increasingly embraced a culture of victimhood, where individuals are absolved of responsibility for problematic behaviors by being labeled "victims." This trend, fueled by a societal emphasis on "rights" and a focus on external blame, has led to the proliferation of new "syndromes" that normalize aberrant behavior while simultaneously making it reimbursable through health insurance.
Fabricating disorders. The process often involves a simple formula: devise a treatment, then invent a "syndrome" that requires it, and finally get it listed in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) for insurance reimbursement. This "Palmer economics" approach, named after chiropractic's expansion of treatable conditions, prioritizes fitting existing treatments to newly defined problems rather than rigorous scientific validation. Examples include:
- Employee Ennui Disorder (a satirical example of this trend)
- Reverse Seasonal Affective Disorder (summer depression)
- Compassion Fatigue Syndrome (burnout in healthcare)
Consequences of over-diagnosis. This expansion of diagnostic categories, while seemingly well-intentioned, can be destructive. It diverts attention from underlying social or behavioral issues, fosters dependency, and can lead to inappropriate or even harmful interventions. The focus shifts from promoting resilience and self-sufficiency to perpetuating a cycle of perceived victimhood and reliance on external "cures," often pharmaceutical.
3. Ideological Capture: How Politics Distorts Psychological Science
Let no one presume that ideology does not influence science.
Ideology over evidence. Psychology, despite its scientific aspirations, has been significantly influenced by ideological agendas, particularly an "ultraliberal agenda." This has led to the suppression of certain research topics deemed "politically incorrect" and the promotion of others, regardless of scientific merit. Journal editors and funding bodies can control what is published or funded, stifling controversial but important inquiry.
Politicization of diagnosis. A stark example is the American Psychiatric Association's 1973 decision to remove homosexuality as a treatable aberrant condition, a decision made by popular vote rather than scientific evidence. This established a precedent where medical and psychological diagnoses became subject to political fiat, leading to a diagnostic landscape "cluttered with politically correct verbiage" that often takes precedence over sound professional experience and scientific validation.
Diversion from core problems. The internal conflicts within psychology, particularly between scientific and practice wings, have created a "stagnated trench warfare." In this environment, politically correct groups often become the deciding power, leading to a "feel-good non-solution" of passing resolutions on diversity, sensitivity, and language purging. This diverts attention from fundamental problems like defining professional competence or establishing a core curriculum, further compromising the field's scientific integrity.
4. The Harmful Allure of Pseudoscience in Clinical Practice
The noble imperative to do something is not a license to do anything.
The "almost-anything-goes" attitude. Clinical psychology has neglected the burgeoning problem of pseudoscientific and unscientific psychotherapies, placing clients at needless risk. These fringe techniques often promise quick fixes or overnight cures, appealing to practitioners and the public with superficial scientific veneers and charismatic leaders. This contrasts sharply with the inherent uncertainty and self-correction of genuine scientific inquiry.
Warning signs of pseudoscience: Pseudoscientific claims often exhibit a set of loosely correlated features that serve as "warning signs":
- Overuse of ad hoc hypotheses to avoid falsification
- Absence of self-correction or evasion of peer review
- Emphasis on confirmation over refutation
- Reversed burden of proof (skeptics must disprove, not proponents prove)
- Absence of "connectivity" to existing scientific knowledge
- Overreliance on testimonials and anecdotal evidence
- Use of obscure or seemingly scientific language
- Absence of boundary conditions (failure to define when the claim doesn't hold)
Dangers of unsubstantiated practices. These practices cause harm in several ways:
- Direct harm: Some therapies are inherently iatrogenic (e.g., rebirthing leading to death).
- Opportunity cost: Depriving individuals of time and resources that could be used for demonstrably efficacious treatments.
- Erosion of trust: Undermining public faith in clinical psychology and its scientific foundations.
Examples of potentially harmful treatments include attachment therapies, Critical Incident Stress Debriefing (CISD), suggestive techniques for memory recovery, DID-oriented therapy, peer group interventions for conduct problems, Scared Straight programs, and facilitated communication.
5. "Diseasing" Childhood: The Profitable Pathologizing of Normal Behavior
The very simple notion that ADD, ODD, and COBD are developmental phenomena explains the ease with which teachers taught grossly overcrowded classrooms during the peak years of the baby boom.
The myth of genetic disorders. A pervasive and unproven claim in mental health is that childhood behavior problems like Attention-Deficit/Hyperactivity Disorder (ADD/ADHD), Oppositional Defiant Disorder (ODD), and Childhood-Onset Bipolar Disorder (COBD) are primarily genetic or caused by biochemical imbalances. This contention lacks scientific evidence and contradicts the predictable nature of genetic traits across generations. Historical accounts from the 1950s reveal orderly, overcrowded classrooms with few significant discipline problems, challenging the idea that these "disorders" were widespread but hidden.
Postmodern parenting's toll. The explosion of these diagnoses is better explained by a cultural paradigm shift in parenting. The transition from traditional child-rearing, which emphasized character development and discipline for self-control, to "postmodern psychological parenting" has inadvertently perpetuated "toddlerhood in perpetuity" (TIP). This new approach, influenced by psychological theories, prioritizes self-esteem and "getting in touch with feelings" over firm boundaries and consequences, leading to:
- Ineffectual discipline methods like "yada-yada discipline" and time-outs.
- Extended toddler behaviors (tantrums, defiance, aggression) well into school age.
- Older children still using strollers, pacifiers, and bottles.
Profiting from pathology. This "diseasing" of America's children serves the interests of mental health professionals, prescribing physicians, and drug manufacturers. It absolves parents of responsibility, positions therapists as "saviors" of a mystified condition, and creates a lucrative market for expensive medical therapies. The biogenetic hypothesis, though unproven, is pragmatically functional, ensuring a steady stream of clients and medication adjustments, while the child remains insulated from accountability and true behavioral change.
6. Ethics Codes as Dogma: The Misguided Fear of Dual Relationships
One of the worst professional or ethical violations is that of permitting current risk management principles to take precedence over humane interventions.
The "evils" of connection. Psychology has developed a rigid, irrational dogma against "boundary crossings" and "dual relationships" in psychotherapy, labeling them as inherently unethical, illegal, harmful, and exploitative. This stance, largely unsupported by credible evidence, stems from an antiquated, psychoanalytic-risk-management approach that prioritizes therapist isolation and neutrality over genuine human connection and therapeutic flexibility.
Manufactured consent. A "core group" of influential professionals, often holding key gatekeeping positions in ethics committees and professional organizations, has manufactured this consent. They achieve this through:
- Repetitive misinformation: Incessantly claiming dual relationships are unethical and lead to harm or sexual exploitation.
- Exclusive reliance on their own writings: Creating an illusion of unanimity and suppressing opposing viewpoints.
- Disinformation: Systematically ignoring research and cultural contexts that support beneficial boundary crossings (e.g., in rural areas, military communities, or non-Western cultures).
- Pathologizing dissent: Accusing therapists who advocate for flexible boundaries of lacking integrity or having pathological motives.
Self-serving motivations. This rigid dogma, while ostensibly protecting clients, often serves the self-interest of therapists and the profession:
- It enhances therapists' influential power by fostering client idealization in isolated settings.
- It promotes an illusion of therapist omnipotence and client helplessness, demeaning clients' agency.
- It allows therapists to conceal personal struggles and justify ineffective treatment by blaming "client resistance."
The pervasive fear of lawsuits and licensing boards, driven by "risk management" advice, leads therapists to prioritize self-protection over clinically appropriate and humane interventions, ultimately "dumbing down" the profession.
7. Community Psychology's Narrow View of Social Justice
Community psychology advocates another important value—respect for diversity—yet does not practice this when it comes to sociopolitical ideas.
A biased definition. Community psychology, while championing social justice and diversity, ironically suffers from a profound lack of sociopolitical diversity within its own ranks. Its dominant liberal worldview, heavily influenced by John Rawls's theory of justice, leads to a narrow definition of social justice problems and interventions. This perspective typically frames societal issues as resulting from the oppression of "disadvantaged" minority groups by a "dominant group," advocating for redistribution of resources and political activism as primary solutions.
Problems with Rawlsian justice. Rawls's theory, which posits that a just society redistributes resources to its least advantaged members, faces several criticisms:
- Illogical conclusions: It's questionable whether self-interested individuals would agree to a system that punishes talent and rewards disadvantage.
- Vague definitions: It lacks objective criteria for defining "least advantaged" or determining the appropriate level of intervention.
- Economic violations: Its proposed government structure would stunt economic growth by controlling prices and redistributing wealth, undermining free market principles.
- "Want satisfaction" agenda: It risks turning every life circumstance into a claim of social injustice, leading to an arbitrary prioritization of wants.
The politics of victimization. This liberal approach fosters a "politics of victimization" with unintended negative consequences:
- Incentivizes victimhood: Reduces personal responsibility and encourages a mindset of entitlement.
- Creates attribution effects: Leads individuals to attribute success to external factors and failure to oppression.
- Fuels prejudice and hatred: By categorizing people into "oppressed" and "oppressor" groups, it promotes scapegoating, ingroup/outgroup biases, and reverse discrimination.
- Lacks efficacy data: There's little evidence that community psychology's interventions based on this framework actually improve socioeconomic status or reduce prejudice.
8. The Suppression of Intelligence Research: A Costly Blind Spot
Indeed, few people now alive have had more impact on the field” of human intelligence (Sternberg, 1998, p. 213). As a scholar, Jensen is “formidable” (Deary & Crawford, 1998, p. 274), “exceptional,” “innovative,” “prolific” (Nettlebeck, 1998, pp. 233,239); “inspirational” (Rushton, 1998, p. 218), and “the quintessential scientist” (Kaufman, 1998, p. 253).
Silencing inconvenient truths. Psychology has actively suppressed research on intelligence, particularly studies exploring genetic or racial differences, portraying such work as "evil" or "pseudoscience." This suppression is exemplified by the treatment of Arthur R. Jensen, a highly eminent scholar whose scientifically rigorous conclusions on intelligence were widely agreed upon by experts but publicly condemned and personally attacked. This "self-serving self-censorship" by academic institutions and professional bodies aims to avoid controversy but ultimately undermines scientific integrity.
Three damaging fictions. This suppression is driven by three pervasive fictions:
- Egalitarian Dogma: The belief that all demographic groups are equipotential in abilities, leading to explanations of inequality based solely on mistreatment or environmental disadvantage.
- Family Effects Theory: The false notion that cognitive differences are primarily due to family advantage, ignoring the increasing importance of genetic effects with age.
- Passive Learning Theory: The erroneous assumption that intellectual ability is merely the sum of learning opportunities, disregarding individual differences in learning rates.
These fictions lead to failed social policies, such as employment discrimination laws that presume guilt based on unequal outcomes, and educational reforms that fail to narrow achievement gaps because they ignore fundamental cognitive differences.
Real-world consequences. The denial of intelligence differences has severe practical implications, particularly for less able individuals. Critics, often from privileged backgrounds, fail to grasp the daily challenges faced by those with lower cognitive skills in areas like:
- Functional literacy: Difficulty with everyday tasks like reading instructions, filling forms, or managing finances.
- Health literacy: Inability to understand medical instructions or engage in effective health self-care, leading to higher morbidity and mortality.
Intentionally ignoring these realities is "unconscionable" and constitutes "social science malpractice," harming the very people the "untruth" is supposedly meant to protect.
9. Reclaiming Psychology: A Call for Scientific Rigor and True Diversity
If we clinicians lose that passion and forget those questions, we are little more than be-doctored, well-paid soothsayers.
A profession at a crossroads. Clinical psychology faces a critical juncture, with the rampant promotion of scientifically questionable claims posing a grave threat to both public mental health and the profession's integrity. The "scientist-practitioner gap," fueled by inadequate scientific training and the rise of postmodern thinking that devalues empirical evidence, has led to a disturbing reliance on intuition and unvalidated practices.
Prescriptive remedies for reform: To reclaim its scientific foundation and ethical standing, psychology must implement several key reforms:
- Mandate critical thinking: Accreditation bodies must require formal training in critical thinking, philosophy of science, psychometrics, and research methodologies for all clinical psychology programs, akin to the Flexner Report's reform of medical education.
- Identify harmful treatments: The profession must actively identify and publicize a list of "Psychological Treatments to Avoid" that are devoid of empirical support or proven harmful, ensuring informed consent and caution in their application.
- Scientifically grounded CE: Continuing education for practitioners must be rigorously vetted for scientific evidence, terminating approval for workshops on unproven or harmful techniques.
- Combat media misinformation: Psychological organizations need coordinated networks of experts to actively challenge erroneous claims about mental health services in popular media, developing public relations training for officials.
- Impose meaningful sanctions: Licensing boards must be willing to sanction practitioners who provide services patently devoid of scientific support or demonstrably harmful, upholding ethical obligations to rely on "best available scientific knowledge."
- Prioritize core mission: The APA must prioritize combating ineffective and harmful practices over expanding into new domains like prescriptive authority, ensuring that psychologists are delivering scientifically informed interventions in their current practice areas.
Embracing true diversity. Beyond scientific rigor, psychology must foster genuine sociopolitical diversity, recognizing that a pervasive liberal bias limits intellectual honesty, creativity, and progress. This means actively exploring conservative alternatives, expanding the definition of diversity to include sociopolitical values, enriching curricula with multiple perspectives, and separating scientific findings from political advocacy. Only by embracing open inquiry, challenging its own biases, and upholding rigorous scientific and ethical standards can psychology restore its credibility and effectively serve a diverse society.
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