Psychotherapy religion vs. psychotherapy science

While the conflict between religion and faith is not a new one, in the field of psychotherapy skepticism is as essential as it is in medicine. Theories of psychotherapy in their infancy or even still in gestation can be presented to the public as if they were already proven true. People depend on the "experts" to have the training to know the proven from the experimental and advise them competently. They have to assume that we are giving them the best available help and advice. Yet perhaps their lives and certainly their well-being depend on what we do to help them.

It's good that new theories and practices arise. Even when the new theories have not yet been tested, or are based on the wildest of suppositions, we have to start somewhere. When we try out new ideas that have promise, the explanations for how they work may lag by years. We can see if they appear to have any validity or if they can be modified so that they are more effective. We can test various aspects of them, keep the valid and dump the others. Then the theories can be changed to support the findings and to suggest new approaches to be tested in their turn.

As long as the people on whom we are testing out new ideas are clearly aware that they are taking part in an experimental treatment AND that they have other alternatives that are not experimental, there is nothing wrong with trying the new ideas out. They should have a right to try an untested or experimental treatment if they are fully informed. Out of experiment and exploration come the ideas that develop into superior modes of treatment.

However, many practitioners of experimental and un-evaluated modes of treatment don't tell their patients. They offer the "latest and best" even though there is not yet any experimental validation. Our patients believe, reasonably enough, that we are providing them the best and most effective treatments, treatments they are not themselves competent to evaluate. Providing them with untested modes of treatment without their informed consent is certainly unethical and in my opinion fraudulent.

Recently a friend who is trained and legitimately credentialed as a psychotherapist wanted to convince me that the newest treatment she had encountered was truly wonderful. She could not provide me with any experimental evidence or journaled research publications. However, her "personal experience" convinced her that "it worked". The theory behind this therapy has absolutely no construct validity. It relies on unsupported beliefs in "energy flow" and "visualization of personal space". There's no question in my mind that some (or all) of her patients experienced something positive and in some cases believed they were "cured". In her mind this and her own experience is enough to convince her that she has found something true and useful. She therefore belongs to the huge class of people who develop beliefs without corroborating evidence and is therefore a "true believer". There's nothing wrong with being a true believer as long as the belief is not presented as factual truth. Essentially her new kind of psychotherapy is a religion and is supported by faith and belief and her personal skills in using it. For some people, single events are enough to convince; personal experience trumps the accumulation of evidence tested rigorously.

Since she is practicing a psychotherapeutic "religion", logical argument has no weight with her. She thinks I need to "experience it for myself", and she believes that this should be enough to convince me. I find it impossible to explain to her why personal experience is not and can never be enough for validation of a psychotherapeutic approach. Every religion believes in unsupported techniques; whether they are spinal manipulation or rain dances or prayer. No satisfactory evidence has ever been found to support these religious practices, but they do not require support since they don't depend on evidence, but only belief. My chances of convincing my friend are about the same as for any member of any religion being swayed by logic.

Every religion works miracles. Some of the time. Every psychotherapy has successes. Some of the time. Every belief system, no matter how weird or in direct contradiction to physical fact, has adherents who will die to support it. All we skeptics have to rely on is evidence. Since everything works (some of the time) we account for the successes by citing the "placebo" effect. The placebo effect itself is a complex topic and is itself effected by a number of factors. The more convincing the "salesman" of the effect, the greater the placebo effect. I have watched many sick people being "cured" in my younger days by tent revivalists. There has turned out to be no evidence for the long-range outcomes, but I'm sure some people were cured. The ones who died had no public complaints to make.

There's an old joke whose ending involves a man saying to his wife (who has caught him with another woman) "Are you going to believe me or believe your lying eyes?" My psychotherapist friend is convinced by what she has seen. As an amateur magician, I'm glad to have a credulous audience, but I don't want credulous believers in charge of my treatment. I know better than to believe my eyes and my own experience. While personal experience can be convincing, for the helping professions it certainly should not be enough.