Clinical Psychology: Problems and Prospects
|"The modern totalitarian state is the psychotherapist for the whole of society. It acts on the elitist principle that it knows everything and the people deserve to be mind controlled and brainwashed for their own good.
Defenders of the totalitarian system demonize their democratic critics as insane, and suppress political speech with the mind control techniques that have grown out of modern psychological and mental health research. If you point out their contradictions, lies, and inconsistencies in their narratives, they call you a conspiracy theorist and chew you out with psycho-babble. And if you acknowledge that you fear their despotic vision for Western society and the world, they call you paranoid and say you have a psychiatric disorder." 1
I began this study with the intention of examining the problems and prospects of contemporary clinical psychology to assist my daughter who was thinking of majoring in psychology and then training as a clinical psychologist (she later decided against this course of action).
As I reviewed clinical psychology it became clear that the capitalist cabal controlling American society is continuing to use clinical psychology to define which human actions and feelings are to be encouraged and which are not to be tolerated, dictating how men and women are to live their lives and how society is to function.
It was interesting to discover that approximately the same negative factors which led me to leave clinical psychology in the 1970s (after completing a master's equivalency) are even more dominant in contemporary clinical psychology.
This same conclusion was reached by Dr. Tana Dineen in her insightful study of clinical psychology: Manufacturing Victims.
"This book is about the industry--the business of turning people into victims in need of psychological services. In recent years, I have come to accept an ethical obligation not only to personally dissociate from this business but, also, to speak out and take whatever action I can to curb its influence."
In House of Cards: Psychology and Psychotherapy Built on Myth, (1994), Dr. Robyn M. Dawes, chairman of the interdisciplinary department of social and decision sciences at Carnegie Mellon University, provides a comprehensive critique of contemporary clinical psychology. Dr. Dawes' major criticism is that clinical psychology has abandoned the goals of creating a "mental health profession that would be based on research findings, employing insofar as possible well-validated techniques and principles."
"It does not limit its focus to the harm being done by virtue of 'the false memories' which some psychologists are now being accused of creating. Rather, it identifies 'Recovered Memory Therapy,' as only one facet of a business enterprise which relies on the manufacture and maintenance of a continuously expanding variety of 'victims.' This book broadens the focus to include other facets, critically examining generally accepted beliefs, not only about repressed memories, but also about the effects of traumas, the epidemic of addictions, the prevention of violence, the fragility of women, the vulnerability of children and the ravages of stress. It looks at how psychologists are promoting these beliefs and, at the same time, selling to consumers their own bogus products, calling them 'proven effective' treatments and packaging them as solutions to social problems."
" I would like to see people challenge the authority, power and privilege of the purported psychological experts of this era, curb the damages being done by psychologists, diminish the influence of the psychology industry, and take back their own lives."
"Instead of relying on research-based knowledge in their practice, too many mental health professionals rely on 'trained clinical intuition.' But there is ample evidence that such intuition does not work well in the mental health professions. (In fact, it is often no different from the intuition of people who have had no training whatsoever.)"
One of the most revealing studies of clinical psychology was carried out by Mary L. Smith and Gene V. Glass: "Meta-analysis of Psychotherapy Outcome Studies," American Psychologist, 32 (1977).
- The study concluded that psychotherapy is somewhat effective: "someone chosen at random from the experimental group after therapy had a two-to-one chance of being better off on the measure examined than someone chosen at random from the control group"
- But the study also produced some surprising results not so welcome to the clinical psychologists:
- Therapists' credentials--Ph.D., M.D., or no advanced degree--and experience were unrelated to the effectiveness of therapy
- The type of therapy given was unrelated to its effectiveness
- Length of therapy was unrelated to its success
If we examine the underlying dynamic of the mental health industry--including psychiatry, social work, counseling, and psychology--we see that this field has essentially become a tool of those in power to define behavior unacceptable to them as "abnormal," "psychotic," or "neurotic." The mental health technologies thus become the "official" diagnostic instruments for the rulers of a society.
In the Soviet Union, psychiatrists "diagnosed" political
radicals as "mentally ill" and incarcerated them in detention centers. In
the U.S., psychiatrists "diagnosed" deviant behavior (e.g., advocating the
use of "illegal" drugs--as in the case of Timothy Leary) as "mental illness"
and incarcerated such people in prisons.
In his creative 1961 study of the mental health field, The Myth of Mental Illness, Thomas Szasz recognized that "the prestige and power of psychiatrists have been augmented by defining increasingly larger domains as falling within the purview of their special
discipline." The same is true for clinical psychologists, as they have grown in numbers to exceed psychiatrists. And the income of clinical psychologists now exceeds that of psychiatrists.
"An estimated $2.8 billion was spent in 1985 on the services of 'office based, licensed, clinical psychologists,' as opposed to $2.3 billion on services of office-based psychiatrists. That $2.8 billion figure is based on an estimated 55 million contact hours at an average charge of seventy-five dollars per hour (now higher); it accounts for two-thirds of all nonmedical professional office-based charges in the mental health area. (The rest is accounted for by licensed psychiatric social workers and other mental health professionals). 2
It's bad enough that Americans are spending large amounts of money on high-priced clinical psychology--when they could receive just as effective help from a paraprofessional--but the overall social effect of "intuitive" psychologists is increasingly pernicious. The two major corrupting ideologies can be termed victimism and egomania.
Victimism leads people to feel that they must have some kind of professional to help them--mental health agent, religious leader, educator, fashion advisor, ad nauseam--because they are incapable of independently making their own decisions or carrying out their own activities. This syndrome was decisively exposed by Freire (Pedagogy of the Oppressed, 1989) and Illich (Deschooling Society, 1976).
"Either you think-or else others have to think for you and take power from you, pervert and discipline your natural tastes, civilize and sterilize you. F. Scott Fitzgerald
Egomania is probably the most pervasive and pernicious ideology in the contemporary world. It leads people to value their own personal wealth, power, fame, body, possessions, etc., beyond any other person or element. For an egomaniac, she or he is the absolute center of the universe around which all else revolves. All other people should accede to their needs, they should be the focus of attention wherever they go, their uninformed opinions should be taken as Absolute Truth. Egomania stares at us in the faces of movie and TV entertainers, politicians, and professionals in all fields who are so enamored of themselves that their gaze is distorted by self-obsession.
Dawes points out the destructive influence of egotism in clinical psychology's obsession with "self-esteem."
is completely infantile ... he does not need and does not have an understanding of the outer world.
It exists for him merely as gratification or denial."|
Walter Lippmann (1889-1973)
"Under the guise of advancing 'positive' mental health--which certainly sounds fine and is consequently hard to oppose--the profession of psychology has propounded a simplistic philosophy of life. This philosophy maintains that the purpose of life is to maximize one's mental health, which is dependent wholly on self-esteem. Some psychologists, like
Shelley Taylor, have 'discovered' that self-esteem is more important even than realism: 'Every theory of mental health,' she asserts, 'considers a positive self-concept to be the cornerstone of a healthy ego.' If the point of life is to maximize self-esteem, it follows that a positive self-concept is everything. Thus, love, lust, friendship, doing the 'right thing,' accomplishment, leaving the world a little better or worse place than one found it, even behavior itself are all of importance only insofar as they impact mental health, which equals self-esteem. A wonderful person who does not happen to think particularly well of herself or himself (for whatever reason, such as a religiously based modesty or an absence of pride) is a failure. A conceited ass, in contrast, has good mental health."
Some current problems in clinical psychology have to do with the practice of third-party reimbursement--psychologists being paid by an insurance company through an HMO or other health care company. Beginning in the 1970s, clinical psychologists were first licensed as mental health practitioners. The history behind this circumstance is given by Dawes.
"After the war (WWII) many American soldiers returned home with psychological problems that were considered severe enough to require hospitalization, but there were not enough psychiatrists to staff the many Veterans Administration (VA) hospitals. This shortage was especially acute given government pay rates. The late E. Lowell Kelly of the University of Michigan proposed a solution: Allow psychologists to treat hospitalized veterans on a (near)-equal status with psychiatrists, who retained the ultimate medical responsibility. His rationale was that psychologists had a qualification that psychiatrists didn't: extensive research training. Thus, the psychologists would bring to the settings a competence different from that of standard medicine, and their unique contribution would be based on this competence. Practice would follow--not precede--research findings, even at a time when nonpsychiatric medical practice was less wedded to such findings than it is today. Kelly was successful in his lobbying arguments, and the field of clinical psychology was born."
To be allowed to practice as clinicians, psychologists have been required to adopt psychiatry's manual of mental disorders, the Diagnostic and Statistical Manual (DSM). Each time a psychologist submits an invoice for psychological services to an insurance
company for reimbursement, a diagnostic code must be included to describe the general category of problem and symptoms presented by the client. This diagnostic code defines the client's problems within the disease model, and makes psychotherapy reimbursable. Some psychologists are uncomfortable with using psychiatric disease classifications for their clients, but insurance reimbursement requires it.
Beginning in the 1990's, insurers began to contain costs by hiring intermediary companies to manage utilization of reimbursable psychotherapy services. Some of these intermediary companies are called "managed care" companies. As a psychologist, if you work for one of these companies you are required to follow their rules, which include:
- To abide by the intermediary company's final decision concerning whether treatment is in fact necessary
- To refrain from informing clients about alternative treatment options that may
contradict the decisions of the intermediary company
- To absolve the intermediary company of any legal or ethical responsibility in the event that the client believes that he or she has been harmed by failure to obtain adequate treatment
- To provide treatment to any and all subscribers who are referred to them
- To submit detailed information about the course of treatment to personnel at these intermediary companies for evaluation and review
- To provide case managers and others who are employed by the intermediary companies detailed information about clients' lives, after the clients have been required to sign away their right to confidentiality
Prospects for Clinical Psychology
While the problems outlined above are severe, the prospects for improving the practice of clinical psychology remain bright. After several decades of lunatic psychological fads such as "recovered memory therapy," "hyperactivity disorder therapy," and "alien abduction therapy," to mention only three, thinking people in the field are beginning to see the need to base psychotherapy on clinical research findings. Renewed interest in soundly-based research in the field will provide a much needed underpinning for future psychotherapeutic practice.
Sufficient attention has been placed on questionable psychological practices and theories so that innovations in the future will receive careful scrutiny. For example, the American Psychological Association is quietly proposing that a psychological manual of mental disorders be created and used by clinical psychologists in place of the current psychiatric DSM. Such a manual could be a horrible nightmare of misidentification of any supposed aberration as a "mental disorder."
The extensively used psychiatric garbage-can concept, schizophrenia, has been exposed by such mental health leaders as Szasz 3 and Sarbin 4. Such groups as the Antipsychiatry Coalition have laid bare many of the claptrap psychiatric concepts.
The newest edition of the American Psychiatric Association's Diagnostic and Statistical
Manual, TR, 2000, now lists almost every aberration as a disease. So if a psychological DSM is created, many people will be following the project assiduously to make sure that a mélange is not the result.
"One new favorite [in the psychiatric DSM] is ODD, oppositional defiant disorder, in which children act like -- surprise, surprise -- the young assholes that children can sometimes be. Teenage rebellion becomes a psychological disorder. Diagnostic manual symptoms include 'often argues with adults,' an unheard of behavior of teenagers calling for antipsychotics such as Risperidone. Side effects of Risperidone include a mild speed like buzz, a super erection lasting hours, lactation and suicidal tendencies. Phew!"
Joe Bageant, "Understanding America's Class System: Honk if you love caviar,"
Oppositional Defiant Disorder also applies to adults. It's defined as: "an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures." So if you question authority and get angry at how the capitalists are murdering workers worldwide, you're considered to be suffering from ODD. Oppositional Defiant Disorder can devolve into "conduct disorder" (CD), which DSM IV TR defines as behavior in which "the rights of others or social norms are violated." Violating "social norms" is now deemed a mental illness requiring treatment.
Psychiatrists and psychologists fabricate counterfeit "disorders" in their Diagnostic and Statistical
Manual and then contrive expensive "treatment programs."
The horrors of psychiatric imprisonment of political dissidents as occurred in the Soviet Union are now sufficiently clear in many people's minds to warn against an identical outrage being perpetrated in the United States. However, it will be necessary to remain vigilant as the federal government uses such phenomena as the Waco disaster and the Oklahoma City bombing as a pretext for eroding our civil rights, including the definition of membership in "suspect" groups as cause for interrogation and/or incarceration.
As leaders such as Szasz, Rabin, Dawes, Dineen, and Masson 5, among many others, expose the lunacies of extremist psychologists, and as the courts begin to disallow the insanities of "recovered memory" litigation, a renewed clinical psychology can begin to take an important new role in the mental health field.