Monday, December 14, 2009

The Devolution of Psychotherapy

Devolution: noun; retrograde evolution, degeneration.

I recently returned from the 6th Evolution of Psychotherapy Conference (1), the "world's largest psychotherapy conference!"

This conference is supposedly a who's who of the world of psychology and psychotherapy. The list of "keynote speakers" included luminaries such as Robert Sapolsky, Aaron Beck, and Philip Zimbardo. However, other people of questionable credentials (e.g., Daniel Amen and Francine Shapiro) and of questionable relevance (e.g., Andrew Weil and Deepak Chopra) were also featured.

Similar to all major conferences, it was expensive (2):$699 for the main conference, plus an additional $249 for the pre-conference, and $199 for the post-conference. In all there were over40 "prominent" people featured and over 200 presentations and workshops. With over 7,000 people in attendance, what where we paying for?

According to the syllabus it was this: "attendees will increase their therapeutic skills by learning: 1. the basic principles and techniques of contemporary schools of psychotherapy, 2. the commonalities that underlie successful clinical work, and 3. the historical development and future projections of psychotherapeutic disciplines."

Unfortunately, those goals were not accomplished.

What the fuck was that purveyors of pseudoscience, Daniel Amen, doing at this conference? And why was he reserved for $249 pre-conference? Jeffrey "I whistle when I talk" Zeig, the person who produces these conferences, is a star fucker. Here is why Amen should not have been there (3, 4, 5).

I will admit that I have never familiarized myself with the work of either Andrew Weil or Deepak Chopra. My bias automatically lumped them in with quacks (e.g., Amen). However, after viewing their addresses, I have a difference opinion of them. Both are vary good public speakers (especially Deepak). Weil has a fairly good conceptualization of the current state of health care, but his prescriptions involved way too much government intervention for my libertarian soul. Deepak prefers to stay in the realm of metaphysics (i.e., philosophy, logic), rather than hard science. There is nothing wrong with that, but the relevance of his speech (and Weil's) to psychotherapy is questionable.

Although she was not a keynote speaker, I have to mention my hatred for the work of Francine Shapiro. I know this will be unpopular, but eye movement desensitization and reprocessing (EMDR) is bunk (6) . Let me clarify that, the theory behind EMDR is bunk (7). I have wanted to dedicate a series of posts to Shapiro and her "therapy," but every time I begin reading the relevant literature, I get so over come with rage that all I want to do is travel to Rwanda and club a Tutsi to death.

In the main auditorium there were various booths promoting various high-tech fancy pants technology such as EEG Spectrum International's "neuro feedback" (8) for clinical practice (An over zealous rep claimed that neuro feedback can "cure" ADHD in just 6 short sessions!).

Sadly, many of the other great names (Barlow, Bandura, Kernberg) had poorly done presentations and workshops.

Now for the good: Robert Sapolsky is amazing. Unfortunately, I am so intimately familiar with his research that I didn't learn anything.

Aaron Beck was amazing. For someone who is pushing 90, he was sharp, spry, articulate, funny, and up-to-date with all the current research.

Zimbardo also gave a great speech. I have never been much of a fan of his, but his presentation altered my perception of him and his work (though I still question the validity of his prison study).

Overall, the conference was not as great as I had hoped. Many of the workshops were a let down. Very little evidence based material was presented (I didn't spend over $800 to meditate in a room full of strangers or express my needs through dance). This conference reminded me of a late night talk show. A lot of bad jokes (told primarily by host Jeff Zeig) and the guests were there only to push their latest products (new books, etc).

If this is the evolution of psychotherapy, I just might change my mind about biological psychiatry.


Anonymous said...

I enjoy your posts very much. I am a libertarian and skeptic, trained psychiatrist who believes in a nutshell that biologic psychiatry is bull shit but that the premise of psychotherapy as a systematized approach to the treatment of emotional problems is equally dubious.This does not mean that talking to people does not help them and that relationships are not wonderful. It means I doubt there is anything special about what goes on in "therapy" outside of what the pt believes about it. Good therapists are good friends and nothing else. Its why people can fake being a therapist but not really fake being an airline pilot or a cardiothoracic surgeon. These things require specific technical knowledge sets and there is little clear indication that the"therapy" people relate as being helpful consistently does. Training does not effect outcomes, unlike flying a plane. Have you considered the conference sucked because the entire premise that therapy is based on the premise "the therapist has special knowledge" he gets from such a conference is a myth?

Anonymous said...

Most people that I know go to professional conferences to get out of their town, let their hair down and have a good time. And maybe network. New knowledge or enlightenment is generally never the goal.