August 7, 2000
Volume 52, No. 39
Scholarship & Research
Lilienfeld paying real attention to pseudosciences
By Paul Thacker
As the parents watched in fascination, their seemingly mute child-with the help of a facilitator's steadying hand-typed out the phrase "I love you." Not much of a feat for an adolescent, only this child had autism-a severe neurological disorder that inhibits social interaction and communication.
Played out on a nighttime news program in the mid-1990s, this scene captivated an American audience already numb to an endless stream of "breakthrough" scientific discoveries. But the discovery would soon morph from dream to nightmare.
Called facilitated communication, the technique was imported from Australia by Syracuse University researcher Douglas Biklen. Originally used with multiple sclerosis patients, Biklen began using the technique for children with autism as well as some severe developmental disorders. The results appeared miraculous as formerly uncommunicative children began to write about being trapped in nonfunctioning bodies.
But some researchers voiced doubts. What troubled skeptics was the bizarre eloquence flying from the children's hands; little kids were suddenly capable of perfect punctuation and reasoning far ahead of their peers. Controlled studies later proved that facilitators were unconsciously controlling the hands of the patients.
"One can hardly blame the parents or the therapists-people who undoubtedly wanted to help these children," explained Scott Lilienfeld. An assistant professor of psychology, Lilienfeld has taken a personal and professional interest in psychological "pseudoscience" and its followers.
He noted the widening gap between researchers and practicing psychotherapists. "More and more we are seeing a large number of practitioners who are using treatment and assessment techniques that are not well validated," he said. "They're not supported by the research. Some of these methods may be relatively harmless; others may be quite harmful."
Another popular form of therapy is Eye Movement Desensitization and Reprocess-ing (EMDR). Started by Francine Shapiro in the late '80s, EMDR has rapidly spread across this country and has been widely praised by the popular media. A treatment for posttraumatic stress and other anxiety disorders, EMDR requires patients to visualize a stressful incident while following the therapist's finger sweeping across their field of view.
The therapy erupted into a full-blown craze, with thousands of therapists learning specific finger movements. The problem? More than 20 studies have shown that the eye movement has nothing to do with any positive effects of the treatment.
"What's disturbing about the craze is that thousands of clinicians sought EMDR training-which incidentally is very time consuming and expensive-long before there was any compelling evidence that it worked," said Lilienfeld.
But EMDR might not be a complete wash. Patients could be experiencing positive effects from what psychologists call exposure. "Any treatment that causes a patient to think about a traumatic event-visualize and emotionally process it-seems to work, particularly if the exposure is prolonged," Lilienfeld said.
But even when practiced "properly," he added, EMDR may have caused some patients to forego other, more effective treatments. "It's a sad story in many ways because what a lot of the proponents of EMDR did and what the media unintentionally conspired to do was to unjustifiably raise patients' hopes that this was a miracle treatment, when it is not."
What EMDR and facilitated communication have in common with other questionable treatments is a lack of evidence supporting their claims. Before these treatments had been put into practice, multiple studies should have been performed to test the therapies' validity.
What can patients do to protect themselves? Lilienfeld continually stresses the need for patients to take personal responsibility while looking hard for evidence. Learn as much about the disorder as possible and be certain that claims are backed up by research and not supposition. A book to start this process is Martin Seligman's What You Can Change and What You Can't. The book explains the current understanding of many disorders while pointing out appropriate therapies.
Most mental disorders also have national research and support organizations. Contact them and find out which therapies have proven most effective for treating the specific disorder.
Finally, make sure therapists are certified and reliable. People have little problem questioning the qualifications and credentials of their plumber or hairstylist, and they should take the same skeptical approach when dealing with therapists.
"It is very appropriate as a client of psychotherapy to ask the
therapist about the type of treatment they are using and what their theoretical
orientation is," Lilienfeld said. "That's something that clients
are not only entitled to do, but should do."