Practicum Monday: Potentially Harmful Therapies

I was perusing the Journal of Psychology and Christianity (27:1, 2008; pp. 61-65) this morning and saw Siang-Yang Tan’s mini article entitled, “Potentially Harmful Therapies: Psychological Treatments That Can Cause Harm.” He was working of a similarly titled article by the so-called Ralph Nader of Psychology, Scott Lilienfeld of Emory U. (in Perspectives on Psychological Science, v. 2:1, 2007, pp. 53-70).

Some therapies on the PHT list would not surprise you. For example, Tan lists re-birthing techniques where you wrap up your client in blankets put them between the therapist’s legs so they can be healed from their birth trauma. Sadly, a teenager suffocated not that long ago here in PA when an unlicensed person attempted this with her client. Also, Tan lists the use of hypnosis with those with Dissociative Identity Disorder (DID).

But, you may be surprised to find that Critical Incident Stress Debriefing (CISD) also makes the list of PHTs. CISD (aka CISM) has been used for years with police and fire fighters to help them debrief from traumatic experiences and the thinking is that this prophylactic intervention helps exposed individuals avoid problems such as PTSD.  But there is evidence that such care may not only not help some individuals, it might actually harm others by increasing their arousal and those inclined to be hyperaroused appear to do better with no debriefing. For more of a critique of debreifing see DeVilly, Gist, & Cotton’s 2006 article in the Review of General Psychology (10:4) entitled, “Ready! Fire! Aim! …”

While CISD is not without merit and not always harmful, its popularity and widespread use without careful analysis should give us pause.

What widely accepted methods of Christian counseling also have the potential for harm?


Filed under christian counseling, counseling science, Psychology

6 responses to “Practicum Monday: Potentially Harmful Therapies

  1. Scott Knapp, MS

    The AACC is presently engaging the ACA in vigorous discussion over a released statement from the ACA ethics panel in 2006 regarding the supposedly unethical and potentially dangerous nature of homosexual “reparative” or “re-orientation” therapy. Of course, this sort of flies in the face of Warren Spitzer’s 2003 research that demonstrated, at least anecdotally, that “re-orientation” therapy has been successfully accomplished for a good number of those who’ve been treated.

  2. Hmmm. This one is a loaded one for me as a large part of my current therapist’s job security seems to be helping me recover from some counseling (with not just one counselor) that ended up complicating some trauma and adding a few more struggles for me to have to walk through. I’ll try not to write a book here, but I will answer in two parts. Feel free to delete one or both if it is not exactly what you were asking of if it is monopolizing the conversation.
    Part One:
    Marriage counseling or anger management counseling or getting in touch with your emotions counseling are all extremely harmful in cases where this is abuse. Most counselors probably know that, but the difficulty seems to lie in knowing when there is abuse. Abusers are notoriously smart about covering up and also playing mind games and drawing people (including trained counselors) into their games and agendas. Abused women notoriously look dysfunctional. It is not hard for me, in hindsight to see what the counselors missed and why they went forward with it and why.

    I have thought a lot about what I wish they’d have done differently or what they could have done differently given the dynamics of my husband’s mind games and my own inability to articulate the abuse (it was only after I separated and learned about the cycles of abuse as well as specifics of what makes something abuse and not just an angry or unreasonable person that I could articulate what happened. In it, all I was was dreadfully confused and losing my mind).

    The one thing that I thing I would warn a counselor is to respect a woman’s fear (I’m not being sexist. I don’t know much about the dynamics of women abusing men. I’m speaking of what I know.) It is not that a woman’s fear within a marriage can only come from abuse. But, given how good abusers are at diffusing and covering up all their own red flags that could indicate abuse, the fear factor is the one which I think should be taken seriously when it is present.

    Counselors do not see women in their daily life, and even if they did, they usually would not have a pre-abuse comparison to be able to see if fear/anxiety depression were really root problems to be treated or serious symptoms and side effects of prolonged abuse. But, I think, if they could go into it with a bit more of an opened mind, not always seeing fear/anxiety/depression as root causes to be fixed, but sometimes red flags to a real and serious problem to which fear is an appropriate response (e.g. no one looks at fear and the actions that come out of it, in response to a tornado or earthquake, as a sign of dysfunction. There is a real reason for that fear and it is not the person’s dysfunction).

    I guess I’m saying that I would hope that counselors (and I know I’m generalizing here, and there may be many counselors who do this) could be a bit less quick to jump to predetermined assumptions (and solutions) about fear and make space for the possibility that the fear is the most reliable indicator they may have for a root problem of abuse. Again, I don’t think fear should always be assumed to be abuse. But I do think it should be listened to a good deal more before quickly jumping into diagnosing antidepressants for the wife, starting anger management for the husband and couples counseling for the couple.

    I have friends where abuse was not in the mix and they got better through couples counseling and anti-depressants. With abuse in the mix, I got worse, and so did the abuse I suffered (which is actually stating it backwards. Getting worse is a normal progression when one is being abused and also simultaneously being seen as the cause of the problem.)

  3. Part Two:
    I would say that any therapy has the potential to be harmful if the counselor goes into it with too much reliance placed on their own intuitiveness, skills and knowledge so that they are overly confident in their assumption that (1) X is the problem and (2) Y is the solution.

    Confidence is a good thing, but sometimes I think it is overrated. I find doubt to be a gift (skill, even?) that I wish more counselors could leave a little space for. Doubt leaves space for surprise, for discovery, for learning curves, for differences in people and differences in problems and differences in solutions that will work in the different contexts.

    One of the things that I have only just come to realize is that part of why the problems I was labeled with and the solutions I was resistant to because they never seemed to fit were that way was that I am (using MBTI language) an ISFJ. I think every one of the counselors I have had (and there have been a lot) was an intuitive. A close friend has been helping me understand more about how intuitives think, and one day recently he asked me. Only as we’ve talked have I begun to realize that “N” assumptions and motives and even abilities were superimposed on to me and assumed to be true about me. And “N” style solutions were presented. When I resisted or said I felt missed, that fit into the assumptions about what had already been predetermined about me. Most recently, I was able to see clearly why something that counselors consistently assumed to be true about me, but it never felt it fit, couldn’t be true. I didn’t have the strengths that made that particular action a possibility, but I also didn’t have that particular weakness. And, amazingly, a weakness I didn’t have couldn’t and wouldn’t be fixed no matter how persistent or qualified counselor after counselor was.

    My current therapist was the first counselor who I have felt believes me if I disagree with an assumption he makes and doesn’t assume that I am denying or hiding something. We talked about it recently and he told me that he has to try to always stay open to people being so incredibly different. Not that there are even only the different types of people he’s studied about or known. But that as long as he lives, he will be surprised by people. That starting point has made space for me to heal, as me. He doesn’t automatically assume that I am right and he is wrong when we disagree. But he makes space to really listen and hear why what he is saying doesn’t feel like it fits. With that kind of openness, he has said that he has learned a lot about me, but also I have found that much more consistently, his observations and insights feel accurate and fit and are helpful. And, Whoooo Hoooo!!!!! change is happening 🙂

  4. oops, can the phrase “one day he asked me”. I got started on a thought I didn’t finish 🙂

  5. Eclexia,

    Thanks for your comments here. I also agree with your comments re: intuitives vs. sensors (is that a word?). We really do see and perceive the world differently.

  6. scottspradlin

    Wonderful to see this blog. Very informative. Keep up the good work.

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