"What we need are more kindly friends
and fewer professionals."
-Jeffrey Masson, Ph.D., a psychoanalyst, in
his book Against Therapy (Atheneum 1988, p. XV)
The best person to talk with about your problems in life usually is a good friend. It has been said, "Therapists are expensive friends." Likewise, friends are inexpensive "therapists". Contrary to popular belief, and contrary to propaganda by mental health professionals, the training of psychiatrists, psychologists, and other mental health professionals does little or nothing to make them better equipped as counselors or "therapists". It might seem logical for formal credentials like a Ph.D. in psychology or a psychiatrist's M.D., D.O., M.B.B.S., or M.B.Ch.B. degree or a social worker's M.S.W. degree to suggest a certain amount of competence on his or her part. The truth, however, is more often the opposite: In general, the less a person who is offering his or her services as a counselor has in the way of formal credentials, the more likely he or she is to be a good counselor, since such a counselor has only competence (not credentials) to stand on. Generally, the best person for you to talk with is a person who has worked himself or herself through the same problems you face in the nitty-gritty of life. You usually will benefit if you avoid the "professionals" who claim their value comes from their years of academic study or professional training. Peter Breggin, M.D., a psychiatrist who does only counselling or "psychotherapy" and never recommends psychiatric "medications" (except while withdrawing from them) or electroshock or psychosurgery, put it this way in one of his books about how to do psychotherapy, The Heart of Being Helpful (Springer Publishing 1997, p. 69):
One solution requires recognizing the real qualities required for becoming a good psychotherapist. Advanced degrees, such as an M.D. or Ph.D., contribute little or nothing to a person's ability to do therapy. Instead, contemporary academic training and supervision can stifle intuitive skills and spontaneous caring. The competitiveness of the academic process winnows out more empathic people in favor of more obsessive and competitive ones. The arduous and largely irrelevant training required to obtain professional credentials encourages the graduates to demand higher prices for their services. The difficulty of getting the required degrees and the myth that the degrees confer an automatic level of expertise allow professionals to create licensure monopolies to enforce their higher prices.
Dr. Breggin makes a similar observation in his book Brain-Disabling Treatments in Psychiatry, Second Edition (Springer Publishing Co. 2008, p. 440):
Being an effective therapist begins with being a person that other people can trust with their most vulnerable feelings. In this regard, by creating an authoritarian and manipulative attitude, most contemporary training programs in psychotherapy do more harm than good. They almost always teach a relativistic, self-protective ethic (doing what works; collaborating with psychiatrists; using drugs along with therapy; making cookie-cutter diagnoses; referring desperate or suicidal patients for drugs, electroshock, or incarceration).
When I asked a licensed social worker with a Master of Social Work (M.S.W.) degree who shortly before had been employed in a psychiatric hospital whether she thought the psychiatrists she worked with had any special insight into people or their problems her answer was a resounding no. I asked the same question of a judge who had extensive experience with psychiatrists in his courtroom, and he gave me the same answer and made the point just as emphatically. Similarly, I sought an opinion from a high school teacher who worked as a counselor helping young people overcome addiction or habituation to illicit pleasure drugs who both as a teacher and as a
drug counselor had considerable experience with psychiatrists and people who consult them. I asked him if he felt psychiatrists have more understanding of human nature or human problems than himself or other people who are not mental health professionals. He thought a few moments and then replied, "No, as a matter of fact, I don't."
In his book Against Therapy, a critique of psychotherapy published in 1988, psychoanalyst Jeffrey Masson, Ph.D., speaks of what he calls "The myth of training" of psychotherapists:
Therapists usually boast of their "expertise," the "elaborate training" they have undergone. When discussing competence, one often hears phrases like "he has been well trained," or "he has had specialized training." People are rather vague about the nature of psychotherapy training, and therapists rarely encourage their patients to ask in any detail. They don't for a good reason: often their training is very modest. ... The most elaborate and lengthy training programs are the classic psychoanalytic ones, but this is not because of the amount of material that has to be covered. I spent eight years in my psychoanalytic training. In retrospect, I feel I could have learned the basic ideas in about eight hours of concentrated reading [Atheneum/Macmillan Co., p. 248].
In his lecture at the 2011 Empathic Therapy Conference in Syracuse, New York, Alaska psychiatrist Douglas C. Smith, M.D. (Doug Smith), said he personally had psychoanalytic training, which is a separate program unrelated to a typical psychiatrist's three or four years of residency training in psychiatry, but Dr. Smith said training in psychotherapy, or talk therapy, is not included in a typical psychiatrist's training. Dr. Smith said "You don't get therapy training in psychiatry. No one does. You get just a smattering, but you don't even learn interpersonal skills, let alone therapy in psychiatric training." In his book The Death of Psychiatry (Penguin Books 1974, p. 65), psychiatrist E. Fuller Torrey, M.D., says "Psychiatrists, then, who turn out to be good 'psychotherapists' do so in spite of, not because of, their medical training." Psychiatrist Peter Breggin, M.D., says the training psychiatrists get is actually counterproductive:
We get trained out of our humanity even if we had a lot to begin with. And then what do we learn? Now as a psychiatrist we don't learn to do therapy. That's going to be done by the social worker, you see, because psychiatry went broke trying to compete doing therapy with social workers and psychologists: We charged twice as much and were not as good. So it got taken over by the social workers and psychologists and family therapists. We don't even get trained in it anymore. I was, but I'm 70 years old! The young guys [young psychiatrists] don't get trained in therapy. So how are they going to change? They don't have anything! The only tools my colleagues have is drugs and shock treatment and an occasional lobotomy. [Peter Breggin, M.D., Changing Our Minds—Clear Thoughts on Depression, Drugs, and Alternative Paths to a Healthy Mind, Living Life Films (DVD), 2004/2010, "Extras" interviews]
Psychiatrist Daniel Carlat, M.D., disagrees, but his description of psychotherapy training may make you question its value:
In all psychiatric programs there is a large psychotherapy component, and what that typically means is that you are really thrown into the room—it's kind of like being thrown into a lion's den, is how it feels when you're first doing therapy, because you have no idea what to say—you get basically thrown into a room with a patient, you wallow around a bit, try to be as helpful as you can, and then you leave, and you talk to a supervisor, and you learn that way. ["Daniel Carlat-Unhinged: The Trouble With Psychiatry", YouTube.com, at 33:41, uploaded Sept. 11, 2012]
In the same lecture (at 6:45), and in his book Unhinged: The Trouble With Psychiatry (p. 189), Dr. Carlat says in a 2005 survey it was found that 29% of psychiatry visits entail psychotherapy and that only 11% of psychiatrists offer psychotherapy to all of their patients. The vast majority of what psychiatrists do now is prescribe counterproductive "medications".
A psychiatrist's perspective on whether psychotherapy is part of psychiatric training probably depends on whether it was part of his or her training.
In his book Warning: Psychiatry Can Be Hazardous to Your Mental Health (HarperCollins 2003, p. xviii), psychiatrist William Glasser, M.D., says "Many medical schools, such as the prestigious Johns Hopkins, no longer require their psychiatric trainees to study psychotherapy." In a Mood Disorders Symposium I attended at Johns Hopkins, called by Joann Ellison Rodgers, its Director of Media Relations, "the home of biological psychiatry", I heard Johns Hopkins psychiatry professor Raymond DePaulo, M.D., say "medications" and ECT and little or no psychotherapy are how he treats patients.
Some of the admissions about psychiatrists and psychologists having no useful expertise I have heard were from people I have known as friends who happened to be practicing psychologists. Illustrative are the remarks of one Ph.D. psychologist in the 1970s who told me how amazed members of his family were that people would pay him $50 an hour just to discuss their problems with him. He admitted it really didn't make any sense, since they could do the same thing with lots of other people for free. "Of course," he said, "I'm still going to go to my office tomorrow and collect $50 an hour for talking with people." Due to inflation, today the cost is usually much higher than $50 per hour.
In his book The Reign of Error, published in 1984, psychiatrist Lee Coleman, M.D., says "psychiatrists have no valid scientific tools or expertise" (Beacon Press, p. ix).
Garth Wood, M.D., a British psychiatrist, included the following statements in his book The Myth of Neurosis published in 1986:
Popularly it is believed that psychiatrists have the ability to "see into our minds," to understand the workings of the psyche, and possibly even to predict our future behavior. In reality, of course, they possess no such skills. ... In truth there are very few illnesses in psychiatry, and even fewer successful treatments ... in the postulating of hypothetical psychological and biochemical causative processes, psychiatrists have tended to lay a smokescreen over the indubitable fact that in the real world it is not hard either to recognize or to treat the large majority of psychiatric illnesses. It would take the intelligent layman a long weekend to learn how to do it. [Harper & Row 1986, p. 28‑30; emphasis in original]
A cover article in Time magazine in 1979 titled "Psychiatry's Depression" made this observation: "Psychiatrists themselves acknowledge that their profession often smacks of modern alchemy—full of jargon, obfuscation and mystification, but precious little real knowledge" ("Psychiatry on the Couch", Time magazine, April 2, 1979, p. 74).
I once asked a social worker employed as a counselor for troubled adolescents whose background included individual and family counselling if she felt the training and education she received as part of her M.S.W. degree made her more qualified to do her job than she would have been without it. She told me a part of her wanted to say yes, because after all, she had put a lot of time and effort into her education and training. She also mentioned a few minor benefits of having received the training. She concluded, however, "Most of the things I've done I think I could have done without the education."
Most mental health professionals however have an understandable emotional or mental block when it comes to admitting they have devoted, actually wasted, several years of their lives in graduate or professional education and are no more able to understand or help people than they were when they started. Many know it and won't, or will only rarely, admit it to others. Some cannot even admit it to themselves.
Hans J. Eysenck, Ph.D., a psychology professor at the University of London, is described in the December 1988 issue of Psychology Today magazine by the magazine's senior editor as "one of the world's best-known and most respected psychologists" (p. 27). This highly regarded psychologist states this conclusion about psychotherapy: "I have argued in the past and quoted numerous experiments in support of these arguments, that there is little evidence for the practical efficacy of psychotherapy...the evidence on which these views are based is quite strong and is growing in strength every year" ("Learning Theory and Behavior Therapy", in Behavior Therapy and the Neuroses, Pergamon Press 1960, p. 4). Dr. Eysenck said that in 1960. In 1983 he said this: "The effectiveness of psychotherapy has always been the specter at the wedding feast, where thousands of psychiatrists, psychoanalysts, clinical psychologists, social workers, and others celebrate the happy event and pay no heed to the need for evidence for the premature crystallization of their spurious orthodoxies" ("The Effectiveness of Psychotherapy: The Specter at the Feast", The Behavioral and Brain Sciences 6, p. 290).
In The Emperor's New Clothes: The Naked Truth About the New Psychology, (Crossway Books 1985) William Kirk Kilpatrick, professor of educational psychology at Boston College, argues that we have attributed expertise to psychologists that they do not possess.
In 1983 three psychology professors at Wesleyan University in Connecticut, in an article published in The Behavioral and Brain Sciences, a professional journal, titled "An analysis of psychotherapy versus placebo studies" question the value of "psychotherapy". The abstract of the article ends with these words: "...there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment" (Leslie Prioleau, et al., Vol. 6, p. 275).
George R. Bach, Ph.D., a psychologist, and coauthor Ronald M. Deutsch, in their book Pairing, make this observation: "There are not enough therapists to listen even to a tiny fraction of these couples, and, besides, the therapy is not too successful. Popular impression to the contrary, when therapists, such as marriage counselors, hold meetings, one primary topic almost invariably is: why is their therapy effective in only a minority of cases?" (Peter H. Wyden, Inc. 1970, p. 9; emphasis in original).
In his book What's Wrong With the Mental Health Movement, K. Edward Renner, Ph.D., a professor in the Department of Psychology at the University of Illinois at Urbana, makes this observation in his chapter titled "Psychotherapy": "When control groups are included, those patients recover to the same extent as those patients receiving treatment. ...The enthusiastic belief expressed by therapists about their effectiveness, in spite of the negative results, illustrates the problem of the therapist who must make important human decisions many times each day. He is in a very awkward position unless he believes in what he is doing" (Nelson‑Hall Publishers 1975, pp. 138‑139; emphasis in original).
An example of this occurred at the psychiatric clinic at the Kaiser Foundation Hospital in Oakland, California. Of 150 persons who sought psychotherapy, all were placed in psychotherapy except for 23 who were placed on a waiting list. After six months, doctors checked on those placed on the waiting list to see how much better the people receiving psychotherapy were doing than those receiving none. Instead, the authors of the study found that "The therapy patients did not improve significantly more than did the waiting list controls" (Martin L. Gross, The Psychological Society, Random House 1978, p. 18).
In the second edition of his book Is Alcoholism Hereditary?, published in 1988, Donald W. Goodwin, M.D., says "There is hardly any scientific evidence that psychotherapy for alcoholism or any other condition helps anyone" (Ballantine Books 1988, p. 180).
Dr. Vernon Coleman, a British physician, criticizes psychotherapy in a chapter titled "Why Mental Health Care Isn't Always Worth Having" in his book How To Stop Your Doctor Killing You (European Medical Journal 2003, p. 115):
What do psychotherapists do? Good question. Basically, they listen to (and occasionally talk to) their patients.
Do they do any good? I don't think so.
I suspect that a chat to a hairdressser or to a barman will do a patient as much good as a chat to a psychotherapist and that patients who are treated with psychotherapy are slightly more likely to become mentally ill, become alcoholics or commit a major crime than are patients who get no psychotherapy.
British psychiatrist Garth Wood, M.D., criticizes modern day "psychotherapy" in his book The Myth of Neurosis (HarperCollins 1986, pp. 2-3):
These misguided myth-makers have encouraged us to believe that the infinite mysteries of the mind are as amenable to their professed expertise as plumbing or an automobile engine. This is rubbish. In fact these talk therapists, practitioners of cosmetic psychiatry, have no relevant training or skills in the art of living life. It is remarkable that they have fooled us for so long. ... Cowed by their status as men of science, deferring to their academic titles, bewitched by the initials after their names, we, the gullible, lap up their pretentious nonsense as if it were the gospel truth. We must learn to recognize them for what they are—possessors of no special knowledge of the human psyche, who have, nonetheless, chosen to earn their living from the dissemination of the myth that they do indeed know how the mind works.
The superiority of conversation with friends over professional psychotherapy is illustrated in the remarks of a woman interviewed by Barbara Gordon in her book Jennifer Fever:
For Francesca, psychotherapy was a mixed blessing. "It helps, but not nearly as much as a few intense, good friends," she said. "...I pay a therapist to listen to me, and at the end of forty-five minutes he says, "That's all the time we have; we'll continue next week." A friend, on the other hand, you can call any hour and say, "I need to talk to you." They're there, and they really love you and want to help." [Harper & Row 1988, p. 132]
In an interview with another woman on the same page of the same book, Ms. Gordon was told this, referring to pain from losing a husband: "Good shrinks can probably deal with it; the two I went to didn't help."
Martin L. Gross, a member of the faculty of The New School For Social Research and an Adjunct Assistant Professor of Social History at New York University, has argued that "the concept that a man who is trained in medicine or a Ph.D. in psychology has a special insight into human nature is false" (quoted in "And ACLU Chimes In: Psychiatric Treatment May Be Valueless", Behavior Today, June 12, 1978, p. 3).
The June 1986 issue of Science 86 magazine included an article by Bernie Zilbergeld, a psychologist, suggesting that "we're hooked on therapy when talking to a friend might do as well." He cites a Vanderbilt University study that compared professional "psychotherapy" with discussing one's problems with interested but untrained persons: "Young men with garden variety neuroses were assigned to one of two groups of therapists. The first consisted of the best professional psychotherapists in the area, with an average 23 years of experience; the second group was made up of college professors with reputations of being good people to talk to but with no training in psychotherapy. Therapists and professors saw their clients for no more than 25 hours. The results: "Patients undergoing psychotherapy with college professors showed ... quantitatively as much improvement as patients treated by experienced professional psychotherapists" (p. 48). Zilbergeld pointed out that "the Vanderbilt study mentioned earlier is far from the only one debunking the claims of professional superiority" (Id, p. 50).
Similarly, in his book House of Cards—Psychology and Psychotherapy Built on Myth (Free Press 1994, pp. 8 & 101-102), psychology professor and former president of the Oregon Psychological Association Robyn M. Dawes, Ph.D., says this:
Virtually all the research—and this book will reference more than three hundred empirical investigations and summaries of investigations—found that these professionals' claims to superior intuitive insight, understanding, and skill as therapists are simply invalid. ... Evaluating the efficacy of psychotherapy has led us to conclude that professional psychologists are no better psychotherapists than anyone else with minimal training—sometimes than those without any training at all; the professionals were merely more expensive.
In his defense of psychotherapy in a book published in 1986, psychiatrist E. Fuller Torrey makes this argument: "Saying that psychotherapy does not work is like saying that prostitution does not work; those enjoying the benefits of these personal transactions will continue doing so, regardless of what the experts and researchers have to say" (Witchdoctors and Psychiatrists: The Common Roots of Psychotherapy and Its Future, Jason Aronson, Inc., p. 198). If you really are desperate for someone to talk to, then "psychotherapy" may in fact be enjoyable. However, if you have a good network of friends or family who will talk to you confidentially and with your best interests at heart, there is no need for "psychotherapy". Just as a happily married man or a man with a good sexually intimate relationship with a steady girlfriend is unlikely to have reason to hire a prostitute, people with good friendships with other people are unlikely to need "psychotherapy".
What if you need information about how to solve a problem your family and friends can't help you with? In that case usually the best person for you to talk to is someone who has lived through or is living through the same problem you face. Sometimes a good way to find such people is attending meetings of a group organized to deal with the kind of problem you have. Examples (alphabetically) are Alcoholics Anonymous, Alzheimer's Support groups, Agoraphobia Self‑Help groups, Al‑Anon (for relatives of alcoholics), Amputee Support groups, Anorexia/Bulimia support groups, The Aphasia Group, Arthritics Caring Together, Children of Alcoholics, Coping With Cancer, Debtors Anonymous, divorce adjustment groups, father's rights associations (for divorced men), Gamblers Anonymous, herpes support and social groups such as HELP, Mothers Without Custody, Nar‑Anon (for relatives of narcotics abusers), Narcotics Anonymous, Overeaters Anonymous, Parents Anonymous, Parents in Shared Custodies, Parents Without Partners, Potsmokers Anonymous, Resolve, Inc., (a support group that deals with the problems of infertility and miscarriage), Shopaholics Ltd., singles groups, Smokers Anonymous, The Stuttering Support Group, women's groups, and unwed mothers assistance organizations. Local newspapers often have listings of meetings of such organizations. Someone who is a comrade with problems similar to yours and who has accordingly spent much of his or her life trying to find solutions for those problems is far more likely to know the best way for you to deal with your situation than a "professional" who supposedly is an expert at solving all kinds of problems for all kinds of people. The myth of professional psychotherapy training and skill is so widespread, however, that you may find people you meet in self-help groups will recommend or refer you to a particular psychiatrist, psychologist, or social worker. If you hear this, remember what you read (above) and disregard these recommendations and referrals and get whatever counselling you need from nonprofessional people in the group who have direct experience in their own lives with the kind of problem that troubles you. You will probably get better advice and—importantly—you will avoid psychiatric stigma.
In their book A New Guide To Rational Living, Albert Ellis, Ph.D., a New York City psychologist, and Robert A. Harper, Ph.D., say they follow "an educational rather than a psychodynamic or a medical model of psychotherapy" (Wilshire Book Co. 1975, p. 219). In his book Get Ready, Get Set...Prepare to Make Psychotherapy A Successful Experience For You, psychotherapist and psychology professor Harvey L. Saxton, Ph.D., says "What is psychotherapy? Psychotherapy is simply a matter of reeducation. Reeducation implies letting go of the outmoded and learning the new and workable. Patients, in one sense, are like students; they need the capacity and willingness to engage in the process of relearning" (University Press of America 1993, p. 1). In their book When Talk Is Not Cheap, Or How To Find the Right Therapist When You Don't Know Where To Begin, psychotherapist Mandy Aftel, M.A., and Professor Robin Lakoff, Ph.D., say "Therapy...is a form of education" (Warner Books 1985, p. 29). Since so-called psychotherapy is a form of education, not therapy, you need not a doctor or therapist but a person who is qualified to educate in the area of living in which you are having difficulty. The place to look for someone to talk to is where you are likely to find someone who has this knowledge. Someone whose claim to expertise is a "professional" psychotherapy training program rarely if ever is the person who can best advise you.
Peter R. Breggin, M.D., Empathic Therapy, a psychotherapy training film, available at breggin.com: In this film, Dr. Breggin shows how anyone, including a person without professional training, can be an effective "psychotherapist". Applying the principles in Dr. Breggin's 22 minute introduction will make you a better person to talk with than many if not most professional "psychotherapists".
A Former Therapist's Critique of Psychotherapy by Daniel Mackler, M.S.W.