Book Review

"Crazy" Therapies
What are they?
Do They Work?

by Margaret Thaler Singer and Janja Lalich
San Francisco: Jossey-Bass Publishers, 1996

There are very few sure things in life, but the following guide to recognizing an incompetent, immoral or quack therapist is about 99.9% guaranteed.

You should not trust your therapist, regardless of his or her reputation, fame, diplomas, certificates, etc., if

1. He or she tries to have sex with you or claims that having sex with one's therapist is "good therapy." Intimate sexual behavior, including erotic kissing, fondling or lovemaking, between therapist and patient is always inappropriate. (The Sexual Predator)
2. He or she tries to have you move in and do chores, keep the books, work the farm, have sex, etc. (The Exploiter)
3. He or she spends a lot of time during your sessions talking about his or her own personal problems, such as her husband's illness, his wife's frigidity, another patient's hang-ups, his sexual needs. (The Neurotic)
4. He or she requires as a condition for therapy that you cut off all relations with your spouse, children, parents and other loved ones. (The Cult Guru)
5. He or she claims to know what your problem is and how to fix it, even though no thorough history of you has been taken. (The Savant Idiot)
6. He or she claims that you must be hypnotized in order to discover either hidden memories or hiding entities which are causing your problems. (The Exorcist)
7. He or she specializes not in treating people for specific problems such as depression or anxiety, but rather in treating people as if all problems have an identical cause. (The Johnny-One-Note)
8. He or she claims to have a technique which works miracles or works like magic, curing those who had heretofore been considered hopeless. (The Miracle Worker)
9. He or she has a checklist which is claimed to be an excellent way to find out if you suffer from whatever the therapist specializes in, and you have enough checks to qualify. (The Scientist)
10. He or she requires as a condition for therapy that you accept certain religious, metaphysical or pseudoscientific notions. To have good therapy you should not be required to believe in God, reincarnation, alien abductions, possession by entities, inner children, Primal Pains, channeling, miracles, or any of the many pseudoscientific theories popular among therapists. (The New Age Pseudoscientist)¹

Any potential patient should be able to identify all of the above traits, except for the last. How is the average person supposed to know what is scientifically accepted therapeutic practice and what is pseudoscientific rubbish? The patient needs a guide through the wonderland of fantasies, myths and untested hypotheses flourishing in the helping professions. Singer and Lalich provide such a guide in "Crazy" Therapies. They guide the reader through the various types of helpers: psychologist, psychiatrist, psychoanalyst, various social workers, hypnotherapists, personal "coaches", seminar leaders, spiritual advisors, psychics, massage therapists, shamans, gurus and every type of New Age healer imaginable. The authors also guide the reader through a maze of therapies that left me wondering why we have jails if these "healers" are not in them. Many of these therapies are not just useless; they are harmful. Reading this book may even encourage some people now considering a career in therapy to go into law instead. You may do more good that way--if you devote yourself to suing or prosecuting "crazy" therapists.

Those thinking of entering therapy and those in therapy who have some serious doubts about their therapists might want to jump to the section on "Consumer Guidelines" in the last chapter. Singer and Lalich provide much practical advice for those who are being asked to put a great deal of faith in a stranger who will be meddling with your mind, your emotional well-being and your life. They remind the reader/patient that you will be revealing very personal things about yourself and other people in your life. The decision to hire a therapist can be a monumental one. It should not be taken lightly. In 1987 "nearly eighty million psychotherapy visits were made at a total cost of $4.2 billion" and, according to a 1994 survey, "a great portion of clients are satisfied with their psychotherapy." The authors provide a number of questions to ask, as well as noting certain signs which should make you run for the nearest exit, such as therapists who try to humiliate you when you ask them questions about themselves or their practice.

In general, if your therapist is telling you that you have to get worse before you get better, is tearing you apart rather than building you up, is letting group members insult and ridicule you, is insisting that you must go deeper and deeper and deeper to feel the feeling, or is doing anything that smacks of old-fashioned ventilation theories, get out as fast as you can and look for a supportive therapist who will listen and respond with human decency. (p. 131)

If you are treated with disdain for asking about what you are buying think ahead: how could this person lead you to feel better, plan better, or have more self-esteem if he begins by putting you down for being an alert consumer? Remember, you may be feeling bad, and even desperate, but there are thousands of mental health professionals, so if this one is not right, keep on phoning and searching. (p. 205)

Most of "Crazy" Therapies, however, is devoted to describing the therapies and offering explanations for how such foolishness became so widespread. In a nutshell, the authors blame the popularity of crazy therapies on three things: the therapeutic relationship is by nature vague and ambiguous; the general increase in demand for instant gratification and the abdication of personal responsibility; and the flight from rational thought. There is no clear expectation of exactly how any particular therapy should progress. For all the client knows, the crazy notions of the therapist are considered general truths in psychotherapy. Blaming others for our problems seems natural. The master of therapy, Sigmund Freud, worked by insight and from the assumption that patient insight into the cause of his or her problem was the key to cure, so why shouldn't the modern therapist accept these unproved notions? Finally, the more bizarre a theory is, the more likely it will get a wide hearing in books and on talk shows. A claim is often valued not for its truth but for its being "exciting" or "mysterious". We want entertainment and excitement, not dry, rational discourse.

Most therapy and psychology bashers begin with hammering Freud, blaming him for all the zaniness that has flourished in the "helping professions." Singer and Lalich engage in their share of Freud-bashing, too. But blaming Freud for the faults of his followers is misguided at best and irresponsible at worst. Freud didn't wrap people in blankets or carpets and have them pretend they were in the womb, nor does anything he wrote suggest that such behavior would be proper. He never claimed he could cure any and all illnesses, nor did he blame his patients' parents for all their problems. He made a study of the irrational; he did not advocate glorifying irrationality. Freud may have been wrong about many things, but crazy therapists should take responsibility for their own craziness. Freud is no more to blame for their crazy therapies than parents, aliens, spirit entities, etc. are to blame for patient problems, or that Jesus is to blame for Jim Jones. I would place Freud's Civilization and Its Discontents and his Future of an Illusion on any short list of books an educated person should read. To encourage the general public to believe that Freud was as moronic as some of his followers is to do a great disservice, for such notions will feed a popular prejudice as well as discourage the study and reading of one of the most creative and critical minds of all time. Freud recognized that spiritual beliefs are based on wishes and desires, not facts, evidence and rational argument. He would have disapproved of therapies which are thinly disguised metaphysical or spiritual belief systems. I don't think we have to guess at what Freud would have thought of therapist Sondra Ray's claim that "Rebirthers consider themselves to be spiritual guides, not scientists."

I wonder which of the crazy therapies discussed by Singer and Lalich would have annoyed Freud the most. I don't think Freud would have considered it very professional to have a patient suckle at your breast, as some therapists do. It is difficult to say which kind of therapist is the worst, but I cast my vote for the 10% who have sex with their patients. Maybe these are therapists who confused "Freud's the one who said Everything is Sex" with "he's the one who said Sex is Everything" while studying their Cliff Notes. Anyone seeking therapy is likely to be vulnerable, trusting and troubled, as well as ignorant of what is accepted therapeutic practice. He or she is easy pickings for a ruthless and unscrupulous therapist. To take advantage of one's power in that situation in order to satisfy one's narcissistic lust is unethical and criminal. All therapeutic professional associations condemn it and many states consider it a criminal offense for a therapist to engage in sexual acts with his or her patient.

On the other hand, I am tempted to say that there is more to fear from therapists who are well-intentioned and believe in possession by spirit entities, past-life regression, alien abduction, primal screaming and other unverified cathartic therapies, reparenting, rebirthing, neuro-linguistic programming (NLP), facilitated communication (FC), Eye Movement Desensitization and Reprocessing (EMDR), Neural Organization Technique (NOT) and a host of other unscientific notions. Singer and Lalich discuss the origins and dangers of each of these "crazy" therapies. One thing they all have in common is that they have not been proven effective by any independent scientific studies, nor are they generally accepted as effective in the scientific community. Their support comes mainly from the "insight" and observations of their founders, and patient feedback which is analyzed and evaluated by the therapists themselves. Most of the innovative therapists reviewed by Singer and Lalich seem uninterested in scientifically testing their theories, though most seem attached to technical jargon.

The "crazy" therapies examined all claim to be miracle cures and to work like magic. All except facilitated communication claim that their one approach will work for just about everybody, no matter what their problem or situation. It is unlikely that all these cookie cutter theories--one size fits all--are correct, but none of their practitioners seem interested in any scientific studies which might prove once and for all which theory, if any, is correct.

Is it Leonard Orr's energy breathing and rebirthing theory? Learn how to breathe energy well and you can breathe away physical and emotional pain, as well as diseases.

Is it Marguerite Sechehaye's and John Rosen's theory of regression and reparenting? Does your therapist have to become your surrogate parent to make up for the terrible job your real parents did?

Is it Jacqui Shiff's theory which requires to you to wear diapers, suck your thumb and drink from a baby bottle?

Is it Sondra Ray's and Bob Mandel's theory that your problems are due to the way you were born? They will help "rebirth" you, properly this time.

Is it John Fuller's, Bruce Goldberg's, Brian Weiss's, Edith Fiore's, Richard Boylan's, David Jacobs' or John Mack's theory? They use hypnosis to discover your past or future lives as an alien abductee, in an effort to help you.

Is it John Bradshaw's theory of the "inner child" you must nurture and be good to?

Is it Arthur Janov's Primal Therapy? You can eradicate all your Primal Pain if only you can learn the Proper Way to Scream and Capitalize.

Is it Daniel Casriel's New Identity Process (NIP)? Screaming unblocks what's blocked, but you need a better kind of scream than Janov's.

Is it Nolan Saltzman's Bio Scream Psychotherapy? His screaming is better than Casriel's or Janov's because it has more Love in it.

Is it Bhagwan Shree Rajneesh's laughter and meditation therapy?

Is it repressed memory therapy?

Is it facilitated communication, neuro-linguistic programming or EMDR?

Or perhaps the winner is Dr. Carl Ferreri, chiropractor, who invented NOT: Neural Organization Technique. This man decided, without the slightest hint of scientific evidence, that all mental and physical problems are due to misaligned skulls. That's right. Other chiropractors are deluded for thinking that it is the spine which is malaligned and needs adjustments. No, it is the skull. Ferreri believes that as you breathe, the bones in your skull move, causing misalignments which can be corrected by manipulation. This theory was put into practice without the slightest proof that cranial bones move or that there is any sense to the notion of "standard alignment" of the cranial bones. Ferreri was not stopped by logic, however, but by lawsuits and criminal charges. His methods of pressing on eye sockets, skulls and jaws were described as "torture" by the parents of children he was treating for dyslexia. His methods were put into practice by the Del Norte School District in northern California after someone there had attended a seminar and came back full of enthusiasm for this wonderful new method of helping children with learning disabilities.

Which of the above has been scientifically shown to be superior to the others? None. Though their advocates claim their theories work for everyone, none of the theories has been put through any scientifically meaningful tests. Their evidence is in the self-validating analyses of their own observations and of their patient's claims.

Singer and Lalich go through the basic assumptions for each type of theory and find them all wanting.

Past-life regression and entity theories are based on the notion that if you discover the cause of your troubles you will be cured. There is no proof for this notion, despite its popularity since at least the time of Freud. Alien abduction therapy would seem to disprove insight and blame theories, since those who think their problems are due to having been abducted by aliens are not relieved and cured by this knowledge. To the contrary, they are made even more disturbed. Past-life regression therapy is considered "pure quackery" by the American Psychiatric Association. Singer and Lalich blame the spate of alien abduction claims on "sleep paralysis", therapist prompting, source amnesia and the popularity of the notion. (p.102) According to the authors:

"Age regression, reparenting, and rebirthing are not proven helpful techniques. There is no scientifically established objective clinical evidence showing them to be beneficial." (p. 45)

"Because objective research on regression techniques is limited, the assumptions about regression remain merely myths based on anecdotal reports from enthusiastic proponents." (p. 26)

"Rather than helping clients to become stronger and more independent, most regression therapies, and in particular the rebirthing-reparenting sort, induce in the client an abdication of responsibility and a state of sickly dependence on the therapists. " (p. 26)

Cathartic theories are based on the notion that if you express your emotions you will purge yourself of your troubles. There is no proof for this notion, despite its popularity since the time of Aristotle. This notion would seem to have been disproved by experiments with children which find that rather than sublimate aggression when encouraged to be aggressive, the children become more aggressive. It also seems to be disproved every week during football and soccer season, where fans seem to increase their aggression levels while viewing their favorite teams in action. (My favorite story in the book is about the couple who go to a catharsis therapist to help them with their anger. He prods them until they physically assault each other and demolish his office. He sends them a bill for $3,000 and tells them he won't have them as patients!) Singer and Lalich note that "The human organism learns as it acts; the more a certain behavior is practiced, the more it becomes a part of the person's automatic acts." (p. 129) Catharsis therapists seem oblivious to this notion and seem surprised when previously calm patients begin making life miserable for others by becoming more and more aggressive. According to the authors, "...rational therapies assist clients to find ways to talk with others, to change situations, and to identify socially useful and mature means to reduce anger-producing interactions and situations." (p. 130)

Reparenting and rebirthing theories are based on the notion that adults have problems because their parents were inadequate. There is no proof of this notion, despite its popularity since the time of Cain and Abel.. "During the course of the therapy, clients regress, become dependent, have their self-esteem and sense of self attacked and diminished, and to some degree lose touch with their previous everyday reality orientation." (p. 130)

Hypnotherapy is extremely popular and is practiced by thousands of therapists who got their training in a weekend seminar or a short course. Singer and Lalich note that

There are no licensing requirements, no prerequisites for training, and no professional organization to which those who hypnotize others are accountable. You can be a real estate agent, a graphic artist, an English teacher, or a hairdresser and also call yourself a hypnotherapist by hanging a certificate on your wall that states you took as few as eighteen hours of courses in hypnosis.

This lack of oversight leads to all sorts of abuses and malpractice. (p. 53)

The authors quote Martin Orne: "The cues as to what is expected may be unwittingly communicated before or during the hypnotic procedure, either by the hypnotist or by someone else, for example, a previous subject, a story, a movie, a stage show, etc. Further, the nature of these cures may be quite obscure to the hypnotist, to the subject, and even to the trained observer." (p. 96) Yet, many hypnotherapists seem oblivious to the dangers and pitfalls of using hypnosis in a therapeutic session.

In fact, many therapists seem oblivious to facts with which any competent therapist should be concerned. For example, it is amazing that all these therapists develop theories which exclude the possibility that a patient might either have a physical problem or a character flaw. No patient is physically ill. And no patient is responsible for his or her problems. It is always someone else or something else which has the faults. Patients apparently never lie, manipulate, deceive, cheat, distort, rationalize, err, etc. If a patient has a "fault," it is that he or she is not completely trusting of the therapist. Patients have "mental diseases" or "syndromes," not character flaws. It would be an astounding fact to discover that emotionally disturbed or mentally troubled persons are completely without flaws in their moral character! Yet, these advocates of crazy therapies seem to treat all patients as if they were innocent children, incapable of the slightest peccadillo.

If there is a major weakness in "Crazy" Therapies, it is that the book does not address the issue of neurochemical disorders (aka mental illness). The authors do not attempt to distinguish people who are having "life problems" but not major neurochemical problems. If you are schizophrenic or bipolar, you will not find this book useful in trying to decide what therapist to see. If you are a family member or loved one of a person with a major neurochemical problem, this book will not help you figure out what you can do to help. Only a person without paranoid delusions, without mania, who is taking his or her medication and is no longer in denial about their illness, could possibly use a check list such as the authors present to help evaluate a potential therapist. It is the family members of the ill person who need guidance. It might be unrealistic to expect a person who needs therapy to be a rational consumer in choosing a therapist, but I don't think it would be too much to ask for some guidance for loved ones of those needing therapy or medical treatment.

Unfortunately, the guidance needed by loved ones of the mentally ill is not a check list for choosing a therapist but a handbook for combat with the mental health professionals who often seem to be little more than obstacles to treatment and recovery. They often seem more interested in following rules, especially rules about "the patient's rights," than they are in making a decision as to what would be the best treatment for a person with a mental illness. The duty to help the patient get well has been obfuscated by officious minions of the court who have misleading titles such as Patient Advocate. Getting through to doctors and social workers is roadblocked by "privacy" issues. Trying to find out what is being done to help your loved one or what you can do to help or provide vital information (such as the discovery of a suicide note) are made difficult rather than easy. Some advice on how to deal with officials whose job is to see that if your mentally ill loved one does not want to take his or her medicine, then by God it is his or her right not to do so and the State will fight to protect this vital individual freedom to the death , or to a contrary court decision, whichever comes first. These petty officials will not care that your non-rich and usually thrifty loved one has just spent her entire life savings on philanthropic enterprises, several cars and trucks she does not need and can't afford, and is sure she is being transported to a higher place of being. The patient may reduce herself to homelessness during a manic explosion, but your tax dollars will not be spent trying to prevent this or minimize the damage. Your tax dollars will be spent for the salary of a Patient Advocate who will know nothing about the patient, but will go to court for her to make sure her "rights" are protected. One right that won't be protected, however, is the right to get well. Maybe in their next book, Singer and Lalich can give some guidance for people seeking care for their mentally ill loved one.

Finally, it is quite amazing that most of the therapists discussed by Singer and Lalich seem oblivious or indifferent to their role in priming and prompting their patients. They condition their patients, prompt them, and in some cases, clearly plant notions in their patient's minds. They give their patients books to read or videos to watch not to help the patient understand a problem but to prime the patient for belief in some crazy therapy. They plant notions during hypnosis, group sessions, etc., and then these planted notions are "recovered" and offered as validation of their therapeutic techniques and theories. Rather than provide real therapy, these "crazy" therapists indoctrinate patients into their own worldviews. This is surreal pseudoscience at its worst. Singer and Lalich have done a great service by exposing some of the worst psychotherapy has to offer. They write: "To society's loss, there is an alarming laxity within the mental health professions when it comes to monitoring, commenting on, and educating the public about what is good therapy, what is negligent behavior by trained professionals, and what is or borders on quackery." (p. 21) "Crazy" Therapies is a first-rate attempt to make up for this deficiency.

Margaret Thaler Singer has been a clinical psychologist, researcher and teacher for over fifty years. She is currently an emeritus adjunct professor of psychology as the University of California, Berkeley. For the past twenty years, she has also done work on cults and is considered an expert in the field of cult menaces. She died in November, 2003, after a long illness.

Janja Lalich is an educator, author and consultant in the field of cults and psychological persuasion.

Their book is humorously illustrated by cartoonist Jim Coughenour.

Bob Carroll
May 29, 1997

¹ All of the above descriptions are found in Crazy Therapies, but of the terms used to describe these types of therapists only "Johnny-One-Note" is used by Singer and Lalich.