Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Monday, April 21, 2014

You Can't Go Home Again, Or Regress to Infancy Either

The idea of psychological regression keeps pushing its way to the front of the discussion, and I suppose I shouldn’t be surprised, because current naïve beliefs about psychology almost always assume that someone can go back to early childhood, back to the womb--   even back to previous lives. Still, when this matter comes up again, I feel like taking up the fight on the side of reason.

In a recent blog post, I referred to  Kathy Brous, who says she accidentally regressed herself back to infancy. (I really must get her book and see how she did it, and I do think she should warn us all of the kind of accident that might have this effect.) Then, a few days ago, I received a flyer advertising a class in qigong (the Chinese exercise/meditation routine) for autistic children. The class instructs parents how to do what they call qigong sensory training, which they are then to do with their autistic children every night. What does that have to do with regression, you ask? Well, here’s what the flyer says: “The routine is designed to normalize your child’s difficulties with touch & sensory sensitivities so they can essentially ‘go back’ and begin to reclaim the key developmental milestones that were missed in the first years of life.” In other words, the qigong presenter (who is someone I know and had respected up to this point) claims that the treatment can cause regression to an earlier psychological stage, followed by rapid recapitulation of previously-missed developmental steps.

The idea of regression has become so embedded in American thought that it is hardly even discussable--  it’s an a priori assumption, an agreed-upon given, even one of dear Mr. Rumsfeld’s known knowns. But let’s just think about it for a bit.
The idea of regression came out of the neurological studies of John Hughlings Jackson in the late 19th century. Hughlings Jackson was interested in seizure disorders (his wife had died from one) and other aspects of brain damage, and in the course of his work he concluded that the nervous system was organized in a hierarchical fashion. This meant that higher-level brain areas acted to inhibit the more primitive parts of the brain, but if the higher areas were damaged, primitive movement patterns would reappear, showing that the lower areas were now “in charge”. Hughlings Jackson’s view of regression was of great interest to Sigmund Freud, whose biological view of personality used the metaphor of regression, comparing psychological changes to neurological events. Freud’s second important metaphor, the idea that human motives and needs acted in a hydraulic manner and could be blocked in their normal flow by disturbing events, worked together with the regression idea, suggesting that if a patient could regress to and remember an event that caused emotional blockage, that blockage would disappear.

Freud’s ideas about regression really involved events after the first year of life or so, and in some of the cases he mentioned, patients had been young adults when the problem incident occurred. However, some of Freud’s students and colleagues, like Otto Rank, suggested that emotional difficulties required regression to the time of birth, and some later authors moved the problem period to prenatal life--  or even, as Scientologists claim, to conception.

So, how do we examine these ideas? It’s certainly true that sometimes people act childish, and if they are children they may show problem behaviors characteristic of earlier ages, things we thought they had “outgrown”. Under hypnosis or other forms of suggestion, people may act as if they are babies, or at least act the way they think babies act. Have any of these people really regressed? The first issue, that of showing less mature behavior, is easily explained as a reaction to stress; it’s not necessary to posit regression in order to explain it. For the second, it’s important to realize that with suggestion people can also act as if they are much older than they are, or at least they can act the way they think a much older person acts. If we are going to accept regression on the grounds of a person being able to act like a baby under hypnosis, it seems that we should also accept “progression” to a later stage of life--  and I can’t believe that even the most devout regressionist would be willing to do that.

It seems, then, that we don’t have evidence that people do regress in the common sense of the term. And according to the usual rules of logic, the burden of proof is on those who claim regression happens, as it is not possible to prove that something never occurs.

Obviously, the most important question about regression has to do with whether there is evidence to support its occurrence. But in the absence of such evidence we can also proceed to consider the plausibility of regression. An important concept that argues against psychological regression is epigenesis. This term refers to the fact that in the course of development, innate biological factors interact with experiences to shape the individual. At every stage of development, new experiences act on a person who has already moved along a developmental pathway determined by biological characteristics added to previous experiences. Thus, the individual who has had Experience A at an early stage may respond very differently to an event than the way someone who has had Experience B responds to the identical event. In the course of development, people really change, and the results of past events may or may not be able to be undone later—but in any case are not undone by repeating early experiences.

To take a biological example, a child who has been badly malnourished may be brought back onto a normal developmental path if given an improved diet at age 18 months, but if the better diet does not appear until age 5, stunting of growth and of brain development will not be corrected no matter how good the food is---  and incidentally, to improve the five-year-old’s diet does not mean to give him 6 months of milk alone and then start him on pureed foods, which would be the appropriate analogy to many psychological regression methods. Similarly, a person who has lost speech due to a stroke is not treated by exposure to infant-directed talk of the kind he originally needed for good speech development.

Erik Erikson’ psychosocial theory of development made good use of the idea of epigenesis. Erikson saw the individual as working through a series of challenges in which he or she needed to find a balance between two aspects of the self and of the world. At each stage, the person brought to the new challenge characteristics that came from previous development, which helped to determine how a balance might be found.  Regression was not an option--  but did that mean that a problem from the past could never be resolved? No, in Erikson’s view, every problem of personality development (like a balance of trust and mistrust) was to some extent re-worked at every developmental stage, in the context of new events and new abilities. Each stage had a focal problem, but other issues were also malleable, so, for example, a person who had in early life had reason to be distrustful could during childhood, adolescence, or later, have new experiences with people that would enable a more positive balance of trust and mistrust.

The idea of epigenesis is that people are influenced by experiences but that they keep on developing and become different persons over time. The idea of regression is that some aspect of an individual remains identical in spite of maturation and experience, but carries with it “buckets” of experiences that can be dumped and replenished with better contents through a regression procedure. This seems to suggest that according to the regressionist view, the personality is somehow independent of the usual rules of time, space, and developmental change.

But, you say, let’s go back to the qigong. What if the regression claim is irrelevant? Isn’t the important thing whether it works? And it turns out that there are claims that it works, but it’s all a bit sticky. For example, in one study (Silva, L., Schalock, M., & Gabrielsen,K. (2011). Early intervention for autism with a parent-delivered qigong massage program: A randomized controlled trial. American Journal of Occupational Therapy), the authors concluded that qigong was effective. Having invited parents to join the trial, and presumably explained that some would receive treatment and others be wait-listed, they compared a group of children whose parents were given 3 hours of training , plus 30 minutes a week for 7 weeks of coaching while the parents performed the procedure in the presence of a trainer, to another group who were not described as receiving any attention except for being told they were wait-listed. So, as so often happens, we have people who are told they’re getting a good treatment, get a lot of attention from enthusiastic trainers, get together with the trainer and the child periodically, and spend more time in direct interaction with the child than usual, and they’re compared to people who don’t get any of that. Not surprisingly, it turns out that families with kids with handicapping conditions do better when they get supportive attention, and the kids then do better too; we don’t have to turn to Chinese medicine for an explanation here. The authors of that study should have had a comparison group with sham qigong  using different movements than the real thing, and they did not have that, so I’m afraid they don’t get to conclude that the treatment is effective.  



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