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Concerned About Unconventional Mental Health Interventions?

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

Saturday, March 31, 2018

Did the Pendulation Chicken Come Before the Emotional Shuttling Egg?


Who lives may learn, we are told, and I am constantly learning new things about alternative psychotherapies. I used to think they were rather separate entities, one splitting off as a “heresy” from another, but the more I consider them, the more I see how much they have in common. I mentioned this a few days ago with respect to one of Bruce Perry’s themes, that a rhythm that resembles a maternal heartbeat can “reset” lower brain functions to normal after they have been distorted by trauma. Like many pseudoscientific ideas, this one has a foot in real science, because human rhythms of breathing or movement can be “entrained’ to other rhythms that they come to match. We use entrainment to soothe babies by rocking, singing, and patting, because we can override the baby’s (upset) tempo and bring it down to our calmer one. But Perry overgeneralizes from the fact of entrainment and decides that rhythms must shape the brain in a powerful, even permanent way—just as practitioners of thought field therapy (TFT) believe that physical tapping at certain rhythms on certain areas of the body can alter psychological functioning. These claims are without any acceptable evidence basis and that’s why we call them pseudoscientific.


Yesterday I had various reasons to be looking into Internal Family Systems therapy (IFS; see https://selfleadership.org/evidence-based-practice.html), a pseudoscientific treatment that claims to treat not just family relationships, but the dissociated “parts” inside a person’s mind. Apparently IFS makes use of “somatic experiencing” and a technique called “pendulation”, in which there is “movement between regulation and dysregulation. The client is helped to move to a state where he or she is dysregulated (i.e. is aroused or frozen, demonstrated by physical symptoms such as pain or numbness) and then iteratively helped to return to a state of regulation”  ((https://en.wikipedia.org/wiki/Somatic_experiencing – incidentally, I would not normally use Wikipedia as a source, but it’s a terrific way to find out what alternative therapists have written about their own beliefs.) I was puzzled by a comment on a blog related to IFS, though—the writer said she “pendulated on” her shoulder or her elbow. I have no idea how this would be done and had assumed that “pendulation” was something an alternative therapist did to a client, but perhaps you can do it to yourself. However, it seems to be yet another use of rhythmic stimulation with the goal of psychological change.

Anyway, what came to my mind on reading this material was a memory of “emotional shuttling” as a part of holding therapy as practiced on children by members of the Evergreen, Colorado, group , such as Neil Feinberg and C.J. Cooill, formerly Connell Watkins, as well as various Utah holding therapists. This involved alternating distressing experiences for the child, like being shouted at and made to shout disturbing statements like “I want to kill my mother”, with calming, apparently sympathetic or even affectionate behavior by the therapist. Again, repetitions of this rhythmic sequence were seen as essential.

The shared goals of  rhythmic “pendulation” and “emotional shuttling” would appear to be the establishment of the power and authority of the therapist over the client. This is not characteristic of modern evidence-based treatments, in which therapist and client--  or therapist and parent—usually work together toward goals that a client hopes to reach. These may be better understanding of impulses and motives, or better knowledge about a relationship, or improved capacity to deal with frustration and impulse control, or better social skills. In all these cases, reaching the goal is a team effort, not something the therapist does to the client. In alternative psychotherapies, the therapist “fixes” the client (or not, as the case may be); in evidence-based psychotherapies, the client is an active participant.

Did pendulation come out of emotional shuttling, or the other way around?  I can’t tell, at this point, and I am thinking that both “rhythm methods”, and their authoritarian roles for therapists, emerged from the 19th century shift from mesmerism (involving touch) to hypnotism, in which the practitioner’s gaze, the rhythmic passes of the hands, and the swaying and ticking watch were all ways in which the hypnotist sought to manage and control the client. Combine those factors with the stress on hypnotism of Milton Erickson, and the physical manipulations of Wilhelm Reich, and there we have common sources for a range of alternative psychotherapies of the present day—not new or innovative approaches, but the same old same old, refurbished with new names and claims.

Incidentally, I should point out something about IFS. At https://selfleadership.org/evidence-based-practice.html, proponents of IFS state that their techniques are evidence-based. Their reasoning is that IFS is listed on the National Registry of Evidence-based Practices and Programs (NREPP), a registry supported by SAMHSA, and if it’s on the registry of evidence-based practices, surely it must be evidence-based. But… awkwardly enough, not everything on NREPP is evidence-based in the sense of being supported by two well-designed, well-implemented randomized controlled trial studies. There are various levels of evidence on NREPP, as there are on other similar sites. In fact, examination of the NREPP material on IFS (https://nrepp.samhsa.gov/ProgramProfile.aspx?id=1) shows that IFS is only rated as “promising” (the third level of evidence), on the basis of one study published in Journal of Rheumatology, not in a psychiatry or psychology journal. Either the authors of the IFS site don’t understand what levels of evidence mean, or they are counting on the strong possibility that their readers won’t know—so, caveat lector!


2 comments:

  1. And what was the Journal of Rheumatology thinking? If it should publish a second study or a follow-up!

    Yes, you can pendulate yourself.

    And here I was thinking it was a fancy word for tapping.

    ReplyDelete