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Concerned About Unconventional Mental Health Interventions?

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

Wednesday, June 11, 2014

Plausibility, Persuasion, Propaganda, and Reactive Attachment Disorder

In my forthcoming book, Alternative Psychotherapies, I’ve discussed how an alternative psychotherapy can be identified by examining its support by empirical research and its plausibility--  the extent to which it is in agreement with established information. Mental health professionals should be able to carry out this kind of examination, but it’s often difficult even for them because they may not have access to research publications, or time to carry out a detailed comparison of a treatment’s assumptions to accepted facts about human beings. It can be even more challenging to try to chase down the historical backgrounds of treatments and to understand their plausibility in that way. (I’ve done this with respect to the so-called “attachment cycle” on another blog:

If it’s hard for mental health professionals to do these tasks, there’s no doubt that it’s even harder for the interested reader whose training is in a different area. Nevertheless, I think it’s possible to use critical thinking to understand when someone is trying to use techniques of persuasion that don’t stand up to close examination. By doing this, we can identify alternative views of psychological phenomena—views that are at odds with what evidence supports. If people have research evidence to support their claims, they almost invariably present it. When they can present no evidence, but use other persuasive methods, we can usually tell this by examining what they say.

There have been some excellent expositions of ways in which scientific thought is different from the pseudoscientific approach characteristic of alternative psychotherapies. Elaine Gambrill, in her book Critical thinking in clinical practice: Improving the quality of judgments and decisions, has provided an almost encyclopedic compilation of comments on this issue, and much of my commentary here will be drawn from her material.

We need an example to use, and although I’m tempted to go at the Primal Wound again, I think  alternative ideas about Reactive Attachment Disorder may be a better instance. Here’s a goodie: This is the site of the Evergreen Psychotherapy Center, interestingly named for the town that was the focus of Attachment Therapy and the location of the death in therapy of Candace Newmaker in 2000.

A common persuasive device is the appeal to authority, and the attachmentexperts  site puts this right to work on the About Us page. There, two Evergreen staff members, Michael Orlans and Terry Levy, are said to be Master Therapists of the American Psychotherapy Association. And no doubt they are; some readers will remember how the pussycat Zoe D. Katze received her Diplomate from this group (check her out on Wikipedia if you haven’t heard about this). In addition to this claim of authority, the website notes that the Evergreen Psychotherapy Center is the only agency in Colorado to be registered with ATTACh (Association for Treatment and Training of Attachment in Children), a parent-professional organization that is in no way associated with licensure or accreditation of treatment facilities. This claim appears to enhance the authority of attachmentexperts, but upon examination under a strong light it is exposed as irrelevant.

The appeal to authority here does not survive even the simplest glance into the claimed sources of authority. Any literate adult could easily find this out. Having found it out, a reader should proceed with eyes wide open, because attachmentexperts has already demonstrated an attempt to persuade without presentation of evidence.

Let’s go on to another example of an attempt to persuade readers to accept a viewpoint that is not supported by evidence. Under the heading “What is attachment disorder?”, attachmentexperts  repeats an argument that has been around since the early days of Attachment Therapy. Here’s what they say: “Research has shown that up to 80% of high risk families… create severe attachment disorders in their children. Since there are one million substantiated cases of serious abuse and neglect in the U.S. each year, the statistics indicate that there are 800,000 children with severe attachment disorder coming to the attention of the child welfare system each year.” What have we here except a common persuasion strategy designed to bypass a reader’s logical examination? “Up to 80%” is not the same as “80%”, as we have all discovered when optimistically going to a sale with “up to 80%” price reductions. Attachmentexperts has committed the fallacy of composition, in which it is assumed that what is true about a part of something is also true about the whole. By referring to what “statistics” say, this paragraph again appeals to authority. Finally, by invoking fear of a disturbing situation, the paragraph tries to distract the reader from the obvious question: if these claims are true, and severe disturbances associated with violence and aggression (see “Attachment disorder: Traits and symptoms”) have been occurring at this rate for, say, 20 years, there should be 16 million such persons in the United States, out of a population of 300 million. In 2010, there were 2, 270, 100 people incarcerated in the U.S., less than half of whom had committed violent crimes. Where do attchmentexperts think the other 14 million people are? (Do I dare to walk out my front door?) If they are violent and aggressive, why have they not been caught and imprisoned for their crimes?  

Let’s look at one other way in which attachmentexperts attempt to persuade the unwary reader. If you look at the site, you will notice that the term “Reactive Attachment Disorder” is not used; instead, the reference is to “Attachment Disorder”. This is done in spite of the fact that books on the site’s suggested list in many cases reference Reactive Attachment Disorder. The attachmentexperts site depends on the resemblance between these two terms to work a little reification and word magic. With one hand, the site’s authors have pointed out the importance of established information about attachment and about Reactive Attachment Disorder, while with the other hand they wag their index fingers and say “that’s not what we’re talking about at all”. Providing a term, Attachment Disorder, that resembles the conventional term Reactive Attachment Disorder, enables attachmentexperts and their supporters to reify their concept--  to claim that since the words exist, such a disorder must also be. (This has come up repeatedly on this blog as readers have argued ferociously that the problems their children have must be Reactive Attachment Disorder, even though they overlap in no particular with that disorder as conventionally defined.)

I’m not claiming that everybody wants to spend their vacation dissecting the persuasive techniques used to support alternative psychotherapies. I’m just saying that even if you don’t have research design and statistics at your fingertips, or if you forgot everything Piaget ever wrote, you can still identify enough ill-omened attempts to persuade you and can figure out when there’s an attempt to pull the wool over your eyes. When you see a few of these attempts, you can be wary about any other communications from the same people. Critical thinking is the way to defend ourselves from those who want to persuade us against our own best interests, whether the persuaders are politicians or psychotherapists.  


  1. I don't know if this is possible, but could you do a post or series of posts about the rationale and evidence for the Love and Logic discipline system?