A tiny couch dangles from a necklace cord on the cover of William Epstein's latest book, Psychotherapy as Religion and the symbolism is clear: the psychotherapist's fabled couch has supplanted the cross and other religious symbols we hang around our necks.
At least that's what Epstein, a professor of social work, contends in some 200 tightly argued pages. The cover image might also symbolize an albatross that hinders the development of what, to Epstein, would be more effective social policy.
Epstein came to UNLV nearly 15 years ago after teaching at the Chinese University of Hong Kong, the University of Southern Mississippi, and the State University of New York at Buffalo. In this work he analyzes a number of clinical studies about the effectiveness of psychotherapeutic treatments. He finds that each study in some way violates the criteria for scientific credibility.
"The typical megabookstore devotes about 300 linear feet of shelf space to psychotherapy, counseling, self-help, and the like," he observes. "The last time I looked there was not one single item on the shelf that questioned the field's effectiveness."
He doesn't mince words in his criticism of those who purport to evaluate the effectiveness of psychotherapy: "I was constantly impressed with the cult-like assurance of presumably neutral researchers that therapy works. These are the very last people who should be evaluating their field's practice, yet the National Institute of Mental Health largely restricts its research grants to them. Talk about insularity!"
Epstein calls psychotherapy "the civil religion of the United States, an institution that shapes American policy thereby demonstrating that rationality plays hardly any role at all in our society's social choices."
In an introduction that draws historical parallels between psychotherapy, Christian Science, and spiritualism, the outspoken professor states his case.
His concern centers on psychotherapy's focus on the determinative influence of character rather than social conditions. "This, in turn, emphasizes the nation's choice of personal responsibility over social responsibility in inspiring social welfare interventions. Thus the poor are most often seen not products of an uncaring, ingenerous, and cruel society, but rather as moral failures, miscreants who have freely chosen to be burdens on their fellow citizens."
He says he became convinced that psychotherapy is "bogus" by "constant observation that it does not work with people we know who have very serious behavioral problems: addicts and alcoholics, the morbidly obese and morbidly thin, phobics, the violent, the drab, the self-centered, and so on. Remission of symptoms is more often coincidental with therapy than a result of therapy."
