One would expect that psychology, like all other academic and health-related professions, would be going woke, though I haven’t heard much about this area beyond the “affirmative care” controversy with respect to transgender people.
But this article below, whose title implies that wokeness is invading psychology, also implies that the influence of “politics” on psychology is pervasive, and is having unhealthy results on patients. It’s from the journal Psychreg, which describes itself this way:
Founded in 2014, Psychreg is a free, award-winning digital publication dedicated to keeping everyone informed about psychology, mental health, and wellness. The publication, as well as the open-access Psychreg Journal of Psycholgy, are published by Psychreg Ltd, a media company based in London, United Kingdom.
Click to read:
I’m going to summarize the thesis in one sentence: psychology has adopted a “politicially correct” narrative, which is that nearly all mental illness or mental disturbance, including schizophrenia, can be traced back to “trauma and attachment narratives”: i.e., the sufferer must have experienced trauma and a loss of attachment some time in their lives.
Now this seems overly simplistic for several reasons. For one thing, it implicitly blames parents or friends for someone’s mental illness, which is not only hurtful when incorrect but can derail therapy. And, as Marshall says “Clearly people can develop psychosis with no trauma or threat in their lives.” He points out that the heritability of schizophrenia is about 80%, which doesn’t rule out environmental causes as contributors to the condition, but also implies that their role is relatively minor.
What I wonder is if this “trauma and attachment” narrative is somehow conditioned by psychologists becoming woke. We all know how loosely the term “traumatized” is thrown about, even used to one’s reaction at hearing “hate speech”. It is one of the three dicta of Lukianoff and Haidt that are said to explain the fragility of today’s youth:
1) The Untruth of Fragility: aka “What doesn’t kill you makes you weaker,”
2) The Untruth of Emotional Reasoning: aka “always trust your feelings,” and
3) The Untruth of Us vs. Them: aka “life is a battle between good people and evil people.”
If you are fragile, you can make sense of your illness as a result of trauma. And if you have a Manichean view of the world, as in #3, you can pin your problems on other people: a breaking of attachment.
Now I’m not trying to denigrate the mentally ill here, for Ceiling Cat only knows how many conditions can be unbearably painful. Rather, I’m trying to understand why the “attachment/trauma” explanation is, according to Marshall, taking over psychology. Just a few quotes:
As a clinical and forensic psychologist, I’ve always been interested in the causes – not correlates – of mental health, because associations, masquerading as causal mechanisms, bedevil psychology. Our profession is at a crossroads between science-based causal reasoning and knowledge versus politically biased narratives, where scientific evidence is irrelevant – and trauma is all that matters.
This part implies that it’s affecting diagnoses:
. . .Clinical culture is creaking under the weight of a blank slate trauma assumption. Even when it comes to the adversity to trauma pipeline, the position is unclear. In outpatient psychiatric clinics in New York, a review of newly admitted patients found 82% with at least one adverse childhood experience (ACE), 68% with two, and a staggering 42% with four or more ACEs; these are correlational studies, telling us nothing about what causes what.
And a bit more:
My experience, and that of others, particularly of child mental health service, is constant reference to trauma and attachment which in turn can leave the impression that this is all that matters. Imagine any other field of study or science that paints a two-dimensional picture of causal mechanisms in human well-being, ignoring decades of science on other factors? Physics without gravity; biology without natural selection. The over-focus on adversity then attachment/trauma, while well-intended, can lead to two-dimensional contaminated mindware, over-applied to every person’s emotional struggles.
. . . . Critical psychiatry approaches can highlight the presumed damaging effects of diagnosis. The problem is that deprived people are desperately seeking diagnoses for themselves, their children, and relatives in their droves. When a person can label pain and distressing emotions, this can alter positively such experiences and is relieving. An excellent diagnostic process should be collaborative and include a causal formulation. A diagnostic process should describe and classify problems, not the person. An ideal diagnostic assessment can view issues on a spectrum and blur the line between normative and pain. What’s the alternative? Well-being descriptions based on poverty, attachment and trauma for profoundly psychotic or seriously depressed people? The risk is that clinicians who overapply trauma/attachment models could explain autism, fetal alcohol spectrum, ADHD, and a raft of neurodevelopmental disorders from this blank slate standpoint.
Now the article isn’t written very well, but I did want to call your attention to what may be a misguided form of ideology creeping into psychology and psychiatry. Do weigh in if you have any experiences about the stuff above. And note that “diagnoses” are often tentative, sketchy, or weird in psychology, as evidenced by the continual changes of the DSM “diagnoses” in successive editions.
h/t: Ginger K.
Another creeping trend that involves Dr. Coyne’s Governor:
https://www.tabletmag.com/sections/news/articles/billionaire-family-pushing-synthetic-sex-identities-ssi-pritzkers
I’m an Illinoisan too, and I thank you for the link.
>We are making God as we are implementing technology that is ever more all-knowing, ever-present, all-powerful, and beneficent.
Yup. That’s exactly not how I think of “God.” Or technology.
If the over application of the trauma/attachment model is real — and driven by “woke” sensibilities — it is likely to turn around and bite them in the butt. Conservatives will use this to argue that children shouldn’t be put in day care, it causes mental illness.
I’m reminded of Jeffrey Moussaieff Masson’s Against Therapy. His conclusion that all psychotherapy is wrong takes on renewed strength in the context of the article our host references.
https://www.publishersweekly.com/9780689119293
Mind you, while I agree with Masson’s position regarding psychotherapy, I’m all in favor of evidence-based psychiatry. I’m not embarrassed to disclose that I’ve been taking an SSRI for many years, and I feel my life is the better for it.
This sounds like it’s about psychoanalysis which is in many ways a pseudoscience, or at lest used to be. There was a bit of an empirical turn in psychoanalysis too, with attempts of tests of critical concepts. Oedipus complex did not survive the tests, if I remember rightly, nor did repression of memories as a causal factor in disease.
Yes, Ruth, Masson sears psychoanalysis in this book. He started out as a Freudian analyst and ended up repudiating Freudianism in particular and depth psychology in general. In this book he also scathes the other talking therapies, like Gestalt and Rogerian. He subsequently became a vegan advocate for animals and has written many books on treating animals with kindness. He’s a fascinating person who has produced a valuable oeuvre, IMO.
Sounds like I want to read some of his works. Yes, Gestalt is also on the woo spectrum if you ask me (but I know less about it). The strange thing about psychotherapy, even of the more down-to-earth kinds like cognitive behavioral therapy, nobody really knows why it’s working and what about it is working, as far as such therapies do work, and short therapy courses generally do have an effect, although there are measurement problems (subjective assessment of symptoms post therapy may be influenced by wishful thinking).
CBT is a highly effective form of psychotherapy and is actually supported by decades of research.
Surely the author is only going after the dodgy forms of psychotherapy like psychoanalysis, and not the entire body of psychotherapy?
I read the book when it was published 34 years ago, and I don’t remember if Masson touched on cognitive behavioral therapy. You’re right to point out that he does debunk therapies that are not evidence-based.
I think he’s just criticizing the infusion of the trauma/attachment motifs into therapy in general, not attacking all of psychotherapy.
I just went through a 20 week Cognitive Behavior Program. I think attachment is more worthy a cause than trauma. The word trauma bothers me. But I was impressed with my therapists who really worked to make me understand that one cannot avoid anything or blame anything and get well. So there is that. But in group, there were people complaining of exposing themselves to things that bothered them. I knew from experience that no one with the label, PTSD, gets better avoiding anything. We are all talking about labels. I think they will come and go. I hope.
> Our profession is at a crossroads between science-based causal reasoning and knowledge versus politically biased narratives, where scientific evidence is irrelevant
I hate to say it, but this is nothing new. In my understanding, psychology has always been at a crossroads of science and various narratives; it’s always been torn in several directions. If it weren’t, we wouldn’t have terms like ‘Christian psychology’ (look it up!). My last psych class was ~20 years ago, so I may have missed something in the meanwhile.
Yes, you may be right, but the takeover of the discipline by attachment/trauma syndrome may be something new, and possibly worse than before. Things can get worse even if they’re not so geat to start off with.
Didn’t Sigmund Freud emphasize child-parent relationships as forces acting on the adult psyche? Not so different from attachment/trauma.
My recollection is that this idea dominated until it was decided Feud was not very scientific in his methods. Pinker (and others) blasted the Blind Slate idea out of the water when he reminded us of the strength of genetic influences.
Yes. I had wanted to comment that this sounds like a return to the seventies where a generation of psychoanalytically trained psychologists/psychiatrists wanted to blame even raving schizophrenia on bad mothering and autism to attachment problems. A new generation of cognitively and empirically trained people then took over. “Schools” cöearöy play a big role here, still do in psychotherapy.
Is it possible that psychiatry is BS profession? This insightful and hilarious piece from Harper’s suggests, at the very least, that psychiatry is a zany and wacky business (I love this essay; I wish I had written it):
https://harpers.org/archive/1997/02/the-encyclopedia-of-insanity/
Also, there’s this from Siri Hustvedt’s recent review in the Washington Post of “Desperate Remedies” by Andrew Scull: “Scull directs the reader’s attention to the fact that after decades of research and billions of dollars spent, not a single biomarker for psychiatric sickness has been discovered.”
Thanks for the references!
I am a Psychologist who just retired from teaching for 12 years in a Sate school. At the time we were not yet woke and the Attachment and trauma narrative did not have much traction at all insofar as schizophrenia is concerned. We taught that schizophrenia is actually several diseases in two broad categories which are negative symptom and positive symptom. Yes, they are treated differently. Negative symptom schizophrenia is much more debilitating and until recently it was difficult to treat the disease with drugs. Positive symptom schizophrenia however has a long history of successful drug treatment. In short, we view not only schizophrenia but other serious mental disorders as diseases of the brain which are often successfully treated with drugs which impact neurotransmitters in the brain. We discussed trauma in conditions such as PTSD but still drugs and psychotherapy are used as treatment. We taught attachment in the context of personality not serious mental disorders. I was not a clinical psychologist and was much more scientific rather than applied. The real schism in Psych is the divide between the scientists and the practitioners. The latter are more likely to fall victim to the woke nonsense. Finally, this attachment/trauma narrative harkens back to the debunked schizophrenogenic mothering of the 1950’s and 1960’s.
That’s what it reminded me of, also. Absurd in the modern day and age, especially since it’s so well known that schizophrenia is an organic disease…more hardware problem than software.
There is strong evidence for schizophrenia and autism as diametric diseases, with opposite deficits (e.g., impaired mentalism with social deficits in ASD, pathological hypermentalism with hallucinations in schizophrenia), and linked to many of the same parts of the genome.
It’s hard to understand why some psychologists are still teaching that the suffering of someone like “Ann” in that article is caused by trauma or bad parenting.
https://www.sfu.ca/biology/faculty/crespi/pdfs/115-Crespi&Badcock2008.pdf
https://www.psychologytoday.com/ca/blog/the-imprinted-brain/201701/opposite-genetic-profiles-autism-vs-schizophrenia
Marshall mentions critical psychiatry, which is a postmodern critical theory of psychiatry and mental illness “challenging the biomedical dominance of psychiatry” (Duncan Double). It is rooted in the radical leftist antipsychiatry movement of the 60s and 70s. (The term “antipsychiatry” was coined by the South African psychiatrist and Marxist David Cooper in 1967.)
“Critical psychiatry is a broad tent, with many different perspectives and influences. Broadly, it can be characterized as a field that takes exception to some or all of the current dominant premises and paradigms and endeavors to explore the implications of various critiques of mainstream psychiatry for actual clinical practice and for the nature and shape of mental health services.” (p. 4)
“Critical psychiatry is distinct from antipsychiatry in that its practitioners generally accept the need for services of some description to support people with mental health problems and have been involved in a wider dialogue about how psychiatric practice needs to change to reflect challenges from the intellectual critiques and the service user movement.” (p. 10)
(Steingard, Sandra, ed. Critical Psychiatry: Controversies and Clinical
Implications. Cham: Springer, 2019.)
“Our profession is at a crossroads between science-based causal reasoning and knowledge versus politically biased narratives, where scientific evidence is irrelevant – and trauma is all that matters.” – John Marshall
Postmodern critical theories (“critical” in the sense of the neo-Marxist Frankfurt School) politicize everything and see systems of oppression everywhere, including medicine in general and psychiatry in particular.
“David Ingleby and his fellow contributors to “Critical Psychiatry: The Politics of Mental Health” (Ingleby, 1981) were united in the belief that, although the locus of care had shifted from institution to community, the fundamental problems of psychiatry remained. The underlying premise of Ingleby’s ideas is that mental illness is a political issue. Although he refers to Foucault, his book was written before Foucault’s ideas had made their full impact. Ingleby accepts the existence of states of profound suffering and alienation seen in psychosis, but questions the interpretations psychiatry makes of such states. He argues that we can best understand conflicting viewpoints about the nature of madness in terms of underlying philosophical systems, and that these systems of thought are ultimately driven by moral and political considerations. Thus, his analysis is conceptual rather than empirical. He argues that the understanding of madness has always been contested and that this reflects two fundamentally different approaches to human experience. Positivism applies the scientific methods of the natural sciences to human experience. Hermeneutics, on the other hand, regards the subject matter and methodology of the human sciences as one and the same thing.”
(Thomas, Philip, and Patrick Bracken. “Critical Psychiatry in Practice.” Advances in Psychiatric Treatment 10 (2004): 361–370. pp. 362-3)
I read the quotation over three times, and as far as I can tell, it has no meaningful content. It says nothing.
I wrote a response, but decided it was more of a screed. I will try to distill it down.
The whole “trans empowerment” movement in psychology could not exist in a field that was otherwise based on science and had patient safety as the primary concern.
My wife is a psychologist specializing in the treatment of schizophrenia. I have seen enough research to convince me that trauma is indeed a major factor in the genesis of schizophrenia. Of course, genetic factors influence the fragility or robustness of an individual to deal with trauma, too. It is not either/or.
A very unethical experiment was conducted in Nazi Germany that sheds light on the issue:
Source: E. Fuller Torrey and Robert H. Yolken, Schizophrenia Bulletin
This is an instance of a general point that I think Jerry has made before in a different context: studies of heritability reflect the distribution of environments that a population has had. Change the environments suddenly, and surprising things can happen, even to a trait with high heritability.
How is that an experiment, Paul? What sort of light, exactly, does it shed on the issue? Where is the control group? Postwar Germany (West only?) was such a different place environmentally and demographically from the Third Reich that I don’t think you can say the so-called experiment used even historical controls, which as it is are the weakest type of control. If you think this episode of mass murder tells us anything about the cause of schizophrenia you should say what you think it shows. Even the authors of the article you link don’t think it shows much of anything, other than to document the greatest crime in the history of psychiatry, as they correctly refer to it.
There is a taboo against citing the results of unethical research, even if conducted according to robust scientific standards, other than to condemn it on the pragmatic grounds of not encouraging others. Torrey and Yolken acknowledge this and justify their own paper on the grounds that the Reich psychiatric mass murder wasn’t in fact research, which it wasn’t.
Nonetheless a minority argument lingered into the 1980s that Nazi research specifically into induced hypothermia conducted at the Dachau concentration camp, which Torry and Yolken allude to, might contain results that could benefit modern victims of accidental hypothermia or near-drowning if the veil of the taboo could be lifted. Unlike many so-called experiments which were just torture administered by people wearing lab coats as if at a costume ball or a fetish party, the hypothermia experiments were commissioned as such for the purpose of saving the lives of Luftwaffe pilots and aircrew forced down in the North Sea.
Berger dug out the surviving harrowing files on the project for a special article in the New England Journal of Medicine in 1990. Material retained in the camp had been destroyed as the Germans abandoned it ahead of the Allied advance but a large volume of material had been forwarded to SS Reichsfuhrer Himmler and was captured in Berlin.
https://www.nejm.org/doi/full/10.1056/nejm199005173222006 (should be free) This article created a stir when it was published, with many criticizing Berger and editor Marcia Angel for breaking the taboo.
His conclusion was that even though the work was done with some scientific intent to learn something, and not just to torture people to death (even though that is what happened to all but two of the hundreds of coerced experimental subjects), the scientific quality was so poor, largely down to the murderous incompetence and mendacity of the investigators, that no useful information could be harvested from the work. Furthermore, he showed how post-war citations of “useful Nazi science” were erroneous in claiming validation of some treatments of hypothermia. These authors were led astray through relying only on secondary sources and abstracts of the work, which were belied by reference to the primary data and methods.
What this “experiment” shows is not much, unless you had thought that the only important contributor to schizophrenia were genetic. And sure, it’s not a scientific experiment. It’s not a “natural experiment” either, exactly, but it still tells you something about the collection of all other variables versus the contribution of genetics.
But mostly, it just serves as a reminder that heritability isn’t a sure guide to what treatments could ameliorate or worsen a problem.
I agree with Paul’s point that increasing or decreasing trauma and other things about the environment can change the estimate of the heritability of mental disorders. But that’s different from the critical psychiatry stance, which seems to be that if we could protect people from trauma they would not develop schizophrenia.
The woke virus has become pandemic in academia, including medicine and psychology/psychiatry/psychotherapy. So-called “disability studies” and “fat studies” (obesity studies) are already part of the family of postmodern critical theories. I just learned that there is a new sort of such studies with a funny name—”mad studies”. Critical psychiatry has already been mentioned, and yet another new phrase used in this ideological context is “critical mental health”, where “the social construction of mental illness” is a central topic.
For more, see:
* Routledge International Handbook of Mad Studies (2022)
* Routledge International Handbook of Critical Mental Health (2018)
Psychology isn’t the only “scientific” field with politically-biased narratives.
PC is pushed all over the place in “science”, especially on hot topics.
Brief examples re:
Covid-19
https://www.nature.com/articles/d41586-021-01430-z
racism
https://www.nature.com/articles/d41586-022-01527-z
guns
https://www.sciencedaily.com/releases/2018/05/180531171607.htm
abortion
https://medicalxpress.com/news/2018-05-quiet-revolution-abortion-rights-ireland.html
How is research into the effects of different gun laws on homicide rates PC?
The Bic vs Raoult controversy re hydroxychloroquine is also not really a example of PC creeping into science, IMMO.
In fact, only the article about racism shows to be sauced by a large dollop of PC.
As someone with insider knowledge of psychology, I can confirm this phenomenon is true. I hear the word “trauma” almost every single day. It’s “trauma this, trauma that”. It seems like the US is a nation of veterans with PTSD. Or perhaps trauma is just thrown around to describe anything mildly bad that happens. Also, attachment theory is very sketchy. It was created by John Bowlby at a time when parental investment theory and other biological theories of parental attachment did not exist, so take it with a grain of salt.
One should note that in medicine, the word “trauma”, unless qualified as “psychological trauma”, refers to physical trauma.
And in South Africa we know about physical trauma, I hardly ever have a quiet weekend. Only during the lockdowns (curfews and alcohol bans -despite the latter being circumvented systematically-) we had some respite. But now the people appear to want to make up for that, more trauma (physical, blunt or sharp) than ever.
Luckily in my districts (South Cape and Central Karoo) gun violence (although not really rare) is not excessively common.
Carl Sagan’s classic work The Demon-Haunted World does a masterful job laying out the damage done by the ham fisted work The Courage to Heal, found on shelves of mostly social workers with master’s degrees in private practice who feel no compunctions about using guided imagery and hypnosis to look for repressed memories of childhood trauma in the dark terrain of their clients’ minds. It is more likely that the dark terrain of psychotherapy, still largely unenlightened by solid research into the very fluid nature of memory, is the more important dark terrain to try to enlighten.
It’s sobering that the latest synonym for “repressed memory”, “dissociative memory disorder”, has an entry in DSM-5 written by clinicians commenting on highly controversial research areas without input from actual researchers in those areas.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826861/
Speaking of the fluid nature of memory, I recently sat with my older brother in his apartment as he recounted something that happened to him as a child, falling out of a car and landing on a gravel road. The reason I felt so amazed by his story was that his story was, detail for detail, a story that I grew up believing happened to myself. I didn’t learn until full adulthood that my “memory” was confabulated.
Just a thought, perhaps you did fall out of the car and your brother “absorbed” that memory as his. Our memories our not reliable things.
The accident happened years I was born. I’m the youngest. I was with the siblings for a holiday gathering as an adult some years later that I first brought up my “memory” of the accident. All the family looked at me strangely for a moment, and someone said, “That didn’t happen to you– it happened to Gail.” Gail’s narration of the story while I could clearly see it in my mind’s eye happening to myself (the car door was loose, mom said “don’t try to shut it tighter, I thought I would try anyway… ) felt a bit surreal.
Throat clearing: I’m not a psychologist, but a retired general physician. My better half is a child psychiatrist (not a psychologist!) and so these matters are the small talk of our household.
Attachment issues are, sadly, very important in lots of psychiatric conditions. Is that political? Well, perhaps in terms of root causes (fragmented families, absent fathers, totally inadequate parenting styles). Describing almost any form of adversity as ‘trauma’ is a political stance rather than a science-based one, in my view.
However, I don’t think it’s fair to lump in clearly biological conditions like schizophrenia. Psychologists are as prone to the phenomenon of “if you have a hammer everything looks like a nail” as the rest of us. Since they have no ability to mess with biological matters with drugs, they do tend to see everything in terms of their hammer, psychodynamics. Sure, twin studies don’t show perfect concordance, and some of that will be environmental, but we still can’t say all of that is trauma and attachment problems! Varying gene expression, differences in neuronal pruning (esp. as it’s clear that substances like marijuana affect pruning by altering neurotransmitter levels) and pure stochastic chance play a part.
Nonetheless, I can’t argue with the creeping politicisation of the social sciences. It’s not new. I was a psychiatry resident for six months as part of my postgrad training at the height of Maggie Thatcher’s reign. It was charming to listen to the lovely psychiatric social workers enrage themselves over her policies, as if only she were to disappear the psychiatry wards would empty and rainbow-coloured unicorns would flit around singing. (To be fair, Maggie did empty the wards, but by closing nearly all long term psych in-patient hospitals! No unicorns filled the streets, only muttering homeless people who talked to themselves.) What has changed is the flavour of politicisation, which has moved from straightforward old left views, to the regimented and uniform woke fashionable concerns. I think it’s fair to say that ‘systemic racism’ is now growing in popularity as a causal factor in the claimed etymology of psychological conditions, either because you were its victim, or from the guilt of implementing it. You can’t escape however you try from formulations like this, which does rather save the lazy psychologist from having to think, to analyse, to figure out solutions for individuals. No wonder it’s attractive to the less gifted members of that worthy profession.
Jerry, you might be very interested in what is going on at ABCT (https://www.abct.org/) with respect David Barlow’s research from many years ago on conversion therapy. A similar blow-up is happening at SRCD (https://www.srcd.org/), where all of the editors of the major society journals resigned last month in protest. Much of this is playing out behind the scenes and on twitter, but both situations are related to political/woke ideologies mixing with science, in sometimes (in my opinion) dangerous ways. Editors are being pressured to change content (at SRCD) or to retract scientifically sound papers (at ABCT and other related journals that are not affiliated with ABCT) because they don’t conform to certain modern ideologies.
I suffered severe mental problems as a child and young adult, more than one leading to suicide attempts). There is nothing from my childhood upbringing that would have caused this as far as I can recall. My two siblings shared the same upbringing but never had any mental problems that they shared with me.
I think much of this conversation is based on popular stereotypes of what psychology is rather than an understanding of the field. Academic psychology doesn’t just cover mental health, hasn’t cared about Freud (other than trying to disabuse students) in decades, has developed some of the most robust methods available for dealing with real-world data, and (rather self-consciously) teaches its students about scientific reasoning at a deeper level than the typical “hard” science curriculum. Don’t dismiss the field. There’s a lot to criticize, of course, but there is a useful baby in that bathwater.
As ‘The Pinkah’ remarked about a sociopath:
“Johnnie came from a broken family”
“Yeah, Johnnie could break any family”.
Cause and effect are not always very clear here.