Exploding the Self-Esteem Myth, the January 2005 lead article of Scientific American takes a roller coaster hit at both modern Psychology and the self -help book industry. Stating that what seemed at first to be a strong link between physical good looks and high self-esteem turned out to be nothing more than a pattern of consistency in how favorably people rate themselves. And continued by stating; Even if raising self-esteem does not foster academic progress, might it serve some purpose later, say, on the job? Apparently not. Studies of possible links between workers' self-regard and job performance echo what has been found with schoolwork: the simple search for correlations yields some suggestive results, but these do not show whether a good self-image leads to occupational success, or vice versa. In any case, the link is not particularly strong. A few other methodologically sound studies have found that the same is true for adults.

The article proceeds by asking; What then should we do? Should parents, teachers and therapists seek to boost self-esteem wherever possible? In the course of our literature review, we found some indications that self-esteem is a helpful attribute. It improves persistence in the face of failure. And individuals with high self-esteem sometimes perform better in groups than do those with low self-esteem. So we can certainly understand how an injection of self-esteem might be valuable to the individual. But imagine if a heightened sense of self-worth prompted some people to demand preferential treatment or to exploit their fellows. Such tendencies would entail considerable social costs. And we have found little to indicate that indiscriminately promoting self-esteem in today's children or adults, just for being themselves, offers society any compensatory benefits beyond the seductive pleasure it brings to those engaged in the exercise. (End quote)

But what about clinical Psychology?

More than half a century ago already Hans Eysenck, analysed the first proper clinical trials of therapy at the Maudsley Hospital, London, compared the improvement rate of thousands of people undergoing psychotherapy with a control group who had similar psychological problems, but who merely remained on a waiting list.

While an encouraging 64 per cent of patients receiving psychotherapy improved after two years from their breakdown, 72 per cent of the control group made a similar recovery with no psychotherapeutic assistance.

Of those having the most rigorous and intensive therapy of all, full blown Freudian psychoanalysis, only 44 per cent recovered.

When Allen Bergin, a psychologist at Brigham Young University, looked closely at this kind of research, he found the data were hiding an even more peculiar story.

The "scatter" of measured change plotted on graphs for patients having therapy was much greater than the scatter for those receiving no treatment.

In other words, those that had psychotherapy either did fairly well, or often actually pretty badly. They tended to lie in extremes of the distribution, compared with those who had no therapy, who all improved by more or less the same amount.

Bergin had uncovered a result that has dogged the field since. Therapy could not only do good, but also harm. Further analysis found the greatest potential for harm was when therapists stuck rigidly to particular schools of training, rather than adapting to the patient.

Therapy has splintered into so many differing and often opposing schools - Freudians, Jungians, transactional analysis and a host of others - that it resembles the plethora of small Left-wing political groupings of the Seventies, often more united by a hatred for each other than the natural enemy, which, in the case of therapy, is science.

Contrary to the research evidence that sticking rigidly to a particular therapeutic orientation is bad for patients, these schools tend to emphasize vigorously why they are better than all the others, in order to survive.

But unlike factionalized Left-wing politics, therapy proved enormously successful and is growing at an incredible rate. The British Association of Counseling had just a few hundred members by the mid-Seventies but has now grown more than twelve fold to 16,000 members.

The Department for Employment estimates that 2.5 million workers in Britain today deliver some form of counseling as part of their jobs.

This dramatic growth has occurred despite the fact that scientific research continues to question the assumptions on which much therapy is based.

A key scientific blow to the therapy empire came in 1975 when Lester Luborsky, professor of psychology at the University of Pennsylvania, published a landmark paper with the title "Everyone has won and all must have prizes", known famously as the Dodo bird verdict, which comes from Alice's Adventures in Wonderland. The title is an ironic twist to Eysenck's early habit of titling chapters in his books from Lewis Carroll quotes.

He found that it didn't seem to matter what particular psychotherapy you had - everyone benefits more or less to exactly the same extent.

Given that many schools of therapy are based on fundamentally opposing theories of human nature, this is an incredible result. It appears to be irrelevant whether you have full blown Freudian psychoanalysis, an hour a day for five days a week for several years to probe your unconscious deeply, or just a few sessions of behavioral therapy, where it is assumed that your unconscious and your conscious do not exist.

This finding suggested that what gets you better are the effects of talking to someone who encourages you and activates hope.

This suggestion was confirmed by another major study conducted by psychologists Hans Strupp and Suzanne Hadley of Vanderbilt University in the United States in 1979. They found that depressed patients treated by a group of untrained people did just as well as those treated by trained and experienced psychotherapists.

Indeed, in 15 separate major scientific attempts to pool all the research done into the effects of therapist experience and training on patient outcome, only one ever found a significant positive association between years of therapist experience and patient benefit.

Yet another scientific nail in the therapy coffin was the extensive study conducted by Dr William Piper of the University of Alberta in 1991. He analyzed 22,500 therapist interventions from audio tapes of sessions, and found the more interpretations the therapist made, the worse the patient got.

All this welter of scientific evidence points to the fact that much of the benefit you can get from therapy is practically indistinguishable from what you might obtain from confiding in a reliable, understanding and intelligent friend.

The dramatic growth of therapy, despite Eysenck's paper more then half a century ago, and all the scientific data since, may be telling us something about the breakdown of relationships in our society, and the decline of conventional coping mechanisms, such as religion and the nuclear family.

Cognitive science is a child of the 1950s, the product of a time when psychology, anthropology and linguistics were redefining themselves and computer science and neuroscience as disciplines were coming into existence. Psychology could not participate in the cognitive revolution until it had freed itself from behaviorism, thus restoring cognition to scientific respectability.

Constructivist theory has roots in Piagetian notions of cognitive development as proceeding from self-directed action during infancy. Nativist theories subsequently became popular by producing claims of cognitive precocity, but left open many central questions concerning mechanisms of development.

By then, it was becoming clear in several disciplines that the solution to some of their problems depended crucially on solving problems traditionally allocated to other disciplines.

On the other hand, the American Handbook of Psychiatry defends therapy by arguing: "Perhaps its effectiveness can never be shown by scientific methods. Perhaps the experience of analysis is like that of beauty, of mysticism, of love - self-evident and world-shaking to him who knows it, but quite incommunicable to another who does not."

This kind of defense of therapy suggests that the rise of counseling is telling us something more worrying, about the continued retreat of scientific and rational thinking in the modern age, in the face of the new primacy of personal anecdotal experience. Only in such an increasingly Alice in Wonderland world can ‘everyone win and all must have prizes.’

For centuries, the holy grail of philosophy and neuroscience has been an explanation of consciousness. Arguably, it is the most fundamental of all questions. How does the loose porridge of neurones and neurotransmitters filling the human cranium produce the miracle of awareness? It seems impossible that experiences such as seeing the color blue, falling in love, or enjoying the fragrance of a rose are all ultimately generated by a clod of brain matter. Consciousness seems to be qualitatively different from everything else that exists in the known universe: a divine flame. This was certainly the view of the philosopher Descartes, L’homme Machine.

There is nothing ghostly or speculative about a brain. Yet, belief in a gossamer mind, snagged and trapped in the biological machinery, remains an enduring and remarkably tenacious image. Even today, in spite of prodigious advances in brain sciences, there are many well-informed commentators who are prepared to argue that consciousness is completely beyond the reach of human enquiry as Steven Pinker has  demonstrated in his book “The Blank Slate.”

One of the most widely cited biological explanations of consciousness is the so-called homunculus solution. This is the suggestion that the brain contains an area designate where images and impressions are interpreted and bound together. Thus, consciousness is manufactured in a precise location albeit one difficult to determine.

This idea is known as the homunculus solution because it implies a central executive: a little man, reduced in size, occupying a chamber in the brain i-om where he performs his singular and very demanding task.

Unfortunately, the homunculus solution has two very fundamental problems. Firstly, in spite of considerable efforts to find the homunculus's hideaway, it seems that there is no specific area in the brain which monitors, nominal - and a convenient fiction that provides us with post-hoc rationalizations to “explain” our behavior; and choice is something that is exercised in the absence of awareness. In reality, we can make nothing more of ourselves than we already are, and all our major decisions are made a good half second before we think of them.

However Steve Pinker  finds himself accused of “saying it's all in the genes” when he is actually only saying that it is 50% in the genes,  humans  are equally disposed towards co-operation.

We have language, make societies and adapt our environment to suit our needs rather than vice versa. We invent ethics, morality and science. Most importantly we have sophisticated minds that enable us to reflect on our actions and to exceed our genetic and cultural programming.


The Making of Disease in Psychology/Psychiatry today

For updates click homepage here