Psychology and Psychotherapy: How Much Is Evidence-Based?

Despite all those Polish jokes, Poland has its share of good scientists and critical thinkers. A superb new book illustrates that fact in spades:

Psychology Gone Wrong: The Dark Side of Science and Therapy, by Tomasz Witkowski and Maciej Zatonski,  Witkowski is a psychologist, science writer, and founder of the  Polish Skeptics Club; Zatonski is a surgeon and researcher known for debunking unscientific therapies and claims in clinical medicine. Together, they turn a spotlight on research and treatment in the field of psychology. They uncover distressing flaws in psychology research, show that many commonly accepted psychological principles are based on myths, argue that psychotherapy is a business and a kind of prostitution rather than an effective evidence-based medical treatment, and question whether psychotherapy should even exist, since in most cases it offers no advantage over talking to a friend about one’s problems and it can cause harm.


They describe how disasters of social control like forced sterilizations and uncritical application of questionable IQ tests were instigated by psychologists who relied on their own flawed thinking rather than on empirical evidence from scientific studies. They tell horror stories about researchers who lied, plagiarized, distorted, falsified or even fabricated data, and got away with committing outright fraud over and over again. In some cases fraudulent studies were accepted as gospel and became the basis for ill-advised treatments.

They argue for transparency in research and show how difficult it is for others to obtain the raw data from studies even when the researchers say they are willing to provide it. They offer proposed solutions to increase transparency and promote data sharing. They discuss problems with peer review, editorial policy, poor research design, non-publication of negative studies, and failure to replicate positive studies. They show how these have created a situation where psychological theories are virtually unkillable.

They show how study results can get distorted and changed in re-telling. Remember the Little Albert experiment?  An infant was conditioned to develop a fear of white rats by exposing him simultaneously to a white rat and a loud noise. This confirmed a popular theory, so it was immediately accepted as evidence that early childhood experiences could create lasting phobias that would extend to similar objects (in this case, to anything white and furry). Most psychology textbooks have misrepresented the facts about that experiment. They get the child’s age wrong, say he was conditioned with a white rabbit, and make up other stimuli that he supposedly reacted to, like a puppy and a teddy bear. Some textbooks even described how the researchers later “deconditioned” Little Albert, but that never happened. The research was done while he was in the hospital; they knew he would soon be leaving the hospital and it would be impossible to continue the research, and they deliberately decided not to decondition him. He died of hydrocephalus at age 6, so there is no way to know whether he would have had a lifelong phobia.

They uncover social control problems in the scientific community. Scientists who observed misconduct in their peers failed to report it in 36% of cases, and 69% of whistleblowers experienced negative consequences after reporting fraud.

Common yet questionable ideas


Psychoanalysis is a castle built on sand. Investigation has shown that Freud falsified or fabricated the details of every case he used to build his theory. His approach was not scientific. He never tested his ideas with experiments that might have falsified his beliefs, and he ignored facts that contradicted his beliefs. Many of his supposed original ideas came from other authors. How did he “discover” the Oedipus complex when none of his patients ever suggested they had such a problem? The answer is in a letter he wrote to a friend saying, “I found in myself a constant love for my mother, and jealousy of my father. I now consider this to be a universal event in early childhood.” Talk about projection and confirmation bias!

When tested, psychoanalysis was shown to be less effective than placebo. Its theories have been disproven, and no reasonable scientist or practitioner takes it seriously today. Yet it persists in popular opinion as one of the primary canons of practicing psychology.

Childhood experiences.  Witkowsi and Zatonski provide ample evidence to debunk these myths:

  1. Personality is formed by early childhood experiences.
  2. Mental disorders are caused by early childhood experiences.
  3. Effective psychotherapy depends on the reconstruction of childhood experiences.

Delving into childhood memories often causes serious problems, and has led to terrible abuses such as the recovered memory movement. The idea of repressed and recovered memories is a creative invention of therapists. Patients are easily duped because it provides a convenient scapegoat to explain their problems and relieves them of responsibility for their inability to cope with their lives. Academic psychologists bear much of the blame for failing to subject pop trends to empirical verification and failing to speak out and denounce false theories.

Child sexual abuse. The typical consequence of childhood sexual abuse is not psychopathology but resilience. Studies have found no correlation with adult mental disorders, even when abuse is frequent or extreme. Less than 10% of victims experienced the abuse as traumatic or shocking at the time it occurred.  Childhood sexual abuse is abhorrent enough in itself without tarring it with false claims that it causes adult mental illnesses. And those who point out the research findings should not be accused of advocating crime.

Psychotherapeutic interventions in general have been remarkably unsuccessful. Only one of the many varieties of psychotherapy is supported by acceptable evidence: cognitive-behavioral therapy. There is no correlation between a therapist’s training or experience and patient outcomes. Amateurs get equal results. The benefits of psychotherapy may be no better than the benefits of talking to a friend; in a sense, psychotherapists are paid to act as friends, which could be considered a sort of prostitution.

Therapy can do real harm and can lead to suicide. It encourages dependence, false optimism, and externalized responsibility. Not one study of AA has ever shown it superior to any other approach for treating alcohol abuse, and in fact untreated patients have similar or better outcomes. Sexual misconduct by therapists has become so common that insurance companies have been refusing to insure them.

Can we replace psychotherapy with something else?  Can a new “salutogenic” paradigm replace the pathogenic paradigm by focusing on human resilience and coping abilities? Mental health is characterized by commitment (a sense of purpose), by the belief that you have some control over your life, and by the understanding that change, not stability, is a natural element of reality. Hardiness is largely genetic but can be developed by exposure to stress.


Psychotherapy is more business than medicine. Bogus therapies abound. The authors devote two entire chapters to neurolinguistic programming (NLP), showing how it developed and flourished without any basis in reality, how the scientific literature served as theater decoration for a pseudoscientific farce, how it infiltrated academia, and how the scientific community irresponsibly failed to denounce it.

In another chapter, one of the authors describes how he perpetrated a psychological Sokal hoax.  He got a bogus article published about a new therapy he invented based on Rupert Sheldrake’s pseudoscientific concept of “morphogenetic fields.” He invented and plagiarized outrageously, and offered clear hints about what he was doing, but the editors didn’t notice. They had some questions, but he made up nonsense answers and they bought his explanations. He accuses the editors of failing in their responsibility to protect their readers from false information and harmful recommendations. He conducted a test by having 172 people read the article: 77% said they would recommend the article to friends, and 61% would recommend the invented therapy to a person struggling with psychological problems. It’s scary to think how easily he could have marketed his new therapy and become rich at the expense of patients. In fact, after he disclosed that it was a hoax, he got a letter from a man who insisted that it was not a hoax; he said he had been thinking along the same lines and had reached the same conclusions.

Reacting to pseudoscience

In the concluding chapter, they describe the strategies employed by scientists with regard to pseudoscience. They include remaining indifferent and keeping silent; playing down the problem;  attacking critics by questioning their competence and even their mental health rather than by engaging with the evidence; talking and giving the illusion of action without actually doing anything. Encouraging further debate, which is always a mistake; passive acceptance of criticism; arrogant hostility (insulting pseudoscientific practitioners and using words like psychobabble, mumbo-jumbo, quackery, and flimflam); and finally open, matter-of-fact criticism – the most fruitful strategy but the one least popular among psychologists. 


You may find some of these ideas questionable or unpalatable. If so, I hope you will read the book and give the authors a fair chance to explain their thinking. This is a well-referenced, well-reasoned book that is chock-full of information about the state of psychology today. It exposes a lot of dirty linen that would be of interest to any reader.  I agree with James Alcock, Professor of Psychology at York University, whose back-cover blurb says it should be required reading for every psychologist and psychology student and anyone contemplating psychotherapy.

I have only one criticism of the book. English is not the authors’ native language, and it shows. There are many infelicities of expression and even errors of grammar and usage. This does not interfere with understanding what the authors meant, but a good editor could have done a lot to improve their text.


This article was originally published in the Science-Based Medicine Blog. It later appeared in Skeptical Inquirer.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine Blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.

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