Letters

Defending psychologists

Thanks to Michael Price for the December Monitor article, “Disputing a slam against psychology,” reviewing critical reactions to the article by Baker, McFall and Shoham, which attacked psychology practitioners for failing to base their treatments on scientific evidence.

I would add the criticism that empiricist-objectivist types like Baker et al. conflate science with “scientism” — the epistemological presupposition that the methodology of the natural sciences gives the only access to truth and valid knowledge. What is needed in this age of the quick fix is serious philosophical questioning about the kinds of knowledge and “evidence” that are appropriate for guiding the therapeutic approach to the depths of a suffering human soul.

Robert D. Stolorow, PhD
Santa Monica, Calif.

Michael Price rightly defends clinical psychology from an irresponsible attack by a group within the American Psychological Society (APS). The views underlying this attack can be described as a form of scientific fundamentalism. Like some of its counterparts in religion, economics and other social arenas, scientific fundamentalism is an ideology claiming special access to the truth but actually driven by anxiety about complex social problems and a hope that rigid adherence to a simplistic program of action will produce clear and certain solutions. Scientific fundamentalists typically invoke reified versions of operationalism and falsificationism long rejected by virtually all serious philosophers of science. However, like their counterparts in other social arenas, scientific fundamentalists tend to cling to questionable conventions, apparently because doing so provides a reassuring feeling of certainty, not to be confused with the actual certainty of the knowledge they hope to acquire. Since real knowledge can rarely be categorized as certain, scientific fundamentalists are prone to react to the limitations of their program with increasing anxiety and attempts to exert political control over those who do not see things their way, and this is precisely what the APS group is now doing with its program of “accreditation.”

APA is to be commended for its resistance to simple-minded positions on psychological knowledge and for the careful work of the 2006 Task Force on Evidence-Based Practice in developing a more sophisticated analysis of these difficult issues.

Michael R. Jackson, PhD
Earlham College

In the “Disputing a slam against psychology” article, APA’s Katherine Nordal is reported as defending psychologists against the charge that we are unscientific in our practice of psychotherapy by claiming psychologists are not frequent practitioners of suspect therapies. One of the therapies listed in the attack was “eye-movement desensitization,” usually referred to as EMDR. A weakness of Dr. Nordal’s defense was that it ignored the fact that EMDR is an evidence-based method of psychotherapy, according to reviews by the International Society for Traumatic Stress Studies, the American Psychiatric Association, the VA/Department of Defense and others. In addition, Francine Shapiro, PhD, the originator of EMDR, was the recipient of the 2009 Div. 56 (Trauma) Award for Outstanding Contribution to Practice in Trauma Psychology. This award would strongly suggest that EMDR is appreciated by psychologists specializing in trauma treatment. It is difficult for us to make a compelling defense of the science of our practice when our arguments don’t recognize the evidence-based practice we do employ.

Howard Lipke, PhD
Wheeling, Ill.


Accurate picture of homelessness

I found your article “More than shelter” (December) not only to be correct, but also quite informative. Being a former homeless person myself, I thought the article was well-written and well-researched. I survived seven years living on the streets of San Francisco due to letting my life spiral out of control via substance abuse, and I must mention that one gets treated like a second-class citizen. The treatment (i.e., attitude) by workers even at places that are supposedly there to help the homeless further alienate and disempower this population. I am glad to see that there are well-thought studies that actually research the needs and wants of this population, rather than herding them like cattle into homes. Transition from the streets to living indoors is a process, and for an individual who is suffering from mental illness, this transition needs monitoring by empathetic and caring people. I believe that having more home-based services for people who are undergoing this kind of transition allows for a smoother shift back into society. I applaud the efforts of this great work. Thank you.

Stephanie E. Maxwell
Carlisle, Pa.


A controversial study

The article by Tori DeAngelis (“Porn use and child abuse,” December) was great journalism, but probably not great science. The results of the Bourke and Hernandez study were certainly shocking and outside what has been generally found from prior research. While the treatment setting may genuinely have brought out more confessions in this population, we have to look at the population they studied and the time frame in which their study took place.

First, the subjects were volunteers in a sexual offender treatment program in a federal prison system that does not mandate treatment. So, how representative of all Internet porn offenders is their population? Second, the study began in 2002. The offenses could have been even years earlier when the Internet was very new. I would have my suspicions that the advent of file sharing programs later in this new century changed the access to child porn and therefore the type of person who would seek it. And finally, nothing in the article addressed the issue of adult pornography addiction on the Internet and the relationship of that phenomenon to the progression to child pornography.

My experience working with this population pretrial in therapy and evaluation indicates that the majority of my patients were primarily compulsively looking at adult porn, with the child porn usually of much smaller numbers compared to the adult porn on their computers. I would be very surprised if the population I see matched the Bureau of Prison study group from 2002. I also have not seen prosecutors or judges take the offense lightly or dismiss these defendants as not a serious threat to society.

Dean L. Rosen, PsyD
St. Louis


Response from the researcher

As we indicate in our paper, we encourage additional research to address the issue of generalizability. With regard to the second point, while technology continues to alter the landscape of sexual criminality, it does not appear that file-sharing programs have altered offenders’ underlying motivational pathways. Rather, such programs merely facilitate the acquisition of desired material.

The next point warrants several comments: First, non-paraphilic individuals do not “progress” to viewing child abuse images after viewing adult pornography any more than they “progress” to child molestation after engaging in sufficient sexual encounters with adult partners. Rather, the extant research suggests that in some cases the images simply reinforce preexisting, latent pedophilic interests. Second, I agree that many pretrial defendants prefer to portray their collection of child exploitation images as an unfortunate consequence of a larger, more benign “pornography problem” (the alternative, after all, is to admit an enduring sexual interest in children). Similarly, only rarely do pretrial offenders admit they engaged in morally repugnant acts by choice; instead, they seek ways to excuse their behavior. Describing their deviance as an “addiction” sounds less volitional and begs for a more sympathetic, “treatment-not-punishment” response by the court. Finally, many child pornography offenders we treated possessed adult pornography, often copious amounts. This arousal pattern is entirely consistent with nonexlusive pedophilia, and adult images are much easier to locate. But the more important issue is the irrelevance of ratio; there should be no “credit” given for the quantity of adult pornography stacked on the other end of the moral see-saw. Offenders who “cross the line” choose to contribute to the online and offline victimization of children. Perhaps, as our exploratory study suggests, we should be cautious when making conclusions about the course of their deviance or the limits of their sexual acting out.

Michael Bourke, PhD
Chief Psychologist of the U.S. Marshals Service


CORRECTION

A December item in “Personalities” incorrectly described the new position of Elizabeth Carll, PhD. She has been elected the chair of the United Nations NGO Committee on Mental Health, a consortium of nongovernmental organizations affiliated with the UN. The group advocates for mental health awareness and access to services across the world. Carll is the first psychologist to be elected chair of the NGO Committee on Mental Health at the UN.


Please send letters to Sara Martin, Monitor editor, at the APA address. Letters should be no more than 250 words and may be edited for clarity or space.