Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Wednesday, November 03, 2004

An eye for fakes - by Jeff Gammage

Used by permission
Philadelphia Inquirer 10/25/2004

An eye for fakes

Exposing the quacks in psychological treatment is a Drexel professor's mission.

By Jeff Gammage
Inquirer Staff Writer

Believe it or not, James Herbert is saying, there's even one that goes like this:

The therapist has the patient tap on certain parts of her body, perhaps her cheek or eyebrow, as she concentrates on what's bothering her. The tapping is supposed to break up blockages in the body's natural "energy field" that are the cause of mental illness.

It's called thought-field therapy or tap therapy, promoted in slick-covered books and pricey seminars as a fast and almost certain cure for serious problems such as depression, anxiety, grief, phobias, addictions, panic attacks, obsessions and post-traumatic stress.

To which Herbert replies:


Herbert, 42, is director of clinical training in the psychology department at Drexel University, where he teaches, lectures and happily and concurrently labors in a self-assigned and self-satisfying role: a slayer of pseudoscience, a canner of canards, a butcher of baloney.

"Some colleagues have wondered, 'Why am I wasting my time?' " he says. "My answer is, I just think it's so important. The best antidote to pseudoscience is science."

Today, in a society always looking for a quick fix, unproven psychological treatments are everywhere. They're not merely damaging the reputation of the field. Some are downright dangerous. Others are financially and emotionally draining, some a torment to desperate parents seeking help for sick children - a subject with which Herbert has too-close acquaintance.

But his inspiration doesn't spring solely from personal experience. Mostly it stems from his education and training, from a desire to improve patient care, and a core belief that a discipline grounded in science stands the best chance of minimizing mistakes and maximizing benefits.

"For James," says former student and frequent coauthor Brandon Gaudiano, now a postdoctoral fellow in psychiatry at Brown University, "exploring the distinction between science and pseudoscience is not an academic exercise, sitting in an ivory tower. It's motivated by the belief that we, as psychologists, need to do our best to 'get it right.' "

Herbert's work places him amid a fierce, internecine debate, between psychologists who see therapy as an art, its practice best left to the skills of the individual counselor, and those, like Herbert, who push for an evidence-based approach.

"There are groups on either end that are vocal and a little bit extreme and have sort of polarized this thing," says Ronald Levant, incoming president of the 150,000-member American Psychological Association.

The argument is more than an academic tiff. It holds the potential to determine how future therapists are trained and even the kinds of treatments insurance companies will pay for - crucial for the 50 million Americans who seek help each year.

The debate has grown so charged that Levant appointed a task force to seek consensus.

As for thought-field therapy, Herbert would just like to point out: There is no scientific proof that tapping on the body will do anything for anybody. Even the promoters of tap therapy acknowledge it has never been tested in controlled trials.

Chasing bogus therapies, though, is a lot like playing Whack-a-Mole - knock one down, another pops up.

That led Herbert to an idea. Instead of continually trying to put out forest fires, he would grow a new forest. This fall he's teaching a new class on pseudoscience in psychology, one he hopes will help foster critical-thinking skills among aspiring therapists.

Herbert walks into the classroom and, without pausing to introduce himself, holds up a photo of a dark-haired little girl.

"Candace Newmaker," he says.

Two dozen students, draggy on a rainy first day of class, stare back. Herbert tells the story:

Candace was adopted at 5, and by the time she was 10 her mother was sure she suffered from attachment disorder, an inability to be affectionate that's thought to be caused by past trauma or neglect.

In 2000, Jeane Newmaker took her daughter to a clinician in Colorado, paying $7,000 to have Candace undergo an intensive two-week therapy called "rebirthing." The idea behind rebirthing, Herbert tells the class, is that attachment disorder springs from the ordeal of being born, and the way to fix it is to have the child relive the experience of birth.

A couple of students shift in their seats.

"I'm not making this up," Herbert says.

First, he says, Candace was wrapped in a sheet and pillows, to simulate a womb. Then the therapists and their assistants - four adults weighing a combined 673 pounds - began pushing against her to mimic birth contractions.

A videotape of the session shows Candace begging for air, screaming that she was going to die. The therapists tell her to "go ahead and die" so she could be reborn to her adoptive mother.

After 40 minutes, Candace stopped screaming. She died the next day at a Denver hospital.

"That is the story of Candace Newmaker," Herbert says.

The room is quiet.

See, Herbert says, goofy therapies aren't simply a contributor to public ignorance. People can get hurt. The therapists in the Newmaker case were sentenced to prison.

Yet pseudoscience - a broad term encompassing everything from dubious diagnostic tools to deliberate hoaxes - doesn't come with a warning label. It's part of a continuum, blatant craziness on one end, hard science on the other, a long gray stretch through the middle.

Keep an open mind, he says. Be alert to innovation. Don't be cynical, but always ask, What's the evidence? Even - especially - in this class.

"I don't want you guys to sit there and believe everything I say," Herbert says. "In fact, this Candace Newmaker thing? Maybe I just made it all up. Go check."

Herbert looks like a young Arnold Schwarzenegger. Tall. Square-jawed. Good teeth.

He was born in Alice, Texas, a scrub-brush town just east of nowhere, and at 6 his family moved to Corpus Christi. At 12 he began honing his skepticism by questioning the existence of God, a line of inquiry that won little favor in oil-patch Texas. By 1989, when he left the University of North Carolina with a doctorate in clinical psychology, he'd long since chosen the doubter's path.

"It sounds a little corny, but he has a passion for developing truth in our field," says Ian Sharp, a postdoctoral fellow at the University of Pennsylvania who studied under Herbert. "He's a great example of someone who does approach everything with skepticism, but also with humility, demanding proof for claims, but not degrading people for certain beliefs."

Today Herbert shares an Ardmore Victorian with his wife, psychology professor Lynn Brandsma, and four children. He spends weeknights practicing kicks in a studio - he holds a brown belt in karate - and weekends repairing wiring around the house. Life is good but not easy. Herbert's 16-year-old son, Aaron, is autistic, functioning at the level of a 3-year-old.

Aaron's autism helped fuel Herbert's interests, as perhaps no condition is more prone to pseudoscience. Despairing parents are willing to go anywhere, try anything, spend everything - and there are people eager to help them do it. A few years ago, the big advance was an assisted-typing therapy called Facilitated Communication. As Herbert writes in the Scientific Review of Mental Health Practice, numerous studies have since demonstrated its fallacy.

"You have to maintain the position of, 'Show me the data,' " he says. "And the more extraordinary the claim, the more evidence is going to be required."

Herbert never met Benjamin Rush. But, he says with a smile, he knows the man's work.

Rush was a celebrated Philadelphia physician, a delegate to the Continental Congress, a signer of the Declaration of Independence. In 1793, when yellow fever ravaged Philadelphia - then the nation's capital and largest city - Rush treated patients with a therapy in which he had absolute faith: copious blood-letting.

Some patients improved - to Rush the proof of his treatment's value. Many others died. But, well, they were gravely ill to begin with. Rush kept right on opening veins.

The same problem exists today, Herbert says, though, fortunately, people aren't having their arteries emptied into buckets. It's part of the reason that doubtful therapies take root - the human tendency to notice information that supports one's beliefs and ignore that which doesn't. Researchers call it "confirmation bias."

See, Herbert says, it's not just that some patients are dupes, or that all purveyors of new therapies are charlatans. It can be much more subtle. If a psychologist treats a patient, and the patient recovers, the therapist thinks his treatment caused the improvement. In reality, that may or may not be true. By employing scientifically tested therapies, healers can erase the human bias, relying on what is knowably true rather than what is intuitively felt - vital when a patient's health is on the line.

"The problem is that clinicians - and this is what makes you crazy - aren't trained in recognizing these biases," Herbert says. "Hey, I don't trust myself - I'm not exempt. I know my brain is biased. So I know not to trust it. We ought to be making decisions on the best science available."

Contact Inquirer staff writer Jeff Gammage at 215-854-2810 or