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Thursday, August 17, 2006

 

The APA and Psychology Need Reform: Full remarks of Nicholas Cummings

Nick Cummings has seldom been wrong about trends in psychology and I do not believe he is incorrect now. These remarks were presented at the APA convention in New Orleans, August 12, 2006.

Dr. Cummings is a past-president of APA and an innovator of the first order. He was a pioneer in managed behavioral healthcare and continues to lead the profession in providing state-of-the-art solutions to psychological service delivery. If you care about psychology as a profession, this is a must read: The APA and Psychology Need Reform.

Comments:
Well, I read the whole thing and I'm not sure what his point is. Or what trend he's predicting. Or what's wrong. Or what is meant to be done. Or what a better system would look like.

But, hey, criticism without solution is the easy part, right? (See, I just did that.)

You seem quite taken by it, perhaps you can summarize. Please.

Does Cummings think that the fall in prestige (or better, an increase in cynicism toward) the psych profession has happened in isolation? The same has occured with all professions since the 1950's. Engineers. Doctors. And this is despite the clear benefits that each of these professions continues to deliver. Ungrateful wretches.

(I'm missed seeing comment on what should be a fairly obvious parallel observation -- an increase in domineering religious fundamentalism over the past 20-30 years. Perhaps I skimmed to fast over the sections blandly referring to the importance of religious belief to people; and missed the bit about polarisation and "magical" thinking.)

And I really don't get the disconnect between calling for the APA to be a body driven exclusively by science, and yet having one that is also not "out of step" with The American Public. Whatever that is. An American public that apparently is made up of a monolythic viewpoint, but also asking that it be made up from self-actualised individuals.

???

Would this be the same American Public that knows full well that being overweight is unhealthy... but who are also heading to morbidly obese hell in a handbasket? Etc . Etc.

Frankly, with half of The American Public still of the opinion that Saddam had weapons of mass destruction... I'm not sure I'd feel uncomfortable leading rather than be lead by that public on occassion.

I guess we'll all remember our youth more fondly than we do the present day :)
 
Thanks for making Nicholas Cummings' address to the APA available. I was most encouraged by the fact that he is aware of the bias that I've been complaining about (with a few others thrown in to boot). My hope is that his remarks will give others the courage to be genuinely open-minded rather than simply 'politically correct'. I don't expect miracles but I'm glad that the challenge has been presented.
 
"Would this be the same American Public that knows full well that being overweight is unhealthy... but who are also heading to morbidly obese hell in a handbasket?"

That statement is out of date. We used to be headed to morbidly obese hell in a handbasket. We don't fit anymore. Now we're heading there in a mine cart.
 
I read the whole thing too, and I don't get it either. It sort of rambles. Maybe someone could summarize for us slow thinkers. What exactly needs to be reformed? What would these reforms look like?
 
Dr. Cummings seems to contradict himself.

On the one hand he laments that the APA attacks therapists practicing reparative therapy thus leaving a one-way street relating to "sexual preference" (that whimsical taste much akin to ice cream flavor preference).

On the other hand Dr. Cummings is upset that "Questioning the efficacy of certain popular but potentially harmful therapies is equated with a lack of compassion toward those who are ostensibly benefitting from such dubious treatments." and wishes that the APA would take a stronger stance against dubious and potentially harmful practices.

There is no question that reparative therapy is dubious (as I think even Dr. Throckmorton would agree) and there is at least some support for the notion that it is harmful (both from studies and from reporting). Applying Dr. Cummings criteria, one would have to say that the APA should be loudly quetioning the efficacy of reparative therapy and not listening to NARTH's claims that they aren't showing compassion to those who are ostensibly benefitting from such a dubious and potentially harmful treatment.

Also, it seems to me that Dr. Cummins is simultaneously decrying APA's past political activism while complaining that they aren't taking stances on other political issues he holds dear like criticizing single mothers. It's difficult to see if he is upset that the APA is political or if he's just upset that it doesn't share his politics (or those of the public at large).

There's nothing wrong with being partisan or wishing that your peers shared your political or religious views. But "why don't more of you believe in God" really is a very odd complaint. How does one go about "reforming" a belief in God?

Cummings points out that the leadership disagrees with his 1950's ideals and calls for an overhaul. Yet present in his complaints is the obviousness that the body of the APA is not in sync with Dr. Cummings, either.

Unfortunately, Dr. Cummings is sounding - to my unschooled ear at least - more as a curmudgeon and less as a reformer.
 
Yes, there are real problems with Reparative Therapy, which are only magnified when the proponents of the therapy try to lay the problems at the feet of the clients. Their failure to acknowledge such problems, and, worse, to try to blame everyone but themselves for the problems is troubling on many levels.
 
Dr. Cummings, I am pretty sure, is using reparative therapy as a generic term. I have been meaning to ask him to be sure.
 
Reparative therapy implies something is broken and can be fixed. Once again, if homosexuality is an illness, what are its symptoms?
 
Define homosexuality.Isn't it different for different people and different at different points in one's life?
Homosexuality (feelings) can cause a mental illness and drive an unhealthy behavior.
Homosexuality (behavior) can cause mental and physical illness
If a person is bothered by the homosexual feelings and wants to change them, it is up to the individual to make that call, not society.
If a person is bothered by the homosexual behavior and wants to change them, it is up to the individual to make that call, not society.
 
In case you haven't noticed, straight feelings and behavior can also cause mental and physical illness. That doesn't make heterosexuality an illness, does it? Would you "help" an unhappy straight person who wanted to become gay? If not, why not?
 
Hateful feelings and hateful behavior towards gays can also cause gays to have emotional and physical illnesses. Treat the hate, not the homosexuality.
 
Homosexuality is whatever it is to the person who is defining it. A person who has unwanted homosexual feelings certainly has every right to change how he/she will respond to those feelings. Promoting an only "go for it if it feels good" attitude is just as inadequate as promoting that you must change. Promoting that the client is right to self determine their attitude towards their own sexuality is fitting.
 
Would you guys get OVER it? No one is saying that people don't have the "right" to try to change. You have the right to push pencils up your nose if you want to -- but I don't have to think it's healthy.

And if words mean whatever you say they mean, why do we have dictionaries? We could all just speak gibberish to one another. Remember, words are how we communicate the Gospel. So their meanings are very important.
 
If a straight person wanted to become gay, would you also respect their right to self-determination and help them to change?
 
Anon: Yes, of course. Our guidelines specifically state this.
 
Dr. Throckmorton: I am truly shocked. Wouldn't this violate your Christian beliefs that homosexuality is sin? How would you help the unhappy straight person change their orientation or behavior? What methods would you use? How would you measure success? Do you know how to make a straight person gay? Is their any scientific research to support such an effort?
 
Hateful feelings and hateful behavior is in the eye of the beholder. If one has a “chip on his shoulder” a comment may seem hateful to the person but if the person has a “so what, that it the way life is, win some, lose some” then a comment may be dismissed. If a person is extremely sensitive, then that “sensitive feeling” needs working on. Treating “society” is impossible.
 
I did not say I would be the best therapist to do this but we do support client self-determination. We cannot be consistent if we do not do that. We have in the guidelines a clause for referral if there are value conflicts or other issues where the alliance between therapist and client would be compromised. I would probably refer but it really does depend on the situation.
 
WOW. I am impressed. I guess I am like you. I have referred to EXODUS in those RARE cases where I think that supressing one's homosexuality may be the client's best chance for happiness and I really disagree with EXODUS.

Of course, when I make such referrals, I follow the APA guidelines about informed consent, homosexuality not being an illness, no scientific basis for sexual reorientation, that such organizations may actually do harm, etc.
 
Well, whoever you are...

Have a look at the sexual identity therapy guidelines and see if you might consider supporting them.
 
I especially pay attention to Koocher's point #1 -- the therapist's ethical responsibility to fully explore why and how a client came to their decision to try to change their sexual orientation.

Most reparative therapists just jump right in because they believe homosexuality is sin. "Why of COURSE, your're unhappy", they seem to say. "That's because you're gay. Let me help you..."

For example, Nicolosi states that only 22% were motivated by "outside pressure". Is he kidding? He says 77% were seeking healing of "emotional hurts" and not feeling "outside pressure".

What caused these hurts? How naive can he be?

He lists "other factors" but seems oblivious to the fact that all of the other factors he measured ARE "outside pressures". And all of these motivations are rated 60% or higher --

* personal sprituality (being taught that you will go to Hell is pressure don't you think?)

* desire for wife and children (a cultural and family pressure, perhaps a "good" one, but an outside pressure nonetheless)

* religious teachings (see above)

* desire for non-sexual male friends (What? I have lots of male friends who aren't gay. What is he talking about? This implies that gay men only think of other men in a sexual way. BALONEY! You don't have to change your orientation to make friends.)

* "conscience" -- does he mean a sense of right and wrong? We are not born with conscience. We LEARN it. Such a sense is developed through social pressure and interaction.

* expectation of an unhappy gay life (Such as? prejudice? loss of job? loss of family and friends? gay bashing? Tremendous bigotry and outside pressure contribute to gay unhappiness. It doesn't occur in a vacuum.)

How can Nicolosi ignore that the fact that ALL of the factors he lists ARE outside pressures?
 
An earlier post says that hateful behavior is in "the eye of the beholder" and suggests that the person needs to work on not being so "sensitive".

I am the victim of a Hate Crime. Don't tell me not to be so sensitive.

A six inch knife plunged five times into the back of an unarmed gay man (my best friend who died trying to protect me)is not "in the eye of the beholder". It's hateful behavior in the back.

And I didn't have a "chip on my shoulder" or a "sensitive feeling." What I had was a hole in my right lung.

The anti-gay hate that fueled this (and similar attacks) CAN be treated. And the anti-hate message should come from Christ's church.
 
Hateful behavior is also in the eyes of the law. You can't do it in our democratic society. You may not target any particular group for acts of hatred. You can go to jail for it.
 
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