Everything You Know Is Wrong. (Almost but Not Really). A Review of. Facts and Fictions in Mental Health by Hal Arkowitz and Scott O. Lilienfeld. West Sussex ...
PsycCRITIQUES October 9, 2017, Vol. 62, No. 40, Article 1 © 2017 American Psychological Association
Everything You Know Is Wrong (Almost but Not Really) A Review of Facts and Fictions in Mental Health by Hal Arkowitz and Scott O. Lilienfeld West Sussex, UK: Wiley Blackwell, 2017. 269 pp. ISBN 978-1-11-83-1130-1 (hardcover); ISBN 978-1-11-831129-5 (paperback). $79.95, hardcover; $21.95, paperback http://dx.doi.org/10.1037/a0041078 Reviewed by
Gerald P. Koocher
What do we really know (or think we know) about mental health? Unfortunately, considerable mythology and numerous erroneous beliefs abound regarding mental health, psychopathology, and psychotherapy. One might think that expert mental health clinicians have the education and training to make such discriminations easily, but many factors align to reduce the ability of both experts and the public to separate fact from “alternative facts.” To begin with, the half-life of knowledge acquired in earning a doctoral degree extends far less than a decade; at least half of what we learned in graduate school has become obsolete before the seventh or eighth reunion of our doctoral class. In addition, the mantra of evidence-based practice remains mired in disputes about what exactly constitutes valid evidence (e.g., randomized controlled trials, meta-analyses, qualitative data, or brand-name psychotherapies). One result is that many experienced clinicians become entrenched in their modes of practice, do not keep up on the latest outcome research, and come to believe through heuristic biases that their tried-and-true beliefs hold continuous validity. Furthermore, portrayals of mental illness in mental health practitioners, dangerous people, pharmaceutical advertising, and sensational news stories often mix facts with nonsense. Mental health experts often weigh into controversies with lots of intuition and firm beliefs but little scientific foundation or predictive validity. Examples abound, and the first half of 2017 has seen numerous putative experts opining on the mental status and personality of President Donald J. Trump and the harm likely to be caused by the Netflix teen suicide drama 13 Reasons Why. The capacity of the public, news media, and even other professionals to critically evaluate the plethora of opinion resented as fact seems quite shallow. One can easily understand the intuitive appeal of conferring credibility that leads to unsubstantiated beliefs and overgeneralization. In the face of these phenomena that can lead to myths and their perpetuation, Hal Arkowitz and Scott Lilienfeld have written a fascinating book aimed at clarifying fact and fiction applied to mental health, psychopathology, psychotherapy, and related issues. Facts and
Fictions in Mental Health consists largely of material previously published as bimonthly columns in the magazine Scientific American Mind. The authors have updated the material and added new content about suicide, bipolar disorder, creativity, and popular conceptions of psychotherapy. With frequent references to popular media, Arkowitz and Lilienfeld cover a wide range of topics ranging from popular myths regarding diagnoses and psychopathology to whether animal-assisted therapies help, what to do about road rage, the use of electroshock therapy today, and whether lunar cycles can trigger odd behaviors. As a scientifically minded skeptic with an interest in quack therapies, I found myself quickly hooked and unable to put the book down. Fortunately, one can easily enjoy it in a single sitting. However, readers who have a vested interest in some of the punctured myths may feel annoyed when their oxen are gored. For example, Alcoholics Anonymous treatment for alcoholism is not perfect, but it works for many. Depression is not simply a problem with brain chemistry. Some of the rationales presented for eye movement desensitization and reprocessing are unfounded, but it is more effective than no treatment at all and similar in outcome to cognitive–behavioral therapy. The DARE program is very appealing, but it does not protect against subsequent substance abuse and so on. Whatever your biases, fairminded readers will have to admit that the presentations are balanced. Facts and Fictions in Mental Health is an engaging and easy read aimed chiefly at a popular press audience. The book could also prove interesting supplemental reading for undergraduate psychopathology courses or as a potential cautionary tale for practitioners. Although sprinkled with references to research and occasional suggested readings, the book is not intended as heavy-duty scholarship. The popular writing tone is clearly intentional, and readers wishing a more rigorous approach will easily find it in Lilienfeld’s rigorous and prolific scholarly writings. Nonetheless, this book does an excellent job at offering easily digestible consumer-oriented information that debunks many popular myths related to mental health.
