by Michael D. Anestis, M.S.
I came across this article in the New York Times health section and thought it would be worthwhile to write a brief reply.
On the one hand, the author does a great job of summarizing the "insight fallacy," one of the many concepts that Paul Meehl and others have called our attention to as they have amounted evidence for the superiority of data over intuition in health care decision making. The insight fallacy is the faulty idea that, by understanding "why" something is as it is, we resolve the issue. To put this in the context of mental illness and psychotherapy, we all - clients and therapists alike - would love to know why people present in clinics with depression, substance dependence, non-suicidal self-injury, psychotic symptoms, etc...The thing is, however, we can never definitively answer that question (although many folks believe they are capable of doing this....which they aren't) and, even if we did, we'd still be left with a problem. We'd simply know why the problem was there.
Anyway, the author did a great job of explaining that the goal of treatment should not and really can not be to help a client understand why they are experiencing whatever is troubling them, but rather how to remedy that issue and decrease the likelihood that it will reemmerge in the future.
Where the author went awry in this article was in his casual description of the dodo bird hypothesis, which we have covered at length on PBB. Below you will see a series of links detailing the evidence against this conclusion (the idea that all treatments work equally well for all diagnoses). Long story short, however, is that the evidence that some treatments work better than others for specific diagnoses is OVERWHELMING, so any commentary in the media that leads to folks in need developing the misconception that it does not matter what type of treatment they receive is highly problematic. If nothing else, I encourage you to read our section on empirically supported treatments for mental illness, in which we discuss the evidence base for a wide variety of psychosocial and psychopharmacological treatments for mental illness.
For more information on the dodo bird hypotheses, click here, here, here, and here.
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If you would like to learn more about this or other topics discussed on PBB, we encourage you to consult our online store for scientifically-based psychological resources.
Mike Anestis is a psychology resident at the University of Mississippi Medical Center and a doctoral candidate in the clinical psychology department at Florida State University
