Wednesday, May 25, 2011

The dangers of pseudoscience

- by Stacey Prince

Last week Psychology Today published an article claiming that Black women are less attractive than women of other ethnic groups. The author, Satoshi Kanazawa, has a history of disseminating racist and sexist conclusions based on weak pseudoscience. After a widespread public outcry, Psychology Today removed the article from their website. However, the damage had already been done, and many readers may not have been aware of the on-line retraction. By publishing Kanazawa’s article in the first place the magazine gave validation to a racially biased finding and its underlying message that Black women are less valued than women of other ethnicities. It’s shameful that Psychology Today gave a platform to this author, who has a history of promoting other equally biased and discriminatory beliefs (click here for a summary). It’s also shameful that this widely read magazine, which puts psychological findings in an accessible, non-academic format and is read by millions, chose to reference conclusions that are so scientifically flawed. In addition to the fact that “Black” is not a definitive category in the first place and that he did not consider the confounding effect of social bias, Kanazawa's conclusions were drawn from another, separate study on adolescent health and behavior that did not even purport to measure the construct he was trying to draw conclusions about. You can read a thorough critique of his findings here.

The problem is, many people reading Psychology Today will not necessarily have the critical analytic skills to understand that Kanazawa’s conclusions are unfounded, and will take them at face value. Those of us who went to graduate school or took undergrad scientific methodology classes have some valuable skills for evaluating research findings, whether they appear in trade or academic venues. For example, we know that correlation does not imply causation, that selecting an appropriate, representative sample is key, and that tiny statistical findings, even when they have significant ‘p values,’ do not necessarily translate to concrete real-world differences. Even if you haven’t had formal training in evaluating research findings, there are some basic things to look for that are “red flags” warning of pseudoscience. This recent article highlights a few such red flags, including being wary of studies that purport to generalize findings from a small and/or non-representative group of participants to everyone, those that try to quantify something that is highly subjective, personal and culture-bound (such as physical attractiveness), and those that don’t reference any conflicting data or possible limitations to their findings.

Unfortunately there is a long history in Psychology (as well as other sciences) of pseudoscience being used to support inaccurate and harmful racist, sexist and homophobic conclusions. For example, the claim that Black people are less intelligent than individuals of other ethnicities based on IQ testing has been roundly debunked, due to the extremely contextual nature of the skills that are actually assessed by such tests, skills that are largely impacted by social and cultural factors including affluence, access to quality education, and nutrition. Despite this, supposed differences in IQ based on race (which itself is a socially constructed concept) have been used to justify slavery and eugenics. Such pseudoscientific findings also uphold the myth of meritocracy - the belief that life presents a level playing field to individuals of all social groups and that everyone can get ahead if they just work hard enough, thereby blaming the individual when success is not forthcoming and ignoring systemic inequities. You can find a very useful summary of scientific racism here. Similarly, conversion therapy (efforts to change an individual's sexual orientation from gay or lesbian to heterosexual) is promoted, often with conservative religious motivations, based on faulty and flawed studies, despite the fact that it has been shown to have significant negative mental health effects for many clients (click here for an excellent review).

Of course, it is also true that empirical evidence can be incredibly useful in advancing social justice – take, for example, the use of data on children of gay and lesbian parents in testimony and amicus briefs to support legislation legalizing adoption by same-sex couples. On the other hand, it can be harmful. The dissemination of findings like Kanazawa's, for example, has the potential to encourage poor self-esteem, eating disorders, and internalized oppression in Black girls and women, let alone biased treatment by others. It was irresponsible of Kanazawa to write the article in the first place, but it was even more irresponsible of Psychology Today to publish it. So, the take home message for readers and consumers of research is this: don’t believe everything you read, and try to develop and utilize critical thinking skills when digesting research findings, whether in mainstream media or professional journals. If you are a therapist and your client brings up research such as this, you can be of great assistance by helping them to analyze the validity of the findings. If you are a mentor or research supervisor, you can help your students understand the social context in which knowledge is accumulated, uncover researchers' underlying assumptions, and when necessary be able to challenge conclusions that are held up as "knowledge" by the powers that be in their community.

Saturday, May 28, 2011

Here's an interesting update: In a landmark case in the UK, a psychologist has been found guilty of malpractice and her license suspended for "treating" a gay man for homosexuality. While this was only an internal sanction of a licensing body rather than a legal ruling, it is still a huge step. In this case the real science regarding conversion therapy - including the fact that it is harmful to more than half the clients treated, causing depression and suicidality, and lack of sound scientific evidence that sexual orientation can be changed - overcame the pseudoscience offered by proponents of conversion therapy, often to veil their underlying religious and values-based motivations.

Here's another update: Psychology today has published an apology on their website, and say they are taking measures to ensure that something like this does not occur again. I would love for them to publish or discuss those measures as I think it would be helpful to all of their readers to understand how to watch out for inappropriate and offensive misuse of science in the media.

Friday, May 20, 2011

Reel Grrls, Real Justice

- by Stacey Prince

OK, so perhaps by now you've heard the story: small non-profit Reel Grrls in Seattle provides media production workshops to young women from diverse communities. Not only do the young women learn skills in areas such as cinematography, animation, and script writing, but they also gain invaluable support and friendship from female mentors at a time of life that can be vulnerable and difficult to say the least. Plus, they make amazing films!!! Here are two examples that are particularly relevant to TJP readership. "Disorder" enters the the imaginative inner world of a young student struggling with a learning disability, and the mockumentary "Coming Out..." takes a humorous look at homophobia.

Reel Grrls is supported by grants and recently media giant Comcast pledged $18,000 to support their summer 2011 programming. A couple of days ago Reel Grrls tweeted about Comcast's recent hiring of FCC Commisssioner Meredith Attwell Baker. Immediately a Comcast executive shot off an email stating that they were going to yank the funding because Reel Grrls was creating a "negative digital footprint" about Comcast (here's the Washington Post story). After a whole bunch of media attention, Comcast retracted its retraction of funding and apologized, but the latest news this afternoon is that Reel Grrls has decided not to accept the money - a very classy and principled decision, in my opinion. Here is a quote from the organization's Executive Director, Malory Graham: Given the serious questions Comcast’s initial decision to take punitive measures on our organization raised about the ability of corporations to stifle public discussion, we have decided to redesign our summer camp to focus on developing films about free press issues.

Wow. Seriously, Comcast? Isn't Reel Grrls doing and modeling exactly what we want young women (and young men, and adults for that matter) to do? Think for themselves, think critically, be able to evaluate the news and cultural context around them and be empowered to do something about injustice (including criticizing it)? If you want to show your support, stand up against censorship and help Reel Grrls keep their programming going, please visit their website.

Thursday, May 26, 2011

Here's an update: Reel Grrls raised $22,000 from over 600 individuals' donations, as well as national recognition for their principled decision to, at least for now, politely decline Comcast's funding. They will be able to move forward with their summer programming, with a focus on free speech issues. Unbelievable - what a great example of community response to show support and help this small non-profit stand up to censorship!

Sunday, May 15, 2011

Psychology: Exile or Liberation?

Mental Health Blog Party

May is "Mental Health Month" and the American Psychological Association's Public Education Campaign is organizing a "Mental Health Month Blog Party" to educate the public about mental health issues. The badge at the top of this article indicates that I’m participating. Although much of what we have posted here has been about, or at least related to, mental health, I hesitated to participate in this APA event because of what this connection to APA might signify to our readers. One of the tensions we have held within TJP leadership is whether Psychology as it is practiced in traditional, academic institutions (such as graduate programs and APA) is an appropriate or effective place to locate work toward liberation, or instead whether it maintains the oppressive structures and hierarchies that we are trying to resist and revise. I ended up deciding to participate strategically and with intentionality, with the goal of exploring the complexity and multiplicity of "psychologies," rather than taking an either/or perspective. Often I have been in situations where there is an adversarial discussion between those coming from a place of community activism and organizing, versus those coming from more mainstream or institutional settings. The assumptions about one another can lead to not finding common ground, when maybe in fact it's actually there. So, I am going to continue holding the dialectic here that TJP has struggled with all along, reviewing some of the major criticisms and limitations of traditional psychology, but also highlighting some of the liberatory work that's being done by individuals and organizations in psychology. This can only be a brief review, but I hope it will stimulate some thought and discussion.

Many critiques have been leveled regarding the ways that mainstream psychology maintains oppressive structures. To highlight just a few:

- Mainstream psychology upholds the values of the dominant (white, male, heterosexual, middle class, Christian) culture. One example of this is that psychology upholds autonomy and individuation as more mature levels of emotional functioning than interdependence, despite the fact that many women, some non-white ethnic groups and non-Christian religions, and many non-Western cultures place a high value on interdependence, community, and relatedness. As long as individuals with relational values and worldviews are compared to those white, male, Eurocentric “norms” of behavior and emotional functioning, they will be viewed as less mature and less evolved.

- Behaviors that are resistant or rebellious toward dominant group members are often labeled as deviant. Examples include children getting angry with adults, People of Color who point out discrimination being diagnosed as paranoid, and women who express too much anger being labeled as unfeminine. This focus on the individual ignores the power dynamics at play in each situation and pathologizes what might be viewed as normative behavior if the lens were widened to view the behavior in context (for the above examples, context might be an abusive parent, racially based discrimination, and sexism in the workplace). This also applies to more global identities or sets of behaviors, such as being gay, lesbian or transgender, all of which have at one time or another been institutionally codified as pathological in the highly utilized and internationally referenced Diagnostic and Statistical Manual (DSM).

- Prevailing treatment approaches, including cognitive-behavioral, psychodynamic, and humanistic, have all been intrapsychically (or, at most, relationally) focused, and have tended to myopically ignore community, cultural, and systemic factors, including power and oppression, that might be playing a large role in the individual’s functioning.

- For many members of marginalized groups (including LGBT individuals, POC's, and immigrants) acculturation is emphasized over maintenance of one's culture - despite empirical evidence strongly suggesting that people who both maintain aspects of their origin culture and acquire some aspects of the dominant culture have the best mental health outcomes. In fact, in many cases forcing individuals to detach from their culture is legal and institutionalized (e.g., Spanish speaking children being forced to speak English in school, most businesses and schools only honoring Christian calendar holidays, etc.) although the latter actions may not be perpetretated directly by psychology or psychologists.

- The science of psychology has largely been conducted by members of dominant groups, who hold a great deal of privilege including whiteness, higher education, and financial security. Further, research has often been conducted on skewed samples who are themselves often members of those same dominant groups - yet conclusions from those studies are sometimes generalized to members of marginalized groups.

- Not only is obtaining graduate education in psychology costly, but obtaining psychological services, especially in a private practice setting, is highly costly as well, often prohibitively so - especially for those who are unemployed and/or uninsured. Further, the assessment and intervention strategies offered by psychologists have not always been evaluated for efficacy with marginalized group members .

- For all of the above reasons and more, mainstream psychology (and psychiatry) has been indicted by many as upholding the status quo and maintaining, rather than dismantling, systemic oppression.

On the other hand...

- Multicultural psychology has strived not for universal, absolute norms of behavior, but instead for culturally relevant ones. More recent iterations have also added a critical understanding of power and oppression to the analysis of the role of culture.

- Many in counseling psychology are exploring effective ways to infuse social justice and anti-oppression work into graduate level training, including curricula, clinical supervision, research, and practicum experiences.

- A growing body of research on racial oppression (and more recently on homophobia/heterosexism) has documented the deleterious effects of bias and discrimination (both personal and systemic) on individual well-being, social functioning, health, and mental health.

- APA recently added advocacy skills as the 13th basic competency required for entry into the practice of psychology, thereby lending validation to this important set of skills which are defined as “actions targeting the impact of social, political, economic or cultural factors to promote change at the individual, institutional, and/or systems level” and include promoting client empowerment, as well as professional involvement in promoting change at the level of institutions, community or society.

- Several organizations associated with APA, including Psychologists for Social Responsibility (PsyR) and Society for the Psychological Study of Social Issues (SPSSI) have tasked themselves with addressing some of the largest and most difficult social issues of our time, including poverty, racial discrimination, genocide, torture, human and civil rights violations, and global conflict resolution.

- Researchers are increasingly relying on qualitative, community based, and participatory action research methods to increase understanding of culture and oppression and to put the purpose and uses of research more in the hands of its participants

- Liberation psychology, originating in Latin America with the work of Martin-Baro and others, has begun to have a foothold in North America. For example, a clinical psychology graduate program (Pacifica University) has a strong liberation psychology foundation, and two of its faculty (Watkins and Shulman) have recently authored an excellent book on the topic. Promoting analysis of the social inequities confronting individuals and empowering them to address those inequities, liberation psychology simultaneously provides an alternative viewpoint to mainstream psychology while still drawing on it.

So what do we do? How do we reconcile this dialectic of strong critiques leveled against mainstream psychology as oppressive, alongside the reformative and transformative work that is being done by many in the field? I would like to end with this quote by Albert Camus: “We all carry within us our places of exile, our crimes, and our ravages. But our task is not to unleash them on the world; it is to fight them in ourselves and in others.” Many people have been exiled by psychology, it’s true – but many others are working to reduce oppression, address the huge social challenges of our time, and work toward liberation. If I have challenged readers to think about the viewpoint that is less comfortable or familiar to them , then I will feel this posting has been successful. I welcome your comments!

Friday, May 13, 2011

TJP Version 2.0

- by Stacey Prince

Leadership council has recently undergone a major transition, and I wanted to share with you about that transition, what we have learned in the past year, and where TJP is going from here. Please click here to read about the changes and plans for the future. I welcome your feedback, questions, and comments!

Sunday, May 8, 2011

They may be micro but their impact isn’t: Sexual orientation microaggressions in psychotherapy

- by Stacey Prince

I recently read an excellent article in the Journal of Counseling Psychology, entitled Sexual orientation microaggressions: The experience of lesbian, gay, bisexual and queer clients in psychotherapy. I will briefly describe it here but I hope this will entice some of you to read the article in its entirety; it’s a great read for psychotherapists, healthcare providers, case managers and anyone working with LGBQ clients.

The article begins with the assertion that, while general affirmation and acceptance of LGBQ individuals has increased, psychotherapy clients still all too frequently report experiences of discrimination and hostility in the therapy setting. Overt forms of discrimination such as the practice of conversion or reparative therapy have declined, but more subtle forms of heterosexism seem to persist. This parallels findings in the area of racial oppression, which have shown that while overt racism has decreased, more subtle and insidious forms of modern racism are still prevalent. Led by psychologist Derald Sue and colleagues, this substantial body of research documented the prevalence of racial “microaggressions,” the term used to describe these more subtle injustices of modern racism.

Microaggressions are described as communications of prejudice and discrimination, expressed through seemingly meaningless or even well-intentioned tactics but that actually deliver a hidden message of hostility, denigration, or invalidation. Examples include a white person stating to a person of color “you are so well-spoken” (indicating that their intelligence and articulateness is surprising or an exception), asking an Asian American individual “where are you from?” (assuming foreignness), or stating that he or she is “color blind” (denying the realities of personal and systemic oppression). Microaggressions differ from overt racism in multiple ways, including the fact that they are contextual, more difficult to identify, and that while there may be legal recourse for someone who experiences overt racially based discrimination, it is much more difficult if not impossible to document and take action against microaggressions.

The article I am describing today attempted to expand the microaggression literature to microaggressions that are based on sexual orientation rather than ethnicity. Further, it explored the negative impact of sexual orientation based microaggressions on the psychotherapy process. Psychotherapists are not immune to heterosexism and homophobia, having been indoctrinated in the same societal stigmatization of LGBQ individuals as everyone else, and therefore may unintentionally perpetuate negative bias toward their LGBQ clients. Although previous research has explored homophobia and heterosexism in psychotherapy, this study was, I believe, the first to try to identify and describe microaggressions based on sexual orientation. It utilized focus groups to explore the experiences of 16 self-identified LGBQ individuals in psychotherapy. Using a series of questions informed by the literature on racial microaggressions and previous work on heterosexism in psychotherapy, investigators identified themes, channels, and impact of sexual orientation microaggressions as they had occurred in participants' therapy experiences.

Several themes representing different types of sexual orientation microaggression emerged from the analysis of participant responses. These included assuming that sexual orientation was the cause of all of the client's presenting issues, even when the client was seeking help for unrelated problems; avoiding discussion of sexual orientation (such as avoiding use of gendered pronouns when referring to partners), avoiding discussion of the negative impact of rejection and internalized heterosexism, overidentifying with LGBQ clients, making stereotypical assumptions about LGBQ clients, expressing heteronormative bias, assuming that LGBQ clients need continued treatment even when clients felt ready to terminate; and suggesting that LGBQ clients should expect conflict and discrimination due to their sexual orientation.

The study also investigated channels of communication on which sexual orientation microaggressions were expressed in the therapy setting. Paralleling the research on racial microaggressions, results indicated that sexual orientation microaggressions occurred on multiple channels, including verbal (direct and indirect comments), behavioral (e.g., body language, silence, demeanor), and environmental (e.g., waiting room literature only relevant to heterosexual individuals and couples).

What was the impact of these sexual orientation microaggressions on the therapeutic process? Findings again paralleled research on racial microaggressions in psychotherapy, revealing that clients had a range of affective responses such as feeling uncomfortable, confused, rejected, invalidated, and angry. They were less likely to disclose issues related to sexual orientation out of a fear of being viewed as abnormal. They reported feeling more doubtful about their therapists' competence and the effectiveness of therapy, and were more likely to terminate therapy prematurely.

The authors ended with some recommendations for addressing sexual orientation microaggressions. These included responding in a nondefensive and transparent way if a client raises concerns, processing the impact of microaggressions on the client rather than focusing on therapist intentions (which may have been positive or neutral), and admitting heterosexism to oneself (thereby increasing self-compassion and openness to feedback) rather than maintaining that one is bias-free. They also described limitations of the study, including the somewhat skewed sample (predominantly white, highly educated) as well as all of the fallacies that are associated with retrospective self-report. Another important limitation not mentioned was that neither transgender individuals were not included in the sample; this is an important area for future investigation and my guess is that transgender clients in psychotherapy may experience many microaggressions similar to those described here, as well as perhaps some additional themes surrounding gender expression and transitioning.

In conclusion, even well intentioned psychologists who aspire to provide culturally competent services to marginalized populations are indoctrinated in racist, heterosexist, classist, and otherwise oppressive belief systems. Further, such views may be outside of one's immediate awareness, inhibiting the ability to recognize and redress microaggressions. The power imbalance inherent in the therapist-client relationship, internalized oppression, clients granting and therapists claiming "expert" status, and a host of other variables curtail clients' ability to recognize and call out such experiences when they do occur. The onus is therefore on practitioners to learn about, self-identify, and rectify incidents of microaggression as they occur in treatment. If therapy is going to be liberatory it at the very least has to be non-oppressive, and understanding and owning one's own microaggressions is an important step in practicing ethical, competent, empowering psychotherapy with members of marginalized groups.