Communicating About

Healths
Contents
Introduction............................................................................................................1
Chapter 1: Feasibility of Implementing Regulation.................................................3
Professional Standards........................................................................................6
Legal Action and Lawsuits.................................................................................16
Chapter 2: Advantages of Control Measures for Alternative Psychotherapies......25
Conventional Methods Informed by Alternative Therapeutic Practices............29
Insights from Energy Therapists Regarding Research........................................40
 Introduction

In the ever-evolving landscape of mental health care, the field of

psychotherapy serves as a cornerstone, providing individuals with avenues for
healing, growth, and self-exploration. While traditional psychotherapeutic
approaches have long dominated the therapeutic arena, a burgeoning interest in
alternative psychotherapies has emerged in recent years, offering new
perspectives and methodologies for addressing psychological distress and
promoting well-being.

"Administering Regulation for Alternative Psychotherapies" embarks on a

critical examination of the regulatory frameworks essential for ensuring the
responsible and ethical practice of alternative psychotherapeutic modalities.
From ancient healing traditions to contemporary integrative approaches,
alternative psychotherapies encompass a diverse array of methodologies,
including mindfulness-based therapies, expressive arts therapies, somatic
psychotherapies, and transpersonal psychology, among others.

The proliferation of alternative psychotherapeutic modalities reflects a

growing recognition of the holistic nature of mental health and the diverse needs
of individuals seeking therapeutic support. However, this diversity also presents
challenges in terms of ensuring quality of care, protecting client welfare, and
upholding professional standards. Effective regulation and oversight are essential
to safeguarding the integrity and efficacy of alternative psychotherapy while
promoting the highest standards of practice and ethical conduct.

"Administering Regulation for Alternative Psychotherapies" delves into the

multifaceted dimensions of regulation and oversight, examining the roles,
responsibilities, and challenges faced by various stakeholders, including
regulatory bodies, professional associations, accrediting agencies, policymakers,
and individual practitioners. Through a comprehensive exploration of regulatory
frameworks, ethical guidelines, and best practices, this book seeks to provide
therapists, supervisors, educators, and policymakers with the knowledge and
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tools needed to navigate the complexities of alternative psychotherapy
regulation.

Central to this exploration is the recognition of the dynamic and evolving

nature of alternative psychotherapy, as well as the need for regulatory
frameworks that are responsive to emerging trends, innovations, and ethical
dilemmas. From the integration of technology in therapy to the globalization of
mental health care, from the exploration of altered states of consciousness to the
incorporation of indigenous healing practices, this book explores how regulatory
mechanisms can adapt and evolve to meet the evolving needs and challenges of
the therapeutic landscape.

Moreover, "Administering Regulation for Alternative Psychotherapies"

underscores the importance of fostering dialogue, collaboration, and
transparency among stakeholders to promote accountability, professionalism, and
continuous improvement in the field of mental health care. Through case studies,
ethical dilemmas, and reflective exercises, this book encourages critical inquiry
and informed decision-making, empowering therapists and regulators alike to
navigate the complexities of alternative psychotherapy regulation with integrity
and efficacy.

Ultimately, "Administering Regulation for Alternative Psychotherapies"

serves as a vital resource for anyone involved in the regulation, oversight, or
practice of alternative approaches to psychotherapy. By promoting a culture of
accountability, safety, and ethical conduct, this book seeks to advance the
responsible and effective delivery of mental health care in an increasingly diverse
and dynamic world.

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 Chapter 1: Feasibility of Implementing
Regulation

The introductory chapter of this book delves deeply into the realm of
alternative psychotherapies, meticulously delineating their characteristics
through a comprehensive analysis of plausibility, evidentiary support, and
historical context, while also drawing parallels between medical and psychological
perspectives. By scrutinizing the historical lineage of alternative treatments, it
highlights the evolution from the once-dismissed "irregular" medicine of yore to
the contemporary landscape of complementary-and-alternative (CAM) therapies
and alternative mental health interventions. Subsequent chapters meticulously
unravel a spectrum of alternative psychotherapies, revealing varying degrees of
implausibility, dearth of empirical validation, and, alarmingly, potential hazards,
both direct and indirect.

Now, as the discourse pivots towards contemplating the appropriate

response to alternative psychotherapies, it becomes evident that the matter is far
from straightforward. While certain instances presented in earlier chapters might
advocate for outright prohibition, the complexities inherent in this decision
prompt a multifaceted exploration. Is it feasible, for instance, to effectively
regulate these treatments? What are the ramifications, both positive and
negative, of professional or legislative intervention to curtail certain methods?
Moreover, does the prospect of banning unorthodox treatments risk stifling
innovation and impeding the development of potentially groundbreaking
therapies? Should the responsibility of endorsing or dissuading alternative mental
health interventions be delegated to educators and practitioners, or is there a
broader societal role to play in this discourse? These questions underscore the
nuanced nature of the issue at hand, compelling a thorough examination of its
various dimensions.

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 When contemplating the regulation or prohibition of alternative
psychotherapies by mental health professional organizations or other entities, a
myriad of factors warrants examination. In the context of the United States, a
fundamental tenet opposing censorship or restriction of methods is enshrined in
the First Amendment to the Constitution. This constitutional provision guarantees
freedom of speech and of the press, while expressly forbidding legislation that
encroaches upon these freedoms. Notably, actions such as contributing money to
political parties have been judicially recognized as protected forms of free speech,
suggesting that the First Amendment safeguards the freedom to discuss,
disseminate, and practice alternative psychotherapies—albeit with the caveat
that practitioners may be held accountable if their interventions result in
demonstrable harm.

Moreover, the First Amendment also extends protection to freedom of

religion, which carries implications for alternative psychotherapeutic practices
intertwined with religious beliefs. For instance, when alternative therapies are
linked to religious rituals, such as the use of exorcism to combat ailments
attributed to demonic possession, constitutional provisions would likely preclude
outright prohibition of such practices.

Nevertheless, in practical terms, the First Amendment's protections are not

absolute, especially when speech or expression has the potential to cause harm.
Legal interpretations of the Amendment have acknowledged that certain forms of
speech or expression may pose risks, thereby necessitating limitations on their
protection. This rationale has historically been invoked to justify censorship of
materials deemed sexually explicit or information pertaining to birth control,
particularly when deemed detrimental to public welfare.

Importantly, the assessment of potential harm as a basis for curtailing

constitutional protections often hinges on the evidentiary basis of such harm.
Analogous to the prohibition against falsely shouting "Fire!" in a crowded theater,
the principle is rooted in the understanding that certain forms of speech or
expression can provoke harmful consequences. However, if there is indeed a fire,
the imperative to alert others overrides concerns of inciting panic, illustrating the
nuanced balancing act between safeguarding public safety and preserving
individual liberties.

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 Similarly, the determination of whether an alternative psychotherapy
qualifies for constitutional protection would necessitate an evaluation of the
frequency and severity of harm attributable to the intervention, as well as the
efficacy of the treatment in most cases. Thus, while the First Amendment serves
as a cornerstone of freedom of speech and expression, its application in the realm
of alternative psychotherapies demands a judicious consideration of competing
interests and societal welfare.

When analyzing speech, print, or Internet publications concerning

alternative psychotherapies, one must consider the commercial nature of many
of these treatments. Indeed, a significant proportion of alternative therapies are
heavily commercialized, often bearing trademarks or service marks, and offering
various materials and services for sale. In the United States, such commercial
speech is afforded greater protection compared to the European Union. This
distinction is critical, especially considering the implications for advertising and
marketing practices within the realm of alternative therapies.

Moreover, prosecuting cases of fraud against alternative practitioners in the

United States presents its own set of challenges. Convicting a practitioner of fraud
necessitates demonstrating both the harm caused by their treatment and their
awareness of its harmful or ineffective nature. This burden of proof can be
formidable, making successful claims of fraud difficult to attain.

Historically, professional organizations closely regulated advertising by their

members, and any deviations from appropriate advertising practices could result
in disciplinary action or ostracization from the professional community. However,
a significant shift occurred around 1980, marked by Supreme Court decisions that
positioned professional advertising as a matter of First Amendment rights.
Consequently, the regulation of advertising by professional licensing boards
became increasingly challenging, granting alternative practitioners greater
latitude in making bold claims about the efficacy of their methods and
disseminating these claims through various channels without fear of reprisal.

The practice of trademarking or service-marking terms and practices within

the realm of alternative psychotherapies introduces additional complexities.
When a therapy is positioned within a clearly commercial framework,
practitioners may argue that revealing supportive evidence would compromise

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their competitive advantage, akin to divulging a trade secret. Consequently,
demands for transparency and evidence publication, typically essential for
establishing the safety and effectiveness of a therapy, may be overridden by
claims of commercial interests.

This interplay between commercialization and evidentiary standards has led

to debates regarding the legitimacy of referring to trademarked or service-
marked mental health interventions as evidence-based therapies. The privileging
of commercial interests over scientific scrutiny poses significant challenges to
ensuring the transparency, safety, and efficacy of alternative psychotherapies,
underscoring the complex intersection of commerce, regulation, and public
health within this domain.

Professional Standards
In instances where the regulation or prohibition of an alternative
psychotherapy proves challenging, health insurance carriers often wield
considerable influence by refusing payment for such treatments, effectively
dissuading their utilization. A prime example of this is illustrated by the Aetna
Insurance Company's policy of withholding reimbursement for alternative
treatments like Energy Field Therapy or Dance/Movement Therapy, among
others. This strategic approach by insurance providers not only serves as a
deterrent to the widespread adoption of alternative psychotherapies but also
underscores the pivotal role they play in shaping healthcare access and
utilization.

However, insurance companies find themselves navigating a delicate

balance between asserting their prerogatives to determine coverage and
addressing consumer demands for desired treatments. In response to advocacy
efforts, such as those from groups championing DIR/Floortime for autistic
children, insurance companies may face mounting pressure to reconsider their
reimbursement policies. Organized protests and concerted advocacy campaigns
from parents or clients can compel insurance companies to relent and provide
reimbursement for alternative psychotherapies, albeit often on a case-by-case
basis.

Contrastingly, professional codes of ethics within the healthcare field do not

mandate the use of evidence-based treatments or the avoidance of potentially
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harmful interventions. While these codes emphasize ethically appropriate
conduct among members of professional organizations, their focus tends to
gravitate towards financial or sexual improprieties rather than treatment efficacy
or safety. For instance, the ethics code of the National Association of Social
Workers (NASW) addresses concerns about incompetence but does not explicitly
address the use of alternative psychotherapies as a component of this issue.
Despite acknowledging the potential risks associated with ineffective or
hazardous treatments, professional ethical codes largely remain silent on the
matter, except in cases where injury or harm occurs.

Furthermore, the applicability of professional ethical codes is contingent

upon practitioners being affiliated with relevant professional organizations. Those
operating outside such affiliations are not bound by the ethical guidelines
outlined by these organizations, thus limiting the extent to which ethical
standards can influence their conduct. This highlights a gap in regulatory
oversight and ethical accountability within the realm of alternative
psychotherapies, underscoring the need for comprehensive frameworks that
address both clinical effectiveness and ethical considerations.

Professional organizations play a crucial role in the oversight of alternative

treatments through the publication of position statements that offer critical
commentary on specific modalities. While these statements lack enforcement
mechanisms to compel practitioner compliance, they serve as important
guidelines for professionals and members of the public alike, signaling that
certain treatments are deemed inappropriate or lacking in efficacy. However, it is
lamentable that such position statements often emerge only after some degree of
harm has already transpired.

Illustratively, the American Academy of Pediatrics issued a position

statement rebuking the use of "patterning" as a treatment for autism and
learning disabilities, marking the second time it had done so. Despite the
comprehensive analysis of theoretical underpinnings and empirical evidence,
which concluded that patterning is not only ineffective but also potentially
harmful, advertisements for patterning services persistently proliferate on the
Internet. Similarly, the American Psychiatric Association issued a statement in
2000 politely rejecting recovered memory therapy, cautioning against both
denying the existence of memories of abuse and encouraging the consideration
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of such memories when they were previously nonexistent. This sentiment echoed
similar statements from professional societies in Australia, Britain, and Canada.
Despite the collective stance against recovered memory therapy, advertisements
for such treatments continue to circulate online, exemplified by the Castlewood
Treatment Center in Missouri, which has become embroiled in lawsuits related to
the use of this controversial therapy.

These instances underscore the challenges inherent in effectively regulating

alternative treatments, as practitioners and organizations may persist in offering
and promoting modalities that have been discredited by professional consensus.
Despite the issuance of position statements, the continued availability and
promotion of these treatments highlight the limitations of relying solely on
professional guidance to deter their usage. Thus, a multifaceted approach
encompassing regulatory oversight, public education, and consumer advocacy is
imperative to mitigate the risks associated with unproven or harmful alternative
psychotherapies.

In the aftermath of the tragic death of Candace Newmaker during an

alternative therapy session in 2002, various professional organizations in the
United States took decisive stances against certain controversial
psychotherapeutic practices. The American Psychiatric Association promptly
issued a position statement advising against the utilization of holding therapy or
rebirthing techniques, citing safety concerns. Concurrently, the American
Psychological Association aligned with a Congressional resolution that specifically
highlighted apprehensions regarding rebirthing methods within the context of
holding therapy.

Subsequently, in 2006, the American Professional Society on Abuse of

Children convened a task force, which published a comprehensive report
rejecting holding therapies on the grounds of their perceived lack of safety and
effectiveness. Around the same time, the National Association of Social Workers
passed a resolution outright rejecting holding therapy as a viable treatment
option.

Despite these concerted efforts by professional bodies to denounce

potentially harmful alternative psychotherapies, such as holding therapy, the
persistence of these practices remains evident. Online sources continue to

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advertise methods that have been explicitly repudiated by these authoritative
position statements, raising concerns about the dissemination of discredited
treatments to unsuspecting individuals seeking help.

Furthermore, in 2009, the American Psychological Association's Task Force

on Appropriate Affirmative Responses to Sexual Orientation Distress and Change
Efforts issued a firm rejection of so-called "conversion" or "reparative" treatments
purported to alter same-sex attraction and orientation. This resolution played a
pivotal role in subsequent legislative efforts to prohibit the use of such therapies
with minors, underscoring the potential impact of professional consensus on
policy initiatives.

In contrast to the United States, the European Union exhibits a more

forthright approach in addressing controversial psychotherapeutic practices.
Organizations and authors within the EU have openly expressed disapproval of
alternative therapies, such as TPO (Theraplay®) advocated by Martha Welch and
Jirina Prekop. Notably, a video campaign promoting TPO in Germany and the
Czech Republic, purportedly with government and church support, sparked
criticism from advocacy groups like APLA (the Czech parent/professional autism
advocacy organization). APLA took a proactive stance by publishing materials
online that directly challenged Prekop and TPO methods, showcasing a more
confrontational approach than typically seen in the United States.

Similarly, members of a Berlin psychoanalytic group authored an edited

volume that extensively criticized TPO, featuring interviews with former clients
who expressed regret over their involvement with the controversial therapy.
These instances highlight the divergent approaches to addressing alternative
psychotherapies between the United States and the European Union, with the
latter demonstrating a more outspoken stance against potentially harmful
practices.

In many states, mental health practitioners are required to partake in

continuing professional education courses as a prerequisite for maintaining their
professional licensure. These courses, while not directly overseen by professional
organizations such as the American Psychological Association or the National
Association of Social Workers, are facilitated by "approved providers." These
providers, which can range from academic institutions to commercial

9
organizations specializing in offering such coursework, are tasked with selecting
and presenting courses while also approving continuing education credits for
attendees. While there exist established standards and criteria for continuing
education courses on paper, the implementation and adherence to these
standards by approved providers can sometimes be inconsistent.

It's worth noting that approved providers have, on occasion, offered

coursework on alternative psychotherapies, such as Energy Field Therapies, and
granted continuing education credits for these sessions. The professional
organizations themselves, which rely to some extent on volunteers to oversee
related tasks, may not always be aware of the inclusion of questionable subject
matter in these courses unless alerted to the issue by members of the
organization.

Unfortunately, the discovery of inappropriate continuing education courses

often occurs by chance, and complaints lodged against such courses can lead to
inquiries into the quality and oversight of the approved provider rather than
solely focusing on the specific course offering itself. This can result in a time-
consuming process that may not always yield satisfactory outcomes.

However, there have been instances where professional organizations have

taken action in response to member complaints. For instance, in April 2014, the
American Psychological Association responded to a complaint from a member by
canceling the continuing education credits that one of its approved providers had
intended to grant for a presentation promoting Attachment Therapy. This action
highlights the potential for professional organizations to address concerns raised
by their members and underscores the importance of vigilance in ensuring the
integrity and appropriateness of continuing education offerings in the field of
mental health.

While theoretically feasible, relying on legislation to prohibit the use of

alternative psychotherapies proves to be an ineffective solution in practice. As
previously discussed, First Amendment considerations pose significant hurdles to
legislative intervention in matters of therapy choice. Moreover, professional
organizations typically assert their autonomy in managing the practices of their
members, often resisting legislative measures that encroach upon their
jurisdiction.

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 Furthermore, crafting legislative language precise enough to effectively
prohibit a specific treatment presents formidable challenges. In many cases, even
minor alterations in procedures or terminology can render a practice exempt
from legal definitions, undermining the intended scope of the legislation.

Even if legislation successfully passes, enforcement remains a considerable

obstacle. Typically, only the practitioner and the client, or the parent of a child
client, are privy to the details of treatment methods. Clients are unlikely to report
potential violations of the law, as they have typically chosen the treatment under
the belief that it is appropriate. Moreover, instances of indirect harm, such as the
failure to achieve desired therapeutic outcomes, often go unrecognized or
unreported by clients.

In cases where direct harm occurs, prosecution is more likely to be pursued

under other laws addressing the specific injury rather than the prohibition of the
treatment itself. Additionally, prosecution is only viable under laws that
criminalize the specific treatment, complicating the legal landscape further. Laws
empowering professional licensing boards to discipline therapists involve
multifaceted procedural steps that may not align with the boards' priorities or
capacities.

Ultimately, the reliance on legislation to curtail the use of alternative

psychotherapies encounters numerous practical and procedural challenges,
highlighting the need for alternative strategies to address the potential harms
associated with such practices.

Despite the inherent challenges associated with enacting legislation to

regulate mental health treatments, several bills have indeed been passed to
prohibit certain therapies when used with minors. One notable example is the
enactment of "Candace's law" in Colorado in 2001, a legislative response to the
tragic death of a child during an alternative treatment session. This law
specifically targeted aspects of the treatment received by the child, explicitly
prohibiting the reenactment of the birthing process in a manner involving
restraint that could potentially lead to physical injury or death. Additionally, the
bill banned the use of any therapy techniques associated with the rebirthing
process.

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 Interestingly, the language of the legislation appears to present a nuanced
stance, potentially permitting rebirthing practices that do not involve restraint or
pose a threat of physical harm, while simultaneously outlawing the broader
concept of rebirthing itself. Notably, other forms of therapeutic restraint, such as
holding therapies, were not explicitly addressed in the legislation, leaving their
legal status ambiguous unless they claimed to reenact the birthing process.

Similarly, in North Carolina, the home state of the child whose death
prompted "Candace's law" in Colorado, a similar bill was passed in 2004. This
legislation included the provision that state funds could not be utilized to pay for
rebirthing treatment, even if conducted in another state. Once again, the
legislation did not specifically address related alternative psychotherapies, leaving
gaps in the regulatory framework.

The complexities of implementing legislative prohibitions of alternative

treatments are further exemplified by events in Utah. Holding therapy emerged
as a focal point of concern in the state, with the Utah Division of Child and Family
Services sponsoring therapist training sessions conducted by advocates of holding
therapy from Colorado around 1990.

These examples underscore the intricate interplay between legislative

efforts, public health concerns, and the nuances of therapeutic practices within
the realm of alternative psychotherapies. Despite legislative attempts to address
specific treatments, navigating the complexities of drafting effective legislation
that accurately captures the nuances of various therapeutic modalities remains a
considerable challenge.

Following the passage of Colorado's "Candace's law," which aimed to

regulate certain mental health treatments, including holding therapy, similar
efforts were undertaken in Utah to address concerns surrounding the practice.
The narrative unfolds with state-sponsored initiatives involving various forms of
holding therapy for children in state custody or those being adopted from state
care. Notably, instances such as the tragic death of Krystal Tibbets in 1995,
attributed to "compression therapy" administered by her adoptive father,
underscored the controversial nature of holding therapy within state-mandated
adoption treatment plans.

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 Despite the termination of state contracts with holding therapy
practitioners following another child's death in 2002, it appears that post-
adoptive subsidies continued to subsidize holding therapy sessions. This
persistence of holding therapy practices, even after official action to terminate
contracts, suggests a complex interplay between legislative efforts and the
practical realities of mental health service provision within state systems.

In response to mounting concerns, Utah State Representative Mike

Thompson introduced legislation in 2002 and again in 2003 to ban holding
therapy practices. The proposed bills garnered widespread support from mental
health organizations and child advocacy groups within the state, as well as
broader national backing. The Utah chapter of the National Association of Social
Workers publicly endorsed the legislation in a position statement, highlighting the
broad consensus among professionals regarding the need for regulatory action.

Despite significant momentum behind the bills, influential state senators

thwarted their progress, preventing them from advancing to a vote in the upper
house of the state legislature. State Senator Parley Hellewell emerged as a vocal
opponent of the proposed legislation, citing personal connections to therapists
practicing holding therapy and advocating for parental autonomy in treatment
decisions. Hellewell's stance found support among "pro family" activists, who
argued against government interference in parental choices regarding their
children's treatment, echoing common sentiments in favor of alternative child
psychotherapies.

Ultimately, despite Representative Thompson's efforts, the anti-holding

therapy legislation failed to materialize, and subsequent attempts to advance
similar measures were met with reluctance from other legislators. Consequently,
holding therapy remained unregulated in Utah, both by legislation and state
licensing rules. While there have been reductions in third-party funding for
holding therapy by the state and private insurance companies, reports suggest
that the practice persisted in Utah for some time, underscoring the enduring
challenges in addressing controversial alternative psychotherapies through
legislative means.

In recent years, there has been a notable push to outlaw "conversion"

therapy or "reparative" therapy, a controversial treatment purported to change

13
an individual's sexual orientation, particularly aimed at altering attraction to
individuals of the same sex. This therapy, also known as "sexual orientation
change efforts" (SOCE), has garnered significant attention due to its strong
religious undertones, raising complex First Amendment considerations regarding
regulation. Conversion therapy is frequently practiced by members of the clergy,
particularly within evangelical Christian circles, and shares foundational beliefs
with charismatic Christian groups.

Proponents of conversion therapy, such as Richard Cohen and others,

attribute homosexual attraction and behavior to what they term "hetero-
emotional wounds" stemming from familial relationships, particularly issues with
a dominant mother and a distant father. According to this perspective, an
inadequate attachment with the father leads men to seek male companionship as
a substitute for the paternal bond, framing homosexuality as a form of "same-sex
attachment disorder." Cohen advocates for addressing these perceived wounds
through therapeutic methods akin to holding therapy, as championed by
psychiatrist Martha Welch, involving prolonged face-to-face embraces designed
to forge a new attachment to the father figure and thereby diminish same-sex
attraction.

Cohen's views on the origins of same-sex attraction extend to the concept

of "inherited wounds," a notion heavily emphasized within charismatic circles,
positing that individuals may inherit spiritual influences or "demons" from their
ancestors due to past sins. However, Cohen asserts that mere spiritual
deliverance or exorcism alone is insufficient to resolve homosexual feelings,
emphasizing the importance of addressing underlying psychological and
emotional factors. He acknowledges the harm caused by well-meaning but
misguided attempts to "deliver" individuals from homosexual feelings without
addressing the root causes or unmet needs that contribute to their struggles.

In essence, Cohen proposes a multifaceted approach to addressing same-

sex attraction, incorporating elements of spiritual liberation alongside therapeutic
interventions aimed at healing emotional wounds and fulfilling unmet needs.
While his perspective may resonate within religious communities, it also
underscores the ongoing debate surrounding the efficacy and ethics of conversion
therapy, prompting calls for legislative action to prohibit its practice.

14
 The movement to legislate against conversion therapy for minors gained
traction with the enactment of a bill signed by the governor of California in 2012.
This landmark legislation declared that licensed therapists employing conversion
therapy techniques on patients under the age of eighteen would be deemed
guilty of unprofessional conduct, subjecting them to disciplinary action by their
respective state licensing boards. Despite legal challenges questioning its
constitutionality, the law received unanimous support from a Ninth Circuit panel,
solidifying its legal standing.

Following California's lead, a similar bill was signed into law by the governor
of New Jersey in 2013, further regulating the use of conversion therapy by
licensed therapists, albeit excluding the clergy from its purview. Presently, states
such as New York and Maryland are also contemplating measures to regulate
conversion therapy as it pertains to minors.

While scientific evidence regarding the safety and efficacy of conversion

therapy played a pivotal role in the passage of these bills, testimonies presented
during legislative proceedings often focused on personal narratives rather than
empirical data. While a few witnesses referenced scientific evidence supporting
the ban, the majority of oral testimonies in favor of the bills underscored the
harmful effects of societal stigma surrounding same-sex attractions during
adolescence. Conversely, opposition to the legislation primarily rested on
religious convictions and assertions that homosexual adults lead unsatisfactory
lives.

The success of conversion therapy bans can be attributed in part to the

concerted political efforts of LGBTQ+ advocacy groups, rather than solely on the
strength of evidence regarding the therapy's effectiveness and safety. Notably,
there has been a lack of systematic investigations into the therapy's efficacy, with
evidence of harm largely anecdotal—an issue characteristic of many
psychotherapies until recent times. Additionally, the potential link between
holding therapy and conversion therapy has not been prominently highlighted in
discussions surrounding the bans.

While it may be unlikely for conversion therapy bans to serve as direct

models for legislation targeting other alternative psychotherapies, they
nonetheless represent a significant milestone in the regulation of such practices.

15
Their endorsement by professional organizations underscores the growing
recognition of the need for ethical guidelines and standards within the mental
health profession.

Legal Action and Lawsuits

When alternative psychotherapies lead to harm, recourse through legal
avenues often becomes necessary, potentially resulting in criminal prosecution or
civil litigation for malpractice. In such legal proceedings, the focus typically
centers on establishing evidence of harm rather than solely scrutinizing the
specific treatments administered, although recent bans on conversion therapy
may alter this landscape.

The use of litigation to regulate certain alternative psychotherapies gained

traction through a series of cases targeting therapists employing Recovered
Memory Therapy (RMT) techniques. These cases revealed instances where
therapists' interventions led to false accusations of sexual abuse or "Satanic ritual
abuse" against the parents of adult clients. Notably, a landmark 1995 Minnesota
case saw a client and her family awarded over two million dollars in damages in a
negligence suit against a psychotherapist. Similarly, a 1996 case in the same state
resulted in substantial damages awarded for psychiatric malpractice. These legal
precedents, reinforced by similar findings in subsequent trials, have contributed
to a decline in the use of RMT, despite the absence of legislative bans and clear
opposition from professional organizations.

Legal recourse has been particularly prevalent in cases where alternative

psychotherapies have led to death or physical injury. For instance, a tragic
incident in 1971, resulting in the death of one client and serious injury to another,
prompted litigation that culminated in disciplinary actions against mental health
practitioners involved. Despite their claims that the treatment, known as rage
reduction therapy, adhered to standard care practices, one practitioner faced a
reprimand while the other had their license revoked. Notably, one of the
practitioners subsequently relocated to another state and remains licensed to
practice as of the present writing.

These legal battles underscore the critical role of legal mechanisms in

addressing the harms stemming from alternative psychotherapies. While
litigation has been instrumental in holding practitioners accountable for their
16
actions and discouraging certain controversial practices, ongoing efforts are
needed to establish clearer regulatory frameworks and safeguards within the
mental health field.

One of the most extensively documented legal cases involving alternative

psychotherapists centered around the trial of Connell Watkins and Julie Ponder
subsequent to the tragic death of Candace Newmaker during a "rebirthing"
treatment. This landmark trial resulted in the conviction of both Colorado
therapists on charges of child abuse leading to death, leading to their
incarceration for a significant duration. Notably, the focus of the trial revolved
around the specific events that led to the child's untimely demise, rather than
delving into the broader discourse surrounding the plausibility, safety, or efficacy
of the treatment itself.

An extraordinary aspect of this case was the presence of thirty hours of

videotaped footage capturing Candace's treatment sessions, providing the jury
with a vivid depiction of the events leading up to her tragic death. The compelling
recorded evidence, coupled with expert medical testimony, unequivocally
demonstrated the causal link between the therapists' actions and the fatal
outcome.

While the trial of Watkins and Ponder garnered substantial public attention,
there exist lesser-known cases involving the practice of holding therapy, albeit
with a twist: rather than prosecuting therapists, these cases involved legal action
against parents. A poignant example unfolded in 2002 with the tragic death of
four-year-old Cassandra Killpack, whose parents, allegedly acting upon advice
from therapists implicated in a prior case, subjected her to a grueling regimen of
"intensive" treatment.

According to reports, Cassandra's demise was suspected to be a

consequence of injuries sustained during a holding therapy session, which
culminated in her tragic passing at the hands of her adoptive parents. In the days
preceding her death, Cassandra endured over fifteen hours of coercive
procedures, including restraint and forced exercise, as part of the prescribed
treatment regimen.

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 The circumstances surrounding Cassandra's treatment further underscore
the concerning involvement of a former therapist whose license had been
revoked in Oregon due to his use of holding therapy practices. Despite facing
professional censure, this individual continued to operate under the guise of
"pastoral counseling" after obtaining ordination as a minister through an online
platform. His involvement in Cassandra's case highlights the ethical ambiguities
and potential dangers associated with unregulated alternative psychotherapies.

Overall, these cases serve as poignant reminders of the critical need for
robust regulation and oversight within the realm of alternative psychotherapies to
prevent further tragedies and ensure the safety and well-being of vulnerable
individuals.

The Killpacks provided a detailed account of the grueling regimen endured

by Cassandra during the initial five days of the "intensive" treatment. These
sessions, conducted daily from Monday through Friday, were slated to continue
into the following week, with each session spanning approximately three hours.
In attendance were a minimum of four adults, comprising the two parents and
two therapists or "support staff."

The treatment protocol during these "intensive" sessions oscillated

between two distinct approaches: restraint methods and forced physical activity.
Describing the harrowing ordeal, the Killpacks recounted how Cassandra was
repeatedly restrained on the floor by the adults, while therapists exhorted her to
resist, purportedly to release her purportedly repressed emotions. In instances
where holding therapy was not employed, Cassandra was coerced into
performing a litany of repetitive physical activities, including kicking the wall,
executing jumping jacks, and running in place, among others. Witnessing some of
these sessions, Cassandra's older sister provided investigators with a chilling
depiction, attesting to the relentless verbal haranguing inflicted upon the younger
child during both the restraint and physical exertion phases.

Moreover, the Killpacks divulged that they were instructed to perpetuate

this punitive treatment regimen at home to facilitate a presumed "breakthrough."
Allegedly advised by one therapist, they were instructed to employ a "paradoxical
intervention" wherein Cassandra would be compelled to repetitively engage in
transgressive behaviors, such as "stealing" food, as a form of punitive discipline.

18
Shockingly, one therapist purportedly suggested that Cassandra should be forcibly
administered water as a consequence for her perceived misdeeds.

Driven by a sense of obligation and fear instilled by the therapists, the

Killpacks persisted with the draconian treatment, fearing that capitulating to
Cassandra's supposed manipulation would thwart the desired "breakthrough."
They claimed to have been warned that failure to adhere to the prescribed two-
week "intensive" regimen would condemn Cassandra to a bleak future
characterized by prostitution, drug addiction, or even violence, including the
possibility of perpetrating harm against her own family. Additionally, the Killpacks
asserted that they were assured of a "one hundred percent success rate" if they
adhered faithfully to the recommended course of action, further fueling their
resolve to subject Cassandra to the traumatic treatment protocol.

The Killpacks purported that they were indoctrinated into a methodology

that aimed to foster a profound dependency from Cassandra upon her adoptive
mother, Jennette, under the guise of fostering a stronger bond between them.
Allegedly, Cassandra was subjected to a stringent regimen where she was
compelled to seek approval from her mother for virtually every aspect of her
daily life, spanning from mundane activities like consuming meals and beverages
to even accessing the restroom. However, a pivotal moment ensued when
Cassandra, in an act of perceived disobedience, purportedly helped herself to a
portion of her sister's drink without obtaining prior consent from her mother.

In response to this perceived infraction, Jennette purportedly imposed a

punitive measure by coercing Cassandra to perch upon a bar stool and consume
an excessive volume of water. As Cassandra's physical state began to deteriorate,
manifesting signs of weakness and partial responsiveness, her parents
purportedly interpreted her condition as a calculated act of manipulation and
defiance. Firmly convinced that Cassandra teetered on the cusp of the anticipated
"breakthrough" prophesied by the therapists, the parents continued with their
treatment protocol, resorting to physically restraining Cassandra, forcibly tilting
her head back, and administering additional water down her throat with
sufficient force to cause lacerations and bruising to her lips, as evidenced by the
findings of the subsequent autopsy.

19
 Despite Cassandra subsequently succumbing to vomiting and collapsing,
the Killpacks purportedly construed her failure to comply with their instructions
as further evidence of defiance, prompting them to persist in their demands. It
was only when Cassandra remained motionless that the gravity of the situation
began to dawn on them, prompting their belated efforts to revive her and their
eventual call for emergency assistance. In recounting the incident to the
emergency dispatcher, Richard Killpack attributed Cassandra's condition to her
purported "emotional problems" and acknowledged their administration of
copious amounts of water as part of their therapeutic approach.

Following Cassandra's tragic demise from hyponatremia, or water

intoxication, she succumbed hours later at the hospital. Subsequently, legal
proceedings ensued against the Killpacks, resulting in Mrs. Killpack's trial in 2006
and subsequent conviction. She served a prison sentence and was subsequently
released on parole in 2012.

In a parallel yet equally distressing turn of events, criminal charges were

levied against Reed and Teresa Hansen shortly after Cassandra Killpack's passing.
The Hansens faced allegations of felony child abuse concerning their adopted
Russian children, purportedly subjected to egregious mistreatment including
confinement in a bathroom and being forced to sleep on bare tile floors with
scant bedding. Teresa Hansen's prior brush with the law, stemming from a
previous child abuse charge involving one of her adopted children found covered
in bruises, compounded the gravity of the situation. Despite receiving a
suspended prison sentence and fines, the discovery of literature endorsing
coercive treatment methods and business cards from the clinic where Cassandra
underwent her "intensive" treatment cast a shadow over the case.

Moreover, the involvement of therapists implicated in these harrowing

incidents did not escape legal scrutiny. The Utah State Attorney General, in
collaboration with the Division of Occupational and Professional Licensing,
pursued charges against two of the therapists involved, one of whom met an
untimely demise in a vehicular accident in December 2004. The surviving
therapist faced probationary measures yet continued to administer treatment to
children within a residential care facility. Despite initial actions against other
individuals named by the Attorney General, no further legal action materialized.

20
 In addition to criminal prosecution, civil lawsuits were filed against the
therapists implicated in the cases, highlighting the profound emotional toll
inflicted upon the victims and their families. Allegations in these suits ranged
from unauthorized performance of holding therapy to advocating punitive
measures such as forced water consumption as a form of discipline. The
emotional trauma endured by the victims further underscored the gravity of the
situation, culminating in out-of-court settlements in both cases to resolve the
legal disputes.

In principle, the assurance of sound therapeutic practices should be upheld

through the mandate of professional licensing for therapists, coupled with
oversight by professional licensing boards. However, this ideal is muddled in the
United States by the existence of fifty distinct sets of state laws governing such
practices. Moreover, the landscape is further complicated by the existence of
numerous relevant professional licensing boards, far exceeding the number of
states. Each state typically maintains licensing boards for psychiatrists,
psychologists, and clinical social workers, and may additionally license marriage
and family therapists, occupational therapists (often involved in autism
treatment), counselors, and other "mental health professionals." Notably, "life
coaches" remain unlicensed. The proliferation of separate licensures and licensing
boards renders it unlikely for any consistent approach to alternative practices to
emerge within a state, and increases the likelihood of alternative practitioners
finding supportive groups for their treatments.

When a consumer or another professional raises concerns to a licensing

board about a practitioner employing inappropriate methods, the outcome tends
to be somewhat unpredictable. While some state boards benefit from the
assistance of professional investigators, many do not. Furthermore, the
operations of these boards are veiled in secrecy, with public disclosures typically
limited to specific disciplinary decisions, such as license suspensions. Instances
where practitioners agree to participate in risk management courses or other
corrective actions often go unannounced. Matters involving sexual relationships
or physical harm or death receive attention, but the utilization of potentially
harmful alternative psychotherapies often goes unaddressed unless it results in
harm to someone able to lodge a complaint.

21
 Children and adolescents who suffer harm from alternative psychotherapies
may not be cognizant of their right to file a complaint until several years after
reaching adulthood, rendering them too late for the licensing board to intervene
effectively. These challenges appear to reflect a broader reluctance within
professional groups to discipline their members, exemplified by instances such as
the American Psychological Association's refusal to reprimand a member involved
in the torture of a prisoner.

Victor, in his commentary on efforts to combat conversion therapy,

advocated leveraging existing state laws pertaining to deceptive trade practices as
a means to curb alternative therapies. He emphasized that victims possess the
ability to seek damages through lawsuits in state courts, citing instances where
such legal action has been initiated against conversion therapy practitioners with
assistance from organizations like the Southern Poverty Law Center. In certain
states, professionals are obligated to substantiate the claims they make in their
advertisements, and failing to do so may result in fines or even the revocation of
their licenses.

While acknowledging that this approach necessitates targeting practitioners

individually, Victor contended that a series of successful lawsuits and regulatory
interventions could undermine the conversion therapy network. This could be
achieved by financially crippling organizations associated with conversion therapy,
driving up malpractice insurance rates for individual therapists, and prompting
practitioners to reassess the viability of perpetuating practices deemed deceptive
under the law.

Additionally, Victor highlighted the potential utility of another legal strategy

that, to his knowledge, has not been employed against alternative
psychotherapies: the qui tam suit. Such suits operate under various "false claims"
acts, either at the federal or state level, where whistleblowers stand to be
rewarded for exposing instances of fraudulent sale of goods or services to
governmental entities. Although the Federal False Claims Act dates back to the
Civil War era, several states have enacted similar legislation. However,
establishing fraud in the context of alternative psychotherapies presents
challenges, as most providers likely genuinely believe in the efficacy of their
methods, or could easily assert such belief in their defense.

22
 The challenges associated with enacting legislation and other regulatory
measures concerning alternative psychotherapies prompt an inquiry into the role
of individual professionals in critiquing these treatments. However, such
involvement has been fraught with difficulties, primarily due to the litigious
climate in the United States and the professional ethics codes cautioning against
public criticism. In this environment, few journal editors in the U.S. are willing to
take the risk of facing a lawsuit from an alternative therapist who claims
defamation resulting from statements published in a journal article.

Contrastingly, in the United Kingdom, where defamation laws historically

placed the burden of proof on the critic to demonstrate the accuracy of their
statements, journal editors have exercised extreme caution when considering the
publication of potentially defamatory content. Even when factual accuracy is
indisputable, British journals may opt to request alterations in tone based on legal
advice, illustrating the chilling effect of defamation laws on public discourse.

Notably, alternative psychotherapists have been known to initiate

defamation suits against critics, particularly targeting statements made on the
internet. While the primary goal may not always be financial compensation, these
lawsuits often serve to stifle public discussion and dissenting opinions. The
prospect of defending against such lawsuits, which can be both time-consuming
and costly, often dissuades critics from engaging in public discourse, even when
confident that the suit lacks merit. Such legal actions can be categorized as SLAPP
lawsuits (strategic lawsuits against public participation), designed to inhibit the
exercise of First Amendment rights.

In response to this challenge, some states have implemented anti-SLAPP

legislation aimed at safeguarding individuals' rights to free speech. However,
despite the availability of these legal protections, engaging in SLAPP-related
proceedings may still require significant resources, potentially outweighing the
benefits of their outcomes. Thus, the fear of litigation continues to cast a shadow
over public criticism of alternative psychotherapies, hindering efforts to openly
evaluate and debate their efficacy and safety.

The preceding section has underscored the complexity of regulating

alternative psychotherapies, revealing that while feasible, it remains a challenging
endeavor. To assess the worthiness of such regulation, it's imperative to weigh

23
the advantages and disadvantages on a case-by-case basis. However, a significant
hurdle arises from the limited understanding of the effectiveness and safety of
most alternative mental health interventions. Consequently, a more generalized
examination of the potential harms associated with these therapies and the
objectives of regulation is warranted.

Direct harm stemming from a psychotherapy can manifest in physical or

psychological forms. Therapies employing physical manipulation or restraint are
at a higher risk of causing direct physical harm. Moreover, psychotherapies hold
the potential to exacerbate emotional issues, leading to conditions such as
depression and suicidal ideation. Additionally, treatments may inflict direct harm
in the form of "emotional burden," encompassing unpleasant and distressing
experiences inherent in the intervention itself. Historically, adverse events in
psychotherapy were seldom discussed, resulting in a scarcity of relevant
information concerning both established and alternative treatments.

Indirect harm resulting from a mental health intervention is less likely to be

physical but can manifest across psychological, social, and economic dimensions.
Ineffective therapies deplete clients' and families' resources, both in terms of
time and finances, potentially hindering access to effective treatments for those
in need. Alternative psychotherapies may also be intertwined with broader belief
systems that pose potential harm, leading clients to reject suitable medical
treatments or becoming ensnared in cult-like groups. These indirect effects often
unfold over extended periods, making them challenging to document
conclusively.

It's noteworthy that regulation of alternative psychotherapies can take

various forms, ranging from mild to severe measures. Criminalizing a treatment,
as seen in certain state rebirthing laws, is an option typically reserved for cases
with clear evidence of direct harm, especially when minors are involved. In
instances of indirect harm, regulation may involve laws categorizing specific
treatments as "unprofessional conduct," with disciplinary actions falling under
the purview of professional licensing boards. Implementing guidelines mandating
informed consent, which necessitates therapists to disclose information regarding
a treatment's efficacy and safety record, could serve as a valuable regulatory
approach, albeit one that is seldom enforced.

24
Chapter 2: Advantages of Control Measures
for Alternative Psychotherapies

One of the primary advantages associated with the regulation of alternative

mental health treatments lies in its capacity to proactively mitigate both direct
and indirect harm inflicted upon clients and their families. This regulatory
framework mirrors the restrictions imposed on the sales of food and drugs, which
are designed to preemptively safeguard public health and well-being. By
establishing regulatory measures, authorities aim to prevent harm from
occurring, recognizing that prevention is often more effective than relying solely
on punitive measures post-harm occurrence.

Moreover, the regulation of alternative psychotherapies has the potential to

catalyze shifts in attitudes within groups that have historically supported such
treatments. While some of these changes may manifest as negative or defensive
responses, akin to a "circle-the-wagons" mentality exhibited by certain factions,
other transformations may signify more positive shifts in belief systems. For
instance, in the aftermath of Candace Newmaker's tragic death, the Association
for Treatment and Training of Attachment in Children, a parent-professional
organization that had previously endorsed the use of physical restraint in its
publications, noticeably softened its stance on coerced restraint, as evidenced by
amendments made to its website. Although the veracity of these public
expressions may be subject to speculation regarding their alignment with internal
organizational changes, they nonetheless conveyed to the public a perceptibly
different approach than previously espoused.

Similarly, concurrent with the introduction of legislation addressing

conversion therapy, several organizations representing "ex-gay" individuals, which
had long advocated for conversion therapy, either disbanded or announced
revisions to their perspectives. While these developments may have been
influenced by broader shifts in public opinion, the timing suggests a potential
correlation with regulatory interventions. Thus, while regulatory measures may

25
not be the sole impetus behind such positive changes, they likely played a
contributory role in fostering more informed and ethically sound practices within
the realm of alternative psychotherapies.

While the benefits of effectively regulating alternative psychotherapies are

evident, it's crucial to acknowledge that regulation can also entail certain
drawbacks. These drawbacks may not necessarily entail direct harm to clients or
families, but they could have broader societal implications.

One major concern revolves around the preservation of freedom of speech,

a fundamental principle cherished across the Western world. Many individuals
would demand compelling evidence of a therapy's harmfulness before consenting
to its prohibition, fearing that such actions could set a precedent for curbing free
speech rights in other domains. In the United States, the First Amendment to the
Constitution intertwines freedom of speech with freedom of religion, explicitly
prohibiting laws that might impede individuals' choices regarding religious beliefs
and expressions. Although religious practices are partially safeguarded, certain
practices like polygamy or snake handling have not received constitutional
protection. Notably, challenges to therapies like exorcism, which are practiced by
groups attributing all illnesses to demonic possession, have primarily arisen
following instances of injury or fatality. Given that most alternative
psychotherapies are not directly affiliated with organized religious bodies, it
appears less likely that they would be shielded under religious freedom
provisions, with freedom of speech serving as a more plausible protective shield.

Organizations such as the National Alliance on Mental Illness (NAMI) have

crafted patients' bill of rights, affirming individuals' entitlement to choose their
mental health treatments and programs. Crucially, this "bill" underscores that
such choices should be informed by comprehensive information about
procedures, costs, and risks, which patients have an unequivocal right to receive.
Consequently, the regulation of alternative psychotherapies could be construed
as a setback in the ongoing endeavor to establish and uphold the rights of the
mentally ill, potentially depriving individuals of the autonomy they currently
enjoy in making treatment decisions.

Organizations advocating for parents' rights have been actively

championing the principle that parents should retain sole authority in

26
determining their children's education and medical care. Despite tragic incidents
where children have perished due to their parents opting for religious or
complementary-and-alternative therapies over conventional medical treatment,
the prevailing legal stance remains that authorities can intervene only when a
child's life is deemed to be in immediate jeopardy. These groups, committed to
safeguarding parental autonomy, played a pivotal role in thwarting proposed
legislation in Utah concerning holding therapy, and have also been significant
participants in the ongoing discourse surrounding conversion therapy. While the
potential risks associated with unbridled "parents' rights" are evident in both
medical and psychological domains, there are valid concerns regarding excessive
interference with parental decision-making. After all, parents are often best
positioned to understand their children's unique characteristics and broader
family dynamics, a perspective that outsiders may lack.

The implementation of prohibitive or regulatory measures targeting

alternative treatments could lead to the establishment of a hierarchical system
where the majority of resources are directed towards supporting established
therapies, even if subsequent evidence reveals their efficacy to be less substantial
than initially touted. This phenomenon is exemplified by the ascendancy of
Applied Behavior Analysis (ABA) as the predominant therapy for autism, a trend
that gained momentum following early reports by Lovaas showcasing its
remarkable success. However, despite subsequent research indicating its limited
effectiveness, ABA has become deeply entrenched within institutional
frameworks, with child study teams and classroom aides often trained in its
application through publicly funded initiatives. While compiling lists of approved
and disapproved treatments may seem straightforward, such an approach risks
unduly shaping therapeutic strategies and impeding the flexibility needed to
adapt to evolving evidence.

Another compelling argument against the regulation of alternative

psychotherapies is the potential stifling effect it may have on further research and
innovation in the field. By imposing regulatory constraints, there is a risk of
discouraging both clinical investigations and systematic research endeavors.
Moreover, such regulations could foster an atmosphere of skepticism towards
novel practices, hindering the exploration of potentially beneficial therapeutic

27
modalities. These concerns will be explored in greater depth in the subsequent
section.

When drawing parallels between the evolution of modern medicine and the
trajectory of psychotherapy, proponents often highlight instances where a novel
medical treatment, initially met with scorn and skepticism, eventually garners
widespread acceptance and becomes a cornerstone of medical practice.
Numerous examples from the annals of medical history substantiate this
phenomenon. One such case is the plight of Ignaz Semmelweis, whose
groundbreaking proposition linking unhygienic practices to the transmission of
puerperal fever was initially dismissed, only to be vindicated later. Similarly, the
revelation that gastric ulcers, long attributed to psychosomatic causes, were
actually rooted in infection underscores the transformative potential of medical
discoveries that challenge prevailing beliefs. Advocates for alternative
psychotherapies draw parallels between the skepticism surrounding their
methods and the initial criticism leveled against medical treatments that
ultimately revolutionized healthcare practices.

The prospect of whether a contemporary alternative psychotherapy

possesses the capacity to catalyze a paradigm shift in psychological theory and
yield novel, effective mental health interventions remains uncertain. Predicting
the future implications of prohibiting or regulating a specific alternative
psychotherapy is fraught with uncertainty. However, by examining established
therapeutic modalities and scrutinizing the historical trajectory of psychological
interventions, we can assess the potential ramifications of regulatory measures
on treatment innovation.

An examination of established therapies offers insights into the origins of

conventional psychotherapies and their evolution from alternative treatments.
Three such therapies, supported by robust empirical evidence, exemplify this
transition. Applied Behavior Analysis, renowned for its efficacy in addressing the
needs of autistic children, has its roots in alternative psychotherapeutic
approaches. Additionally, Cognitive Behavioral Therapy for depression and
anxiety, pioneered by A.T. Beck, emerged from a meticulous study of maladaptive
thought patterns characteristic of emotional disturbances. This approach involves
assisting depressed individuals in identifying and challenging automatic negative
thoughts, reinforcing more adaptive cognitive patterns through therapeutic
28
intervention. Furthermore, Prolonged Exposure Therapy for post-traumatic stress
disorders aims to mitigate learned anxiety responses by facilitating gradual
desensitization through controlled exposure to distressing stimuli. These
examples underscore the transformative potential of alternative psychotherapies
in shaping contemporary mental health interventions.

None of the established psychotherapies discussed in this book emerged

from alternative psychotherapy practices. Moreover, they do not espouse
alternative beliefs in concepts such as repressed memory, catharsis, or the
existence of unmeasured energy fields in the body. Instead, these established
therapies are rooted in extensive psychological research and theories on human
cognition and learning, drawing from studies conducted on both humans and
non-humans. Importantly, the foundational psychological research underlying
these therapies was never dismissed or deemed unacceptable. While a
comprehensive examination of all established psychotherapies would be
impractical within the confines of this book, it is reasonable to assert that their
origins similarly lie in fundamental research rather than in any novel alternative
treatment paradigms.

Conventional Methods Informed by Alternative Therapeutic

Practices
The question arises: do the alternative psychotherapies outlined in this
book harbor the potential for new and effective therapeutic methods? An
exploration of their backgrounds and underlying assumptions suggests otherwise
—or, at the very least, that no other treatments with comparable backgrounds
have demonstrated efficacy. As highlighted in preceding chapters, alternative
psychotherapies often share beliefs not present in the foundational principles of
established treatments.

It is notable that alternative psychotherapies frequently exhibit strong

connections with the philosophy of transcendentalism, which rejects the notion
of evil and posits a connection between human experience and a larger universal
soul or spirit. These transcendentalist concepts have filtered down to
contemporary alternative psychotherapies through various channels, including
the New Thought movement of the 1880s and ideologies such as Christian
Science, which advocate the power of "mind over matter." Contrarily, the

29
materialist traditions of conventional psychology have historically opposed such
approaches, with notable exceptions such as William James's interest in mediums
and spirit communications.

Throughout the twentieth century, conventional psychology has

experienced shifts in its theoretical frameworks, yet these fluctuations have not
reached the level of paradigm shifts observed in other disciplines. Initially
adopting a strong nativist perspective, psychology gradually transitioned to a
behaviorist, environmentalist stance by the 1940s. However, as understanding
grew regarding the genetics of behavior, psychology embraced a more nuanced
view that balanced innate and experiential factors in shaping personality.
Similarly, attitudes toward the mind-body connection evolved over time, with
earlier emphasis on the influence of the mind on bodily health giving way to a
recognition of bidirectional interactions between mental and physical well-being.

A significant transformation in psychological thought also occurred

concerning causal determinants, shifting from a search for singular factors
influencing outcomes, such as parental behavior's impact on children's
development as proposed by Freud, to a transactional perspective by the 1980s.
In this transactional view, the reciprocal influence between two elements over
time was emphasized, reflecting a more complex understanding of psychological
processes.

Effective psychotherapeutic methods have emerged within conventional

psychology as it navigated from simpler to more intricate views on the interplay
between innate and learned behaviors, the relationship between psychology and
physiology, and systemic understanding of psychological causality. Notably, all
validated methods of psychotherapy adhere to a materialist orientation.

In contrast, alternative psychotherapies often diverge from materialist

assumptions, incorporating considerations of unidentified energies or spiritual
influences into their frameworks. These therapies typically adopt an
environmentalist perspective, attributing human characteristics solely to
experiential factors and emphasizing the plasticity of the nervous system in
development. Furthermore, alternative treatments frequently assert the potency
of bodily practices and manipulations in shaping mental states and capacities,

30
often focusing on singular causal factors for psychological outcomes rather than
adopting a transactional view.

While some alternative psychotherapies have integrated psychoanalytic

concepts like regression and repression, it is evident that established treatments
have not arisen from unorthodox proposals, nor have alternative psychotherapies
emerged directly from conventional psychology. Consequently, this suggests that
regulatory efforts targeting alternative psychotherapies may not impede the
potential development of treatment innovations.

While not all alternative psychotherapies result in direct harm, their

overarching ineffectiveness renders them indirectly harmful. Those treatments
that have been proven to cause direct harm are more likely to face some form of
regulation. However, such regulatory measures are often compromised by
ambiguous legislation, the limited authority of professional organizations, or the
autonomy of professional licensing boards. Despite these challenges, regulation
of alternative psychotherapies is not without its drawbacks, and potential harms
must be considered. Nevertheless, it remains uncertain whether regulation
significantly hampers therapeutic innovations.

Is there an alternative solution to address the issue of implausible,

ineffective, and potentially harmful mental health treatments aside from formal
regulation? Some have proposed public education as a viable approach. However,
the effectiveness of such education may be limited, as it is challenging to provide
comprehensive guidance beyond simple lists of effective and ineffective
treatments. Moreover, the dynamic nature of therapeutic practices, including
frequent changes in treatment names and practices by alternative practitioners,
complicates efforts to educate the public on assessing treatment plausibility and
research support.

Mental health professionals and educators preparing future professionals

are arguably best positioned to develop a nuanced understanding of alternative
psychotherapies and disseminate this knowledge to clients and colleagues. In
recent years, there has been a growing recognition of the importance of
educating mental health professionals about alternative treatments. Some
pioneering efforts have been made, such as the publication of texts discussing
various alternative psychotherapies and quasi-medical treatments. Additionally,

31
forthcoming resources like the Encyclopedia of Clinical Psychology are poised to
provide valuable insights into controversial treatments, further enhancing
professional awareness and understanding in this domain.

Given that alternative mental health interventions often rely on the

absence of critical thinking to foster adherence to their belief systems, addressing
educational strategies has involved emphasizing critical thinking, argumentation,
and persuasion. Mental health professionals must possess the skills to assess
claims of research support, evaluating the level and robustness of the evidence
presented. As demonstrated throughout this book, effective critical thinking
requires mental health professionals to also grasp the historical context of
alternative psychotherapies to gauge their potential efficacy. Additionally, a solid
foundation in psychology is crucial for professionals to assess the plausibility of
interventions accurately. To cultivate these skills, education should commence at
the undergraduate level and continue to be honed during professional training.

Furthermore, it's imperative to consider the role of mental health

professionals in mitigating the harm caused by alternative psychotherapies.
However, possessing adept assessment skills alone may prove insufficient without
a shift in attitudes towards criticizing practitioners and practices. Presently,
negative assessments are typically acceptable only when endorsed by
organizations or included in task force reports. The mental health profession
often discourages individual expressions of concern or disapproval of treatment
methods, as reflected in professional ethics codes. Rarely is it acknowledged that
voicing disapproval of a mental health intervention is not only a matter of free
speech but should also be viewed as an ethical obligation for professionals. If
future codes of ethics adopt this stance, mental health professionals may more
effectively work towards preventing the direct and indirect harm stemming from
alternative psychotherapies.

An energy therapy encompasses medical or psychological interventions

aimed at modifying some form of energy within or around an individual's body,
purportedly to enhance physical or mental well-being. These energies are
typically conceptualized as existing in a field form, with the National Center for
Complementary and Alternative Medicine (NCCAM) categorizing energy therapies
into two classifications. The first category, known as Putative (or Biofield) Energy
Therapies, deals with energy fields believed to envelop and permeate the body
32
but cannot be measured using conventional physical means. These fields may or
may not be perceived as emanating from the body itself. Conversely, the second
category, Veritable Energy Fields, involves treatments utilizing measurable
energies such as sound waves, light, or magnetism. This chapter will delve into
some Putative Energy Therapies, while a subsequent chapter will explore
Veritable Energies, especially in their application for educational or
developmental purposes. It's worth noting that proponents of Putative Energy
Field treatments may argue that their methods involve verifiable energies that
are simply challenging to measure accurately.

One aspect of energy therapies that adds to the complexity is their frequent
utilization for addressing both physical and mental health concerns
simultaneously. While energy therapies for physical ailments have been
extensively discussed elsewhere, this chapter will primarily focus on their
relevance to mental health or mood issues. It's common to observe these
therapies being employed alongside conventional medical treatments,
particularly in cases where treatment for mental health or mood disorders is
integrated into the broader aim of addressing physical illness. For instance,
energy therapies might be utilized to alleviate pain or depression associated with
cancer treatment, with research often examining both physical and psychological
outcomes. Treatments rooted in traditional Chinese or Japanese methods, for
example, often consider both physical and psychological aspects at each point of
intervention. Stimulating a specific point may be believed to not only relieve local
pain but also alleviate anxiety and depression. While some publications cited in
this chapter may primarily focus on physical ailments, our focus here will be on
exploring the intersection of energy therapies with mental health and mood-
related concerns.

The landscape of alternative psychotherapies is vast and constantly

evolving, making it challenging to compile an exhaustive list of all available
treatments. While this chapter will delve into several energy field therapies
deemed representative of their class and sharing common characteristics, it's
important to acknowledge that there may be numerous other therapies not
covered here.

Energy field therapies operate under the premise that both psychological
and physical functions are governed by energy permeating the body and its
33
surrounding space. Unlike the energy utilized by cells for biological processes, this
energy is believed to transcend ordinary physical concepts, resembling the
notions of prana in yoga or qi in traditional Chinese philosophy. Often perceived
as the essence of life, this subtle energy is considered distinct from the energy
powering the body's physiological functions. Proponents assert that trained
observers can detect this energy field and that physical manipulation or proximity
to the body can influence psychological and physical well-being by altering this
energy field. It's believed that such alterations occur through the interaction
between the therapist's energy field and that of the patient. While some
practitioners incorporate patterns akin to those found in Chinese and Japanese
medical traditions into their practice, others rely on their intuitive ability to
identify issues within the patient's energy field.

Central to Chinese traditional practices like qigong is the concept of a

dynamic flow of energy, known as qi, which sustains the body's vitality. According
to this theory, blockages in the flow of qi can lead to pain, physical ailments, or
psychological distress. The body is thought to contain a network of meridians or
pathways through which qi flows, and disruptions in these pathways are believed
to manifest as dysfunction in related body parts. Traditional remedies such as
acupuncture aim to alleviate these blockages by applying pressure or stimulation
to specific points along these meridians. While some authors emphasize that
acupuncture involves more than just energy therapy, for the purposes of this
discussion, the focus lies on the manipulation of qi flow and the therapist's role in
redirecting this energy to restore balance and well-being.

Reiki, originating from Japanese practices, represents a therapeutic

modality deeply rooted in traditional systems, albeit not necessarily ancient.
Central to Reiki is the concept of "universal life energy," which practitioners
harness to promote healing. The practice involves a series of twelve hand
positions, where the practitioner either places their hands on or slightly above
the patient's body, applying gentle pressure. Unlike qigong, Reiki masters do not
manipulate or transmit energy; rather, they act as conduits for the universal life
energy, which is believed to originate externally to both practitioner and patient.

Thought Field Therapy (TFT), born in North America, shares parallels with
aspects of qigong while also introducing its own proprietary techniques, some of
which are kept confidential for commercial reasons. Fundamentally, TFT
34
practitioners select specific points on the skin associated with acupuncture
meridians, aiming to alleviate the patient's symptoms through stimulation. This
stimulation typically involves tapping the designated area, with the number of
taps determined based on the intensity of the patient's emotional or
psychological distress. According to its developer, Roger Callahan, addressing the
appropriate encoded form for each disturbing emotion through tapping can lead
to rapid and comprehensive results, as energy is believed to shift through tapping
at the correct rate and location.

Emotional Freedom Technique (EFT) emerges as a derivative of TFT,

integrating the patient's focused attention on the problem alongside tapping on
designated meridians. The technique is designed to clear blockages within the
body's energy system by tapping on specific endpoints of the body's energy
meridians while the patient concentrates on a particular issue. This process
purportedly sends pulses of energy to rebalance the body's energy system in
relation to the specific concern, thereby altering the brain's processing of
information related to the problem. Tapping while attuned to the issue is likened
to rewiring or rerouting the brain's conditioned negative response, ultimately
facilitating a shift in energy dynamics.

Therapeutic Touch (TT) and Healing Touch (HT) represent Western

adaptations of traditional practices like qigong and Reiki. In these modalities,
practitioners either move their hands in close proximity to the recipient or lightly
touch them. Unlike approaches focusing on specific meridians or energy points,
TT and HT practitioners rely on their tactile sensitivity to detect disturbances
within the patient's energy field. By intuitively identifying these disruptions and
applying corrective measures through touch, they aim to alleviate distress and
alleviate pain by restoring energetic balance.

Similar to TT and HT, Polarity Therapy also aims to address imbalances in

energy flow. This technique involves the application of manual pressure to
specific soft tissue pressure points, vertebral areas, and opposing locations
simultaneously. Additionally, rocking motions may be utilized on bony or soft
tissue surfaces to further promote energetic harmony. Another approach, Brain
Integration Technique (BIT), operates under the premise that emotional trauma
can disrupt brain function and impede the flow of life energy. BIT practitioners
administer touch therapy at three distinct points on the patient's head, waiting
35
for the synchronization of pulses at these locations, which is interpreted as an
indication of restored energy flow.

When assessing whether a therapy qualifies as an alternative treatment,

one crucial consideration is its plausibility within the framework of established
beliefs. Energy therapies, by their nature, challenge several fundamental
principles of modern scientific thought regarding natural phenomena. Of
particular concern is the concept of a subtle energy field that eludes detection by
conventional physical means. Disciplines such as psychology and medicine adhere
to a materialistic monism, positing that all phenomena, including thoughts and
emotions, are rooted in physical processes. Therefore, proposing the existence of
an undetectable form of energy contradicts this materialistic paradigm and
renders therapies based on such principles inherently implausible.

Energy therapists themselves express concerns regarding the

conceptualization of energy therapy in the absence of tangible material factors.
For some, the quest for a physical correlate to the purported human energy field
is akin to the pursuit of the "Holy Grail." There have been suggestions positing the
human energy field, or "biofield," as a weak electromagnetic field surrounding
living organisms. One author defined the biofield as a "complex, extremely weak
electromagnetic field of the organism hypothesized to involve electromagnetic
bioinformation for regulating homeodynamics." Drawing on the role of non-linear
systems in biological processes, this author hinted at limitations in the genetic
view of life, suggesting that it fails to account for subtle characteristics and the
efficacy of alternative interventions. In this view, interventions may function
informatively, employing stimuli of minuscule intensity to harmonize with the
organism's natural dynamics and restore balance. For instance, Rubik advocated
for material factors in discussing Sympathetic Resonance Technology, which
utilizes subtle energy and information bands to counteract disruptions in biofields
caused by external influences like electromagnetic fields from electronic devices.
Other proponents of energy therapies have turned to quantum mechanics as a
potential explanatory framework. One author proposed that the actions of free
electrons could provide information guiding medical decisions, with the
amplitude and frequency of their vibrations indicating the type and potency of
remedies. Similarly, Thought Field Therapy suggests that mechanical energy from
tapping is transduced into biofield energy.

36
 A second concern surrounding energy therapies pertains to their lack of
parsimony in theoretical explanations. Modern scientific disciplines, grounded in
the principle of parsimony, advocate for simpler explanations over more complex
ones when both are equally effective. The purported effects of energy therapies
on mental health, while lacking robust empirical support, can be readily explained
by well-established psychological phenomena such as social demands, placebo
effects, expectations, and cognitive dissonance. The proponents of energy
therapies' assertion that subtle energies are necessary to account for these
effects raises questions about the parsimony of their explanations.

While numerous conventional therapies lack robust evidence of

effectiveness or rely on weak evidence, the absence of systematic evidence
becomes particularly problematic when a treatment is also deemed implausible.
Similarly to advocates of conventional therapies, proponents of energy therapies
recognize the value of claiming that their practices are evidence-based.
Consequently, there have been efforts to investigate the outcomes of energy
therapies, yielding results of varying degrees of supportiveness and reliability.
Many research reports in this field have been accompanied by arguments
asserting that the research methods associated with conventional treatments are
neither necessary nor appropriate for unconventional therapies.

When investigating the evidence for conventional therapies, little reason

typically exists to scrutinize the basic components of treatment, whether they
involve speech, gestures, facial expressions, role play, or gradual exposure to fear-
inducing stimuli. These components are well-established, thoroughly described,
and known to have effects on both practitioners and patients. However, with
energy therapies, there may be a need to study the fundamental actions or tasks
of the therapist. Information gleaned from such investigations can be equally or
even more crucial than outcome studies examining the effects of these
treatments.

For instance, Therapeutic Touch (TT) underwent scrutiny in a notable

"science fair" project conducted by a young girl. In this experiment, blinded TT
practitioners were asked to determine whether the researcher's hand was
positioned near their right or left hands. The therapists performed at chance
level, leading to the conclusion that they were unable to detect energies

37
purportedly necessary for health-restoring interventions. Such findings cast doubt
on the underlying mechanisms and efficacy of energy therapies.

Several systematic reviews have attempted to assess research reports on

specific energy therapies used for psychotherapeutic purposes. However,
conducting such reviews can be challenging due to the poor quality of available
research. For example, Astin, Harkness, and Ernst examined investigations of
"distant healing," which encompassed strategies claiming to heal through the
exchange or channeling of supraphysical energy. Despite including over a hundred
clinical trials with randomized assignment to groups, the focus of most reports
was on physical symptoms rather than psychological variables. Similarly, another
systematic review focused on studies of healing touch, which aimed to alleviate
pain, depression, and post-traumatic stress disorder. While some positive effects
were reported, reviewers expressed difficulty in determining the quality of the
studies due to poor design, execution, or reporting, making definitive conclusions
challenging. In cases where methodological flaws and opaque reporting are
prevalent, alternative explanations for observed effects, such as regression to the
mean, become equally plausible as the purported energy therapy explanations.

Several studies have examined Thought Field Therapy (TFT), with detailed
discussions appearing in a special issue of the Journal of Clinical Psychology.
Notably, the material on TFT was published without undergoing peer review,
raising questions about the reliability of the findings. For instance, one study
evaluated twenty participants for heart rate variability before and after TFT
treatment. However, the methodology employed in this study, focusing solely on
heart rate variability, may not be sufficient to establish TFT as an evidence-based
therapy. Similarly, a randomized controlled study of "voice technology," a variant
of TFT allowing treatment over the telephone or radio, found no significant effect
on subjective reports of distressed feelings.

Another example is the research on the Emotional Freedom Technique

(EFT), which assigned participants to different groups, including one receiving EFT
treatment and several comparison groups. Interestingly, all groups that engaged
in tapping, regardless of whether they followed the EFT protocol or not, reported
significant improvements in their fears. However, the group that received no
treatment did not experience similar improvements, suggesting that factors

38
common to tapping experiences may have contributed to the observed effects
rather than the specific techniques of EFT.

In studies evaluating the effectiveness of energy therapies like qigong and

Polarity Therapy, researchers often fail to include suitable comparison treatments
necessary for drawing clear conclusions about efficacy. For example, a
randomized controlled study of qigong's effects on cancer patients' fatigue and
mood compared qigong group sessions to standard care routines. However,
without a control group receiving an alternative treatment or no treatment, it
becomes challenging to attribute any observed effects specifically to qigong.
Similarly, a study of Polarity Therapy randomized stressed family caregivers to
either receive Polarity Therapy or an "enhanced respite control" involving
temporary relief from caregiving duties. The lack of clarity regarding the
differences between the treatment and control groups' experiences complicates
the interpretation of the findings.

In a peculiar investigation into the effects of Reiki treatment, bacterial

cultures were subjected to the therapy instead of human participants.
Surprisingly, the results suggested that overall, the cultures treated with Reiki
fared better, but intriguingly, those treated by practitioners in a negative mood
performed worse. This observation hints at the assumption within some energy
therapies that the intention or emotional state of the practitioner plays a crucial
role in the treatment outcome. Consequently, controlling for this factor becomes
imperative when attempting to establish an evidence basis for such therapies.

A recurrent issue in research on unconventional treatments, particularly in

investigations into energy therapies, is the tendency to limit statistical analyses to
repeated tests of pairs of scores, rather than conducting a more comprehensive
overall comparison. This methodological approach increases the likelihood of
accepting chance results as evidence of a significant treatment effect. For
instance, if a difference between two scores is deemed significant at the .05 level,
it implies that such a difference would occur 5 times out of 100 merely by chance
and without any influence from the treatment. When multiple such comparisons
are made, the probability that the differences are due to chance escalates
accordingly. In a study examining the efficacy of Healing Touch, participants were
unaware whether they were receiving genuine Healing Touch or a sham
treatment. While the overall differences in "quality of life" scores were found to
39
be insignificant, 2 out of 10 comparisons of pairs of scores yielded significance at
the .05 level—a scenario suggesting that these differences may be attributed to
chance.

Adhering to conventional guidelines for establishing evidence of treatment

effectiveness, it becomes challenging to escape the conclusion that the evidence
for energy therapies is tenuous at best. Researchers in the field of energy therapy
have themselves acknowledged the existence of factors beyond the treatment
itself that could influence therapy outcomes. For instance, in a study exploring
phantom limb pain, Leskowitz highlighted the use of acupuncture and light
therapy targeting the area where the missing limb is felt to exist. He noted that to
an observer, it may seem as though the needles or laser light are directed at
empty space. The success of these treatments raises questions about whether
external energy fields may mediate phantom limb pain, or whether a robust
placebo response is triggered by the unexpected therapeutic focus on seemingly
vacant space. Leskowitz's observation underscores the complexity of variables
involved in studies of energy therapies.

Insights from Energy Therapists Regarding Research

Many proponents of energy therapy resonate with the sentiment expressed
by Reiki researchers regarding the tension between the scientific paradigm's
emphasis on replicability and generalizability and the inherent individualization of
Reiki practice and treatment. This emphasis on individuality extends not only to
the therapists themselves but also to those undergoing treatment. One author
has proposed that the "bioinformation emitted during laying-on of hands" may be
uniquely intertwined with the psychophysiological states of the practitioner's
intention, underscoring the personalized nature of energy therapy practices.

Furthermore, energy therapists often hold the view that research

methodologies may not adequately capture the intricacies and nuances of their
interventions. For instance, some therapists argue that the effects of treatment
may extend beyond the targeted issue, potentially leading to improvements in
unanticipated areas, which traditional research frameworks may overlook.
Similarly, proponents of Thought Field Therapy, such as its founder Roger
Callahan, advocate for alternative research approaches, suggesting that self-

40
reported outcomes suffice and that control groups are unnecessary due to the
perceived potency of the therapy's effects.

Despite efforts to provide research support for energy therapies, systematic

evidence remains lacking. While some practitioners have attempted to engage
with scientific inquiry, many within the energy therapy community assert that
conventional research methods are either irrelevant or ill-suited to their
practices. Consequently, energy therapies are often categorized as
unconventional due to their limited evidence base and their perceived divergence
from established scientific principles.

Additionally, energy therapists often attribute their practices to ancient

wisdom passed down through generations of Asian practitioners. Claims of
antiquity are frequently associated with modalities like Reiki or qigong-related
acupuncture, which purportedly draw upon centuries-old traditions. However,
while these methods may indeed have historical roots, they are not as ancient as
their proponents often assert. Moreover, historical developments and cultural
influences have contributed significantly to the evolution and popularization of
energy therapies as alternative interventions in contemporary mental health care.

Qigong, deeply rooted in ancient Chinese philosophical systems, is often

depicted through traditional diagrams illustrating channels believed to facilitate
the flow of energy. However, the modern practice of qigong, while drawing
inspiration from its historical origins, is largely shaped by more recent
developments. Anthropologist David Palmer (2007) traced the genesis of modern
qigong practices to 1949, when a Chinese political functionary coined the term to
describe a regimen of body training intended to be disseminated by "medical
workers." These practices were intentionally stripped of elements deemed
superstitious by the Chinese Communist Party, emphasizing a combination of
breathing techniques, meditation, and physical exercises.

Qigong's evolution gained momentum in the 1950s as it spread beyond its

place of origin, especially amidst political shifts in China that encouraged the
promotion of indigenous traditions. However, by the late 1970s, qigong
underwent a transformation, veering away from its simple and affordable health-
oriented focus. A new breed of qigong emerged, characterized by practitioners
externalizing their qi to allegedly heal patients, even from afar. These

41
developments led to sensationalized accounts of mass trance, spiritual
phenomena, and claims of paranormal abilities attributed to qigong masters. The
emphasis shifted from individual practitioners mastering the art to relying on
charismatic healers to perform miraculous feats.

By the 1990s, the Chinese government grew wary of the public spectacle
surrounding qigong, viewing it as a religious movement at odds with the values of
modern Chinese society. In response, attempts were made to suppress qigong
practices, further exacerbated by concerns over public embarrassment.
Consequently, some qigong masters sought refuge in the West, emigrating to
escape the political backlash and continue their teachings in more hospitable
environments.

Similarly, the history of Reiki shares parallels with that of qigong. While
Reiki's principles and practices align with traditional Japanese systems, its
contemporary manifestation can be traced back to an early twentieth-century
Buddhist practitioner with a background in monastic training and martial arts.
This practitioner emphasized spiritual development through the practice of Reiki,
employing techniques reminiscent of Taoist healing practices.

Subsequently, one of his disciples sought to refine Reiki into a healing

modality, establishing a clinic to treat physical ailments. This lineage continued
when another disciple introduced Reiki to Hawaii in the late 1930s, where it
underwent further adaptation and integration into Western contexts. The
emphasis shifted towards physical and mental healing, diverging from its original
focus on spiritual growth. Today, many Western Reiki practitioners trace their
lineage back to the methods propagated by the Hawaiian master, emphasizing
therapeutic applications over spiritual development.

Despite their actual historical origins, the allure of Reiki and qigong to
Westerners can be attributed to their perceived "Asian" and seemingly "ancient"
qualities. Throughout Western history, there has been a fascination with
"orientalism," dating back to early encounters with Asian cultures such as Japan
and China. This fascination has manifested in various forms, ranging from
aesthetic trends like japonaiserie and chinoiserie to intellectual pursuits such as
comparative religion studies by American Transcendentalists. These individuals

42
sought to uncover shared concepts among different religions, hoping to establish
a universal system of understanding.

The appeal of the perceived ancientness of Reiki and qigong is somewhat

more elusive but may stem from a fascination with esotericism and the notion of
unlocking secrets from the past. This interest in ancient wisdoms is often
romanticized and valued for its perceived authenticity and depth.

Moreover, the adoption of Asian practices in the West has been influenced
by the interests of certain Christian groups. In North America, non-fundamentalist
Christian sects have been known to endorse practices like meditation, yoga, and
Reiki, sometimes incorporating them into healing services. The sacramentalism
characteristic of movements like the nineteenth-century Oxford Movement
among Anglicans has paved the way for the integration of rituals from diverse
cultures into Christian practices. Additionally, the dualistic worldview of
Christianity, with its emphasis on the immortality of the soul, resonates with the
belief in non-material vital energy held by energy therapists.

Interestingly, Western psychology shares some conceptual parallels with the

energy flow theories espoused by energy therapies. Ancient physicians like Galen
attributed bodily movement to the flow of "moving spirits" through nerves, while
René Descartes elaborated on this idea using hydraulic metaphors. Descartes
proposed that these "animal spirits," akin to a wind or fine flame, originated in
the brain's ventricles and traveled through nerves to induce muscle contractions.
Despite not directly positing an energy flow, Descartes' model featured structural
similarities to the meridian pathways proposed by energy therapists. This aspect
of Western psychological tradition may contribute to the acceptance of energy
flow concepts in explaining human functioning.

The Western tradition of esotericism has a rich history that spans various
epochs and cultural movements. Originating with alchemists and Hermetic
philosophers during the early Renaissance, it continued to influence nineteenth-
century practitioners of magic and Satanism. This mode of thinking is
characterized by a focus on correspondences as sources of knowledge, drawing
connections between seemingly disparate elements to uncover hidden truths.
One notable offshoot of esotericism is astrology, which asserts causal
relationships between specific celestial bodies, months of the year, botanical

43
specimens, and parts of the human body. According to astrological principles,
celestial events influence earthly phenomena, with specific correspondences
often rooted in tradition or based on perceived physical resemblances.

Similarly, energy therapies employ various forms of correspondences to

guide their practices. In qigong, for instance, practitioners believe in the
association between traditional meridians and the flow of energy affecting
specific organs and mental functions. Despite lacking anatomical connections,
acupuncture points are believed to correspond to particular bodily functions or
emotional states. In Reiki, practitioners utilize a conceptual framework where the
head and torso are regarded as the focal points of the body's subtle bioenergetic
system. Treating these areas is likened to watering a plant at its roots, with the
twelve hand placements symbolizing connections to different areas of the body
targeted during a full treatment. Although the energy transferred during
treatment is believed to go where it is needed, practitioners still adhere to the
prescribed hand placements for holistic healing.

Moreover, practitioners of Thought Field Therapy (TFT) integrate traditional

acupuncture meridians into their treatment protocols, but they also emphasize
the importance of tapping sequences determined by a proprietary algorithm. This
algorithm, developed by TFT founder Roger Callahan, is tailored to individual
patients using Applied Kinesiology techniques pioneered by chiropractor George
Goodheart. By identifying weakened muscles associated with emotional
disturbances, practitioners map out a sequence of meridian points to tap, relying
on the assumed correspondence between muscular functions and psychological
states. Thus, TFT treatments are intricately woven with the concept of
correspondence, aligning physical and emotional elements to address holistic
well-being.

The explorations into the "invisible" forces of electricity and magnetism

during the eighteenth century unfolded within a framework that bears striking
resemblance to contemporary energy therapies. Metaphors used to describe
electric and magnetic phenomena, such as "current" and "flow," echo the
language employed in depicting the movement of qi through meridians in
traditional Chinese medicine. This parallel is most pronounced when considering
the proposed therapeutic applications of electricity and magnetism, particularly
evident in the practice of mesmerism pioneered by Franz Anton Mesmer.
44
Mesmer's initial theory posited that health was governed by a magnetic fluid
within the body, whose equilibrium could be disrupted or restored. The
restoration of health thus hinged upon reestablishing the harmonious flow of this
fluid, a task achievable through the use of magnets and the magnetic influence of
the practitioner, who was believed to possess inherent magnetic qualities capable
of positively influencing the fluid's movement within another's body.

As mesmerism evolved into hypnotism in the nineteenth century, with its

emphasis on the practitioner's gaze and non-contact hand movements, the
parallels with energy therapies grew more pronounced. The practice of
mesmerism, characterized by trance states induced in patients, bore resemblance
to contemporary energy therapies in its attribution of supernatural abilities to
individuals in altered states. Mesmer's student, de Puysegur, observed that
patients in trance could exhibit extraordinary powers, such as clairvoyance,
prophetic insights, and diagnostic abilities akin to those attributed to practitioners
of Healing Touch and qigong. These phenomena reflect the mystical aura
surrounding mesmerism, reminiscent of the religious fervor associated with
qigong practices in the modern era.

Furthermore, the depiction of mesmerism in literature and popular culture,

through portrayals of mesmerists performing "magic passes" and influencing
subjects with their gaze, may have paved the way for the widespread acceptance
of energy therapies among the general populace. Analogously, the portrayal of
mesmerism in literature has been suggested to contribute to the credence
afforded to mesmerism and spiritualist beliefs during its heyday. Thus, the
cultural dissemination of mesmerism through various media channels may have
primed society for the reception of energy therapies, fostering an environment
conducive to their acceptance and integration into mainstream healthcare
practices.

The acceptability and emergence of energy therapies in the late twentieth

and twenty-first centuries can be traced back to earlier historical events that
emphasized emotion over analytical thought and introduced field theories into
psychological discourse. Although these issues were initially introduced in early
twentieth-century Germany, they reverberated throughout the world as
geopolitical changes unfolded. As discussed in a previous chapter, Germany
experienced a "crisis of science," marked by attacks on the Enlightenment's
45
emphasis on human reason. This crisis led to a lack of confidence among
intellectuals, undermining the dominance of explanatory disciplines and fostering
interest in understanding-based approaches that appeared better equipped to
address human concerns. Notably, psychology was increasingly perceived as
belonging to the Geisteswissenschaften, or mental and moral sciences, rather
than the Naturwissenschaften, or natural sciences.

During this period of crisis, schools of thought such as Gestalt psychology

emerged, aiming to develop a new holistic model grounded in physical field
theories (Henle, 1978). Figures like Max Wertheimer (1880–1943) and Kurt Koffka
(1886–1941) within the Gestalt psychology movement critiqued the atomistic,
mechanistic framework of the physical sciences that psychology had previously
adopted. This framework, akin to Freud's hydraulic model or associationism, was
seen as inadequate for understanding complex human phenomena. Additionally,
there was a growing interest in field theories of physics, both as standalone
concepts and as potential frameworks or metaphors for understanding
psychological processes. The field metaphor, with its implications of
interconnectedness and non-linear dynamics, resonated strongly with the
principles underlying energy therapies.

Field theories of psychology, like their counterparts in physics, allowed for

the simultaneous consideration of multiple variables and the incorporation of
non-mechanical effects. Furthermore, they introduced the notion of field-specific
rules of functioning, distinct from those governing classical mechanics. By
applying the field concept to psychology, scholars were able to explore
psychological phenomena without tethering them to the principles of other
scientific domains, thereby paving the way for alternative explanations rooted in
principles beyond those of the natural sciences.

A notable parallel between Gestalt theory and energy therapies lies in the
concept of isomorphism, a fundamental tenet within Gestalt psychology.
Isomorphism posits that the brain operates as a volume conductor rather than a
series of linear electrical currents following the pathways of neurons. According
to this perspective, events occurring within the brain's electromagnetic field are
directly correlated with, or isomorphic to, the phenomena consciously perceived
by an individual. This concept of isomorphism arose as a response to perceptual
anomalies, particularly visual illusions, which fascinated Gestalt theorists. These
46
illusions often involved distortions such as straight lines appearing bent or vice
versa, or objects appearing longer, shorter, closer, or more distant than their
objective reality. Gestalt theorists attributed these perceptual distortions to
corresponding distortions in the brain's electrical field.

While isomorphism seemed plausible during a period when neural

conduction mechanisms were poorly understood, empirical testing by researchers
like R. W. Sperry challenged its validity. Sperry's experiments, which involved
placing materials like mica plates into the visual cortexes of cats to disrupt the
electrical field, found no significant impact on visual perception. This and similar
studies, coupled with advancements in neuroscience, led to the rejection of the
electrical field hypothesis and the concept of isomorphism.

Another significant development in the application of field theories to

psychology was the emergence of dynamic systems theory. This theoretical
framework, which is occasionally invoked to justify the mechanisms underlying
energy therapies, describes the characteristics of factors that mutually influence
each other and undergo continuous change, akin to the dynamics observed in
living organisms. Dynamic systems theory posits that these systems are self-
organizing and operate according to rules that may differ from those governing
other systems. Moreover, such systems possess a remarkable capacity for
reorganization, whereby even a minute change in one factor can trigger a shift
into an entirely different mode of functioning. This perspective on dynamic
systems has found particular relevance in explaining developmental changes and
dynamics within family relationships.

The dynamic systems approach's emphasis on the potential for small,

imperceptible events to produce significant changes resonates strongly with the
claims made by energy therapies. These therapies assert that minute
interventions can have profound effects on mental and physical health, aligning
closely with the principles of dynamic systems theory. Thus, proponents of energy
therapies may find considerable support in the dynamic systems perspective,
which offers a theoretical framework conducive to understanding the purported
mechanisms underlying these unconventional healing practices.

Conventional medical practices typically adopt a mechanistic perspective,

viewing the body and mind as governed by observable physical and chemical

47
processes. This approach presupposes that all functions, illnesses, and treatments
are grounded in these tangible phenomena. In contrast, many alternative
practices, including energy therapies, embrace a vitalistic viewpoint. This
perspective asserts that life processes involve a distinct power or energy beyond
ordinary physical or chemical events, and practitioners of these modalities often
operate under the belief that manipulating this life energy can facilitate healing.

Both traditional osteopathic and chiropractic practices exemplify this

vitalistic approach. Practitioners of these disciplines historically claimed that their
hands-on manipulations of the body could alleviate blockages inhibiting the
body's natural healing force, known as the vis medicatrix naturae. While modern
chiropractic methods primarily focus on physical discomfort, there was a time
when chiropractic interventions were applied to mental illness. In fact,
chiropractically oriented psychiatric facilities existed, where chiropractic
treatments were administered to patients with psychiatric disorders. Anecdotal
reports suggest that chiropractic adjustments were believed to offer therapeutic
benefits beyond conventional medical treatments for such conditions.

For instance, a chiropractor's purported success in treating severely

mentally ill patients led to the establishment of the Forest Park Sanitarium in
Iowa in 1922, which continued to provide chiropractic care for psychiatric patients
until 1961. Accounts from this period describe remarkable recoveries, with
agitated and delusional patients responding positively to chiropractic adjustments
and achieving significant improvements in their mental health within a relatively
short period.

These chiropractic claims align closely with the notion that an inherent life
force, often referred to as the Innate, can become blocked or released, leading to
functional disturbances or recovery, respectively. According to chiropractic theory,
the Innate is believed to propagate through the nerves via vibrations, with
deviations in vibrational frequency indicative of illness or imbalance. Adjustments
performed by practitioners aim to correct these blockages and restore the body's
natural equilibrium.

The concept of the Innate, as articulated by D. D. Palmer, the founder of

chiropractic treatment, bears remarkable resemblance to the principles
underlying modern energy therapies. Palmer described the Innate as a universal

48
intelligence inherent in all living beings, transcending material laws and
conditions. While Palmer's terminology differs from that of energy therapists, his
conceptualization of the Innate closely parallels the notion of a vital force or
energy posited by practitioners of energy therapies.

Alternative treatments, much like mainstream psychotherapies, reflect the

influence of Freudian and post-Freudian psychoanalytic theories. Within the
realm of energy therapies, certain aspects can be likened to Freud's concept of
libidinal pressure, although the analogy to his "hydraulic" theory falls short when
compared to theories involving energy fields. Instead, energy therapies bear a
closer resemblance to what Freud termed "wild psychoanalysis."

The emergence of "wild" psychoanalytic ideas gained prominence in 1923,

a year often dubbed the "schismatic year" for psychoanalysis. This pivotal period
saw the publication of Georg Groddeck's "Book of the It," wherein Groddeck
delved into the notion of an indefinite force, referred to as the "It," that animates
individuals and integrates them as integral components of the universe. Groddeck
interpreted various illnesses as manifestations of a simultaneous desire for and
fear of love and death, symbolizing inner conflicts and serving a purposeful
function dictated by the It. Central to his philosophy was the interconnectedness
of body and mind, both responsive to the life force and healing energies inherent
in nature.

The influence of Groddeck was further amplified with the release of "The
Development of Psychoanalysis" in 1924 by Sandor Ferenczi and Otto Rank, two
additional proponents of "wild psychoanalysis." Ferenczi introduced the concept
that "someone gets ill with another one," shifting mental illness into a relational
perspective. He emphasized touch and mutual emotional intimacy with patients,
highlighting unconscious emotional factors as determinants of mental well-being.
Similarly, Rank underscored the symbolic nature of symptoms, viewing them as
representations of underlying conflicts and traumatic memories.

Wilhelm Reich, a disciple of Ferenczi, expanded on these ideas by

introducing the concept of energy fields into psychotherapy and medicine
through his orgone theory in the 1930s and 1940s. Reich's "character analysis"
method focused on identifying and releasing tensions and stiffness in the body,
believed to stem from prenatal experiences, parental attitudes, or birth trauma.

49
He postulated that the pulsatory cycle of tension and relaxation, essential for life,
was disrupted by what he termed "character armor." Reich associated this
disruption with the inability to experience genuine pain and joy.

According to Reich, "orgone" was vital for maintaining this pulsatory cycle
and could be observed, measured, and harnessed for therapeutic purposes.
Despite facing opposition from authorities over claims of orgone's ability to cure
cancer, Reich's teachings persisted, with groups dedicated to "orgonomy"
advocating for his treatments. Over time, orgone therapy has intersected with
therapies manipulating biofields, such as Therapeutic Touch and Reiki, indicating
a convergence of ideas within the realm of energy therapies.

50