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House of Cards : Psychology and Psychotherapy Built on Myth
Robin Dawes spares no one in this powerful critique of modern psychotherapeutic practice. As Dawes points out, we have all been swayed by the "pop psych" view of the world--believing, for example, that self-esteem is an essential precursor to being a productive human being, that events in one's childhood affect one's fate as an adult, and that "you have to love yourself before you can love another."
352 pages, Paperback
First published October 1, 1993
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Displaying 1 - 25 of 25 reviews
August 30, 2009
During the 2005-2006 school year, I sat in on a course in epistemology with a friend of mine. The teacher talked extensively about psychological literature and how such literature might inform philosophical thought; for example, there are philosophy articles using statistical techniques (namely ANOVAs) to test philosophical propositions. During that semester, the teacher referred to Robyn Dawes's wonderful book and said "I'm practically sleeping with that book." I leaned over to my friend and said "Ew! The professor and I are sleeping with the same book!" When I once saw this 70-year old hunched back man at a conference, my heart skipped a beat because of the size of my intellectual crush I have on him.
When I was a disenchanted clinical psychology student, I read this text and thought that Robyn Dawes grasped and addressed many of the very issues I was having. He describes his own disenchantment with the field, but is NOT against the field. At the most basic level, he argues that psychotherapy works (contrary to what many who know OF the book but have not read it think), but also argues that the mechanism by which therapy is effective is not known (much to the chagrin of adherents to psychoanalysis, Rogerian techniques, CBT, or any other school of therapeutic thought). Additionally, he illuminates some of the biases that psychologists have and how we might address them. Finally, he points out many examples of psychological thinking that psychologists would prefer were ignored.
I read this book in a weekend. It is a quick, easy read that connected with my view of psychology. I believe that this book would help most people think better about the field of psychology.
When I was a disenchanted clinical psychology student, I read this text and thought that Robyn Dawes grasped and addressed many of the very issues I was having. He describes his own disenchantment with the field, but is NOT against the field. At the most basic level, he argues that psychotherapy works (contrary to what many who know OF the book but have not read it think), but also argues that the mechanism by which therapy is effective is not known (much to the chagrin of adherents to psychoanalysis, Rogerian techniques, CBT, or any other school of therapeutic thought). Additionally, he illuminates some of the biases that psychologists have and how we might address them. Finally, he points out many examples of psychological thinking that psychologists would prefer were ignored.
I read this book in a weekend. It is a quick, easy read that connected with my view of psychology. I believe that this book would help most people think better about the field of psychology.
August 21, 2007
How psychologists and psychiatrists really don't know what they are doing. Inexperienced therapists are as effective as MDs. It is inexcusable for psychologists to be giving expert opinion in court.
July 11, 2009
Not perfect but somebody needed to write this book. It's funny that it pisses so many people off. But most of it is all true.
September 27, 2010
Dawes clearly has an ax to grind with clinical psychology. Ego and status are what motivate this book. As an academic psychologist Dawes doesn't want to be associated with "those psychologists". Real psychologists do science and those practitioner-psychologists employ pseudo-science. With this as his jumping off point Dawes goes on to a select reading and interpretation of the scientific literature to prove that point. While some of his points are well founded his partisanship flattens out the complexity of the issues being discussed. In service of proving his point he cites the USA Today and other such sources. To get a more balanced and nuanced reading of psychology and psychotherapy I would recommend The Great Psychotherapy Debate: Models, Methods, and Findings (Counseling and Psychotherapy: Investigating Practice from Scientific, Historical, and Cultural Perspectives). Don't be confused by his ploy of neutrality he is anything but. Above all this is a book about the politics within psychology today.
November 1, 2020
Required reading for Deliberate Practice course. The rationale for reading this books was “how can you be an effective psychologist if you don’t understand your field’s greatest critic?”
A lot of Dawes’ points are simply unfair generalizations but I think it moved the field from the time of publication to where we are now, with our emphasis on evidence-based practice and deliberate practice.
A lot of Dawes’ points are simply unfair generalizations but I think it moved the field from the time of publication to where we are now, with our emphasis on evidence-based practice and deliberate practice.
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March 29, 2020All in all, I believe that this is a must-read book for all psychologists (clinical or otherwise), aspiring students and for the public in general, so that all that take interest in this field can critically look at it and not be totally blinded by these persisting myths. It really is an eye-opener to the difference between the profession of psychology and the science of psychology. As a firm believer of the importance of psychotherapy and clinical psychology to the public in general, I found it hard to read some of the critiques made by Dawes, and even harder to understand that they were well supported by literature. However, I came to agree with the author. What we do as professionals does in fact work, we just don’t really know why it does. So, even though the truth may hurt at first, it is the truth, nevertheless, and what we do with it is what matters most. It is my belief that only by identifying this issues and trying to overcome them (with more empirical research) can we, as a profession, move forward and do what psychology was meant to do all along, that is, to establish a mental health profession based on research findings so as to best help those who seek or need our professional help. Furthermore, we should never forget that «our knowledge of psychology and related social sciences is highly probabilistic” (pp.245) and, thus, we should carefully examine every piece of information and not immediately take it for granted. This is something that I always thought but that recently has gained more prominence. In fact, in Psychology we work with individuals and every one of them is different from the other; they have different pool genes, they come from different contexts, they went through different experiences growing up, etc. There is no two people alike. Even twins who share the same genetic material and who grew up in the same house and shared the same school, can react differently to the same event. We each have our own background, our own individuality and so there is an infinity number of variables that make it (almost) impossible for Psychology to be an exact science, because our object of study – people – is always different. However, that doesn’t mean that we shouldn’t try to make it as scientific and objective as possible. What we should do is recognize our own limitations and don’t make claims seem to be 100% certain when there are so many variables in play – they are only probabilistic, as Dawes states! So, if you are still in doubt whether to read House of Cards or not, my advice is the same as the author’s final remark: Just do it!
August 27, 2016
A devastating critique of psychology and psychiatry by a professor of psychology.
* How psychologists have no skill in helping people, beyond what an empathetic layperson with minimal training in simple techniques. (Actually an empathetic layperson can be quite helpful. His point is that paying someone with many diplomas on their wall $150/hr is not adding any value.
* Psychologists and psychiatrists do not get better with experience.
* How their predictions consistently fall well short of simple statistics based predictions
* That their expert testimony in court is mostly nonsense.
Why? The practice of psychology is largely based on intuition and experience, which are very poor teachers when feedback is not rapid and accurate. There is little reliance on actual scientific research.
The rapidly escalating credentials required to practice psychology are little more than a ploy to reduce competition and increase incomes.
The wider lesson here is that people who claim to be experts actually may not be experts. Can they fix things better than other people? Can they predict outcomes better than a simple statistical analysis? Can they set things up so they work well? If not, then however impenetrable their jargon, how impressive their titles, they are not experts.
Ironically the parts of psychology that are most soundly based e.g., IQ testing, personality testing, etc are the parts that people have most doubts about.
* How psychologists have no skill in helping people, beyond what an empathetic layperson with minimal training in simple techniques. (Actually an empathetic layperson can be quite helpful. His point is that paying someone with many diplomas on their wall $150/hr is not adding any value.
* Psychologists and psychiatrists do not get better with experience.
* How their predictions consistently fall well short of simple statistics based predictions
* That their expert testimony in court is mostly nonsense.
Why? The practice of psychology is largely based on intuition and experience, which are very poor teachers when feedback is not rapid and accurate. There is little reliance on actual scientific research.
The rapidly escalating credentials required to practice psychology are little more than a ploy to reduce competition and increase incomes.
The wider lesson here is that people who claim to be experts actually may not be experts. Can they fix things better than other people? Can they predict outcomes better than a simple statistical analysis? Can they set things up so they work well? If not, then however impenetrable their jargon, how impressive their titles, they are not experts.
Ironically the parts of psychology that are most soundly based e.g., IQ testing, personality testing, etc are the parts that people have most doubts about.
June 17, 2019
Psychology is one of my most read genres, and this book provided a great balancing incite to a lot of the ideas prevalent in psychology. It took a very measured, and systematic approach to cautioning the wholehearted reliance in psychology and psychiatry "professionals" without throwing out the "baby with the bath water". It wasn't the easiest or "funnest" read on this topic, but it was informative and thought provoking. If you're already pretty familiar with the subject, dive in and maybe get an adjustment to your perspective on it.
September 30, 2023
Fun summary of research (up to the early 90s) about the uselessness of psychological training, experience, and licencing. (But not the uselessness of talk therapy, importantly. You just don't need an expensive professional.)
I really liked Chapter 5, on the social costs of overestimating therapists relative to "paraprofessionals" (just empathetic people and coaches). Therapy deadweight loss is still mainly an American problem - compare the 21% of Americans in therapy to the ~2% of Brits (another 2% on waiting lists and maybe 2% private though). British therapy is said to be "unregulated" (but actually that just means that the mandatory training is about halved); as a result Americans pay about twice as much per session. It seems to add up to ~1% of GDP.
I'm interested in whether anything has changed in 30 years. People say the word "evidence-based" now, for instance. CBT took over in this time period, and is more scientific than the old quack schools. Rorschach blots are dead, lobotomies are out, and I hear less about polygraphs and people naively inducing false memories for court testimonies. But the profession is much larger now, and so much more powerful and able to defend its monopoly profits and mythologise itself.
Rather than admit that training is ineffective, this 2009 review rejects RCTs; this 2019 one rejects ANOVA.
Psychotherapy works overall in reducing psychologically painful and
often debilitating symptoms. The reasons it works are unclear, because entirely different approaches may work equally well for the same problem or set of problems. Recovery is a base rate phenomenon... we can do little better than by predicting from the overall rate of recovery; we have no insight into exactly why some people get better while others don’t...
We also know that the credentials and experience of the psychotherapists are unrelated to patient outcomes, based on well over five hundred scientific studies of psychotherapy outcome...
psychotherapy works due to “nonspecific effects”... those that result from “the quality of the relationship” between client and therapist. This idea is supported by the finding that good psychotherapists tend to be empathetic, trustworthy, and warm... given that some therapies that are not based on relationship variables (like some behavior modification techniques) are successful, the
interpretation that their success too must be based on some unevaluated quality of relationship remains speculative... The implicit message is that taking up arms against troubles does some good psychologically even if it does not fully “by
opposing end them.” When people enter therapy they are making a choice to deal with their problems rather than simply feel overwhelmed by them.
professional psychologists claim to be able to make predictions about individuals that transcend
predictions about “people in general” or about various categories of people... In no comparison was the clinical prediction superior to the statistical prediction. In predicting academic performance, for example, a simple linear weighting of high school rank and aptitude test scores outperformed the judgments of admissions officers in several colleges. In predicting the success of electroshock therapy, a weighting of marital status, length of psychotic distress, and a rating of the patient’s
“insight” into his or her condition outperformed one hospital’s medical and psychological staff members. In predicting criminal recidivism in several settings, past criminal and prison record outperformed expert criminologists... In one study, Goldberg and Len Rorer even presented professionals with the results of the statistical formula to help them in their judgment, but they did worse than the formula itself... the inability to predict implies a lack of understanding—not because understanding and prediction are synonymous but because a claim to understanding implies an ability to predict. Evaluating the efficacy of psychotherapy has led us to conclude that professional psychologists are no better psychotherapists than anyone else with minimal training—sometimes than those without any training at all; the professionals are merely more expensive. Moreover, in predicting what people will do, clinicians are worse than statistical formulas, and statistical formulas are a lot less expensive
I really liked Chapter 5, on the social costs of overestimating therapists relative to "paraprofessionals" (just empathetic people and coaches). Therapy deadweight loss is still mainly an American problem - compare the 21% of Americans in therapy to the ~2% of Brits (another 2% on waiting lists and maybe 2% private though). British therapy is said to be "unregulated" (but actually that just means that the mandatory training is about halved); as a result Americans pay about twice as much per session. It seems to add up to ~1% of GDP.
I'm interested in whether anything has changed in 30 years. People say the word "evidence-based" now, for instance. CBT took over in this time period, and is more scientific than the old quack schools. Rorschach blots are dead, lobotomies are out, and I hear less about polygraphs and people naively inducing false memories for court testimonies. But the profession is much larger now, and so much more powerful and able to defend its monopoly profits and mythologise itself.
Rather than admit that training is ineffective, this 2009 review rejects RCTs; this 2019 one rejects ANOVA.
October 20, 2021
Pretty good. The research finding that training has next to no effect on therapy results is surprisingly strong.
January 22, 2018
Насколько полезны психологи для общества? Как понять, действительно ли психотерапевты помогают своим клиентам? Обладают ли в самом деле опытные психологи глубоким пониманием человеческой натуры?
Ответы на эти вопросы не так просты, как может показаться на первый взгляд. Если люди ходят к психологам (и платят, к слову, неплохие деньги за эту возможность) и в целом остаются довольны результатом – то можно ли это считать доказательством пользы психотерапии? Но те же самые люди могут с не менее успешным результатом прибегать к услугам астрологов («он так чётко всё расписал, прям точно про меня!»), гомеопатов («всегда принимаю Фуфломицин (тм), сразу на ноги ставит») и прочих мракобесов.
Поэтому настоящим критерием эффективности психологической помощи можно считать не личный опыт тех, кто к ней прибегает, и даже не наблюдения самих психологов (которые в связи с принадлежностью к роду человеческому точно так же подвержены всем когнитивным ошибкам, свойственным разумным приматам), а рандомизированные научные исследования на достаточно больших выборках. Собственно, рассмотрению притязаний психологов и психотерапевтов с точки зрения строгого научного метода и посвящена книга Робина Доуса «Карточный домик» (нет, там не про Спейси).
Масса научных исследований показывает: если у вас есть признаки депрессии, повышенной тревожности или иных эмоционально-психологических проблем – то вполне возможно, что поход к психологу является наиболее эффективным способом их решить. Прохождение курса психотерапии по статистике примерно в два раза повышает вероятность успешно справиться с психологическими проблемами; если быть точным – до 65% с базового уровня в 35% (треть депрессирующих людей в итоге вполне справляется со своими проблемами самостоятельно).
При этом, похоже, совершенно неважно, к какой школе психотерапии будет принадлежать мозгоправ – с точки зрения эффективности, все они показывают примерно одинаковый результат (за исключением бихевиористов, которые несколько опережают коллег). Более того, уровень опыта психолога так же не оказывает видимого влияния – вчерашние студенты не менее эффективны, чем доктора наук с многолетним стажем; а регулярные встречи для «разговора по душам» с профессором истории, которому выдали методичку «психотерапия для чайников за полчаса», вероятнее всего поможет вам не хуже, чем наблюдение у какого-нибудь светила психологии.
Внятно и однозначно объяснить этот парадокс непросто, но основной вывод напрашивается следующий: несмотря на уверенность самих психологов в наличии у них мощной экспертизы и тонкого понимания людских душ, на самом деле скорее всего они ею не обладают. На это намекают и эксперименты, показывающие, что в части предсказания поведения людей эксперты-психологи не могут показать результат лучше простейшей статистической модели, которая принимает решение на основе одной-двух переменных (даже в том случае, когда эти переменные и предсказание модели известны экспертам).
Практических выводов из этого можно сделать несколько:
1. Если вас беспокоят психологические проблемы, то походить к психологу – это неплохой вариант. Не стремитесь только к топовым специалистам с максимальными ценниками – гораздо важнее для результата окажутся не «корочки» и громкое имя психолога, а особенности вашего личного контакта с ним.
2. В ситуациях, где от психолога зависит принятие какого-либо важного решения (например, оценка кандидатов на работу; или экспертиза в суде) – то следует с повышенным скептицизмом отнестись к его анализу.
Кстати, было бы интересно распространить аналогичный методологически анализ на другие популярные сферы услуг – бизнес-тренинги, тренинги личностного роста и т.п. Есть подозрение, что оба эффекта (получение пользы участниками при отсутствии достоверно обнаружимой экспертизы тренеров) вполне могут оказаться актуальными и здесь.
Ответы на эти вопросы не так просты, как может показаться на первый взгляд. Если люди ходят к психологам (и платят, к слову, неплохие деньги за эту возможность) и в целом остаются довольны результатом – то можно ли это считать доказательством пользы психотерапии? Но те же самые люди могут с не менее успешным результатом прибегать к услугам астрологов («он так чётко всё расписал, прям точно про меня!»), гомеопатов («всегда принимаю Фуфломицин (тм), сразу на ноги ставит») и прочих мракобесов.
Поэтому настоящим критерием эффективности психологической помощи можно считать не личный опыт тех, кто к ней прибегает, и даже не наблюдения самих психологов (которые в связи с принадлежностью к роду человеческому точно так же подвержены всем когнитивным ошибкам, свойственным разумным приматам), а рандомизированные научные исследования на достаточно больших выборках. Собственно, рассмотрению притязаний психологов и психотерапевтов с точки зрения строгого научного метода и посвящена книга Робина Доуса «Карточный домик» (нет, там не про Спейси).
Масса научных исследований показывает: если у вас есть признаки депрессии, повышенной тревожности или иных эмоционально-психологических проблем – то вполне возможно, что поход к психологу является наиболее эффективным способом их решить. Прохождение курса психотерапии по статистике примерно в два раза повышает вероятность успешно справиться с психологическими проблемами; если быть точным – до 65% с базового уровня в 35% (треть депрессирующих людей в итоге вполне справляется со своими проблемами самостоятельно).
При этом, похоже, совершенно неважно, к какой школе психотерапии будет принадлежать мозгоправ – с точки зрения эффективности, все они показывают примерно одинаковый результат (за исключением бихевиористов, которые несколько опережают коллег). Более того, уровень опыта психолога так же не оказывает видимого влияния – вчерашние студенты не менее эффективны, чем доктора наук с многолетним стажем; а регулярные встречи для «разговора по душам» с профессором истории, которому выдали методичку «психотерапия для чайников за полчаса», вероятнее всего поможет вам не хуже, чем наблюдение у какого-нибудь светила психологии.
Внятно и однозначно объяснить этот парадокс непросто, но основной вывод напрашивается следующий: несмотря на уверенность самих психологов в наличии у них мощной экспертизы и тонкого понимания людских душ, на самом деле скорее всего они ею не обладают. На это намекают и эксперименты, показывающие, что в части предсказания поведения людей эксперты-психологи не могут показать результат лучше простейшей статистической модели, которая принимает решение на основе одной-двух переменных (даже в том случае, когда эти переменные и предсказание модели известны экспертам).
Практических выводов из этого можно сделать несколько:
1. Если вас беспокоят психологические проблемы, то походить к психологу – это неплохой вариант. Не стремитесь только к топовым специалистам с максимальными ценниками – гораздо важнее для результата окажутся не «корочки» и громкое имя психолога, а особенности вашего личного контакта с ним.
2. В ситуациях, где от психолога зависит принятие какого-либо важного решения (например, оценка кандидатов на работу; или экспертиза в суде) – то следует с повышенным скептицизмом отнестись к его анализу.
Кстати, было бы интересно распространить аналогичный методологически анализ на другие популярные сферы услуг – бизнес-тренинги, тренинги личностного роста и т.п. Есть подозрение, что оба эффекта (получение пользы участниками при отсутствии достоверно обнаружимой экспертизы тренеров) вполне могут оказаться актуальными и здесь.
August 31, 2024
A RESEARCH PSYCHOLOGISTS CRITIQUES HIS PROFESSION
Robyn Mason Dawes (1936-2010) was an American psychologist with the Oregon Research Institute, who wrote other books such as 'Rational Choice in an Uncertain World: The Psychology of Judgment and Decision Making,' 'Everyday Irrationality: How Pseudo- Scientists, Lunatics, And The Rest Of Us Systematically Fail To Think Rationally,' etc.
He wrote in the Preface to this 1994 book, "As I argue throughout this book, behavior is influenced by multiple factors. My own decision to write this book has been motivated by two factors in particular: anger, and a sense of social obligation... Why is anger a motivation for writing this book? Because the rapid growth and professionalization of my field, psychology, has led it to abandon a commitment it made at the inception of that growth. That commitment was to establish a mental health profession that would be based on research findings, employing insofar as possible well-validated techniques and principles... Instead of relying on research-based knowledge in their practice, too many mental health professionals rely on 'trained clinical intuition.' ...
"I am angered when I see my former colleagues make bald assertions based on their 'years of clinical experience' in settings of crucial importance to others' lives---such as in commitment hearings... or about suspected child sexual abuse... I feel a sense of obligation because society has supported my research and has personally supported me sufficiently well that I do not... have to take a vow of semipoverty to pursue my interests." (Pg. vii-ix)
He states in the first chapter, "Emotional suffering is very real, and the vast majority of people in these expanding professions sincerely wish to help those suffering. But are they really the experts they claim to be? Is our society justified in granting them special status and paying them from common funds?... These questions have been studied quite extensively, often by psychologists themselves. There is by now an impressive body of research evidence indicating that the answer to these questions is no." (Pg. 4)
He asserts, "Under the guise of advancing 'positive mental health'... the profession of psychology has propounded a simplistic philosophy of life. This philosophy maintains that the purpose of life is to maximize one's mental health, which is dependent wholly on self-esteem." (Pg. 33) He rejects the proposal to train psychologists in the prescription of drugs: "Because there are so many more psychologists than clinical psychiatrists, success in this endeavor could quite literally glut the country with people giving out drugs and people living under their influence." (Pg. 36)
He argues, "The most defensible answer to the question of why therapy works is, We don't know. We should do research to find out, and indeed many people are devoting careers to just such research. But we do know that the training, credentials, and experience of psychotherapists are irrelevant... The horrible irony is that by supporting licensing, income, and status for credentialed practitioners, the mental health professions have treated variables that really don't matter as if they did matter." (Pg. 61-62)
He adds, "Psychotherapy works... There is no reason, however, to seek out a highly paid, experienced therapist with a lot of credentials. If verbal therapy is sought, paraprofessionals are equally effective, especially empathetic ones." (Pg. 73)
Dawes' book will be eagerly read by those who are critical of psychology and psychiatry.
Robyn Mason Dawes (1936-2010) was an American psychologist with the Oregon Research Institute, who wrote other books such as 'Rational Choice in an Uncertain World: The Psychology of Judgment and Decision Making,' 'Everyday Irrationality: How Pseudo- Scientists, Lunatics, And The Rest Of Us Systematically Fail To Think Rationally,' etc.
He wrote in the Preface to this 1994 book, "As I argue throughout this book, behavior is influenced by multiple factors. My own decision to write this book has been motivated by two factors in particular: anger, and a sense of social obligation... Why is anger a motivation for writing this book? Because the rapid growth and professionalization of my field, psychology, has led it to abandon a commitment it made at the inception of that growth. That commitment was to establish a mental health profession that would be based on research findings, employing insofar as possible well-validated techniques and principles... Instead of relying on research-based knowledge in their practice, too many mental health professionals rely on 'trained clinical intuition.' ...
"I am angered when I see my former colleagues make bald assertions based on their 'years of clinical experience' in settings of crucial importance to others' lives---such as in commitment hearings... or about suspected child sexual abuse... I feel a sense of obligation because society has supported my research and has personally supported me sufficiently well that I do not... have to take a vow of semipoverty to pursue my interests." (Pg. vii-ix)
He states in the first chapter, "Emotional suffering is very real, and the vast majority of people in these expanding professions sincerely wish to help those suffering. But are they really the experts they claim to be? Is our society justified in granting them special status and paying them from common funds?... These questions have been studied quite extensively, often by psychologists themselves. There is by now an impressive body of research evidence indicating that the answer to these questions is no." (Pg. 4)
He asserts, "Under the guise of advancing 'positive mental health'... the profession of psychology has propounded a simplistic philosophy of life. This philosophy maintains that the purpose of life is to maximize one's mental health, which is dependent wholly on self-esteem." (Pg. 33) He rejects the proposal to train psychologists in the prescription of drugs: "Because there are so many more psychologists than clinical psychiatrists, success in this endeavor could quite literally glut the country with people giving out drugs and people living under their influence." (Pg. 36)
He argues, "The most defensible answer to the question of why therapy works is, We don't know. We should do research to find out, and indeed many people are devoting careers to just such research. But we do know that the training, credentials, and experience of psychotherapists are irrelevant... The horrible irony is that by supporting licensing, income, and status for credentialed practitioners, the mental health professions have treated variables that really don't matter as if they did matter." (Pg. 61-62)
He adds, "Psychotherapy works... There is no reason, however, to seek out a highly paid, experienced therapist with a lot of credentials. If verbal therapy is sought, paraprofessionals are equally effective, especially empathetic ones." (Pg. 73)
Dawes' book will be eagerly read by those who are critical of psychology and psychiatry.
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January 13, 2020. the rapid growth and professionalization of my field, psychology, has led it to abandon a commitment it made at the inception of that growth. That commitment was to establish a mental health profession that would be based on research findings, employing insofar as possible well-validated techniques and principles. . . . What was never envisioned was that a body of research and established principles would be available to inform practice, but that the practice would ignore that research and those principles. . . . Instead of relying on research-based knowledge in their practice, too many mental health professionals rely on ‘trained clinical intuition.’ But there is ample evidence that such intuition does not work well in the mental health profession. (In fact, it is often no different from the intuitions of people who have no training whatsoever.)
(Dawes 1994: vii– viii).
(Dawes 1994: vii– viii).
May 26, 2021
Excellent book making excellent points that almost 30 years later are still being ignored. It's not an easy read in places and polemical in style I still think anyone interested in Psychology or Psychotherapy should read it.
February 21, 2020
The first part should be read by every clinical psychologist, especially if they care about giving the best treatment to their patients (as they should)
July 11, 2019
House of Cards - Psychology and Psychotherapy Built on Myth is a very good book that needs more recognition. It describes and really criticizes the lack of scientific method in psychology and debunks the myth of the experienced psychologist as well as many others that are now taken for granted in the field. Unfortunately the book is also very detailed, filled with expositions, repetitions of concepts and statistical information on the studies that prove the author's point, so it is rather difficult to read; it is certainly not a book you take to help you relax. Every psychologist in the world should read it, though, as well as any aspiring students or people considering going to therapy.
To make it clear, this is not an anti-psychology book. It continuously says that therapy helps. What it also says is that the amount of training and experience of the therapist is statistically irrelevant. That irritates the author tremendously, as he is a psychologist himself and desires that his chosen scientific field evolve and ... well... become a real science. Robyn Dawes unfortunately died in 2010, at the ripe age of 74. During his life he studied human irrationality, intuitive expertise and statistical applications in medicine and psychology. No wonder that in House of Cards, he is ranting against the practice of psychology as it is today.
A few concepts in the book are very interesting and quite frightening. After WW2, a lot of people came traumatized and needed mental attention. At the time, a psychologist needed to be a psychiatrist as well, having gone through the university and studied medicine; they were all doctors, with a Ph.D. degree. So what they did in the US was to create another type of degree, called Psy.D, letting people without medical training enter the field, with only minimal instruction. This created the myth of the intuitive expert who can tell things about people because he has experience, having little else. Dawes proceeds to mercilessly debunk this myth.
In order to do that, he uses - what else - the scientific method. He gathers data as objectively as possible and then tries to find correlations. One correlation that is not found is one between amount of experience (or indeed, formal training) and positive results. One that is, though, is that therapy does help. We just don't know (or better said, we don't know how to quantify) why. One obvious reason would be that, in order to come to therapy, people need to accept they have a problem and then make the first step in solving it: showing up. This alone shows that the person is already actively pursuing healing, a major step into healing themselves. He also analyses diagnosis, often using standardized tests that presumably can help a specialist determine mental issues and their type. However, presented only with test results, the experts don't really get to any useful conclusion.
Dawes is not stopping at psychology, even if that is his main focus. In one chapter he speaks of studies that have proven that doing a thing for a long time doesn't necessarily teach you anything, especially if there is no immediate feedback on whether what you did was good or bad. This also applies to some types of medical diagnosis. And yes, those people went through school - that has the main purpose to promote people who can get through it much more than to provide a comprehensive body of knowledge - and graduated, but when faced with ambiguous symptoms, they pretty much randomly guess what the patient is afflicted by. Think about that when you go to just one doctor and he tells you that he knows what you have because he's experienced.
Anyway, as I said, the book is difficult to read, it is more like a scientific paper and, as much as I wanted to finish it, I realize that I am not an aspiring psychologist, nor am I planning to go to therapy soon. Also, since I have people close to me interested in the field, it wouldn't help to talk to them about how they don't use the scientific method and they are not real doctors ;). Joke aside, this book is invaluable for anyone in the field. Not for me, though, and so I decided to indefinitely postpone reading it to the end.
To make it clear, this is not an anti-psychology book. It continuously says that therapy helps. What it also says is that the amount of training and experience of the therapist is statistically irrelevant. That irritates the author tremendously, as he is a psychologist himself and desires that his chosen scientific field evolve and ... well... become a real science. Robyn Dawes unfortunately died in 2010, at the ripe age of 74. During his life he studied human irrationality, intuitive expertise and statistical applications in medicine and psychology. No wonder that in House of Cards, he is ranting against the practice of psychology as it is today.
A few concepts in the book are very interesting and quite frightening. After WW2, a lot of people came traumatized and needed mental attention. At the time, a psychologist needed to be a psychiatrist as well, having gone through the university and studied medicine; they were all doctors, with a Ph.D. degree. So what they did in the US was to create another type of degree, called Psy.D, letting people without medical training enter the field, with only minimal instruction. This created the myth of the intuitive expert who can tell things about people because he has experience, having little else. Dawes proceeds to mercilessly debunk this myth.
In order to do that, he uses - what else - the scientific method. He gathers data as objectively as possible and then tries to find correlations. One correlation that is not found is one between amount of experience (or indeed, formal training) and positive results. One that is, though, is that therapy does help. We just don't know (or better said, we don't know how to quantify) why. One obvious reason would be that, in order to come to therapy, people need to accept they have a problem and then make the first step in solving it: showing up. This alone shows that the person is already actively pursuing healing, a major step into healing themselves. He also analyses diagnosis, often using standardized tests that presumably can help a specialist determine mental issues and their type. However, presented only with test results, the experts don't really get to any useful conclusion.
Dawes is not stopping at psychology, even if that is his main focus. In one chapter he speaks of studies that have proven that doing a thing for a long time doesn't necessarily teach you anything, especially if there is no immediate feedback on whether what you did was good or bad. This also applies to some types of medical diagnosis. And yes, those people went through school - that has the main purpose to promote people who can get through it much more than to provide a comprehensive body of knowledge - and graduated, but when faced with ambiguous symptoms, they pretty much randomly guess what the patient is afflicted by. Think about that when you go to just one doctor and he tells you that he knows what you have because he's experienced.
Anyway, as I said, the book is difficult to read, it is more like a scientific paper and, as much as I wanted to finish it, I realize that I am not an aspiring psychologist, nor am I planning to go to therapy soon. Also, since I have people close to me interested in the field, it wouldn't help to talk to them about how they don't use the scientific method and they are not real doctors ;). Joke aside, this book is invaluable for anyone in the field. Not for me, though, and so I decided to indefinitely postpone reading it to the end.
March 25, 2012
I read this book not long after it first came out, and it validated grave misgivings I had about psychology as practiced.
A person pursuing a career in the scientific fields, such as medicine or engineering, is supposed to correctly identify the problem at hand, and solve the problem utilizing methods and principles that have been developed from scientific research. A physician is not to use some half-baked medical theory that he just came up with. An engineer is not to use Aristotelian physics.
Robyn Dawes argues in this book that the practice of psychological therapy has somewhat moved away from its research base. For example, the efficacy of Roschach tests are not backed by scientific investigation. Dawes even advises that if someone wants you take a Roschach test, walk out and perhaps even get a lawyer.
It is believed, for example by a prominent follower of Ayn Rand, that having self-esteem is an important precursor to being a productive human being. But this idea does not have scientific backing. It is believed that what happened in one's childhood determines what you are as an adult; again, no scientific basis for this.
Then there are all sorts of New Age therapies. Past life regression therapy. Alien abduction therapy. All bogus.
Dawes also gives examples where statistical tests have a superior prediction rate than that of the judgment of individual psychologists. A research psychologist developed a simple statistical formula based on ten MMPI scores to determine if a mental patient is neurotic or psychotic. This formula was right about 70 percent of the time. As for psychologists not using this formula, "none of them could surpass the 70 percent accuracy mark; occasionally, some did on some samples, but they could not repeat their superior performance on other samples..." (p. 85)
A study showed that, while psycho-therapy is efffective, the therapist's credentials and experience were unrelated to the effectiveness of therapy. Also, the type of therapy given was unrelated to its effectiveness, and the length of therapy was unrelated to its success.
There are two things I would have liked to see Dawes have gone into more. One, social policy suggestions. After all, if "talk" therapy is effective, but professional therapists don't have anything "special" to offer, then occupational licensure in this field should be done away with. This would increase the supply of therapists, which would lead to lower medical costs for the patient. Second, while Dawes briefly discussed psychoanalysts such as Freud and Jung, it seems to me that Dawes doesn't really call out psychoanalysis as bogus. But that can be a review for another day.
I've looked at the reviews and ratings here at goodreads for this book, and frankly, those that give this book three stars or less have not really engaged with the points made in this book.
A person pursuing a career in the scientific fields, such as medicine or engineering, is supposed to correctly identify the problem at hand, and solve the problem utilizing methods and principles that have been developed from scientific research. A physician is not to use some half-baked medical theory that he just came up with. An engineer is not to use Aristotelian physics.
Robyn Dawes argues in this book that the practice of psychological therapy has somewhat moved away from its research base. For example, the efficacy of Roschach tests are not backed by scientific investigation. Dawes even advises that if someone wants you take a Roschach test, walk out and perhaps even get a lawyer.
It is believed, for example by a prominent follower of Ayn Rand, that having self-esteem is an important precursor to being a productive human being. But this idea does not have scientific backing. It is believed that what happened in one's childhood determines what you are as an adult; again, no scientific basis for this.
Then there are all sorts of New Age therapies. Past life regression therapy. Alien abduction therapy. All bogus.
Dawes also gives examples where statistical tests have a superior prediction rate than that of the judgment of individual psychologists. A research psychologist developed a simple statistical formula based on ten MMPI scores to determine if a mental patient is neurotic or psychotic. This formula was right about 70 percent of the time. As for psychologists not using this formula, "none of them could surpass the 70 percent accuracy mark; occasionally, some did on some samples, but they could not repeat their superior performance on other samples..." (p. 85)
A study showed that, while psycho-therapy is efffective, the therapist's credentials and experience were unrelated to the effectiveness of therapy. Also, the type of therapy given was unrelated to its effectiveness, and the length of therapy was unrelated to its success.
There are two things I would have liked to see Dawes have gone into more. One, social policy suggestions. After all, if "talk" therapy is effective, but professional therapists don't have anything "special" to offer, then occupational licensure in this field should be done away with. This would increase the supply of therapists, which would lead to lower medical costs for the patient. Second, while Dawes briefly discussed psychoanalysts such as Freud and Jung, it seems to me that Dawes doesn't really call out psychoanalysis as bogus. But that can be a review for another day.
I've looked at the reviews and ratings here at goodreads for this book, and frankly, those that give this book three stars or less have not really engaged with the points made in this book.
May 18, 2018
Being a Clinical Psychologist, this book both shook the foundations of my professional identity, and reminded me of graduate school where my scientific enquiries into everything were looked down on and discouraged by my trainers. Clinical impressions, clinical experience, clinical intuitions, emotions, and the "all powerful" concept of process... This book reminded me that being critical is not a bad thing, except when being critical threatens someones deeply held beliefs. This quickly became evident when I discussed some of the concepts from this book with my colleagues. It was not well received at all. When one person believes something thats not true, they are delusional. When a group of qualified professionals believe something that is not true, it clinical experience. Don't be deterred from seeking the help of a Clinical Psychologist however, it can have great benefits. Just be aware that there are practitioners out there who are licensed to do one thing, but do whatever they like instead, labelling their practice as eclectic and intuitive. Stick with what works for you. If it doesn't work after a few sessions (no progress) its time to consider shopping around. And possibly reading this book :)
November 24, 2021
What would you do if you worked in a profession that ignored its own best practices? What if your industry claimed to be able to do things that they simply couldn’t do? How could you move a profession forward when you knew that most of your colleagues weren’t in the know? I’m not talking about one of my professions, software development, instead I’m talking about psychology and the spot that Robyn Dawes found himself in. (Most software developers haven’t bothered to pick up a single book on software development theory or practices.) Dawes’ response as a concerned professional and an educator was to focus on what he knew is right in his classrooms and to write a book about the problems with his industry – House of Cards: Psychology and Psychotherapy Built on Myth.
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May 25, 2012
An excellent book, full of colorful descriptions of obviously wrong and harmful behavior by the clinical psychologists (both as individuals and as a body). I've been reading it immediately after having read "Thinking, Fast and Slow" by Daniel Kahneman, and it complements that book nicely. The only possible fault of this book is perhaps that the author has obviously a chip on his shoulder against the clinical psychologists, and sometimes it shows.
May 16, 2016
Excellent read with good references to literature and a great critical analysis of the state of psychology and psychotherapy, all of which is probably still relevant today. It's even worth a careful second and third read! Anyone who argues the point for labels in behavioural or psycho-pathological problems, needs to consider the points made in this book very carefully so as to form a balanced and informed opinion.
July 31, 2013
Robyn Dawes was a doddering old man when he wrote this, as is obvious by his wandering prose and unfinished thoughts left at the end of the chapter. The book itself was informative insofar as it picked apart the things wrong with the psychological profession, but focuses only on the negative and never really mentions the positive.
October 2, 2013
This is an angry book. It is mostly about abuses of clinical psychology. However, it has some very good chapters on expert witnesses in criminal trials and interrogators in criminal investigations. I particularly liked his discussion of the value of social science and meta-analysis. It gave me new confidence in the field that i have seen bashed by physicists.
August 15, 2022
An essential read for those considering entering the field of counselling or psychiatry. Dawes brings solid research and arguements as to why there really is no validity to many of the claims and beliefs within the field of psychotherapy.
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February 11, 2019While it is a good book, there is some "Boomer Posting" and silly left wing normie comments.
Still worth reading and recommending.
Still worth reading and recommending.
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