Sneaky Rhetoric: Words to watch out for – Part II

Explorations Outside the Box

Here’s more from Wikipedia’s Manual of Style/Words to Watch, followed by my own examples of sneaky rhetoric. What makes the rhetoric sneaky is its use of insinuation to instill bias in the mind of the reader (or listener). Insofar as this bias takes hold under the radar of one’s awareness, it interferes with clear-headed examination of the matter at hand.

Source: https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Words_to_watch (accessed on 8/25/15 at 3:41pm).

Expressions of doubt

“Examples: supposed, apparent, purported, alleged, accused, so-called …”

 “Words such as supposed, apparent, alleged and purported can imply that a given point is inaccurate, although alleged and accused are appropriate when wrongdoing is asserted but undetermined, such as with people awaiting or undergoing a criminal trial; when these are used, ensure that the source of the accusation is clear. So-called can mean commonly named, falsely named, or contentiously named, and it can be difficult to tell these apart. Simply called is preferable for the first meaning; detailed and attributed explanations are preferable for the others.

Punctuation can also be used for similar effects: quotation marks, when not marking an actual quote, may indicate that the writer is distancing herself or himself from the otherwise common interpretation of the quoted expression; the use of emphasis may turn an innocuous word into a loaded expression. Such occurrences should also be avoided.”

Synonyms for said

“Examples: reveal, point out, expose, explain, find, note, observe, insist, speculate, surmise, claim, assert, admit, confess, deny, clarify…”

“Said, stated, described, wrote, and according to are almost always neutral and accurate. Extra care is needed with more loaded terms. For example, to write that a person clarified, explained, exposed, found, pointed out, or revealed something can imply that it is true, where a neutral account might preclude such an endorsement. To write that someone insisted, noted, observed, speculated, or surmised can suggest the degree of the speaker’s carefulness, resoluteness, or access to evidence when that is unverifiable.

To write that someone asserted or claimed something can call their statement’s credibility into question, by emphasizing any potential contradiction or implying a disregard for evidence. Similarly, be judicious in the use of admit, confess, and deny, particularly of living people, because these verbs can convey guilt when that is not a settled matter.”

Other examples of sneaky rhetoric

Here are some of my own examples of words that aim to create an impression, to bias for and against, without contributing useful information:

Whine: Conveys selfishness, self-pity, being spoiled and small-minded

Be inconvenienced: implies an expressed concern is based on the desire for convenience and an unwillingness to give up comfort and selfish ways.

Rant: Indulgent and unthinking

Hysterical: Out-of-control emotions (as opposed to “passionate” if you happen to agree with the speaker)

Rambling: the flow of words become an associative chain with little relation to reality

So-called: some descriptor is not legitimate

Hype: nefarious others are exaggerating

Nefarious [sarcasm]

Wrack and ruin [sarcasm]

Scare Tactics: reducing warnings of potential danger to motivation to frighten

Orthodox: accepted as truth by blind sheep (not to be confused with “the consensus”, which conveys authority but not the type to be questioned)

Robert Reich and Uncertainty

Politics and Economics

Commentary on: The Upsurge in Uncertain Work by Robert Reich
Published on Monday, August 24, 2015 by RobertReich.org

In this opinion piece, Reich argues that “uncertain” work – with “no predictable earnings or hours” is becoming a pervasive reality in America. To quote: “It’s estimated that in five years over 40 percent  of the US labor force will have uncertain work; in a decade, most of us.”

Trouble is, that “40 percent” link doesn’t work. Trouble is, Reich doesn’t include any data to back up his gloomy picture of where the US labor market is heading. Guess I’m going to have to do the work for him. My go-to resource? The Bureau of Labor Statistics, of course! I recommend the BLS to anyone interested in making accurate statements about the state of working America.

Reich argues that workers are becoming “fungible” – that is, interchangeable and easily replaced. Hence, the uncertainty about hours and earnings. One would think fungibility and uncertainty would be reflected in actual labor market conditions, such as less full-time work, more layoffs, and an increasing number of multiple job holders. But it just ain’t so.

Let’s start with working hours. The BLS publication Trends in hours of work since the mid-1970s  examined trends in working hours in the US between 1976 and 1993 and concluded that “the average length of the workweek for most groups has changed little since the mid-1970s”. In 1993, 76% of wage and salary workers were employed full-time (35 hours a week or more). And in July 2015? BLS stats showed that 80% of workers were full-time. I don’t see a trend here – at least, not a trend for reduced working hours.

Ok, so maybe, per Reich, people are having to work multiple jobs to get their full-time hours. Luckily, the BLS has the numbers: fewer workers hold multiple jobs now than they did 20 years ago, although the total number employed is much greater. So much for that theory.

Well, then, perhaps the uncertainty that Reich sees all around him is due to higher rates of layoffs. Maybe people are super-nervous about losing their jobs. Luckily, the BLS does annual Job Opening and Turnover Surveys – and surprise, surprise – the layoff and discharge rates in the last year were less than what they were in 2005, and there is  no trend that more workers are getting separated from employers. Furthermore, the current median time with the same employer has been  trending upward  trending upward for the last 20 years and is currently 4.6 years.

Reich’s proposed fixes to the perceived problem of uncertainty are also questionable. First: “Whatever party – contractor, client, customer, agent, or intermediary – pays more than half of someone’s income, or provides more than half their working hours, should be responsible for all the labor protections and insurance an employee is entitled to.” Please think that through. For instance, a worker’s hours may vary by employer/contracting party every week. (This situation is commonplace for many of the self-employed – think handymen and bookkeepers). Such a system would create perverse incentives. For instance, contracting parties may want to minimize the amount of work they send any single person (not to mention reducing what they pay) to avoid reaching the threshold for benefits, harming both the contractor and the contractee. And how would the contracting party even know that they pay more than half someone’s income? Will there be a minimum number of hours worked before this kicks in? Who will be keeping tabs?

Reich also proposed a rather generous one-year “income insurance” for workers whose monthly income has dipped below 50% of their five-year average. How would this affect worker and job search behavior? One way would be to incentivize dropping out of the job market for those who are so inclined. The result would be a lower labor market participation rate. Anything that significantly lowers labor market participation rates will reduce tax revenue and GDP, which weakens the safety net and ultimately harms more workers than it helps. Plus, extended (unemployment or income) insurance isn’t an unmitigated good – while essential during economic slowdowns, in recovering economies, it can serve as a drag on further growth. There is plenty of research to bear this out – but, then again, Reich isn’t an economist and maybe he’s just not keeping up with the field.

On the other hand, a modest Basic Income Guarantee along the lines I’ve proposed in previous posts would go a long way to softening the blows of outrageous fortune, without bankrupting the state, adding to the regulatory and tax burden, or disincentivizing work.

Harnessing the Placebo Effect in Psychotherapy

Scientific Encounters

Often when we think of the placebo effect, we think of sugar pills that have no “real” medicinal benefit but work their magic through expectation of benefit. In physical medicine, there is some reluctance to rely on psychological mechanisms for healing (even if these mechanisms trigger physiological processes, like the release of endorphins) given the taint of deception. After all, the physician is asked to “do no harm” and isn’t encouraging self-delusion a form of harm? Truth and goodness go together, right?

Well, yeah, in my book – but it’s complicated. Take psychotherapy. Psychotherapy is all about harnessing psychological mechanisms to get better. So are we to privilege some mechanisms over others? And when we try to heal ourselves, we often self-consciously rely on “belief” even though part of us knows we’re placing more faith in optimism than is warranted by the cold, harsh facts of our situation. But we also know that such faith can make a difference in getting through or getting buried.

A lot of psychological interventions instill hope, provide a plausible narrative that makes sense of one’s misery and show a credible way out. The specific narrative and techniques matter less than whether the client buys into them. Plus there are the “common factors” of therapy that make a big difference in outcomes: the experience of positive regard, empathy, collaboration, and an alliance with the therapist. Leaving out placebo effects, common factors, environmental factors (e.g., “fresh start” experiences like new job or new partner), regression to the mean and personal characteristics of the therapist and client, the specific  treatment may contribute as little as 1% to treatment outcomes (ouch!).

These thoughts were triggered by a recent meta-analysis showing the benefits of Cognitive Behavioral Therapy (CBT) to be declining as time goes on. The authors of the study speculate that this may be because CBT’s placebo effect is wearing off. Let’s face it: CBT is pretty old-hat. Yesterday it was CBT; today, it’s mindfulness. When you take away the hype, and the expectations it engenders, what’s left? Mostly the warm and fuzzies.

I’m still a big advocate of The Truth, come hell or high water. But I know that a lot of people aren’t such sticklers for Getting It Right. And for some people, belief really helps. It changes their physiology, behavior and environment – and somewhere in that sea of change, something real happens.

Still…

 

Sneaky Rhetoric: Words to watch out for – Part I

Explorations Outside the Box

These posts are selected quotations from Wikipedia’s Manual of Style/Words to Watch, followed by a few of my own examples of sneaky rhetoric. What makes the rhetoric sneaky is its use of insinuation to instill bias in the mind of the reader (or listener). Insofar as this bias takes hold under the radar of one’s awareness, it interferes with clear-headed examination of the matter at hand.

Source: https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Words_to_watch (accessed on 8/25/15 at 3:41pm).

Puffery

 “Examples: legendary, great, acclaimed, visionary, outstanding, leading, celebrated, award-winning, landmark, cutting-edge, extraordinary, brilliant, hit, famous, renowned, remarkable, prestigious, world-class, respected, notable, virtuoso, honorable, awesome …

“Words such as these are often used without attribution to promote the subject of an article, while neither imparting nor plainly summarizing verifiable information. They are known as “peacock terms” by Wikipedia contributors. Instead of making unprovable proclamations about a subject’s importance, use facts and attribution to demonstrate that importance.”

More examples of puffery: scholar, prominent, pioneering, highly-respected, revolutionary, amazing, leader in his field.

 Unsupported attributions

“Examples: some people say, many scholars state, it is believed/regarded, many are of    the opinion, most feel, experts declare, it is often reported, it is widely thought, research has shown, science says, it is often said …

” Weasel words are words and phrases aimed at creating an impression that something specific and meaningful has been said, when in fact only a vague or ambiguous claim has been communicated. A common form of weasel wording is through vague attribution, where a statement is dressed with authority, yet has no substantial basis. Phrases such as those above present the appearance of support for statements but can deny the reader the opportunity to assess the source of the viewpoint. They may disguise a biased view. Claims about what people say, think, feel, or believe, and what has been shown, demonstrated, or proved should be clearly attributed.”

More examples of Unsupported Attributions: experts agree, the latest evidence shows, cutting-edge research reveals, it is an established fact that,…

 

Jonathan Franzen, Climate Change, and the Environment

The Environment

Recommended read: Carbon Capture: Has climate change made it harder for people to care about conservation? by Jonathan Franzen in the April 6, 2015 Issue of The New Yorker.

Franzen sees the all-consuming warrior spirit of climate change activists as potentially hurting other environmental causes by redirecting priorities and resources away from conservation projects to the cause of reducing green house gases. Climate change is one threat to biodiversity but there are others, such as habitat loss and fragmentation. If funds are diverted away from preserving habitats, climate change mitigation isn’t going to help those species already lost due to insufficient protection. Is the operation really a success if the patient dies?

Franzen isn’t minimizing the potentially catastrophic effects of global warming. He is simply asking that we accept the reality of trade-offs in any particular proposal to counter climate change, arguing that reductions in GHGs isn’t the only thing that matters when designing and greenlighting projects. Efficient energy developments can harm wildlife and local ecosystems. Care must be taken.

The dominance of climate change in environmental discourse can also turn off people who could become allies in other contexts. Public concern about climate change has been declining for years. It may be the climate change narrative lacks traction because humans have a hard time envisioning and caring about dire events that may or may not happen within their life time. In contrast, the disappearance of wildlife is very real and very now. No one has to be hectored into “believing” that species are dying off on an epic scale. And you don’t have to be of a particular political persuasion to care and want to do something about it.

Franzen notes that human brains aren’t really designed to engage in complex probabilistic thinking about possible scenarios hypothesized to unfold over the span of decades and centuries. Skepticism about climate change springs in part from human nature. Franzen takes issue with the characterization of opponents of aggressive mitigation efforts as a bunch of knaves and idiots, arguing that inaction on climate change isn’t the result of the knaves manipulating the idiots but of rational self-interest and healthy democratic processes.

Another issue is that in some ways we have already lost the battle with climate change. It’s going to happen because governments and people aren’t going to make the necessary sacrifices. As Franzen puts it:

“Even in the nations most threatened by flooding or drought, even in the countries most virtuously committed to alternative energy sources, no head of state has ever made a commitment to leaving any carbon in the ground. Without such a commitment, “alternative” merely means “additional”—postponement of human catastrophe, not prevention. The Earth as we now know it resembles a patient whose terminal cancer we can choose to treat either with disfiguring aggression or with palliation and sympathy. We can dam every river and blight every landscape with biofuel agriculture, solar farms, and wind turbines, to buy some extra years of moderated warming. Or we can settle for a shorter life of higher quality, protecting the areas where wild animals and plants are hanging on, at the cost of slightly hastening the human catastrophe. One advantage of the latter approach is that, if a miracle cure like fusion energy should come along, there might still be some intact ecosystems for it to save.”

Franzen isn’t suggesting we just throw up our hands in the face of inevitable climate change. Of course we need to do what we can. But knowing that the climate will change, we should also focus on preparing wild areas for the changes that lie ahead:

“In an era of globalism of every sort, a good conservation project has to meet new criteria. The project has to be large, because biodiversity won’t survive in a habitat fragmented by palm-oil plantations or gas drilling. The project has to respect and accommodate the people already living in and around it. (Carbon emissions have rendered meaningless the ideal of a wilderness untouched by man; the new ideal is “wildness,” which is measured not by isolation from disturbance but by the diversity of organisms that can complete their life cycles.) And the project needs to be resilient with respect to climate change, either by virtue of its size or by incorporating altitudinal gradients or multiple microclimates.”

Sound advice.

The Spirit of Bureaucracy

Politics and Economics

The private sector can’t do everything – we need government, regulations, and taxes. But why are government agencies so encumbered by bureaucratic inefficiency? Here are some possible answers:

  1. Staying within budget often means next year’s budget will be smaller – government agencies can’t pocket savings (and government employees don’t receive bonuses for savings or great income-generating ideas) so efficiency, risk-taking, and creative problem-solving often go unrewarded.
  2. Government agencies are subject to constraints that prevent them from “allocating the factors of production” as optimal – that is, they cannot move people and equipment to where it is most needed
  3. Government agencies must serve goals not of their own choosing. These goals may be politically motivated, unreasonable or impractical, but they cannot be rejected.
  4. As tax-funded enterprises, government agencies have a public mission and their actions are closely scrutinized to make sure the public good is being upheld. So individual players in the system will error on the side of caution, which is rational. But if you multiply the millions and millions of individual actions, each makes sense within its local context, but the net effect is overall inefficiency, which isn’t doing the public much good at all.
  5. Government workers operate under many rules. Official routines tend to be characterized by excessive complexity, e.g., follow these procedures, use those forms, buy only from these vendors, which makes bureaucrats worry more about process than outcomes.
  6. Once government workers are hired and have passed a probationary period, keeping one’s job has less to do with personal qualities than with broader issues, like budgets and the political winds. Initiative, creativity and risk-taking are poorly rewarded. Adequacy is enough. As long as you just do your job, you’re likely to get raises and promotions according to the rules.

All these factors conspire to disincentivize going beyond the call of duty. Proactive and creative people would shrink under such a regime. And they do, or they end up working in the private sector.  Ok, accepted: government organizations are inherently inefficient and risk-averse. Next question: is that such a bad thing, and if so, what can be done about it? Stay tuned.

A couple references:

http://www.the-american-interest.com/2012/03/04/james-q-wilson-1931-2012/

Wilson. 1989. Bureaucracy: What government agencies do and why they do it. In Brief

Mindfulness and the Ideological Square: Emphasize Their Bad Things

Observing Mindfulness

The next few posts will be looking at mindfulness as an ideology. According to Teun A. Van Dijk in Politics, Ideology and Discourse – an entry in the Elsevier Encyclopedia of Language and Linguistics (2005) – the following “ideological square” has been found to be pervasive in ideological discourse:

. Emphasize Our good things

. Emphasize Their bad things

. De-emphasize Our bad things

. De-emphasize Their good things

Let’s focus on the “bad things” in the square, starting with “emphasize their bad things”.

First a brief word count from Kabat-Zinn’s Full Catastrophe Living (FCL) to set the tone: suffering: 112; pain: 555;  stress: 588;  death: 63;  premature death: 6;  cancer: 109;  danger: 9;  dangerous: 14; risk : 45 ;  threat: 39;  threaten: 11;  toxic: 22.

Just as everyday awareness pales in comparison to mindful awareness, so everyday life pales in comparison to the mindful life. According to Kabat-Zinn, not living mindfully is to be in a world of “loss and grief and suffering” (FCL, Kindle p. 440). Mindfulness makes it possible for us to be “fully awake, not lost in waking sleep or enshrouded in the veils of [our] thinking mind” (ibid, p.2346) Living unmindfully, we are “half unconscious…reacting automatically, mindlessly” (ibid, p 9894).

In mindfulness discourse, contemporary life is not only spiritually impoverished, it is downright dangerous. Toxins are pervasive, threatening the delicate homeostatic balance of the interconnected world. Dangerous chemicals, including caffeine, alcohol, nicotine, sugar, additives, preservatives, fertilizers and pesticides, are “placing our exquisitely evolved homeostatic biochemical networks at some unknown degree of risk for cellular and tissue disruption and damage” (ibid, p.8759). It’s not just chemicals that are toxic. Thoughts, lifestyles and people can be toxic too.

The use of “toxic” is prevalent in the mindfulness cybercommunity. Here are a few examples I found in a quick Google search (6/6/14 – 2pm):

The Toxicity of Greed and the Mindfulness of Generosity

The Power of Mindful Empathy To Heal Toxic Shame

Advanced Mindfulness Techniques that Change the Brain: Rewire Depression, Anxiety and Toxic Lifestyle Habits

Could You Be Addicted to Toxic People and Environments? Remedy: Mindfulness Meditation!

It’s ironic that an ideology associated with a certain serenity of spirit is so alert to danger and threat. The list of psychological, physical, and societal ills associated with unmindful living seems endless. To Kabat-Zinn, television is especially pernicious, “much of it frenetic, violent, cruel, and anxiety-producing, and all of it artificial and two-dimensional” (FCL, Kindle p.9204). Add to the toxic mix all the “food stress, work stress and role stress, people stress, sleep stress, time stress, and our own fears and pain” (ibid, p.9405), the inevitable “reactivity” to such stress and it’s no wonder our very survival as individuals is in peril:

“A lifetime of unconscious and unexamined habitual reactivity to challenges and perceived threats is likely to increase our risk of eventual breakdown and illness significantly.” (FCL, Kindle p. 5436)

Without the self-knowledge and wisdom that comes with mindful living, the human race may actually be doomed. As Kabat-Zinn puts it:

“And when the human mind does not know itself, we get ignorance, cruelty, oppression, violence, genocide, holocausts, death, and destruction on a colossal scale. For this reason, mindfulness writ both large and small is not a luxury. Writ small, it is a liberative strategy for being healthier and happier as an individual. Writ large, it is a vital necessity if we are to survive and thrive as a species.” (ibid p.9078-9084

The mindfulness community’s emphasis on how bad life is without mindfulness stems in part from the Buddhist tradition, namely the Four Noble Truths, of which the first is the Truth of Suffering (e.g., anxiety and trying to hold on to what is forever changing). In line with Geertz’s conception of religion, Buddhism is about dealing with the problem of suffering.

But religions are not equally ideological. Strongly ideological religions elaborate on the problem of suffering, highlight and extend the realm of suffering, widening the chasm between the world of the blighted and the world of the blessed (in this world and beyond).

Reference:  Jon Kabat-Zinn Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness, Kindle Version, Revised Edition 2013; Bantam Books, New York).

Heuristics that are useful except when they aren’t

Explorations Outside the Box

Heuristics that are useful except when they aren’t:

  1. It depends
  2. Context is everything
  3. The devil’s in the details
  4. Avoid categorical thinking
  5. Dose matters
  6. What are the trade-offs?
  7. What’s the pay-off?
  8. Pause
  9. What’s being left out?
  10. Behavior speaks louder than words
  11. Motive is less important than merit of the case
  12. Subjectivity is not the opposite of objectivity
  13. Acknowledge what you don’t know
  14. Nothing is obvious
  15. Action does not require certainty
  16. Hold fast to principle and be willing to compromise
  17. What matters most right now?
  18. Be nice
  19. What’s the other side’s best argument?
  20. No heuristic works all the time

Global warming and how to win hearts and minds

The Environment

Public concern in the US about global warming peaked in 2000, when it reached 72%. It is now about 58%. While the majority of Americans accept that human-caused global warming is happening (including most liberal and moderate Republicans), many feel that that the dangers of climate changes have been greatly exaggerated.

If climate change activists are truly interested in converting the general public to their cause, I suggest toning down the rhetoric. Don’t use “consensus” as an argument. Don’t refer to skeptics as “deniers”. Avoid ad hominem attacks. Don’t argue from extreme cases – that is, assume that the worst case scenario will happen without drastic action now. Alarmism is rarely an effective form of persuasion (see, e.g., The Boy Who Cried Wolf).

Which brings me to: Ten Commandments of How to Fail in an Environmental Campaign Environmental Politics Volume 10, Issue 1, 2001 by Avner de-Shalit (Associate Fellow Oxford Centre for Environment, Ethics and Society, Mansfield College, Oxford).

Here’s the Second Commandment:

“Always Use the Terminology of Despair (Environmental activists “try to show how desperate a situation is… and [since many] can point to cases in which scenarios predicted by environmentalists have failed to materialize….Also, people generally react in a very basic way to the threat of dire consequences and horrific scenarios. They simply repress and doubt what they hear – a common strategy when faced with alarming prognostications. Thus while environmentalists try to force an impression on the general public with their somewhat exaggerated predictions, the eventual outcome is counter-productive: many people simply disbelieve, do not want to believe, or even refuse to listen.”

As any business knows, if you want to convince people of the value of your product, do some research on your potential customers. And don’t waste your time on people who have made it clear they will never buy what you’re selling.

Regarding climate change, you have to be able to distinguish mild or moderate skeptics –people on the fence or who have doubts about this or that aspect of climate change theory – and those whose opinions are pretty much set in stone. Don’t paint all skeptics with the broad brush of “denier” – that just creates resentment and may even push some people into the arms of strong disbelievers. (How that process works: if one side shows no respect and treats your doubts with sarcasm and condescension, there are others who may at least listen without immediately trying to bat down your concerns and questions).

For a more informed understanding of why people may doubt global warming, start reading the actual research about factors that influence people’s opinions and beliefs about global warming. The journal “Environment and Behavior” would be a good start. I also recommend the article “Climatologists’ patterns of conveying climate science to the agricultural community” in Agriculture and Human Values. In that paper, the key issue seemed to be trust in the source of information.

Concluding, some tips on getting the climate change message across:

  1. Acknowledge that “mistakes have been made” – e.g., that in the past, predictions of future calamity have been made by aligned individuals/groups, which have turned out to be false, such as the population explosion and peak oil. So acknowledge that credibility is an issue and that some mending of fences is called for.
  2. Don’t underestimate the intelligence and sophistication of those with whom you disagree. For instance, don’t push a message of authority and proof regarding scientific forecasts that are expressed in a wide range of scenarios, each with a range of confidence, and which rely on different assumptions. Acknowledge that uncertainty and prognostication go together. (For a great illustration of the latter point, check out the number of time “uncertainty” is used in the latest IPCC report).
  3. Don’t talk down to people you disagree with – avoid mockery, sarcasm, and condescension.
  4. Don’t question the values or motives of those you disagree with. Not seeing climate change as “serious” can mean different things to different people and does not in itself imply callous indifference to the plight of the planet or humanity. I know a lot of climate change skeptics who care deeply about environmental matters and are quite willing to make personal sacrifices if they think it will help a greater cause.
  5. Don’t assume homogeneity among those you disagree with. Climate skeptics range from those who are absolutely certain that climate change is not real, serious, and/or anthropogenic to those who are skeptical about some of the dominant claims or opinions. By characterizing climate skeptics as a “type” best characterized by the supposed attributes of their most extreme associates, one pushes further away those with whom there might have been some common ground.
  6. Quit pushing “consensus” as a reason to embrace global warming predictions. Consensus by itself is never sufficient, so quit badgering people with it. I doubt people believe the earth circles the sun because it’s the “scientific consensus” or that vaccines usually work because that’s the “consensus” – they believe because they have seen, heard or read of evidence that support these beliefs.

Cognitive Behavioral Therapy and The Placebo Effect

Scientific Encounters

Johnsen, T. J., & Friborg, O. (2015, May 11). The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis. Psychological Bulletin. Advance online publication. http://dx.doi.org/10.1037/bul0000015

From the Abstract:

  • A meta-analysis examining temporal changes (time trends) in the effects of cognitive behavioral therapy (CBT) as a treatment for unipolar depression was conducted.  A comprehensive search of psychotherapy trials yielded 70 eligible studies from 1977 to 2014. … temporal trends indicated that the effects of CBT have declined linearly and steadily since its introduction, as measured by patients’ self-reports (the BDI, p _ .001), clinicians’ ratings (the HRSD, p _ .01) and rates of remission (p _ .01)… Thus, modern CBT clinical trials seemingly provided less relief from depressive symptoms as compared with the seminal trials.

The authors speculate that the placebo effect may be an important factor in the decline in CBT’s efficacy. They note that the “placebo effect is typically stronger for newer treatments; however, as time passes and experience with therapy is gained, the strong initial expectations wane. One may question whether this is the case with CBT. In the initial phase of the cognitive era, CBT was frequently portrayed as the gold standard for the treatment of many disorders. In recent times, however, an increasing number of studies …have not found this method to be superior to other techniques. Coupled with the increasing availability of such information to the public, including the Internet, it is not inconceivable that patients’ hope and faith in the efficacy of CBT has decreased somewhat, in recent decades. …CBT apparently reached a ceiling effect during its first few years.” (p. 16)

Bottom line: A lot of the promise of CBT may have been due to a placebo effect: high hopes and high expectations, plus a narrative that makes sense of one’s misery. Now that CBT is old hat and just about anyone who has been to a therapist has been exposed to CBT, it no longer has that je ne sais quoi that inspires optimism – or at least a better mood. Not feeling that great? It’s probably because of your irrational and inaccurate cognitions. That used to help – but less and less as time goes by.