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Sigmund Freud once described “wild psycho-analysis” as the practice of psychotherapy by physicians who had not been well-trained in psychoanalytic technique, noting that “doctors form a large contingent of quacks in psychoanalysis.”¹ Psychoanalysis has been in decline for decades, and today there are many other theoretical models of psychotherapy, but there is still a danger that psychotherapists may get so creative that they engage in “wild psychotherapy.” There is much to be learned from a study of the negative examples of how well-known therapists have done psychotherapy.

Some of the methods described in this paper are clearly far outside the boundaries of the standard practice of psychotherapy. While it is generally safe and effective to use evidence-based techniques, psychotherapy mavericks prefer to trust their own intuition instead of clinical research. Some “innovative” and “creative” techniques raise questions of safety, ethics, and competency to practice psychotherapy. Here are a few that I review in my 2021 book Wild Psychotherapy.

Anthony Robbins

Anthony “Tony” Robbins is a motivational speaker, life coach, consultant, and author of numerous bestselling self-improvement books. Instead of attending college, Robbins worked as a janitor and a workshop organizer for motivational speaker Jim Rohn. Robbins taught himself psychology, studied many methods to provoke change, and developed his own theory of human motivation. Robbins began leading seminars in the 1980s, which often included fire walking, massages, audience participation, and an emphasis on self-help and positive thinking (for his Fox Family Channel series Exploring the Unknown, Skeptic publisher Michael Shermer walked barefoot across 1000-degree coals without getting burned and without thinking positive thoughts, which you can watch on YouTube). Robbins wrote several books and appeared in many latenight television infomercials to sell his products.²

In 2002, Robbins founded the Robbins-Madanes Center for Intervention with family therapist Cloe Madanes. The purpose of the organization is to train life skills coaches to help people deal with mental health and addiction problems. Although Robbins calls his sessions with clients “strategic interventions,” they are indistinguishable from psychotherapy. Examples of Robbins’ therapy sessions are available in several films, such as Back from the Edge, Conquering Overwhelming Loss, and Love and Passion.³ In the films Robbins conducts psychotherapy in large group meetings with volunteer clients who have a variety of severe emotional problems, including feeling suicidal. His approach is based on techniques with little scientific support, such as Neuro-linguistic Programming and Ericksonian hypnosis, and he uses an eclectic mixture of self-help homilies, affirmations, pop psychology clichés, and New Age ideas. He appears to use his charisma and personal authority — which are substantial and energizing (he’s 6′ 7″ tall and has a commanding voice) — to influence his clients to accept his view of their problems. In his therapy Robbins emphasizes arousing the client’s emotions to have a cathartic experience; he says, “Your heart has the answers, not your head.”

The 2016 documentary film Tony Robbins: I Am Not Your Guru shows Robbins working with several clients during a large seminar. There is loud, dramatic music and group pressure to participate, while Robbins runs and jumps around the stage. During the seminar Robbins singles out people to work with in front of the huge audience. He diagnoses people’s problems with little background knowledge and tells them what to do with no apparent concern about potential negative outcomes (because, he tells an interviewer, “I read people”). He tells people he has just met “I love you” and you can “change in a moment.” While many people have dismissed Robbins’ seminars as expensive entertainment, there is a risk that the people he works with in his seminars could be harmed.

Robbins’ highly manipulative interventions (as seen in I Am Not Your Guru) include, for example, asking a suicidal female client to tell her story of childhood rape in front of the audience and then let three male strangers in the audience hug her. She is told to call these men her “uncles” and to stay in contact with them for the next ten years. Robbins tells another female client to call her boyfriend to break up with him during the therapy session, which she does (although a note at the end of the film says they got back together later). In the film Robbins calls himself “a practical psychologist” and refers to what he does as “therapy” and “interventions.” It is highly unlikely that Robbins’ expensive, superficial form of therapy has lasting beneficial results for his clients after they recover from the emotional “high” of the large group experience, which is similar to a high-energy rock concert or a charismatic church service.

Robbins has no college degree, no graduate degree, and no certification or licensure as a mental health counselor, family therapist, social worker, psychologist, or psychiatrist. The danger of untrained, unqualified people practicing psychotherapy is that they will harm their clients. Although Robbins calls what he does in his sessions “life coaching” it is clearly mental health counseling or psychotherapy, since he treats people with mental disorders.⁴ He is likely the most highly paid therapist in the world, since his clients pay a minimum of $4,000 to attend his seminars and compete for his personalized attention during the seminars.

It is illegal to practice psychotherapy without a license, but anyone can practice as a “life coach” because no degree or certification is required; but coaches are legally prohibited from treating people with mental disorders. Robbins sees most of his clients for only one brief session, conducts no intake or assessment, and does little or no follow-up, making it difficult to determine how much damage he may have caused.

Phillip McGraw

Phillip McGraw is a television celebrity and host of the Dr. Phil television show. He earned a doctoral degree in clinical psychology and worked as a therapist and consultant before meeting Oprah Winfrey, who produced his syndicated daily television program. The American Psychological Association (APA) said “his work has touched more Americans than any other living psychologist.”⁵ Unfortunately, millions of Americans probably think that what McGraw does on television is representative of all psychotherapists. On his show McGraw conducts brief sessions with a wide variety of clients, with no pretense of confidentiality, although he has not been licensed to practice therapy since 2006. In addition to his television work Dr. Phil sells vitamins, nutritional supplements, and weight loss products.

Based on very superficial knowledge about his clients, McGraw challenges them to make large-scale behavioral changes without offering them the empathy or support that is usually considered fundamental to the practice of counseling. McGraw has said that he failed as a therapist in private practice because he had “no patience for my patients.”⁶ His “pull-no-punches, good ol’ boy shtick” includes making fun of clients’ decisions, telling them “You either get it or you don’t” (they either agree with his opinions or they don’t). He never seems to need a moment to think before telling his clients what they should do. To be charitable this is, perhaps, the result of squeezing counseling sessions into several short minutes between commercial breaks on a television show, but the risk of doing harm is elevated thusly.

The National Alliance for the Mentally Ill accused McGraw of ethical violations and malpractice after a TV program in which he diagnosed a nine-year-old boy as a potential future serial killer, caused by permissive parenting. He advised the boy’s parents to lock him in a room containing nothing but a bed.⁷ While McGraw’s abrasive, bullying style can be entertaining, it has little in common with good counseling, and he has often been accused of exploiting his vulnerable clients for ratings. McGraw plays the role of a stern, no-nonsense father who knows what is best for everyone else and he does not hesitate to tell people what to do. Some psychotherapists are direct with clients, but telling them what to do is risky and can have significant unintended consequences.

Since he has not been licensed as a counselor or psychologist since 2006, McGraw cannot legally practice counseling or psychotherapy. People who appear on his television show sign a waiver saying that he does not practice therapy or a substitute for any form of therapy, and that his advice is not real psychological advice, but the waiver is misleading.⁸ McGraw tells people with mental health problems what they should do to deal with their problems, which may be very poor quality counseling, but it is counseling. The waiver would appear to be an attempt to avoid legal liability if McGraw’s advice causes more problems than benefits. No doubt many of his clients on the TV show need psychological help, and they should be referred to qualified, licensed professionals, rather than exploited for the entertainment of the public.

Because McGraw is not qualified to practice counseling or psychotherapy, it is unclear why he is allowed to see clients on television or anywhere else. It is interesting that although psychology licensing boards prohibit the practice of psychology without a license, and there is no exception for televised therapy, enforcement of such laws is extremely lax. It is unfortunate that the licensure laws often fail to protect the public from people who pretend to be qualified counselors or psychotherapists.

Laura Schlessinger

Dr. Laura Schlessinger (known as “Dr. Laura”) is a therapist, radio talk show host, and author of several self-help books. She has a doctoral degree in physiology and took some courses in marriage and family counseling; she obtained licensure and had a private practice in California. Schlessinger has worked in radio for 40 years, giving advice to callers regarding their personal emotional problems. In addition to conducting very brief therapy sessions with callers, she also often talks about morality, social issues, and conservative politics. At its peak her show was the second-highest rated radio show (after The Rush Limbaugh Show) and was heard on 450 radio stations.⁹ Her show is now on SiriusXM radio.

The danger of untrained, unqualified people practicing psychotherapy is that they will harm their clients.

The style of therapy practiced by Schlessinger on her radio call-in show is not recognizable as being based on any theory or model of how psychotherapy is normally practiced. Based on a very small amount of information about her clients, she simply tells them what they should do (based mostly on her own moral values and experiences). It is unclear whether Schlessinger thinks of her mini-counseling sessions on the radio as psychotherapy, but they meet the definition (offering help to people with a wide variety of mental disorders and emotional problems).¹⁰ She is licensed currently as a marriage and family therapist in her home state of California,¹¹ presumably so she can practice counseling on her radio show. However, on the show she counsels clients in states where she is not licensed to practice counseling. It also seems deceptive that she calls her radio program “Dr. Laura” when her doctoral degree has nothing to do with counseling or psychology.

Dr. Laura’s responses to clients are often not just unhelpful, but abusive. For example, while counseling a woman who felt alienated from her mother, Schlessinger said “You want to dump a mother who raised you, and you’re pissed at her? What the hell is wrong with you? … I seriously would rather smack you across the head than anything else right now, you ungrateful little twit; you insensitive, ungrateful twit.”¹² According to her website, her show offers “no-nonsense advice” and “preaches, teaches, and nags.”¹³ Schlessinger’s radio show is popular, probably because it can be entertaining to hear her harangue and abuse her clients, but it is unknown whether any of them have actually been helped.

Reparenting Therapies

Psychologist Arthur Janov¹⁴ created Primal Therapy, a treatment for neurosis that required patients to become conscious of traumatic childhood experiences and express their anger, frustration, and pain through spontaneous and unrestrained screams, hysteria, or violence. He also designed a “birth simulator,” consisting of a long, oily vinyl tube through which clients could squeeze to re-experience the birth process. Janov’s patients included singer-songwriter John Lennon, actor James Earl Jones, pianist John Williams, and Apple founder Steve Jobs.

Psychiatric social worker Jaqui Lee Schiff¹⁵ developed a form of therapy based on transactional analysis theory which she called “total regression reparenting.” The treatment is meant to correct problems adult patients have due to defective parenting. The patient is regressed to a childlike ego state and then reparented by the therapist to help the patient develop a healthier ego. The therapist attempts to regress the patient by doing bottle-feeding, cuddling the patient on the therapist’s lap, hugging, spanking, and related methods. The patient is meant to trust the therapist as a substitute parent and change negative thinking patterns. There are many therapists who practice various forms of reparenting therapy, such as rebirthing or attachment therapy, although several children have died while undergoing the controversial treatment.¹⁶

Psychologist Tanya Teton practiced what she called Radical Reparenting Therapy, which involved her regressing clients to infancy and re-nurturing them. She asked adult clients to sit in her lap and drink from a baby bottle or nurse from her bare breast. Sometimes she had clients wear a diaper, and she powdered their behinds.¹⁷ Rebirthing and reparenting treatments have little evidence for their safety or effectiveness and are illegal in some states.

Recovered Memory Therapy

The debate over therapy for false recovered memories of childhood sexual abuse has been called “the most acrimonious, vicious and hurtful internal controversy in the history of modern psychiatry.”¹⁸ Ed Cara called the belief that repressed memories can be recovered in therapy “the most dangerous idea in mental health.”¹⁹ The debate over recovered memory therapy raised several questions. Do repressed memories exist, and, if so, are they accurate? Can false memories be implanted by therapists in clients?

Because all memories are “recovered” in a sense, repressed memories should really be referred to as a form of dissociative amnesia. Research suggests that memories of sexual abuse may be repressed by a subset of people who experienced abuse, but repressed memories are no more or less accurate than ordinary memories.²⁰ Research by Elizabeth Loftus showed that people do not recall the past, they reconstruct it.²¹ Thus, therapists should be cautious about uncritically believing that clients’ memories are true.

This article appeared in Skeptic magazine 27.1
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There is no consensus about how recovered memory therapy should be practiced. However, there is widespread agreement that false memories of sexual abuse can cause immense harm.²² Although some therapists may elicit false memories by asking leading questions or using suggestion, hypnosis or guided imagery, most therapists presumably seek to elicit true rather than false memories. The problem is that since it can be difficult or impossible to establish the truth of memories presented by clients in therapy, simply accepting them as true can result in unintentional problems. It would be harmful to either uncritically accept false memories or disbelieve genuine recovered memories. Recovered memory therapy has not been accepted by the psychiatric or psychological communities as a legitimate form of psychotherapy, and it has thankfully mostly fallen into disuse after a number of lawsuits against therapists who practiced it by their clients or clients’ families who were harmed.²³

Energy Psychology

Psychotherapy based on the unverified existence of “subtle energies” and “energy fields” is extremely controversial. Several different kinds of Energy Psychology have been described, but they all rely on unusual procedures adapted from non-Western cultures, have unverified mechanisms of action, and claim to be unusually rapid and powerful.²⁴ Although techniques based on energy psychology were introduced more than three decades ago, good evidence of their effectiveness is still lacking, and none of them are included on the American Psychological Association’s list of evidence-based psychological treatments.²⁵

The basic method of energy psychology involves manual stimulation of acupuncture points by touching or tapping, sometimes combined with humming tunes or counting aloud. It appears that often the developers of these techniques promote them in books and workshops based on anecdotal reports of their effectiveness and have little or no interest in conducting controlled research, which could determine whether the method actually works better than existing methods. Promoters often claim 90 or 100 percent success rates with all psychological problems, and this in less than one hour sessions.²⁶

No evidence for the existence of meridians, invisible psychological energy fields, or energy blockages that could cause psychological problems has been found. Since the elements of the theory of energy psychology cannot be detected or measured, the theory is unfalsifiable, and hence unscientific.²⁷ Energy psychology treatments may help some patients feel better, but such effects are most likely due to the placebo effect, and no dismantling studies have demonstrated that energy psychology methods are more effective than standard evidence-based treatments such as systematic desensitization and exposure and response prevention. The only properly controlled dismantling studies that have tested energy psychology found that it had no effective ingredients separate from those found in standard treatments.²⁸

Even the most fervent advocates of energy psychology readily admit that the hypothesized mechanisms of action have not been tested, let alone supported, and that those who speak in favor of the approach have “undeniable bias resulting from…identification with the approach.”²⁹ While the advocates of energy psychology cite over a hundred studies to support it,³⁰ almost all of the studies lack randomized placebo controls, meaning there is very little good evidence for the approach.³¹ For whatever reason, some psychotherapists are interested in pseudoscientific theories, metaphysical ideas, and New Age self-help methods, and incorporate them into their therapy. Consumers would be well advised to seek therapists who prioritize evidence-based psychotherapy, and avoid bizarre treatments that waste their time, money, and “energy.”

Conclusions

The interest in evidence-based practice in recent years is partly a reaction to the extreme practices of some psychotherapists. There are few constraints on what psychotherapists do in the real world. Although there are professional and ethical standards that are meant to define the boundaries of practice, the will to sanction well-known mavericks is weak, and typically only the most egregious abuses are ever adjudicated.³² Therapists are rarely brought before a licensing board to defend their practices unless a client or a colleague complains, and the whole system seems to be designed to avoid raising questions about the effectiveness of interventions. It is interesting that the most well-known psychologist in America (Dr. Phil McGraw), and the most highly paid therapist in America (Tony Robbins) are not actually certified or licensed to do what they do. As media personalities and ultra-rich celebrities, they seem to be exempt from legal regulations that apply to other people.

In general, the most effective forms of psychotherapy used to treat mental disorders are those that have incorporated scientific research findings into their practice, such as cognitive behavior therapy (CBT). The use of techniques that have little evidence of their effectiveness is problematic, since professional ethical standards favor the use of treatments that have good evidence of their effectiveness. Evidence-based treatments for mental disorders should be considered the treatments of choice, unless there is a good reason not to use them. There is little need for therapists to use controversial and potentially harmful treatments with their clients. Resources on evidence-based psychotherapies are readily available,³³ as are resources listing treatments that should be avoided.³⁴

Chapter excerpted from Timothy C. Thomason’s Wild Psychotherapy (Flagstaff, AZ: Flagstaff Institute, 2021)