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Dick Price was a 30-year-old journalist assigned by the liberal magazine, Ragtag, to cover the

Young trial. Although Nancy Mackintosh had free-lanced for Ragtag, the two journalists hadnever met. As the publicity mounted, other reporters were sent to cover the story, but no onecovered it so extensively as Price, who attended every session from the beginning, and interview-

ed everyone connected with the case who was willing to be interviewed. He had a special interest in it, as hehad previously interviewed Alan Browne and written about Love Two.

At the outset, Price had had little association with psychotherapy, but from what he could seesecond-hand from friends, the only result of all those hours of self-indulgent naval watching, and all theexpense, sometimes to the extent of unbearable debt, seemed to me to be a personality disturbance thattherapy never cured and may even have brought on. He had read somewhere about a psychologist whosaid that psychotherapy can turn into an addiction. According to the office gossip, Marshall Evans, a former

reporter who now worked in the Ragtagmail room, had consulted one psychiatrist after another, as eachproved too expensive or otherwise disappointing. After twelve years of psychotherapy, it was hard for Price

to imagine that man being worse off. When Evans money ran out, he saw a high school counselor with asomewhat illicit private practice on the side. At least the fees were lower. Except for Marshall, and WoodyAllen movies, Price had had little contact with or knowledge of psychotherapy before the trial. Afterwards,however, he talked with many of the principals in the case. His final report was published in a series ofarticles.

One of Dick Prices interviews was with Peters first lawyer, the one who was dismissed from thecase before the trial began. Leland Wilson was a crude and portly man in his late fifties, a heavy drinker whomostly handled minor divorce and property cases. Wilson insisted that they meet at a bar across the streetfrom his office over sandwiches and beer. He was happy to be interviewed and somewhat overgenerouswith his time. Wilsons plan had been to maintain that Young couldnt control his action, that the intensityof his feeling for his patient had blinded him and that the Mackintosh woman had deliberately brought it on.She was the one who tried to seduce him. It was a strategy with which he had saved many a client fromexorbitant alimony payments.

Anyway, that was my plan. It didnt work out that way, of course, not in this case. The gentlemanlyDr. Young adamantly refused to allow me to impugn the young lady in any manner. He insisted that she wasentirely innocent of any blame. I also thought it was a ridiculous case from the beginning and that it wouldnever get to court. If the plaintive is blameless, then the defendant must be guilty. Thats the adversarialsystem. There always has to be blame on one side or the other.

When it was all finally over, Wilsons local advertising of Peters support of the woman who wassuing him provided an island of respect for Peter amid a sea of disdain. The publicity also brought addition-al clients to Wilson, proving once again that any publicity is good publicity for a person in his profession.

That Ed Pervis, Nancys high-priced and famous lawyer, was prosecuting was what first drew public

attention to the case. Price found out later that Pervis had been recommended to Nancy by her editor, WaltHarris. Unknown to Nancy, and discovered by Price only much later, Harris supplemented the attorneysfees with money supplied by a health insurance company that was interested in publicly exposing psycho-therapy as unproven and, therefore, not a medical procedure entitled to reimbursement. Nancy knew, ofcourse, that Walt was paying Perviss fee, but she learned about the insurance company backing of, andfunding for, the publicity campaign only after the trial was over.

As the young case began, Ed Pervis sent the following email to his brother, Desmond Pervis, whowas also a lawyer:

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Hi, Desmond,

Im taking the Young case. There may be positive effects of psychotherapy, but if training in

clinical psychology does not improve effectiveness, what are people doing? Paying for a dream? I know that

I am being paid to destroy the image of the psychotherapy industry in the public mind. The trial is to be a

showcase for exposure of the pressure that a self-appointed profession can exert, thereby wasting public

and private money. I am aware that the trial will consist of critics and defenders of psychotherapy, notcritics and defenders of Dr. Peter Young. The health insurance people operate according to the short-term

goal of proving that psychotherapy is not a medical treatment because it is not based on science. Their aim

is to establish a firm basis for ridding their books of psychotherapy expenses. They want me to demon-

strate through expert witnesses that psychotherapy is an unverified procedure. When I looked over the

documents they supplied, as well as those produced by my client, I saw that it would be easy to do. Several

books highly critical of psychotherapy have recently been published. Its in the air. Some of the public have

already turned against it, partly because they fear rising insurance costs. For years the field has been

fighting a frantic, but losing, battle to redeem itself. It will be like shooting fish in a barrel. Duck soup.

Criticizing psychotherapy does not meet the kind of resistance from the faithful it would have met twenty

or thirty years ago, for the very good reason that the size of the faithful has diminished. I was most

impressed by many separate studies that found either no evidence or only weak empirical evidence thatbenefits of psychotherapy are derived from specific ingredients.

I know the case is weak as far as malpractice is concerned, but it is just silly enough on the face of

it to attract media attention, which, after all, is the point for the health insurance interests and is always

the point for lawyers. We both know well that medical malpractice refers to damage caused by negligent

behavior, and that only if residual damage can be demonstrated is it a matter for the legal system. Clearly,

Nancy Mackintosh had not sustained the kind of permanent harm that would hold up in court. But I also

know that the strong evidence countering psychotherapy will ensure high profile in the media. I decided to

take it on, provided I receive my usual fee, and also provided that I am free about how I present it. The

target is a profession that did not prepare Dr. Young to deal with my clients problem. But it was also true

that Young erred in promising to help when he should have known that he was unprepared. The case will

hinge on misrepresentation, and victory will come from attendant publicity, whatever the judge decides.

At the trial, Pervis stated the accusation as follows:

My client, Nancy Mackintosh, has been a victim of Dr. Youngs state of passionate yearning thatnot only erased his ability to help her, but, in fact, brought about the identical problem for which she hadsought help in the first place. Dr. Young claimed not only that he could help her with that specific problem,

but also that his methods were especially suitable for such problems. We contend that this wasmisrepresentation. Here was a professional, fully sanctioned and certified by his profession and by thecommunity, who was acting in a manner contrary to what would be professionally appropriate. It is mycontention that he misrepresented his ability to aid my client in pursuit of her clear objective.

Pervis was aware that he was fudging. He knew that Young acted within the boundaries of what wasconsidered ethical by his profession. But his promise to help Ms. Mackintosh could not be justified. Thatwas where his real guilt lay.

Young was also guilty of failing to recognize the significance of the Browne findings. Had he doneso, he might have recognized his own condition for what it was and acted more appropriately. Pervisadmitted that, in this, Dr. Peter Young did not differ from most of his colleagues, and had no troubleconceding that Young had high moral standards, that he was conscientious, and that he believed that he wasacting in the best interests of his patient. That was not the point. Pervis contended that there were solidgrounds for seeking retribution for emotional and other damages suffered by his client as the result ofiatrogenic treatment that should not have occurred.

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Despite his honorable intentions, Pervis maintained, Youngs actions were both inappropriate tothe situation and injurious to his client. Furthermore, in stating that he understood what he did notunderstand, and that he could help what he should have known he could not help, he misrepresentedhimself and his abilities to his prospective client.

Although the main objective of those who were paying for the trial, and for the media hype, was notto sue a practitioner, but to publicly discredit his discipline, Pervis had wondered whether, when Nancysrole changed from client to investigative reporter, the legal situation may also have changed. He searched,

but he found no relevant precedent in the books. In point of fact, Pervis motive was not identical with thatof the health insurance companies. He didnt like the way psychotherapy operated. It presented a fictitiousface to the public. A case like this, he thought, if the media handled it well enough, would not damnpsychotherapy, but would redefine it in a way that would make it more honest about what it is. Like DonnaPayne, whose website he consulted, Pervis saw that counseling was a much-needed service closely related tohealth. He was sure that insurance would eventually be forced to cover counseling about how to carry out amedical regime, dealing with complaints, or providing instruction in self-management strategies. There wereforms of counseling that could, Pervis believed, reasonably be considered an aspect of medical treatment.His target was not counseling; it was the so-called psychodynamic therapy aimed primarily at bringing theunconscious to consciousness.

When Price mentioned to Ed Pervis that Young had fired Wilson because he was unwilling to

subject Nancy Mackintosh to degradation, Pervis said, Good for the good Dr. Young. I know Leland; weused to play squash together, about ten years ago. Hes an old-fashioned, misogynist moralist.

In his article, Price wrote that Attorney Pervis had approached the Young case warily. The messagewas in the details, and they certainly piled up. Before it was over, the lid was blown. Of course the explosionof public attention only occurred because of the financial support given by insurance interests. Although

Price was not offered, and did not receive, any payment for his articles other than his usual Ragtagsalary,other media people received money under the table for their efforts. Money buys. Neither Pervis nor thehealth insurance people cared whether Young was found innocent or guilty, as long as all of psychologysdirty linen would be exposed. And there was dirty linen there. Pervis knew it was a gamble to play to theworld that way, instead of the relative privacy of the normal courtroom, but he had become convinced thatpsychotherapy could be dangerous and that the public had allowed itself to be misinformed. Pervis had won

fame and fortune through other highly publicized cases. His motive in the Young case, he told Price, was toact in the public interest.

During the trial, both sides lined up a powerful docket of witnesses. Many of them came fromwithin the field of psychology itself. For example, there was past President of the American PsychologicalAssociation, Martin Seligman. Seligman told Price that he had not wanted any more publicity than it wasalready getting and, therefore, he had refused, at first, to testify. But as the press coverage mounted, herealized that since the story was getting so much public attention that was damaging to the image of theprofession, he decided that it was his duty to answer the critics.

In his testimony in support for Young, Dr. Seligman described the Consumer Reports study atlength, from which he had drawn the conclusion that, although no specific modality of psychotherapy didbetter than any other for any disorder, patients benefited very substantially from psychotherapy. He

pointed out the many cases in which well-controlled efficacy studies found a difference between some formof psychotherapy and no therapy. He had also decided that expensive, highly controlled studies were not, in

fact, the only, or even the best, way to measure the effectiveness of psychotherapy. The Consumer Reportsmethod, in which patients and former patients evaluated their therapy by anonymous questionnaire, was,Seligman believed, a superior measure of the real effect of psychotherapy. The conclusion, Youngsattorney, Nigel Ward, got him to say, was that a well-credentialed practitioner, such as Dr. Young, actedappropriately. Seligmans case for psychotherapy was strong enough, but he didnt really help Young verymuch, in the judges mind, because he was only saying that anything a professional did, unless it wasexplicitly contrary to ethical principles, was acceptable.

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Also testifying in favor of psychotherapy, although not strongly supportive of Young, was the viewof Michael Lamport Commons, a psychologist at the Harvard Medical School. Commons insisted thatmedication plus psychotherapy, especially in cases of depression, was found to be better than medicationalone, a view reinforced by Lynn OConnor of the Wright Institute.

But Pervis placed in exhibit a statement by Benjamin Beit-Hallahmi, a psychologist at the Universityof Haifa, that expressed strong disagreement. In an email to the evolutionary psychology list, Beit-Hallahmiasserted that 99% of psychotherapy systems on the market today have not met any real test of effective-

ness.

Dr. Craig Welstein, another spokesperson from the psychotherapy profession, was adamant in hisdefense of Young. He said, We have strict rules about sexual relations with clients. Dr. Young did notbreak those rules. As he himself testified, his actions were entirely within our ethical guidelines. He hadmerely opened the door to having the client give expression to what he believed were repressed feelings. Hehad an entirely reasonable theory that Ms. Mackintoshs past relationships had been spoiled by repression,and, therefore, it was the repression that had to be worked through in the therapeutic relationship. Igathered from his testimony that he had considered his own feelings as irrelevant. He did not believe that hewas acting on them, but rather that he was trying to achieve open expression of feeling. It was a matter ofdealing with what the patient was not able to look at, and yet was the force behind her problems in sexualrelationships. I fully support Dr. Young.

Price felt that the testimony by Dr. Charles Cornwallis, Peters mentor, whom Peter had consultedprior to making his confession of love to his patient, was especially important in bringing out moral com-plexities. Cornwallis testified that he had listened carefully to Peters argument and had found it to belogical. When he suggested the possibility that Ms. Mackintosh might not in fact feel the way Peter thoughtshe felt, Peter had countered that twenty years of clinical experience had made him expert in recognizing themeaning behind subtle overt action, even such actions as direction of gaze, angle of incline of the head, andgeneral bodily orientation. Cornwallis found it hard to argue with that. Dr. Young had, after all, written amoderately well-received book on clinical intuition. Cornwallis believed that Peter had taken seriously every-thing he said, and, in keeping with his mentors advice, had decided on a plan that would be so tentative andnoncommittal, that he would be able to backtrack if his judgment of his patient was in error. Cornwallisemphasized in his testimony, and later to Price, that he had found Peter Young to be a professional of

outstanding quality and the highest moral purpose.Barry Allen. Ph.D., was a maverick therapist who combined hypnosis with a technique he called

finger arching, in which patients pressed specific parts of their bodies while discussing particular subjects.Although he was not called on to testify, in an interview he told Price that he differed from some of hiscolleagues in that, as far as he was concerned, the man had exceeded his authority and committed an actcontrary to the ethical guidelines of the profession. He therefore had no right to expect help from hiscolleagues.

In his opening statement, Nigel Ward said, My client, Dr. Peter Young, is innocent of any unpro-fessional behavior. No one has disagreed with this. He has not, you realize, so much as touched theplaintive. He cannot, therefore, be accused of a sex offense.

Pervis interrupted with, The defendant has not been accused of a sex offense. Let the record show

that clearly. Furthermore, Ms. Mackintosh asserts that he did touch her, albeit it was briefly and only on hershoulder.

Thank you, Ward replied. He continued:

My client has been accused, not of a literal sex offense, but of behaving in a manner that wasclaimed to have been injurious and not in keeping with the role he was expected to play and or the help hehad promised to give. We maintain that, on the contrary, Dr. Youngs behavior was entirely in keeping withhis role as he defines it and as his profession defines it. Whatever the effect of his behavior might havebeen, and however mistaken it may have been in this instance, it cannot be claimed to be unprofessionalwhen it has full backing and support of his colleagues.

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A surprising moment among many surprising moments in what Dick Price referred to as this weirdtrial came when Ed Pervis, Nancy Mackintoshs attorney, said he felt that Young should be found notguilty by reason of inadequacy of training that was beyond his control. In other words, while Youngsactions were the triggering incident, there was this larger issue.

In his final report, Price wrote:

It became difficult to tell whose side the witnesses were on. Both lawyers were attacking theprofession, not the professional. The difference was that Pervis was contending that Dr. Young was guiltybecause he should have known better; Ward was contending that Young was innocent because he had notdeviated from accepted practices of his discipline. To interested parties the stakes were high. The case wasbilled in the press as the one that would enable health insurance companies to avoid reimbursing patientsfor psychotherapy expenses, even when they had been recommended by a physician, and even when the

diagnosis given was listed in theDMS-IV.

To some, it was the case that would protect the public from a large scale scam. To others, it wouldprevent the public from receiving needed services. There was passion on both sides. Ward brought inseveral witnesses to testify that psychotherapy had been valuable to them, even lifesaving. It was said thatYoung was being used to destroy his profession.

Pamela Cushing was a former professor who, thirty years earlier had published the book, Patient,

Beware!, that made many of the same points that Nancy Mackintosh found concerning psychotherapy.Cushing had focused mainly on a critical analysis of psychodynamic psychotherapy from a scientificperspective. Ultimately, her opposition to the entrenched traditions of the time led to the end of her aca-demic career. Price called her a pioneer who was ahead of her time and who paid the price of thewhistleblower. During her interview with Price, she told the following story:

I recall well the first talk I ever gave on the subject of psychotherapy. It was before a colloquium atthe University of Atlanta. During the discussion period, several women expressed objection to my thesisthat psychotherapy was not founded on science and was demeaning toward women, which it certainly wasduring that pre-feminist era. I realized later that those in the audience who objected to my thesis were allpsychotherapy patients. Being analyzed did not then have the stigma that it later acquired.

As we walked from the lecture hall to the reception room after my talk, a woman faculty member

(whose name, unfortunately, has been lost to me) took my arm. She whispered that it was brave of me to saywhat I was saying and that she hoped I would not have trouble because of it. For years thereafter, I laughedwhen I told about the womans irrational concerns. I was cocky. It turns out that that very dear womanwho gave me a warning that I did not hear, was prophetic.

In the early days of arrogant Freudianism, those who criticized orthodoxy were branded aspsychologically disturbed, themselves. From my vantage in social psychology, I had assumed those dayswere over. However, eventually, my academic competitors branded me, behind my back, with such effec-tiveness that I had to leave the university. I should also point out that the status of women at that time wasnot what it is today, and that I was also condemned for my sympathies toward feminism.

But the point here is that, over the years, I have found much additional evidence that corroboratesthe conclusions I wrote about in that book. In essence, I denied the validity of the measures used to

determine effectiveness. A strong rope ties patients to therapists and to the talking cure process. A few yearsearlier, a similar punishment had been visited on a psychology researcher named McClosky who hadpublished a remarkable study, in which delinquent boys given psychotherapy were found in later years tohave committed more crimes or otherwise more intensely misbehaved than the control group of similaryoungsters who did not receive therapy. I recall a barrage of attacks against her and against her findings.

Dr. Cushing continued:

But I should also point out that my book, Patient, Beware!, received only one review in apsychological journal. Professor van Dauler of the University of Houston did not entirely disagree with mythesis, but he condemned me for, as he put it, throwing the baby out with the bathwater.

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Indeed, Dauler apart, Cushing informed Price that her book was respected in important sources. Itwas highly recommended in the review journal of the American Association for the Advancement ofScience, at the same time that an adjacent review of a book by a psychoanalyst was not recommended. Aliterary magazine editor agreed that psychotherapy is a dubious enterprise whose value is supported muchmore by faith than by evidence. That editor also anticipated, erroneously, that the book would bedevastating in its impact. Perhaps it was for some people. Another reviewer said that the facts Cushingpresented could not be denied. A distinguished social psychologist called it a book that counters the unsub-

stantiated pros of therapy with some of the documented cons, and past president of the of the AmericanPsychological Association Leona Tyler called it a service to all of us who are trying to make psychologyuseful to people.

Price was astonished. He said, Do you mean to tell me that your book, making the same points thatwitnesses in this case are making, and published over thirty years ago was highly praised by importantpeople, and yet, not only did your career suffer as a result, but your message failed to reach the public?

Its true. In fact, there were even more positive blurbs from important sources than those I havealready mentioned. The late Joseph Wolpe, Professor of Psychiatry, Temple University School of Medicinewrote that I had performed an important service in showing up the iniquities of so-called dynamicpsychotherapy. Other psychotherapy critics from within the profession, such as psychiatrist Thomas Szaszand psychotherapist Albert Ellis, made public statements of support. Barbara Seaman, feminist writer of

semi-scientific books, predicted that psychotherapy would change as rational voices like mine clarify thesexist assumptions on which much of it is based and that she hoped that every therapist and of courseevery patient reads this important book. Anthropologist and popular writer, Marvin Harris, wrote that

Patient, Beware! should be mandatory reading for anyone who is about to seek mental help for themselvesor their loved ones. Others called me a very fine scholar and even a creative spirit. Anne Rosenfeld,

senior editor of the magazine Psychology Today, said that she was impressed with my courage anddetermination, as well as my continuing spirit of scientific inquiry. I could go on.

But, Price said, it seems that your message received an enormous amount of support frompeople within the field. I dont understand how you could have been punished for writing it.

Part of the explanation was about money. WhenPatient, Beware! was first published, one of myclinical psychology colleagues expressed what I think was the most honest reaction. He said, Pamela, youllmake paupers of us all.

That certainly nailed it.

Yes, Cushing replied. It was honest. You know, my sympathy actually goes out to the clinicalpsychologists who roam the land selling conversation and assuming that they are doing good. Peter Youngis prototypical. He feels that he has been well-trained.

Like the Germans in World War II, Ward said.

There is a certain limited similarity, except that I believe that psychotherapists do not believe thatthey do harm to their clients. The only similarity is in the following of directives from immoral, or in thecase of psychotherapists, erroneous, sources.

With all the evidence in your book, as well as other books, I still find it hard to understand how the

field can maintain its prestige and standing in the academic and professional community, Price repeated.

Cushing continued:

Its like the drug war. Its a question of demand. People desperately want help to exist with thekinds of problems they face. It doesnt take much to get them to believe that psychotherapy will help.Courts, schools, and parents need to feel they have some solution to the problems posed by troublesomepeople. Thats why various government agencies bought clinical psychology services. Peter Young and theothers like him do not realize that they are in a field with clay feet. Nor does the fact that psychotherapy isunscientific mean that what happens in therapy sessions is necessarily without benefit. At the very least, theexistence of psychotherapy conducted by professionals with impressive degrees gives people some hope that

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there may be solutions to otherwise intractable problems. I dont even think it would be a good idea to closethem down completely.

Price said, I think Ive lost you. What do you recommend?

Cushing explained,

Psychotherapists need to change their image, to make it clear that they are not based in science.Whether a given patient in a given situation with a given therapists will in fact be helped is not predictable.

To remove the certification they now are awarded would automatically reduce their power to stigmatize.And, frankly, I dont think it would undermine what power they have to help. The problem is that too manypeople have vested interests. In my own, brief stint as a licensed psychologist, a parent was irate when Iwould not give his son a diagnosis that would enable him to be reimbursed by his insurance company formy fees. I tried to explain that it could send an untrue as well as damaging image of his son through hishealth, school, and perhaps, even employment, records. I said that it was not a label the boy deserved. Butthe father remained irate, and took his child to someone else who would do what he wanted.

The image that emerged in Dick Prices mind was that psychotherapy was a slippery and subjectivefield filled with good people trying their best to do good, to earn their fees, and to learn on the job.

Before concluding his series of articles, Price also consulted

Donna Payne, sister-in-law of the defendant and advocate offorms of talk treatment, which she distinguished from psychother-apy. Donnas position was that counseling could be useful, by pro-viding information, suggesting possible actions, and helping thosein need to evaluate the outcome of each possibility.

In the interview, Donna gave Price other reasons why solittle had been done to correct the faulty image of psychotherapy inthe public mind, and why few people had done what Cushing haddone, publish criticism openly. She said:

Almost everybody falls into one or another of thefollowing categories, none of which produce enough motivation to understand or to complain if they did

understand. First, most people are as ignorant of the truth as they are remote from the problem. Theyvaguely assume that there must be some value to psychotherapy, although they had never had any directinvolvement with it, personally. Furthermore, they have seen statements from mental health advocates thatsuggest that there is a pressing need for more, not less, help for the mentally ill. This is the position of mostmembers of the academic community. It was a view staunchly advocated by First Ladies and Senators whopushed for a parity bill that would end the differentiations that HMOs used to award much more supportto physical than to mental conditions. Most advocates of the bill had relatives who were mentally ill. Theyknew from first hand experience that schizophrenia, bipolar disorders, and depression were true illnesses inneed of medical care. On the other hand, as Professor John F. Kihlstrom has advised, parity should beearned by a mental-health industry when mental illness is rigorously diagnosed on the basis of underlyingpathology; when proposed new therapies are based on established scientific principles; when specific

treatments have been demonstrated to be effective for specific illnesses; and when practitioners routinelychoose the most cost-effective alternatives. Kihlstrom admits that progress toward such goals is beingmade, but slowly.

A second group with a favorable view of psychotherapy is people who know of a friend oracquaintance who had claimed to be helped, or who as, say a teacher or judge had, themselves, referredpeople to psychiatry through conventional channels. Or they might have had a neighbor who was a clinicalpsychologist and who seemed like a nice guy. In any case, even if there were some problems with thescientific basis of psychotherapy, they believe that some sort of service is needed to handle misfits.

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In other words, there are many people, perhaps most, who accepted the general view more or lessuncritically, as their acquaintance with psychotherapy was minimal, but not negative, Price volunteered.

Yes, Donna continued. And then there are also passionate advocates, the therapy addicts,sometimes derisively called lifers. These people cannot imagine life without psychotherapy, nor can theybelieve it is without value, at least for them. These are the last people who would want to criticize it.

There are also persons for whom therapy may have brought adverse consequences, but who hadmade large investments of time, money, and effort; they may be disinclined to admit that it had all been invain, or worse. They may rationalize that, although positive results were hard to see, things might have beenworse without it. Others might admit to themselves, and possibly confess to intimates, that therapy hadbeen damaging to them, yet they did not wish to criticize publicly a person to whom they had revealedintimate details and who held the power of diagnosis over their heads.

And, Price added, we shouldnt forget those hopelessly in love with their therapists. Love Twoagain.

Right, Donna agreed. And, as everybody knows, members of professions have an unspokengentlemans agreement that disinclines one from criticizing another.

Finally, of course, we mustnt forget the therapists, themselves, who may be aware of the weaknessin their field, but who enjoy the personal power, prestige, and money that comes with being a psychothera-

pist. In the face of all this, who would raise the issue?Who would, indeed! Only the do-gooder, it would seem, Price conceded.

Donnas contention, as something of an insider, was that the biggest obstacle to exposing the flawsinherent in the psychotherapy enterprise (and all its adjuncts, such as their assessment instruments) was theintricate network of associations and colleagueships among psychotherapists, businesses with vestedinterests, the courts, educational institutions, and other government agencies. Although they may not haveendorsed it fully, they use it in various ways in furtherance of their own goals.

In addition, Donna concluded, there are probably some instances of real help, although, in myopinion, it doesnt often bring help commensurate with the expense, time, dependency, and stigmatization.

In other words, Price asked, you dont really condemn it completely.

It depends on what it refers to. I suspect that much of what is called psychotherapy includeselements of what I call counseling. Lately, the professional journals make no real distinction, which is un-fortunate, because I think that a distinction needs to be made, even if for no other reason than to stem thestigmatizing that receiving psychotherapy brings. The problem lies, as we noted, with money. If theinsurance companies will pay only when there is a medical diagnosis, then the medical mystique willcontinue wielding its damaging effects on peoples reputations. On the other hand, counseling should, in myview, be paid for when it has medical value.

I dont understand, Price said. How can talk have medical value?

Many people need more than the kind of instructions physicians give if they are to carry outmedical treatment instructions.

You mean like making sure they take medications?

Yes. Also how they manage exercise and diet. These things bear directly on health.But cant psychotherapists do that?

Of course they can, they should, and sometimes they do. But the traditions of psychotherapy,derived from psychoanalysis, explicitly exclude giving the kind of advice and instruction that would beneeded. Instead, the training such as Peter Young received, is geared toward diagnosis and treatment ofconditions emanating from unconsciously driven pathology.

But thats absurd! Price exclaimed.

It really is, Donna agreed. I would like to see certain forms of counseling covered by healthinsurance companies, but not the so-called dynamic psychotherapy espoused by my brother-in-law, except,

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perhaps, in cases of mental illness in which it really helps. Unfortunately, research has not been able tofigure that one out clearly enough to be useful.

Tana Dineen was a vigorous critic of psychotherapy. In her book, Manufacturing Victims, firstpublished in 1998, she stressed the largely successful efforts of the psychotherapy industry to marketits various products. In an email to Pamela Cushing, Dineen admitted that she had not known of the olderwomans book, published three decades earlier than her own, a book that she considered not at all outdated.The fact was that the psychotherapy situation had not changed in certain basic ways. If Cushing had writtenher book 30 years later, some of the emphases would be different, but its basic message would be the same.

Cushing had responded to Dineen that It was both interesting and disturbing to think of thenumber of years which have gone by between the publication of my book and yours.

Although all motives are complex, Price believed Cushing when she said she saw writing of heroriginal book as a way to meet a moral obligation. She realized that no one else would write it. It was not herfield, but her research was extensive. She attended psychotherapy conventions where she witnessed first-hand how psychiatrists and clinical psychologists got themselves out of logical dilemmas of therapy thatfailed by placing blame on the patient.

In the long period between Cushing and Dineens books, there were many other critics, but they

tended to find fault with particular types of therapies or particular practitioners. Price found that Cushingand Dineen were among the very few to attack the enterprise at its core rather than merely blamingproblems on a small minority of miscreants. The ethics of the American Psychological Association were,like those of most professional societies, self-protective. In a proposed revision of ethical standards,suggestions were solicited from the membership. Cushings recommendation that records be open to clientswas patently ignored.

Many of those whom Price interviewed agreed that psychologys imitation of medicine was a majorproblem, but also that the time might be coming for the bubble to be burst. Price noted that even strong

advocates of psychotherapy, like Bruce Wampold, who asserted in his book, The Great Psychotherapy

Debate, that psychology should give up the ghost and stop trying to be medical. Former APA PresidentGeorge Albee had been sounding the same message for decades. Albee said that adoption of the medical

model places psychology in servitude under the yoke of another professions desires and restrictions.Psychiatrist J. Allan Hobson and journalist Jonathan Leonard, in Out of Its Mind: Psychiatry in Crisis,excoriated psychiatry by pointing out multiple problems in the current practice of psychiatry. They leveledtheir most acrimonious attack against clinical psychology for its essentially unscientific nature. They calledpsychology a refuge for intelligent people who are uncomfortable with hard science. David Smith,Director of the New England Institute, went even further. He wrote in an email to the evolutionarypsychology Internet list that psychotherapy is conservatively, 95% superstition. The recovered memorydebacle of the 1990s had also struck a serious blow to the image of psychotherapists as knowing andunbiased professionals. Furthermore, alternatives (effective medications, self-help groups, and laycounseling) developed in greater and greater profusion, to help with some of the things for which peoplemight otherwise have sought psychotherapy.

Price also quoted Harold Knight, the insurance company representative that Pervis had put on thestand. He directed Knight to explain the relationship between psychotherapy and his companys policies.The man was frank. He said, Because it makes a very large difference to our budget, we certainly do care.We do not deny a vested interest, an admitted preference toward finding convincing grounds for notincluding psychotherapy as a legitimate medical treatment. But the fact that we are motivated doesnt makeus wrong in our judgment. We looked at the relevant reports in the scientific literature and we cite the wordsof psychotherapists themselves as well as the conclusions of persons biased toward psychotherapy.Although there may be a role for come forms of counseling as an aspect of medical procedures, there is nobasis for considering psychotherapy to be a medical procedure.

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Pervis brought up the issue of the biological basis of Love Two, using Thelma Holloway, anevolutionary psychologist. His point, supported by Holloways testimony, was that Love Two was themotive behind Dr. Youngs action, a motive that Young himself neither understood nor recognized. Sheexplained that, in his book and other writings, the late psychologist, Alan Browne, had repeatedly empha-sized that Love Two was an automatic subjective reaction, but that behavior remained volitional, completelyunder the individuals control. That was why it was not possible to detect the condition with certainty,however one might suspect its existence in a particular individual. In fact, Browne insisted that many, if not

most, persons experiencing Love Two are able successfully to hide it from others. Holloway described thevariety of actions taken by people while in the state of Love Two ranging from shy silence to overt appeals.

She said, The first response by many evolutionary psychologists to Brownes thesis was that theLove Two idea doesnt fit the theories of evolutionary psychology because the individual, once caught in itsspell, has little ability to choose. It seemed not, therefore, to be adaptive that is, it did not function as apositive evolutionary force. It seemed to be an inhibitor of fecundity. These people dont want children;they want candlelight and wine. The whole thing seemed a foolish cultural invention. At least, that was theinitial, short-sighted, reaction to Brownes book and to Love Two theory.

But now, a virtual deluge of reports from scientific laboratories around the world are showing thatthe various emotional states are being associated with specific observable biochemical changes in the blood.

Antonio Damasio, in his book,Descartes Error, outlines the possible neurological and hormonal mecha-

nisms that appear to underlie romantic love. Anthropologist Helen Fisher had reported that specific parts ofthe brain were active when people looked at photographs of loved ones. Furthermore, Love Two obviouslypermits sane and reasonable decisions. Although major love researchers as well as ordinary folk havereferred to the state as a madness, they emphasized that observable behavior can range all over the place. Inthe future it might be possible to detect the condition independently of verbal reports, perhaps by a bloodtest, more likely through brain imaging. At present, since many people are successful in hiding it, neitheraction nor words are definitive. Furthermore, as far as evolution is concerned, not only is Love Two deepin the genes, it is a major force toward the development of monogamous unions that lead to families andinhibit sexually transmitted contagion.

A few of evolutionary anthropologists have enthusiastically embraced Brownes theory, althoughthe highly public Helen Fisher, does not include Love Two among types of love. She has made references to

Brownes work, but she considers Love Two as infatuation thereby failing to recognize its specificity, itslengthy endurance, or its ability to be hidden.

After the trial, an insurance company spokesperson issued the following statement:

Dr. Youngs style of psychotherapy should not be confused with counseling, which is

limited in scope, not necessarily revelatory on the clients part, and aimed at

specific goals; for example, to explain hospital proceedings and to hear complaints,

to improve study habits, or to persuade people to eat more healthful diets. With

medical costs rising, we dont need to waste money on unproven, wasteful, and

possibly dangerous treatment methods. Psychiatry, at least most of psychiatry

there are a few holdouts from the days when all psychiatry was Freudian ismedicalized. Psychiatrists are having considerable success in locating physiological

markers and in treating mental disorders with medication. Clinical psychology, on

the other hand, is largely limited to conversations and verbal exercises. We want to

see more money funneled into real treatments for real conditions.

Do you mean that health insurance companies will reimburse for counseling?

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And, Price persisted, he was certainly less at fault than when doctors take sexual advantage oftheir patients.

I agree with that, Pervis replied. He continued:

There have been documented cases of physicians taking sexual advantage of female, and even, insome cases, male, patients. Discovery was duly punished by revocation of license and even jail time. Theproblem with psychotherapy is that it is of a completely different order. It is fluid, unscientific, andessentially secret. A sexual encounter with a medical doctor is an encounter between persons with well-defined roles. The talking therapist, on the other hand, is privy to the most private aspects of the personslife, aspects unknown to any others. This alone places the therapist in a position of unusual personal power.It is common for patients and former patients of psychodynamic psychotherapy to be closed-mouthedabout it (contra Woody Allen). They are especially reluctant to criticize either the therapy or the therapist,no matter what happened in therapy, even where sex reared its head, as it was bound and determined to do,given the intimate, comfortable setting of the psychotherapy setting. It is a setting quite unlike the public,sterile and gloved atmosphere of the typical medical encounter. Therefore, I do not think there is basis forcomparing a highly structured and public set of interactions with the loose, secretive, personal, goings on inpsychodynamic psychotherapy.

In a conversation with Nigel Ward some years after Youngs trial, when they happened to meet at a socialgathering, Dr. Cornwallis, Peter Youngs mentor, said:

None of us accepted Love Two theory at that time, even though we faced it in one form oranother almost daily as a factor in the lives of our patients, even in our own lives. It was only afterconsiderable physiological data had been accumulated, that the attitude of the professionals shifted towardaccepting that Love Two was very much as Browne had described it. What had been interpreted as mentaldisorder came to be seen as a normal, common, distinct, and unvarying state that could exist apart fromother aspects of the personality in that before, after, and even largely during a Love Two episode, disordermight be entirely absent. By not understanding the nature of his condition, I have to admit that I had ledpoor Peter astray. But, at the time, I reflected the official view of the profession. In retrospect, of course, Ishould have listened harder to what Young was saying. But in my own defense and in defense of the

profession, Brownes thesis had not been presented in a peer-reviewed journal, and therefore there was noobligation to take it seriously.

During Prices interview, Youngs attorney, Nigel Ward, contended that Young was both innocentand nave, more victim than blameworthy.

But of whom was he a victim? Price asked. Not his patient, who was sincere, trusting, andentirely honest, at least at first. Eventually, both Youngs behavior and what her research had uncoveredconvinced Ms. Mackintosh that the whole business was smoke and mirrors, and that Dr. Young had indeedfallen into a state of limited volition and disturbed perception.

Thats true, Ward agreed. Therefore, Mackintosh had three choices. She could have quit. Maybeif she had it to do over again thats what she would do. Her second alternative was to disbelieve the criticsand have greater trust that Young was, in fact, doing the right thing, the thing that would help her in the

end. She tried that, but the accumulated evidence her research weighed increasingly against that route. Andthere was also what she perceived as his nonverbal, body cues. Finally, she could have chosen to continue ashonestly as possible, but with the additional intention of getting a story about the field of psychotherapy forwhich her experience with Young was a valuable resource, since he was following the standard proceduresof his profession. She did not intend to write about him, specifically, but about psychotherapy, using herpersonal experience only as background. That, of course, is what she eventually did.

In his final article, Price wrote:

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If I were starting out today, Id persist in my original intention to complete amedical education, as Ruth wanted me to do. No one can say that my becoming aclinical psychologist instead of the more powerful, and, today much more powerful,psychiatrist was her fault. But back then it seemed a long and tedious route to achievewhat I saw as the same goal, that of becoming a psychotherapist. But the disciplines ofpsychiatry and psychology have diverged. Psychiatry has become almost totallymedicalized. There is even a resurgence of interest in psychosurgery. One psychiatrist ispursuing interest in schizophrenia as a viral infection. Another sees autism as genetic.Others are bringing Darwin in and claiming that the best way to understand mentaldysfunction is to look for its evolutionary advantages. It doesnt help psychotherapysimage that the major mental illnesses are generally believed to be untreatable by talkmethods. Although many surveys report psychotherapy to be helpful when used along

with medications, some find medications alone to do the job.Actually, talking therapy for schizophrenia was abandoned as long ago as Freud,

himself. Thats nothing new. Over the years, I have treated a number of patients Iguess I should call them clients suffering from the effects of having a family memberdiagnosed as schizophrenic. Several of them were referred to me by psychiatrists. Iunderstand that referral from psychiatrists, who are medical doctors, to psychologists,who are not medically trained, are common.

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