Attachment to Theories

It is human nature to concoct theories in attempt to explain various phenomenon. As human beings, we have the capacity to problem-solve, to think critically and creatively about issues which impact us. For centuries, people have constructed theories as a means of “making sense” of things.

The need to create theories arises most often when the reason or cause of an event or circumstance is not readily apparent. For example, in ancient Greek mythology, the god Apollo rode his chariot across the sky every day, carrying the sun from east to west. Now we have modern science to explain the earth’s rotation on its axis every 24 hours, thus creating the appearance of the sun moving overhead from east to west, so the myth of Apollo is no longer necessary.

In modern times, science has replaced mythology and theory as our means of understanding various phenomena. While modern science has helped us understand many phenomenon, we still do not know what happens to us after death. This explains the popularity of major world religions which offer theories to answer these questions, such as heaven in Christianity or reincarnation in Hinduism.

In contrast to physics, chemistry, and biology, which have existed for millennia, psychology is a relatively new science. Relatively little is known about the causes of, and effective treatments for, mental illnesses. Therefore, numerous psychological theories have been proposed over the past century in attempt to explain psychological disorders. For example, in the 1950’s mental health professionals believed that autism and schizophrenia were caused by emotionally frigid “refrigerator mothers.”

With the advent of better science in recent decades, we have learned that parenting style plays no role whatsoever in the development of autism nor schizophrenia. While the precise causes of these brain disorders are unknown, we do know that autism and schizophrenia are neuro-biological disorders with strong heritability components, and that the patient’s parents can be extraordinarily valuable resources in treatment if they are given the right professional support.

While our current understanding of mental illness is in its infancy, recent scientific research has shed some light on factors that influence the development of mental illnesses. We also have some scientific data demonstrating that certain types of treatment are more effective than others for certain populations. In light of our current understanding of the etiology and effective treatment of mental illness, I am profoundly disappointed when I read about well-meaning but misinformed psychologists who cling to antiquated theories of mental illness and practice antiquated treatments.

For example, psychologist and author Judy Scheel, Ph.D., LICSW, believes that eating disorders are rooted in unhealthy or disrupted attachments to parents. In her recent Psychology Today blog post, she writes:

“For many individuals, eating disorders are attempts to fix externally what is internally vulnerable in an individual. Yet the cause of an eating disorder can often be traced back to attachment patterns that are weak or failing in childhood, which leave someone vulnerable to a whole host of self-esteem, self-worth and relationship issues later in life.”

This theory has a familiar odor. It reeks of refrigerator mothers, castration anxiety, and unconscious conflicts. In 1950, this was all we had. But now, in 2011, we know so much more.

Why do some psychologists cling to antiquated theories which have been disproven? Similarly, one may ask why many people cling to the theory of creationism when we have solid scientific evidence to support evolution. For some people, the notion that “we came from monkeys” is insulting and offensive and clashes with their existing belief system. The story of creationism is a foundation of Judeo-Christian religions, and (at least in its literal interpretation) is incongruent with Darwin’s theory of evolution.

The same is true with psychological theories. Many people who have been trained in psychodynamic or relational approaches feel that the new science runs counter to everything they have been taught and undermines the type of treatment they practice. They cling to their theories and defend them with religious fervor. The new science threatens their religion.

The problem here is that psychology is not a religion; it is a science. In the United States, we all enjoy freedom of religion – the freedom to believe whatever we wish and practice any religion we choose without persecution. We should not have freedom of science. As experts in the field of psychology with doctoral-level degrees, we should not have the freedom to write and publish whatever we happen to believe, and practice whatever method of treatment we wish, without accountability.

I was a graduate student relatively recently (2001 – 2008), and I was taught many things in my training that I no longer believe to be accurate. This is not a failure of my training; this is a reality of an evolving science. New developments occur in medicine all the time, and physicians who have been in practice for 20 years have had to learn and re-learn new ways of practicing as the science of medicine has evolved. This is expected. It is taken for granted by most patients.

As psychologists, we have a responsibility to educate ourselves about the latest scientific developments in our field and utilize our expertise to help people in need. Clinging to unproven theories, in the face of new science, is irresponsible, lazy, and potentially harmful. When challenged on their ideas, many old-school psychologists will use phrases such as “everyone’s opinion is valuable” or “can’t we agree to disagree” or “there is no right way to treat eating disorders” or “I feel unsafe.”

Here is the problem – this is not group therapy. We cannot sit around and validate one another’s feelings and hold hands and sing Kumbaya. Yes, all people are equal, but all ideas are not equal. Some ideas are supported by reliable scientific evidence and others are not. There may not be one right way to treat eating disorders but there are many wrong ways, and there are methods and techniques which clearly work better than others for most people.

We must let go of unhealthy, dysfunctional attachments to old ideas. Clearly, these attachments to antiquated theories contribute to the development of unhelpful psychotherapy. Perhaps today’s unhelpful psychotherapy is an attempt to validate one’s early training.

5 Replies to “Attachment to Theories”

  1. great blog. i particularly like the kumbaya comment. it reminded me of the residential treatment my bulimic daughter received. my daughter is 22, living at home, and i find a void in the treatment of eating disorders for adult children. thanks for your insight.

  2. Thank you, Dr. Ravin, for this post that demonstrates your clear thinking and dedication to promoting and providing treatments proven to be the most effective available for eating disorders so far. I’m sure you will keep up-to-date on the research and new treatments as the years go by so that you will continue to do the best possible work for your patients.

  3. Dr. Ravin, you are a beacon of light in the darkness of superstition and magical thinking. Thank you for another illuminating post.

  4. There is no one size fits all for eating disorders – whether that is how it developed or the best approach for treatment. Eating disorder etiology is as unique as is the
    person who suffers with it. My book, and my life’s work, deal with helping
    families heal and patients recover. There is no shame or blame. My book, When Food is Family: A loving approach to heal eating disorders,
    finds ways in simple language, exercises and reflections to help families
    understand the emotional and relational underpinnings to eating disorders and attachment issues that may be present before the eating disorder developed or have emerged once the disorder has taken hold. Not all families will find themselves in my book, but many have. However the disorder emerged, relationships and families are affected when a loved one has an eating disorder.

    The causes of eating disorders are complex. We must consider all the possible contributing factors which include biological, genetic, environmental, cultural and
    relational. My book teaches families how to speak an emotional language, it helps families understand the metaphoric use of the eating disorder, it helps families learn to communicate and share in the responsibility of familial healing, it helps the person with the eating disorder take responsibility for her well being.
    We professionals need to be aware and committed to understanding all that is before us; this includes biological, genetic, environmental and relational issues to eating disorders. As we teach our patients about not having all or nothing thinking, we professionals must have the same responsibility and view the individual as a whole person.

    The work of Cynthia Bulik, Ph.D., is significant and her contributions are vital. This is not an either or conversation. Attachment issues do not equate with bad
    parenting. Nature and nurture – not nature or nurture.
    Teasing our one or two words without context is dangerous. I encourage you to read the wonderful work of Daniel Siegel, MD. I am extremely grateful for the opportunity to dialogue about this very important subject and trust that we shall all remain open minded, balanced, respectful and thoughtful. Judy Scheel

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