Dr Caroline Leaf – Inside Out and Back-to-Front

Dr Caroline Leaf, communication pathologist and self-titled cognitive neuroscientist, put this up on her social media pages this morning:

“Never feel bad for being sad. Emotions should not be kept inside because that will only make things worse. Talk to someone, cry, scream… whatever helps you feel better. One of my favorite movies is Inside Out because it really highlights the importance of letting yourself feel sad as part of the healing process. I really encourage all of you to not keep emotions bottled up. Let it out!”

Inside Out is one of my favourite movies too.  It is a rich layering of some complex psychology, told through a wonderfully relatable narrative that is beautifully told.

Inside Out is about the emotions that live inside us. Riley, an 11-year-old girl, moves from Minnesota to San Francisco, and the movie tells the story of her emotions as they deal with all of the conflicts and chaos that comes with adapting to such a big change.

The main characters are Joy and Sadness, which share “headquarters” with Anger, Fear and Disgust.  Each character has its own role to play, which Joy, as the main narrator of the movie, explains:

“That’s Fear.  He’s really good at keeping Riley safe.”
“This is Disgust. She basically keeps Riley from being poisoned, physically and socially.”
“That’s Anger. He … cares very deeply about things being fair.”

And Sadness?  “And you’ve met Sadness.  She … well, she … I’m not actually sure what she does …”

Dr Leaf explained that Inside Out, “… really highlights the importance of letting yourself feel sad as part of the healing process.”

Well, that’s one way of putting it, but Inside Out is actually much much deeper.  The story of Inside Out demonstrates that all of our emotions are needed in order to be a healthy human being.

Joy thinks of herself as the primary emotion, and does her best to keep Sadness away from the control panel.  Over the arc of the story, Joy learns that Riley needs Sadness too – that some problems can’t be solved with distraction or a pop-psychology pep-talk and positive attitude.

By the end of the movie, Joy allows Sadness to take over, helping Riley to process all of the things she had been struggling with after the major life change of her move to San Francisco.

This is what Dr Leaf was referring to, I think.  Yes, sadness is part of healing from any major life change including grief.

What Dr Leaf didn’t discuss was the role of the other emotions in Riley’s life.  Yes, Joy and Sadness are important, but the movie demonstrated all the way through that Fear, Anger and Disgust were all just as important, and the end of the movie showed that Riley’s core memories, which each formed a different aspect of her personality, were various combinations of all of the emotions.

But that’s not what Dr Leaf teaches.  For decades, her teaching has been back-to-front, claiming that emotions like anger and fear are toxic, and that toxic emotions cause damage to your brain and damage to your health.  She tells her followers not to think toxic thoughts or to have toxic emotions, but to take control of your thought life.

“Toxic thoughts are thoughts that trigger negative and anxious emotions, which produce biochemicals that cause the body stress.” [1] (p19)

“Hostility and rage are at the top of the list of toxic emotions; they can produce real physiological reactions in the body and cause serious mental and physical illness.” [1] (p30)

“There are two groups of emotions that are polar opposites: positive, faith-based emotions and negative, fear-based emotions. Each has its own set of molecules and performs as spiritual forces with chemical and electrical representation in the body. Faith-based emotions are love, joy, peace, happiness, kindness, gentleness, self-control, forgiveness and patience.  These produce good attitudes and thoughts.  Fear-based emotions include hate, anxiety, anger, hostility, resentment, frustration, impatience and irritation. These produce toxic attitudes and create a chemical reaction in the body that can alter behavior.” http://tkr-onfire4him.blogspot.com.au/2009/01/controlling-toxic-thoughts-and-emotions.html

“When you think a toxic thought, or make a bad choice, or you hang on to anything that is negative—anger, bitterness, hurt, irritation, or frustration—it impacts the production of those chemicals.”
“Through an uncontrolled thought life, we create the conditions for illness; we make ourselves sick! Research shows that fear, all on its own, triggers more than 1,400 known physical and chemical responses and activates more than 30 different hormones. There are INTELLECTUAL and MEDICAL reasons to FORGIVE! Toxic waste generated by toxic thoughts causes the following illnesses: diabetes, cancer, asthma, skin problems and allergies to name just a few. Consciously control your thought life and start to detox your brain!” https://drleaf.com/about/toxic-thoughts/

So it’s really interesting to see Dr Leaf discuss a movie that promotes the exact opposite of her teaching.  Perhaps she’s finally coming around to what real neuroscientists and researchers have been saying for ages, that “adaptive coping does not rely exclusively on positive emotions nor on constant dampening of an emotional reaction … Adaptive coping profits from flexible access to a range of genuine emotions as well as the ongoing cooperation of emotions with other components of the action system.” [2]

If Dr Leaf is finally coming around to real science, then that’s great, but she can’t have it both ways … she can’t promote expressing your emotions on one hand and then suppressing them on the other.  If she wants to come back to the fold of real science, then she’s going to have to renounce her previous teaching, and take it down from her website.  Otherwise it ends up being conflicting and hypocritical as well as being downright confusing.

So, Dr Leaf, you’re welcome to use movies like Inside Out to illustrate good psychological principles, but if you want credibility, you should work on some consistency.

References
[1]       Leaf CM. Switch On Your Brain : The Key to Peak Happiness, Thinking, and Health. Grand Rapids, Michigan: Baker Books, 2013.
[2]       Skinner EA, Zimmer-Gembeck MJ. The development of coping. Annual review of psychology 2007;58:119-44.

Advertisements

Dr Caroline Leaf, Testimonials, and Levels of Evidence

ScreenshotDrLeafTestimonial

It’s nice to be appreciated.

Gratitude is a wonderful thing. The Bible encourages it (1 Thessalonians 5:18), and psychology has detailed why. Gratitude increases happiness and life satisfaction, while tending to decrease depressive symptoms [1]. And it’s not just good for the giver, but also the receiver. I always appreciate it when my patients thank me for helping them. Genuine gratitude makes you feel good inside.

Dr Caroline Leaf, Communication Pathologist and self-titled Cognitive Neuroscientist, must be positively glowing right now. She has been getting a lot of positive feedback from her fan base of late, and she has decided to share it with the world via her social media feeds.

I’m sincerely happy for those people who feel they have been helped by Dr Leaf’s work. I remember my darkest days, feeling far from God and unable to find my way out of the emotional black hole of depression. It’s always so good to hear that others are finding their way out too.

While I’m happy for those who are sharing their stories to Dr Leaf, I can’t say I feel the same for Dr Leaf herself. It’s excellent that people are sharing their stories with her privately but publishing them is another matter. At best, it’s ethically delicate.

The testimonies are likely to be from people recovering from a psychological or emotional challenge, which carries an ongoing level of vulnerability. Even if Dr Leaf has their consent to publish their stories, sharing their problems with the world can still cause or contribute to psychological damage. Without knowing their whole story, Dr Leaf has no way of judging whom she may or may not harm.

It’s also a bit disingenuous. By publishing a series of testimonials, Dr Leaf is essentially self-promoting. It’s one thing for a supporter to spontaneously offer her praise in a Facebook or blog comment. But Dr Leaf specifically asked for her followers to send in their testimonies so she could publish them.

Screen Shot 2014-08-03 at 12.12.25 amScreen Shot 2014-08-03 at 3.05.21 am

Soliciting testimonials to republish is an old advertising trick. According to the Market Science Institute, “Testimonial solicitations – in which firms solicit consumers’ personal endorsements of a product or service – represent a popular marketing practice. Testimonials are thought to offer several benefits to firms, among them that participating consumers may strengthen their positive attitudes toward a brand, through the act of writing testimonials.” [2]

Testimonials are very good as a marketing tool. Who can argue with a person who says that Dr Leaf helped turn their life around? Saying anything negative just makes you sound like a cynical old boot.

And that’s the real problem, because while publishing a whole bunch of positive stories is good for marketing, it makes it very hard for those who had a genuinely bad experience to say anything. No one wants to listen to those people whom Dr Leaf has confused or mislead – it makes for terrible PR. Those people feel devalued, and sometimes worse, because it seems like everyone else had a good result from Dr Leaf’s teaching, except them.

Testimonials also make for very poor scientific evidence. Indeed, testimonials are considered the lowest form of scientific evidence [3]. It’s all very well and good for a bunch of people to share their positive experiences, but as life changing as the experience may have been, they are not evidence of the effectiveness of Dr Leaf’s teaching. Without specific, well-designed research, no one can say if the testimonials Dr Leaf is publishing are the norm. Recent research demonstrates that self-help literature for depression may not have any benefit over a placebo treatment [4]. So it may be that any improvement attributed to Dr Leaf’s teaching was actually the placebo effect. Dr Leaf can list testimonials until she’s blue in the face, but that doesn’t prove that her work is scientific or therapeutic.

I’m sure would say that she’s asking for testimonies so that she can share the joy of others with her followers, or seek to give glory to God, or something like that. And perhaps she is. I’m not sure how she reconciles that with Jesus words, “Be careful not to practise your righteousness in front of others to be seen by them. If you do, you will have no reward from your Father in heaven.” (Matthew 6:1) But that’s for her own personal consideration.

Whatever her intentions, the soliciting and publishing of personal testimonials from potentially vulnerable people is ethically delicate. I think she’d be better to step away from publishing these testimonials.

And for her readers and followers, the testimonials need to be seen for what they are: just individual stories. Sure, we should rejoice with those who are rejoicing (Romans 12:15), and so good for those who feel Dr Leaf has helped them. But they do not constitute evidence for the therapeutic efficacy or scientific integrity of the work of Dr Leaf.

References

  1. Toepfer, S., et al., Letters of Gratitude: Further Evidence for Author Benefits. Journal of Happiness Studies, 2012. 13(1): 187-201 doi: 10.1007/s10902-011-9257-7
  2. Marketing Science Institute. Consumer Testimonials as Self-Generated Advertisements: Evaluative Reconstruction Following Product Usage. [cited 2014, Aug 3]; Available from: http://www.msi.org/reports/consumer-testimonials-as-self-generated-advertisements-evaluative-reconstru/.
  3. Fowler, G., Evidence-based practice: Tools and techniques. Systems, settings, people: Workforce development challenges for the alcohol and other drugs field, 2001: 93-107
  4. Moldovan, R., et al., Cognitive bibliotherapy for mild depressive symptomatology: randomized clinical trial of efficacy and mechanisms of change. Clinical psychology & psychotherapy, 2013. 20(6): 482-93