I'd like to use this thread to collect reports of adverse effects or concerns about The Work by Byron Katie as used in licensed psychotherapy, counseling and unlicensed/fraudulent practice. I realize that there are Byron Katie threads in the Religion section and LGAT/Human Potential, but I think that some of the concerns specific to psychotherapy may not be found by new readers browsing the forum if they are not also in this therapy section.

It would be appropriate to link to accounts in those threads related to psychotherapy from this thread.

Although I have been researching this topic for two weeks, I have found no direct evidence of double-blind, peer-reviewed research that demonstrates the effectiveness or the appropriateness of using The Work (AKA Inquiry Based Stress Reduction/IBSR for those professionals who don't feel comfortable saying they do "The Work" in therapy?) in psychotherapy. Yet Byron Katie International is an approved source of continuing education credits for many mental health professionals and there are astonishingly numerous anecdotal reports in this forum, online venues, and Byron Katie's books about the use of The Work in therapy and counseling.

Today I sent an email to the APA which hopefully will be the beginning of my involvement of advocating for a rational process of evaluating and applying (or not) Byron Katie's ideas to the treatment of mental disorders. I'm sure that is not surprising to veterans of this board, but it would probably be surprising to people who have been receiving this form of "treatment" in licensed practice, especially if the treatment isn't going well.

The letter follows (sent to the public policy division of the APA):
I have searched the American Psychology Association website and have been unable to find information about a directed process of self-inquiry that appears to be used in conjunction with or replacement of cognitive behavioral therapy by licensed mental health providers. The method is called The Work, developed by Byron Katie: www.thework.com

Recently I came across an article published by Anil Coumar and Ricardo Hidalgo of the University of Washington Student Mental Health Center describing how these two licensed mental health providers are using this untested method on vulnerable students at the State's expense: [www.clearlifesolutions.com]

Coumar refers to The Work on his University of Washington biography as Inquiry Based Stress Reduction.

I thought that if such a treatment were effective enough to be used by licensed mental health providers alongside or instead of cognitive behavioral therapy that there would be articles and research in the APA database, but I found none. Does the APA have a position statement on the utilization of The Work and/or Inquiry Based Stress Reduction (as developed by Byron Katie) in licensed mental health care for diagnosed mental disorders? If no such position currently exists, what is the process for requesting that the APA investigate this topic as a matter of public policy and patient advocacy?

Licensed therapists and counselors, please use your credentials and status as APA members to bring concerns about the lack of evidence of effectiveness and the potential for harm of The Work by Byron Katie/Byron Katie's Inquiry Based Stress Reduction to the attention of investigative news reporters, state attorneys general, and the American Psychological Association. Please also share your concerns and actions in this thread. This is especially helpful for vulnerable mental health patients searching the web to find out about "Byron Katie negative effects" "when The Work doesn't work" "byron katie the work harmful". The Byron Katie websites, published in many languages, and the websites of Byron Katie facilitators overwhelm search engines, leaving those unsettled with their experience with The Work (especially as facilitated by a licensed therapist or counselor) feeling alone, confused, and alienated.

Dr. Laura Markham is a Clinical Psychologist and Columbia University Ph.D. She is the only psychology credentialed professional who I have found that has made an attributed statement less than approving of Byron Katie's The Work and/or it's application toward trauma, child abuse, and neglect:

[www.ahaparenting.com]

She specifically addresses concerns about Byron Katie's use of The Work in potentially forcing psychological breakthroughs in a comment to a reader at the end of the article. Specifically I wanted to share these excerpts from Markham's comment:

"... I did not actually recommend Byron Katie's practice. Although I use similar wording for two of the questions (Can you prove that thought is true? Who would you be without it?) I very specifically do not recommend the next part of her process, which is about "turning it around." I think that part is designed to get people to take responsibility for their experience, which can be a useful exploration and can be empowering. However, it can also induce shame and guilt if it is forced on someone. In the case of trauma, as I mentioned, it can be a repeat victimization. So I would not recommend it to a lay audience without the support of an experienced therapist."

"I am not aware of any studies of either the Sedona Method or the Byron Katie method, but I urge you to distinguish between the basic questions she suggests, and her larger method that includes the turn-around. There is nothing wrong with her basic questions, in my view. There is something very wrong, and unsafe, about "forcing" someone to "make a psychological breakthrough" without adequate psychological support or under the pressure of "performing" in front of a group. "

I've saved this article (Become a more inspired parent by questioning your thoughts; dated March 18, 2010; Author Dr. Laura Markham) on my hard drive as I have noticed from previous posts on culteducation.com that criticism of Byron Katie tends to disappear once attention has been brought to it.

If you are unfamiliar with Byron Katie, Stephen Mitchell, The Work, Byron Katie International, The School for The Work, The Institute for The Work, and/or related Certified Facilitators of The Work, or The Work Foundation, Inc. this is a Byron Katie thread in Cults, Sects, and New Religious Movements: [http://forum.culteducation.com/read.php?12,12906]

The above thread has many contributions discussing the possible role of Neuro Linguistic Programming (NLP) and Hypnosis in the creation and marketing of the Byron Katie/The Work materials. There are also numerous participant reports related to attending Byron Katie/The Work facilitated workshops and seminars, as well as discussion of some specific Certified Facilitators of The Work.

This thread in Large Group Awareness Training, Human Potential: [http://forum.culteducation.com/read.php?4,9147] also has detailed reports from individuals exposed to Byron Katie/The Work workshops, seminars, websites, books, and audio/visual materials. (The link abbreviation may seem like a repeat- it is a different link than the one posted above)

While it may seem overprotective, I would caution people to not expose themselves to Byron Katie International published works if they are unfamiliar with NLP, hypnosis, and thought reform. There may be intentionally confusing, hypnotic, and repetitive elements of Byron Katie's prose and recorded statements that disarm the reader or listener unduly. Byron Katie's Wikipedia article as of this date contains absolutely no reference to concerns or criticisms about the safety or appropriateness of using The Work in psychotherapy and appears to be very similar to her literary biography.

Two articles have been published that look into Byron Katie's background somewhat:
Los Angeles Times; November 24, 2002; Adato: How a self-help guru is born [http://www.culteducation.com/reference/general/general853.html]*

The Noumenon Journal; October 23, 2001; Massad: An interview with Byron Katie [http://www.realization.org/page/doc1/doc107a.htm]

If you research this topic, please also beware of the many Byron Katie interviews available online that are simply opportunities for Byron Katie to explain The Work and engage interviewers in doing The Work. Interviews of this type usually include lengthy passages of Byron Katie responding to a very brief query from the interviewer such as, "Just what is The Work?" If her answer is somewhat confusing to the interviewer, Byron Katie suggests that the interviewer do The Work with her (sometimes in front of a live television or radio audience) in order to clear up any confusion. If The Work is just four questions and a turn-around, why is it so confusing to people and why does Byron Katie need to explain it over and over again, often using exactly the same words?

*I gave the link to this article from the culteducation.com archive because material including references to Byron Katie's past that have been published before 2006 tends to disappear. Please see Stephen Mitchell's discussion on the discontinuation of one of Byron Katie's earlier works: A Cry In The Desert in the book's amazon.com review section [http://www.amazon.com/review/R1YXFUPQ2UU5PF/ref=cm_cr_pr_viewpnt#R1YXFUPQ2UU5PF]. If the book contained factual errors, why was it published in 1996 by The Work Foundation, Inc. and then discontinued only after Stephen Mitchell became involved in the organization in 2000?

I filed a complaint about a potentially unlicensed mental health provider on October 12, 2010 with the Washington State Department of Health. This person calls themselves a family therapist/counselor in the State of Washington and uses Byron Katie's The Work as the basis for resolving internal stress during parenting conflicts but only has an expired registered counselor credential. Today I got the notice that the complaint was closed (I'm assuming without investigation?) due to my request for anonymity and a lack of alleged harm.

When I discovered that The Work was the basis for the "treatment" and that the provider was not legally a counselor in Washington State, I determined not to seek "services" from this person. So because I was wise enough to say no, the lack of harm apparently screened out my complaint. And because this individual is very connected within the field of *positive discipline/parenting*, my professional field as well, I asked to remain anonymous in communications, though I gave the Department of Health all of my contact information and even personal emails between myself and the provider. So that desire for self-protection doubly discounted the complaint.

I must wait perhaps 30 or more weeks for the public disclosure request I made to review the complaint file.

The provider I filed a complaint regarding is named Naomi Aldort: [www.naomialdort.com]

She somewhat suddenly disclaimed her Ph.D. and psychologist credential about two weeks ago. Claims and disclaims past and present are documented here: [mdcsurvivors.blogspot.com].

I did get the public disclosure request, initiated November 9, 2010 and fulfilled May 31, 2001. It took 29 weeks to process.

I didn't learn much from the request (I asked for the "readily available documents" to shorten my wait), except that Aldort had been notified by mail that an allegation of unprofessional conduct had been made, the complaint was closed without investigation, and the complaint/investigation could be renewed if new complaints were made or new information became available. Complainant identifying information is redacted from the documents under whistleblower protections.

Given the recent Ph.D. disclaim, it seems the documents that need to be reviewed are Aldort's original resumes and applications filed with the Washington State Department of Health as she was a registered counselor licensed through that governing body from 1994-2010. Aldort does not provide any documentation online regarding any of her credential claims, including the "not credible" Ph.D. she claims to have "acquired" from Wiltshires Universities (sic): [clarificationstatement.blogspot.com] and [clarificationstatement.blogspot.com]

The blogger sustainableFamilies at Austin Holistic Parenting On A Dime has written a few posts on Byron Katie style counseling:

Tuesday, January 25, 2011
The damage of Byron Katie style counseling for abuse
[austinholistic.blogspot.com]

Friday, January 8, 2010
More on Byron Katie
[austinholistic.blogspot.com]

Wednesday, November 4, 2009
Remember Colleen Conaway, Liz Neuman, Kirby Brown, and James Shore
[austinholistic.blogspot.com]

Sunday, November 1, 2009
More notes on Byron Katie.
[austinholistic.blogspot.com]

Saturday, October 31, 2009
Beware the Man or Woman who tells you they know the Will of God
[austinholistic.blogspot.com]

The gist of sustainableFamilies contributions:

"I am deeply concerned that any therapist would apply this approach to people who are in pain and have struggles with abusive situations, especially in childhood when it is understandable that we don't understand the dynamic of abusive situations.

She literally asked a victim of childhood sexual abuse to "turn her statement around" to say, "I abused him." When the victim agreed to take on that responsability, Byron Katie responded, "Now isn't that a more true statement?"

This is completely wrong. After having this discussion the person is considered cured and should never think about the abusive situation again or else they are abusing themselves by allowing the abusive situation to enter their thoughts. It's all so disturbing and it saddens me that I've seen her turn up as a speaker in places here in my city. Why do people follow this woman? Why do therapists decide to employ this in real therapy where people are often vulnerable and confused and looking for real guidance and support?"

On June 16, 2011, the following question was posted at AskMetaFilter by the user xarnop: [ask.metafilter.com] (excerpts presented here for brevity)

"Am I right to be concerned about "The Work", created by Byron Katie, being used it real therapy? How do I diminish the toll of three years of therapy that definately wasn't right for me?"

"I experienced severe PTSD after a traumatic abusive relationship and extreme loss 10 years ago. I went to a counselor that I really liked in many ways but there was a certain part of the counseling that seemed really off to me...
I.e. instead of thinking you were abused by someone else you would then say, "I abused myself" or "I abused the person I previously thought was abusing me."

"I find all of this rather disturbing honestly, and it concerns me that counselors would use these techniques as presented by Byron Katie with people who need to mourn devestating loss, or who are processing past abuse, or who have seen horrific events. On the one hand, I think it would be possible to take some of her methods and restructure them to fit into a healthy therapeutic approach, but left exactly as they are, I think the techniques are in themselves harmful to the human psyche."

"During the course of this "therapy" I was basically unable to talk about anything that happened in the abusive relationship I was in because I had to redifine it as not abusive or as me abusing myself and have no negative emotions or thoughts about it or I was considered to be harming myself. That's another thing-- if you have a engative emotion you are the one harming yourself. It is no such thing as pain other than people hurting themselves with negative thoughts.

So basically other than "Stop thinking about that relationship or you are harming yourself" there was no discussion of what happened in the abusive relationship.

It's been really hard for me to undo the toll this has taken on me. Cognitively I disagree with these methods but I still feel inhibited about ever speaking about anything I've ever been through because if I ever let myself think about it "I'm harming myself."

There are to date 27 response including several that suggest the original author report his/her experiences to the appropriate licensing board and/or at least to the counselor in question.

On June 4, 2010, Anil Coumar, Director of Student Mental Health at the University of Washington, presented the following training:

"Inquiry Based Stress Reduction: A Practical Approach to Mindful Living
A workshp for mental health professionals-six CE hours

Inquiry Based Stress Recuction (IBSR) is a new therapy approach useful with individual clients, couples or in group therapy settings. IBSR is a clinical adaptation of The Work of Byron Katie. In this introductory workshop, find out how to identify the underlying concepts that cause your clients' suffering. Learn to guide clients through an investigation of each stress-inducing concept using the Four Questions."

The Washington Adminstrative Code legally defines counseling and psychotherapy, but I am unable to find a legal definition for the stand alone term, "therapy"

(6) "Counseling" means employing any therapeutic techniques, including but not limited to social work, mental health counseling, marriage and family therapy, and hypnotherapy, for a fee that offer, assist or attempt to assist an individual or individuals in the amelioration or adjustment of mental, emotional, or behavioral problems, and includes therapeutic techniques to achieve sensitivity and awareness of self and others and the development of human potential. For the purposes of this chapter, nothing may be construed to imply that the practice of hypnotherapy is necessarily limited to counseling.

(11) "Psychotherapy" means the practice of counseling using diagnosis of mental disorders according to the fourth edition of the diagnostic and statistical manual of mental disorders, published in 1994, and the development of treatment plans for counseling based on diagnosis of mental disorders in accordance with established practice standards.


The Amercian Psychological Association describes therapy as "treatment for psychological problems." [www.apa.org]

I was under the impression that as of June 2010, The Work was decidely NOT therapy for reasons of legal liability regarding licensing and potential adverse outcomes,

"In 1999 the California Board of Psychology raised that issue after listening to a tape of Katie working with an incest survivor. Katie says the board wanted to know what would happen if she were hosting a session elsewhere and the woman subsequently had a breakdown. Katie argued that the woman's emotional state after the dialogue was her own responsibility, just as it had been before they met. Ultimately, with no finding that she was practicing psychotherapy, the investigation was dropped. As a matter of policy, the board would not comment for this story or release records." [www.culteducation.com]

This is today's report on the status of the Registered Trademark "Inquiry Based Stress Reduction"
"On Wednesday, February 25, 2009, a U.S. federal trademark registration was filed for INQUIRY-BASED STRESS REDUCTION by Byron Katie International, Inc., Ojai 93023. The USPTO has given the INQUIRY-BASED STRESS REDUCTION trademark serial number of 77677727. The current federal status of this trademark filing is ABANDONED-FAILURE TO RESPOND OR LATE RESPONSE. The correspondent listed for INQUIRY-BASED STRESS REDUCTION is Ellen W. Stiefler of Stiefler Law Group, P.C., 3525 Del Mar Heights Rd. #111, San Diego CA 92130-2122 . The INQUIRY-BASED STRESS REDUCTION trademark is filed in the category of Education and Entertainment Services . The description provided to the USPTO for INQUIRY-BASED STRESS REDUCTION is Educational services, namely, providing and conducting educational seminars, workshops, and classes in the field of stress management and dissemination of written and audio study and exercise materials in connection therewith." [www.trademarkia.com]

As of May 19, 2012, ClinicalTrials.gov, a service of the U.S. National Institutes of Health lists three clinical trials for Inquiry Based Stress Reduction (IBSR), all proposed in Israel from 2010-2011: [clinicaltrials.gov], but no study results are posted for any of the trials.

In two of the trials, severe psychiatric diagnoses (e.g., bipolar disorder) are listed under exclusion criteria: Pilot Clinical Trial (Phase II) of Inquiry-based Stress Reduction (IBSR) Program for Survivors of Breast Cancer (Nov 2010) [clinicaltrials.gov] & Trial of Inquiry Based Stress Reduction (IBSR) Program for BRCA1/2 Mutation Carriers (May 2011) [clinicaltrials.gov]

The methodogy for all three studies is the same, as is quoted here from the Trial of Inquiry-based Stress Reduction (IBSR) Program for Health Care Professionals [clinicaltrials.gov] (emphasis mine):

"Intervention:

Subjects will receive weekly 3.5 hour sessions conducted by two facilitators trained in IBSR and certified by BKI to conduct this intervention.
Class size will range from 12-16 participants.
All the sessions will be standardized and follow the training manual developed to maintain consistency in the program.
Subjects will receive a training manual and CD's to support home practice of various forms of inquiry practices.
The training manual will include weekly exercises, and program content related to the content identified below. In addition, the manual will include a weekly diary for recording homework practice activities.

The IBSR-BC program is a 12-week program adapted for consideration of BC survivors' health status. During the process, participants will be encouraged to identify and inquire about their stressful thoughts: regarding relationships with others, Beliefs that prevent them to promote their health, Judgments regarding their body, cancer related stressful thoughts, self judgments, and fear from cancer recurrence, death and suffering. This intervention provides for management of specific emotional/psychological symptoms (stress, anxiety, depression, fatigue, and fear of recurrence) and physical symptoms, such as pain and sleep and enables the participants to inquire and be relieved of their stressful thoughts, and emotions caused by these thoughts. Through the use of self-inquiry practices subjects are taught to increase awareness of their thoughts and feelings, to observe their emotional and physical responses during situations perceived by them as stressful, and allow their mind to return to its true, peaceful, creative nature. Through the process of self inquiry, subjects take an active role in investigating their stressful thoughts, and by this regulating their stress and managing symptoms and emotions, thus enabling them to cope better with the distress of having cancer.

Throughout the 12-week IBSR(BC) program, all subjects will be requested to formally meditate and perform self inquiry exercises alone or with a partner for a minimum of 15-45 min per day, 6 days per week; this time increases per week as participants becomes more experienced.

Daily practice will be recorded in a diary and IBSR worksheets each day. Indicators of IBSR (BC) 'compliance' will be established at prior to 70% attendance at the IBSR(BC) sessions and completion of 70% of the homework assigned based on a minimum of 15-45 min practiced each day. The total number of minutes/hours practiced over the 6-week program will also be assessed."

I am exceedingly interested in the materials used and participant results from this study and would greatly appreciate any links to supporting resources that readers are able to provide.

[www.haaretz.com]

Israeli hospital, teacher team up to reduce cancer-induced stress
High-school teacher Sandra Yosef-Hassidim joins Tel Aviv's Ichilov Hospital to employ Byron Katie's 'The Work' technique in a cutting-edge study.
By Alona Ferber | Feb.19, 2012 | 5:33 AM

The labor strikes that so often cripple the country may create unwelcome stress for many Israelis, but for Sandra Yosef-Hassidim, a teachers strike that swept the nation in 2008 provided an opportunity for transformation. Frustrated by a months-long work stoppage that seemed to yield few results, the high school teacher from Modi'in read "Loving What Is," a best-selling book that outlines a framework for dealing with stress and negative emotions.

"I really wasn't interested in spirituality at all. I had a kind of Dutch, European, matter-of-fact kind of thinking," the 44-year-old immigrant from the Netherlands recalled this week.

A friend had recommended the book years earlier, but it was only then that the once-cynical Sandra opened it up and "got really sucked into it."

Since then, Yosef-Hassidim, who immigrated to Israel in 1985, says she has successfully applied the book's teachings in her classrooms with 10th-, 11th- and 12th-graders to help students who are experiencing stress - for example, during exams. She has also run workshops for other teachers, utilizing training she first received in the method, known as "The Work," in Los Angeles.

This past year, while on sabbatical, Yosef-Hassidim assisted a revolutionary project run jointly by Ichilov Hospital in Tel Aviv, Tel Aviv University and Tel Hashomer hospital, to test the effect of The Work on breast cancer survivors and on carriers of the BRCA1 and BRCA2 breast cancer genes.

The essentials of The Work, pioneered by Byron Katie - who developed the method in the 1980s after a 10-year battle with depression and eating disorders - bears a number of hallmarks: It features four questions and three "turnarounds" that are applied to the stress-inducing thought in question. "But it's more than that. It's much deeper," says Yosef-Hassidim, who describes The Work as "an intellectual meditation" with cognitive elements and parallels to Zen Buddhism and Zen meditation.

"We are disturbed not by what happens to us, but by the way we think about what happens," she explains. "Once you start questioning your thoughts, they lose their grip on you." Practitioners of The Work question stress-inducing thoughts, and test them against reality in order to "Love what is," as the title of the bestseller suggests.

Like Yosef-Hassidim, the director of the research at Ichilov, Dr Shahar Lev Ari, is a facilitator of The Work himself, and has been familiar with the method since 2004. He says he saw the potential for using The Work as part of a holistic health-care approach when he saw practitioners questioning cancer-related thoughts with Katie on stage at her international workshops.

The project at Ichilov, says Dr. Lev Ari, is the first experiment to look at the effect of The Work on cancer survivors and cancer gene carriers, and the first time that The Work has ever been placed under scientific scrutiny. The research project was funded by Katie's foundation and other private donors.

The results of the project, which had a total of 96 volunteers at the outset and took over six months to complete, were unveiled at an event at Ichilov on Tuesday. They showed a significant improvement in sleep quality and the sense of family support among the gene carrier group, and improvements in a number of quality-of-life indicators for the survivors.

Katie, who is in Israel this week to run a three-day seminar attended by several thousand people, attended the ceremony, where she was greeted with an ovation by a full auditorium that included the women who participated in the study.

Lev Ari says he plans to continue the research next year and to include patients being treated for cancer in the research as well. "We are only at the beginning of the work," Lev Ari says. He also confirmed that Ichilov will begin offering a program using The Work on a regular basis as a service to BRCA1 and BRCA2 gene carriers and breast cancer survivors in early March. Participants will have to pay to participate.

The idea that "suffering is optional" was met with resistance at first by the women who volunteered for the research, says Yosef-Hassidim, but in the end participants underwent a "transformation."

Hani Sade, a 44-year-old participant in the cancer gene study, says the weekly sessions helped her cope with the fear related to carrying the gene, and she describes the project as "a huge gift."

"Talking about it makes me shudder," she says.

In three months, the participants, who took part in a three-and-a-half-hour group session every week, in addition to one individual session, went "from being frightened and closed" to being "open and willing to face whatever they have to face," says Yosef-Hassidim. The sessions, which included about 15 women at a time, were "intimate, and a "very profound experience," she says.

Yosef-Hassidim estimates that there are currently thousands of people using The Work in Israel, and adds that she is one of over a hundred members of a working group that meets every month. She also volunteers for a 24/7 free helpline hosted by Katie's website, which is designed for people "needing occasional assistance or support in doing The Work," according to the website.

The Work "is definitely spreading" in Israel, says Yosef-Hassidim, "and it is a very good thing for our country, because there is a lot of stress here."

In particular, she says she believes the method could help mend divisions in Israeli society. She has attended workshops in the past with both Arab and Jewish members, and among her plans is a project "to set up a workshop in co-facilitation with someone from the Arab sector and have a joint group of Arab and Jewish members."