Placebo insight: the rationality of insight-oriented psychotherapy.

It is widely believed that the insight-oriented psychotherapies provide their clients with valid methods of self-exploration that lead to bona fide self-knowledge. It also is widely believed that clients' insights must be true in order to be therapeutically effective. Both these claims are implausible. I argue that because clients face significant epistemic pressures in the therapeutic encounter, the insight-oriented psychotherapies are highly susceptible to generating placebo insights, that is, illusions, deceptions, and adaptive self-misunderstandings that convincingly mimic veridical insight but have no genuine explanatory power. The insight-oriented psychotherapies also are highly susceptible to generating therapeutic artefacts that appear to confirm the insights acquired by clients. The powerful treatment methods to which clients are subjected generate some of the very psychological and behavioral facts that clients claim to "discover" in their explorations. This impugns the scientific status of the insight-oriented psychotherapies.