[Editor’s note: Though limitations in WordPress force us to attribute this article solely to returning author Tomasz Witkowski, it was written and submitted by both Dr. Witkowski and his colleague Maciej Zatonski, whose books have been favorably reviewed by Harriet. Welcome back!]
It is currently estimated that at least one in four readers of this article will die of cancer. This rather simple statistic leads rational readers to consider such cause of their death as quite likely. As a result, some of us will make conscious efforts to follow certain lifestyle that could potentially minimize the above risk. The fact is that we are not able to influence the vast majority of known factors that contribute to our individual risks of developing cancer, not mentioning the causes that still remain unknown. Despite the progress made in medical oncology in the last two decades, many of us will receive a death sentence long before it will be actually carried out. Unlucky diagnosis of certain malignancies, or other currently untreatable and unmanageable conditions, can constitute such a sentence for many of us. In such moments, support that we receive from those that surround us is of exceptional importance. Some of us consider doctors to be oracles, and we can often be inclined to perceive capabilities of physicians as superhuman; at the right moment, a nurse can transform into an angel of hope.
In such life and death circumstances, psychologists – as people thought to be able to soothe the souls of the afflicted and fuel their hearts with positivity – become the bearers of hope for the sick, as well as their families. Many psychologists have dedicated their entire careers to helping people diagnosed with cancer. They have even developed a new field of expertise that deals with topics such as the links between cancer progression and psychological factors. This emerging discipline is called “psycho-oncology”. It is defined as an interdisciplinary field at the intersection of physical, psychological, social, and behavioral aspects of the cancer experience. It researches emotional reactions of patients at various stages of cancer progression, including emotional impact on patients’ families and on the medical personnel engaged with them. Psycho-oncological “knowledge” is applied to help patients in an appropriate manner depending on the treatment phase and/or stage of the disease. The main forms of aid are: psycho-education, support, attitude changing, and “debunking” of myths associated with cancer. This is achieved using methods and techniques applied in psychotherapy.
Although many prominent scholars practice and research psycho-oncology, the field is contaminated with suspicious pseudo-scientific constructs, claims made by self-appointed gurus, and fraudulent (as recently proven) research results coming from the most distinguished scientists.
Enter Hans Eysenck and Ronald Grossarth-Maticek
In May 2019 a report from an internal enquiry conducted by the King’s College London (KCL) was released. This report diplomatically labels 26 articles published by Professor Hans Jürgen Eysenck as “unsafe” (the list attached to the report contains only 25 articles). Eysenck was one of the most renowned and influential psychologists of all time. When he died in 1997, he was the most cited living psychologist and the third-most cited of all time, just behind Sigmund Freud and Jean Piaget. In the global rating of most cited scholars across all social sciences Eysenck ranked third, following only Sigmund Freud and Karl Marx. Up to this very day it is difficult to find a ranking where Eysenck does not hold one of the podium places.
The report published by the KCL committee scrutinised only articles from peer-reviewed journals that Eysenck co-authored with Ronald Grossarth-Maticek, and analysed data relevant to personality and physical health outcomes in conditions like cancer, cardiovascular diseases, their causes and methods of treatment. All of reviewed research results were assessed as “unsafe”. In their publications both authors claimed no causal connection between tobacco smoking and development of cancer or coronary heart disease, and attributed those outcomes to personality factors, as described by James Coyne in Science Based Medicine. In one of their research projects conducted among more than 3,000 people, Eysneck and Grossarth-Maticek have claimed that people with a “cancer-prone personality” were 121 times more likely to die of the disease than patients without such a disposition (38.5% vs 0.3% ).
The authors have also contributed personality factors to the risk of developing coronary heart disease. Their publications stated that subjects who were “heart-disease prone” died 27 times more often than people without such temperament. The cancer-prone personality was described as generally passive in the face of stress from external sources. Those who were heart disease-prone were unable to leave from an unsatisfactory situation by themselves, which in turn made them increasingly violent and hostile. In contrast, a “healthy” personality was autonomous, with a positive outlook on life and its challenges.
Those completely improbable results were quickly adapted by the psychological community to justify interventions that are, in best-case scenarios, ineffective. In the world of clinical medicine, oncologists are rarely familiar with all tools used by psychologists. Doctors assume that supplementary psychological services, often well embedded in hospitals, use methods of similar quality tested with similar scrutiny as the therapies found in mainstream medicine.
The greatest hits in the album of suspicious publications are articles where the authors “demonstrated” that they can effectively “prevent cancer and coronary heart disease in disease-prone probands”. In one of their projects, 600 “disease-prone probands” received a leaflet explaining how to make more autonomous decisions and how to take control over their destinies. This simple intervention resulted in one of the most spectacular findings in the history of medicine, psychology, and probably in the entire scientific literature. After over 13 years of observation, the group of 600 patients randomly assigned to this “bibliotherapy” (as it was called by the authors) had an overall mortality of 32% when compared to 82% among the 600 people who were not lucky enough to receive the leaflets. Surely those findings, published in 1991, must have revolutionised medical oncology…or at least cause a significant consternation.
It is difficult even to estimate the real costs of services provided by “psycho-oncologists” that have no validity nor clinical justification. To make things more difficult, those interventions are often mixed into a wider offering that includes more validated methods (like CBT for anxiety related to diagnosis of cancer). It is easy however, to imagine how it might cause unnecessary suffering to people diagnosed with a terminal condition, especially when patients are told that the disease is the result of who they are or what they believe in. The impact might be exacerbated once patients realise how difficult it might be to do anything about it. Common sense suggests that assigning blame for being diagnosed with cancer to patients’ convictions or beliefs does not feel therapeutic. And after the KCL report, we know why it feels like that: it’s simply not true.
Why has this stood unchallenged for so long?
Why are those made up and improbable results repeated, quoted, and implemented in hospitals around the world? Because they claim extraordinary results at virtually no cost (apart from hefty prices of experts involved in giving away ineffective leaflets). There might be another reason – a dependency created between a psychologist and a vulnerable patient, which later fuels the need for further interactions: a self-sustaining loop of demand for services designed to solve only the problems it created. Significant sums of money often follow the newly created, yet unnecessary, needs. Are there better ways to spend limited healthcare budgets? We leave the answer to the readers. One thing we know for sure – Eysenck appeared to have quite robust business intuitions, as we will show in later in the article.
Eysenck’s uneven research history
The report published by the King’s College London fuelled yet another stormy debate among academics. We are not dealing here with a case of a junior academic at the starting line of his scientific career, as in the 2013 case of Diedrik Stapel’s frauds. This time we are talking about one of the founding fathers of psychology, someone whose contribution to the field can only be matched by less than a dozen of titans of social sciences. But similarly, as in all other announcements of scandalous frauds in psychology, the scientists confronted with new facts appear to be perplexed. Are there any foundations for their confusion?
Eysenck built his academic credentials primarily around a dimensional model of personality that he authored. The model was based on factor-analytic summaries rooted deeply in our biological predispositions. This model withstood the test of time, mostly due to multiple research findings that validated his model’s predictive validity. Generations of psychologists “diagnosed” their patients using Eysenck’s personality questionnaires. Nowadays the model has been updated, but its core elements still form the basis of the so-called Big Five (the name given to the world’s most popular concept of personality). Eysenck played a crucial role in establishing the field of clinical psychology in the United Kingdom, relentlessly promoting novel, much more efficacious behavioural therapies, as opposed to traditional psychoanalytical approaches.
Eysenck’s fame however was densely intertwined with controversies, such as his surprising defense of Sir Cyril Burt – a discredited psychologist who falsified or entirely made up the majority of his research results, including the names of his non-existing co-authors. Eysenck could have been blinded by his loyalty to Burt, the first knighted psychologist for his contributions to science. After all, it was Burt, who as Eysenck’s long-standing mentor, helped him to jump in the deep end of the pool of social sciences.
However, we can’t play the loyalty card when we try to explain Eysenck’s quite peculiar beliefs in parapsychology and astrology. His convictions can be only described as naïve, since the parapsychological experiments that he often quoted to prove the existence of the paranormal were always flawed with obvious methodological infractions, and none of them were ever replicated. James Randi – the stage magician and famous sceptical thinker – has accurately noted that Eysenck was supporting and backing deceitful clairvoyants and fortune tellers, promoting them as authentic and never criticising, or even mentioning, the deceitful methods that they use. In 1977 Eysenck started to write an article in support of the absurd and wildly nonsensical Mars effect proposed by a French psychologist and astrologer Michel Gauquelin. The article was devoted to a purported statistical correlation between athletic eminence of the positioning of the planet Mars relative to the horizon at the time and place of birth.
Eysenck’s set of beliefs was largely ignored, probably in the same way we tolerate certain eccentric quirks of the senior people that we respect. Unfortunately, not all of that crankiness was harmless. The Psychology of Politics turned out to be a very controversial book. Eysenck suggested that political behaviours may be analysed in terms of two separate and independent dimensions: traditional distinctions between the left and the right, and how “tenderminded” or “toughminded” a person is. The research that formed the foundation for his book was widely criticised on a number of grounds, including emphasising that his findings could not be extrapolated to the entire British middle class, because his sample was formed primarily from far younger and better educated people. Furthermore, supporters of various political parties were unreliably recruited in inconsistent ways: communists were enrolled through party branches, fascists in non-specified ways, and supporters of other parties through questionnaires distributed by Eysenck’s students to their friends. He has later compared the answers from 250 middle-class supporters of the Liberal Party with 27 answers from liberal working-class representatives. As a cherry on the top of this methodological blunder, he rounded up the scores in a way that would support his hypotheses. Other, similar controversies could fill another few paragraphs.
However, the most destructive and infamous of his achievements was the publication of the book entitled The Causes and Effects of Smoking in 1980, where he condemned the already established causal relationship between tobacco smoking and lung cancer. His later cooperation with Ronald Grossarth-Maticek resulted in the publication of numerous articles that were recently assessed as “unsafe”. The irregularities uncovered during preparation of the KCL’s report appalled and shocked the global scientific community.
The first methodological cavils in the works of Grossarth-Maticek were raised as early as 1985 by David Gilbert in his letter directed to Hans Eysenck. What is even more remarkable is that Gilbert worked for the R.J. Reynolds Tobacco Company at the time when he pointed out his concerns to Eysenck. It wasn’t until late 1980s before more serious allegations were formed against Eysenck-Grossarth duo. In 1991 the Psychological Inquiry devoted an entire issue to the works of the two authors. Leading authorities in psycho-oncology and medical statistics described their concerns, concentrated mainly around two issues. The first related to the accuracy of the data due to the recruitment strategies, reliability of measurements, and other errors in data collection. Second was the lack of credibility of the results, which often showed unprecedented outcomes, unseen in other similarly conducted experiments. Their results did not fit in any meaningful way into then-current clinical knowledge or to up-to-date achievements and advances in aetiology of cancers and other medical conditions.
Those concerns were collected and presented jointly one more time in 1993 by the psychiatrists Anthony Pelosi and Louise Appleby from Priory Hospital in Glasgow. A few attempts to replicate Eysenck and Grossarth-Maticek experiments were also undertaken in 1996 and 1997. The replication attempts did not confirm the original findings.
Curiously enough, the fact that escaped the majority’s attention was that Grossarth-Maticek claimed his affiliation to King’s College, while never having actually worked there. He was employed at the University of Heidelberg. The Institute of Psychiatry at KCL employed only Eysenck.
Following the money…to cancer
Let’s take a closer look at Eysenck’s already-mentioned “business” intuitions. Suspicions raised with regard to accuracy and honesty of the research conducted by Eysenck were flagged not only by the scientific community. In 1996, The Independent published an article uncovering payments made by a clandestine American tobacco fund and other the largest tobacco manufacturers to Eysenck in excess of £800,000 (worth approximately $1.3 million USD at 1996 exchange rates). The secretive fund, known as Special Account Number 4, released millions of dollars to mostly American scientists who were carefully chosen by tobacco industry lawyers because their research results could be used to protect tobacco companies from claims raised by victims of tobacco-related lung cancers.
In his response to those revelations, Eysenck stated that he has never heard of the Special Account Number 4. He could not also recall from where the millions of British pounds for his research came. When asked directly about his opinion about his engagement with the tobacco industry lawyers in the process of selecting and screening academics to lead research projects, he responded briefly: “As long as somebody pays for the research, I don’t care who it is”. He also stated that it is the quality of the research that matters, not the funding source and later added that he had never used the above-mentioned funds. The documents uncovered during court trials revealed that Eysenck was one of the key beneficiaries of tobacco industry in Great Britain and that Special Account Number 4 granted him an additional special financial award for so called “consultations”. The medical consequences caused by defending the tobacco industry and denying the link between smoking and lung cancer are yet difficult to estimate. Lung cancer killed at least 1.5 million people in 2012 alone. As this condition is predominantly related to tobacco smoking, and usually develops over decades, there is no reliable way to estimate how much damage could have been caused by delaying the introduction of antismoking policies by even one year. It is also easy to imagine that some individuals could delay (or even completely abandon) the idea of quitting smoking when shown with leaflet that postulated that they have no or low risk of developing lung cancer, because their “healthy” personality.
Despite all these controversies, nobody took any actions to retract the research articles published by the Eysenck-Grossarth-Maticek duo. Apparently, allegations as described above are not sufficient to warrant any decisive actions amongst the scientific community – at least not when dealing with a legend. And it probably wouldn’t have led to anything if it wasn’t for Anthony Pelosi, who published an article in the Journal of Health Psychology in February 2019 calling out Eysenck’s case “one of the worst scientific scandals of all time”. As it turns out, it was not easy to publish his article. Pelosi had written his paper three years earlier upon receiving an invitation to write an article for the Personality and Individual journal, established by…Eysenck himself. When Pelosi submitted his paper to the journal it was immediately rejected, taking him three years to find a publisher that would accept the manuscript.
Pelosi’s article was accompanied by an open letter to King’s College London written by David Marks, the editor-in-chief of the Journal of Health Psychology, where he appealed to the KCL and the British Psychological Society (BSP) to conduct an official investigation and requesting retracting, or at the very least correcting, 61 publications, including over 40 articles, 10 book chapters and 2 books – both issued three time.
Fabrications and investigations
Following the open, public requests KCL initiated an enquiry into only one-third of the publications requested to be reviewed by Marks. The reviewed papers were diplomatically described as “unsafe” in the report that was released upon the completion of the investigation. The enquiry was focused exclusively on the publications of authors who reported the Institute of Psychiatry as their affiliated employer at the time of publication. Since Eysenck has completed his collaboration with the Institute in 1983, all of his works published after that date were not included in the enquiry. The British Psychological Society has responded to the open letter and refused to conduct an independent enquiry, pushing the responsibility back to the universities.
When in the 1970s the fraudulent practices of Sir Cyril Burt, who was Eysenck’s mentor, were finally and incontrovertibly proven, it appeared to be an unprecedented case in the history of psychology. The scope and panache of Burt’s fabrications of research results, his bravado and arrogance (Burt would copy his made up numbers in subsequent publications with accuracy to 2 decimal places), and his sense of impunity (he made up non-existent co-authors of his articles), were so shocking that it seemed nobody would feel brave enough to repeat such manipulations and cover-ups in the future. Especially when we take into account the fact that Burt operated in times where verification of certain facts, which today takes no more than few hours, would then require many weeks of phone calls, letters, long journeys, repeated visits to archives, etc.
Unfortunately, we did not have to wait very long for another scandal. Apart from few minor psychological fraudsters who are being uncovered every few years, Burt was finally dethroned “nobbily” by a Dutch social psychologist Deidrik Stapel in 2013. At least 58 of his articles turned out to be falsified and subsequently retracted. Since then, frauds committed by Dirk Smeester and Lawrence Sanna were revealed. We’ve also learned of falsified research papers of yet another German psychologist working in Amsterdam – Jens Förster, and an American psychologist Brad Bushman. The scandals did not spare even the best universities in the world. Sandra Lozano was fabricating results of her research in the walls of Stanford University, while Marc Hauser was making up his numbers at the heart of Harvard. Last year the world was shocked when Philip Zimbardo’s forgeries of his famous Stanford prison experiment were exposed. This counting rhyme is obviously non-exhaustive and could be continued for much longer. Today we are focusing however only on frauds committed by one of the most notable, prominent and distinguished academics in the history of the psychology. Since the British Psychological Society refused to investigate the allegations of Pelosi and Marks that 61 publications must be retracted, we are unlikely to witness (at least not very soon) Hans Eysenk to drop from the list of most cited psychologists, despite him having high chances to dethrone the current King of Scientific Fraudsters Diederik Stapel with 58 publications retracted. When analysing this case, we must not forget that those particular accusations are aimed at only a fraction of Eysenck’s research activities. During his extremely fertile life he managed to publish over 900 scientific articles and have over 50 books translated later into numerous foreign languages. Shouldn’t those also be verified?
After humiliating degradation and after losing his job Diedrik Stapel published a particular memoir of a fraudster, where he described a rather accurate characteristics of the academia of psychologists. He emphasises virtually complete lack of any structure of control or self-correction: “Nobody ever checked my work. They trusted me.” They will continue to trust even more once the fraudster will secure a strong position in the academic hierarchy and seal it with titles, degrees, prizes, awards and honoris causa doctorates. They will continue to claim that science has self-correcting mechanisms built into it. And the price for such misperceived and ill-understood academic freedom will be paid by members of the general public when they make everyday decisions related to smoking or when deciding to improve on their personalities, fed by misconstrued beliefs related to the development of cancer, unnecessary suffering, and premature deaths. Those damages will never be assessed.