Hi TOK List,

    I thought I would post a note I just sent to the Society for the Exploration of Psychotherapy list serve. Several comments were raised by practitioners that were worried about trying to reduce or define the practice of psychology in terms of the science. The way they were worded I think it might have been a reference to my position that I believe we can anchor the practice of psychotherapy to the science of human psychology. This claim needs to be unpacked because on first read it sounds like I am trying to reduce the practice to empirically supported treatments, which of course is not the case at all. For those interested, I thought I would share how I framed what I am trying to do.

 

Also, let me note that, although it was a close election for SEPI President, Barbara Ingram was the victor over me! Congrats to my dear friend, who is also a TOK Society member! I am very happy for her. She will make an excellent president I am sure. For the clinicians on the list, I strongly recommend her work on integrative clinical case formulation.

Best,
Gregg

 

 

Hi All,

 

Interesting discussion re science and psychotherapy.

 

I am not sure, Tom, but I think that you and I might agree much more that is apparent. In terms of where the disagreement might be, I do advocate for thinking deeply about the relationship between the science of human psychology and psychotherapy. And I argue that there should be “commensurability” between the science and practice to the extent possible and that absent such commensurability is a sign of serious limitations in our core knowledge. By commensurability I mean the language and concepts that inform our understanding of human psychology should be in line with the language we use in psychotherapy. I use biology and medicine and physics and engineering as examples where the basic science (i.e., physics and biology) have concepts and language systems that are generally in line with the professional applications (i.e., engineering and medicine).

 

It turns out that there is a deep problem with this view, however. The problem is that the science of human psychology is unlike biology and physics. Why? Because it lacks a coherent language system and subject matter. This is what I call “the problem of psychology” and it has been known by scholars since the beginning of the 20^th century. Human psychology is defined not by a subject matter in the world (i.e., it has no clear “ontological reference”), but is rather defined by a method. It is an approach to (mind, behavior, consciousness, experience, psyche, soul, human relationships and cultures etc) that is grounded in scientific empirical epistemology. In other words, it is about applying the assumptions and methods of modern natural science to the (animal and?) human condition to achieve knowledge.

 

I DO NOT think that our psychotherapy practices should be dictated by scientific empirical epistemology. That is why I am always disagreeing with folks over on the Div 12 list serve. They think they can develop “intervention recipes” for “psychological disorders” that are “empirically supported/validated” by RCTs because this method represents the goal standard of empirical epistemology. This is a big error because the nature and philosophy of psychotherapeutic practice is fundamentally different than the task of natural science.

 

  The kind of science-practice approach I advocate for can be thought of as a meta-psychological/meta-philosophical approach. It is one that is both scientific and humanistic, epistemologically and ontologically informed, and grounded in both empirical findings and a coherent descriptive metaphysics (see this article for more on this). It is one that seeks coherence and commensurability between the language systems that inform our conception of the science of human psychology and the actual, real world work we do in the clinic. Notice that the latter is unique, particular and “real”, whereas the task of science is to develop general models of truth that transcend local conditions. Science is about theory; practice is about reality. This is one of the key reasons we need a philosophy of practice that is very different than a philosophy of science. I believe that practice should be guided by the philosophy of design, not the philosophy of natural science. The reason is simple: The goals of therapy and the talents required are very different than the goals of natural science. This is why health service psychology as a profession is very different than psychological science. This is another thing the folks over at Div 12/”clinical science psychology” advocates fail to realize.

 

   My “unified framework” offers such a metapsychological/metaphilosophical view. It zooms out and tries to provide a more commonsense language that (a) includes the key insights from the major paradigms (thus holds and respects them); (b) gives rise to a useful way of bridging human psychology with psychology; and (c) gives us a common language grounded in science to talk to each other and talk to our patients/clients (who of course bring their own unique languages for making sense of the world).

 

To give an example, I developed Character Adaptation Systems Theory which re-aligns the major individual psychotherapy paradigms in terms of human systems of psychological adaptation. Here is the technical paper on it. Here is the straightforward description:

The behaviorists focus on habits (sleeping, eating, exercise, sex and substance) and lifestyle patterns shaped by contingencies in the environment.

The emotion focused frame focuses on emotions and emotional functioning that organize the core of our phenomenology.

The psychodynamic frame focuses on core relational patterns and systems of coping and defense that often reside in sub or unconscious portions of our mental world.

The cognitive frame focuses on (verbal) interpretations, attributions, and explanations for the agent-arena relationship, whereas the existential frame focuses on deeper/broader meaning making and core narrative and identity functions. Both work with the language-based “justification system” of character adaptation.

 

Here is a diagram that depicts what I am getting at:

 

Notice the left side captures the different systemic and developmental angles that the individual paradigms often neglect.

 

My bottom line is that I think we need to step back and try to develop clarity for our terms and empathy for both our concerns and what we are trying to advance. To follow Marv, if we can get consensus on these issues, then perhaps we might achieve some real cumulative advance in both our understanding and our practices. Currently, I see the field as fairly stagnant.

 

Sincerely,
Gregg