Hi Gregg, I appreciate your last two posts and the clarifications in them. From our previous conversations, I already knew that you have a basically critical stance towards psychotherapy as a scientific endeavor and that you prefer a metamodern approach to a modern or postmodern one. I also believe that you and I have different emphases in our work. You’re attempting to ground psychology in a cohesive big picture and I’m focusing on the relatively small picture of moving psychotherapy forward. The title of my last book, *Practicing Psychotherapy in Constructed Reality*, essentially says it all: conducting psychotherapy in constructed reality is radically different than imagining that it occurs in fundamental reality. I fully admit that my definition of “constructed reality” is more metaphoric than precise, yet the concept remains both central and useful. I think that the psychotherapy field—consciously, implicitly, and, most importantly, unconsciously—sees psychotherapy operating in fundamental, naturalistic and scientific reality. The medical model requires this assumption as does virtually all of our major schools of psychotherapy. This assumption is the major source of psychotherapy’s inability to flourish; at core, it’s why we can’t create training and experience effects in our practitioners. Conversely, the concept of constructed reality imagines psychotherapy operating in another realm—a place of enormous fluidity, where limitations are only set by meanings, and where a word or a gesture can create a new reality. By extension, the psychopathology is as constructed as the healing rituals that cure it; moreover, this reality is sufficiently “big tent” that it can encompass spiritual and shamanic forms of healing as well. I’ve been using a number of metaphors to point towards this perspective. The first is the one included in my first post: imagine that you are an exorcist that knows the spirits are constructed; how does this knowledge free and empower you? Lately, I’ve been using another metaphor vis a vis Milton Erickson and my old graduate school mentor, Jack Watkins, both pioneers of the use of clinical hypnosis. Imagine you are a 1950’s era clinical hypnotist. You have created many hypnotic phenomena including hypnotic amnesia, post-hypnotic suggestions, and ideographic signals from the unconscious mind. You have seen many clients achieve rapid, profound changes in trance and you are experimenting with naturalistic trance experiences. You believe you have discovered a new reality, one that points the way to a more effective way to work with human suffering. While we are all aware that clinical hypnosis did not end up being a cure all, it continues to provide a metaphor for what it means to exist in a clinically fluid reality, as does the imagination of being an enlightened exorcist. Fully accepting that techniques lack inherent power—taking the finding literally—opens another door to pragmatically experiencing this kind of reality. Helping therapists figure out how their assumptions about reality affects their work is central to psychotherapy’s evolutionary possibilities. (Those who want to follow my speculations further can take a look at my YouTube channel: https://urldefense.proofpoint.com/v2/url?u=https-3A__www.youtube.com_channel_UC3uYv2Wqo5pluLHE9nMIiXA&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=F3TXOnyAfSWNKWt48bbPtQh9YLAxoSAIvGGhzzXMDRI&s=WuM8k0tXhBsKUeBQrLF3ztlpxi2WyI_xW2GSxfTn4I8&e= ) I have no trouble with the way that you are using maladaptive patterns because you have made the effort to ground the concept in UTOK and its critique of extant assumptions. It can still be useful, however, to compare your definition to the one from Buddhist psychology: human suffering is due to a misidentification with the false idea of self. Now, I’m not actually a Buddhist but I do appreciate that their definition points towards the idea that the world is fluid but it becomes reified when we enter cultural reality (identify with the false self.) The Buddhist worldview is derived from and is an extension of the concept of Maya (illusion) that arises from Vedanta and is a very nice metaphor for my understanding of constructed reality. Frankly, from one way of looking at it, “maladaptive patterns” and “misidentification with the false Self” aren’t really that far apart…. However much I recognize your underlying thought, I don’t think that’s how SEPI and the psychological world understands maladaptive patterns. They immediately use the phrase to validate their implicit underlying assumptions about psychotherapy and fundamental reality and the importance of using skills to remediate confusion. In short, they use the phrase to continue down a fruitless and unproductive pathway. At present, even the constructionist therapies—e.g., Narrative, Collaborative and Buddhist psychotherapy—are overtly wedded to skills and techniques; much of their theory is helpful, their practices not so much. To my knowledge, Scott Miller and his colleagues are the only approach that has taken the research findings literally. His approach, which is atheoretical and primarily dependent on using feedback, is actually showing some interesting, positive results in terms of outcomes. While I certainly join with the crowd that respects Scott’s approach and work, I believe that it would be significantly extended by a theoretical exploration of operating in constructed versus fundamental reality. In sum, you know that I believe that your UTOK work is a wonderful contribution and that I have told you that it fills in many of the gaps created by my more metaphoric approach to constructed reality. However, I do believe that your SEPI work with Goldfried will be misinterpreted by most as an endorsement of the status quo approach to understanding psychotherapy. I’d love to take up your invitation to have a UTOK conversation about this. Best, Stephen Stephen Bacon, Ph.D. 351 S. Hitchcock Way #B110 Santa Barbara, CA 93105 website: drstephenbacon.com (805) 563-2820 On Fri, Apr 15, 2022 at 3:33 AM Henriques, Gregg - henriqgx < [log in to unmask]> wrote: > Thanks to all. > > > > I would like to be clear about a few things. First, I do not think we can > understand UTOK and view the world via the same old fashioned > epistemological lenses. That is, I do not think we can frame the proper > debate in epistemology as being a choice between a modernist, rationalist > empirical account of truth (i.e., the scientific method reveals how to see > the world accurately) and a postmodern constructionist view (epistemology > is a function of the socio-historical justification systems and truth is > constructed via power relations or contextually). > > > > Perhaps the easiest way to frame this dispute is via Wittgenstein, and > contrasting his early, picture theory of language > <https://urldefense.proofpoint.com/v2/url?u=https-3A__en.wikipedia.org_wiki_Picture-5Ftheory-5Fof-5Flanguage-23-3A-7E-3Atext-3DThe-2520picture-2520theory-2520of-2520language-2Cof-2520affairs-2520or-2520atomic-2520fact&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=F3TXOnyAfSWNKWt48bbPtQh9YLAxoSAIvGGhzzXMDRI&s=WBgSxnBPghp6npMIocDPg3KFX4qOW27F2_IiHOkkYWE&e= .> > and truth to his evolution in the concept of language games > <https://urldefense.proofpoint.com/v2/url?u=https-3A__en.wikipedia.org_wiki_Language-5Fgame-5F-28philosophy-29&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=F3TXOnyAfSWNKWt48bbPtQh9YLAxoSAIvGGhzzXMDRI&s=Gz18rdkFlIL6Se8KvOWRpj0KTl5qxCq-3X5Ns7qoaI8&e= >. Via the > manner it holds and frames JUST into the ToK System, UTOK developmentally > inverts Wittgenstein. That is, Wittgenstein goes from a correspondence > theory of truth to a constructionist vision and his powerful insights are > crucial in grounding the post-structural move in continental philosophy. > Developmentally, UTOK starts with the equivalent of the language game > insight via JUST. It then evolves into a picture theory of scientific > knowledge via the ToK System. The result is a novel relation between > epistemology and ontology. It is one well characterized as a metamodern > synthesis of rationalistic empirical correspondence theory of truth frames > for science and the social construction of reality by networks of > propositions contextualized in their sociohistorical contexts and placed in > the pragmatic space of dealing with problems in living. > > > > It is from this vantage point that I am responding to Stephen’s important > set of arguments and insights via psychotherapy. Psychotherapy has indeed > failed to “show up” in a way that accords with modernist views of reality. > Indeed, the academic branch of psychotherapy, with its focus on empirically > supported treatments, modeled itself the medical model. Yet as Wampold > shows in *The Great Psychotherapy Debate, *it is clear that psychotherapy > is a participatory, psychosocial relational process, not a “diagnose the > ‘true’ problem and treat it with the right intervention” system. It is a > transjective, relational participatory process, such that the two > participants (in one-on-one therapy) co-construct a healing narrative. In > this regard, I am siding with Stephen and agree that the findings of > research associated with expertise and outcome strongly suggest that our > privileged knowledge has deep weaknesses in it, especially to the extent > that they are framed via the Empirically Supported Treatment model or other > models that place its work in a truth independent of the subjects and > context. > > > > Of course, this is the central point of UTOK proper. That is, UTOK > highlights that the core of psychological science has deep weaknesses in > it. It lacks a clear ontological framing that can afford cumulative > knowledge. Thus, it is lost in a chaotic fragmented swirl. Mainstream > scientific psychology, with its methodological behaviorism, is a patchwork > of findings that is not up to the task of either organizing our knowledge > of the mental nor informing us how to frame and treat the psyche. It is > indeed a hapless endeavor to try to anchor psychotherapy in a > methodological behaviorism. > > > > UTOK’s mental behaviorism is different. It grounds the field in ontology > and posits from their a clear understanding of scientific psychology that > can coherently frame mental behavior at the Mind and Culture planes, and > the idiographic psyche (i.e., the unique, particular, subjective knower in > the contextual real). We can conclude from UTOK that psychotherapy is very > much about creating a healing context that affords the psychological doctor > or other therapist to align with the individual’s psyche and work to > co-create epistemic shifts that afford new ways of meaning making. UTOK > means we do not need to choose between rationalist modernist views or > postmodern constructionist/constructivist views. Rather, we now have an > ontology for human language games and how they evolve in the context of > lived experience. Moreover, when I look at psychotherapy via a UTOK lens, > I see it as a process of treating the psyche via helping individuals become > aware of maladaptive problems. > > > > Best, > Gregg > > > > *From:* theory of knowledge society discussion < > [log in to unmask]> *On Behalf Of *William McCartan > *Sent:* Friday, April 15, 2022 1:19 AM > *To:* [log in to unmask] > *Subject:* Re: TOK RE: Common Core of Psychotherapy/Entrenched > Maladaptive Patterns > > > > *CAUTION: *This email originated from outside of JMU. Do not click links > or open attachments unless you recognize the sender and know the content is > safe. > ------------------------------ > > What a thread, brilliant minds coming together to talk as adults and find > a way forward, hopefully to help people like me. At 60 I'm not taking the > help so knock it off, I'll make it the rest of the way just fine. The idea > of this listserve and the cooperation of those involved can really bring > hope to the generations following us in history, with the way the world is > tearing itself apart these stones have to be laid. Discussion is important > for clarity, just don't get lost in the words. > > > > Have a great night everyone > > > > Thank you Gregg for letting a knucklehead like me follow the discourse. > > > > Peace > > > > William J McCartan > > > > Billy > > > > Get Outlook for Android > <https://urldefense.proofpoint.com/v2/url?u=https-3A__aka.ms_AAb9ysg&d=DwMF-g&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=QWM6ytX8wlzmXxqNZFxEKQ65-DM8CNhTA2BUvQhPJJY&s=oARayw6ky0LBnrsoanOZPfd4lmHfXGsmlZAOHRH9se4&e=> > ------------------------------ > > *From:* theory of knowledge society discussion < > [log in to unmask]> on behalf of Nicholas Lattanzio < > [log in to unmask]> > *Sent:* Thursday, April 14, 2022 11:13:23 PM > *To:* [log in to unmask] <[log in to unmask]> > *Subject:* Re: TOK RE: Common Core of Psychotherapy/Entrenched > Maladaptive Patterns > > > > *CAUTION: *This email originated from outside of JMU. Do not click links > or open attachments unless you recognize the sender and know the content is > safe. > ------------------------------ > > Almost like we're playing word games.. like the French say, the more it > changes the more it stays the same. Such is life. > > Regards, > > Nicholas G. Lattanzio, Psy.D. > > > > On Thu, Apr 14, 2022, 12:59 PM James Tyler Carpenter < > [log in to unmask]> wrote: > > *CAUTION: *This email originated from outside of JMU. Do not click links > or open attachments unless you recognize the sender and know the content is > safe. > ------------------------------ > > Fascinating thread, Everyone. Gregg, we agree. It’s all made up;-) > > > > Warmly, always, > > Tyler > > > > James Tyler Carpenter, PhD, FAACP > > www.metispsych.com > <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.metispsych.com&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=YifQmHh4n9gIAvHk1eElkEcCMh2uk_y2YExIiA30FrM&s=NKmT0iWg9MAAvZ1FecAoCpNWJWbieoelONS_UEUMavI&e=> > > > https://urldefense.proofpoint.com/v2/url?u=http-3A__www.experts.com_Expert-2DWitnesses_search-3Fkeyword-3DClinical-2520psychology-26keywordsearchtype-3DAll-2520Words-26category-3DClinical-2520forensic-2520-26categorysearchtype-3DAny-2520Word-26name-3DJames-2520tyler-2520carpenter-26namesearchtype-3DAll-2520Words-26company-3DMetis-26companysearchtype-3DAll-2520Words-26address-3D-2520-26addresssearchtype-3DAll-2520Words-26state-3DMA-26statesearchtype-3DAny-2520Word-26country-3DALL-2520-28or-2520Choose-2520a-2520Country-29-26countrysearchtype-3DAll-2520Words-26page-3D1-26freshsearch-3D1&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=F3TXOnyAfSWNKWt48bbPtQh9YLAxoSAIvGGhzzXMDRI&s=Z1JhIXqrZquqKPQllQqFL5Z8cLG7uprCAT3ATK04x68&e= > <https://urldefense.proofpoint.com/v2/url?u=http-3A__www.experts.com_Expert-2DWitnesses_search-3Fkeyword-3DClinical-2520psychology-26keywordsearchtype-3DAll-2520Words-26category-3DClinical-2520forensic-2520-26categorysearchtype-3DAny-2520Word-26name-3DJames-2520tyler-2520carpenter-26namesearchtype-3DAll-2520Words-26company-3DMetis-26companysearchtype-3DAll-2520Words-26address-3D-2520-26addresssearchtype-3DAll-2520Words-26state-3DMA-26statesearchtype-3DAny-2520Word-26country-3DALL-2520-28or-2520Choose-2520a-2520Country-29-26countrysearchtype-3DAll-2520Words-26page-3D1-26freshsearch-3D1&d=DwMFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=YifQmHh4n9gIAvHk1eElkEcCMh2uk_y2YExIiA30FrM&s=f5_X19RZNKy9AG-1c9sMNPVK_oNPYQS1hZJD9fA0A5s&e=> > ------------------------------ > > *From:* theory of knowledge society discussion < > [log in to unmask]> on behalf of Henriques, Gregg - henriqgx < > [log in to unmask]> > *Sent:* Thursday, April 14, 2022 12:50:00 PM > *To:* [log in to unmask] <[log in to unmask]> > *Subject:* Re: TOK RE: Common Core of Psychotherapy/Entrenched > Maladaptive Patterns > > > > Stephen, > > > > I DO NOT think that we should consider Western psychotherapy to be > currently scientific in a paradigmatic or ontological sense. And thus I > agree that a better frame to understand its totality is constructionist. > And so there is much that you and I agree on. > > > > At the same time, this is precisely what UTOK is about. The basic issue > from a UTOK perspective is that we have not solved the ontology of the > mental or of human persons. And that we now can. And that is a game changer > going forward. And the argument is not empirical, but grounded in logos. > > > > I support many facets of your vision and your argument and believe it > is a wakeup call that SEPI should listen to. But I also think that the fact > that the problem of psychology could not be solved but now can be solved > ontologically is a game changer. And so, clearly, that is where I am going > to be placing my efforts. But I do believe yours is an important voice that > should be wrestled with. But I did decide to orient SEPI for my Presidency > in a different direction. > > > > May be we should have a special UTOK conversation about this? > > > > Best, > Gregg > > > > *From:* theory of knowledge society discussion < > [log in to unmask]> *On Behalf Of *Stephen Bacon > *Sent:* Thursday, April 14, 2022 11:16 AM > *To:* [log in to unmask] > *Subject:* Re: TOK RE: Common Core of Psychotherapy/Entrenched > Maladaptive Patterns > > > > *CAUTION: *This email originated from outside of JMU. Do not click links > or open attachments unless you recognize the sender and know the content is > safe. > ------------------------------ > > Hi Greg, > > I appreciated your response and understand how your other priorities > forced its brevity. However, given the imminence of the SEPI conference, I > thought it appropriate to continue our dialog. > > One of the key points in your response is that we need to be careful not > to draw too many conclusions from the research findings about techniques > lacking inherent power and our privileged knowledge failing to enhance > outcomes. If these findings were actually isolated and standing on their > own, I would agree that we should take care not to stretch them too far, > but in actuality they are reinforcing factors tightly woven into an > overarching theory—a theory that points in a significantly different > direction than the theories pursued by psychotherapy in general or SEPI in > particular. > > In my first posting, I refer to Berger and Luckmann’s cross-cultural > analysis of mental heath practices and note that they see western > psychotherapy as one practice among many and believe that all of these > practices are constructed. Western psychologists by and large agree with > this analysis with one exception: they believe that other culture’s models > are constructed but argue that our western one is not given that it is > based on science. And certainly, small parts of our mental health model > are scientific and based in fundamental reality; for example, clients with > low thyroid get depressed and the depression can be ameliorated with > thyroid supplements. > > But psychotherapy is a different matter. And given this presupposition > about science, it is incumbent on western psychologists to refute the > Berger/Luckmann social constructionism hypothesis by advancing compelling > arguments showing that western psychotherapy is indeed different. Instead, > we get instance after instance supporting the constructionist perspective. > For example, the dodo bird hypothesis, showing that systems with radically > different underlying theories and interventions still get equivalent, > positive results is a huge argument for constructionism and the importance > of expectancies and beliefs. The fact that something as absurd as > eye-movements has a prominent place in the treatment for PTSD certainly > suggests that we have little superiority to shamanic interventions with > crystals and chanting. And what about Donald Spense and his argument that > clients improve equivalently whether they are resolving false memories or > accurate memories. Finally, Scott Miller has documented that there have > been no evolutionary improvements in the effectiveness of psychotherapy > over the past 40 years; the effect sizes from psychotherapy are equal at > the beginning and end of that period. I could go on and on with other > examples that demonstrate that the kind of evolution we expect to see from > a science-based professional discipline simply isn’t happening with > psychotherapy. > > And, yes, the biggest argument that our mental health model is as > constructed as the ones from other cultures comes from the fact that we > have been unable to develop techniques with inherent power and our > privileged knowledge fails to correlate with outcomes. These are glaring > findings. They don’t stand on their own. What they do is endorse the > social constructionist theory of psychotherapy. Human suffering is real > but our symptoms, explanations, and interventions are constructed. > > What this means for SEPI is that the path to psychotherapy integration > must begin with the concept that our approach to mental health is as > constructed as other cultures. Indeed, it is the possibility that we have > the capacity to become self-aware of this constructionist factor that > should allow us to improve our extant outcomes and the outcomes of other > cultures Every other culture, including ours, is absolutely fixated on > validating our own particular constructs; however, we have a good shot at > evolving because part of our intellectual world is working hard to develop > the ability to deconstruct our assumptions. The way forward is to focus on > the power underlying therapeutic explanations and rituals: beliefs, > expectancies and the charisma of the therapist. > > The most common response I’ve received for these arguments goes something > like, “I can’t refute what you’re saying logically but, since I know that > it doesn’t feel true, I’m going to ignore your points.” That would be the > exact same counter argument one would get trying to convince exorcists that > the spirits are constructs. We should be better than this… I believe, > however, that our culture of open dialog—and all the work we’ve done on > constructionism and Kuhn’s paradigm shifts—puts us in a position where at > least a significant minority of us might move in another direction. > > I’m going to close with a striking story from hundreds of years ago which > illustrates all of the points made in this response. Constructionism > didn’t begin in the west in the 20th century but had its origins in the > east, particularly with Vedanta and certain Buddhist thought. In the > following story, the teacher points out that when the disciple understands > that techniques have no inherent power, then they will be on the right > path. This story is attributed to Dogen Zenji. > > When asked why he practiced zen, the student said, “Because I intend to > become a Buddha.” > His teacher picked up a brick and started polishing it. The student asked > “What are you doing?” The teacher replied, “I am trying to make a mirror.” > “How can you make a mirror by polishing a brick?” > “How can you become Buddha by doing zazen? If you understand sitting Zen, > you will know that Zen is not about sitting or lying down. If you want to > learn sitting Buddha, know that sitting Buddha is without any fixed form. > Do not use discrimination in the non-abiding dharma. If you practice > sitting as Buddha, you must kill Buddha. If you are attached to the sitting > form, you are not yet mastering the essential principle.” > The student heard this admonition and felt as if he had tasted sweet > nectar. > > best wishes, > > Stephen Bacon, Ph.D. > > 351 S. Hitchcock Way #B110 > > Santa Barbara, CA 93105 > > website: drstephenbacon.com > <https://urldefense.proofpoint.com/v2/url?u=https-3A__nam12.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Furldefense.proofpoint.com-252Fv2-252Furl-253Fu-253Dhttp-2D3A-5F-5Fdrstephenbacon.com-2526d-253DDwMFaQ-2526c-253DeLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn-5F5nBEmmeq0-2526r-253DHPo1IXYDhKClogP-2DUOpybo6Cfxxz-2DjIYBgjO2gOz4-2DA-2526m-253DQigTUFx4kWQGsp4ZgFINw-5F8TXftzDmBMiOqUYyMSoZE-2526s-253DdkGInDey218Le7Fr7Mkp5C74J8DsNKsnGZIJ7q6lCcI-2526e-253D-26data-3D04-257C01-257C-257C3ef165bc756d4b51c84008da1e36d893-257C84df9e7fe9f640afb435aaaaaaaaaaaa-257C1-257C0-257C637855518185658657-257CUnknown-257CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0-253D-257C3000-26sdata-3D01adHk9vPP-252FGxiKasoy2BV1Y-252B2yew2ZZMqDLverNcvQ-253D-26reserved-3D0&d=DwMF-g&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=X3PpFX5lG-J8pG11CoNMRgGb9Lg2ieLZv6pxBgF2elQ&s=9Vq1A3G10RFhNfEtQMHLywP5_0hhS6gWmeMv0yV1pTE&e=> > > (805) 563-2820 > > > > > > On Mon, Apr 11, 2022 at 4:28 AM Henriques, Gregg - henriqgx < > [log in to unmask]> wrote: > > Many thanks for this interesting argument, Stephen. > > > > It warrants significant thought and a careful reply. I unfortunately do > not have the time at this point to give it the attention it deserves. > Indeed, I need to go back and respond to some commentaries on Dissociative > Identity Disorder. Unfortunately, my life has placed a number of demands on > me and limited my time. > > > > Briefly, my response is: Yes, the lack of the correlation of expertise and > outcomes is an important finding that must be wrestled with. However, I do > not draw the same conclusion regarding its meaning. Indeed, the argument > from that finding to the argument that entrenched maladaptive patterns is > not what psychotherapy treats is too great a stretch. Here is a possible > explanation for the findings. It is a fact that the ontology of psychology > and psychotherapy is lame. The schools of thought have partial truths. You > can enter into the common ground through them. And there are some > expert/guru/charismatic figures who find a school and get good results (as > you know there are master-class clinicians who do have qualitatively better > outcomes). And then people form a school and train. However, because the > school only had a partial truth, the followers of the school actually > double down on an incomplete picture, such that their expertise is weak > tea. And trying to become an expert in a specific school of thought does > not help you much. > > > > My point is this. I can’t draw much ontological insight from this finding. > I do acknowledge substantial existential anxiety from it. Indeed, part of > my decision to give up my license last year can be justified by the > finding. But I don’t think it makes much sense to build a theory of human > functioning from it. > > > Best, > Gregg > > > > *From:* theory of knowledge society discussion < > [log in to unmask]> *On Behalf Of *Stephen Bacon > *Sent:* Saturday, April 9, 2022 9:37 PM > *To:* [log in to unmask] > *Subject:* Common Core of Psychotherapy/Entrenched Maladaptive Patterns > > > > *CAUTION: *This email originated from outside of JMU. Do not click links > or open attachments unless you recognize the sender and know the content is > safe. > ------------------------------ > > Hi Greg, > > As you know, I’m a big TOK fan and really appreciate all you have been > doing to put psychology into a larger context and to address some of the > fundamental questions in our field. That said, I do have some > disagreements with where you, Goldfried and Smith have been going on the > common core of psychotherapy. > > To keep this relatively brief, I’d like to focus solely on one of your > initial principles: “The core problems of psychotherapy involve entrenched > maladaptive patterns.” While this sentence appears fairly self-evident, I > believe that it leads us in an unproductive direction. > > While I know that you are familiar with my work, let me review it briefly > for other readers. I am also concerned with developing the common core of > psychology. My work is founded on an extensive literature review designed > to ascertain whether psychotherapeutic techniques have inherent power. My > basic argument in this area is simple: if psychotherapeutic techniques > have inherent power, then experienced therapists should best the > inexperienced given that they know more techniques and have practiced them > more assiduously. Moreover, trained therapists should best the untrained > because they know relatively more techniques. > > I have conducted extensive literature reviews (Bacon, 2020, 2022) that > document that therapist experience and therapist training do not correlate > with improved outcomes. This leads to the conclusion that clients are not > changing secondary to the inherent power of our interventions; rather, > following Jerome Frank, they are changing because they believe in our > explanations and expect that going through our prescribed cures will create > healing. In sum, we are using therapeutic rituals not techniques with > inherent power. > > Even more provocative and alarming, the lack of experience and training > effects mean that all of psychotherapy’s privileged knowledge—diagnoses, > clients characteristics, psychological systems, research studies, etc.—also > fail to contribute to enhanced outcomes. Certainly, psychotherapy > works--approximately 55% of our clients get better pretty much no matter > what we do (Bacon, 2022)—but when our privileged knowledge is of little use > it’s pretty clear we have no real idea why. > > Returning to the statement that psychotherapy treats entrenched > maladaptive patterns: unfortunately, this concept runs directly into the > two research findings about techniques lacking inherent power and > privileged knowledge not enhancing outcomes. More specifically, treating > maladaptive patterns implies that good psychotherapy replaces those > dysfunctional strategies with more effective ones; in other words, you’ve > been doing it the wrong way and I’m going to work with you so that you can > do it the right way. If psychotherapy works like that, then our techniques > must have inherent power. If I’ve been skiing the wrong way and falling > down, and you know and teach me a better way to ski, that’s the definition > of a technique with inherent power. > > If mentally ill clients don’t know the right way to live and we > psychotherapists do, then we have a technique with inherent power. That > means that therapists who have practiced telling more people how to live > right would be better than beginners and trained therapists—who have > privileged information about how people should live—would best the > untrained. It also implies that therapists should be quite a bit more > effective at living well than the average person and simply saying that > statement out loud is kind of embarrassing….. > > The other argument, that therapists aren’t specially gifted at knowing the > right way to live but are gifted at helping clients figure out their own > right way to live fails in a similar fashion. If we really know how to do > that especially well, then that ability is a technique with inherent power > and experienced therapists should do it better than the inexperienced and > the trained should best the untrained. In sum, logical as it may seem, we > are not in the business of remediating entrenched maladaptive patterns and > that is not the beginning point to develop a common core for psychotherapy. > > There is an entirely different but highly useful additional perspective on > “entrenched maladaptive patterns” that comes from the latest behavioral > genetics research. Robert Plomin, in his 2018 book, *Blueprint*, > proposes the radical idea that there are no lasting, sustained positive > effects from the nurture side of the nature/nurture spectrum. More > specifically, he states that the positive attempts made by healthy families > and excellent schools to instill high functioning life strategies in > children is ineffective. > > Parents obviously matter tremendously in their children's lives. They > provide the essential physical and psychological ingredients for children's > development. But if genetics provides most of the systematic variance and > environmental effects are unsystematic and unstable, this implies that > parents don't make much of a difference in their children's outcomes beyond > the genes they provide at conception. (p. 82) …. In essence, the most > important thing that parents give to their child is their genes. Many > parents will find this hard to accept. As a parent, you feel deep down that > you can make a difference in how your children develop. You can help > children with their reading and arithmetic. You can help a shy child > overcome shyness. Also it seems as if you must be able to make a difference > because you are bombarded with child - rearing books and the media telling > you how to do it right and making you anxious about doing it wrong. > (p.83)….. The shocking and profound revelation for parenting from these > genetic findings is that parents have little systematic effect on their > children's outcomes, beyond the blueprint that their genes provide (p. 85) > > To understand how Plomin arrived at this shocking conclusion, it’s useful > to examine a simplified example: the effects of environment on weight. > Imagine adopted children who are being raised in a household with normal > weight parents and very healthy eating strategies. While in the household, > these healthy strategies have a positive influence and help the children > have normal weight. After becoming adults, however, their weight has a > correlation of 0 with the adoptive parents’ weight and a high correlation > with the genetic parents’ weight. The healthy strategies learned in their > adoptive household did not have a sustained influence once they are out in > the world. Similarly, good strategies practiced by families and schools > have a positive effect while one is there but the attempts to teach and > instill life-long, healthy strategies fail. > > Plomin sees human suffering and mental illness as an interaction between > genetic vulnerabilities and environmental stress. He does not believe that > mental illness comes from entrenched maladaptive strategies; if it did, > then the adoptive children in homes with poor eating strategies would have > a correlation with their adoptive parents’ weight. Our clients aren’t > suffering from bad strategies and they won’t be fixed by teaching good > strategies. > > That said, one of the major confusing factors in terms of sorting out this > area is how well psychotherapy works. Given that approximately 55% of our > clients get better no matter what we do, it is tempting to view this > client success as an endorsement of the extant explanations and the > underlying assumptions. More specifically, the key assumptions receiving > endorsement are that mental illness works like medical illness—i.e., > diagnosis plus evidence-based intervention equals cure—and that mental > illness operates in fundamental reality and follows a rational, rule-based > order. > > But a moment of reflection reveals that the research results radically > challenge these assumptions. If the medical model is a functional > representation, and if psychotherapy occurs in fundamental reality where > science is the dominant paradigm, then we should have already been > successful at developing techniques with inherent power and our privileged > knowledge should correlate with enhanced outcomes. > > We know psychotherapy works. The secret to developing the core is to > figure out “why” the research documents such abysmal training and > experience effects. “Entrenched maladaptive patterns” requires us to > continue to use the paradigm that has been proven to be unproductive. It > would be far better to explore psychotherapy’s core by following the > implications of these provocative and unsettling research results > regardless of where they might lead. > > There is a famous Sherlock Holmes story about the significant clue in a > murder is that the “dog didn’t bark in the night” (the lack of barking > implied the dog knew the intruder). Similarly, we have an enormous clue > that we have been reticent to pursue: how come the hundreds of thousands > of books, articles, and research studies fail to enhance outcomes and how > could the work of so many gifted and hard-working psychologists amount to > so little? Our research doesn’t “bark in the night” and very few > psychologists appear to care…… > > Fortunately, Berger and Luckmann, back in 1967, offer a compelling > explanation. They examined mental health models cross-culturally and > argued that human suffering is inevitable and, hence, every culture is > required to develop a mental health paradigm and a class of healers > dedicated to applying the paradigm. In addition, they pointed out that the > cultural members will have symptoms congruent with the constructed model > and achieve healing via the culturally-sanctioned technology. As most of > us are aware, Berger and Luckmann concluded that the suffering was real but > the explanations for the suffering and the technology for its relief were > constructed. > > If, therefore, we compare our mental health model with an “exorcism of > malevolent spirits” mental health model, it becomes clear why our > psychotherapy techniques lack inherent power. The secret is that for the > 55% of clients that generally respond well to psychotherapy, they will get > better no matter what model is offered—CBT, psychodynamic, EMDR, or primal > scream—as long as they find the model credible. Our clients are just like > the exorcists’ clients; they get better no matter what kind of spirit is > diagnosed and no matter what kind of ritual is prescribed. The exorcism > clients get better but no one would argue that the rituals have inherent > power. The techniques have no inherent power; rather their power is > derived from beliefs and expectancies. > > In the exorcism culture, a great deal of effort is expended on determining > exactly what type of spirit is possessing the person and which ritual will > specifically eliminate that spirit. We, of course, see those efforts as a > waste of energy because we recognize that the real healing factors are > rituals, beliefs and expectancies. Thinking that “entrenched maladaptive > patterns” is the first step in exploring the core of psychotherapy is > equivalent to arguing that the first step is to determine what kind of > spirit is present. It implicitly pushes us towards the next step—a > continuing search for techniques with inherent power—which can redress the > bad strategies. This, of course, will result in further additions to our > privileged knowledge—additions which will be just as ineffective as the > hundreds of thousands of preexisting concepts. > > In your article you discuss the importance of moving beyond common > factors: “we were able to lay out the argument that we can move beyond > common factors and clarify the common ground of psychotherapy with much > greater levels of specificity and utility.” This, of course, is what > anyone who is interested in developing the core of psychotherapy must > accomplish. While there is no time in this short note to explore the > implications of how to move past common factors, there are intriguing clues > inherent in our exorcism example. Suppose we were operating in a culture > that required exorcisms to cure mental illness but we were in the small > group of exorcists that knew that the spirits were a construct. What kind > of edge would that give us over the standard exorcists who believe in the > spirits? Exploring the implications of that question begins to take us > beyond common factors; moreover, it suggests a different direction for > developing the core of psychotherapy. > > > > References > > Bacon, Stephen. (2020). A Constructionist Extension of the Contextual > Model: Ritual, Charisma, and Client Fit. *Journal of Psychotherapy > Integration, **30*(4), 506–521. https://urldefense.proofpoint.com/v2/url?u=https-3A__doi.org_10.1037_int0000188&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=F3TXOnyAfSWNKWt48bbPtQh9YLAxoSAIvGGhzzXMDRI&s=o7ydPwlvHf4-muxVEq8PzQEnZhjOgA19P-8yJgPWWus&e= > <https://urldefense.proofpoint.com/v2/url?u=https-3A__nam12.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Furldefense.proofpoint.com-252Fv2-252Furl-253Fu-253Dhttps-2D3A-5F-5Fpsycnet.apa.org-5Fdoi-5F10.1037-5Fint0000188-2526d-253DDwMFaQ-2526c-253DeLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn-5F5nBEmmeq0-2526r-253DHPo1IXYDhKClogP-2DUOpybo6Cfxxz-2DjIYBgjO2gOz4-2DA-2526m-253Dw-2D1n7uNluLema8vfyhZ96gIqgkknssdzbg3pUntkcig-2526s-253DlDvq4QjhPAM-2DRFqMws-2DfgEradx8eudHNBpQXpmnlBAU-2526e-253D-26data-3D04-257C01-257C-257C3ef165bc756d4b51c84008da1e36d893-257C84df9e7fe9f640afb435aaaaaaaaaaaa-257C1-257C0-257C637855518185814450-257CUnknown-257CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0-253D-257C3000-26sdata-3D89ehT2q9lB5fKLHq4445ZWqYAvklkAmcl3C4ajtIGsE-253D-26reserved-3D0&d=DwMF-g&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=X3PpFX5lG-J8pG11CoNMRgGb9Lg2ieLZv6pxBgF2elQ&s=kfmXj1QJ2Axx3NsXpnhZJB-FEsgtSCt_b83jfYCb1XQ&e=> > > Bacon, Stephen. (2022). *Deconstructing the great psychotherapy myth: > Therapists and clients are confused about how therapy works* [Video]. > YouTube. > https://urldefense.proofpoint.com/v2/url?u=https-3A__www.youtube.com_watch-3Fv-3DL-5F54PhNY6vk-26list-3DPLuSjXeuKpouUoV9vN4O9hZw-2D4oqTX6y29&d=DwIFaQ&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=F3TXOnyAfSWNKWt48bbPtQh9YLAxoSAIvGGhzzXMDRI&s=WXmjy1urYHVZUZvRy0Arfcbgtk2zYOXCqxpUK3kNk10&e= > <https://urldefense.proofpoint.com/v2/url?u=https-3A__nam12.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Furldefense.proofpoint.com-252Fv2-252Furl-253Fu-253Dhttps-2D3A-5F-5Fwww.youtube.com-5Fwatch-2D3Fv-2D3DL-2D5F54PhNY6vk-2D26list-2D3DPLuSjXeuKpouUoV9vN4O9hZw-2D2D4oqTX6y29-2526d-253DDwMFaQ-2526c-253DeLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn-5F5nBEmmeq0-2526r-253DHPo1IXYDhKClogP-2DUOpybo6Cfxxz-2DjIYBgjO2gOz4-2DA-2526m-253Dw-2D1n7uNluLema8vfyhZ96gIqgkknssdzbg3pUntkcig-2526s-253DAZAKNHqzfFvuLDvSukAVXbobzYs0OI8iQXiBVi5bQHI-2526e-253D-26data-3D04-257C01-257C-257C3ef165bc756d4b51c84008da1e36d893-257C84df9e7fe9f640afb435aaaaaaaaaaaa-257C1-257C0-257C637855518185814450-257CUnknown-257CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0-253D-257C3000-26sdata-3De2hSHNTYNFg3MpJPaznMJlrkByX9sSUNEhZe1yqueZY-253D-26reserved-3D0&d=DwMF-g&c=eLbWYnpnzycBCgmb7vCI4uqNEB9RSjOdn_5nBEmmeq0&r=HPo1IXYDhKClogP-UOpybo6Cfxxz-jIYBgjO2gOz4-A&m=X3PpFX5lG-J8pG11CoNMRgGb9Lg2ieLZv6pxBgF2elQ&s=xa2fv-63aAgoOl7n3ellqWmFAxoVZXeLdFNTJ2sGknU&e=> > > Berger, P. L., & Luckmann, T. (1967). *The social construction of > reality.* Anchor Books. > > Plomin, R. (2018). Blueprint: How DNA Makes Us Who We Are. United > Kingdom: Penguin Books Limited. > > > > Stephen Bacon, Ph.D. > > 351 S. Hitchcock Way #B110 > > Santa Barbara, CA 93105 > > website: drstephenbacon.com > 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