Hard Facts and Cold Comfort

A divide in the practice of psychology.
One of the nice things about psychology is that it encompasses a variety of approaches. The therapists do have an eye on current research, and will incorporate findings into practice, where possible. An article by Mary Sykes Wylie in the Psychotherapy Networker on trauma researcher Bessel van der Kolk nicely addressed one of the key rifts in psychology today. That rift is between research and practice, science and art. Art, because for all the manualized treatments, doing psychotherapy is largely an intuitive endeavor that has more in common with the humanities than the sciences. People will disagree strenuously on this point.

Mixing sciences and humanities.
Attempts at taking a scientific approach to psychotherapy research are problematic because so much of what goes on has to do with people’s subjective experience. (See also the humor-driven view of research.) Outcome research is reduced to symptom inventories — questions that ask you to rate your depression on a scale from one to seven. Attempts to harness science in the service of psychotherapy are problematic because science and research make generalizations about groups while psychotherapy is involved in the intimate treatment of individuals and attending to what makes them unique.

Here’s the quote:

More than just about any other field, the town-gown split between scientists and practitioners in psychotherapy reflects sharp differences in fundamental ways of taking in the world. “Skepticism is the core of scientific enquiry,” says trauma expert Alexander McFarlane of the University of Adelaide. “Science is based on statistical comparisons between groups–it’s not a science of the individual subject. And it’s supposed to be critical–scientists make their money out of criticizing ideas. Therapy, on the other hand, happens in the realm of the individual stories people tell, and the variety of ways they do it.” The therapeutic endeavor is built on a framework of reasonable trust and belief in what the patient says, not criticism. “You can’t treat patients if you don’t believe in what you’re treating,” says McFarlane. In a moment of candor not calculated to endear him to his researcher colleagues, van der Kolk says simply, “It’s an issue of temperament: Therapists seem to enjoy living with the uncertainty, unpredictability, and complexity that comes with the intimacy of the relationship, whereas most laboratory scientists are most committed to establishing ‘facts,’ which, by virtue of the dictates of the scientific method, can only encompass a small slice of the total complexity of human beings.”

Kalea Chapman, Psy.D.

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