One from the archives:
What will contribute to the growth of psychotherapy as a discipline?
Is psychotherapy a science? If it’s not a science then is it reliable? Psychotherapy is not a science, though some approach it from this perspective. They cite efficacy studies that suggest a specific treatment is more effective for a particular disorder. What gets lost in this equation is that these results are the product of quite artificial constraints and their conclusions are based on generalities. Many individuals do not fit within the generalities.
Psychotherapy is rooted in the humanities. It deals with subjective human experience and last time I heard that cannot be measured. Courtesy of Ken Pope: In the Journal of Trauma & Dissociation Judith Herman writes about the strengths and weaknesses of “craft tradition” among which she considers psychotherapy. Herman is a very respected researcher in the field of trauma. Her book Trauma and Recovery is a landmark text.
Some strengths of craft traditions:
They are strongly embedded in the practicalities of daily life and, as such, are constantly subjected to empirical (though unsystematic) tests of utility. They preserve a highly complex body of knowledge and skill, resisting reductive standardization. They are taught relationally, through a long apprenticeship that fosters discipline, high standards for performance, and an ethic of care. Within their disciplined forms, crafts permit wide scope for individual imagination and creativity.
Here are some of the weaknesses:
Craft traditions also have many weaknesses. Because crafts are highly complex and resistant to reductive standardization, successful practice depends on individual skill, which is highly variable. Training through long apprenticeship fosters the development of authoritarian personality cults, schools of master craftsmen and their disciples. These schools or sects can become secretive, stagnant, ritualized in their practice, and grandiose and dogmatic in their claims. Examples from psychology abound: One has only to mention the psychoanalytic, behavioral, family therapy, and expressive therapy schools and the manifold schisms and sects within them, each named for its ruling patriarch.
Finally, an enlightened path forward for psychotherapy:
Though the practice of psychotherapy is still a craft, this does not mean that we have to perpetuate the worst features of craft-guild behavior by clinging to sectarian allegiances and claims. In physics one does not find Maxwellian or Einsteinian schools; there is simply physics…. Though psychotherapy is not yet at the level of a science, we can foster an attitude of scientific inquiry based in respect for the clinician’s craft. We can encourage more naturalistic observation and open sharing of therapeutic work, using whatever methodology seems appropriate to the question being explored. Most of all, we can cultivate an attitude of humility, curiosity, and wonder at human resiliency, acknowledging that we are still far from understanding the active principles in recovery from psychological trauma.