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Clinician's Digest - Page 3

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In the May 2011 Smithsonian Magazine, science journalist James Gleick discusses memes—units of information or ideas, not necessarily factual but assumed true, that spread like viruses, infiltrating the metaphorical DNA of our perspectives and discourses. Many float in and out of therapists’ offices. Years ago, psychologist Martin Seligman pointed out that the belief that childhood events have a greater influence on our personality development than adult events doesn’t have nearly enough empirical evidence to support its entrenched position in therapy, yet the belief persists. We once “knew” that our ways of being in the world were determined by the struggles between id, ego, and superego. Later we believed our thought patterns created, influenced, and could ultimately solve our difficulties. Now we believe that our problems derive from unfortunate genetic or neurotransmitter configurations, underregulated amygdalas, and overdeveloped prefrontal cortexes.

Everyone has a need to create paradigms and then assume they are truths. In The Belief Instinct, social psychologist Jesse Bering points out that the brain is biologically predisposed to make sense of things—to find order and meaning. We can’t avoid creating meaning. Unfortunately, as media philosopher Marshall McLuhan once pointed out, we also can never totally understand the environment of which we’re a part.

In his 1997 book Cultures of Healing, psychologist Robert Fancher, deconstructing psychoanalytic therapy, Cognitive-Behavioral Therapy, and biological psychiatry, insisted that their explanations of personality and the process of change were philosophical, not scientific. In a 2010 interview with David Van Nuys, Fancher broadened his notion to include other therapies. Therapists, he said, “tend to find something that makes us feel secure, and then we socialize patients into it.” We ought not to delude ourselves or our clients, he insists, that we “know” all about them and how they can change.

In his essay, “The Autobiography of a Theory,” psychologist George Kelly described beginning to feel uncomfortable with his Freudian “insights.” So he started fabricating new ones for clients, some of them “preposterous.” His only criteria for the insights: “that the explanation account for the crucial facts as the client saw them, and that it carry implications for approaching the future in a different way.” Many of the explanations, including the preposterous ones, worked surprisingly well. Kelly noted that his experiment shouldn’t justify an “anything goes” philosophy, but that both therapists and clients should beware of allowing their own “orthodoxies” to constrict therapy.

What should therapists do, given that we often—Fancher would say fundamentally—traffic in ideas masquerading as facts? The solution may lie in having a coherent but flexible vision of therapy; perhaps adopting the same stance toward therapy that therapy students are taught in multiculturalism classes. At one time, such classes focused on defining the characteristics of different groups, a practice that closed off curiosity and inquiry and engendered stereotyping. Now students are taught to be acutely aware of their own assumptions, biases, and orthodoxies, not to mistake them for facts, and to be willing and able to step outside what they assume they know to learn from their clients.

Tell us what you think about this article by leaving a comment below or sending an email to letters@psychnetworker.org.

Resources:

Family Therapy:

For an overview of BSFT and adherence difficulties, see Journal of Consulting and Clinical Psychology 79, no. 1 (February 2011): 43-53.

Therapy “Facts”:

For Fancher interview, see www.mentalhelp.net/poc/view_doc.php?type=doc&id=36039

For the Kelly essay, see Clinical Psychology and Personality: The Selected Papers of George Kelly, Brendan Maher, ed. Wiley: New York, 1969..

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