Letter to the Editor
Your November cover article, Inconvenient Truth Tellers, made me think of a very common form of denial in the practice of and education in clinical psychology. I work in a department that engages the community. As a child psychologist, my job is to set up counseling centers in private or charter elementary and high schools around Chicago’s underserved and troubled communities while supervising therapy and assessment externs and interns who provide the clinical services. It is really difficult to stand up for science in my own workplace culture. There are sufficient practitioners and ideologies of relational (often psychodynamic influenced) therapies that students who want to specialize in CBT approaches are often ridiculed (among staff, behind students’ backs) for being small-minded. Of course there is evidence as well on the vital importance of interpersonal qualities in therapy, those that constitute the “therapeutic alliance,” so it makes total sense to help students become strong in that relational competency. Furthermore, psychodynamic theory may be helpful in conceptualizing deep, inner, dynamics of clients, such as detailing how individuals develop various defensive character armors to protect against threatening emotions and thoughts, and indeed against oftentimes traumatic cultural and environmental realities. Perhaps my own history as a psychologist hailing from England in which R.D. Laing carved out a deep, influential and culturally intractable mystique and mental hold, warms me irrationally to the various theories of the irrational!
Still, CBT remains in my workplace the proverbial “elephant in the room.” Students want to acquire training in that which science seems to be supporting more and more for practically all psychological ailments, but the cultural norms set by my fellow staff around psychodynamic-influenced therapy make it difficult to speak out about cognitive and behavioral approaches. Several still use the Rorschach Inkblot Test and in a recent annual schedule of didactics for the assessment externs which all five of us staff are lecturing in to provide 30 seminars, one staff chooses to take up 4 of her 6 topics on the Rorschach (Exner system) (2), projective drawings (1) and TAT cards (1). I don’t want to alienate myself from the department or appear hostile to my fellow staff, so I have discussed these issues briefly amongst them at more informal opportunities (e.g., over lunch), and I mostly remain silent. I find myself emailing students all the time PDF versions of the great articles by Lilienfeld and Garb that provide overviews of where science stands on the Rorschach (including on those areas of evaluation for which it may still be valid), and of course the old Exner system has just been replaced by a totally new one anyway, which I have not yet studied for its efficacy, and nor has anyone else here.
It often feels as though I am in the USSR with the need to keep science secret, and here I am in 2013 in the oldest democracy. In fact, one has to really make sure that one trains our supervisees well in the act of clinical conceptualization and relational presence from somewhat of a psychodynamic perspective since over-eagerness to impart a scientific perspective to a student may be viewed by staff as one’s own personal weakness in the interpersonal, possibly even a reflection of deep-seated neurosis on one’s own part that one is trying to avoid by keeping to a more “mental” and “cognitive” perspective.
Of course, a very big problem is that few people really the evidence for most important positions well, though we surely should do our best to stay in touch with research if we are serving the public, and training those who will, in an ethical and professional manner. You touched on climate change denials, but let’s face it, which amongst us has seriously studied the hundreds if not thousands of documents reviewed by the IPCC? I happen to know that climate has changed drastically over the past millennia and that humans don’t actually know the annual alterations over that vast period as well as they do from our limited sample of a few hundred years of record-keeping. And I am not denying the apparent consensus either. I, like most people, simply take scientists’ evidence and conclusions “on faith.” Most people, for example, cannot immerse themselves in the complexities of evolution and the studies supporting it (though there are some great popular books out there that summarize such studies, such as “Darwin’s Dangerous Idea”). We take our science “on faith.” That is itself a serious problem that helps to make it easier, at least, for those denying the scientific consensus. Again, without awareness of our own limitations IN awareness, we can’t really move forward can we? Psychological factors are at work here, and if we don’t or can’t preface our findings on bias with the ever-presence of that bias, how do we convey the distortions that are at work? Plus, not all people are open to examining their own biases, so a discussion of biases appears to some as an attack (especially when liberal-minded scientists – and I speak as a liberal – are not critiquing the limitations of their own liberal bias which would at least be a gesture in illustrating that bias affects us all and not just those we don’t agree with, or even those we find annoying). I have done this myself in the past few years as a conscious effort and it is highly disorienting. I purposely critiqued the weaknesses of my own socialist thinking, and read conservative discussions of economic and political matters for a while as a counter-balance, and while I must admit that I keep a liberal bias of some sort at this time, it is an unsettling no-man’s-land indeed to find that many truths, including those we hold most dear, co-exist in our complex reality with those we vehemently disagree with. And all the more so when we consider the psychological backdrop of our reality (not “the” reality that we study in science, but “our” reality that we actually live in, the manifest and experienced world filtered through our central nervous system).
Leave a comment below and continue the conversation.