Psychology's Dilemma

“Pop Psychology” and “psychobabble” are two terms that are often used in a pejorative sense to describe elements of the field of psychology. No other science has earned such monikers that belittle the institutions and research upon which they are founded. The roots of these negative expressions can be linked to a long colorful history that has defined psychology, a history that has been marked by contradictions and, at times, embarrassing failures. Although physical and biological sciences have had similar setbacks, their progression has been largely linear – the most current theories are generally accepted by the majority of scientists in each discipline. Psychology, on the other hand, is rife with dissension among its practitioners and within the public eye. This discord is due to the subjective nature of the social science; research is taken less seriously and the highly contextualized nature of treatment makes no theory universal. Ultimately, psychology is faced with a time-dependent dilemma: the dynamic and transitional nature of human beings, culture, and society at large will always heavily influence the direction and progress of psychology.

I have always considered psychology more of an art than a field that corresponds with the classic academic approach. Most sciences stack blocks of knowledge on top of each other that stand the test of time, but psychology’s blocks do not rest easy. They crumble as the world builds around them. Empirically driven data that supports the efficacy of one form of treatment may not be replicable in 20 or 50 years. Some modalities do have legs and will walk their way into the future, but the rest ebb and flow like the tides or the ever-shifting sand on a beach. I like to think of clinical psychology as a giant whack-a-mole game. The psychologist stands with his mallet and predictably swings at the exterior moles; they slither out at the same pace and earn a calculable, familiar swing. However, the middle-moles are constantly changing their rhythm and pattern. The mallet-swinger must have a dynamic approach if he or she wants to keep playing successfully.

Certain cultures and people don’t respond well to particular modalities of treatment, even when they have the evidence that supports their efficacy. For example, an individual ensconced in certain fundamentalist faiths may have difficulties with the language that surrounds the mindfulness based aspects of DBT. It could feel like a betrayal to his or her faith, even though the mindfulness principles of the therapy are non-secular.

The limitations of psychological research extend beyond the goodness-of-fit barrier. Like any person, researchers have agendas. An altruistic desire to have an impact makes the researcher subject to confirmation bias, or sometimes, more conscious alterations of data sets to meet a theory. Such research might not be replicable even immediately after publication. This is not unique to psychology, but again, the highly subjective nature of the science makes it easy to juke the stats and fit a round peg into a square hole.

In my opinion, one of the few blocks of knowledge that will stand the test of time indefinitely for psychology is the therapeutic relationship. During the application process for graduate school, I stated something to this effect during an interview. I spewed examples and quoted Rogerian principles. The interviewer responded with the question, “Then why don’t people just see their barber?” I backpedaled a bit, and replied that the therapeutic relationship alone was not sufficient for certain types of mental illness, and that in those cases the theoretical orientation does matter, something I uphold. However, in retrospect, I wish I had said that sometimes a barber might be sufficient. If we groom through Carl Roger’s six conditions for constructive personality change, we will see that a barber could meet them. The only difference would be that he or she has a pair of scissors in his or her hands.

The field of psychology is intrinsically related to what is happening in the world. As people change so does the therapy they receive. The most important take away is that understanding the cultural, temporal, and societal background of a client is a crucial determinant for successful outcomes. Pigeonholing someone into an evidence based therapy may be a limiting factor for certain cases. But this is just a bunch of psychobabble from a pop-psychologist about popular psychology. Disregard.