Is clinical psychology all a load of crock???

Great Debates
#1

I know the thread title has the potential to be flamed, but I’ll carry on (I meant no harm, honest :)). When a particular “theory” is posited in psychology, for example (at the risk of getting flamed for even bringing up this “Godfather” of modern psychology) Sigmeund Freud’s take on the inner workings of the human psyche, how sure are we that the background to the theory is correct?

Let’s say for instance, his Oedipean concept (you know, that thing about killing your father to sleep with your mother :)). How can we say with any scientific objectivity that the reasons behind any aggressiveness/conflict with your father is rooted in these “instincts”? I mean, not to reign in on the parade, but I have tons of ideas (most of them extremely sexual) on why human behaviour is the way it is, and why certain people will react in the manner that they do. Any and all of these can be correct, or none of them could be. I don’t see any reasonable way to scientifically determine (at the physical level) how true these theories are, or for that matter, just how false they are. I’m not being smug here; I genuinely have this concern for the science at the most fundemantal level. If I’m missing out - please inform me.

Don’t get me wrong, I clearly understand that these clinical practitioners are far more skeptical and rigorous with thier data than I have described - and I don’t wish to make a brick shit-load of all thier hard work. But I have done quite a lot of reading (what, you thought I just got here?) both in journal and university text-book format. And though I’ll agree that some stuff even the psychologists/authors themselves say is controversial and point to a very balanced way of viewing things (for example, studies involving child cognition), there are also other studies conducted (for example, in sports performance) that just seem more like common sense. What I mean by “common sense” is that I could deduce the same thing even without the aid of said study (e.g. “it has been found that the best way to increase confidence in the subject is to start off with an easy target, and gradually build up. However, never exceed the limit as this can lead to negative feelings of self worth if failure is apparent”).

“Well then what’s the problem?” I hear you say. See the thing is, I have no real way of determining whether what I am saying is true at the basic brain level (you know what I mean - you’ll have to excuse the cheap phrases). On top of which, if I go on to describe a theory which could be a possible explanation, I have no way of knowing that my ideas are any more correct than say, yours.

I understand that evolutionary psychology is still in its relative infancy, so I shouldn’t take everything they come out with as gospel - but I am wondering how they can really publish this stuff without thinking what they are doing is a little bit like a pseudo-science (Okay there, I said my piece. How’s your mom?). Some anthropology can provide clues to our ancestor’s behavioural patterns, but can we really determine how much influence they hold over our actions in this modern society? In fusing together history with science, are we losing sight of the main picture in psychology (the science)?

I am very hopeful (and, if I’m going to be honest, more inclined to believe) clinical psychological theory (or whatever you would call it) that is more grounded in neurobiological reactions and processes. Even Roger Penrose’s ramblings on the nature of consciouseness seem more fruitful (or at least, somewhat indicative) than the “random stabbing in the dark” which I percieve as psychology, as it stands. Am I wrong to so harshly dissmiss it? Does it actually provide benefits that I am not seeing?

In the end, is it not better that we study the physical/chemical processes (say for e.g., and at the risk of drawing some excessive snickering, at the atomic- level) going on inside the brain than “wasting time” analysing the mood swings of Mr. Pector and attempting to draw some conclusions from that?
–Apologies for any spelling and grammer mistakes. Once again to remind you that I’m not attempting to poo-poo this “brand” (if you will) of psychology, just perhaps gain a clearer perspective on it-- X

#2

Xavier,

I’m with you - personality theory is pseudo-science: absolutely unprovable. I majored in Psych, and came to the conclusion that while Social Psych, which studies behaviors of large numbers of people, has some validity in predicting mass tendencies, individual psych other than the organic is mostly a matter of coming up with effective ways of convincing a patient to straighten up and fly right. The theories may provide individual practioners and their patients with ways of looking at the past that help to facilitate this, but they are not science in any sense. There are a number of aspects of Psych that arescience, but when it comes to explaining why someone behaved as they did, anyone’s guess is as provable as anyone else’s. We’re talking, in essence, religion rather than science.

That being said, psych-therapy can still be of enormous benefit to many people. Having an objective listener whose job it is to help you find solutions to your problems, or simply to listen, can be worth an enormous amount to many of us. Theories of personality help therapists to get a grip on the huge complexity that constitutes each individual with whom they meet. The problems happen with a few therapists who then mold their patients to fit the theory. But such therapists don’t strike me as terribly common. All of this, of course, is my take based on the study I’ve done, and YMMV.

#3

A lot of current psych IS a crock but a surprisingly large amount isn’t as well. There have been a number of really quite ingenious experiments out there that have managed to get around the inherent difficulties in measuring the brain. Freud’s theories have been largely debunked in the academic world, there may still be some practising psychologists who borrow from it but not many.

But clinical psych as a whole HAS been shown to be largely bunk. I believe there was a study where a person was randomly assigned either a clinical psych, a random person off the street or a phone psychic and asked afterwards to evaluate how well it went. The clinical psychologists came in dead last and the phone psychics came in 1st.

As for your observation that most of psychological findings turn out to be “common sense”, whats important is the ones that turn out to be the complete opposite. There have been litereally hundreds of findings where a previously assumed “obvious fact” has turned out not to exist under rigourous observation. I think my favourite one has to be that they have shown that psychologists are worse at guessing a person’s emotions than the average person. Another completely bizarre one is that if you pay someone to eat crickets and then shout at them, they will enjoy the crickets more than if you merely payed them and was nice to them. Neither of these are exactly common sense views and both have fairly important implications.

In the end, a fair chunk of psychology is strictly in the realm of science and that chunk is growing very fast. I think it would be naive to discount the field because of a few patches of pseudo.

#4

Are any of you aware of the study reviewed in Skleptic magazine last year that purpoted to try and measure the effects of phycological therapy? Apperently the army looked at a large number of people who had problems of some sort and either got help or did not. As I recall, they found no statistical benifit to the therapy. There were some problems with the study (nothing is perfetc). But an interesting result. I can’t find a cite though. Sorry.

#5

I consider modern therapeutic psychologists to be little more than witch doctors. There are literally hundreds of psychological theories out there most with little to no evidence backing them up. It is scary how many people, including the shrinks themselves, that are convinced in the validity of psychologists (in terms of knowing how the human mind works). Having said that, I do think the current DSM is trying to be scientifically based. Also I do believe therapy can help some people but not because of some great understanding of the human mind by therapists. I read a study where they took an equal number of shrinks and professors posing as shrinks and tried to see how well they did with student patients. They had an equal long-term “success rate.” Perhaps some people simply need a caring, professional, smart, and communicative person to talk to. Personally I think neuroscience is going to pull psychology out of the mystical pseudo-science swamp that it has been living in since it’s birth. It may take a few hundred years but we will eventually know how the human mind works.

#6

Xavier

When the Sociobiology debate was big (mid to late 70’s) Stephen Jay Gould accused sociobiology of being nothing but “just-so stories” and this has always been a popular misconception about the science. However, sociobiology creates testable hypotheses which often have predictive power, so this slur is unjustified. Evolutionary Psychology is merely another name for the branch of Sociobiology which deals with Homo Sapiens. Evolutionary Psychology is not merely reliant on anthropology, in fact I find that you single it out as pseudo-science quite odd as it is the only form of psychology to explain human behaviour from first principles.

Evolutionary Psychology provides a very important complementary viewpoint to an understanding of human behaviour, that of ultimate causation. This will never completely replace proximate explanations of behaviour, but it allows us a more fundamental understanding of human nature. The study of history and the research done in evolutionary psychology does not seek to replace current research, merely to provide complementary evidence and theories. Some of these theories lack powerful evidence but they do not claim to have any predictive power either. Case in hand, Trivers’ Cognitive Arms Race hypothesis: he explains how emotions could have developed out of the need to regulate increasingly sophisticated trade.

I don’t think you really mean clinical psychology by what you are referring to, so much as research psychology in general. Important discoveries have been made in psycholinguistics by mapping brain function; using fMRI psycholinguists have discovered that irregular and regular verbs are conjugated using different neural processes, but other more important discoveries have been made without the need to map brain functioning. Coltheart’s Dual-Route process for reading is supported by two rare dyslexias: phonological and surface dyslexia. How these operate at a fundamental level is unimportant, what is important is that one causes the inability to read non-words, and the other the inability to pronounce irregular spellings. Through this, and through further experimental data, we gain the understanding that our brain reads words by activating two processes, one that checks for a word in the mental lexicon and another that pronounces words phonetically. The two operate in parallel, and the mental lexicon is quicker than the phononetic reading process. I cite these as important examples of how we can gain understanding about neural processes; both with and without neurological techniques.

But important results can be gained from even less fundamental levels of research. If a result can be gained that is reliable with a very small chance of occurring by chance (1%, say) then I’ll be confident that such an effect exists. The only problem with such results is you end up with a bunch of reliable non sequitirs as a body for your science; results with predictive power but with a great deal of room for interpretation. I assume this is the problem you are referring to in the OP? The more studies we do, the more cohesive our understanding of the various aspects of human behaviour becomes, so this problem goes away with time. The methodology for such studies tends to be weaker than those looking at neurological processes due to their generally subjective nature, but this doesn’t render them invalid.

Freudian psychology is more or less dead. Its hypotheses are untestable, and its treatments have not been shown give a reliable improvement to patient’s wellbeing. Very few freudian psychologists exist today (at least in my country). The validity of clinical psychology specifically was discussed in a recent thread by TVAA, which was called “Mental Disorders aren’t necessarily valid”. However, it seems to me you are looking for an explanation for psychology in general.

#7

In today’s society, a psychologist’s function is to replace the social position that was held by religious leaders a generation or 2 ago.
Once upon a time, people with problems went to their priest or minister , and found good, helpful advice, phrased in the language they needed to help them cope.In times of emotional stress and weakness, people want an authority figure who can counsel them on what to do.
Today, we have replaced the authority figure wearing a priest’s white collar who dictates an answer, with an authority figure wearing a doctors white gown, who suggests an answer. It is more appropriate for our society today, but the end result is the same.

The scientific approach of psychology today is no more helpful than the religious approach was 100 years ago. If the counsellor is a good, sympathetic listener , and the patient WANTS to accept the advice given, then the patient will probably feel better after talking to him–whether the counsellor is a shrink or a minister.( And of course, modern medicines can help ,too, so most people today prefer a doctor/psychologist to a priest.)

Most people who pay a clinical psychologist for 2 hours of his time each week,would probably improve their health just as much if thcould find a caring friend who was willing to talk with them for same 2 hours.But friends are hard to find when you are weak and troubled. So lets not critizice the shrinks–they help a lot of people.But it isn’t science–it’s friendship-for-a-fee.

#8

To say that Freudian theory is dead is akin to saying that Newton’s theories are dead. They were both wrong on some things, right on a lot of things, and both have been improved upon since. Don’t confuse psychodynamic theory with psychoanalysis. The former is explanatory while the latter is a therapeutic approach given what we know about the former. I, like many, believe that object relations theory does a pretty good job of explaining how people get fucked up but that psychoanalysis still doesn’t do a very good job of curing them.

#9

If I may add to this thread, this is what drives me crazy:

It seems that certain psychologists would have us believe that many of us develop convoluted responses and defense mechanisms as a way of dealing with problems/conflict. And that these responses cause problems later, problems we need professional help to sort out.

Well, I don’t understand, from the perspective of human development and evolution, why we’d be this way. What an ineffective way for humans to respond to problems. It makes no sense that this would be common, that we’d be so susceptible to messing ourselves up.

#10

Even the most die hard genetic adaptionists seem to agree that human beings developed some capacities which were originally best specialized to tasks like communal living and basic communication, but had related but unexpected side effects that spiraled out of control into human culture and abstract language, all of which served to radically alter the way human beings think and work. This may well have involved new psychological traits that were counter productive to some individuals, but it also gave rise to very effective culture-wide strategies for creatively dominating and exploiting nature that more than made up for it.

Remember that evolution is not something with foresight or intention. When the early humans with bigger and better brains happened to survive and reproduce better than others, it was simply for immediate reasons of survival, not because it foresaw related problems that themselves would come along with the likewise unforseen innovation of culture and complex language. Alll these things have emerged much much too fast for the mechanism of evolution to have created or responded to them, at least directly.

#11

That has been a common result in evaluations of the benefits of nearly all forms of psychological/psychiatric treatment for decades now. The rates of natural remission from symptoms of most neurotic disorders is no different to the rates of relief achieved by practitioners. In one study some time ago patients at a hospital were randomly assigned to psychiatrists, psychologists, nurses and domestic staff for “treatment”. The remission rates were best for the domestic staff and nurses.

I have little doubt that most (or all) forms of psychiatry are just a confidence trick. None of their claims regarding the nature of the psyche are provable and given the failure of the treatments based on these theories I assume they are as lame as Freud. However some humanistic psychological methods (say Cognitive Behaviour Therapy) are rooted in evaluation of real life behaviour without trying to fit the therapy into an intellectual model. They would seem to offer therapy that is just as practical as having guitar lessons to improve your playing.

#12

Few studies being talked about here without actual cites.

Mosto of the critiques seem to be aimed at earlier methods which are indeed ‘unscientific’ in that they are essentially untestable eg classic freudian. More recent methods have a fair amount of empirical support and are generally based on less ‘mysterious’ mechanisms. Anyone who claims that its not effective under any circumstances has a bit of a case to make, the literature doesnt generally support that position - as is true for many positions counter arguments and studies exist but they are not by any means the consensus.

In any case the focus these days isnt really so much on basic counselling techniques which can be learnt or intuitively known by many people fairly easily. Its more a question of tailoring interventions to particular situations, ethical considerations and being trained to keep up with current best practise.

Its true that its a very young science. I do think things are changing at a very rapid rate though.

Otara

#13

Comparing Freud to Newton is a ridiculous analogy. Care to point out any Freudian theories that are still in use, or at least are fairly accurate? Care to show me a testable hypothesis of Freudian psychology that stands to this day?

The Master Speaks.

Not every human behaviour has to be adaptive. Our environment has changed drastically in the past few millenia without sufficient conditions being met to cause a rapid change in our biology, so we aren’t necessarily as adapted to our environment as we could be.

Also, adaptions that suited hunter/gatherers well could now be causing these ineffective ways of dealing with problems. Things like an aversion to certain foods and some phobias may seem anachronistic in this modern age but would have had a clear survival advantage back in the day.

#14

Short response: yes. Clinical psychology is not a science.

There are branches of psychology that are sciences, but unfortunately they have yet to split off into their own fields.

#15

Thank you, mrsam and Apos, for answering my question. You’ve given me some stuff to chew on; very helpful!

#16

Well, I wrote a whole damn post that got eaten so to summarize:

  1. The concept of the unconcious
  2. Defense mechanisms
  3. Clinical Psychology is a social science. You ain’t gonna find laws or hypotheses that can be “proven.”
#17

  1. Care to show me some specifics of his theory that are considered useful in modern psychology? The unconscious is a useful concept, but saying Freud has a place in the modern study of the unconscious is like saying Democritus has a place in the modern study of nuclear physics IMO.

  2. Again, I sincerely doubt the place of Freud in the modern theory here.

  3. To be honest, I don’t really defend Clinical Psychology. However, clinical psychology is a great deal ahead of Freudian psychology. Clinicians are grouping symptoms into groups that commonly occur together and are differentiable from one another, which is a whole lot better than pinning them on “genital phase” or “oral phase”.

#18

I think it is useful, probably necessary, to distinguish between psychoanalysis (Freudian and related, a practice with clients/patients), clinical pyschology (a licensed discipline with clients/patients), psychiatry (a branch of medicine oddly granted police powers), social psychology (an academic and research discipline overlapping with sociology and anthropology), and psychology in general (an academic discipline addressing much of the above but tending to be research-centric), and mental health counseling (often social work).

Most (although far from all) clinical psychologists are short-term behavior-mod specialists, whose practice owes more to Skinner than to Freud. There tends to be very little focus on why the clients act or feel as they do: the emphasis is on techniques to change patterns to more acceptable or desirable ones, usually with very concrete changes in activity.

A good deal of clinical counseling is done by social workers who work from a different framework, one historically unique to social work itself, but again geared towards the modification of behavior. Clinical social work is patterned around formal identification of goals and mapping out change strategies – some versions emphasize client self-determination in setting goals and assessing progress, others are considerably more paternalistic.

Most psychiatry (although not all) is medical-model and tends to address problematic symptoms with prescription medication. As with clinical social work, some psychiatric practice centralizes patients self-determination, involving patients in understanding medication and weighing pros and cons and making their own decisions, although (as with most medical practice) it tends to take the form of choosing between options laid out as such by the doctor; and at the other extreme self-determination can be totally negated, as psychiatry has the authority to command involuntary commitment and impose forced treatment.

All of the above three are approaches that expend very very little energy investigating the subject’s life history as a sequence of emotional and cognitive events that led up to the current situation, and attempting to unravel them and attain some form of “breakthrough”, e.g., assisting the subject to recall traumas that led to automatic / ritualistic / compulsive behaviors as coping mechanisms, etc etc.

Practices that do that kind of thing include, but are not limited to, Freudian psychoanalysis and its offshoots. Competing schools that date back to the same era are Jungian and Adlerian. All three of them are in less than good repute at the moment (although Jungian may be making a modest comeback). Then there are competing schools of practice that are of more recent origin, such as those of R. D. Laing (which has its adherents) and Primal Scream (which I think has been pretty much discarded) and Transactional Analysis (unsure), and others with much older roots (counseling by the clergy for instance).

I personally find a lot of resonance in the Laingian stuff, although I find him unduly specific and mystical about some of it; I do tend to see mentally/emotionally aberrant conditions as processes that are better understood as verbs than nouns, as healthy insofar as the subject will pass through these states of being as a means of working stuff out. I think the Freudian stuff, in which most of the matrix of human personality and behavior is explained as normative delusion and misapprehension and the mentally/emotionally aberrant conditions as abnormal failures to form these delusions and misapprehensions, is indeed the beforementioned “crock”, although as others have pointed out we’ve tended to absorb what he said that was sensible as everyday obvious (the centrality of sexuality and eroticism in symbolic and conscious thought and motivation, for instance) while discarding the crap and remembering him mainly for the crap.

Finally, you have the research and explanation-oriented portions of the disciplines, which make no attempt to treat subjects and are instead geared towards refining the power of prediction. There is everything from pure science to institutionalized attempts to design social control to Yet More Crockery going on in there as well, but it isn’t clinical, and the nature of the separate branches and disciplines is such (i.e., territorial) that findings here do not tend to directly inform or change clinical practice.

#19

I saw a clinical psychologist for about 6 mths last year. She was very effective in making me feel worse.

I would agree they are a paid “friend” (though it was free) I just wish the “friend” didn’t feel being quiet and nodding was actually going to be helpful at all.

Of course she gave excellent advice like “get more sleep” and “going for a walk helps when you are depressed”

Yep she was sooooooooo useful.

#20

She refused to give me medication because I had “issues” (well…DUH) after stopping entertaining her weekly, my GP gave me medication and all was well again.