Psychology and a Misunderstanding

There is a curious anomaly at the heart of clinical psychology. While outwardly the profession presents itself as an example of the scientist-practitioner approach (e.g., Marzillier and Hall, 1999), many clinicians themselves are uncertain that what they do is best described as ‘scientific’ (e.g., John, 1998; Jones, 1997). On this issue there is clearly a gap between how the profession presents itself and what practicing clinicians feel they do (Pilgrim & Treacher, 1992).

Although research into the status of the scientist-practitioner model has suggested that it is ‘widely endorsed’ by the profession, it was recognised that those sampled were not fully representative (Kennedy and Llewelyn, 2001). My own experience is that many clinicians are unsympathetic, even hostile, to the idea that their practice is underpinned by science. Long and Hollin (1997) described a number of commonly held objections to the scientist-practitioner model. These included the view that the scientist and practitioner roles were incompatible, that research is not impartial or value free, that empiricism equals positivism and that research is unnecessarily quantitative. Over the years I have regularly heard similar arguments against the scientific basis of clinical practice. For many it seems that far from sitting at the heart of clinical practice, science is at best an irrelevancy and at worst a duplicitous hindrance. Although this view might be widespread, I believe it is based on an outdated conceptualisation of science and that continued adherence to it will hold back the development of the profession and its practice.

The misconception stems in part from the naive combination of realism and positivism that so often underpins ideas about science (Corrie & Callahan, 2000). In short, realism holds that there is a single or true reality and positivism that reality can be objectively known. The view that science is a positivist enterprise that tells us what the world is really like is not confined to the lay community, but also holds sway with some scientists. Stephen Hawking (1988), for instance, has written, “There are grounds for cautious optimism that we may now be near the end of the search for the ultimate laws of nature” (p.157).

The belief that science charts a singular, objective reality has been termed the discovery narrative (see Follete, Houts and Hayes, 1992). From this perspective science is seen as the process by which we discover (literally ‘un-cover’) the true nature of the world and the criterion by which a theory is said to be correct or ‘true’ is the extent to which it corresponds to reality. But while this view of science is widespread and often implicitly held by scientists themselves, it has never been popular with philosophers (Leahy, 1991). They point out that it is impossible to know whether our observations or theories correspond to reality as there is no independent test their accuracy (Rorty, 1991). Similarly, many prominent scientists have not been so sure that they are engaged in a discovery process. Albert Einstein, for instance, argued that science progressed by way of invention (‘durch Entdeckung’), rather than by discovery (‘nicht durch Erfindung’). And similarly Niels Bohr said, “There is no quantum world. There is only abstract quantum description”. For these two great physicists, science was not about discovering reality, but rather it was a process by which we invent ways of talking about the world. This is the invention narrative of science.

The invention narrative holds that science does not ‘discover reality’, but instead finds useful ways to talk about the world. There is no assumption of a singular reality that can be objectively known. This type of positivistic thinking has no place in the invention narrative. Rather science is how we organise our experiences, and specifically experimental data, in ways that are useful for solving certain problems. As such, science is not interested in ontology (i.e., the study of reality), but rather practical utility. A theory is said to be ‘true’ when it works and not because it corresponds to reality (Rorty, 1991). This is straightforward except that what works depends on what you are trying to do and this means that two different theories can both ‘true’ if they do different things. For instance, the opposing theories of Copernicus and Ptolemy (i.e., helio vs. geocentrism) can both be true as they set out to achieve different things. In simple terms, Copernicus wanted an efficient description of planetary movements while the Ptolemy produced an account that was consistent with Holy Scripture and thereby maintained religious authority. Similarly, John Maynard Smith (1989) has noted that both Creationist and Darwinian theories can be said to be correct as they achieve different things. He writes,

All previous societies had myths about origins. The truth they conveyed was a symbolic one, contributing to an understanding of the purpose of the universe and man’s role in it. Darwinism is also an account of origins, but it is intended to be taken literally and not as a myth. (p.21)

Therefore, both Darwinism and religion can be seen as ‘true’ as they are both successful by their own standards at achieving their aims (i.e., an explanation of biological evolution and guidance for how people should behave). Rather than seeing theories and explanations as approximations of reality, they are better viewed as ‘tools’. And just as it makes no sense to ask whether a hammer or a spanner is true or false, so equally it is nonsense to ask whether a theory is true or false. Instead, the issue is how effective are the ‘tools’ to hand at accomplishing the tasks to which they are being applied (Hayes & Brownstein, 1986).

What does this mean for science’s much lauded objectivity? Quite simply, as B.F. Skinner pointed out there is no special vantage point ‘perched on the epicycle of Mercury’ from which an impartial observation can be made. There is no way to transcend our acculturated selves. Every observation therefore is subjective in the sense of being personal and objectivity is understood “not as a property of the external world, but as a description of the effectiveness of scientific activity” (p.220, Roche & Barnes-Holmes, 2003).

If we view science as a process of invention, rather than discovery, then is it essentially any different from literature or the arts? The answer is no. Like science, the arts offer powerful ways to help us understand the world and our place in it (Feyerabend, 1975; Newnes, 2002). Certainly there are differences in method, but they are not fundamental in terms of epistemology (Leigland, 1999).

It is important to stress that the invention narrative does not mean that science invents data. Science routinely produces (one could say ‘discovers’) new data and while they are of immense importance, they are of little value unless they are organised meaningfully. Hence the scientific process ‘invents’ useful ways of organising its data and it is these organisations that we call theories. Naturally the theories by which we organise and understand data are related to what we are trying to do or the problems we are trying to solve. When the problems that we face change, then so do our theories and the so-called ‘reality’ in which we live.

Does this mean, as the dodo bird from Alice in Wonderland announced, that “Everyone has won and all must have prizes”. No doubt the prospect of such relativism fills many with a deep unease. But while in principle this is possible, in practice people tend to find common cause and to agree on particular goals and the markers by which to measure them by. As such, science is part of our collective effort to overcome the challenges that confront our communities. This is a model of science as a liberal, pluralist and democratic political process as outlined by John Dewey and fellow pragmatism theorists such as William James and B.F. Skinner.

What has all this to do with clinical psychology? The belief held by some clinicians that science is positivistic, simplistically quantitative and largely irrelevant to everyday practice is to see science through the eyes of realism. There is an alternative view. The invention narrative sees science as the process by which we develop tools to solve certain problems, rather than how we discover the true nature of things. If at times that means quantifying or simplifying a problem, then so be it, but if a problem can be solved by another way (i.e., qualitative methods) then that is good science too. Science is about practical utility, not a methodology or ontological accuracy. Inevitably this means science is a collective and democratically political process for as human beings we live in communities and not in isolation.

The invention narrative of science offers those who have hither to seen science as an exercise in realism/positivism an alternative conceptualisation that enables a more sympathetic view. Why does this matter? Because as things currently stand there are many clinical psychologists who are detached from the scientific process and whose views, skills and energy are therefore lost to it. And of course the loss goes both ways, as their clinical activity is not then supported by advancements in science. Hopefully this paper will facilitate a rapprochement.

References

Corrie, S., & Callahan, M. (2000) A review of the scientist practitioner model. British Journal of Medical Psychology, 73, 413-427.

Feyerabend, P.K. (1975) Against method: Outline of an anarchistic theory of knowledge. London: Tavistock.

Follette, W.C., Houts, A.C. & Hayes, S.C. (1992) Behavior Therapy and the New Medical Model. Behavioral Assessment, 14, 323-343.

Hawking, S.W. (1988) A Brief History of Time: From the Big Bang to Black Holes. Bantam: New York.

Hayes, S.C. & Brownstein, A.J. (1986) Mentalism, behaviour-behavior relations and a behaviour analytic view of the purposes of science. The Behaviour Analyst, 9, 175-190.

John, I. (1998) The scientist-practitioner model: A critical examination. Australian Psychologist, 33, 24-30.

Jones, A. ‘What’s the bloody point?’ More thoughts on fraudulent identity. Clinical Psychology Forum, 112, 3-9.

Kennedy, P., & Llewelyn, S. (2001) Does the future belong to the scientist practitioner? The Psychologist, 14, 74-78.

Leahy, T.H. (1991) A history of modern psychology. Prentice Hall: New Jersey.

Leigland, S. (1999) Pragmatism, science and society: A review of Richard Rorty’s Objectivity, relativism and truth: Philosophical papers vol 1. Journal of Experimental Analysis of Behavior, 71, 483-500.

Long, C. & Hollin, C. (1997) The scientist-practitioner model in clinical psychology: A critique. Clinical Psychology and Psychotherapy, 4, 75-83.

Marzillier, J., & Hall, J. (1999) What is clinical psychology? Oxford: Oxford University Press.

Maynard Smith, J. (1993) Did Darwin get it right? Penguin Books: London.

Newnes, C. (2002) The rhetoric of evidence-based practice. Ethical Human Sciences and Services, 4, 121-130.

Pilgrim, D. & Treacher, A. (1992) Clinical psychology observed. Routledge: London.

Roche, B., & Barnes-Holmes, D. (2003) Behavior analysis and social constructionism: Some points of contact and departure. The Behavior Analyst, 26, 215-231.

Rorty, R. (1991) Objectivity, relativism and truth: Philosophical papers vol 1. Cambridge: Cambridge University Press.

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