As a final word on epistemology, it is worth noting that the prop which keeps CBT concepts upright, and which supports most of empirical psychology, is the area of psychometrics. Psychometrics is psychology’s proudest achievement, and perhaps the only body of knowledge unique to it. As with CBT, however, its epistemological base is as dubious as the uses to which it is put. Continue reading
Having explored the dubious history and origins of CBT, it is time to turn our attention to its theory, epistemology and methodology. Despite shrill appeals to science and reason, there has been much critique of CBT from an a priori perspective, three fine examples of which can be found here, here, and here. I will not repeat their points. Much of what I say here of CBT is applicable elsewhere in mainstream, Anglophone psychology. The failings of CBT in particular, and of psychology generally – and they are many and serious – are, in my view, both avoidable and instructive. I discuss them here in order to learn from them, with a view to constructing a better psychology (by which I do not mean merely a more refined CBT, or an empirical psychology with better-researched norms). Continue reading
Psychoanalysis was the first of the systematic talking therapies. The first couple of generations of psychoanalysts consisted principally, with some notable exceptions, of Central European Jews from Vienna, Budapest, Berlin and elsewhere. By the 1930s, this part of Europe had fallen to fascism, and this cataclysm was ominous (and eventually catastrophic) for Jews. A diaspora ensued, with Freud himself relocating to London, and many others moving there also, with other prominent destinations including Paris and the Americas. In these diverse environments, various sub-schools of psychoanalysis emerged, with considerable differences in their theory and practice. ‘Ego psychology’ was the sub-school which dominated psychoanalysis in the US to such an extent that it came to be identified (by some) as the only ‘true’ form of psychoanalysis. It was out of this context – post-war US, mass demand for psychological interventions, and the growing influenced of managed care – that Beck’s CBT first emerged. Continue reading
What follows in the next few posts is a longish essay on CBT as the dominant force within applied psychology, and its place as an ideology which supports various practices of domination.The length of this essay is unwieldy for a blog format, so I have broken the piece into sub-sections, which I will publish one at a time, before eventually assembling the piece into pdf form. As ever, discussion is welcome.
The structure of the piece is as follows:
1. Cleaning the Augean Stables
2. The Founding of CBT,and Beck’s Foundational Errors
3. Psychology, Epistemology, and CBT
3a. A Note on Psychometrics
4. The Ethics and Politics of Intervention
4a. Two Brief Case Studies in Biopolitics
5. Project for an Unscientific Psychology
It seems to me an urgent task to critique the dominant ideology which has psychology in its grasp, namely Cognitive-Behaviour Therapy (CBT). As a general rule of thumb, whenever one sees an acronym in psychotherapy, one can assume the presence of glib, corporate-friendly pseudo-scientific pap, and that is entirely the case here. However, unlike NLP, for instance, (I do not mention more popular doctrines, but I mean them), CBT is taken seriously by many clinicians and patients alike. Despite numerous signs of its weakening, CBT remains strong where it is most influential, namely, in academia, third-party payers, and among regulators. Continue reading
The following was presented at a meeting of the Lacan Circle of Melbourne in July, 2013:
Marie-Helene Brousse (2013, p. 24) said of diagnosis that it was considered by Lacan ‘as an act, implying a decision requiring logical argumentation and clinical confirmation’. Alas, this is not the modus operandi for mainstream psychiatry and psychology.
What is visible within a science, the sorts of statements it can make and encompass, the discursive strategies it deploys – these are all contingent upon some prior condition, at least, according to a disparate range of modern philosophers. For Heidegger, Gestell (enframing) provides the precondition for something to be made present. For Foucault, drawing from the latter, an episteme is the condition of possibility of knowledge. In Kuhn’s philosophy of science, paradigms provide the boundaries within which ‘normal science’ can occur, and Wittgenstein wrote of the rules of language games.
Whilst these concepts are not straightforwardly equivalent, what they share is the idea that there are a priori assumptions that precede scientific research, and that the products of such research will be contingent upon these assumptions in various ways. The assumptions ordain in advance what can be seen, and what can be said, and what simply makes no sense within a given perspective. This point seems to be forgotten by those who are most enthusiastic about the notion of psychology as a ‘science’ (as opposed to say, psychology as a branch of metaphysics, or as a subset of psychoanalysis).
What psychology makes visible, and what it articulates, within its particular framework, is principally devoted to the statistical study of hypothetical constructs (diagnoses, ‘traits’, states, ‘behaviours’, etc). What is rendered invisible, or unsayable in this approach? First, and most obviously there is no proper consideration of ontology, no thorough or coherent analysis of the sort of being to whom one is appending all these statistical artifices. Secondly, there is a refusal of the qualitative dimensions of empiricism, as if anything that cannot be assigned a number is essentially non-existent. Thirdly, there is very largely a repudiation of the social and linguistic dimensions of human life – despite their conceptual contiguity, sociology, history and linguistic perspectives are sidelined in an Anglophone psychology that is fundamentally atomistic, with socio-linguistic ‘’factors’ tacked on as a kind of ontological afterthought. This accounts, for instance, for the ludicrous lengthiness of the tired nature-nurture debacle, as if something like human ‘nature’ could wander about unmediated by social bonds, laws and language. No such nature exists, except, perhaps, in mythology, yet to question these untenable assumptions, or others (‘temperament’ comes to mind, as does the notion of ‘cognition’) is to situate oneself outside of respectable scientific discourse, as currently conceived. There are the two options from which to choose, it seems to me – either a narrow, quantitative, pettyfogging ‘science’ of psychology, that ignores the most vital aspects of human life in pursuit of concepts that are as degraded as they are ridiculous; or, something altogether different to science itself, but which replaces rigour with statistical fetishism.
Of course, within a science (or paradigm, or framework) like psychology, there can only ever be a limited contest of ideas. Mostly, there is a contest of power, more or less independent of ideas. Authorities determine what is scientific or ‘evidenced-based’. To dare to observe flaws in the ‘science’ of psychology is to risk accusations of unprofessionalism or scientific nihilism. Students and would-be practitioners must obey their masters if they want a Masters.
And these issues are not merely theoretical. If an entire discipline construes human subjects as mere bundles of data, from which ‘information’ is to be extracted as efficiently as possible, one might expect this to be reflected in clinical practice, and it is (often). The individuals, institutions and systems that treatment people thus can regard themselves ‘scientific’.
Archives of a Divided Subject 