Of ‘Psychopathic’ Children & Interventionist Clinicians

Researchers in New South Wales are on the hunt for ‘psychopathic’ pre-schoolers. Apparently, they have created a ‘diagnostic tool’ in which young children are shown images, either ‘distressing’ or ‘neutral’, in order to classify the child as either ‘healthy’ or ‘callous’ on the basis of their responses. The 10% of children who were found to be ‘unemotional’ can be targeted for early intervention.

On the Crisis of Reproducibility in Psychology

As we might expect, most results in psychology are not reproducible. As the authors who obtained these results say, ‘reproducibility is a defining feature of science’. From this, we could conclude, as have many in the field, that the answer is more experiments, tweaked statistics, metholodogical tinkering and the like. Or, we could make a point that is not so much epistemically radical as it is blatantly obvious, and that is that psychology is not a science at all. It does not resemble science except in the most superficial of respects. It isn’t just the failure of replication documented here, but the complete impossibility of findings in psychology ever being abstracted into formulae for precise prediction.

The Problem with Randomised Controlled Trials (RCTs)

I have recently been debating the merits and problems of objective, quantitative research in mental health. (One of my interlocutors has posted a lengthy response here, arguing in favour of ‘objectivism’). RCTs are a methodological device introduced into mental health from general medicine. Whilst they are merely problematic in the latter, they are outright misleading in the former.

Against ‘objective’ tests

One of the effects of the anti-subjective, objectifying approach in psychology and psychiatry is to leave subjects themselves in an alienated position with respect to their own suffering. Forms of misery which are by definition subjective – melancholia, grief, anxiety, or even physical pain, for that matter – can seem to have no validity unless ‘verified’ in some ‘objective’ form (a blood test, or psychometric scale, etc).

This is an unfortunate position, as it mistakenly treats that which is subjective as if it were non-existent outside of these tests. It leads to absurdity, as grief (for example) is no less real or horrendous for being impossible to quantify. The impulse to seek for ‘objective’ measures of pain implicitly devalues the speech of the suffering subject, and also implicitly posits their disposition, as one in which they are not personally implicated. After all, why examine your life if your most profound and intimate experiences are reducible to neurochemical effects? It also assumes that one person’s suffering is essentially the same as another’s – homogenous – and that it is merely a matter of numbers, of degree on a scale. It is true that speech and subjectivity are clinically and scientifically ‘messy’, but this does not justify rejecting them through objectification.

I cannot see anything in this demand for objectification that is respectful toward private suffering, supportive of therapeutic effects, or grounded in rigorous thinking.

Lost in Cognition

There is a tradition among certain psychoanalytic writers and schools, to decline any engagement with the world outside of analysis. In this tradition, psychoanalytic literature becomes a continual exegesis of the master(s), devoid of reference points to the world beyond. Thankfully, Eric Laurent and his colleagues are most definitely not of this tradition, as Laurent’s new book, Lost in Cognition, demonstrates amply.

The Ethics & Politics of Intervention: A Critique of CBT as Ideology (Part 5

The state of ethics in psychology, in Australia, at least, is lamentably primitive, and the politics of psychological practice virtually unspoken. If psychology is presumed a science, after all, how can it be political, any more than the laws of thermodynamics, or quadratic equations? Ethics is taught as a subject to psychology students, but it amounts to little more than a few strictures and prohibitions – do not fleece patients, do not maintain conflicts of interest, no sexual relationships, etc. By themselves, these prohibitions are perfectly reasonable, but they hardly constitute a level of ethical discourse beyond that which the average five-year old might grasp. The continuities between the biopolitics of the clinic and those of the factory, the school, and the prison are invisible. Foucault, Laing, Szasz and others go unread and misunderstood; ‘anti-psychiatry’ is even used as a term of abuse, as if criticism of this or that diagnostic system was tantamount to nihilism. If academic psychology avoids direct confrontation with complex ethical questions, the same can be said of regulators, at least in Australia. The regulators certainly enforce prohibitions and punish violators, and there is plenty of evidence that they are rapidly escalating regulatory requirements (and, of course, fees). None of this gets to the heart of the matter. The more important question, generally evaded by the discipline, is what is it that is happening, ethically and politically speaking, when one does psychology? And when one does CBT, in particular?

A Note on Psychometrics: A Critique of CBT as Ideology (Part 4)

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.

Psychology, Epistemology, Theory and CBT: A Critique of CBT as Ideology (part 3)

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).