Psychiatrists (in general) have no more insight into human nature
than the average person. When I say "psychiatrist", I mean those
people who give psychotherapy (whether the type of therapy be
psychoanalysis or otherwise) and those who counsel/oversee
patients at psychiatric hospitals. Those people who do scientific
research into the nature of the mind, or who base their
theories/practices upon that research, generally know what they're
talking about. There are those who refer to the later as
psychologists and the former as psychoanalysts, but that
distinction isn't important for this discussion.
*Ahem*. Anyway, there's some pretty good evidence to back
up this assertion. First is a study done by Mary L. Smith and
Gene V. Glass, published in the 1977 American Psychologist. It
was a meta-analysis of 375 other studies of psychotherapy,
summarizing the results of these studies. Three things of
interest that they found were:
The experience and credentials of a therapist were totally
unrelated to the effectiveness of the therapy given.
With a few exceptions, the type of therapy given was unrelated
to it's effectiveness.
The length of therapy was unrelated to it's success.
If therapists actually knew something about human nature, then
presumably more experience would lead to better performance.
Also, if the one of the many different psychological theories was
true (or close to true) than the type of therapy that derived from
that theory would do better than the others, but none of the types
of therapy was found to be better than any of the others.
Finally, many psychological theories hold that people improve more
the longer they are in therapy; since this is false, there must be
something wrong with the theories.
Other indications that psychiatrists don't have any special
insights into human nature are:
Psychiatrists often do worse than chance when
making various predictions about what their clients will do.
When given written case documents about a patient, the answers
given by psychiatrists and people with no psychological training
are very similar.
When there are equations that can be used to make
predictions about behavior, these equations always do better
than psychiatrists do. Even if the psychiatrists use the
equation as a starting point or guideline, and try to improve on
it, they still do worse than if they had followed the equation
So how did things get to this state? Because most of the
psychological theories used by psychotherapists isn't based on
scientific experiments, but on clinical experience.
Psychiatrists do part of their training in a hands on manner,
under a full fledged psychiatrist. Now, how does one go about
learning from experience? Well, you do this, and it
worked, and then you did that, and it didn't work, and you
pick up experience. But if you're talking with a patient for
weeks and months, and they get better, how can you tell if what
you did was the cause, or if was some outside cause? Or maybe
they just would have gotten better with the passage of time.
Moreover, how do you tell what parts of your therapy helped, which
were useless, and which actually harmed the patient?
The training that isn't hands on involves studying previous
therapy cases (vicarious clinical experience) and learning
psychological theories that were based upon clinical experience.
So everything is based on clinical experience, from which it is
difficult to learn good information, and little is based on
science. As Robyn M. Dawes put it, a true "House of Cards".
This lack of correct knowledge and theories is covered up by
Margaret A. Hagen calls "The Witch Doctor Fallacy". Suppose
that, in some imaginary tribe, someone who has a mental illness is
tied to a stake, beaten, burned, and chanted over by a witch
doctor, in order to drive out the spirit which is causing the
mental illness. The patient gets better, and both the patient and
witch doctor attribute this to the the shaman's correct diagnosis
of demonic possession. The same problem happens with modern day
psychiatrists: John Doe goes to a psychiatrist, he gets better, so
both of them think that the psychiatrist must have known what he
was talking about.
An aside: this criticism of psychiatrists does nothing to recommend
Scientology or Dianetics. Although it is claimed that these
were based on scientific experiments, the types of experiments,
the methodology used, and the data generated have never been
released, so no peer review has been possible. Under these
circumstances, the testimony from Scientologists or Dianetics
practitioners has as much validity as the testimony from people
who go to Freudian therapists.
Title: House of Cards; Psychology and Psychotherapy Built on
Author: Robyn M. Dawes
Publisher: The Free Press, a division of Simon & Schuster
Title: Whores of the Court
Author: Margaret A. Hagen, Ph.D.