A soft science that, in very few words, holds that both conscious understanding of yourself and direct action on the underlying biology can be used to help deal with mental states that impair your day-to-day life.

See also antidepressants, therapy.

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:

  1. The experience and credentials of a therapist were totally unrelated to the effectiveness of the therapy given.
  2. With a few exceptions, the type of therapy given was unrelated to it's effectiveness.
  3. 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 exactly.

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.


References/sources:

Title: House of Cards; Psychology and Psychotherapy Built on Myth
Author: Robyn M. Dawes
Publisher: The Free Press, a division of Simon & Schuster Inc.
ISBN: 0-684-83091-4

Title: Whores of the Court
Author: Margaret A. Hagen, Ph.D.
Publisher: ReganBooks
ISBN: 0-06-039197-9

Psy*chi`a*tri"a (?), Psy*chi"a*try (?), n. [NL. psychiatria, fr. Gr. the mind + healing.] Med.

The application of the healing art to mental diseases.

Dunglison.

 

© Webster 1913.

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