[I know this has been done to death, but I thought I’d write up my own take on it anyway.]
The most basic difference between science and religion, the one that makes them butt heads and complicates any discussion of the two, is their difference in epistemology.
Modern science starts with the assumption that we know nothing, and painstakingly have to establish every assertion as true. There have been studies done to confirm and quantify things that everyone takes for granted, such as that something that is farther away looks smaller than something that is closer. Scientists confirmed that this is true, and more importantly were able to describe the equivalence between distance and size, which has implications for eyewitness testimony. Ideally, research is conducted to confirm or deny and/or measure a specific point. Negative results can be just as informative as positive results. It is a flawed, human process, but one that is self-correcting and that builds on itself. It starts from nothing and, by collecting, investigating, and quantifying data, reaches conclusions. These conclusions are then tested by other scientists to see if they are accurate, and are modified in response to new data. Science works forward, the evidence pointing towards the conclusions.
Religion works in exactly the opposite way. It takes a given premise as a fact, and then looks for evidence to confirm the premise. Most importantly, disconfirming evidence is either devalued or ignored. Since the premise is known to be true, any evidence that shows it is false is de facto flawed. Religion works backwards, with the conclusions determining which evidence is correct.
This is a feature of not just religion but of many non-scientific beliefs, including pseudo-sciences. Disturbingly, I’ve found such belief systems in my own profession. Psychology is one of the soft sciences, and in some places it’s so soft it’s fluffy. Classic Freudian psychoanalysis, which has entered popular culture as the definitive form of psychology, is an example of this. Freud never performed research, and based all of his conclusions on a very limited number of case studies from his own practice. He assumed that he and his patients, all of whom were upper-middle-class Viennese, were representative of humanity. He came up with a lot of clever psychological mechanisms to explain their various disorders. When researchers tried to confirm his theories, they found that he had been right about a surprising number of things, but that he had mostly been wrong. Psychology changed from focusing on the subconscious to focusing on observable behavior and to describing cognitive processes. Yet it took decades for traditional psychoanalysis to be abandoned, and it continues to be used today in a modified form.
Another example I came across is William Glasser’s Choice Theory. I first heard of it in a counseling class in grad school, and I thought that it sounded very interesting. But when I got his books from the library and started reading them, I was dismayed to find that they were mostly conjecture. Worse, he claimed that if only everyone would ascribe to, study, and understand his theory, the world would become a Utopia. It sounded like he was trying to start a religion. I still think that the basic premise of his theory, that everything we do is a choice, can be a useful therapeutic tool. Many people feel that their problems are caused by forces they can’t control, and so rationalize not doing anything about them. I think that Impressing on them that their life is a result of their choices can be a powerful motivator for constructive changes. But I don’t think it is anything more than that.
Both classical Freudians and Glasser operate the same way religions do. They assume that a premise is true – neurosis are caused by subconscious pressures, everyone’s problems could be solved if only they would understand that it is their choices that cause them – and pick their evidence to conform to the premise.
On the other hand, there is research that makes me proud of my field, like forensic psychologists quantifying the size an object appears at a given distance, or findings in social psychology like the classic Milgram experiment. These studies produce evidence that can then be used to form theories. Sometimes they are wrong, but the faulty data is eventually weeded out and the theories are stronger for it.
I think that in religion, in science, in every field, we should try to move from evidence to conclusion rather than from conclusion to confirmation. It is the best way we have of knowing what is.
In my field, rehabilitation and pain medicine, there are a lot of "empirical" but unproven theories and treatments. Even as we aspire to become more scientific and rigorous, there is alot of stuff that has remained widespread even though it's unproven.
ReplyDeleteFor example, alot of the complementary medical therapies for pain. I'm not discounting all of them. But most of the "evidence" consists of personal testimonials or poorly designed studies. As in religion, it works backwords, attempting to confirm something that is already assumed to be true. Homeopathy is one field that comes to mind, which in fact has been studied and consistently fails to yield positive results in controlled trials. Yet some people swear by it, and there are practitioners galore.
Money and profit motive has some influence IMO, along with some psychological aspects, such as giving a sense of hope and control in the face of helplessness.
I have heard doctors say that they don’t care if homeopathy and other “complementary” therapies are wholly the placebo effect, as long as they help the patient feel better. I can understand where they’re coming from, but I think it risks legitimizing these therapies as effective in their own right. There are many people out there who think homeopathy = natural, and natural = automatically better than modern scientific medicine. If these therapies are used in hospitals, these people will claim that even the medical establishment acknowledges that they work, and may forgo real medicine in favor of some “natural” treatment.
ReplyDeleteAnother problem is that for those who believe in them homeopathic treatments are almost like a religion. They will tell you why every study with negative results was flawed. Worse, I saw a claim (though in a slightly different context) that a therapy, though it had been used over a long period with many different patients and no discernable results, should not be discontinued because it had not been “proven” to be ineffective. One wonders what standard of proof would be necessary to show that something doesn’t work!
This raises the classical ethical question of the intentional use of a placebo. Rather than send my back pain patient for Shiatzu, I could give him a really strong "pink pill" and tell him that this will make him feel much better. The closest I come to this is giving the patient a rx for a little known obscure but harmless analgesic and telling him that in my experience this medicine works really well. I also do "trigger point" injections (no charge in the israeli health system) which I think is largely placebo effect.
ReplyDeleteFrom my rather minimal knowledge of psychology I understand that the benefits of some types of psychotherapy have not been rigorously proven, and may be due to a combination of placebo and regression to the mean.
But alternative medicine is a big business. Not only the practitioners, but the big chains and companies like GNC that sell supplements and natural remedies, and the pharmacists who recommend them.
That's capitalism.....
> From my rather minimal knowledge of psychology I understand that the benefits of some types of psychotherapy have not been rigorously proven, and may be due to a combination of placebo and regression to the mean.
ReplyDeleteThere’s some evidence that therapy is itself therapeutic – that is, sitting and talking about your problems to someone who mostly listens, combined with the assumption that consulting an expert will help solve your problems, actually helps solve problems.
G*3, in my reading for grad school, I've found that most types of therapeutic techniques don't have a significant effect one way or the other. The forming of a quality relationship between therapist and client seems to be the most effective thing, and whether you use Cognitive-Behavioral or psychodynamic types of therapy doesn't seem to matter for depression & anxiety as much. This changes of course once you get into areas like phobias and bipolar disorder, but in general, there doesn't seem to be a lot of science in formulating a therapeutic technique or treatment methodology for most people except "it works."
ReplyDeleteThis is why, when I begin practice, I'm interested in cognitive psychology. Once you have an idea of how people process information and what kind of thought and perception processes moderate the interpretation of the information, then you can at least apply the unscientific techniques to something scientific. That's probably as much science as you're going to get in a therapeutic context IMHO, but I'm not as knowledgeable in this area as I should be, so I could be wrong.
I do want to ask you though, because I haven't thought much of this myself. Do you think that you could develop a therapeutic methodology & techniques starting with a scientific, rather than philosophical or ideological basis? Is this just an area that it's impossible to do it in? It's been over 100 years since Freud began writing on psychology and I haven't really seen any theories developed based on a fully scientific methodology yet. The integrative guys are mostly picking and choosing what feels right to them for their personal style rather than conducting experiments and running statistical analysis to compare techniques against each other.
Its an interesting question, and I’m not really sure. Personally, I heavily favor behaviorism, with some cognitive aspects for counseling. Part of the problem with psychology is the popular perception, unfortunately shared by some practitioners, that its about what makes you feel better. I prefer to see psychology as the study of what people do (behaviors) and why they do it (cognitions, social influences, etc.).
ReplyDeleteAlso, like you said, a lot of the softer therapeutic techniques break down when trying to deal with actual disorders as opposed to life problems. For most serious disorders, the real solution is psychotropic drugs. I think that in the near future most of psychology will be reduced to pharmacology and managing the disorder. Its been moving in that direction for years already.
My preference for behaviorism may be related to my working mainly with the MR/DD population and with kids who are receiving services through EI and CPSE. Simply, it works. It has solid studies behind it, and its basically methods for training people to do things.
They weren't Venetians, they were Viennese.
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