"Trust me, I'm a psychologist"

Mind Hacks, a psychology and neuroscience blog, posted a piece called Trust me, I'm a brain scan. They report on a study (a meta-study, actually—a study of studies) that found that, when the results of a particular piece of research are presented alongside a picture of a brain scan, readers were considerably more likely to find the results credible as compared with those not presented with such a picture, even when presented with otherwise identical information.

Ooh, science!

We’re willing to put a tremendous amount of faith in science even if we don't understand or investigate the foundations of that science. The more science-y information seems, the more we’re willing to believe it.

The local news in New York seems captivated with science-y sounding studies, and nary a 6:00 pm broadcast can pass without some “new” bit of information on the merits (or demerits, seemingly alternately) of chocolate or red wine, or of a particularly outlandish exercise routine. The credibility line is always, “Researchers have found…” (Or, more often, “Researchers at New York Presbyterian Hospital have discovered…”—the script likely written entirely by the hospital’s publicist.)

Psychology gets its turn at this science-y game as well. Psychology is a science--the subset of science--after all, that speaks to the captivating mystery of human behavior. Psychologists, we’re told, have discovered why men cheat, why “opposites attract,” why some people vote for Republicans, and why New Yorkers prefer to stay up late.

We’ve come to view psychologists as experts on what’s really going on, deep inside.

Why?

We also recognize that psychologists—professionals from the same discipline as these research psychologists—are the one’s we ought to seek out for help when we’re in emotional pain. (Representatives of a number of disciplines provide psychotherapy, but “psychologist” is most commonly whom we think of.)

A logical connection to make, then, is that somehow a psychologist’s knowing what’s going on deep inside, their understanding of why I’m doing whatever it is I’m doing, i.e. the cause underlying my pain, is central to the method they will use to help.

Certainly many clinical psychologists (which is to say those who practice psychology—psychotherapy, really—with clients, as differentiated from research psychologists) operate that way. Whether it’s through a psychoanalytic lens (grounded in the methods of psychology originating with Freud) or through a more behavioral lens (flowing out of a psychological methodology that studies, empirically, the faculties of cognition and behavior—from which flow those studies most likely to show up in your 6:00 pm new broadcast), the central question is: Why do you do what you do?

Why can be helpful, and is a part of any work in therapy. Developing a picture of why we do what we do can lend a productive self-consciousness to our lives. We can address these causes on their own terms, find emotional release, or use that understanding to shape new habits.

What too often gets lost, however, is that when we’re seeking help in therapy why is less important than how. If we’re struggling with emotional pain, we want a therapy that can help us make changes in our lives; the bottom line is, we need to discover how.

From Why? to How?

Psychoanalysis is far and away the most prominent form of therapy available in New York. While there are countless varieties of psychoanalysis, all are grounded in Freud’s belief that adult struggles emerge, primarily, from the experiences of early childhood. The process of psychoanalytic therapy is, roughly speaking, uncovering those experiences and seeing how they relate to our current lives. Freud believed that the cure was to “make the covert, overt” and in so doing, cure neurotic (i.e. historically grounded) pain.

This sort of therapy has been helpful to countless people, but the intense focus on why to the exclusion of how leaves many people wanting. Quite regularly I encounter in my New York practice a new therapy client who reports the following, nearly verbatim: “I’ve been in a ton of therapy. I’ve worked through my childhood, and I feel at this point that I am completely aware of why I do what I do. Now I just need some help to change it.”

Having an expertise on why is great for landing an interview as an expert on the local news, but when you’re shopping for a therapist you need an expert on how.

If you’re looking for a plumber do you want someone who can explain the cause of your clogged-up toilet, with a deep understanding of the complexities of modern residential plumbing, or do you want someone who can fix it?

We give away trust too easily based on an expertise in why people do things.

You’re a you, not a “people”

One of the things that makes science-y stories particularly juicy is a research study backing them up that can make a broad assertion about human behavior. The standard for why to be credible is that the tendency articulated in the study has been seen repeatedly, across a large number of study participants.

A huge assumption made in research psychology is that if something is demonstrable in a large group of people it can be seen as a general principle or human behavior. Among other things, such research is normative, which is to say that it presumes to define a set of behaviors or traits as normal, and by extension, an absence or dysfunction in those behaviors or traits as abnormal.

The application of the results of such studies to the clinical practice of psychology, in your therapy, presumes a huge leap by conflating what is normal with what is desirable or, most importantly, desirable for you.

It’s also worth noting that a significant amount of the time, the “people” this research studies are often college students, and in particular psychology and sociology majors; after all, they’re the most available to participate in the studies!

A matter of trust

Trust is a critical part of any relationship, and particularly in therapy. Obviously. If you're getting into the gory details of your life, tackling issues long left untouched and signing on to make big changes in your life, you've got to trust your therapist. Too often this is seen as solely a matter of credentials. A therapist has a degree and a license and looks the part and talks the talk. While none of this is irrelevant, it is simply not sufficient as a basis for trust. No one, no matter where they went to school, or how many times they've been quoted in the news should get a free pass. Expertize on why things happen, while a novelty that's occasionally helpful, isn't enough.