Friday, January 10, 2014

Theories of Depression: Explanations or Justifications?

Paper presented at Thinking Critically about Psychology: Gender, Power and Clinical Practice, Umeå University, 31st May 2013.

I

In january 2007, I lost the ability to sleep. I was utterly exhausted, and the very thought of having to cope with another day made me so anxious that it was impossible to fall asleep. This became a vicious circle: I desperately needed to sleep, but I couldn’t, because I was worried I wouldn’t be able to sleep.

Sleeping pills was a relief. For the first time in weeks, I could finally get a full night’s sleep. However, I remained dependent on sedatives throughout the spring. And then things got worse.

Summer 2007 saw a complete breakdown, and I made an involuntary visit to the psychiatric emergency ward. I was convinced – or rather persuaded – to start taking antidepressants. The first two weeks were pure hell, but then the anxiety went away and things became more stable. I could study, I could do housework, I could be with my family – but I was somewhat cutoff from the world. I wasn’t unhappy, but I wasn’t really happy either. I just didn’t care (a common experience for people on antidepressants; see Teal, 2009). However, it wasn’t until I tried to quit antidepressants and started to feel things again that I realised the numbing side-effects of my medication.

I’m still on antidepressants, because quitting proved very difficult. Too large a dose, and I begin to feel numb, almost anesthetised, and caught in a bubble cut off from the rest of the world. To small a dose, I may feel fatigued, angry and find myself in constant conflict with loved ones and other peers. However, I can’t tell if this dependence on antidepressants is due to some physiological disorder in my brain that is somehow ‘corrected’ by psychoactive drugs, or if it is due to the fact that I have been exposed to these kinds of chemicals for years.

II

Why do I tell you this? For two reasons. First, when I criticise the diagnosis of depression – which I will do in a short while – it does not mean that I deny the existence of the very phenomenon. I do, however, argue that what is often routinely diagnosed as ‘depressive disorder’ is poorly understood and that treating it as a pure medical condition actually do more harm than good.

Second, my own story is not in any way unique. Like many people receiving a major depression diagnose, the illness metaphor and the solution in terms of psychopharmaceuticals might be relieving, but over time this usually proves an unsatisfactory understanding of one’s own suffering, particularly since depression usually means recurring episodes. Depression often means a continuous process of trying to make sense of my depressive suffering. The question ‘what is wrong with me?’ seldom receives a final answer (Karp, 1996, p. 75).

III

What is a ‘theory’? The word comes from the greek θεωρία (theoría) which means ‘contemplation’, ‘consideration’, ‘speculation’. In Aristotle, θεωρία is the contemplative activity of man, the state of being a spectator that seeks neither glory nor wealth, but pursuits θεωρία for the sake of itself.

Nowdays, a ‘theory’ refers to a linguistic account or narrative that seek to explain how some phenomenon come about, usually in terms of general principles independent of the phenomenon in question. To explain something, then, means to uncover, to lay bare, to clear something of obscurity, to illustrate the meaning of something.

Suppose I make the observation that every time I run the washing machine, a sock disappears causing another odd pair of foot garment. Why is that? Is the washing machine broken? Is there a little sock-eating goblin living in the washing machine? Does the washing machine open up a wormhole in the spacetime fabric of the universe that consumes exactly one sock every time i run the colour wash program? All these speculations are, by definition, theories, since they try to explain some observed phenomenon by referring to some principle or state of affairs that goes beyond the phenomenon itself.

However, this is hardly scientific theories. A scientific theory is not just any speculation on the nature of things, but a coherent statement consistent with empirical evidence obtained through accepted scientific methods. A good scientific theory, such as Einstein’s general theory of relativity, explains phenomena like gravity in a way that it can exactly predict what will happen if I drop a cannon-ball from the leaning tower of Pisa (give and take some deviations due to measurement errors, air drag, et cetera).

IV

Aristotle contrasts θεωρία (theoría) with πρᾶξις (práxis), the doing of things. Theory involves no doing apart from itself, and practice does not necessary have to be informed by theory. I can, for example, theorize on the causes and nature of health and illness without actually treating any patients, and I can cure patients without knowing how or why the cure worked.1

I would argue that this clear distinction between theory and practice – between thinking and doing, between the mental and the physical – is a fallacy. Theory is never disconnected from doing. I always have a reason why I formulate a theory, and this reason is always grounded in some aspect of my everyday life. I do not just speculate on the causes of a certain illness; I do it for a reason – if not to heal the sick, maybe I do it in order to cope with my own illness, to promote my academic career or make money on pharmaceuticals.

This applies to science as well. Science is never pure, detached speculation, but guided by some knowledge interest. A critical view on scientific knowledge means putting it in its historical and cultural context. It means asking questions like who do scientific theory, for whom, and, in case of psychology, to whom does this particular theory apply? Science is never devoid of power.

V

If theory never goes without praxis, praxis is never disconnected from theory. At the very least, I can make up a theory ex post facto that, given the circumstances, explains that what I did and the way I did it was the most sensible thing to do. Or maybe it wasn’t, maybe I was wrong – but I would still provide some kind of narrative that explained why things ended up the way they did.

Obviously, this is not scientific theories, but rather justifications, that is, a reason or excuse that provides convincing and morally acceptable support for a behaviour, a belief or an occurence.

What I would like to argue here, is that if theory and practice – what we think and what we do – are interdependent, then the distiction between explanation and justification is blurred – whether or not these theories are called scientific. This, I would claim, is also the case with psychological theories and clinical practice – the theories we use to explain and make sense of peoples psychological distress and what we do as clinical psychologists is inextricably interdependent.

This might seem trivial and obvious: of course our practice as clinical psychologists is theoretically informed. But I would like to emphasize the other direction, that is, the way science and psychological theories are used to justify our clinical practice.

VI

Before I continue I would like to say a few words on psychology as a science. First, most psychological theories are not so much explanations as models. A model is a simplified representation of a complex reality, where cruicial aspects of the model corresponds to the real phenomenon, whereas others does not. A die-cast toy car might be an exact replica of a real car when it comes to its three-dimensional configuration, but it has no engine and you can’t use it for driving. It sits very nicely on the shelf, though.

Psychological theories, or models, consists of variables and their interrelations expressed in mathematical terms such as correlations, effect sizes and – chief among them all – goodness of fit. Psychological theories are, however, very much unlike scientific theories in physics and chemistry. Whereas the law of gravity applies to any physical object in any thinkable situation, psychological theories are probabilistic in nature and applies to group averages, not real persons. I can’t help but quote the psychologist and philosopher Daniel Robinson on this matter:

What has been characteristic of experimental psychology is the adoption of a rather prosaic set of experimental ‘controls’ and a repeated-measures paradigm. In a wide variety of settings, this method of procedure has yielded fairly stable functional relationships between dependent and independent variables under conditions generally so unlike the domain of interest as to render generalizations jejune. (Robinson, 1995, p. 332)

Psychological theories tries to make sense of people’s psychological functioning: what they think, what they feel, and what they do. Now, I’m also ‘people’, so psychological theories applies to me as well. Thus, psychology claim to explain my own thoughts, feelings and actions. This reveals a peculiar circularity: Psychological theories that claim to explain people’s experiences, thoughts, feelings and actions are used to make sense of my own experiences, thoughts, feelings and actions – thus changing the very experiences, thoughts, feelings and actions that the theories tried to explain in the first place. Perhaps the Scottish philosopher Alasdair MacIntyre puts it better:

Psychology is not only the study of human thinking, feeling, acting, and interacting: it has itself – like the other human sciences – brought into being new ways of thinking, feeling, acting and interacting. We ordinary people whom the psychologist studies have turned out to be not quite the same ordinary people that we were before such extraordinary people as William James and Freud and Köhler and Piaget: Psychologists have had varying (sometimes striking) success in interpreting the human world; but they have been systematically successful in changing it. (MacIntyre, 1985, p. 897)

VII

What is depression? Depression is often understood in terms of the diagnostic criteria in the DSM-IV or the newly published DSM-5 (when it comes to depression, the difference between DSM-IV and DSM-5 is marginal). The diagnose of depression consists of a number of symptoms that, when they occur in certain combinations in a person, are a sure sign of an underlying ‘depressive disorder’.

My aim here is not to dismantle the diagnostic criteria of depression or the DSM-IV, but I would like to point out three noticeable peculiarities. First, several criteria is remarkably vague and open to interpretation, leaving the choice between depressive disorder or no depressive disorder to the psychiatrist’s or physician’s discretion (Stoppard, 2000).

Second, the nine diagnostic criteria can be combined in 1816 ways and still make up a valid diagnosis of ‘major depressive episode’. This means that a vast variety of different forms of psychological distress can be classified as ‘depression’. It might be justified to ask whether this diversity of symptoms indicates exactly the same underlying ‘disorder’. According to the DSM-IV, they do. Of course, it is only possible to hold such a view if you weed out all personal meanings attached to one’s psychological distress.

Third, there is a remarkable gender gap in the prevalence of depresson diagnoses. There are, on average, two depressed women on every depressed man (see Velde, Bracke, & Levecque, 2010 for a reasonably recent review). Why is that? Among all biological and psychosocial theories that try to explain this gender gap, I would like to highlight the observation that the diagnostic criteria themselves are gender biased. As the social psychologist Carol Tavris puts it: . Recently, men’s depressions and their different or ‘atypical’ ways of experiencing and expressing depression has gained attention. Some scholars has actually proposed a special ‘male’ form of depression (Winkler, Pjrek, & Kasper, 2005; Zierau, Bille, Rutz, & Bech, 2002). I read this as an acknowledgement that the diagnostic criteria for depression were gender biased towards women in the first place.

The very idea of a ‘depressive disorder’ adheres to an illness metaphor or medical model, that is, depression (and other mental health problems) is understood as a kind of mental ‘disease’. This is highly problematic, for several reasons. For one thing, the diagnose of depression is not stable, but varies with cultural and historical context. In fact, the very term ‘depression’ has been around for litte more than a century. Maybe it is better to avoid diagnostic criteria and terms like ‘depressive disorder’ alltogether, and, in accordance with Jeanne Marecek (2006), use terms like ‘depressive suffering’ which can be expressed in many different ways, not just the ones mentioned in the DSM-IV.

What is depression, then? This is where theory comes in. Although the DSM-IV claims to be purely descriptive (but it is not), real people – psychiatrists and psychologists – always have some theory why the person they just diagnosed as ‘depressed’ are depressed. Maybe the best theories are those held by depressed people themselves, but – with few exceptions – their views are seldom heard (notable exceptions are Danielsson, 2010; Heifner, 1997; Karp, 1996).

VIII

Let’s have a look at some theories of depression. Probably the most prominent psychological theory of depression is the one that sparked the cognitive psychotherapies: Aaron Beck’s cognitive theory of depression.

According to this theory, the core of depression consist of a primary triad, that is, a persistent negative evaluation of self, the environment and the future. This primary triad causes negative emotions, which leads to a loss of positive motivation. This ends up in a paralysed will, avoidance, withdrawal and suicidal wishes (Beck & Alford, 2009).

The solution, then, is to scrutinize the negative thoughts and subject them to reality testing. Debunking the ‘schemas’ that make up the negative triad means that the vicious circle of negative thoughts, emotions and motivation is broken. This is the general rationale of the cognitive therapy: Change the way you think, and the rest will follow.

The cognitive theory of depression and cognitive psychotherapy – that is, praxis – are inextricably linked. Actually, given the explanation of the cause and maintenance of depression, the solution to the problem (cognitive psychotherapy) is fairly obvious. The solution is already embedded in the description of the problem: the way theory frames the problem also implies the solution.

One might ask if cognitive theory explains why cognitive psychotherapy works, or if cognitive theory justifies the use of cognitive therapy? Is cognitive theory the explanation or justification for cognitive psychotherapy?

IX

When modern psychopharmacology emerged in the 1950s, it was discovered that some substances had a favorable effect on depressive symptoms. This led to the very first generation of antidepressants, monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). The search for an explanation to why these substances had this effect led to the monoamine hypothesis of depression. Accordning to this hypothesis, depression is caused by a deficit of certain neurotransmitters, mainly norephinephrine and serotonin.

Again, the solution seem obvious: If depressed people lack certain neurotransmitters, just make sure there’s more of it. This is what selective serotonin reuptake inhibitors (SSRIs) do. Or, to be more precise, nobody really knows how SSRIs work, but it is believed to have something to do with increasing the extracellular level of serotonin in the synaptic gaps between neurons.

Although the monoamine hypothesis fits well with the ‘illness’ metaphor for psychological distress – that is, mental problem as a kind of physiological disease – few physicians or psychiatrists actually believe that depression is that simple. Nevertheless, this is often the story told when antidepressants are prescribed.

Again, one must ask if the monoamine hypothesis explains why antidepressants work, or if the monoamine hypothesis justifies prescriptions of antidepressants.

X

By now, I guess you can see where this is going. Similar arguments can be put forward for psychodanamic theories, behavioural theories, and so on. Theory is inextricably interconnected with practice, and the distinction between explanations and justifications is always unclear.

However I would like to mention just one more ‘theory’ of depression, namely the diathesis–stress-model (Stoppard, 2000). The word diathesis derives from the greek term for ‘disposition’ (διάθεσις) and refers to a specific predisposition to a disease or other disorder. If subsequent stress exceeds a certain threshold, the person will develop depression.

The diathesis–stress-model allows identification and quantification of specific risk factors and protective factors for depression, something that probably has contributed to the popularity of the model. Examples of such risk factors are gender, heredity, family background, negative childhood experiences, personality, social circumstances and stressful life events.

Although the diathesis–stress-model might be useful when singling out individuals at high risk for depression, I would hardly regard it as a proper theory. The diathesis–stress-model is essentially a matrix of factors, outcomes and probabilities, but it does not add much to the understanding of depressive suffering, if anything at all. It cannot explain the causes or inner workings of depression; why some people are helped by psychotherapy while others are not; why some people are dependent on antidepressants while others are not; and so on.

All this, of course, assuming that depression is an ‘illness’ that requires ‘treatment’ – an assumption that can be contested as well.

References

Beck, A. T., & Alford, B. A. (2009). Depression: Causes and Treatments. Philadelphia, PA: University of Pennsylvania Press.

Danielsson, U. (2010). Träffad av blixten eller långsam kvävning: Genuskodade uttryck för depression i en primärvårdskontext (PhD thesis). Umeå universitet, Institutionen för folkhälsa och klinisk medicin, Familjemedicin.

Heifner, C. (1997). The male experience of depression. Perspectives in Psychiatric Care, 33, 10–18. doi:10.1111/j.1744-6163.1997.tb00536.x

Karp, D. A. (1996). Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness. New York: Oxford University Press.

MacIntyre, A. (1985). How psychology makes itself true—or false. In S. Koch & D. Leary (Eds.), A Century of Psychology as Science (pp. 897–903). New York: McGraw-Hill.

Marecek, J. (2006). Social Suffering, Gender, and Women’s Depression. In C. L. M. Keyes & S. H. Goodman (Eds.), Women and Depression: A Handbook for the Social, Behavioral, and Biomedical Sciences (pp. 283–308). New York: Cambridge University Press.

Robinson, D. N. (1995). An intellectual history of psychology (3rd ed.). Madison: University of Wisconsin.

Stoppard, J. M. (2000). Understanding Depression: Feminist Social Constructionist Approaches. London: Routledge.

Teal, J. (2009). Nothing Personal: An Empirical Phenomenological Study of the Experience of Being-on-an-SSRI. Journal of Phenomenological Psychology, 40, 19–50. doi:10.1163/156916209X427972

Velde, S. V. de, Bracke, P., & Levecque, K. (2010). Gender differences in depression in 23 European countries: Cross-national variation in the gender gap in depression. Social Science and Medicine, 71, 305–313. doi:10.1016/j.socscimed.2010.03.035

Winkler, D., Pjrek, E., & Kasper, S. (2005). Anger attacks in depression: Evidence for a male depressive syndrome. Psychotherapy and Psychosomatics, 74, 303–307. doi:10.1159/000086321

Zierau, F., Bille, A., Rutz, W., & Bech, P. (2002). The Gotland Male Depression Scale: A validity study in patients with alcohol use disorder. Nordic Journal of Psychiatry, 56, 265–271. doi:10.1080/08039480260242750


  1. It must be admitted that this is an over-simplification. Aristotle contrasts θεωρία (theoría) with ποίησις (poiésis) and πρᾶξις (práxis), the activity of making and doing, respectively. The difference is τέλος (télos), end or purpose; the τέλος of ποίησις is in some other thing that comes into being by the activity of ποίησις, whereas πρᾶξις is an end in itself. Ποίησις is building a house, πρᾶξις playing the flute. Thus, curing patients would rather be considered an activity of ποίησις, since it has an end. However, I use practice (or praxis) in the modern sense of simply ‘doing’ in general. This simplification, I would argue, is not completely unwarranted; the distinction between ποίησις and πρᾶξις is not always that clear in Aristotle’s own work.

Wednesday, October 5, 2011

On the ontology of depression

What is depression? The answer you usually get from professionals in the mental health business is that depression is what you have if you meet the criteria for major depressive episode (MD) in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). These criteria include, among others, depressed mood, diminished interest or pleasure, fatigue, and so on. There are nine main criteria, and with some additional criteria over 70 combinations of symptoms yelds a depressive diagnose.

But this does not answer the original question, what depression is. The criteria in DSM-IV only describe how to recognize depression, they do not account for any etiology (from greek αἰτιολογία, ‘give reason for’), that is, DSM-IV give no reason or cause for the cluster of symptoms that constitute the diagnose of major depressive episode.

The diagnostic criteria for depression have been criticized (see, for example, Marecek, 2006; Horwitz & Wakefield, 2007; Stoppard, 2000). However, my current interest is this elusive question about what depression is, the question of the ontology of depression. Ontology (from greek ὤν, ‘being’) referes to the metaphysical question of what entities exist and in what way they can be said to exist.

As Stoppard (2000) points out, the definition of ‘mental disorder’ as used in DSM-IV is not really that ‘purely descriptive’ and ‘atheroetical’ as is usually claimed. Most important, a mental disorder is solely defined in terms of something residing within an individual, a ‘manifestation of a behavioral, psychological, or biological dysfunction in the indivual’ (APA, 1994, p. xxi). According to this, the cause of depression and it's mechanisms must be sought within an individual. Although this definition does not exclude social or interpersonal factors, it does certainly exclude the view that depression, as defined by DSM-IV, is but a sociocultural expression of human suffering, an expression that varies with different cultures and different parts of the world (Marecek, 2006).

Thus, the definition of mental disorders used in DSM-IV implies that depression actually exists in some material way in the world. It is some kind of dysfunction within the individual—let it be behavioral, psychological or biological—similar to a medical condition like diabetes, cancer or a broken leg. The big difference, of course, is that there are no objective tests, nothing akin to a blood sample, that can be used to diagnose depression. It can only be inferred through a clinical interview, based on the criteria in DSM-IV and professional judgements.

Stoppard (2000) tend to view depression as a social construction that is created as the clinical interview progresses: ‘depression is discursively constructed as an entity in the course of a particular kind of interpersonal interaction called the clinical interview’ (Stoppard, 2000, p. 30). The point is that the ontology of depression is unclear. It may even be that depression does not exist at all. Viewed as a social construction, depression is but a name for a particular way of expressing human suffering—a way that primarly apply to women in the western world (Tavris, 1992).

Theories of depression is a way of accounting for the etiology of depression. When the origin and course of depression is explained, an answer to the ontological question of depression is explicitly or implicitly proposed (at least for the majority of theories). According to cognitive theories, depression is caused by a particular way of thinking and interpreting the world. According to some psychodynamic theories, depression is caused by repressed loss and anger. According to behavioral theories, depression is caused by learned helplessness and sustained by lack of positive reinforcement. In any case, depression is established as something that actually exist, a particular process within the individual. This, as it happens, is exactly the way DSM-IV defines mental disorders.

Although the diagnostic criteria of depression can be criticized, revised and refined, the very idea of a depressive disorder as DSM-IV defines it does not contradict most theoretical work on depression. Problems arise, however, if depression is viewed as a sociocultural expression of human suffering (or, as Marecek [2006] puts it, ‘depressive suffering’). The very existence of a distinct depressive disorder with some kind of material ontological status must be questioned. Symptoms, as they appear in DSM-IV, must be viewed as a culturally dependent way of naming a particular way of behaving and experiencing the world, a way that does not fit within ‘normality’. Theories of depression, then, is nothing but a way of explaining abnormal behaviour, explanations that have a profound impact on the way ‘depressed’ people are viewed and treated within primary care and mental health professions.

There are several problems with either of these two ontological perspectives. In short, the view that depression is something that actually exists within an individual can be questioned based on cross cultural and anthropological studies. What is called depression in the western world does not exist in all cultures, or is at least rather different from the criteria in DSM-IV (Marecek, 2006). On the other hand, the view that depression is but one of many possible expressions of ‘depressive suffering’ cannot account for the fact that there are some people that seem to suffer from severe and cronic ‘depressive impairment’ for no apparent reasons.

So, what is the ontological status of that phenomenon we call ‘depression’? The most honest answer, at least for the time being, must be: I don't know.

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Marecek, J. (2006). Social suffering, gender, and women’s depression. In C. L. M. Keyes & S. H. Goodman (Eds.), Women and depression: A handbook for the social, behavioral, and biomedical sciences (pp. 283-308). New York: Cambridge University Press.
Horwitz, A. V., & Wakefield, J. C. (2007). The loss of sadness: How psychiatry transformed normal sorrow into depressive disorder. New York: Oxford University Press.
Stoppard, J. M. (2000). Understanding depression: Feminist social constructionist approaches. London: Routledge.
Tavris, C. (1992). The mismeasure of woman. New York: Simon & Schuster.

Thursday, September 22, 2011

Stoned rats and post-traumatic stress disorder

Strange things pass as ‘psychological research’ these days. According to the Times of India, Irit Akirav and Eti Ganon-Elazar conducted an experiment with rats, where some of the rats were given synthetic cannabinoids (that is, marijuana) after being exposed to extreme stress (unfortunately, I have no access to the original article). A week after, some of the rats ‘did indeed display symptoms resembling PTSD in humans’—but not the ones that were administered marijuana a short while after the traumatic event. After repeating the experiment, where they injected marijuana directly into the amygdala, they could ‘conclude that the effect of the marijuana is mediated by a CB1 receptor in the amygdala’.

Seriously?

With the caveat that I have not read the original article, this experiment reveal some serious flaws in ‘scientific’ thinking, aside the doubtful ethics in harming animals for the sake of suffering (not as an unwelcome side effect of an otherwise important quest for knowledge, or at least potentially important).

First, how do you diagnose rats with post-traumatic stress disorder? A characteristic feature of PTSD is flashback memories, that is, unwanted and obtrusive memories or re-experiencing of the traumatic event. How do we know that the poor rats have terrifying flashbacks of the extremly stressful events the (hopefully) benevolent scientists exposed them to? How do we even know that rats have episodic memory?

The answer is simple: we don't. The poor rats cannot tell us what they experience or how they experience; they have no language. To say that rats experience post-traumatic stress disorder, is simply an anthropomorphism, that is, an attribution of human characteristics to non-human animals.

Of course, Akirav and Ganon-Elazar knows this. They don't claim that the poor rats experience PTSD; they say that the rats ‘display symptoms resembling PTSD in humans’, but by doing this, they implicitly anthropomorphize the behaviour of the rats. Indeed, the research aims at investigating the effect of cannabinoids on stress and trauma in humans, not rats. Nobody has any plans on opening a psychiatric clinic for rats, at least not that I know of.

Simply put, the fact that rats ‘display symptoms resembling PTSD in humans’ does not necessarily has anything whatsoever to do with humans experiencing PTSD. Humans have the ability of framing experiences in terms of meaning, their episodic memory is inextricably intertwined with language, and even traumatic events gain their meaning in a cultural context. This is not the case with rats. At least as far as we know, since we can't ask the rats. Structural similarity does not imply functional similarity.

Second, the way the research is conducted, it is obvious that PTSD is understood in terms of the workings of the nervous system. This is an example of the medical model of psychiatric disorders that so dominates the mental health services, at least in the western world. Simply put, all mental phenomena—ideas, feelings, sensations, perceptions, concepts, art, science, faith, consciousness, illusions and the like—can be reduced to physiology or neural functioning. Thus, all anomalies in psychological functioning and all psychological suffering, is considered a kind of malfunction in the workings of the brain, most often some kind of inbalance in the levels of particular neurotransmittors. This way of accounting for human suffering robs the sufferer of all context, of all meaning, of all that makes the sufferer human.

And what is the consequence of this revolutionary discovery? Should the emergency toolkit on regular flights include some weed, just in case of a disaster?

Wednesday, September 7, 2011

Mainstream psychology

This entry is ridicously long. It started out as a short clarifying note on ‘mainstream psychology’, but grew to an entire chapter. My apologies for any inconvenience.
The one rule that anyone with moral stamina actually can follow is the one that commands us to avoid the comforts of the ‘mainstream’.
(Robinson, 2000, p. 43)
Within the field of theoretical psychology, and particularly critical psychology, there are frequent references to ‘mainstream psychology’, usually in a context that implies that it is something problematic, bad, or even dangerous. Although this is a topic for debate and disagreement, it might be helpful to elaborate on what this ‘mainstream psychology’ refers to.

At first glance, the sheer diversity of the numerous subfields of psychology hardly suggest that there is anything ‘mainstream’ about psychology at all. Cognitive, biological, developmental, social, clinical and personality psychology—just to mention a few—all have their own set of theories and methodological approaches. Neuropsychology, which at the outset is a branch of neurophysiology, has little to do with organizational psychology, a discipline bordering on economics and business management. Nevertheless, they are regarded as different aspects of human functioning and activity, often in a ground-up fashion where biological processes are seen as the foundations of organizational behaviour.

A widespread textbook in psychological research methods claims that ‘most [psychologists] represent mainstream psychology, which is integrative in nature, drawing from many psychological theories and many areas of research’ (Graziano & Raulin, 2007, p. 24). This ‘integration’ of theories from such diverse research areas as, for example, social psychology and psychophysics, is often done in a rather unreflective manner, insensible to the underlying meta-theoretical or even metaphysical assumptions.

Mainstream psychology is all about those underlying assumptions. They are hard to spot, and I realise I have expressed them in various ways over the years, so what I give an account for here is the present formulation: mainstream psychology draws on the assumptions that (1) mental phenomena can and must be measured in order to be scientifically meaningful (the quantitative imperative), (2) all mental phenomena can be reduced to the laws of neural function (reductive materialism), and (3) in order to conduct scientific research proper, the psychologist must subscribe to the ‘empirical’ method.

The quantitative imperative

The quantitative imperative is ‘the view that in science, when you cannot measure, you do not really know what you are talking about, but when you can, you do’ (Michell, 2003, p. 5)⁠. In order to be scientifically meaningful, psychological phenomena must be quantified and measured (measurement being ‘the assignment of numerals to objects or events according to rules’ [Stevens, 1946, p. 677]⁠).

This focus on measurability dominate contemporary psychology: cognitive psychology is entirely based on measurement of behavioural responses and reaction times, psychometric self-rating scales are mandatory in clinical psychology, complex mathematical procedures are used in attempts to measure ‘personality’, social psychology relies on measurement and observational methods, and so on. Simply put, anything that goes into an analysis of variance (ANOVA) is eligible for psychological research, anything that doesn't, is not. (This is also an aspect of the dedication to the ‘empirical method’.)

William James
Modern psychology take this measurability of mental phenomena for granted, but it was controversial and widely debated during the late 19th century when psychology was founded. For example, William James (1842–1910), one of the founders of american psychology, criticized the german psychophysicist Gustav Fechner (1801–1887), who, according to James, in the notion of Weber's law held the position
1) that the just-perceptible increment is the sensation-unit, and is in all parts of the scale the same (mathematically expressed, Δs = const.); 2) that all our sensations consist of sums of these units; and finally, 3) that the reason why it takes a constant fractional increase of the stimulus to awaken this unit lies in an ultimate law of the connection of mind with matter, whereby the quantities of our feelings are related logarithmically to the quantities of their objects.
(James, 1890, p. 545)
What Fechner claims is that there is a lawful regularity between our inner experiences and the events and objects of the external world, and that this regularity can, as with all natural science, be mathematically expressed. To this, James has the following objections:
To begin with, the mental fact which in the experiments corresponds to the increase of the stimulus is not an enlarged sensation, but a judgement that the sensation is enlarged. What Fechner calls the ‘sensation’ is what appears to the mind as the objective phenomenon of light, warmth, weight, sound, impressed part of body, etc. Fechner tacitly if not openly assumes that such a judgment of increase consists in the simple fact that an increased number of sensation-units are present to the mind; and that the judgment is thus itself a quantitatively bigger mental thing when it judges large differences, or differences between large terms, than when it judges small ones. […] But really it has no meaning to talk about one judgment being bigger than another. And even if we leave out judgments and talk of sensations only, we have already found ourselves […] quite unable to read any clear meaning into the notion that they are masses of units combined. To introspection, our feeling of pink is surely not a portion of our feeling of scarlet; nor does the light of an electric arc seem to contain that of a tallow-candle in itself.
(James, 1890, p. 546)⁠
Although James interpretation of Fechner should be accepted only with some caution (James was rather impatient with contemporary german psychology), his criticism of the supposed quantifiability of mental phenomena is still valid. The fact that contemporary psychology relies on behavioural observation and operationalism, that is, ‘the intuition that we do not know the meaning of a concept unless we have a method of measurement for it’ (Chang, 2009)⁠, does not change the fact that the measurability of the matters of interest is not a scientific fact, but an epistemological assumption.

Reductive materialism

The previously mentioned textbook on research methods also claims that psychology is the scientific study of behaviour, and is ‘often considered to be a social science, but its roots are clearly in the natural sciences’ (Graziano & Raulin, 2007, p. 25)⁠. Although this reflects the predominant conceptions of contemporary psychology, it has little support in history. At the outset, psychology was never a simple branch of natural science, nor concerned only with behaviour. Psychology is not a straight line from Wilhelm Wundt and his laboratory in Leipzig to Philip Zimbardo and the Stanford Prison Experiment.

During the 19th century, when psychology was founded as a scientific enterprise, three traditions or approaches to matters of psychology emerged and have prevailed ever since, although one of them became the dominant perspective at the expense of the others. First, there is what Robinson (1995) terms reductive materialism, based on the proposition that ‘all mental states, events, and processes originate in the states, events, and processes of the body and, more specifically, of the brain’ (p. 306). Reduction in this context refers to the notion that psychological phenomena can be reduced to the laws of neural function, and materialism to the ontological claim that, in the end, all that exists, even consciousness, is nothing but matter in motion. Thus, all a ‘true science of the mind’ needs is a careful examination of and experimentation with the nervous system and its functions. In other words, psychology is perceived as a natural science, in search of the universal laws that govern behaviour and the human mind.

Second, introspectionism is the view that the subject matter of psychology is consciousness, and the method of choice is introspection, that is, the psychological method of self-examination. Robinson (1995)⁠ carefully points out that this refers to experimental introspection in the tradition of Gustav Fechner and Wilhelm Wundt, not the ‘method of private or personal introspection of the philosophers’ (p. 306). The introspectionists were convinced of the irreducibility of mental phenomena and claimed that only the person who had an experience could report it. According to the introspectionist approach, psychology is a mental or human science, in search of the universal laws that govern human experience.

Third, some observers were persuaded neither by the reductive materialists nor the introspectionists. Materialism can shed no light on the complexities of social life, and introspection can never discover any ‘laws of the mind’. The proper subject of psychology, they claimed, ‘is the actual conduct of real persons in socially significant settings, their doings, their ideas, and the pressures operating on them’ (Robinson, 1995, p. 312)⁠, thus proposing that psychology must be a kind of social science. In some ways, this is the precursor to contemporary social psychology.

Wilhelm Wundt
Note that both William James and Wilhelm Wundt (1832–1920)—two significant names in the history of psychology—were introspectionists. Despite the modern dedication of ‘father of experimental psychology’, Wundt developed a holistic, anti-reductionist Physiologische Psychologie, that more closely resembles the later Gestalt-psychologists and Husserl's phenomenology, than American experimentalism (Kim, 2009)⁠. Both James and Wundt were trained physiologists, but aimed at establishing psychology as an independent discipline bordering on physiology and philosophy.

It should also be noted that the introspectionist view did not oppose materialism, at least not as much as it opposed Cartesian dualism and German idealism. The claim was that mental phenomena—ideas, feelings, sensations, perceptions, concepts, art, science, faith, conscious, unconscious, and illusions—cannot be reduced to mere physiology or neural functioning, but must be studied on their own terms. William James adopted a neutral monist view, that is, the belief that ultimate reality is all of one kind, a kind of ‘neutral stuff’, neither mental nor physical. Wilhelm Wundt wrote at length on what he called psychophysical parallelism, which might be thought of as a monist variant of the dual-aspect theory:
If we could see every wheel in the physical mechanism whose working the mental processes are accompanying, we should still find no more than a chain of movements showing no trace whatsoever of their significance for mind. So that, despite the universality of the parallelistic principle, all that is valuable in our mental life still falls to the psychical side.
(Wundt, 1907, p. 446)⁠
To the extent that reductive materialism and introspection were competing approaches to psychology, it was the former that were successful. Experimental introspection never resulted in reliable, repeatable observations, even with experienced observers (Wundt and his assistants used trained ‘observers’ in the Leipzig laboratory, not naïve ‘subjects’ like contemporary psychology), and there were major disagreements on what exactly could be observed through introspection. Oswald Külpe (1862–1915) and Edward Titchener (1867–1927) abandoned Wundt's strict paradigm of careful and immediate introspection and tried to study higher cognitive processes experimentally, an enterprise to which Wundt strongly disagreed. Külpe and Titchener, on the other hand, disagreed on the possibility of conscious content not based in some kind of mental imaging, a dissent that went down in history (now mostly forgotten) as the imageless thought controversy (Thomas, 2010)⁠.

John B. Watson
All in all, this led to a loss of confidence in the scientific value of introspection and paved the way for alternative approaches to psychology, most notably observations of behaviour. This also meant that the subject matter of psychology changed, from the introspective study of consciousness and the reductive materialist examination of neural functioning, to the pure study of behaviour. In this regard, John Watson's (1878–1958) behaviourist manifesto marks the end of this debate, rather than the beginning of behaviourism (Richards, 2010)⁠:
Psychology as the behaviorist views it is a purely objective experimental branch of natural science. Its theoretical goal is the prediction and control of behavior. Introspection forms no essential part of its methods, nor is the scientific value of its data dependent upon the readiness with which they lend themselves to interpretation in terms of consciousness. The behaviorist, in his efforts to get a unitary scheme of animal response, recognizes no dividing line between man and brute. The behavior of man, with all of its refinement and complexity, forms only a part of the behaviorist's total scheme of investigation.
(Watson, 1911, p. 158)⁠
Burrhus Frederic Skinner
Although few psychologists actually subscribed to the extreme reductionism expressed in Watson's work, it helped to establish psychology as a natural science. Psychology adopted a highly technical language (stimulus, response, conditioning, reinforcement, etc), initially borrowed from the russian physiologist Ivan Pavlov (1849–1936) and later developed by the chief architect of behaviorism, B. F. Skinner (1904–1990). ‘Mentalistic’ references to consciousness, feelings, emotions, mental images, fantasies and the like, were not ‘objectively observable’ and thus utterly unscientific (Richards, 2010).

The questions of consciousness and mind-body dualism, that so bothered the pioneering psychologists, were quite simply abandoned. Instead, the reductive materialism that underpins behaviourism and Pavlovian reflexology were, perhaps unwittingly, taken for granted. With time, it became a prerequisite for scholars of psychology, thus securing reductive materialism as the primary approach within academic psychology. The advent of cognitive psychology, which must be considered the current ‘paradigm’ of psychology, has not changed this. The ‘cognitive revolution’ was not much of a revolution when it comes to epistemological concerns. On the contrary, cognitivism meant nothing more than accounting for subjective experiences (not merely ignoring them) by the notion of ‘cognitive processes’.

The ‘empirical’ method

In their textbook on research methods, Graziano and Raulin (2007)⁠ claims that ‘all areas of psychology use the scientific model to study behavior’ (p. 25), where model refers to the ‘model of the research process’ to which the entire book is devoted. It is, perhaps, significative of the discipline of psychology that 24 pages is dedicated to the history and philosophy of science in general and psychology in particular, while the remaining 353 pages concern how to properly conduct psychological research.

Daniel N. Robinson
Scholars in other academic disciplines often (rightly) accuse psychology for its dogmatic use of the ‘empirical method’. Empirical in this context essentially means ‘experimentation’, and Daniel Robinson summarizes matters tellingly:
What has been characteristic of experimental psychology is the adoption of a rather prosaic set of experimental “controls” and a repeated-measures paradigm. In a wide variety of settings, this method of procedure has yielded fairly stable functional relationships between dependent and independent variables under conditions generally so unlike the domain of interest as to render generalizations jejune. It is a credit to the psychologists of the nineteenth century that they valiantly undertook to apply such methods to psychological phenomena, for only by attempting to develop psychology in such a fashion could the limits of the method be assessed. It is less of a credit to the legions that have dutifully imitated these efforts for the better part of a century.
(Robinson, 1995, p. 332)⁠
To laymen and first-year students of psychology, it is rather surprising that contemporary psychology is hardly ever concerned with apparent psychological matters such as ‘mind’, ‘consciousness’ and ‘self-reflection’. This is not so because such phenomena don't exist (because they do!), but because the accepted method—the ‘empirical’ method—is unable to address these matters. ‘The contemporary psychologist, if only insensibly, has made a metaphysical commitment to a method and has, per force, eliminated from the domain of significant issues those that cannot be embraced by that method’ (Robinson, 1995, p. 333)⁠.

What is meant by ‘empirical’ in this context is something rather different from what the historic empiricists—John Locke, George Berkeley, David Hume, John Stuart Mill, and even William James—had in mind. ’”Empirical,” if the contemporary usage is to be captured, must also suggest measurement, practicality, impersonality, ethical neutrality and (ironic) “antimetaphysicalness”’ (Robinson, 1995, p. 334)⁠.

A characteristic feature of this dogmatic use of the ‘empirical’ method is the heavy reliance on statistical procedures. Statistics, as used in psychology, is a way of ‘modelling reality’ by distinguishing systematic variation from individual or ‘random’ variation—in other worlds, to describe (and hopefully explain) human behaviour in terms of mathematical relations between variables. This dependency on statistical procedures has some important epistemological implications, particularly when it comes to null hypothesis significance testing (NHST)—the mandatory p-values without which hardly any article in experimental psychology is publishable.

First, NHST of so-called parametric procedures (such as Student's t-test, ANOVA and linear regression) relies on the normal distribution, which, in its original formulation by Carl Friedrich Gauss (1777–1855), was a method to minimize the impact of measurement error. When using these methods in psychology, the notion of ‘measurement error’ is used in its very broadest sense, where human subjects are treated as ‘errors’ deviating from a grand mean. Thus, means are not about real people, but of some kind of abstract, generalized man.

Second, the very idea of NHST is based on probability theory and statistical inference, where the improbability of a given result from a stochastic (or random) process yields statistical significance. More specifically, a statistical test calculates the probability of the data (D) given the null hypothesis (H0), that is, P(D|H0). Besides regular misinterpretation of p as the probability that H0 is false—that is, the probability of the hypothesis given the data, P(H0|D)—rejection of H0 is frequently taken as an affirmation of the theory that led to the test:
So even when used and interpreted “properly,” with a significance criterion (almost always p < .05) set a priori (or more frequently understood), H0 has little to commend it in the testing of psychological theories in its usual reject-H0-confirm-the-theory form. The ritual dichotomous reject-accept decision, however objective and administratively convenient, is not the way any science is done.
(Cohen, 1994, p. 999)⁠
The mechanical—and sometimes anxious—use of statistical procedures in psychology reflects its metaphysical commitment to the ‘empirical’ method. As Jacob Cohen so aptly puts it:
All psychologists know that statistically significant does not mean plain-English significant, but if one reads the literature, one often discovers that a finding reported in the Results section studded with asterisks implicitly becomes in the Discussion section highly significant or very highly significant, important, big!
(Cohen, 1994, p. 1001)⁠
Third, even if the use of NHST is gradually abandoned in favour of statistical modelling (Rodgers, 2010)⁠, the question what the mathematically expressed regularities represent remain. If almost all persons stop at a red light, is that because the manipulated independent variable (red light) causes the observed dependent variable (stopping the car)—or because the cultural meaning of red light when driving a car means ‘stop the car’ and most people simply choose to conform to those cultural understandings? Regularities, whether mathematically expressed, cannot be taken as evidence that behaviour is causally determined and predictable. Considering culture, people within a particular society can be expected to show certain similar patterns of behaviour in specific contexts—including the psychology laboratory (Moghaddam, 2005)⁠.

The rigorous experimental settings, the arcane statistical procedures and the seemingly ‘hard facts’ in the form of numbers and p-values, brings psychology a semblance of ‘scientificality’: of objectivity, accuracy, validity. However,
[p]rogress in science is won by the application of an informed imagination to a problem of genuine consequence; not by the habitual application of some formulaic mode of inquiry to a set of quasi-problems chosen chiefly because of their compatibility with the adopted method.
(Robinson, 2000, p. 41)⁠

References

Chang, H. (2009). Operationalism. (E. N. Zalta, Ed.) The Stanford Encyclopedia of Philosophy. Retrieved from http://plato.stanford.edu/archives/fall2009/entries/operationalism/
Cohen, J. (1994). The earth is round (p < .05). American Psychologist, 49(12), 997-1003. doi:10.1037/0003-066X.49.12.997
Graziano, A. M., & Raulin, M. L. (2007). Research methods: A process of inquiry (6th ed.). Boston: Allyn & Bacon.
James, W. (1890). The principles of psychology. New York: Holt. Retrieved from http://www.archive.org/details/theprinciplesofp01jameuoft
Kim, A. (2009). Wilhelm Maximilian Wundt. (E. N. Zalta, Ed.) The Stanford Encyclopedia of Philosophy. Retrieved from http://plato.stanford.edu/archives/spr2009/entries/wilhelm-wundt/
Michell, J. (2003). The quantitative imperative: Positivism, naïve realism and the place of qualitative methods in psychology. Theory and Psychology, 13(1), 5–31. doi:10.1177/0959354303013001758
Moghaddam, F. M. (2005). Great ideas in psychology: A cultural and historical introduction. Oxford: Oneworld.
Richards, G. (2010). Putting psychology in its place: Critical historical perspectives. Hove, England: Routledge.
Robinson, D. N. (1995). An intellectual history of psychology (3rd ed.). Madison: University of Wisconsin.
Robinson, D. N. (2000). Paradigms and “the myth of framework”: How science progresses. Theory and Psychology, 10(1), 39-47. doi:10.1177/0959354300101004
Rodgers, J. L. (2010). The epistemology of mathematical and statistical modeling: A quiet methodological revolution. American Psychologist, 65(1), 1-12. doi:10.1037/a0018326
Stevens, S. S. (1946). On the theory of scales of measurement. Science, 103(2684), 677-80. doi:10.1126/science.103.2684.677
Thomas, N. J. T. (2010). Mental imagery. (E. N. Zalta, Ed.) The Stanford Encyclopedia of Philosophy. Retrieved from http://plato.stanford.edu/archives/fall2010/entries/mental-imagery/
Watson, J. B. (1911). Psychology as the behaviorist views it. Psychological Review, 20(2), 158–177. doi:10.1037/h0074428
Wundt, W. M. (1907). Lectures on human and animal psychology: translated from the second german edition (4th ed.). London: Swan Sonnenschein.

Thursday, July 28, 2011

The insane are not ‘us’: on normality, psychiatric diagnoses and Norwegian terrorism

After the Oslo bomb and Utøya massacre there is a strong demand of declaring the perpetrator, Anders Behring Breivik, mentally disturbed. Yesterday, the swedish psychiatrist and profiler Ulf Åsgård claimed that Breivik suffers from several personality disorders, among them psychopathy, narcissism, borderline and, notably, obsessive–compulsive personality disorders. This was his judgement after having read a few pages in Breivik's ideological manifesto ‘2083: a european declaration of indepencence’.

The desire to declare Breivik mentally disturbed is quite understandable. He is a tall, blond scandinavian, just like me (well, I'm not that tall, and my hair colour is more like the brown rat, but that is beside the point), but he can't possibly be like me because I would never even think of killing a single person, less massacre young men and women at a youth camp. Following that logic, Breivik can't be normal, since normal people are not mass murderers. He can never be one of ‘us’; he must be insane. (If the perpetrator would have been a muslim, he or she would not have been one of ‘us’ anyway, and the desire to regard him or her as insane, I suspect, not that pressing.)

But what do we mean by ‘normal’? What we consider normal can be judged from at least four points of view. First, the statistical norm defines normality as an interval on a distribution of properties that, at least in theory, can be measured. For example, a person over 2 meters is considered unusually tall. Intelligence is another example: less than 70 points on the Wechler Adult Intelligence Scale (WAIS) is considered that far from the population average of 100 points that it is taken as a indication of mental retardation (in fact, this is the definition of mental retardation according to DSM-IV).

Second, social norms defines what is socially acceptable, and what is not. Social norms are contextual, culturally dependent and varies considerably over the world. Of course, no society allows killing people, at least not of their own kind. However, at war, things are different, and Breivik is at war, at least according to his manifesto.

Third, ideal norms are based on some idea of good health and psychological functioning, for example ‘a state of somplete physical, mental, and social well-being and not merely the absence of disease or infirmity’ (WHO, 1946).

Fourth, people that suddenly change in an unpredictable way, although still within statistic, social and ideal norms, are often considered abnormal or at least unusual. Even becoming ‘normal’ can be ‘abnormal’: consider, for example, the psychotic patient that suddenly behaves perfectly normal, or the Alzheimers patient that suddenly remembers everything. This marked change compared to his or her baseline of everyday functioning would certainly be considered abnormal.

Thus, what is ‘normal’ depends on how we see normality. In the case of Anders Behring Breivik, all and none of the above views applies. Of course, he can be a complete lunatic with a severely screwed worldview, emotionally disturbed and without ability of empathy, but he might as well be a consequent, determined man taking the necessary, rational consequences of his political convictions. He killed at least 68 people in cold blood, yes, but even ‘normal’ people do that in war. What is normal depends on the context.

So, is he a narcissistic, obsessive–compulsive psychopath with clear borderline tendencies (or, in other words, completely screwed up), as psychiatrist Ulf Åsgård claims? First, this judgement can not be based on a few pages from his manifesto. It requires meeting Breivik in person, interviewing and observing him. Second, psychiatric diagnoses, and particularly personality disorders, are pretty arbitrary labels of certain behaviour.

Since the 1970:s, when the dominating psychodynamic theories were challenged, psychiatry has worked hard to become a part of medicine and natural sciences. Among other things, this meant revising the diagnostic system (Diagnostic and Statistical Manual of Mental Disorders, DSM) so that it would resemble medical diagnoses. Consequently, all etiology (causes) were removed from the psychiatric diagnoses in the third revision of DSM, published in 1980. Psychiatric diagnoses are merely descriptive.

In this way, psychiatric diagnoses resembles medical diagnoses. A diagnose is a list of symptoms, which, when present, indicates some kind of underlying problem. An inflammation, for example, is a symptom of either an infection or a wound. After finding the correct diagnose, the physician treats the cause of the symptoms, in this case the infection or wound.

An important feature of medical diagnoses is that they are largely decontextualized. It doesn't matter if you broke your leg falling down the stairs or being hit by a car, the symptoms are the same, the leg is still broken and the treatment is the same in both cases.

However, this is hardly true for psychiatric diagnoses. First, since they are only descriptive, there can be no clear cause in a psychiatric diagnose. For example, the symptoms of depression has no equivalent known cause as the symptoms of a broken leg. On the contrary, several different causes can hide between a single diagnose, and the same cause can give rise to different diagnoses. Psychological distress is caracterized by equifinality (different etiologies behind same symptoms) and multifinality (same etiology behind different symptoms).

Even worse, expressions and conceptions of psychological distress differs between cultures. What we know as ‘depression’ in the western world is expressed in rather different ways in other parts of the world. For example, on Sri Lanka, depressed people often report bodily pain, particularly under their feet. This, of course, raises the question if people on Sri Lanka really are depressed? Or the other way round, how do we know that the conglomerate of symptoms we call ‘depression’ is nothing but a culturally dependent expression of psychological suffering?

Personality disorders are defined as ‘an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it’ (DSM-IV), but in reality they are even more fluid than ordinary (so called ‘axis I’) diagnoses. In the end, what qualifies as a personality disorders is what the working groups of the American Psychiatric Association considers being a personality disorder. Thus, the personality disorders have changed over time, with disorders like ‘sadistic personality disorder’ and ‘masochistic personality disorder’ being removed in DSM-IV (1994). It seems that personality disorders will be completely revised in DSM-V, including the very definition of ‘personality disorder’!

So, what can we gain from declaring the terrorist Anders Behring Breivik mentally disturbed or suffering from a severe personality disorders? Nothing much, I'd say. A psychiatric diagnose does not add anything to our understanding of why he did what he did, since psychiatric diagnoses are stripped of all etiology. However, a diagnose frees us of the need to understand; if he is insane, you can't understand anyway. Finally, and most important, if he is insane, he is certainly not one of ‘us’.

Tuesday, July 12, 2011

The 14th Biennial Conference of the International Society for Theoretical Psychology

Faculty of Education,
Aristotle University
Two weeks ago, I attended the 14th Biennial Conference of the International Society for Theoretical Psychology, a pretty small conference with some 160 participants from all over the world, held in Thessaloniki (Θεσσαλονίκη) during the greek financial crisis, with general strikes, protests, riots and police interventions. Although we did not experience much of that on the Aristotle University campus, i intend to comment on the greek situation at the end of this blog post.

This was my first academic conference. An academic conference, or symposium, is a conference where researches present and discuss their work, and this is usually done by presenting a ‘paper’ written for the conference. The first thing that struck me was how these papers were presented. With few exceptions, they were actually read out loud, word by word, with no or very few visual aids. Some presenters accompanied their reading with beamer presentations, sometimes with the actual text of the paper projected in a tiny, unreadable font.

Reciting the paper worked for some presenters, but for the most part, it didn't. As a pretty experienced lecturer, I tend to think that the aim of an oral presentation is to mediate my idéas and theories to the listener, that is, carefully guiding the audience into my world of terms and ways of thinking. Reading a paper out loud is not always the best way to do this. On the contrary, academic writing is often an exercise in complex formulations and precise nuances, something that is easily lost when reciting a text. It is very difficult to do justice to a text, particularly if English is not your native language.

Still, I get the idea that ‘presenting a paper’ at a conference means, litterary, to read the paper out loud. The paper is a work in progress to be discussed. However, since discussions constrain to a few minutes (at best) at the end of the presentation, reading a paper out loud seem like a waste of time. ‘Give me the text and I'll read it myself’, was something I thought more than once. Better consider the presentations a didactic situation, as any other lecture at a university (although that does not mean things necessarily get better).

The second thing that struck me was that the world ‘dialog’ is the current buzz-word in theoretical psychology circles. This was not only reflected in paper titles such as On dialogue in educational contexts, Rethinking dialogicality, The role of rhetoric in a dialogical approach to thinking, and Twelve sensitising questions for examining dialogicality, but also in the seemingly mandatory references to either Lev Vygotsky or Mikhail Bakhtin.

This is an aspect of what is sometimes refered to as ‘the sociocultural turn’ in psychology, or the view that culture, as a ‘web of meanings’, precedes psychology. Culture is not something that is added to the biological constitution of man, but the very foundation of mankind itself. All human understanding is rooted in culture, and thus social and interpersonal. All knowledge is socially constructed, a result of interpersonal processes, and ‘objective’ knowledge is simply a fallacy. I guess this is where the ‘dialogicality’ comes in, as a kind of umbrella term for all those interpersonal processes in which we construct our knowledge of ourselves, others and the world.

Manolis Dafermos (Μανόλης Δαφέρμος), assistant professor at the University of Crete (Πανεπιστήμιο Κρήτης), tried to put this ‘dialogicality’ in a historical context with his paper Greek philosophical dialogue and modern psychology, where he compared the ancient greek dialogue of Plato with its conteporary conception in psychology. I will return to his paper in future posts.

A large number of papers were presented at the conference, of which I could attend only a small fraction. To me, the most worthwile presenter was Stavroula Tsinorema (Σταυρούλα Τσινόρεμα), professor of contemporary philosophy at the University of Crete (Πανεπιστήμιο Κρήτης), who presented a paper titled The body-mind problem on the interface between psychology and epistemology: a philosopher's perspective. The body-mind problem and related questions of consciousness happen to be part of my greatest interest, and professor Tsinorema made a thorough review of the concept, from Aristoteles, over René Descartes, to modern neuroscience.

Though, the most rewarding aspect of the conference was not the presentations, but meeting and chatting with all those like-minded researchers, not to mention the celebrities within the field of theoretical psychology. I must admit that I felt pretty proud and respectful when professor Jeff Sugarman approached me, gave me his card and told me to get in touch if I had any questions (some half an hour before I had mentioned that I was reading his and Jack Martins work on hermeneutic psychology).

Of course, there were also some gossip, like who-has-said-and-done-what and who-sleeps-with-whom. I guess that is a part of all human activities, including academic conferences.

Finally, as I mentioned in the beginning of this post, this conference was held in Greece during the protests and riots regarding the austerity measures the greek government is forced to implement. On tuesday, there was a general strike among all government employees, and about one third of the conference participants did not make it to the keynote speaker from their hotels since all public transportations stopped. Athanasios Marvakis (Αθανάσιος Μαρβάκης), the conference general, informed us on the situation. There is a strong feeling among the greeks that the austerity measures are unjust, party because greeks in general can not see their part in the crisis, party because the austerity measures are unequally implemented. As the anonymous economist behind the blog Redesigning the foot writes:
Imagine a place where one person earns 91,000 euros and 9 others earn 1,000 euros. Now try and tell these people that, as their average wage is 10,000 euros, they are earning too much and so they must all accept a cut in their wages. How would you expect them to react?
This economist, who calles himself Albert John on twitter (I have tried to figure out who he, or she, is), claims that the Greek crisis actually is due to the structure of the Euro. In fact, he argues quite convincingly and I really recommend his blog, since even a non-economist like me can understand how things stick together. That said, I am thankful that Sweden chose to remain outside the Euro.

Sunday, July 10, 2011

Theoretical psychology and the subject matter of psychology

This blog, named Theoretical Psychology, is the English counterpart of my swedish blog Psykologidoktoranden (“The Psychology PhD Student”). For quite a while I have felt the need to write in english, for two reasons. First, the academic language, at least in psychology, is English. I might as well get used to that reality. Second, my interest in theoretical psychology and philosophy is not shared by many within the discipline of psychology, certainly not in Sweden. Networking within the field of theoretical psychology, is probably best done on an international basis.

Scholars and laymen familiar with psychology probably recoqnize numerous subfields of psychology—developmental psychology, neuropsychology, personality psychology, social psychology, psychophysics, et cetera—but theoretical psychology is less known. I actually learned about it last year, after seven years as a scholar in psychology.

Theoretical psychology, at least according to Wikipedia, “is concerned with theoretical and philosophical aspects of the discipline of psychology”. It is often described as a interdisciplinary field that involves not only all fields of psychology, but also philosophy, history, sociology and antropology. However, I prefer to look at it as mainly meta-theoretical psychology, where the crucial question is what psychology really is about in the first place. Theoretical psychology is about the very foundations of disciplinary psychology itself.

What is psychology? This is a justified question since the subject matter of psychology is not so easily defined, particularly compared to disciplines like geology (rocks) or zoology (animals). Often psychology is defined by its methods (the psychological experiment and sophisticated statistical procedures) or simply—although seldom explicitly—defined as “what psychologists do”. Ever since William James and Wilhelm Wundt (the “fathers of psychology”) psychologists have argued over what psychologists should do, or not should do. Is psychology about experiences, consciousness, behaviour, mental processes, brain functioning, or something else?

The essential problem with any attempt to define the subject matter of psychology is the exclusion of all other views on psychology, which de facto is being practiced at universities all over the world. At the end of the day, defining psychology as “what psychologists do” might not be that bad after all. Unfortunately, this ends up in psychology being more of a tradition than a clearly demarcated discipline. Traditions tend to resist change.

Within the American Psychological Association, Division 24 is concerned with the theory and philosophy of psychology. The divisions of APA are numbered in sequential order, and the 24th division was formed in 1962. It has some 500 members, which should be compared to over 154,000 members of the APA. The International Society for Theoretical Psychology (ISTP) has some 200 members worldwide (that is, subscribers to the paper version of the journal Theory and Psychology). Psychologists, in general, do not trouble themselves with philosophical questions about psychology. Instead, implicit or explicit, they accept the basic assumptions of mainstream psychology: empirism, materialism and reductionism.