Criticism of Psychiatry and Clin. Psychol.---Overlapping?

I just finished reading the Wikipedia article on Clinical Psychology and the Talk Pages.

Some of the systems under the C.P. rubric seem more appealing to me than others (though I do or may have doubts about them, philosophically), but it's unclear how they'd be considered "clinical". (They seem more philosophical.)

Most of the criticism seems to be directed toward psychiatry on this forum and elsewhere, very little toward psychology. Is the latter considered more benign? Does it have many or any of the same problems as psychiatry (the main one for the latter being prescribing harmful brain medicines and an alliance with the government to foribly incarcerate.)

How do those of you who are anti-psychiatry and/or who have been harmed by it, feel about any or all of the various psychological systems and their practices?

heracles wrote:How do those of you who are anti-psychiatry and/or who have been harmed by it, feel about any or all of the various psychological systems and their practices?

Can you explain what you mean by "psychological systems". Are we talking about measurement and inference practices or theoretical explanations of behaviour and experience?

heracles wrote:Most of the criticism seems to be directed toward psychiatry on this forum and elsewhere, very little toward psychology. Is the latter considered more benign?

Psychology is a much more open area of study. There aren't the same presuppositions and there is a more rich area of criticism which runs somewhat contrary to psychiatry. There is almost no one challenging the current paradigm in psychiatry and no one dealing with any of the conceptual problems that exist (i.e. what is a disorder?). For this reason, psychology, as an area of study, seems to free from social and intellectual criticism.

Sorry,this isn't in topic. You won't talk to me. PM won't allow moderators to be catagorized as "foes", which you are to me and vice vera. Please see to this. I know you hate me more than Hades itself.

Thanks, if that's what we are to be, make it officials, how f--ing sad, but do it

If I repulse you, then just do it, supper simple, but I can't stand all this ignoring, How the hell is this theraputic? What the hell do they teach you in Canada, anyway?

Infinite_Jester

I believe there is a fairly lengthy anti-psychology (not anti-psychiatry) discussion on Philosophy Forums, indeed maybe a few.

The word "clinical" implies to me a claim or of scientific rigor and precision, and there are manuals that seem to roughly mirror the DSM. What I'm asking is why humanistic psychology for example is considered as falling under the "clinical" psychology label. Is there a body that defines and regulates what "clinical" psychology is and are the other "freer" and "more open" psychologies compatible with it's rigorous standards? I just don't understand their inclusion (in the Wikipedia article) in "clinical psychology".

I am also skeptical of "pigeon-holing" people's mental and emotional problems, just to meet some standard of scientific precision. It seems psychology needs to be as much art and insight as "science". I feel my mind and emotions are a complicated blend and may not fall into just one or a few precisely defined "disorders".

Your words to me sound very "educated". I wonder if the "discipline", the "abstract theory" of clinical psychology might get in the way of understanding the subtlies and complexities of mental and emotional suffering. (I'm a community college dropout.)

Again, I'm more open to some of the psychologies---humanist, existential, etc.---but I'd want to explore them skeptically without someone seeing or resenting me as being "oppositional defiant" or something.

Not sure this answers your question, but it's my best attempt.

Hey Heracles,

I think you bring up many interesting criticisms of clinical psychology however, I think that many of these are answerable when you consider the current philosophy of science in psychology as well as how psychologists deal with the problems that exist within their domain of study. With that said, I think there are some problems you didn't mention that are, in my opinion, much more important than the scientificity of psychology.

heracles wrote:I believe there is a fairly lengthy anti-psychology (not anti-psychiatry) discussion on Philosophy Forums, indeed maybe a few.

This is true. People do use the term "anti-psychology" but it's very unclear what people mean by that. I think many of the people who are against psychology don't understand that alternative paradigms in psychology like existentialism, gestalt and humanism are part of psychology's very rich subject matter. Maybe you can clarify some of the claims of anti-psychologists for me.

heracles wrote:The word "clinical" implies to me a claim or of scientific rigor and precision, and there are manuals that seem to roughly mirror the DSM. What I'm asking is why humanistic psychology for example is considered as falling under the "clinical" psychology label. Is there a body that defines and regulates what "clinical" psychology is and are the other "freer" and "more open" psychologies compatible with it's rigorous standards? I just don't understand their inclusion (in the Wikipedia article) in "clinical psychology".

All clinical psychology really studies is the application of psychological research and theory for clinical practice which is incredibly broad. There are psychologists who work in prisons, hospitals, psychiatric units, private practice, schools and businesses and what they do in these situations is entirely contingent upon what psychotherapy or intervention they are using. As for the claim that the word "clinical" signifies or represents scientific objectivity, I don't see how this really has any significance unless you are contending that this is deceptive.

With that said, there are no restrictions on what psychotherapy you can provide for clients however, many graduate programs focus exclusively on evidence based practices like Cognitive Behavioural Therapy, Dialectical Behavioural Therapy and Behavioural Interventions meaning that there are fewer and fewer clinicians doing psychoanalytical, existential and humanistic psychotherapy. Also, many insurance providers and government institutions are only willing to cover evidence based practices causing a further decline of alternative therapies and this decline may continue unless alternative therapies can explicate what their treatment is and subject it to experimental scrutiny.

So there are forces at work shaping what kind of treatments clinical psychologists are doing but these forces are largely driven by the goal of providing effective treatment for mental/emotional suffering and problems in living. Which makes sense right? If CBT, DBT and BI are the most effective we should do those until someone comes up with something better.

heracles wrote:I am also skeptical of "pigeon-holing" people's mental and emotional problems, just to meet some standard of scientific precision. It seems psychology needs to be as much art and insight as "science". I feel my mind and emotions are a complicated blend and may not fall into just one or a few precisely defined "disorders".

Although it's true that states of consciousness like the feeling of sadness are qualitative, it doesn't follow that we can't study them in a scientific way. In fact, this is why the Likert Scale was invented (http://en.wikipedia.org/wiki/Likert_scale) and why researchers use pretest-posttest designs to compare individual's reported experiences with their reported experiences (that way there is no apples and oranges problem).

Hopefully I've been able to convince you that psychology does consider alternative paradigms and psychotherapies and that we can study private experiences in a reasonably objective manner however, there are some problems with clinical psychology that I promised to explain. So here they are.

(1) The effectiveness of psychotherapeutic treatment is always defined in terms of the reduction of symptoms of mental disorder which may not be in keeping with what client's actually want. For example, children diagnosed with paediatric Bipolar Disorder are sometimes given antipsychotic and mood stabilizing medications because it reduces the symptoms of the disorder however, what people seldom consider, among other things, is whether or not the reduction of symptoms is equatable with quality of life. If a child sits in a drooling heap all day the reduction in symptoms doesn't really matter.

(2) No clinical psychologist has been able to explain what mental disorders are supposed to be. Are they theoretical constructs, latent variables, undiscovered biological attributes, criteria or common/garden psychological concepts? (And no you can't say they're all of the above! I hear this all the time... *face palm*).

(3) Many of the disorders in the DSM have no logical relationship with each other (paedophilia, narcissism, premature ejaculation, and schizophrenia...?) so their inclusion within a category seems senseless. Also, the criteria for inclusion in the category includes terms that are observer relative (i.e. function and deviance) making the concept disorder, for a lack of better words, fuzzy. In DSM-5, the task force has taken the position that it cannot be defined in a logical and coherent way

Those are some problems I see. It's a shame that no one really cares about these

heracles wrote:Again, I'm more open to some of the psychologies---humanist, existential, etc.---but I'd want to explore them skeptically without someone seeing or resenting me as being "oppositional defiant" or something.

Not possible. You go against the current paradigm in psychology you get bonked on the head by the academic community. That's just the way it goes.

Take care.

Infinite_Jester, thanks for the reply.

First and foremost let me make it clear where I’m coming from:

1. I read, join and participate in forums such as this one because I’m going through emotional difficulties (in recent years, quite tenacious and intense) and suspect I may have cognitive issues (ADHD, sluggish cognitive tempo…).
2. I want to hear some ideas about them to see to what extent I can use them to help myself.
3. Sometimes I may just want to vent and converse.
4. I feel less alone learning that so many people have felt and experienced what I have (and have been quite surprised that they have.)
5. Generally I am skeptical of academics and professionals and view their theories and standards or whatever with skepticism. (I’m a lower working class community college dropout.)
6. I find many or most to be condescending and I strongly suspect there would be class and “extra-scientific” biases in their interaction with me even though they may deny it, even to themselves. In fact, some may be Christian, but atheists and secularists are just as irksome. I’m none of these. I’m very skeptical and wary of everyone and all ideologies/belief-systems/”theories”.
7. Though I appreciate the good intentions behind it, I’m a little irked by people who blithely try to get me to get “professional help”. I feel I have improved through my own efforts, with less stress and expense.
8. I don’t trust many people, including Ph.D’s, professionals, experts, properly certified people, etc. and do not wish to “spill my guts” to them and believe I can do just as well with my self-help (which recently has included participating on these forums.)
9. I’m not interested in joining the “mental patient” club. I’m not trying to convince anybody that I’m “certifiably” disordered (or whatever). If somebody thinks I’m “malingering”, that bothers me a little, but it’s not terribly important. In fact, I don’t even like the idea of being “labeled”. It seems to put you in a sort of “professional patient” social category where you’re all pathetically dependent and subservient to your “therapist”, like some penitent to a priest. I’m just exploring my “pain” and ways of alleviating it.
10. Even if I were open to psychotherapy, I couldn’t afford it---last I heard it was $120 a session---and I don’t want to go through some degrading government application process to get it free or discounted. (Been there, done that.)

So, as I understand you, “clinical” psychology is not so much a theory of the way the mind and emotions work, but an overarching system of evaluating different “systems” for effectiveness. (I include in the term “system” both the “theoretical explanations of behavior” and “measurement and inference practices”, which I would think, for any given system, may be interrelated.)

The third and last definition of “clinical” in my Funk & Wagnall’s Standard Dictionary (5th printing, 1991) is “coldly scientific or detached”.

I can accept clinical psychology as a soft science and better than nothing, but it still seems to pretend to be and wants to be validated by its peers as “harder” than it really is. Doesn’t much of the “data” it collects come from “self reporting” by patients? I’ve taken diagnostic surveys and couldn’t for the life of me figure out how I should answer many of the questions. My mind went blank when I read them. Even the multiple choice of categories and “degrees” (“1 to 10, very little, very much…”) barely helped me at all. When I was going to the doctor a lot, they shoved one of these “screening surveys” in front of me, and feeling I had to answer it to get good treatment (the power factor), I did. It was supposedly about “depression” and asked a lot of very loaded and leading questions. Bordered on useless to my mind. I know they’d scrawled various “disorders” on my chart in the past, so I know I was a “hypochondriac” in their records system, so I wonder if this was a not so subtle way of “dealing” with me. I felt very manipulated, and don’t think my answers were necessarily that accurate.

I found the comments on the anti-psychology thread of Philosophy Forums to be pretty insightful and reflective of a lot of intelligent criticism of “much” of psychology. I see no reason to assume, that this critic at least, “doesn’t understand” the richness and diversity of psychology, that there are alternate paradigms. (I’ve come to a hypothesis that there’s a strong tendency for intelligent and educated people (like yourself, perhaps) to underestimate the intelligence of people who may be less intelligent and educated than they are. We may not be geniuses with advanced degrees, but we’re not complete idiots and ignoramuses either.)

Here are few comments on some of the “alternative” psychologies described in Wikipedia’s Clinical Psychology:

Humanistic. Sounds like it has the most potential. But why can’t I just read about it and discuss it with others, when and where I’m comfortable.

Cognitive Behavior Therapy. Good, but a bit too martinet and smugly judgemental for me. Callous toward people who have complex and deep pain.

Existential. “People are largely free to choose”. That’s kind of harsh, and philosophically problematical. My need to doubt and question every step of the way would irk “my therapist”.

Postmodern. “Since 'mental illness' and 'mental health' are not recognized as objective, definable realities… the goal of therapy is something constructed by the client and therapist.” This resonates a lot with my own ideas, but I think I can do it on my own, with maybe some help now and then with forum members.

Positive. I really cannot stand "positivity". It makes me feel terrible. I'd rather face the brutal truth squarely and honestly---that's how I move toward relief---not all chirpy, sugar-coated and pollyannish. I know "positive" people see this as destructively "negative", and we'll probably never accept each other's attitudes, so "positive psychology" is out before it ever began.

I suppose you could say it’s my “disorders” that prevent me from “getting professional help”---social-phobia, narcissism (brittle ego), oppositional defiance, paranoia, avoidance……but it’s my choice and I feel it’s the best one. I’m not against *all* psychology or people getting professional therapy and more power to anyone these work for.