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Playing Without a Full Deck : HOUSE OF CARDS: Blurred Roles of Therapists and Research Psychologists Gives Unsettling Credentials to Some Popular Beliefs, By Robyn M. Dawes (Free Press: $22.95; 338 pp.)

May 08, 1994|Carol Tavris | Carol Tarvis' books include "The Mismeasure of Woman" and "Anger: The Misunderstood Emotion."

I no longer tell people I'm a "social psychologist"; they think it means I'm a therapist who likes parties. They listen politely as I try to explain that research psychologists--the people who conduct empirical studies of child development, thinking, memory, prejudice, mob violence, language or any other aspect of human behavior--are not the same as clinical psychologists or any other kind of psychotherapist. My efforts usually fall on deaf ears. "How many patients do you see a week?" they ask, or maybe, "What do you make of this really interesting dream I had . . .?"

It was not always thus. In 1959 the American Psychological Assn. (APA) consisted of 18,000 members, of who only 2,500 specialized in clinical or counseling work. By 1988, there were 68,000 members, of whom 40,000 were in clinical or counseling. Today the proportion within the APA is even greater, and that does not include all the therapists who are not Ph.D. psychologists but who have various other degrees (such as marriage and family counselors or social workers) or no degrees at all. Accordingly, the word "psychologist" has, in the public mind, become synonymous with "therapist."

The reason this matters, argues Robyn Dawes in "House of Cards," is the widening gap between researchers and therapists in what they know and how they know it. In the rapid and explosive growth in the sheer numbers of therapists, the practice of psychology has abandoned its original commitment to establish a mental health profession based on research findings, using well-validated techniques and principles. On the contrary, Dawes shows, the training of most psychotherapists has come loose from its original moorings in scientific procedures (such as the use of control groups before concluding that one method is better than another) and empirically based knowledge (such as observing how children actually recover from trauma), instead, many therapists actively disdain research as being irrelevant to their practices; they know, they say, from "clinical experience" and "intuition" what is right.

Such claims make Dawes rightfully angry, as over and over again he reveals the unwarranted arrogance of therapists whose claims to expertise rest entirely on air. Drawing on more than 300 empirical investigations, he shows why "professionals' claims to superior intuitive insight, understanding, and skill as therapists are simply invalid" (Page 8). Psychotherapy has grown and achieved status, Dawes observes, while ignoring research that contradicts its claims, adopting principles that are "known to be untrue," and using techniques "known to be invalid" (Page vii). Dawes debunks dozens of incorrect ideas promulgated by psychotherapists who know little or nothing of psychological research. For example:

--Belief: Abused children invariably become abusers; children of alcoholics become alcoholic. Fact: The majority do not.

--Belief: Childhood trauma inevitably creates predictable adult psychopathology. Fact: Most children are resilient and outgrow traumatic experiences. Our "belief in the tyranny of childhood," says Dawes, "has little more foundation than a belief in a mountain god."

--Belief: Memory works like a tape recorder, faithfully recording everything that happens from the moment of birth. Fact: For normal physiological and psychological reasons, adults do not remember events that happened roughly before the age of 3, even if Roseanne says so. Memory is not recorded in perfect form; it is constantly being reconstructed from aspects of the event, subsequent interpretations and one's current feelings and beliefs about the past event.

--Belief: Self-esteem is the key ingredient in well-being and achievement; low self-esteem is the main cause of drug abuse, violence and teen-age pregnancy. Fact: Literally thousands of studies have failed to support this belief, which guided the California Task Force on Self-Esteem. As Dawes observes, the task force performed an unintended public service; it demonstrated that "the Holy Grail of pop psychology"--the belief that high self-esteem is the ticket to happiness and low self-esteem is the cause of social problems--"is nothing more then a mirage." What research does show is that children need a sense of competence and mastery at learning new skills. Self-esteem will follow.

--Belief: The more impressive the credentials, the better the therapist. Fact: Studies repeatedly show that for the everyday problems of life for which people seek advice and help, all that is necessary is a kind and empathetic counselor. The credentials of the "expert" are unrelated to the success of therapy.

--Belief: Clinical psychologists and other therapists are better than the rest of us at predicting, from interviews, whether a paroled prisoner will be violent, whether a student should be accepted to college or graduate school and whether an employee will cheat. Fact: They aren't.

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