Meeting the Minds—Dr. Lloyd Robertson, Part II

Dr. Lloyd Hawkeye Robertson is a Faculty Member in the Master of Arts – Integrated Studies Program of Athabasca University, who is now in career transition.  He has a private practice as an educational psychologist and counsellor.  In this second part of our two-part interview, we dig into Dr. Robertson’s views on what’s happening in the field of Psychotherapy, and what needs to happen next.

What is the current state of the discipline in providing explanations of human motivation? How does a modern psychotherapist work with a patient, e.g., assess their problems if any, gauge their therapeutic needs, and decide on treatment for the short-haul or the long-term, and so on?

Psychotherapy has been dominated by the medical model with abnormal or self-destructive behaviour seen as symptomatic of an underlying disease.  The Diagnostic and Statistical Manual of the American Psychological Association is the “bible” for diagnosing such diseases in Canada and the list keeps growing with every new edition.  If you use psychometrics to make diagnoses, you are basically using the Bell Curve – the top 2% on any given scale are considered “clinical.” Sometimes it makes sense to look at clusters of symptoms for common themes, and sometimes it is instructive to measure a person’s responses against a normed control group; however, it is possible to do so without relying on the medical model.  It is possible, for example, that getting depressed is a logical decision given one’s circumstances and past experience.  If that is the case, then anti-depressant medication is, at best, a band-aid and a diagnosis is, at worst, an excuse for accepting that band-aid.  There is no virus that caused the “disease” of alcoholism.  You didn’t get it from the saliva of another alcoholic.  No, the alcoholic made some life choices based a host of needs and circumstances and can choose to make better choices.  Granted, given the chemical effects on brain chemistry, this can be difficult, difficult but not impossible.  I think my profession, especially Counselling Psychology, is moving away from the medical model and toward collaborative and educational models.  I am encouraged by the recent popularity of Positive Psychology which works on client strengths and client definitions of what is pleasurable and meaningful.

What were failed hypotheses in the history of psychotherapy? What were successful hypotheses in the history of psychotherapy?

I think Jung’s theory of the collective unconscious could be best described as “unfalsifiable.” But a more immediate failure was Freud’s notion of penis envy.  Adler immediately broke with Freud on this issue pointing out that if women are envious of men it likely has more to do with being in a subordinate position with respect to power relationships and not that they actual want to have a penis.  The idea that we begin life as a “blank slate,” popular in the 1960s, has been debunked.  In the modern era, the notion that testosterone leads to “toxic male sexuality” is another sexist idea rooted in a dominant ideology.

I think the early notion of the inferiority complex has stood up well.  I think the idea that behaviour can be shaped by operant conditioning is sound providing that is not taken to be the whole story.  I think the genetic basis of “the big five” including extraversion, conscientiousness, openness to experience, agreeableness and neuroticism has been demonstrated.  The efficacy of Cognitive Behavioural Therapy in treating certain conditions such as depression, anxiety and psychological trauma has been demonstrated.  The importance of the therapeutic relationship in predicting outcomes has been demonstrated with implications for the individualization of therapy.

Looking at the history of psychotherapy, the people most of us know about are Sigmund Freud and Carl Jung.  What made their contributions to the history of psychotherapy important?

Freud is best known for his tripartite division of the psyche into id, ego and superego presaging modern psychologists like Susan Blackmore who contend that nature and nurture are both equally deterministically oppressive.  I think Freud’s greatest contribution is that he popularized the idea that psychology is a science.  And he was a scientist if you use, as a definition, the careful observation of phenomena leading to reasoned inference as exemplared by classical Greeks like Plato, Aristotle, and the humanist Democritus.  He was not a scientist in the modern sense that relies on hypothesis testing and random sampling.  Freud’s second greatest contribution was that he brought the study of human sexuality out of the constraints imposed by Victorian prudishness by making it central to his theories.

Jung’s conceptualization of archetypes from which we create meaning has application to cultural and self studies.  His notion that there exists a collective unconscious is controversial.  Clearly all cultures at all times cannot have the same collective unconscious, and when the notion is broken down to human collectives it becomes problematic.  Although Jung was never a Nazi, his conceptualization of the collective unconscious was used to support the notion that the so-called “Aryan race” had a particular mission and destiny.  Jung’s earlier comment that the psychology of Freud and Adler might be okay for the Jews but his psychology is for the “Volk” did not help.

And who should we know about in the history of psychotherapy but probably don’t?

Alfred Adler.  It is instructive that you failed to ask me about him along with Freud and Jung, yet his contributions may be more lasting.  That is not your fault, or the fault of popular culture, but a reflection of the historic power relations within my profession.  For example, you are aware that Humanist Psychotherapy began in the 50s and 60s as a “third wave” reaction to Behaviorism and Psychoanalysis.  Therapists like Abraham Maslow and Carl Rogers said people had a striving for self-actualization and therapy should be client centred.  Yet, Adler had been saying the same things, using different terminology, half a century earlier.  He said people have a striving for perfection and that there are at least two experts – the therapist who is an expert in how people change and the patient (the term “client” was not yet in vogue) who is expert on his self.  Therapy was pictured as a collaboration between two experts.

Perhaps the humanist psychotherapists failed to credit Adler because he also had a foot in the Behaviourist camp.  His “homework assignments” were a method of shaping and reinforcing behaviour.  But the classical behaviourist might have been put off by Adler’s support for the idea that mankind has consciousness and the power of choice.  In this way Adler anticipated Cognitive-Behaviourism.  The founder of Rational Emotive Behaviour Therapy, Albert Ellis, did credit Adler’s influence in the development of his school of psychotherapy.

In the late twentieth century, Narrative Therapy proposed that humans are meaning makers and that clients are in need of re-writing their self-narratives to edit out self-defeating assumptions.  Adler did something similar in suggesting that our worldviews are shaped by numerous influences, beginning in childhood, and that therapy included editing (re-authoring) self-defeating worldviews and motivations.

Previously, I noted that psychotherapists are increasingly describing themselves as “eclectic” as they borrow from various traditions.  In Adler we have the means to unite most psychotherapies under one theoretical tent.  Were that to happen, psychology would have matured into a true science united in a Khunian paradigm.

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