RESPONSES

Psychotherapy and Science: A Reply to Joseph Schwartz

David Livingstone Smith

I would like to offer a brief reply to Joseph Schwartz's paper `Is physics a good model forpsychoanalysis? Reflections on Langs and Badalamenti' (British Journal of Psychotherapy11(4), pp. 594-600). Schwartz's paper is itself a contribution to a series of papers discussingthe work of Langs and Badalamenti (Burgoyne 1994; Harris 1994; Langs & Badalamenti1994a, 1994b). All too often contentious contributions to the psychotherapeutic literature arepolitely ignored (I use `psychotherapy' as a generic term inclusive of psychoanalysis). It isrefreshing to find that intense and sustained scientific and philosophical debate isencouraged within the pages of this Journal.

Schwartz critizes Langs and Badalamenti on several fronts. Roughly half of Schwartz'spaper is taken up with technical comments on their handling of models derived from physics(and applied to psychoanalytic data). Schwartz, a physicist by training, is well equipped todiscuss such issues whereas I, in my ignorance of mathematics and physics, am not. I willtherefore refrain from commenting on these elements of his paper. Schwartz also providessome ad hominem criticism and some reflections on the issue of the scientificity ofpsychoanalysis, the latter of which will be my main concern.

On the ad hominem front, Schwartz objects to what he calls the flamboyant andunrestrained tone of Langs and Badalamenti's paper. This is fine as an expression ofSchwartz's impatience but carries little cognitive significance. The style and tone of a paperhave no intrinsic relationship to the value of its content. In fairness, Schwartz seems toconcede this point.

On the philosophical front, Schwartz claims, without any presentation of evidence orany gesture towards providing any supporting argument, that:

For me Langs seems to reify the unconscious - to turn a mental process, the unconscious, into athing - while at the same time his technique seems to me to have the danger of leaving the clientisolated and in an anxious, persecuted state. (p. 597)

Schwartz goes on to say that:

But then, coming from a Sullivanian tradition, I would say that, wouldn't I? The question is how weconstructively resolve theoretical and clinical differences such as these?

In other words, Schwartz has engagingly used his own discomfort with Langs'stopographical and clinical notions to point out that discomfort does not provide grounds fora rational critique of psychotherapeutic claims. Conversely, conviction cannot rationallyunderwrite the truth of psychotherapeutic claims. I wholeheartedly endorse this position.Both Schwartz and I interpret science as a (largely)

David Livingstone Smith is the Director of Regent's College's MA in Psychotherapy and Counselling.Address for correspondence: School of Psychotherapy and Counselling, Regent's College, Inner Circle,Regent's Park, London NW1 4NS.

British Journal of Psychotherapy, Vol 12(3), 1996© The author

David Livingstone Smith 373

methodological enterprise. In my own view science is just all of those methods forevaluating the truth value of claims about the universe in a relatively objective fashion.

The term `relatively' is important here because, as Schwartz goes on to state, science hasimportant sociological dimensions which constrain scientific rationality. He thinks thatLangs and Badalamenti present an idealized conception of science which, as they put it, `allows nature to speak for itself. He states (p. 598):

I do not believe it is possible any longer to sustain this view of `allowing nature to speak for itself.Nature is mute. Galileo's telescope showed four blurred specks of light.1 Who was to say what theymeant?

This objection is overstated. Galileo's telescope showed that there was something to beaccounted for. By the same token, quantitative research instruments may reveal correlationswhich need to be accounted for. Nature is therefore not entirely mute: she just does not tellthe whole story. Once a pattern has been discovered, the researcher generates imaginativeconjectures which, of course, might then be evaluated by means of further quantitativeresearch. It is a commonplace notion in contemporary philosophy of science that `theoriesare underdetermined by data', i.e. that any body of data is compatible with a number oftheories. The fact that a piece of reality can be explained in a variety of mutually exclusiveways does not necessarily lead to the relativistic conclusion that all theories are equally `true'. A very important aspect of scientific activity is the formulation and implementation offurther tests designed to eliminate competing hypotheses.

In light of this, I cannot endorse Schwartz's claim that mathematical models are not theway forward for developing ways of adjudicating rival psychotherapeutic hypotheses.Surely, if a psychotherapeutic theory makes some claim about patterns of human behaviour- as all psychotherapeutic theories do - then it should be possible to measure incidences ofbehaviour to determine whether or not the pattern deduced from the theory actually occurs.If we give up on the principle of measurement we are, in effect, throwing in the towel withrespect to creating a science of psychotherapy. This is not to say that mathematics is theonly way forward (it is not and is in fact quite useless in isolation from the moreimaginative aspects of scientific activity), nor is it to say that all (or even most) aspects ofpsychotherapy can or should be treated in a scientific fashion.

Langs, Badalamenti, and Schwartz believe that psychoanalysis should be regarded as abranch of biology. I am not sure that I can agree with such a strong claim which I fear mayerode important distinctions. However, there is a case to be made that biological reasoningcan provide very significant guidance and inspiration for psychoanalysis, psychotherapy andpsychology generally, and that it is generally better suited to this than is physics.

The philosopher Ruth Garrett Millikan (1984, 1993) has pointed out that one of thedistinctive properties of living systems (and also, by the way, of artefacts) is their capacityto malfunction, whereas non-living items in the physical world (excluding artefacts) cannotmalfunction. A liver, for instance, can malfunction whereas a stone cannot. Why is this thecase? Millikan shows that a stone cannot malfunction because it has no function in the firstplace. There is nothing that it is supposed to do.2 In order to understand what a liver issupposed to do, its `proper function' in Millikan's terminology, we need to understandsomething of its evolutionary history. We need to ask the question 'By virtue of dischargingwhat function has this living system

374 British Journal of Psychotherapy (1996) 12(3)

proliferated?' What does the liver do to secure its continued existence down the generations?What is its evolutionary purpose?

Psychotherapy is, of course, all about living systems. Its discourse is replete with thenormative notions of function and dysfunction. According to Millikan's analysis, as soon aswe start talking about such norms we employ biological patterns of reasoning. It is at leastworth seriously investigating the extent to which related biological notions might be of useto psychotherapy (for a good example, see Slavin & Kriegman 1992).

Notwithstanding our broad agreement about the significance of biology forpsychotherapy, I believe that Schwartz overstates the case when he claims that physicalmodels are simply irrelevant to psychotherapy. The irreducibility of biology to physics doesnot entail that physics, or models derived from physics, are globally irrelevant to biology.Surely, models are to be judged by their fruits. There is no reasonable point in excluding apriori any form of scientific modelling. If Langs and Badalamenti have generated as little asone result by the use of tools derived from physics which would have been inaccessible tonaive observation, then the use of such tools has been vindicated.

If we want to help develop the nascent science of psychotherapy, we must extract thecausal and correlational claims of psychotherapy from the larger body of ideological, moraland semantic claims. From these we must select those claims which are, in principle,inductively testable, rejecting those which are not so testable. We must then strive todevelop means of testing these claims. I have argued that many of Langs's clinical claimsare eminently testable (Smith 1991). This is not the same as saying that they are true, or thatthey are some how more true than less obviously testable claims. My suggestion aboutextracting testable causal and correlational claims does not entail the rejection of its moral,ideological and other aspects.

The problem with this strategy, of course, is that there are losers. If our purpose is toexclude false psychotherapeutic explanations, investigators must be prepared to face thelikelihood that cherished beliefs will fall by the wayside. I believe that psychotherapistsretain and defend their preferred theories or approaches primarily for non-cognitive reasons.Psychotherapeutic theories provide quasi-religious solace and illusions of omniscience inthe face of the terrible pain, humiliation and complexity of human life. So, I do not thinkthat it really is so hard to discover the appropriate way forward for psychotherapy, but it ishard to find sufficient numbers of people who are prepared to go forward without beingparalysed by the fear that they will fall off the edge of the world.

Notes

1. Schwartz is referring hereto Galileo's discovery, by means of his primitive telescope, offour of Jupiter's moons.2. Of course, this changes if the stone is selected as an artefact. The stone can in principlefail to function successfully as a doorstop or a paperweight ... or a toothbrush! It just cannotmalfunction as a stone.

References

Burgoyne, B. (1994) Response to Langs and Badalamenti from a Lacanian psychoanalyst. In BritishJournal of Psychotherapy 11(1): 105-9.

Harris, T. (1994) Response to Langs and Badalamenti from a social scientist/psychotherapist. In BritishJournal of Psychotherapy 11(1): 109-14.

David Livingstone Smith 375

Langs, R. & Badalamenti, A. (1994a) A formal science for psychoanalysis. In British Journal ofPsychotherapy 11(1):92-104.

Langs, R. & Badalamenti, A. (1994b) Response to Burgoyne and Hams, the discussants of 'A formalscience for psychoanalysis'. In British Journal of Psychotherapy 11(2): 303-5.

Millikan, R.G. (1984) Language, Thought and Other Biological Categories. Cambridge, MA:Bradford/MIT.

Millikan, R.G. (1993) White Queen Psychology and Other Essays for Alice. Cambridge, MA: Bradford/MIT.

Slavin, M. & Kriegman, D. (1992) The Adaptive Design of the Human Psyche. New York: GuilfordPress.

Smith, D.L. (1991) Hidden Conversations: An Introduction to Communicative Psychoanalysis. London:Routledge.