The Science of Therapy

In a conversation between Humberto Maturana and Heinz von Foerster (Truth and Trust), Maturana says that the difference between science and philosophy is that science conserves the phenomenon to be explained and alters the explanatory principles to fit, whereas philosophy conserves the principles. When reflecting on the lack of progress psychotherapy has made in the last 50 years, I wonder if its because the practice of explaining psychotherapy is becoming a philosophical pursuit, rather than a scientific pursuit.

I find it frustrating that the things we know about therapy are very rarely explored scientifically. I’m not claiming to know how, and statistics was my worst subject at Uni, but I’d like to follow someone who does. Science is supposed to explore and explain observable phenomena. There are observable, reproducible phenomena that happen when a client comes to therapy, but the field of therapy rarely applies scientific method to explain these phenomena. Where else would you find researches still designing trials to explore what we have known for 50 years, namely that therapy is effective?

Well I guess in part it has to do with the next step. We still don’t know why or how therapy is effective. When faced with such a dilemma science is supposed to come up with a hypothesis that explains the phenomenon and then test it. Its not supposed to ignore an inconvenient phenomenon and persist with its principles.

Humberto Maturana, a Chilean biologist has a really meticulous way of speaking about this. In this article he details what a scientific explanation is impeccably. ONTOLOGY OF OBSERVING The Biological Foundations of Self Consciousness and The Physical Domain of Existence. Humberto R. Maturana (Here is the link)

I had to have a little lie down after reading it though. My husband says that reading Maturana is like eating Christmas pudding. I thought I’d have a go at summarising the part about science into a sort of deconstructed Christmas souffle.

Here goes:

A scientist’s job is to provide an explanation of a phenomenon.

This scientist needs to understand that they themselves are observing the phenomenon to be explained and cannot extract themselves from their own observing. So the phenomenon to be explained is integrally tied up in their observing, and is not in itself some independent reality.

An every day explanation is always an answer to the question about the origin of the phenomenon to be explained, and is accepted or rejected by the listener depending on whether or not it satisfies certain criteria of acceptability that the listener specifies.

A scientific explanation, however, is the criterion of validation of a scientific statement. It specifies the phenomenon to be explained. It provides a generative mechanism (the hypothesis), that if it is allowed to operate, gives rise to the phenomenon to be explained, and tells you what to do so that if you do it you will be able to observe the phenomenon that it was explaining in the first place.

So what would a scientist do when confronted with psychotherapy research findings?

Start with the phenomenon to be explained:

Lets pick one.

A client comes to therapy and gets over their problem. The reason they got over their problem is a function of them, not the therapy. But if they didn’t come to therapy and were on a waiting list, they wouldn’t have got better. A weird phenomenon hey! Therapy is effective, but the largest outcome variance is client factors, which seemingly has nothing to do with the therapy.

A hypothesis:

Someone comes to therapy in a disconnected state. They’re all over the place like a mad woman’s knitting. They are running around like a headless chook. Then they have a therapeutic conversation that generates the experience of reconnection, and they are now cooking with gas. They are “in the zone” and then they go out into their life connected with their resourcefulness and resolve their problem with their own client factors.

When that doesn’t work, reconnection isn’t enough. The missing resource then needs to be learned. The savvy therapist then creates an experience where the client is reconnected with their ability to learn, and with their own individual process of learning. The client then goes out into their life and learns the missing resource and gets over their problem.

What about feedback though?

The phenomenon

Feedback improves effectiveness. Well at least it has the potential to. It does seem to matter what you do with the feedback.

Feedback from the client improves outcome. Feedback from the therapist doesn’t improve outcome.

What’s the hypothesis that provides a generative mechanism that if it were to run would create the phenomenon to be explained?

I’m guessing client feedback puts the attention back on the client and stops the therapy veering into irrelevant territory. What do you think?

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