Is psychology/psychiatry scientific?

[Pluto]

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Here's a fun question for the gang: is psychology/psychiatry a real science? I don't have an answer but it could make for a feisty debate.

Many, though by no means all, patients have benefitted from psychotherapeutic approaches which have been developed and tested using scientific methodology. Certain core concepts seem to have some merit. But at the risk of being 'sour grapes' as someone seemingly treatment-resistant, it's not all rosey.

Problem 1: Reliability
A 'proper' science, such as chemistry, tends to have a rigorous foundation. There is nobody disputing that water is H₂O. Similarly, the speed of light is not debated by physicists. Geologists can clearly define different types of rocks.

However, psychology/psychiatry seems to lack this same level of precision. As a dynamite example, scrutiny of the mental health of a certain 20th century dictator has yielded more than a dozen different alleged diagnoses. Why? Was his life inadequately documented? Is it the Goldwater Rule? In what other discipline would such a mess be acceptable?

Now of course, all sciences have a long history of shifting as understanding evolves via experimentation. Today, we have a radically different understanding of gravity compared to pre-Newtonian times. In a way, each preceding theory is proven 'wrong', and today's understanding of gravity is likely to itself be superseded in the future. However, there is a workable consensus for practical purposes at any point in time, and that is what matters.

Problem 2: Value Judgements
The classic example is homosexuality. In the 1952 DSM, the psychiatric overlords lambasted gayness as falling under the larger "sociopathic personality disturbance" category of personality disorders. But then, in 1973, all was forgiven and the 'disorder' label was dropped.

So, what changed aside from some social movements and a few people's opinions?

Closer to home, I think we all know about the 'suicidal people are all mentally ill' viewpoint of this same field. But alas, is this just some guy's latest opinion, too?

Problem 3: Fake Solutions
This is another one that might only impact a minority who fall through the cracks, but is important nonetheless. Behind closed doors, professionals sometimes use the term 'shit life syndrome' in reference to calamities being faced by people which are so severe that there is no genuine solution in sight.

Apparently, it is never OK to simply admit that they do not have the answer. This might lead directly to facing difficult questions, including debates around euthanasia. We can't have that. So let's bring on the antidepressants instead.

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Problem 4: Biased Professionals
Many psychological issues faced by patients entail emotionally-charged interpersonal conflicts. These may be fueled by difficult circumstances and/or so-called disorders. Typically, each party in a conflict will view the other as having the problematic behaviour.

So, who gets to play God and decide which party to side with? The 'expert professional' does, of course. Sometimes, whoever is paying the bill for the session will be given a very sympathetic appraisal, and their foes might get battered with more demeaning labels than a 1950s homosexual.

One study found that over 80% of mental health professionals have themselves experienced a mental health difficulty, with nearly half reporting a diagnosed disorder. Jung's term, the 'wounded healer', is a sympathetic way of describing the sorts of people who might be driven to help others as an outlet of their own pain.

But equally, there is the danger of bullies and sadists being drawn to this profession in order to gain the authority to belittle and cast judgement upon suffering individuals. That authority hinges on the claim that psychology/psychiatry is a legitimate science. Yes, I speak from experience, and things I have witnessed. Some experts did far more harm than good. How about you?

 

[whywere]

In most of my experiences involving mental health folks, it was always about MONEY. I can remember more than one person who would look at the clock and cut me off and tell me that my time was up and ask in the next session. It might have been ok except that it usually was the last question in a series of questions, and I would leave lost and confused.

Some truly do care probably but not in most of my experiences

Walter.

 

[Defenestrator]

As a scientist I'd say it's not a science in the strictest sense - it's not even remotely objective for a start, you're dealing with so many different variables (every person is completely different from one another) that it's way too subjective to apply to the scientific method, and reproducibility is a big part of that.

So no, I don't think it's scientific even though they try to be.

 

[Pale_Rider]

No money, no mental health treatment. lol

 

[Praestat_Mori]

Being able to talk about "a problem" that takes all our energy bc it's "threatening" us can be a kind of relief if we get acknowledged. That is what is behind the "science". That doesn't address "wrong-wired brains" due to genetics.

Mental health is complex - trauma-induced mental health problems could be "erased" if there was a way to "format" the brain and make it forget the trauma.

Mental health can't be cured by meds it's either we can find a way to cope with it or not - that is what works for some people in therapy but not all of them. Psych meds are nothing else but drugs - some become "happy" when on drugs some don't.

Mental health problems that are the cause of "bad genetics" can't be cured bc we simply have no way to change our genetics.

It's not real science unless we can find a way to securely format wrong-wired brains or remove trauma experience or whatever causes mental health issues.

Mental health problems are not developed from one minute to the other - it's a long and slow process that often starts in early childhood and is a reaction to (uncontrollable) circumstances.

I hope my thoughts make some sense.

 

[JesiBel]

Too experimental, the human mind and each individual's existence is a separate universe. Not always "fixable."

Perhaps with several years of exchanging words (therapy) and trying different medications, it will work for some.. Perhaps they can improve their quality of life somewhat and move forward. Or like religious cults and sects... it's quite comparable.

Maybe I'm too pessimistic.

But if everything is screwed up, pills and a pat on the shoulder won't make a difference. I don't know, the reality is one, and it doesn't make sense to dress it up to make it more tolerable. If I can't save myself, knowing everything that's happening inside/outside me... then I don't think anyone else can.

And it's not that one hasn't tried hard.. I'm still here writing, one more day... one more chance and battle. Tomorrow... back to the routine. Surviving... for now. There is no magic or medicine that can change everything. Nobody would commit suicide if that were the case.

 

[willitpass]

It's a strange thing because it's a scientific field almost solely reliant on patients word of mouth. They use scientific methods to gather statistics and assess efficacy of treatment, yet the way of gathering the data is primarily self-reporting from patients. Unlike any other field of medicine, there are no blood tests or MRIs or EEGs that can tell you that a patient is or is not responding to a treatment. You can only hope that said patient is being truthful when they full out a survey of come to an appointment. Needless to say this is far from foolproof. It's the least scientific method of practicing a scientific field, because there is no way to avoid the inevitable error in reporting. Even if a patient isn't flat out lying, they may have difficulty accurately verbalizing what they are experiencing, and again, there are not tests to answer for them.

 

[Gustav Hartmann]

The mind is for sure the most difficult thing to approach by science. I guess science is easiest if the objekt is as far as possible away from the subject. So physics should be perfect. In the realm of psychology the subject is the object, it´s too selv reflective. It is like trying to see your face without a mirror.

 

[Linda]

No, for the most part it's not science. (I'm a scientist myself.)
That's not entirely their fault. Trying to figure out how brains work, let alone how to fix them when they go wrong, is exceedingly difficult, and progress to date has been very limited.
However, that doesn't mean that psychiatry is always useless. They have a bunch of techniques which experience has shown can sometimes help some people. What is missing is a good, scientific understanding of why those techniques work (when they do work) and why they don't work in all circumstances. So it's all a bit hit and miss. Perhaps we can compare it to how other branches of medicine were 300 years ago: capable of getting good results some of the time, but not nearly as effective as modern medicine.

 

[Forever Sleep]

I watched this ages ago:



The part I found really weird was that some 'scientists' working in the psychology field didn't seem at all interested in/ even resistant to studying the brain. Maybe because it might contradict the books and theories they cling to.

I just find that weird. Imagine being a Cardiologist while having no idea or interest in how the heart works! It's unthinkable really. Imagine them diagnosing a serious heart condition and prescribing drugs/ treatment solely based on a patients description of their symptons. It may just be indigestion!

I feel like the idea of studying the brain, questioning the causes of certain symptoms, looking for patterns is certainly scientific in nature. But, I find the actual process of diagnoses utterly baffling and very woolly.

 

[WatchmeBurn]

Depends on your definition of 'science', really.

Does it have the same methodological precepts of the natural sciences? No, but nor is it entirely a natural science anyway as psychology (of which psychiatry is part of) is partially social. It occupies an awkward area between the social and natural sciences that makes it difficult to place epistemologically.

But if 'science' is the systemic investigation of data for the purpose of knowledge-creation (a broader definition that I think is more suitable and doesn't create an arbitrary heirarchy between the natural and social sciences) then it is a science, albeit a flawed one. It's just not as well developed as a lot of other fields of research because the biological mechanisms aren't well understood, the technology to do objective diagnosis is lacking (not helped by the mediocre understanding of the pathophysiologies of various mental health disorders), and there is insufficient integration between the social and biological aspects of the field. It could be a lot better.

But it's not just pseudoscience, e.g., you can't compare it to homeopathy or acupuncture or whatever.

 

[penguinl0v3s]

As a scientist I'd say it's not a science in the strictest sense - it's not even remotely objective for a start, you're dealing with so many different variables (every person is completely different from one another) that it's way too subjective to apply to the scientific method, and reproducibility is a big part of that.

So no, I don't think it's scientific even though they try to be.

Science doesn't have to be purely objective--just look, we have many social sciences. You're confusing science with TEM in STEM, which is a higher level of objectivity.

You can think of how we use both experiments are better than observational studies--both are tools to find trends, but one has more limitations because there are confounders. It's a weaker method, but that doesn't mean it's completely useless.

 

[SmilingNoMore]

I watched this ages ago:

This is so old, 11 years ago! If people know about this, why is there still so much suffering? Is it all because of pharmaceuticals and money again? I mean, I believe there is a cure for certain cancers, diabetes etc., and that doctors simply prescribe meds to have a long-term patient, as opposed to healing someone.

If I understand the video correctly, I'd say psychiatry can be scientific, but the profession chooses to ignore methods available to make a diagnosis? Therefore, if the brain is treated like an organ and there is something abnormal, then the treatment can be designed for the patient to have a normal functioning brain, in theory. But it almost sounds too simple. And who gets to decide what is normal?

I've not had therapy myself, so maybe I'm missing something, but I've never heard of anyone with a positive experience. Thanks for all the interesting info, I've learned something new. If only the powers that be cared more about mental health and research, a lot could be done to make the world a better place.

 

[Pale_Rider]

Not for DID. Some don't even belive in it. Others have minimal training for it. They say the average diagnosis time for somebody with DID is 12 years. That doesn't seem like a science to me.

 

[Forever Sleep]

This is so old, 11 years ago! If people know about this, why is there still so much suffering? Is it all because of pharmaceuticals and money again? I mean, I believe there is a cure for certain cancers, diabetes etc., and that doctors simply prescribe meds to have a long-term patient, as opposed to healing someone.

If I understand the video correctly, I'd say psychiatry can be scientific, but the profession chooses to ignore methods available to make a diagnosis? Therefore, if the brain is treated like an organ and there is something abnormal, then the treatment can be designed for the patient to have a normal functioning brain, in theory. But it almost sounds too simple. And who gets to decide what is normal?

I've not had therapy myself, so maybe I'm missing something, but I've never heard of anyone with a positive experience. Thanks for all the interesting info, I've learned something new. If only the powers that be cared more about mental health and research, a lot could be done to make the world a better place.

To be fair, I'm only a lay person. Not scientific or medical in the slightest so, I don't actually know if there are scientists and doctors out there using this research. I suppose everyone who goes to the doctor complaining of low mood can't be sent for a brain scan. Very costly I imagine and probably not great to flood the brain with radiation. Still, it baffles me that we don't seem to know more about the brain than we do. In comparison to other organs. Again, maybe that's my ignorance and lazyness to read what's out there. Ok, the brain is very complex but, all the more reason to put resources into studying it- surely.

Maybe they prefer to focus on curing known diseases. However- vunerability to eg. cancer, obesity, addiction may be the result of people who are unhappy and anxious who then rely on unhealthy substances to try and get them through. In a way, figuring out the dynamics of these negative emotions and how to effectively diagnose and treat them may prevent people taking more destructive paths to begin with.

I agree with you. What is available clearly isn't entirely effective. There are plenty of people who are still miserable despite their treatment.

 

[Adûnâi]

You're confusing science with TEM in STEM, which is a higher level of objectivity.

Maybe it's also linguistic semantics? In Russian, naooka (from oocheet - teach) encompasses everything, even history (which isn't considered a science?). Russian calls humanities "humanitarian sciences" to distinguish them from the "exact/natural sciences" (STEM). In German, it's Wissenschaft which is likely as wide.

Wait, everything Russian is just translated from German, continental vs Anglo split so real.

Wissenschaft - Wikipedia

en.wikipedia.org

Wissenschaft (lit. "knowledgeship") is a German-language term that embraces scholarship, research, study, higher education, and academia. Wissenschaft translates exactly into many other languages, e.g. vetenskap in Swedish or nauka in Polish, but there is no exact translation in modern English. The common translation to science can be misleading, depending on the context, because Wissenschaft equally includes humanities (Geisteswissenschaft), and sciences and humanities are mutually exclusive categories in modern English.[1] Wissenschaft includes humanities like history, anthropology, or arts (study of literature, visual arts, or music) at the same level as sciences like chemistry or psychology.[2] Wissenschaft incorporates scientific and non-scientific inquiry, learning, knowledge, scholarship, and does not necessarily imply empirical research.

 

[KuriGohan&Kamehameha]

As someone who studied the brain at university for several years (albeit not strictly psychology or psychiatry, my course was more focused on the biochemistry and strictly biological research side of things) I think both fields have varying degrees of credibility, with psychology being the lesser one imo.

While many of the justifications for psychiatry are based on shaky evidence, i.e. the serotonin imbalance theory of depression, or blocking dopamine with antipsychotics being the best method of stopping psychosis despite the universal harms of removing dopamine on movement, cognition, etc, psychology seems to have a lot more woo that goes unchecked.

In most countries, psychology is extremely unregulated. In the UK, for example, there is very little oversight on who can call themselves a counselor, while doctor is a protected title. Medical treatments have to go through long processes to get approved, typically, unless they're fast tracked in emergency situations, but therapists can start practicing new modalities (which have barely been researched) in a lot of places after a one day course.

In some places, a court of law can force people to attend therapy, while the actual "therapy" being conducted wouldn't have to follow any sort of standard and would be up to the discretion of the therapist. Side effects or harms of therapy are never discussed, it feels like there is very little of the scientific method being employed to figure out what works and what doesn't, to the point where it feels more like a cult than a genuine field that wants to progress itself.

To me it is extremely baffling how psychology is held at the same level as traditional medical science by the law and most institutions. I have never seen a clinician acknowledge that therapy is not effective/beneficial 100% of the time, there is always some shift of blame to the patient no matter what, rather than the methods being employed. Imagine having a surgeon who doesn't have the skills to perform a procedure telling a patient that it is their fault the surgery failed, rather than the technique used by the surgeon being inappropriate for the situation. Everyone would agree that is nonsensical to assign blame to the patient, but this is what happens in psychological institutions all the time.

In terms of quality of research, a lot of it is very poor and unreproducible. When dealing with complex, chronic conditions you really need long term follow ups and large sample sizes in your studies. In psychological research, I often see an absurd amount of patients being excluded from studies to make the final results more favourable, i.e. no complex presentations like being suicidal.

Psychiatry is not much better for this, and also does not like to acknowledge the harms done to patients. That's not to say some people aren't helped by these things, there certainly are people who benefit from these institutions, but it's often overstated as a lot people who might see a therapist or psychiatrist are dealing with issues that will resolve on their own without any sort of treatment, and many clinicians actively avoid people who are "complex" or treatment resistant. Once again, if we want to compare to medicine, would it be appropriate for any other doctor to turn someone away if they had multiple health conditions?

I think the poor state of these fields and how unscientific they are speaks to the general public's disdain for those labeled as mentally ill. There are still a LOT of people who do not believe in any sort of mental struggles at all, and do not see the plight of those suffering as anything worth investing in research wise, especially if they believe the current standard of practice when it comes to psychiatry and psychology are just fine. I got this impression myself when I studied Neuroscience and pretty much 80% of my learning was about up and coming research into neurological disorders like epilepsy, Parkinson's, Alzheimer's and other forms of dementia, and very occasionally, autism. The research into psychiatric conditions where I was was pretty much nonexistent.

Of course, it is very challenging to do research in this field, especially in the ethics side of things. Yet, it seems clinicians have no problem subjecting patients to things that are known to cause harm like potent antipsychotic regmines, involuntarily hospitalisation, many new age "trauma therapies" as it's the status quo.

 

[Adûnâi]

I got this impression myself when I studied Neuroscience and pretty much 80% of my learning was about up and coming research into neurological disorders like epilepsy, Parkinson's, Alzheimer's and other forms of dementia, and very occasionally, autism. The research into psychiatric conditions where I was was pretty much nonexistent.

A beautiful comment overall! (Although I would add that psychiatry does more harm by virtue of drugging its patients, often children? Whereas if you bring a child to the therapist, chances are, it won't be worse than being raped and tortured at home?)

But this point - from what I know, there is no biochemical evidence for the existence of mental disorders at all, so wouldn't it make sense that neuroscience doesn't deal with them? I'm not sure if I'm contradicting your previous point about how many "do not believe in any sort of mental struggles at all" because I'm not denying that mental struggles exist, but the biological basis for them.

From what I know, the schizogenic mother concept has been completely phased out simply because of the huge taboo of putting the blame on the parent. Let alone the trans issue, but I won't go into that because this is a trans-friendly space.

Of course, it is very challenging to do research in this field, especially in the ethics side of things. Yet, it seems clinicians have no problem subjecting patients to things that are known to cause harm like potent antipsychotic regmines, involuntarily hospitalisation, many new age "trauma therapies" as it's the status quo.

As long as suicide is not recognised as a human right, it's a sure sign of the system continuing to spew out bullshit like lobotomy or radioactive treatments, merely under new guise.

 

[cowboypants]

If you had any psychotic break say two- three hundred years back you would have been deemed insane, kept away from society or thought of as possessed. There would have been not much solution other than to wait it out. That alone tells how much we have progressed because of science.

What we have access now in medical care is not the final product, even we aren't, as humans we are evolving. While I myself have criticisms about the side effects of meds or the mental healthcare approach, I have hope for the future where individuals don't suffer like we do,

I think it will be one of the most complex things humanity would work on, without our brains we wouldn't have built this society and whatever we have access to. We don't see cats and dogs using the internet, but we do

 

[Linda]

I watched this ages ago:



The part I found really weird was that some 'scientists' working in the psychology field didn't seem at all interested in/ even resistant to studying the brain. Maybe because it might contradict the books and theories they cling to.

I just find that weird. Imagine being a Cardiologist while having no idea or interest in how the heart works! It's unthinkable really. Imagine them diagnosing a serious heart condition and prescribing drugs/ treatment solely based on a patients description of their symptons. It may just be indigestion!

I feel like the idea of studying the brain, questioning the causes of certain symptoms, looking for patterns is certainly scientific in nature. But, I find the actual process of diagnoses utterly baffling and very woolly.

Thanks for posting that video. It's really important. (I have just sent the link to my nephew, who works in mental health.)