Psychiatry, is it science?

[Ben Tilly]

This thread is still going on? And is still about whether recovered memories can be laid at the door of psychiatry?

If you want to lay a disaster at the door of psychiatry, try frontal lobotomies and the excesses of electroshock treatment. (Yes, I know that brain surgery and elecroshock treatment still are used. But less often and with substantially more care. Even so elecroshock treatment in particular is still controversial.)

And for the record I still hold to my original response at http://www.internationalskeptics.com/forums/showpost.php?p=2132363&postcount=10. Psychology is not a science for the reasons that I gave there. (Which has nothing to do with whether people are trying to follow the forms of science, and everything to do with whether consensuses have emerged that fit in the broader framework of science.) That said, what about psychiatry? My response is that psychiatry is on the boundary. There is no question that, for instance, research on the effectiveness of schizophrenia drugs is science. Ditto research on the mechanism for prozac's functioning. So lots of psychiatry is definitely on the science side of the equation. However there are many subtle questions that can arise in the practice of psychiatry (more so for some psychiatrists than others, of course) whose answers don't fall within the framework of science. (Where the boundary of science is what I described in that post.)

Cheers,
Ben

 

[Jeff Corey]

...Psychology is not a science for the reasons that I gave there. (Which has nothing to do with whether people are trying to follow the forms of science, and everything to do with whether consensuses have emerged that fit in the broader framework of science.)...

I disagree. Your criterion of consensus is vague and not found in any definition of science that I have been able to locate. When did geology become a science, according to your criterion? Half a century ago when continental drift was finally subsumed under plate tectonics?
In any case, we'll just go on doing scientific experiments until consesus somehow appears and grants us scientific status in your eyes.
Of course, you might be implying that efforts are mere scientism and doomed to failure. Alas, no consensus will ever emerge, in the case that that is true.

 

[Ben Tilly]

I disagree. Your criterion of consensus is vague and not found in any definition of science that I have been able to locate. When did geology become a science, according to your criterion? Half a century ago when continental drift was finally subsumed under plate tectonics?
In any case, we'll just go on doing scientific experiments until consesus somehow appears and grants us scientific status in your eyes.
Of course, you might be implying that efforts are mere scientism and doomed to failure. Alas, no consensus will ever emerge, in the case that that is true.

It is a paraphrased version of Kuhn's description of a science. My criterion doesn't admit of an exact boundary for becoming a science, but certainly geology had a pretty good consensus after Lyell's Principles of Geology (first published in 1830). (Note that a science isn't distinguished by having right answers, but rather by agreement on the right approach to use. For instance chemistry was pretty clearly a science back in the days of phlostigon even though it was basically wrong about everything.)

Furthermore you may consider the criterion vague, but your librarian certainly doesn't consider it a vague point that stocking the journals the astronomers want costs far more than stocking the journals the philosophers want. That's a pretty easy to measure situation. (That's also a more recent development, and is a result of publishers figuring out how to use citation indexes to figure out what journals they can charge top dollar for.)

Anyways when librarians complain about the price of psychology journals, psychologists aspire to publish their best stuff in journals like Nature, and Science, and they in turn regularly publish psychology research papers, then you'll be a science in my eyes. Of course those are effects, what comes before that is that citation indexes have to start indicating a shared consensus. Which means that psychologists have to reach agreement on what insights are truly key and who is doing good research.

To the best of my knowledge, psychology simply doesn't look like that right now. For an admittedly dated view of what psychology looks like from outside, read http://wwwcdf.pd.infn.it/~loreti/science.html. My interactions with psychologists over the years incline me to give more credit to the field than Feynman does, but his basic complaints remain valid for a lot of the research that I've run into over the years.

Anyways in the long run psychology hopefully will achieve a consensus. But it doesn't seem to have yet.

Cheers,
Ben

 

[Jeff Corey]

OK, now I get it. A science must have a consensus, but can be completely wrong. As in the case of phostogen and the continental drift can't be correct because rock don't drift theory.
I prefer not to have any such consensus, thank you very much. I had a Freudian professor once, from back when that was the nonsensus.

 

[Ben Tilly]

OK, now I get it. A science must have a consensus, but can be completely wrong. As in the case of phostogen and the continental drift can't be correct because rock don't drift theory.
I prefer not to have any such consensus, thank you very much. I had a Freudian professor once, from back when that was the nonsensus.

A better statement is that without having a consensus that has compelling enough evidence for it to convince interested bystanders, the results of activity in that field won't look like science. As for why, well Sir Francis Bacon put it very well when he said, [SIZE=-1]"Truth emerges more readily from error than from confusion."[/SIZE]

Now you had great fun in mocking me for calling something science when (with the benefit of hindsight) it was so clearly wrong. However a moments thought should tell you that any criterion for science that includes, "they must be right" is a criterion that makes it impossible to say who is doing science today. Because we never know that a new fundamental discovery could turn established wisdom on its head. (It certainly has happened enough in the past...)

Furthermore, your sarcasm notwithstanding, a lot of useful science tends to get accomplished before fundamental concepts are correctly understood. For instance geologists manage to demonstrate and chart out the Ice Ages over a century before continental drift was discovered, and chemists developed a number of experimental techniques and a useful practical understanding of the ideal gas law before oxygen was correctly understood.

And finally I'll note that the internal consensus that Freudians achieved among themselves was not the kind of externally visible and accepted consensus that I am talking about. That it was not is indicated by how many people of their time didn't accept what they were doing as really a science. (For instance one of the motivations for Popper's falsifiability criterion was that he wanted a way to distinguish science from non-science that put garbage like Freudianism into the non-science bucket.)

Cheers,
Ben

 

[Jeff Corey]

A better statement is that without having a consensus that has compelling enough evidence for it to convince interested bystanders, the results of activity in that field won't look like science...

Let's see now. How many interested bystanders does it take? Who are these bystanders, anyway? People who have nothing more than a nodding acquaintance with the field of behavior analysis? Who should be forming this consensus? Philosophers?
I think not.

 

[Ben Tilly]

Let's see now. How many interested bystanders does it take? Who are these bystanders, anyway? People who have nothing more than a nodding acquaintance with the field of behavior analysis? Who should be forming this consensus? Philosophers?
I think not.

And there you go dodging the point. The bystanders are irrelevant to whether you succeed. It is just that if you have succeeded, it will be obvious. Do you need to be an expert to realize the impact of Linnaean taxonomy in biology, The Principia in physics, the periodic table in chemistry, the Hubble constant in astronomy, continental drift in geology, and so on? Of course interested bystanders have nothing to do with that consensus. It is just that true consensus based on solid evidence makes itself obvious.

Has psychology achieved any sort of similar global consensus?

If that question is too vague for you, then try this. I believe that you're a psychologist at a university. So consider the following hypothetical experiment. Suppose that each member of your department was asked to come up with the 10 most important papers in psychology from the last hundred years. Do you think that at least 3 papers would turn up on everyone's list? If you repeated that experiment with the 5 most important concepts in psychology, would at least 2 be on everyone's list?

No?

Then you've just demonstrated the lack of consensus that I was referring to.

Cheers,
Ben

 

[ponderingturtle]

Because psychiatry is a medical subfield, psychiatrists are MDs., the others are not.
It's no big deal, but the distinction is stressed in chapter one of every intro psychology text.

Then you can not concider any form of thearapy(well other then drug thearapy) to be psychiatric? Or does it relate solely to the individual and not to any particular treatment? Luchog and Dave where seeming to argue at least in part that treatments fit into either psychiatry or psychology. Now you say that it is not the case. And that if a psychaitrist was useing CBT he would not concider himself to be practicing psychology.

 

[Jeff Corey]

And there you go dodging the point. The bystanders are irrelevant to whether you succeed. It is just that if you have succeeded, it will be obvious. Do you need to be an expert to realize the impact of Linnaean taxonomy in biology, The Principia in physics, the periodic table in chemistry, the Hubble constant in astronomy, continental drift in geology, and so on? Of course interested bystanders have nothing to do with that consensus. It is just that true consensus based on solid evidence makes itself obvious.

Has psychology achieved any sort of similar global consensus?

If that question is too vague for you, then try this. I believe that you're a psychologist at a university. So consider the following hypothetical experiment. Suppose that each member of your department was asked to come up with the 10 most important papers in psychology from the last hundred years. Do you think that at least 3 papers would turn up on everyone's list? If you repeated that experiment with the 5 most important concepts in psychology, would at least 2 be on everyone's list?

No?

Then you've just demonstrated the lack of consensus that I was referring to.

Cheers,
Ben

And there you go, switching the criterion, from interested bystanders to consensus within a department. The researchers in that department range from a biopsychologist studying pain receptors in mice to a social psychologist studying attraction in couples. They might have different views on the most important concepts and papers.
As for your survey idea (not an experiment), it would be mildly interesting to try it in the other departments in the Science Division, too.

 

[drkitten]

And there you go, switching the criterion, from interested bystanders to consensus within a department. The researchers in that department range from a biopsychologist studying pain receptors in mice to a social psychologist studying attraction in couples. They might have different views on the most important concepts and papers.

But that's his point, Jeff. In a well-established science, "everyone knows" what the important results and questions are, even if they're not the ones that you personally are working on at the moment.. For example, when the Super-Kamiokande team reported the discovery of positive neutrino mass in 1998, almost every physicist world-wide recognized it as one of the most important physics discoveries in recent history. Even astrophysicists, solid-state physicists, guys involved in the theoretical description of superconductivity, and so forth.

Similarly, when Hilbert published his list of the twenty-three most important problems in mathematics (1900), everyone more or less agreed with him -- even the people who weren't working on the consistency of arithmetic recognized that it was an important concept (and for that matter, recognized the significance of Godel's later papers on the subject).

As for your survey idea (not an experiment), it would be mildly interesting to try it in the other departments in the Science Division, too.

In rather broad terms, that sort of thing has been done for a long time. In point of fact, that's what "impact factors" try to quantify. One of the key (measurable) differences between psych journals and chemistry or physics journals, for example, is the "obvious" difference between A-list and B-list journals in terms of readership, citations, impact.... and concomittantly, cost.

 

[Ben Tilly]

And there you go, switching the criterion, from interested bystanders to consensus within a department. The researchers in that department range from a biopsychologist studying pain receptors in mice to a social psychologist studying attraction in couples. They might have different views on the most important concepts and papers.
As for your survey idea (not an experiment), it would be mildly interesting to try it in the other departments in the Science Division, too.

Thank you for admitting my point, even though you apparently don't recognize that you have. In part I suspect that you don't recognize it simply because you don't realize how different the hard sciences are in this respect.

As drkitten notes, I did not switch the criterion. Rather I'm saying that the type of consensus that I'm talking about makes itself obvious in many different ways. Therefore its existence can be seen in many ways. When experts have a compelling case leading to fundamental agreement about what is important, then this becomes something that laypeople notice. When experts agree on which questions are truly key for the field, that shows up in citation patterns that publishers notice. And so on.

FYI, I got the idea for that survey experiment from an actual survey that I heard about many moons ago which was similar to what I suggested. They found no consensus within psychology departments on what was important and substantial consensus within the hard sciences. Which comes as no surprise to anyone who has substantial exposure to those areas.

You've admitted the lack of consensus in psychology. For a contrast go to a math department and ask mathematicians whether they think that Goedel's Incompleteness Theorem should rank in the 10 most important results of math in the 20th century. While you are there, some others that would be good candidates for that list include the discovery of the axiom of choice from the Banach-Tarski Paradox, the classification of finite simple groups, the invention of the notion of a topology, the invention of category theory, and the formalization of Hilbert spaces. No matter what their field, they are likely to agree with the importance of those results. (Though some may point out that there is some doubt that the finite simple groups have really been classified, but that is an issue for another time...)

While you're there ask them whether a top 10 list for discoveries from the 19th century should include the formalization of Calculus (finished in the 1870s IIRC), the Central Limit Theorem, the Prime Number Theorem, the invention of Fourier Series, and Galois' proof of the insolvability of the quintic with ruler and compas. No matter what their field of study, they will probably agree that everything there is important.

I don't know other fields as well as math, but if you're adventuresome, wander over to the biology department. Say that you've heard that the single most important biology paper in the 20th century was the 1953 discovery by Watson and Crick of the structure of DNA. (If you want a copy, see http://www.fossilmuseum.net/Biology/WatsonCrickNature.htm. Note where it was published...) Ask if this claim is really true. While you're at it ask whether Darwin's Theory of Evolution ranks in the top ideas from the 1800s.

Wander on over to the astronomy department. Say that you heard that 3 of the 10 most important discoveries in astronomy in the 20'th century were Hubble's discovery of the expansion of the universe, Penzias and Wilson's discovery that there was a constant background of microwave radiation from everywhere (which is now interpreted as being left over from the Big Bang), and the paper B2FH (named for the Burbidges, Fowler and Hoyle) on the synthesis of various isotopes in stellar reactions. Ask if this is really true.

Physicists should generally agree that Hahn and Strassman's discovery of fission (with under-acknowledged assistance from Lise Meitner) had a truly immense impact (pun intended) on the 20th century. Their list of top 10 theories from the 20th century will likely include things like relativity (special and general), quantum mechanics, quantum electrodynamics, Noether's theorem and the idea of gauge groups. From the 19th century they'll agree about the importance of Maxwell's equations, conservation of energy, Fourier series and entropy.

And so on.

In short, the consensus that you find in the hard sciences is clear. It is obvious to people in the field. It is visible to bystanders. It is understood by (very importantly for running the journal) Nature's editorial staff. Without that consensus I wouldn't be able to give you example after example of statements about what is important that there is large-scale agreement on. But the consensus exists and I can make those claims. (Feel free to test them if you want.)

By your own words you've admitted the reality that there is no similar consensus in psychology. Until there is, effort may be expended and results established, but the overall result won't look like progress to people outside of psychology. And psychology will continue to not look like a science to people in established sciences. Even though they won't generally be able to give good explanations as to why it is not, they'll know it is not.

Finally let me note that my comment that psychology is not a science is in no way meant to be a criticism of the effort that psychologists have put out. Rather it is a reflection of the fact that the mind is a complex thing - so complex that people haven't been able to reach agreement on how to approach studying it. There are many approaches that seem to get you somewhere, and no agreement on which are likely to be the most productive in the end. Hence the lack of consensus. By contrast the hard sciences have chosen to study more tractable problems and so are able to come to consensus more easily.

Cheers,
Ben

 

[money]

When experts have a compelling case leading to fundamental agreement about what is important, then this becomes something that laypeople notice.

You then go on to list an impressive number of very important theorums that laypeople probably have absolutely no knowledge of.

Wouldn't it be a better exercise to ask groups of say, social psychologists what the ten most important papers are? I see little reason why this consensus would be congruent with a consensus of another I/O psychologists. Just because both these groups are included under the rather broad field of psychology, and they may not agree, doesn't make either sub-field, or the field in general, not science. No matter the opinion of any amount of laypersons.

 

[Ben Tilly]

You then go on to list an impressive number of very important theorums that laypeople probably have absolutely no knowledge of.

Laypeople? In general, no. But interested laypeople, yes. (After all I am an interested layperson and I am able to draw up this list.)

But the exercise that I'm doing isn't just doable across a specific type of science. Here is, off of the top of my head, a top 10 list for discoveries in science from the 20th century.

1. Fission
2. Antibiotics
3. DNA
4. Quantum Mechanics
5. Continental drift
6. The transistor
7. Radiometric dating (C14 being merely the best known form)
8. The Big Bang
9. Goedel's First Incompletness Theorem
10. Einstein's theories of relativity

One could argue with the order that I gave. One could argue endlessly that some things should be on that list and others not. But virtually every scientist would agree that that is at least a reasonable list. (Random note. I included #9 even though I don't consider math a science because mathematicians seem to participate in a shared value system with the hard sciences.)

It is hard for me to imagine anyone who is interested in science who has not heard of most of these discoveries. They might not know, for instance, what the structure of DNA actually is or anything about quantum mechanics. But they have heard of them and know that they are important.

Wouldn't it be a better exercise to ask groups of say, social psychologists what the ten most important papers are? I see little reason why this consensus would be congruent with a consensus of another I/O psychologists. Just because both these groups are included under the rather broad field of psychology, and they may not agree, doesn't make either sub-field, or the field in general, not science. No matter the opinion of any amount of laypersons.

Depends on the point of the exercise. If the point is to try to figure out what is important in psychology, then that would be a better way to go about doing it. But if the point is to figure out whether psychologists have a broad agreement about what is truly important in psychology, then my approach is better.

I'm not trying to come up with an opinion about what is important in psychology. I am trying to figure out whether psychologists have come to an agreement on the subject. And the answer seems to be that they have not.

As for whether this kind of fundamental agreement is important for something being science, look at the evidence. Every one of the hard sciences that people agree are sciences show that kind of fundamental agreement. The various "soft sciences" generally do not. (The only exception that comes to mind is economics.) Within society (and the hard sciences in particular) there is widespread skepticism about whether the soft sciences are really sciences. And one of the most influential books about the philosophy of science settled on this factor as being critical.

So while your understanding of a science may not include the importance of having this kind of internal consensus, mine certainly does. And there is no question that adding that criteria makes the definition of a science become much closer to the opinion that many practitioners of the most successful sciences have.

Cheers,
Ben

 

[Dancing David]

Then you can not concider any form of thearapy(well other then drug thearapy) to be psychiatric? Or does it relate solely to the individual and not to any particular treatment? Luchog and Dave where seeming to argue at least in part that treatments fit into either psychiatry or psychology. Now you say that it is not the case. And that if a psychaitrist was useing CBT he would not concider himself to be practicing psychology.

Well it is an interesting idea of overlapping sets, I will not try to draw a Venn diagram but use wors.

Psychiatry: a medical field as a large set, defined by the study of psychology in the days prior to the advent of effective psychotropic medications. Becoming more medical as time has progressed. Psychiatry being bounded by obtaining an MD and getting the special training to be a psychiatrist as a doctor.

Psychiatrist: an MD with special traing in psychiatry. Thier traing includes talk therapy in many cases and at least a good knowledge of the various forms of talk therapy.

Psychology: The study of human behavior, currently has many proponents and adherents of various styles. Some are solely theoretical and consumed with what I think of as metaphysics, they indulge in such things as Freud, Alder , Perls, Jung and some are philosophers obessesed with ideas like meta-cognition. In the US and I assume in many places in the world they are a dwindling part of the set. Skinner met with great resistance when he proposed that psychology should base it's study on the observable behaviors and study them, however this is the begining of psychology as science, observable measures and outcomes. In a university setting the departmens will vary, a small amount of philosophers(I met one on-line once Titus Rivas) and thoswe who define thier study differently as social, cognitive, emotional, linguistic and many other areas of things that intersect with human behavior. There are many people who publish books that are classified as psychology that are not written by psychologists.

Psychologist: a person who usualy is defined by having a degree in the academic field of psychology. Is also legaly defined in many areas to denote a speciality to perform certain tasks, most involve testing and assesment but talk therapy may be practiced and often is.

Therapy: a general term denoting some form of intervention to change the situation, usualy requires a specific degree and training. Chemo-therapy for example is medication.

Therapy in the mental health field: usualy but not always denotes the practice of talk therapy, it is usualy legaly deined and requires certification and special traing , it involves a higher fee than counseling and involves a much higher liability. Includes a huge variety of forms and practices from CBT (cognitive-behavioral), RET(rational-emotive), family network, social network and a huge array of the introspective less objective models. The concept of therapy is usualy set by legal parameters and varies from state to state, who may practice and call themselves a 'therapist'. Therapists are generaly more stand alone than counselors.

Counseling: a very vauge term in general to denote anyone who does a lesser form of talk therapy with less training, theoretical less intensity, greater focus on solely the area of intervention and less liability. The definition of counselor is used widely in various fields, it usualy implies less training than a therapist. It is a legal and a general term , it can be legaly defined in a specific area of practice but also has a general meaning to denote anyone talking to someone to help them in thier life. Legal defintion and requirement vary widely from state to state. usualy a counselor would have a trained individual supervising them to oversee thier practice in the best case scenario.

Social work: another term like counselor that has a general and a specific meaning. It is usualy a legal term to denote specific traing and requirement to preform certain tasks. But it has a geberal meaning that denotes social service provision.


So to answer the question at long last.

A psychiatrist may practice medicine or some chose to practice talk therapy or some combination of both. Most psychiatrists practice medicine but not all, many are engaged in different forms of talk therapy and most use it to inform and influence their practice. Psychiatry is usualy used in the menatl health field to denote the medical treatment of mental health issues but has quite a hold over from the past. Many psychiatrist chose to become involved in talk therapy of some sort.

 

[Dancing David]

Ben Tilly: HI and welcome to the discussion.

I prefer to think of science as the practice and use of the scientific method.

 

[blutoski]

But we are looking at the point of view of the mental health industry. From this logic all mental health practitioners are practicing psychaitry at some level, just like nurses and EMT's practice medicine at some level.

"at some level" is pretty cheesy quibbling on your part. When I post to this forum, I'm practicing medicne "at some level." Doesn't make it healthfraud or woo.

So why does this make psychaitry more woo resistant than psychology? I have still not gotten an answer about that statement from anyone. Or a reason why from a mental health perspective they should be viewed at as highly seperated.

Does this mean that a phycologist who treats people is practiceing psychiatry then?

No, you're obfuscating. Psychiatrists and psychologists have different scopes of responsibilities even within the healthcare system (I'm assuming that you understand from my previous posts that a sports performance motivator is not doing the same work as somebody treating a schizophrenic), based on the DSM-IV, and backed up by legal systems. I have listed the distinctions in previous posts, as have other posters. Not much more to add.

And how much of their thearapy is backed by solid research and thus does not fall into the Woo catagory?

I would say 'all'.

 

[blutoski]

ANd we see yet still more definitions of of the two, and that psychaitrists can practice psycology makes it even more confusing.

For you, maybe.

And how does this relate to the thearapy given by each? And what the hell do non doctorate level thearapists do, psychaitry or psychology?

All psychiatrists are doctors, by definition.

When I complete my MA in psych and pass the professional exams, I will hopefully be doing therapy with families coping with a member who is from a different culture. This could include transcultural adoptions, mental, or physical disabilities.

There are many opportunities for sub-doctoral psychologists, inside and outside the role of therapist.

They are not limiting their practices in such a manor as psychaitrists can often legaly practice psychology.

They need to do additional clinical work and pass additional exams before being licensed to conduct therapy. At least, this is the case in Canada. MDs who do both Psychiatry and psychology are rare, and often have a psych undergrad.

 

[ponderingturtle]

Ben Tilly: HI and welcome to the discussion.

I prefer to think of science as the practice and use of the scientific method.

But it does say something about the quality of the data, that you can find so many compeating mutualy antagonistic idiologies running around. I think that his is part of what makes mental health have so little resistance to woo ideas.

 

[ponderingturtle]

Well it is an interesting idea of overlapping sets, I will not try to draw a Venn diagram but use wors.

So the idea is that thearapy and treatment, asside from medication, exist outside psychology and psychaitry? So you can not say if a therapy is psychiatric or psychological?

 

[ponderingturtle]

"at some level" is pretty cheesy quibbling on your part. When I post to this forum, I'm practicing medicne "at some level." Doesn't make it healthfraud or woo.

That is because the treatment offered by people lower than doctors are heavily legally restricted. As an EMT there are lots of things I am required and required not to do and say. I don't see these requirements that are written by many doctors having a correlary in mental health at all.

No, you're obfuscating. Psychiatrists and psychologists have different scopes of responsibilities even within the healthcare system (I'm assuming that you understand from my previous posts that a sports performance motivator is not doing the same work as somebody treating a schizophrenic), based on the DSM-IV, and backed up by legal systems. I have listed the distinctions in previous posts, as have other posters. Not much more to add.

And what I have gotten from Dave is that you can't say if any treatment is psychatric or psychological with the exception of medication. So treatment is divorced from theory and discovery then?

Is talk thearapy everyones bastard stepchild?

I would say 'all'

So thought field intergration and other energy psychologies are backed by strong research now.