Re: Psychotherapy

From: Harnad, Stevan (
Date: Thu May 25 1995 - 17:21:09 BST

Here's some questions from Emma Flynn. As my replies may be helpful
to others doing this question, I'm forwarding them to all of yr3.

Hi Emma! You wrote:

> From: "Flynn, Emma" <>
> Date: Thu, 25 May 1995 16:14:27 GMT
> Dear Stevan,
> You said to e-mail you if we had any questions concerning the
> reading. I have quite a few........ PSYCHOTHERAPY.
> 1. I think I understand the basic concept of the hermeneutic circle
> but I just want to make sure. It involves the interpretation of
> information. We all have theories concerning certain elements of the
> world, whether they are scientific or social. Thus when we have new
> information we attempt to fit it into the ideas that we already have.
> Thus we verify our own ideas by flipping from the theory we hold to
> the new information back again to our own idea. Thus each provides
> verification of the other. Is this correct? Thus this process is
> dangerous in scientific theory because it never questions the initial
> ideas......It is a question of expectancy as eg. peer review.

Not quite. A scientific theory is not just another hermeneutic system --
though it can become one if the author keeps trying to save the theory
in the face of conflicting evidence either by trying to explain away the
negative evidence or by trying to bend the theory to fit it. Apart from
the special case of this kind of theory-saving in scientific theory,
which is indeed hermeneutical, hermeneutics in general is different
because it is not really theoretical explanation but merely theoretical

An interpretation is not tested or refuted by data; it is merely
applied to data. The example I kept giving you was a horoscope.
Horoscopes are not tested against the actual data about how your day
went. You do not say: My horoscope said I would be lucky today and I
was not, hence astrology is false. You find things that happen in your
(otherwise appalling) day that might have been even worse and you say:
You see, there's the lucky bit; look what might have happened, but it
didn't. But that's just because you accepted the astrological
system to begin with.

The reasoning, in other words, is circular: You start out accepting the
interpretation system to begin with; then the rest is simply its
application to any and every thing. This is why I gave you the image of
Polonius and the cloud that was shaped like a camel, or weasel, or
whale or what-have-you; or the bible and the pin, where you ask your
deep question, and the biblical verse gives the answer (interpreted,
like a horoscope). Freudian interpretation is like that; so is
psychoanalytic interpretation (of dreams, past events, etc.).

To step into the hermeneutic circle is to interpret something in terms
of some symbol system: The interpretation, which fits any and
everything, is of course always self-confirming, hence circular.

> 2. My second point is a complaint? What is Grunbaum trying to say in
> his article? I did not know that you were going to set us articles
> that are written in a foreign language.

I agree about Grunbaum's writing, but you should see how it looked
before I translated it from English to English (i.e., see the book
itself, and you will come back to the BBS version with relief)!

He's saying that Freudian theory has not yet been tested because the
therepeutic relationship is contaminated by suggestion, influencing both
the therapist and the patient (the hermeneutic circle). He does think
that Freudian theory was intended to be testable, and still could be
testable, and some of it could even turn out to be correct (e.g., the
theory of repression). Others (including me) think even that's optimistic...

> 3. I am getting a little exasperated by reading the articles concerning
> PT. I seem to be going round in circles. Every article seems to dispute
> the previous one. Every fact has evidence to deny and support it, both
> being equally convincing. Since Glass and Smith et al further studies
> have illustrated the effectiveness of PT and overcome some of the
> criticism of Prioleau. Aren't they simply in their own hermeneutic
> circles?

Welcome to Debates in Psychology! That's what controversial issues are

You need not resolve it all, just give a clear and even-handed account
of the pro's and con's, and the evidence and arguments supporting them.
Then you can say what you think, and what would be needed to decisively
settle the debate, if it's possible.

Yes, to the extent that the people defending their theories against
negative evidence are doing theory-saving, they're doing heremeneutics.
But there IS a fact of the matter about whether, for example, a therapy
actually works. What would be a decisive way of determining that fact?

> 4. Eysenck (1994) stated that PT works because of the proposals given
> by Frank (1961)
> a. Therapists are seen as help givers
> b. Treatment occurs in a 'place of healing'.
> c. Illness/ Neurosis is rationalized and placed in an optimistic light.
> Thus it all a kind of expectancy effect. However if these are some
> of the reasons that it does work, it is more effective than simply
> resorting to the pill-pushing ethos?

Slow down! If it's an expectancy effect, then the question is: When
there is something really wrong with someone, does the therapy make it
better -- as measured by an objective means that is not based merely on
a self-fulfilling expectation on the part of patient and/or therapist?
Pills, if tested by properly controlled (double-blind) studies, do NOT
have their effects merely because of expectancy.

> Have many studies had an extremely
> long follow-up time? Perhaps PT allows the person to rebuild their
> preconceptions and so will have new stategies and coping mechanisms,
> which they can use in the future. Whereas Pill-placebos merely produce
> pill dependent individuals.

As far as I know, the long follow-up data are even WORSE for therapies
than the short ones (see Prioleau et al), because expectancy effects
wear off. Some pill studies have good long-term results.

The truth will come from the proper data: Do you have data to back up
your negative view of "pill-pushing" and "pill-placebo dependence"?
The only way to stay out of the hermeneutic circle of self-fulfilling
prejudices and stereotypes here is by basing your conclusions on
evidence rather than hearsay or preconceptions...

> Are we answering the question is PT a valid theory OR does PT hold
> some benefits in society?

The first question is whether PT works as a THERAPY, i.e., does it do
any good, if measured objectively, with proper controls?

The second question is whether the THEORY underlying PT is testable, and
if so, has it been tested and supported by objective evidence, with
proper controls?

Benefit society? I'm not sure what you mean. Perhaps astrology benefits
society too, because it makes people feel they have understood their day
better. But what sorts of benefits do you have in mind, particularly if
the first two tests above should draw a blank? (I'm not saying they do
draw a blank -- just that they might.)

> Please HELP. I understand all the arguments against PT, the placebo
> effect, the question of suitable controls and the problem of meta
> analysis. But I want some secure evidence to support PT - merely for
> argument's sake. Cheers, Emma (Emfly92)

The problem is, that I am not sure anyone can GIVE you any solid
supporting evidence! That's why this question is controversial, and in
the Debates series. All you can do is give a fair analysis of the
evidence, for and against, strong and weak. Chrs, Stevan


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