Hey Science: Stay In Your Lane

You DO have a lane, you know.

Science is taking over everything. Even theology. Ten years ago while getting an MTS I noticed articles published in theology along the lines of miracles can’t exist because science says they are not possible. It has consumed medicine and now the field of psychotherapy — not that either of them were not scientifically based before now, but this has gone too far. The term bandied about is “evidence based medicine and evidence based psychotherapy”.

Sounds great and perfectly logical doesn’t it? The underlying belief is that science is the way to discern truth and accuracy. It keeps the darkness of false beliefs, of fooling ourselves about outcomes, away. It holds us accountable for our practices – all good. What could possibly be bad about this noble intention? It’s got to be good.

I say, in at least the case of medicine, something sinister is going on. And in psychotherapy something ineffective is being promoted.

Let’s start with evidence based medicine. The glaring problem is the outcomes of gold standard experiments are tailor made to meet the demands and needs of pharmaceutical companies. If this is so, then the foundational reason we bow to science – that it shines a pure light on truth is false – false at its very foundation. That foundation is based on greed and business, to be exact.

I assume you are incredulous about this. Forty years ago I was attending a medical conference. I rode with a research MD in a cab. We were pleasantly relaxed from a little wine, so we talked freely. She said, “I was told by my bosses to lower the baseline for a certain drug. I did. Now thousands of women will be prescribed that drug when they don’t need it. Eventually they will die from it.”

Now if you think that was a stray anomaly think again. Look how long ago did that happen? Do you really think things have improved since then? As one former NIH scientist said last week, “Scientists are businessmen.”

Like psychotherapy, medicine is art. The more clinical experience you have, if you are skilled at critical thinking, the better your outcomes. You rely heavily on your intuition. You know that patients are all different and what works for one will not work for another. The number one requirement of such a skilled physician is “Listen to the patient.” When you listen like this you put things together that no scientist could. In that practice you listen for the anomalies.

Evidence based doctors listen to the algorithm and to the science. They are present to the fact based data in their heads. Have you noticed them looking at their computers and not you? They are not present to you.

Sounds scientific? But statistics are all based on averages – the mean, or the common “denominator”. Science is normative. What can the majority be given? A drug. What does the majority need? How many side effects can the majority tolerate?

Worse, evidence based medicine destroys critical thinking. You stop putting things together because, supposedly, its been done for you.

Science is a box. Nothing can happen out of that box.

Have you noticed during the pandemic doctors were denied the ability to use any drugs off label? “Off label” is a pharmaceutical term, not a medical term. The “label” was created by pharmaceutical companies. What they forget is the understanding of the chemistry is in the doctor’s hands. No pharmaceutical company should be controlling what a doctor does – ever. Science is not medicine. STAY IN YOUR LANE. You, dear reader, should be protesting in the streets about this.

Imagine why suddenly no doctor should prescribe off label? The two drugs that could have controlled the pandemic cost 50 cents a pill. Let’s call Big Pharma’s gold standard studies gold bullion studies.

Let’s move on to psychotherapy. I will never forget at a wonderful venue called Science and Consciousness a physicist was sure he could cure bulimia. His pop psych reading of the problem informed him that bulimics have faulty body image. So his solution was to change their negative thoughts by having them look in the mirror and say over and over “My body is beautiful.”

For god’s sake, physics may be the Queen of the Sciences but knows absolutely nothing about psychotherapy. Stay in your lane. This does nothing to help with bulimia. I worked with bulimics for decades and had them stop throwing up in two weeks. It was most assuredly NOT cognitive therapy. And not simple at all.

Cognitive behavioral therapy has taken over the field. It comes from behaviorism, the basic science of psychology. It smugly calls itself the gold standard of psychotherapy, borrowing from hard science, when it should call itself the bronze standard because patients tell me all the time it doesn’t work.

Here, at least, there doesn’t appear to be a financial intervening variable in experimental results unless all patients in cognitive therapy have to be put on drugs.

Pharmaceutical companies did intervene with the mental health profession when they pumped out the slogan the public buys completely – all mental illness is caused by a chemical imbalance (so take chemicals to cure it).

With cognitive behavioral therapy comes a focus on thinking. As I heard one behaviorist say “What is therapy but learning.” (Learning is a science.) What!!! The art of psychotherapy has been lost. The patient is turned into a thinking machine with cognitive problems and beliefs that need to be changed. When we get the cognitions adjusted properly the patient will be cured. Cogito Ergo Sum distracts us yet again.

This therapy is soul-less, compassionless, ignores the heart, wishes to do away with irrational emotions (as does the chemical treatment of mental illness), and especially shies away from deep experiences in therapy. Can you imagine a cognitive therapist crying with her patient? (And you had better know which patients you can cry with and which it would be detrimental for.)

Why is that? None of these “useless parts of the human being” can be measured. The soul and heart are invisible and sometimes illusive. And many scientists consider belief in the soul as a quaint belief. Irrational feelings are the problem and they are “caused” by negative thoughts (absolutely erroneous). Experiences are not to be trusted.

Science, of necessity, had to ignore experience because long long ago, in the dark ages, people made incorrect assumptions based on their experiences. But when it demands therapy would be without experience it has moved out of its lane.

The magic and mystery of excellent psychotherapy is gutted by this gold standard. I remember the almost spiritual silence that came over us as trainees when we witnessed our teachers treating a patient. We were apprentices to an art, an effective art. Sure we were rigorously trained in the science before being allowed to train in the clinic. But that science served us. It trained our minds. Never was it the god to whom we had to bow. Never did it “train us” in the art of depth psychotherapy. Stay in your lane. Confine yourselves to Social Psychology.

I had a new patient 5 years ago. She said, “In three weeks with you I have gotten further and seen more change in myself than with two years of cognitive therapy.” I have heard this over and over.

OK, Science. What are you going to do with that? I’m not going to get it measured. Or even published. It stands for itself.

For further reading, here’s some research backing up what I am saying:
https://www.sciencedirect.com/science/article/abs/pii/S027273580600081X