... Are we really so sure "we’re not in Kansas any more"? Quantitative methods and research epistemology in psychotherapy: a critical perspective.

Massimo Grasso, Pietro Stampa

Abstract


An ideological illusion turns up periodically on the scene of the cultural debate, appearing every thirty to fifty years.  The last time it took the semantic form of the “neutrality of science”; today it is in the guise of its “a-theoretical” nature.
The scientific-professional community is awash with a sort of repulsion towards the components and products of non-immediately quantifiable thought, in favor of an objectivizing reductionism that vastly overrates technology, servomechanisms, shortcuts and schematicism. The prevailing tendency is to reduce every continuum and all complexity to simple, discrete elements that can be measured in a linear way. The role of subjectivity in models of representation of reality is drastically cut down — subjectivity becomes “noise”, and in order to get rid of it more easily without being forced to recognise it, it is translated into numbers. One imagines observable “facts” beyond all interpretation. This is a remarkable turnaround: it is no longer god that is dead, but Nietzsche. 
The illusion changes its name, but it is still the same. A historian of ideas could reconstruct its route from the middle ages to our times: but such an operation ofBegriffgeschichte is outside our domain and outside the spatial and conceptual limits of this article  — we will therefore confine ourselves to talking about it in terms of current interest, with an occasional flashback to the 1950s-70s. And we will obviously confine ourselves to the domain of the research and professional practice of clinical psychology and psychotherapy, in which the pervasiveness of the illusion, as if by a “domino effect”, brings a certain numer of conceptual consequences that constitute a corresponding number of epistemological pitfalls,  which give rise to further systematic distortions of reality in the representations of interpersonal relations in instituted and non-instituted contexts,  and of the mental life of the single subjects involved in the relationships themselves. 
This illusion has been the focus of some of our recently published work (Grasso & Stampa, 2005, 2006, 2007; Grasso, 2006) in which we have tried to examine in depth some questions concerning the concepts of health and mental illness and their connection to the diagnostic and therapeutic pratice in the psychological and psychiatric domain, issues that will in part recur in this article.  
Let us go over the central issue. Thinking about clinical work in psychology and in particular about the outcomes of the clinical psychology and psychotherapy intervention, and about the dynamics involved in these processes, has in recent years been gaining in importance. But within this thinking the aspect that has been dealt with the least is precisely the one that, more than all the others, could give it meaning: we are referring to its methodological framework.   
As we will try to explain below, we have often found ourselves dealing with positions that have given sustenance to our observations and arguments, at times very critical because of the simplifications and reductionisms they feed on. As in the well-known filmThe Wizard of Oz, we have had the feeling that we have run into many Dorothy Gales, who, having left the mediocre reality of the farm where they live – sepia-coloured in the film – and with their big eyes wide open upon seeing a world suddenly in colour, where everything is big and beautiful, marvellous and amazing, turn to their little dog and say,«Toto, I’ve a feeling we’re not in Kansas anymore».
But are we, researchers and professionals in clinical psychology and psychiatry, really sure that we are not in Kansas any more? 
In other words, we felt that research in clinical psychology and psychotherapy has often been fed by facile enthusiasm and dubious excitement about seemingly simple, brilliant solutions to complex problems: but often they are not simple solutions but rather, in our view, simplistic expedients. As in the film promotion, we seem to have heard now and then resounding slogans like ‹‹Mighty Miracle Show of 1000 Delights» or «Gaiety! Glory!Glamour!», just as the belief has been passed on the us by someone that we are unquestionably on the  Yellow Brick Road, that is, on what we could call the “right” road, with no possible doubts or second thoughts.
We know very well the risk we are running by adopting a critical position (and we will state at the outset that we do not enjoy it), in order to dampen the raptures of the many elated Dorothies encountered, to embrace the viewpoint of the  Wicked Witch of the West, if only to avoid ending up being melted by a bucket of water on the kitchen floor: but also because, more substantially, our intention is not to smother the yearning for research and for the new and find ourselves trapped in inertia and immobility. Our position is therefore not an easy one and we realise that: however, we do want to point out, if our eyes reveal it, like Andersen’s boy («but he has nothing on at all»), the “emperor’s possible nudity” and perhaps remember, and remind ourselves, that behind the magnificent wizard of Oz, there may at times be hiding a harmless old man from Omaha, Nebraska.

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Rivista di Psicologia Clinica. Teoria e metodi dell'intervento

Rivista Telematica a Carattere Scientifico Registrazione presso il Tribunale civile di Roma (n.149/2006 del 17/03/2006)

ISSN 1828-9363