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Counting on change in accounting for change
An interview with Ype Poortinga, past president of the International Association of Cross-Cultural Psychology and a Professor of cross-cultural psychology at Tilburg University, Leuven, Belgium
You have said the century of the psyche is over? What do you mean by psyche?
For a long time there has been an idea of a sort of separate psychic existence of human beings, which was concretised in a notion of soul and that kind of thing. To some extent, we are still inclined to talk about psychological processes, meaning in fact psychic processes, as things which sort of exist in their own right by themselves and which can be defined in terms of trait-like or process-like notions. Now, one of the future developments I expect for psychology is that first of all this notion of a sort of quasi-independent psychic existence will disappear, that we will become more monistic in that respect, that there will be much more close connections between human beings as behaviourally functioning and human beings as biological organisms.
The nature/nurture controversy is not going to be dissolved that easily. But I think that now we have seen, perhaps already for the last 30 years, despite the increase in socially oriented psychology, we have come to a much closer grip on how behaviour possibly is related to neuronal, neurological, biological functioning. And I think that psychologists are opening up to that. A word like testosterone is not such a dirty word as it used to be. How these developments will go in detail, I don,Äôt know. It's not that I am pleading here or that I am expecting a sort of far-reaching biologising of psychology but the nature of the interactions between biological predispositions of the human organism and the influence of the environment, also in the sense of a broader cultural context, I think will undergo all kinds of development and become more explicit.
What implications does that have for psychotherapy? The practice of psychotherapy is implicitly based in some ways on this notion of the psyche.
Psychotherapy is one clear example of overgeneralising, overemphasising what kinds of changes can be brought about through psychotherapy. Look at things like homosexuality, which for a long time was seen as something that was related in Freudian traditions to early environments and mother-son relationships or something like that. Think about the claims that have been made by psychotherapists about the success that they could have in treating even clearly organic illnesses or illnesses in which there is a strong organic component, like schizophrenia or depression.
The idea has been going around that in China there would be no depression. So we are making depression an entirely cultural thing. I think this kind of myth-making in conceptualisation has carried over also in pretensions about the possible effects of treatment. I think that, just like many other psychologists, psychotherapists have been chewing off far more than they could bite (sic). And one of the developments that I think is a very good development is that the field of clinical psychology has moved to a very large extent in the direction of health psychology, where the difference is that you infer far less about underlying, broad processes, etc. which we still are not sure to what extent they are valid and conceptualisations with a high utility. The movement is now far more hands down.
You can grasp it far better than in the past and it is less pretentious. It comes at a price. But I think there is enough work to do in health psychology. To find a balance may be difficult but for the time being I think that this has been a very welcome change and I think that with the progress in finding out more about the biological roots or the environment-biology interactions of certain kinds of illnesses, the demarcation between where organic intervention is indicated even if only at the level of symptom treatment. And where psychotherapy is better indicated, it may not be psychotherapy in any classical sense, but just providing social support, community development, making people more at ease with their environment. That sort of thing, I think, where a well-trained psychologist can be of utmost importance and of utmost help.
There is also some concern amongst some thinkers that even if psychotherapy is more focused on caring than on curing, there is still a moral obligation to do valid caring. First of all, we have to make some distinction between what we do as psychologists , "what we know on the basis of our scientific training and education at university, our professional training at post-university courses and our experience," any reference to experience is dicey. There is absolutely no indication for example that older psychotherapists are better than younger psychotherapists. Also, I think experience is what has led us up the garden path. Not only in psychotherapy but also in other areas of psychology, where we have a very clear sense of success of our interventions, for example and when we make proper records and compare with the non-experimental group, our expectations turn out to be exaggerated.
So, there is that problem that we have to take care of and I think the liberty issue is going to be very central in that respect. Now, the liberty issues are much better resolvable, at least can be partially answered in areas where, lets say, the relationship between the action of the psychologist and the behaviour target and the targets of change can be defined and studied. If we are working with vague, broader psychological dimensions, that relationship is not clear. There is wonderful work done by a Danish psychologist in the 60's and 70's, where he looks at all kinds of motivation theories and he classifies the assumptions and theoretical conceptions of these theories in terms of whether the concepts are relatable to empirical criteria or whether the relationship between these concepts stay at a theoretical level. And I think that many of the broader classical approaches to psychotherapy have a high degree of theoretical notions which are related to other theoretical notions but which are difficult if not impossible to relate to testable, empirical statements.
Some of your arch-critics might say: "Come on, psychotherapy is always going to be an unmeasurable thing on some level."
That's fine with me, but then you have to admit it and then you have to admit at the same time that it is not and cannot be based in the science of psychology. And then we have the problem which we have in alternative medical approaches, like homeopathy, and one step further and I think it's a small step: "What's the difference between an astrologer and a psychotherapist?" We have to be careful that we don't make more out of science than there is, but at the same time, are we going to be a science-based profession or not. And if it is not going to be science-based, fine with me, but then be explicit about it.
You think it is more likely that it moves towards trying to be a science-based profession in the next century? That is what you are expecting?
If psychotherapists want to continue to receive money from public funds, I think that ultimately a psychotherapist has to have an empirical accountability which goes beyond the impression of meaning. The very least is the satisfaction of the client and it may be that psychotherapy, with or without substance, carries far there. But I think that ultimately, there are going to be insurance companies, there's going to be parliaments, lawmakers, ministries of health, who want to see more in terms of rates of efficacy. Let's face it, many people are very happy when they have talked to a minister of religion or the guy who throws the bones. The question is: "To what extent can psychotherapists validly claim that they are going beyond that. What is it in psychological science that they can add to what the minister of religion does." I think it's a question which has been asked in the past, which has sometimes been rejected as a valid question, but I think it is a question which will come up from time to time and it will become stronger as issues of accountability become stronger. And I think they are becoming stronger with more pressure on health-related budgets, with more pressure on a ration, economically-driven kind of health care.
If this was the century of the psyche, what will the next century be?
You asked me to speculate and I have no particular reasons to believe my guesses about the future are better than anyone else's guesses. Many of these things that I am saying about the future are not expectations, but hopes. I hope that the next century is the century of behaviour rather than the psyche. I think that would be misunderstood in the sense that it would be linked to very narrow, reductionistic behaviourism. But it has to end up somewhere between the psyche and the behaviourists.
Ype Poortinga is the past president of the International Association of Cross-Cultural Psychology and a Professor of cross-cultural psychology at Tilburg University, Leuven, Belgium.