Psychiatry and scientific method : problems of validating causal hypotheses in psychotherapeutic contexts

Abstract

Adolf Grunbaum and others have criticised Freudian Psychoanalysis (FPA) methodologically, because of the potential inferential liabilities of testing causal psychoanalytic claims in the interview sessions. Also, Grunbaum has prescribed scientific experimentation (especially prospective group-comparison studies) as the best means of overcoming these methodological deficiencies. I argue, firstly, that the opportunities for making reliable inferences (including some causal ones) in psychotherapeutic interviews are better than Grunbaum canvasses, though I do this for a theoretically weaker form of psychodynamic psychology than FPA (i.e. General Psychotherapeutic Counselling, or GPC). Secondly, 1 argue that there are substantial problems with and limitations of experimental methodology, both in itself and when applied to test the specific kinds of hypotheses psychotherapists are interested in. Grunbaum and others fail to draw adequate attention to the generic problems of experimentation. I argue that insofar as the acquisition of psychological knowledge is concerned, it is legitimate to distinguish two broad categories of inductive processes capable of providing it: (i) folk-psychological (or FP-) reasoning; and (ii) experimentation (including epidemiology). (By 'FP-reasoning' I mean the largely inherent capacity that human beings have for making inferences about the psychology of others or themselves, in folk-psychological terms.) I argue that FP-reasoning is in some respects inductively superior to experimentation. If this is correct, there ought to be no automatic methodological priority granted to experimentation in psychology and psychiatry. Various topics related to the above are developed. For example; (i) some problems of the practical application to the psychotherapeutic domain of a principle of causal relevance (provided by Grunbaum) are examined; (ii) a sketch for a model of testing for causal relevance in the special case of insults (provided by Grunbaum) is criticised, and an alternative model is proposed; (iii) some general problems of justifying FP knowledge-claims are discussed, and sceptical attitudes towards the acquisition of folk-psychological knowledge are criticised.

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