Does the difference make a difference?

• A Different Slant on CMT, Part II by Vic Comello, 11/27/98
  • Sole? Entirely? by Jim Duffy, 11/28/98
    • Ouch! by Vic Comello, 11/28/98
      
      

Setting aside the question of what in fact motivates persons to be impaired in achieving their desired aspirations that conflict with their installed views of reality or, that is, regardless of whether a patient's difficulty arises from survivor guilt or from one's own hesitation to confront new experiences challenging old beliefs, you seem to be very satisfied that CM therapists do a fine job of helping patients achieve their more salutary aspirations. That much seems clear, for you have consistently repeated your confidence in the therapeutic efficacy and empathic skillfulness of CM practitioners.

Since I think it may ultimately not be possible to give a conclusive inferential argument establishing in general that the lions's share of the evidence weighs on behalf of a guilt/interpersonal accouting or an intrapsersonal accounting such as yours, Vic, we are left having to use our own judgment and our own experience as well as the clinical data provided by the San Francisco group in deciding which position represents the best inference about the truth of how the world works.

In addition, however, I am satisfied the CMT's view conduces to effective interventions and thus works as an efficient problem-solving algorithm or set of guidelines for conducting therapy.

That said, I want to ask if you would explain what in particular you see as the basis for your emphasizing a role for intra-personal causes? That is, what do you see as the importance of this new slant you advoate?

I understand that there is a question here of formulating a comprehensive theory purporting to describe the truth about how the world works. But other than this--other than finding the truth about a scientific inference, and given that inductive "truths" are always tentative and only more or less believable approximations to THE truth according to the soundness and relevance of the evidence, in what way would your inferences serve to make practical improvements to what CM therapists already do?

If, that is, CM therapists do their job quite well, how would adopting your point of view be of benefit? How would patients' benefit?

Other that finding THE truth about scientific inferences (which does not happen given that inductions, unlike deductions, are always doubtful, for even when using the gold standard of controlled experimental tests of causal hypotheses, doubts always remain and assumptions are always made), what do you wish to show as "the difference that makes a differnce," as William James used to say? Apart from the question of the probative value of anyone's clinical observations and rationale versus that of others, do you see some benefit adopting your intra-personal framework and, if so, under what conditions would your framework be more beneficial? Still asked differently, is there a benefit in some instances with some patients to adopting your framework as a more efficient practical problem-solving algoithm or guideline in order to make, for example, more cogent interventions or in order to focus more quickly on key issues or something of that sort?

• Premature by Vic Comello, 11/28/98
  • Eager to learn... by Jim Duffy, 11/29/98
• A Different Slant, Part IIA by Vic Comello, 11/29/98