A Note on Psychological Theories

• MPD and Freudian theory by Leigh , 2/26/98
  • A (pseudo)Freudian take on MPD by August Dolan-Henderson, 3/1/98
    
    

You will probably not find much of help in Freudian theory. As Joseph Weiss has documented in two books, when you aim at Freud, you pursue a shifting target. Freud's concept of defensive mechanisms changed radically over the years and would have changed even more had he lived longer. The reason is that Freud founded his theory initially on an incomplete and basically incorrect physiological model. After failing in 1895 to systematically relate elements of this model to one another and to what he knew about hysteria and other nervous disorders, he gradually moved away from it while keeping much of its language intact. In his parlance, his concepts evolved from being "physiological" to being purely "psychological." Or put another way, again in his parlance, they became his "mythology," a type of cultural frame of reference that changed with accumulated clinical experience, lending new meanings to his clinical concepts with each change.

Because Freud's concepts are metaphorical, they do not possess strict logical consistency in themselves as a set of bookish definitions. They did possess that consistency in Freud's mind and do in the minds of the Freudian practitioners that came after him, however. That's because the most important thing that a clinician brings to a clinical setting is his or her sense of empathetic intuition. A clinician who can relate elements of his own life to what his patient is experiencing adds a sense of humanity to the clinical equation that far surpasses the knowledge contained in any theory.

What I have said about Freudian theory holds true of every school of clinical practice. The formal theory is in every case only a pale reflection of the sense of humanity that participates in clinical successes. The reason is that the clinician is consciously aware of only that part of his or her empathetic understanding that can be expressed in terms of the language of the formal theory. The rest, comprising the bulk of what is used to help patients, remains unconscious and beyond the pale of the formal theory.

It is important for students to become aware of many different clinical frames of reference. There is danger, however, in attempting to be guided in clinical practice by taking ideas from this theory and that. One reason is that a theory as practiced is a cultural entity whose concepts cannot be fully appreciated from the outside. Another is that what really makes the theory seem to work is this sense of empathetic intuition that far surpasses the contents of any theory. Look to yourself more for the clinical wisdom you seek.

I wonder if students are curious about many theoretical frames of reference out of an initial reluctance to becoming indoctrinated in the theoretical viewpoint being taught them in school. To become a practitioner of a particular type does entail submitting to the confinement of a mental straightjacket. It might help, though, to recognize that there is much wisdom in the language of any good theoretical viewpoint.

I feel extremely comfortable with how Control-Mastery theory operates in a clinical setting and with many of its concepts and interpretations its practitioners make. That is not because I agree completely with the formal theory, but rather because the San Francisco school as a cultural setting does foster the type of empathetic intuition I was talking about in copious amounts.

If the founder of Control-Mastery theory were someone with the name of Comello, I would probably carp that the theory is too Roman Catholic in orientation. Irrespective of its origins, the theory in its present form places far too much emphasis on guilt and human relations in general. It bolsters this emphasis with experimental data, which is obtained in a procedurally scientific manner, but which can be explained in other, more fundamental, terms.

With this said, I think it would be a mistake for Control-Mastery theory to change its language, because that language--although a bit off the mark scientifically--is extremely meaningful to patients. There is much wisdom here, as there is in the language of any good school of clinical practice.

• A Request by Jim Duffy, 3/13/98
• I second that emotion by jessica, 3/16/98
• Be Careful What You Ask For by Vic Comello, 3/16/98
  • Question? by Jessica, 3/17/98
    • Words by Vic Comello, 3/18/98