Theoretically speaking…

A theory is a generalized explanation and body of knowledge about how something operates. These explanations are used to predict and assume outcomes for specific actions. A theory stands if the results can be consistently replicated by researchers under similar conditions.

In the field of psychotherapy, research seems to come out daily promoting one theory of therapy over another. Each theory proponents pushes their theory to be the most effective and often have substantial research as evidence to its effectiveness. The rigor shown by these researchers can be impressive and their work has created shifts in, not only the content of educational training, but also funding for programs which are designed to assist the public with mental health issues.

I remember talking with one therapist who told me that the only real reason he started using his theory of therapy was that it was “evidence based”. He had not tried any other forms of therapeutic interventions because he felt there was not as much research to back up other theories. He said close to seventy five percent of his clients got better using his approach. My question to him was, “What about the other twenty five percent who don’t change?” He politely changed the subject at that point.

 

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Even though there are some great aspects to having a solid theory of how to do therapy, these theories can sometimes become cumbersome and limiting if we think each individual will automatically fit into our theory. Our clients may not have received the memo that they are to respond a certain way at a certain time due to a certain intervention. When the client does not fit the theory presented by the therapist sometimes the client is then labeled “resistant”. When a client is seen as resistant due to his or her inability to conform to the will of the therapist, the therapist may then become frustrated, angry, feel ineffective or become burned out due to his or her strict adherence to their theory.

The best way to handle the “resistant” client is to throw away your theory. This may be blasphemy to many who cling to their theories in a dogmatic, evangelical way. Many times our theories are good for some clients but not good for others (the twenty five percent). If all we have is one way to assist others we may find ourselves surrounded by “resistant” clients who make us work too hard, feel defeated and uninspired in our vocation. When we allow ourselves to create new interactions in the moment with each new client without a set scripted theory, we may find that every therapeutic encounter can feel much more exciting and creative. What if every client needed his or her very own theory of therapy?

The great scientist Karl Popper believed that theories by nature are abstract, and can only be tested in reference to their implications. Popper asserted that a theory is irreducibly conjectural and brought about by our imagination to solve problems that have come about in a distinct cultural and historical context. He felt that the truth of any theory cannot be verified by scientific testing. It can only be falsified.

To quote the brilliant family therapist Carl Whitaker: “I have a theory that theories are destructive.” Whitaker argued that too much reliance on a theory can cause a loss of objectivity for each unique person and situation. He felt this could result in a loss of compassion and care for the client. He argued that clinicians should consider give up strict adherence to theory and become alive as a real person in their sessions. As he eloquently put it, “Part of the problem is the theoretical delusion that science is curative; that enough knowledge, enough information, the right kind of facts will bring about the resolution of life’s doubts, the resolution of all distress.” I think Carl got this one right.

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