Psychiatrists:

• Doctoral degree (MD) in medicine (4 years).
• Specialization in psychiatry, the area of medicine specifically charged with diagnosing, treating, and preventing nervous and mental disorders (three years in residency training).
• Training bias to view clinically significant impairments in affective, behavioral, and cognitive functioning as a result of disease or defect.
• The profession that developed the categorical diagnostic nosology (currently the Diagnostic and Statistical Manual of Nervous and Mental Disorders – 5^th edition (DSM-5)) which lists (depending on how one calculates it) from 157 to almost 300 conditions, up from about two dozen 40 years ago.
• Licensed by the state to diagnose and treat nervous and mental disorders.
• Licensed to prescribe medication.
• May be trained also as psychotherapists or psychoanalysts.

Clinical Psychologists

• Undergraduate degree (BA or BS) in psychology (4 years)
• Doctoral degree (Ph.D. or Psy.D.) in clinical psychology (5-7 years)
• Trained to do applied practice with people experiencing problems in living, as well as to conduct quantitative and qualitative scientific research, and be informed consumers of research to bring cutting edge models and empirical findings to clinical work.
• Specialization in psychology (the study of behavior and mental processes) with subspecialty working with people who display problems in affective, behavioral, and cognitive function that significantly interfere with social or occupational functioning.
• Training bias to view clinically significant impairments as a result of maladaptation or reliance on flawed coping mechanisms
• While able to use the DSM-5 to provide appropriate codes for insurance reimbursement, psychologists tend to be skeptical of the categorical approach to diagnosis (i.e., one has or does not have the condition) in favor of a more dimensional conceptualization that emphasizes degrees of adaptation and dysfunction, rather than disease and defect.
• Licensed by the state to diagnose and treat nervous and mental disorders.
• Trained to use empirically developed, objective, reliable, and valid measures of affective, behavioral, and cognitive function to assess a patient’s strengths and vulnerabilities, and use these findings to make actuarially based predictions about the best treatment approach.
• May be trained as psychotherapists and psychoanalysts.

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Scientific method. Psychologists embrace an investigatory attitude that champions a disciplined approach understanding behavior – of nonhumans as well as human beings. The scientific method proceeds along steps:

• Observation of a phenomenon, and for psychologists it is about investigating some aspect of behavior as well as mental processes observed or inferred;
• Formulating an investigatory question;
• Articulating a testable hypothesis;
• Constructing a way to test the hypothesis as objectively as possible, using a methodology designed to minimize bias and maximize reliability and validity of measurement;
• Collecting the data – usually using quantitative but sometimes well-controlled qualitative measures;
• Analyzing the data, usually using inferential statistics to generate predictions about the probability of a “false positive” or “false negative” finding, or in other words to determine the likelihood that a result is true, reliable, and valid;
• Use these findings to design further studies to replicate and extend the results and construct what psychologists call a “nomothetic net” (think: geodesic dome) of relationships, that enhance prediction of a phenomenon.

Topics of psychological investigation. Below is a non-exhaustive list of areas of behavior and mental processes that psychologists’ study:

• Biological bases of behavior and cognition;
• Sensation and perception
• Development across the life span
• Learning
• Memory
• Cognition, language, and creativity
• Intelligence: What it is and how to assess it
• Consciousness
• Emotions, stress, and health
• Sex, gender, and sexuality
• Social behavior, cognition, and influence
• Theories of personality
• Abnormal psychology: Clinically significant disorders that interfere with social and occupational functioning
• Treatments for psychological disorders
• Applied psychology.

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• Common sense refers to sets of ideas that are often broad, deceptively unspecific, and when held up to scientific scrutiny, they do not accurately predict outcomes. Here are some examples.
  • “Birds of a feather, flock together, right?” Psychology experiments have determined that to be true. Sometimes.
  • “Opposites attract, correct?” Again, sometimes but not always, suggest data coming from psychology labs.
  • “It’s better to rid yourself of angry feelings by ‘letting it out’ (shouting, beating on pillows, etc.), right?” Again, nope. Psychology experiments show that doing so only makes people angrier!
  • “People don’t confess to a crime they did not commit.” Psychology experiments indicate the opposite, and people often do provide false confessions.
  • “In an emergency, there is more safety in numbers.” Actually, psychology experiments have shown the opposite. You have a greater chance of someone helping you in an emergency with fewer surrounding people.
• Common sense relies on experience and deductive reasoning, which can be based on false premises, often transferred intergenerationally and across social groups. Psychology relies on the scientific method to: observe a phenomenon; craft hypotheses about it; design controlled studies to collect unbiased, reliable, and valid data; analyze the results and assess statistically the probability that the finding is “true” and not a false positive or false negative; develop a theory based on empirical results to guide future, disciplined explorations of the phenomenon.
• Common sense draws on an individual’s personal experience (e.g., “It has been my experience that . . . .”), which, because it is limited, can lead to wrong decisions. Psychology makes conclusions most frequently based on scientifically collected data from groups of people.
• Common sense is atheoretical. Psychology relies on investigators developing testable theories to guide and discipline research.
• Common sense is dramatically subject to confirmation bias. Psychology studies have demonstrated that if a belief appears widely held – especially by self-anointed ‘experts’ – people unconsciously look for examples that confirm that belief.
• Common sense implicitly encourages rush to judgment, intolerance of ambiguity, hindsight bias, and confirmation bias. Psychology studies by being well-controlled, driven by theory, with data collected and analyzed statistically encourages critical analysis, appropriate skepticism, sensitivity to interpretive biases, and an emphasis on replication of findings.

References

Lilienfeld, S. O., Lynn, S. J., Ruscio, J., & Beyerstein, B. L. (2010). 50 great myths of popular psychology: Shattering widespread misconceptions about human behavior. New York: Wiley.

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What is apt to be impactful with someone
is someone else being themselves with you,
which then encourages you to be yourself with them
– Earl C. Brown

I have been seeing patients for over 40 years using an approach oriented by humanistic psychology, interpersonal relations research, mother-infant observational studies, developmental psychology across the life span, personal construct psychology, and relationally oriented theories. As a licensed psychologist, I have taught undergraduates, directed a graduate program in Clinical Psychology, supervised advanced trainees in my field as well as in psychiatry, as well as have conducted research on important issues in psychotherapy (assessing interpersonal styles and how we impact each other in relationships, suggestibility, malleability of memory), and written and spoken in public about the importance of a scientifically informed approach to practice. These experiences have led me to an evolving credo, a set of beliefs and principles formed from my lived professional experience, that are the foundation of my way of being a clinician. (Unless otherwise noted, I use the terms psychotherapist/psychoanalyst, and therapist/analyst interchangeably here).

Furthermore, I want to be clear that my guiding principles emerge from an identity as a psychologist first and foremost: someone interested in behavior and mental processes; someone who informs his work from empirical, quantitative and qualitative research; someone who knows from experience that the discipline of scientific thinking and core knowledge in basic psychology (e.g., how our biology influences our feelings, behaviors, and thinking; how we learn and develop across our lives; how we remember; how we act in groups and respond to efforts to influence our actions, beliefs, and values) is critical and practical for effective and ethical psychoanalytic intervention.

Further, my life experience as a clinical psychologist, psychotherapist, psychoanalyst, professor, expert witness in Federal Court, small-business consultant, husband, father, and human being have convinced me that more than almost anything else, people are hungry to have the experience of being deeply known, understood, and grokked, a term coined by Robert A. Heinlein in the classic novel Stranger in a Strange Land. That is my mission every day: to listen, hear, inquire, understand . . . and grok.

In this regard, interpersonal communication theorists, behavior and cognitive-behavior therapists, humanistic, personal construct, and interpersonal psychologists, psychoanalytically informed feminists, Self Psychologists, and relational psychoanalysts have taught me again and again about the importance of a collaborative treatment alliance with my patients. Collectively, they remind me of the rewards that accrue when I lean forward with humble relatedness and the here-and-now presence that facilitates my tracking of affect. An important part of this way of being is to take a credulous attitude toward my patients; accept the notion that for the most part, patients say what they mean and mean what they say! My stance is not to prove them wrong, and impart some perspective as if it is their truth. This way of being with patients assumes a collaborative though asymmetrical relationship, one in which both patient and practitioner create together an environment in which patients feel nurtured, encouraged, and can find their growing edge.

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• An initial 90-minute intake appointment, where we discuss immediate concerns, problems, and reasons for seeking professional consultation at this time, where I obtain historical and other relevant background information;
• A session where patients complete several scientifically developed, objective, reliable, and valid measures to assess problems in living as well as interpersonal strengths, needs, and vulnerabilities, which give us textured information about one’s beliefs, experiences, thoughts, and feelings;
• A 90-minute feedback appointment, where we review the findings together, with the broad objective of better understanding what brought you to my office. Together we devise goals for a therapeutic plan and determine the frequency of sessions going forward.

Please know that while I do not believe the subjective experiences (one’s inner state) of a person can be completely described by responses on psychological assessment tools, my experience, both as a clinician and researcher, has taught me the value of gathering this kind of information.

In addition to the qualitative information obtained in our initial 90-minute appointment, objective data obtained from these normed, standardized, and empirically supported instruments help us:

• Assess (measure) and conceptualize the nature and extent of your life difficulties in ways we both can use in our work together. Based on these findings, I am able to consult the research literature and formulate additional hypotheses in my effort to better understand the origins of your current difficulties. Particularly important, these data enable us to better collaborate and formulate an effective treatment plan together;
• Identify “pathways and channels” to facilitate personal growth and change in relationships. Scores on these measures are often helpful to patients because they provide an emotional vocabulary putting words to feelings, thoughts, attitudes, and characteristic patterns of behavior that are frequently difficult to express clearly upon initial intake;
• Clarify the strengths you bring to our therapeutic project;
• Discover problems that either you might not have been able to articulate or we had not thought initially to explore;
• Articulate answers to the following two critical questions at the outset:
  • What do you want to get out of our therapeutic relationship?
  • How will you know when you have gotten what you want from our relationship?
• Monitor progress toward reaching the goals we mutually set for our relationship.

In my experience, this gentle, respectful, and systematic assessment approach balances subjective information gathering (via our one-to-one discussions) with predictions from objective assessment about what approach is likely to work best to reach our therapeutic goals. This process accelerates our ability to answer what I call

The Prime Directive:

Why does it make sense that I am having these sets of problems with these people in these situations in my life, and what can I do to be more effective and satisfied in these relationships.

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