First year doctoral paper, by Jim Byrne

2009-11-02T08:26:00.001-08:00

June 2004
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From Personal Certainty to Significant Doubt:
A painful research journey
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by Jim Byrne, MA(Ed)., Dip.CP.Psych

Introduction
In this paper I propose to look back at the period when I was training to be a Rational Emotive Behaviour Therapist, and the first couple of years of my private practice. This was an “apparently purist” period in my development as a researcher/writer in the field of psychotherapy studies. My aim will be to take a look at the attitude towards “certainty”, or the nature of “reality”, which I held in 1999-2000. In particular, I will look at a series of articles which criticized Rational Emotive Behaviour Therapy. I will also look at a number of refutations which I wrote in response to those critiques; and some correspondence which I had with the editor of The Rational Emotive Behaviour Therapist, which is the journal of the Association for Rational Emotive Behaviour Therapy. My main question will be this: Did I produce my refutations on a “defensible basis”, from the viewpoint of a “viable epistemology”? And what would I change if I were writing those refutations today?

Research Methodology
My approach to methodology was influenced by Hart (1998/2003), who maintains that methodology is more than just methods and techniques, but must represent an approach which is consistent with an explicit ontology and epistemology. Before commencing this assignment, it seems I had an eclectic, and even self-contradictory ontology, which flipped from realism to relativism, and back again, under the pressure to explain changes in external circumstances. Since working on this assignment, I have moved towards a more integrated ontology, which attempts to balance relativism and realism in a phenomenological/constructivist matrix of perspectives. (Willig, 2001, chapter 9). I commenced my work on methodology by writing an outline document of some 2,000 words, and then restructuring it using the following four questions from Silverman (2000), page 235.

1. How did I go about my research? I began by rejecting the idea of conducting a primarily quantitative study, from a positivistic perspective, as I have done on a number of occasions in the past. I also started out by doubting that “science”, in the positivistic sense, is a “reality” rather than an ideological construct which has been propped up since the time of Aristotle to the time of Popper and Kuhn, by faltering and failing philosophies of science too numerous to mention; and none of which seems to be beyond intellectual challenge. (Losee, 1993). In particular, I rejected hypothetico-deductivism for two of the three reasons given by Willig (2001, pages 4-5); namely: (1) that hypothetico-deductivism does not provide sufficient space for theory development, if all new knowledge has to be based on testing hypotheses which are implicit in current theories; and (2) that hypothetico-deductivism is a myth, as shown by Kuhn (1970), and Feyerabend (1978), in that, in reality, scientists do not test hypotheses in the way Popper suggested they do.

I wanted to find some data, linked to an issue which I personally value: the existence of which could be verified, even if it continued to be subject to various interpretations by different researchers. (Gee, 1999, page 139; and Willig, 2001, page 150).

Ontologically, I started from Wittgenstein’s view that we have to accept as given fact that “forms of life exist”. (Winch, 1990, page 40). However, these forms of life show up as phenomenological perceptions in the minds of humans. (Kenny, 1994; and Hume, in Magee, 2001). This leads to a constructionist view of phenomena. (McLeod, 1994/1997; and Gergen, 1985). In other words, although “I” can rap on “the table” to demonstrate that it is “present”, I only have “pure information”, inside of my brain, about the existence of the table. (Brooks, 2004).

Phenomenological constructions can be seen as constituting a range of levels of “abstract reality”. (Watts, 1990; Korzybski, 1933/1990; Lunzer, 1986). Both “concrete entities” (such as ‘a man’) and “abstract entities” (such as ‘inflation’, or ‘emotional disturbance’) exist, but in a phenomenological manner, inside the minds of humans. Their existence is by interpretation and social agreement. (Banister et al, 1994, page 53). Or as Winch (1990) expressed it: “…when we speak of the world we are speaking of what we in fact mean by the expression ‘the world’: there is no way of getting outside the concepts in terms of which we think of the world… (T)he world is for us what is presented through those concepts”. (Winch, 1990).

Epistemologically, based on the foregoing ontology, my task is to “…elucidate what is involved in the notion of a form of life as such”. (Winch, 1990, page 41). My theory of knowledge is that I construct a ‘life story’ about ‘forms of life’ (such as counselling and therapy processes) based on observation, experience and memory, and my human reasoning processes. (Aune, 1995). I agree with Kant that we are born with a capacity to identify (and look for) causation, and to be aware of space and time. (Magee, 2001; Kant, 1929/1973; and Lakoff and Johnson, 1999).

I agree with Korzybski (1933) and Nierenberg (1982) that we seem to have an inborn capacity to perceive and look for structure, order and relations in our perceptions. (This seems to be a function of the ‘embodied mind’ of Lakoff and Johnson, 1999, as opposed to the disembodied mind of Descartes’ Meditations). I agree with the social constructionist view that “facts are records of events which are made by humans”. (Novak and Gowin, 1993). They are no better and no worse than the person or device recording them. In this sense, facts are conclusions which are constructed by a person or persons, and are found to be acceptable to them for their own reasons/purposes, after due consideration of (some or all of) the competing possibilities. (Lehrer, 1990). There also seems to be a power dimension to our knowledge constructions: (e.g.: Marx’s ‘ideology”; and Foucault’s “network of self-legitimizing power and knowledge” [Marx and Engels, 1970; Foucault, 1990]). While the involvement of power elites in the construction of knowledge is virtually undeniable, it also seems almost impossible to establish a “method of enquiry” into these power structures which would be any more defensible than Marx’s “dialectical method”, or Foucault’s “archaeology”. Any “narrative” we construct about knowledge, and its relation to power, can be contested by another “narrative”!

2. What overall strategy did I adopt, and why? Several months before commencing my study proper, I began to keep a research diary, in which I began to develop themes, and to seek some kind of reconciliation between my (occasional) naïve realism and my (official stance of) radical relativism. I sent analytic memos to myself, and began to collect and read relevant articles, books and papers. I knew I could not rely on my memory as a source of “historical data”.

I started out from the position that the main “form of life” in which I am interested is counselling and psychotherapy, as a “healing discipline”. So I asked myself, ‘What data do I have to hand which could benefit from analysis and publication?’ The answer was: A range of articles, by Neenan (1997, 2000); Bond and Dryden (1996); and my refutations in the form of Byrne (2001a, 2001b, 2001c, 2003, 2004). I considered using Gee’s (1999) simple mark-up approach to Discourse Analysis; but did not pursue that. As I began to work on developing a strategy, I moved between seeking to follow a ‘known method’ of enquiry – e.g. Bell (1987), pages 53-57 – to rejection of prescribed methods – e.g. Feyerabend’s (1978) “anything goes”, pages 29-33. I was also drawn towards the approaches to “argumentation analysis” in Hart (1998/2003). And even as I set out to follow Bell and Hart, I wanted to somehow use Interpretative Phenomenological Analysis (IPA) with a single case study approach, as described in Willig (2001), in a way which would allow me to be both the researcher and the research subject. This produced lots of creative tensions.

3. What design and techniques did I use? I set out to develop a form of “critical review” of the relevant articles, based upon an informal fusion of “argumentation analysis” and “interpretative phenomenology”. (Hart, 1998/2003, and Willig, 2001). This was an ‘anarchistic activity’ of the type described by Feyerabend (1978). I also used creative strategies from Cameron (1992), which involved immersing myself in lots of reading and note taking; and then attending musical concerts (including Indian Bollywood brass music), and wandering aimlessly around colourful environments (such as Woolworth’s high street store, in Halifax, or the local market). I also wandered around Waterstone’s and Blackwell’s bookstores, in Manchester, browsing; and drinking coffee in local cafes, while taking notes. (This is partly Cameron’s “artist’s date” technique, and partly De Bono’s idea of holding unrelated ideas together until they yield a new, creative product. See De Bono 1971, 1973, 1977, 1991, 1995).

A second major element of my methodology came from Gordon Allport, who, in 1947 “urged his colleagues to consider personal documents as a critical source of theory-building. …”: (Maykut and Morehouse, 1994). In keeping with Maykut and Morehouse’s finding that several studies confirm that personal documents can be very useful, I went back through the various drafts of my articles, to (1) look for “edited out” clues to my attitudes; (2) to look for margin notes on the documents I was critiquing; and (3) to review my emails and letters concerning the articles I was critiquing.

A third element was the idea of ‘self- interviewing’, which came from Fiona Williams, (in Shakespeare et al, 1993). Williams writes about self-doubt in the research process, and how she intuitively came to the idea of interviewing herself in writing. Because she wanted to tell a personal story, she found it necessary to develop a technique for turning herself into a research subject (or respondent). I saw distinct value in this approach, and I made full use of it: producing a questionnaire which was fairly open in terms of the responses which were possible, and then responding to those questions as honestly and as analytically as I could.

4. Why these (design/techniques) and not others? I wanted to use mainly published sources of data; to use a justifiable approach to analysis and interpretation; to use physically available documents; and to minimize the use of introspection and personal recall.

I did consider interviewing two individuals who know me well, and who witnessed my responses (reactions?) to Neenan (1997, 2000) and Bond and Dryden (1996), and who might well have views which seem relevant to my quest to understand that period of my life and work. However, I ruled this out on the grounds that their opinions, while potentially helpful, cannot be taken to be “objective” or “right”. They would be mere personal responses, unlike my interpretations of the selected documents, which could be re-analyzed and re-interpreted by other (later) researchers, and measured against some agreed phenomenological bench marks. (The contradiction here is that I did go on to interview myself!)

The Process of Material Review
I began this phase of my work by collating all the materials that I might eventually be able to review, into one ring-binder. I read the documents over and over again, and made margin notes using a coding system which I evolved for this purpose. Eventually, I narrowed the study field down, and I decided to begin the process of review by looking for evidence of “absolutistic thinking” in my critique of Neenan (1997), in Byrne (2001b). The two clues to absolutistic thinking that I chose to look for were:
1. Pseudo-objectivity, as expressed in such phrases as “It is…”, “It was found…”, and so on, as opposed to “I think…”, “I found…” and so on;
2. The “is” of identity, as expressed in “Neenan is wrong…”, as opposed to “Neenan seems to have erred…”, and so on.

I then decided to begin reviewing Byrne (2001b), because it was the published form of my critique of Neenan’s view of high frustration tolerance. However, I quickly found that there was very little to get hold of in that piece. Then I realized why. Byrne (2001b) is the conclusion drawn from Byrne (2001a). All of the reasoning and argumentation from Byrne (2001a) was cut out to suit the editor of The Rational Emotive Behaviour Therapist, who favoured brief and interesting pieces. But because of the lack of basic argumentation and analysis, and so on, it is impossible to see how Byrne (2001b) was put together.

I therefore decided to analyze Byrne (2001a), looking for the two types of absolutistic thinking described above. This is what I found:

(a) Making the case for full-blooded, Ellisonian REBT
Altogether, during my analysis of Byrne (2001a), I found fourteen examples of absolutistic, dogmatic “is’s”, which I would have preferred to present as “seeming to be”. In other words, these are fourteen examples of me presenting my ‘perceptions’ as ‘realities’.

I found five instances where I invoked the concept of ‘verification’, or ‘a scientific approach’, or ‘to show conclusively’, or ‘verify clinically’. The aim of these statements seems to have been to ‘demonstrate’ that my position was defensible, and ‘superior’ to Neenan’s (1997) position.

I also found three misleading statements, including the use of “I found” instead of “I conjectured”; “I demonstrated” instead of “I suggested”, and the idea that, because an attitude (that is to say, specifically, the attitude of ‘moderate frustration tolerance’) seems to be ‘inadequate’, that therefore “it does not exist”! (Inadequate attitudes could and probably do exist!)

On page six, I say: “No emotional improvement can normally be expected in the absence of hard work, and specifically the hard work of disputing irrational beliefs…” This is an absolutistic statement, which denies “spontaneous remission”, and “gradual improvement”, and “improvement with age”. It may well be the case that hard work normally helps in dealing with our emotional, behavioural and relationship problems, but my statement is too absolutistic. Furthermore, there is no incontrovertible proof that “disputing irrational beliefs” is essential to achieving emotional improvement. This is so if we accept the results of Smith and Glass (1977), and Smith, Glass and Miller (1980), which studies seemed to demonstrate that virtually all therapies are effective: the so-called ‘equivalence of outcomes’ phenomenon.

On the top of page eight I imply that I am going to use “…a more scientific approach...” when all I mean is that I am going to encourage the client to use “quantification” of the degree of badness of their problem. This is actually a subjective evaluation by the client. This seems to me to clearly not be science in the sense of testing hypotheses, making predictions and checking the results, or running controlled experiments. And I imply that using this system of quantification of the degree of badness of a problem will allow me “…to show conclusively that moderate frustration tolerance (MFT) is a useless innovation, therapeutically speaking”. I am not sure that I would now want to claim that I can show anything “conclusively”! I think I would want to stick to the point that MFT “seems to me” to be “useless” (or better still, “less useful” than high frustration tolerance – since “useless” could seem like gratuitous offensiveness towards the ideas of a fellow practitioner!)

Half way down page 11, I say “…moderate frustration tolerance (MFT) is just another form of ‘inadequate frustration tolerance’…” And at the bottom of that same paragraph I say: “…it is false and useless…” Again, it would have been better to use the Law of Seeming, (Kenny, 1994). “It seems to me…”, rather than “It is…”. And, again, “false” and “useless” sound more like insults than critical evaluations. At the very least, such labels are not designed to win hearts and minds!

On page 21 I say “All of my clients give up awfulizing in the first or second session with me”. This would have been better expressed as “Most …begin to give up…” The statement is unrealistic, and implies that therapy is very much more efficient and effective than it probably ever is. It ignores the fact that humans seem to struggle for a lifetime with their emotional urges and attitudes. It ignores my later perception that “some clients” seem to be unwilling to try to get better; and some are more attracted to the idea of anti-awfulizing than are others.

On page 23, I claim that MFT is “a meaningless distinction”. This is a very harsh judgement, and offensive to Michael Neenan.

Overall, then, it seems I have some problem keeping “is’s of identity” out of my work, even though “officially” I do not subscribe to them. I can be pompous, arrogant, opinionated and offensive – in small doses! But overall, I come out of this review reasonably well – or, at least, very much better than I could have done. There was considerable evidence of reasonable and rational attitudes, and logical and well supported claims. But I’d better tighten up my guard against using “is” where I mean “seems”; and “found” when I mean “proposed”; and so on. And I’d better learn to separate the author from the authored text, and respect the author, even when I have nothing but negative regard for the text. The text is not the author.

(b) Letters to the Editor
The next document in my assignment file is a letter to Professor Stephen Palmer, Editor, The Rational Emotive Behaviour Therapist journal, dated 29th January 2001. In paragraph two I make reference to my ontology/epistemology as follows:

“Whereas in general I am probably as sceptical as Gorgias, there is one ‘piece of knowledge’ which I claim to know for sure; and that is that human communication is very difficult – (but of course, now that I come to reflect upon it, I realize that I either borrowed that from Gorgias, or I came to his view by my independent enquiries; or I absorbed it by osmosis)”.

So, firstly, this illustrates that I was, at that time, taking a relativist perspective on “reality” and “knowledge”. This was, after all, twenty-one years after I began to study Zen Buddhism, which is entirely relativistic: (Watts, 1990). And I studied Zen for more than twelve years. It was also seventeen years since I’d studied est, which teaches that “Life is empty and meaningless, and I’m a machine!” And Gorgias’s most famous quote (and perhaps the only scrap of his teaching which has survived?) was this: “Not one thing exists. If it did, we could not understand it. And if we could understand it, we could never communicate it”. This seems like a clear indictment of the human capacity to perceive, comprehend and communicate, given the relativistic nature of human language.

However, in a footnote on page two of this letter, I say:
“I admit to being ill-disciplined in my very rough draft article (on the role of questioning in REBT), in that a couple of times I did not resist the serious temptation to take a couple of “swipes” at Michael (sitting-duck) Neenan, instead of being more disciplined and sticking to Neenan’s view on ‘Socratic questioning’ from Neenan (2000)”.

This confirms my worst suspicion, that, despite “being” a “relativist”, I was getting upset about the “errors” and “transgressions” of Michael Neenan; as if I was “right” and he was “wrong”. But there was worse to come. On page four, I began to focus on Michael Neenan’s advocacy of the Beckian approach to questioning.

I then engaged in an emotional rant against Beck’s (1976/89) view of emotional disturbance; rather than a cool and calculated assessment of Beck’s role in the world of psychotherapy. I clearly had a big “is” about Beck and Cognitive Therapy, such as “Beck is wrong” and “Cognitive therapy is not as good as REBT”. These implicit claims are not justified on the basis of any “hard and fast” evidence. And this big “is” contradicts my statement above about being as sceptical as Gorgias. I am clearly committed to REBT, and committed against Cognitive Therapy. As choices these would be fine; but I seem to be saying that no other choice would be justified on the basis of reason and evidence. This is an implication too far. And what this study shows me is that I am capable of moving from scepticism to dogmatism in a matter of just seven pages of a letter. How can I integrate these views, and avoid such flip-flopping in the future?

Then, on the top of page 8, I present an emotional reaction against ‘scientism’: which is the over-statement or exaggeration of the status of science, and its techniques of enquiry: (Winch, 1990). I would prefer to have been able to state this argument in much cooler language. I then continue by ‘tarring’ Neenan with the scientism brush, which may not be entirely justified on the basis of what he actually said. And while I point to the “shaky foundations of science” to disarm science, I also try on other occasions to enrol science in my army to do battle with Neenan and Beck, and others. And indeed, ultimately, by May 2001, I had produced a highly positivistic proposal to run laboratory experiments at the University of Leeds to test REBT for effectiveness against Cognitive Therapy and a placebo condition: (Byrne, 2001c). So I clearly am very confused about the status of science, its limitations, and its potential uses. I’d better get this sorted out.

On page 11, paragraph 7, I admit that I was ‘exercised’ in the way I presented some of my ideas about Neenan (1997) in earlier letters and draft articles. This seems like a nice euphemism for ‘controlled anger’ (or even uncontrolled anger!). Where did this anger come from? If I am such a relativist, such an “enlightened being”, how come I got so worked up about these articles? According to REBT theory, I must have had some absolute demands or commands about Michael Neenan and Aaron Beck, which seemed to me to be written on a tablet of stone somewhere. But where is that tablet of stone?

The second point to note is that I seemed very keen to defend Albert Ellis from Neenan. This continues in the next point, paragraph 8, as follows:
“…it might be useful to look at why I might have drawn attention to a personal attribute of Michael Neenan’s (i.e. his lack of grounding in general philosophic training). Without looking too far, I think the triggering event was Michael Neenan’s use of the concept of ‘smacking of arrogance’ to try to account for Albert Ellis’s distinction between elegant and inelegant therapy”.

So I could say that I got caught in a “drama triangle” (from Transactional Analysis), trying to rescue Ellis (and the credibility of my private practice) from Neenan: (Stewart and Joines, 1991).

In the first paragraph of page 12 there are three confusions of “is” and “seems”; and the general tenor of the paragraph is that REBT “is” right; Cognitive Therapy “is” wrong. The second paragraph proposes a kind of “Leninist split” between REBT and CT. And the final paragraph on page 12, which continues to the top of page 13, shows that I really do relate to REBT as the “truth”! But even in this I vacillate and wobble, as shown on page three of my next letter to Stephen Palmer, dated 8th February 2001, as follows:

‘… I do not agree with your recommendation to give up the first person in an attempt to avoid personalization of issues. I think the way forward for me in avoiding overly-personalized critiques of "offending viewpoints" will be to accept DeBono's (1977) basic rules of everyday thinking, as follows:

‘I. Everyone is always right. (A person's ideas are always right in the context of what he sees and the way he sees things).

‘II. No one is ever right. (In an absolute sense, for rightness is related to a particular context, a particular set of ideas).

‘So, Michael Neenan "is" always right; just as I "am" always right. And yet, neither of us "is" actually right, in an absolute sense.

‘But would that position not result in my abandoning my commitment to REBT? No. Because I also apply an "However":

‘However: "...some viewpoints are better than other viewpoints, not simply because authorities say so, but because there are compelling reasons to support these viewpoints". This is what John Chaffee calls "Stage 3 Thinking", or "Critical Thinking": (Chaffee, 1998). (But notice that an absolute “is” has been re-imported here. The statement that “…some viewpoints ‘ARE’ better…” really means, they “seem” to “somebody” to be better!)

‘So if I focus upon the compelling reasons why my approach seems to me to "be" "better" than Michael Neenan's approach, without making any reference to any of his personal characteristics, but only to: his evidence and my evidence; his claims and my claims; and the implications of his proposals; then I believe I will have gone as far as any individual could reasonably be asked to go.

It seems I am back in my “relativism” cap, having clambered out of my “irate cap”. But is it possible to stabilize myself to remain always and only in the relativism mode? If I can avoid getting into a drama triangle in defence of others; and I can learn to see my private practice as not resting on “absolute supports” but rather on “reasonable suppositions”, then I may well be able to do so. After all, it has been postulated (by relativists) since the time of Hume that “Apart from mathematics we know nothing for certain. But we still have to live: and to live is to act. All actions have to be based on assumptions about reality”.

(c) Bond and Dryden (1996)
I then went back and reviewed Bond and Dryden (1996). I also reviewed my critiques of this paper, and especially Byrne (2001c, 2003, 2004). From this review, I concluded that I was right to criticize Bond and Dryden’s conceptual errors, and that it is indeed possible to test the central hypotheses of REBT, in so far as it is possible to test the central hypotheses of any system of therapy. Having run our tests, however, we then face the much more difficult task of making justifiable claims about the “meaning” of the results!

A Self-Interviewing Reflection on the Review Process
When I had completed the material review, I set about interviewing myself about the process, to arrive at the conclusions which I had sought at the start of this paper. Due to pressure of space, I will simply present the questionnaire here, and summarize the results in the conclusion, which follows shortly.
My questionnaire contains ten questions, most of which I am still happy with. The ones I am most unhappy with are those that asked me to introspect about what I was feeling: namely questions 2, 3 and 5 below:

1. Did I begin with excessive certainty about the validity of REBT?
2. Did the articles by Neenan (1997) and Bond and Dryden (1996) cause me to experience uncertainty and doubt?
3. Or did they cause me to feel “defensive certainty”?
4. Had I begun with “personal certainty” - (REBT works for me!) – which became generalized into “therefore it works, full stop!”?
5. Or is it the case that I “contained” a number of different, and mutually exclusive, beliefs about the nature of reality, including therapy?
a. Were these what Potter and Wetherell would call socially-agreed “interpretative repertoires”?
b. Or more like TA “ego states”?
c. Or different “schemas” from different periods of my psychological development?
6. Have I moved into “reduced certainty” – i.e.: “It seems to work for me and my clients, but…” – or “qualified validity”? Or was I always capable of qualifying my claims for REBT’s efficacy?
7. Am I moving towards an accommodation with uncertainty and doubt? This could involve being willing to live in “a process of questioning”.
8. Did I produce my refutations on a “defensible basis”, from the viewpoint of a “viable epistemology”?
9. What would I change if I were writing those refutations today?
10. How can I now construe the field of counselling and therapy so as to bring my thinking into line with my latest learning?

The most important points from my answers to those questions will be summarized in the conclusion, which follows shortly. Firstly, I want to append the final point from my answer to question 10, about my understanding of the field of counselling and therapy today:

I (thus) have a range of choices as to how to view counselling and therapy, as follows:
1. Some therapies may be more effective than others, and REBT may be up the top of the list. (Not much support for this idea). (Some forms of writing therapy seem to be more effective than others; especially those which promote positive thinking, and which focus on client resources and coping strategies. Lowe, 2004).
2. All therapies produce broadly equivalent outcomes; and these outcomes are not directly related to the techniques of therapy. (Quite a lot of support for this idea. Smith and Glass, 1977; Wampold, 2001, et al).
3. All therapies work by placebo, and all of these placebos are broadly equivalent. (Some evidence for this idea. Cited in Erwin, 1997; and Horgan, 1999).
4. All therapies work by placebo, but some (like the human givens approach, and other solution focused approaches) are more effective than the others. (Some evidence for this view, but brief, patchy and contradictory! Cited in Griffin and Tyrrell, 2004)
5. Or all happiness results from choosing it, and choosing to live from our positive strengths, rather than emphasizing our weakness and lacks. (Seligman/Baker. Recently emerging approach. Seligman, 2003; and Baker and Stauth, 2003).

Conclusion
Now that I have completed my review and reflection process this is what I think of the journey:

Firstly, I think I have been changed by my first year of doctoral study at the University of Manchester. Hughes (1990) renders part of Kuhn’s theory of “normal science” within “paradigms” as being the socialization of individual scientists into schools of thought, with pre-existing beliefs, attitudes, and theories; plus “…a shared set of symbols, metaphysical commitments and values, as well as criteria of judgement and the worth of work done. So becoming a member of a scientific community involves enculturation into the paradigm”. (Page 73).

I’m not sure the counselling community at the University of Manchester would see themselves, collectively, as a “scientific” community, since they seem to be more than a little sceptical about the status of science in this post-modern era. So I will rephrase my statement from above to say that I seem to be becoming a member of a community of researchers, and to be strongly influenced by the normative stance of that community. However, there are also ways in which that stance was part of my own approach to knowledge for many years now, ever since I began to seriously study Zen Buddhism, in 1980.

However, what has come out of the reflection, enquiry and analysis contained in this paper is this: I was significantly split between “relativism” and “realism”; and this paper has presented me with the opportunity to try to resolve that split. The split manifested in a flip-flopping from realism to relativism. I was also, when wearing my “realism” hat, prone to arrogance and aggressive denunciation of my adversaries; and I am now committed to never repeat that unacceptable behaviour. I am committed to respecting the individual researchers with whom I disagree, and only to criticize and challenge their products, and not them as individual thinkers. What I learned from developing my present study, and relating it to the model shown on page 147 of Willig (2001), is that I now seem to have moved into the middle ground between naïve realism and radical relativism, and gravitated mainly towards interpretative phenomenological analysis.

I will now review the results of the self-interview process shown above, and draw my conclusions from the evidence uncovered:

My personal experience of using REBT to cope with a serious career crisis, in 1992-1994, persuaded me that REBT is a highly effective therapy. It seemed to me to work where meditation, positive affirmations, self-hypnosis and relaxation, as well as a working knowledge of Transactional Analysis and Gestalt therapy, failed to help me to cope with feelings of anxiety and depression.

I found some evidence in the documents reviewed above that I developed excessive certainty, resulting in the view that REBT “is valid” while Cognitive Therapy “is invalid”. This view cannot be sustained by the available evidence.

I tell my clients that REBT worked for me, and would “probably” work for them as well. However, I have from the beginning of my private practice encouraged my clients to “find out for themselves” if REBT worked for them. This seemed to be the action of an “open minded” enquirer – who was encouraged by the fact that, to the extent that clients came back and reported on their progress, they normally got better, and attributed their improvement to REBT!

However, once I saw Neenan (1997), in the summer of 1999, my “propositionality” about REBT revealed itself for what it had always been: a firm belief in the “certainty” that REBT describes the causation of emotional disturbance, and outlines the one and only cure! The basis of this reasoning was this: “It definitely works for me, and my clients. Therefore, it must be effective in general with everybody and anybody”.

There is some evidence that my attitude towards REBT was context dependent. If REBT was not threatened, I could “appear” very detached about it. If it was challenged, I would react defensively. And, perhaps even more importantly, when Neenan (2000) criticised Albert Ellis, I was hooked into a “drama triangle”, designed to “rescue” Ellis from his detractors.

There is also evidence in this paper that I have now shifted to “reduced certainty” about REBT, in that it seems to be – post Smith and Glass (1977) – one of many therapeutic “winning formulae”. I still am prone to think of it as “one of the best”, but had better remind myself that this conclusion is not based on conclusive evidence!

I reviewed documentary evidence that suggests that my critique of Michael Neenan (1997, 2000) contained many reasonable statements and arguments; mixed up with a minority of unreasonable and unsustainable statements and arguments. However, in the background correspondence there is evidence of unreasonable assumptions which are not defensible, and which are based on a dogmatic epistemology.

I have retained certain criticisms of Neenan (1997, 2000) and Bond and Dryden (1996); especially that there is “empirical support” for REBT, even if it does not “prove” what I originally thought it “proved”. It does exists, whatever it might mean! And Bond and Dryden (1996) were wrong to assert that it is not possible to test the core hypotheses of REBT. I have demonstrated – in Byrne (2001c), and elsewhere – that it is possible to test the “musturbation” hypothesis; and the “cognitions as primus inter pares” is actually not an REBT hypothesis. It’s not easy; and it’s not cheap. In fact it is prohibitively expensive. But it is theoretically possible, given an adequate budget and a large urban institute in which to base the project.

I briefly reviewed the evidence from Smith and Glass (1977); and Smith, Glass and Miller (1980). That evidence seems to support the idea that most of the major systems of therapy probably normally produce positive therapeutic outcomes, which are broadly equivalent to each other. (However, this view is somewhat challenged, though not totally confounded, by Baker and Stauth, 2003. The question to be answered is this: How was Dr Dan Baker, a ‘freshly minted clinical psychologist’, able to succeed in helping Kate (a highly disturbed and withdrawn inpatient) to achieve a total recovery from her distressing illness, when all his senior colleagues, using almost twenty-five different modalities, had repeatedly failed?) There is a further indication, in Lowe (2004), that Smith and Glass, and Wampold, may not be right in their view that “all therapies intended to be therapeutic produce broadly equivalent outcomes”. Geoff Lowe, in evaluating various forms of “writing therapy” found that not all forms produce equal outcomes. In particular, writing activities which focus on coping strategies produce better outcomes than those which are simply focused on self-expression. Focusing on current traumas also produced better results than focusing on historic traumas. The use of more positive words also mapped towards better outcomes than the use of more negative words. These results seem to suggest that there are specific aspects of a therapy which, when modified, will produce better results – especially the promotion of positive over negative thinking, and the promotion of self-efficacy over self-doubt. This seems to challenge the Smith and Glass (1977) findings.

This view is then confused by Erwin (1997), who muddies the water by citing evidence which implies that it may be that psychotherapy is not more effective than a credible placebo. This view is also supported by Horgan (1999), who presents evidence that the placebo effect is the primary ingredient of psychotherapy, SSRIs, and other treatments for mental disorders. And Erwin infers that the whole of psychotherapy is “in crisis” because of this placebo problem. In response to this, I point out that it seems that the whole of philosophy and science has been in crisis since David Hume announced that, outside of mathematics, there are no certainties. (And Low, 2004, concedes that the controls in the writing studies he has reviewed do not always constitute credible placebos, given that participants may often be able to detect which is the ‘active, therapeutic condition’.)
I have no good reason to be concerned about the critiques of Bond and Dryden (1996) or Neenan (1997, 2000). The greater concern is Erwin (1997) and Horgan (1999); and to a lesser extent Baker and Stauth (2003) and Seligman (2003). So, in future studies, I will try to grapple with the problem of the possibility that all of my clients who benefit from visiting me are really experiencing the placebo effect; or learning to hope; or being reconnected with their sense of having choices in life.

I found very little evidence concerning “why” I seek certainty; or why I absolutized REBT; or retained contradictory “scripts” about science and certainty. This is not surprising, given Lyons’ (1986) work on the limitations of introspection.

I then reviewed Cohen (2004), who has spent more than twenty-five years interviewing psychologists. I wanted to see if there might be something about the ‘psychological mind’ that would account for my conflict with Neenan/Bond and Dryden. Although I found that the major historic figures of psychology - including Freud, Watson, Skinner, Frankl, Adler, Rogers, and so on – had frequently fought viciously with each other, I was also aware that scientists in general have something of this reputation, from Newton onwards. (Brown, 2000). Many scientists, of almost every stripe, engage in ‘I am right, you are wrong’ thinking. However, De Bono (1991) points out that this is ubiquitous, being the creation of the Ancient Greek logicians, and reintroduced into Western thought by the Renaissance. The cool detachment of Western logic seems to hide rather than eliminate human emotion, and it may also hide the apparent fact that we do not “have” beliefs. Rather our beliefs seem to “have us”!

There are various inferences which I could make concerning why I “thought” the way I thought; why I argued the way I argued; and so on. But it seems to me to be virtually impossible to validate any of these inferences, since we cannot get inside of my head to look for biochemical evidence to support any particular theory of motivation. And there are no observations or experiments which can be applied to the “past”! As Lyons (1986) points out:
“It might turn out that we are remarkably unreliable whenever we give ‘introspective reports’ – no matter how immediate and on the spot – on deliberations that precede choice or action. We come up with the choice or engage in the behaviour, and we produce a convincing account or rationale for why we did so, but the superimposed conviction that we have privileged access to the cognitive moves that produced the choice or behaviour seems to lack evidence, for the regularities of choice and behaviour seem better explained in other ways”. (Page 101)

What I can comment upon is this. I do not like to behave in destructive or unhelpful ways. I do not wish to offend others, even if they are behaving in ways to which I strongly object. I do not wish to repeat this experience of making myself angry at the critics of REBT, and confusing them with their views. In the future I will work overtime at resolving my own ‘psychic difficulties’, and make sure I “…separate the people from the problem”. (Fisher and Ury, 1990).
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POSTSCRIPT
According to my diary, next Monday (23rd August), I will have at least three clients to attend to: One face-to-face; one on the telephone; and one over the internet. When I get up on Monday morning, I will begin to mentally prepare myself for those encounters. I will have to make some assumptions about “who” those individuals “are”; what their problems amount to; and how to intervene in their problems in a way which will be most likely to help them to improve their thinking, feeling or behaviour, in the light of their goals.

I know from previous experience that I shall assume that their attitudes/beliefs – at point B in the A>B>C model – are responsible for their affects/behaviours at point C. I will assume, with Epictetus, that they are not upset by what happens to them (at point A), but rather by the attitudes which they adopt (at point B) towards their problems (at point A). Robertson (2000) might object to this approach. He might insist that “No one has the right to pick and choose a theory as a matter of personal preference and then offer it as a service to someone when there is a possibility that that service might do harm”. However, there are about 500 studies of REBT treatment, conducted over several decades, which show that it is effective as a therapy, in that it produces client-confirmed positive outcomes. And no studies exist, as far as I know, that show that any level of harm has ever been inflicted by the administration of REBT procedures. (See http://www.rebt.org/professionals/research.asp So, I can certainly maintain that I have met Robertson’s concerns, namely that: “We have to move towards evidence-based practice and away from cults and ideologies”.

However, I still have Erwin (1984, 1997), and Horgan (1999) to contend with. They would probably maintain that all previous studies of REBT might be confusing a placebo effect with an “active ingredient”, and that the most I can hope to achieve with my three clients on Monday is a placebo effect. Well, so be it. If it’s merely a placebo effect, I will have to live with that; as will practitioners of all other systems of counselling and psychotherapy; but my experience is certainly that when I work with a determined client, who does their homework, then the outcome is normally very satisfying for the client.

In the future, I will get down to looking at Erwin and Horgan, and investigating how to challenge, or test/evaluate, their claims about the placebo effect.

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From Certainty to Doubt, A doctoral research journey

First year doctoral paper, by Jim Byrne