Is it just me, or are this week's readings really Pomo?

This week’s authors seem as captivated by Postmodernism as contemporary artists, writers, and movie makers who may more readily garner the term. Perhaps I’m just stuck in a bygone undergraduate art history major way of reading articles and thinking about things. Or perhaps I shouldn’t at all be surprised that Postmodernism has seeped into psychology. Or, to be Postmodern about it, perhaps both.

Questioning assumptions; dissolving stark dichotomies; converting accepted facts into narrative “texts;” weaving together appropriations; getting “meta-” about things: Westen, Novotny & Thompson-Brenner (2004) and Smith (1999) traffic in all of these. W, N, & T begin by proposing (per Robert Abelson, 1995) that “the function of statistics is not to display ‘the facts’ but to tell a coherent story.” The authors then parody the rise of Empirically Supported Therapies (ESTs) in a pseudo-Arthurian tale starring the “Knights of the Contingency Table,” and ending in the qualified success of empirically supported therapies. Then, the authors revise the parody, writing in a more troubling ending involving oversights, untested assumptions, client relapses, biased funding, and “invoking the name of Empirical Validation” in vain. The two narratives merge into a palimpsest.

W, N, & T send the vaunted notion of “empirical support” through the wringer, emphasizing the validity of properly designed meta-analyses over blockbuster studies funded by drug companies. “Empirical support is not a dichotomous variable,” is W, N, & T’s concise entrée into the deconstruction treatment outcome studies that neglect the long-term view of patients’ struggles, which often include relapse. W, N & T also advocate consumer access to “details essential for assessing the internal and external validity of even high-quality studies.” This shrinking space between those with information/power and those without invoked for me the Postmodernist practice of collapsing the space between artist and viewer, or “breaking the fourth wall” in theater.

Cherished classifications of theoretical orientation are Smith’s target in “The End of Theoretical Orientations?” He proposes “a new kind of meta-theory of therapy.” This meta-theory isn’t a static code but more of a process, or, as Smith puts it, “a creative act.” When faced with patients who elude easy diagnostic categorization, “one must abstract pertinent change principles from the empirically supported procedure for a different condition, and then through a creative act, translate that principle into a plan for the situation in which the procedure is untested.” Certainly this “activity” is best performed by the Super Clinicians that W, N & T describe at the end of their article: “clinically competent decision makers (rather than paraprofessionals trained to stay faithful to a validated manual) who have the competence to read and understand the relevant applied and basic research, as well as the competence to read people.

Unlike many Postmodern artifacts in which so much questioning and deconstruction leads to a sense of absurdity or meaninglessness, these articles are wildly constructive. They don’t grind us down with their knowing allusions and dark ironies; instead they rally the reader to think in new ways about therapy.