Is Behaviorism Becoming a Pseudoscience? Replies to Drs. Wyatt, Midkiff and Wong

Article excerpt

ABSTRACT:

Wyatt and Midkiff (2006a) and Wong (2006a) argued that the eclipse of token economy treatment for schizophrenia was due not to scientific judgments but to the biological politics of the mental health field. I argued that the treatment's fate was due to its own limitations, particularly the failure of effects to generalize adequately to natural environments given deinstitutionalization (Wakefield, 2006). Wyatt and Midkiff (2006b) and Wong (2006b) vigorously disputed my claim. In this reply, I analyze their responses regarding generalization, and their arguments for behavioral etiology. I conclude that we all agree that such treatments were not shown to adequately generalize, providing a scientific reason for the treatment's fate. I also find their etiological arguments unsound. Even-handed attention to evidence, recognition of behaviorism's limits and strengths, and an integrative approach are essential if behaviorism is not to veer toward pseudoscience.

KEYWORDS: behaviorism, behavioral treatment, schizophrenia, token economy, etiology of schizophrenia, mental disorder, history of psychology, history of psychiatry, philosophy of science, harmful dysfunction, biological causation, pharmaceutical industry, psychotropic medications

In an earlier issue of this journal, I published a commentary (Wakefield, 2006) on Dr. Wong's (2006a) and Drs. Wyatt and Midkiff s (2006a) target articles in which they critiqued the turn toward biological approaches and away from behavioral approaches to severe mental disorder. My commentary elicited vigorous, quite harsh responses (Wong, 2006b; Wyatt & Midkiff, 2006b). The Editor having generously allowed me to reply, I hope to advance the discussion by clarifying the arguments behind the heated rhetoric.

First, some general comments might help orient the discussion. In their target articles, both Wyatt and Midkiff and Wong attempt to resuscitate behavioral intervention for severe mental disorders by attacking biological psychiatry and blaming behaviorism's waning fortunes on the politics of the mental health field rather than on any scientific findings about behavioral intervention: "The decline of behavioral approaches in the treatment of psychoses is a minor mystery in the history of science, and I have suggested tiiat an understanding of this seeming dead end requires that one look beyond the activities of behavioral researchers to larger ideological, political, and economic movements..." (Wong, 2006a, p. 169). And the conclusion, as expressed by Wyatt and Midkiff (2006a), was that "it is time for a paradigm shift, away from extreme biological causation and toward an environmental causation model..." (p. 147). In other words, the fault lies not in behaviorism itself, but in its political stars.

I pointed out that the authors' claim that the waning of behavioral intervention was due to politics, not scientific considerations, needed to be assessed as a causal hypothesis, and this entailed assessing the scientific pros and cons of behavioral intervention: "Such a claim must be supported not merely by showing that biological psychiatry has weaknesses-so does every theory!-but by showing also that behavioral approaches do not have equal or greater weaknesses" (Wakefield, 2006, p. 203). I also noted that political processes always accompany scientific change; the question is whether there was an underlying scientific logic that allowed those forces to hold sway, and whether political processes replaced or merely accompanied a reasonably legitimate scientific judgment. For example, the switch at many psychiatric institutions from predominantly psychoanalytic to predominantly biological research often involved intense politics, but was grounded in legitimate scientific considerations.

The potential pseudoscientific status of the audiors' "politics" claim should be clear. When Freudians blamed rejection of the oedipal theory on the defensiveness of opposing dieoreticians, that was dismissed as pseudoscientific avoidance of evidence. …