House of Cards: Psychology and Psychotherapy Built on Myth
Lewis, Bradley Md, American Journal of Psychotherapy
ROBYN M. DAWES: House of Cards: Psychology and Psychotherapy Built on Myth. Free Press, New York, 1994, 338 pp., $22.95.
Robyn Dawes writes House of Cards out of "anger and a sense of social obligation." He is angry because psychology has "abandoned a commitment ... to establish a mental health profession that would be based on research findings." Instead, Dawes complains that "too many mental health professionals rely on 'trained clinical intuition'." From his perspective, trained clinical intuition is unreliable, uncertain, and often at odds with documented scientific data. Yet, psychologists use these clinical intuitions to make paternalistic judgments about real people in both clinical and legal settings. Not only that, according to Dawes, much of the myth of clinical psychology has infiltrated into our culture and has contributed to our individualistic and egoistic obsessions. The result is a self-indulgent "new age psychology" which is bad for the community but good for psychologists.
In the first part of House of Cards, Dawes reviews the "claims of mental health experts versus the [research] evidence." He finds no evidence for psychologists' claims of expertise in the areas of psychotherapy, prediction, diagnosis, clinical experience, and licensing. In other words, psychologists do not have special knowledge about people or psychotherapy and they do not deserve special licensing or privilege. They particularly do not deserve the status of "expert." Dawes does find data to support the usefulness of psychotherapy, but he finds untrained psychotherapists as beneficial as trained ones. (Dawes finds an exception in the case of the few psychologists who use behavioral techniques.) As a result, psychotherapy should be deregulated and demedicalized; anyone should be able to sell advice for a fee provided that they do not use public resources (insurance) to pay for it. The only role for licensing would be in "institutional settings," like hospitals and prisons, where the patients are unable to make informed choices about their caretakers and should be protected by society.
In the second part of House of Cards, Dawes leaves the research data behind to detail "his own views" about how "a misplaced trust in professionals . . . has led to unjustifiable and pernicious obsessions: obsessions with self-esteem, with the quick attainment of desirable goals, and with an unrealistic sense of security and superiority to other people." For Dawes, "these obsessions do not have desirable consequences for our society."
House of Cards comes off as a loose polemic against psychology and psychotherapy. Dawes appeal to the scientific "facts" never questions the wisdom of applying the natural science model (where the goal is explanation and prediction) to the social sciences (where the goal is often interpretation and understanding). It is far from clear that the natural science model is the best way to proceed in social science. Even if it were, Dawes never addresses the postpositivist philosophy of science literature, which demonstrates that natural science, itself, is not as objective and value free as we once hoped. …