Who controls explanations of unwanted behaviors.

Mancuso, James C. (mancusoj@capital.net)
Tue, 10 Feb 1998 22:48:09 -0500

Hello:

Last evening I circulated a piece that had come through my e-mail. I
said that I had found the piece amusing. Let me explain the source of
my amusement in case my point might be left unmade.

To begin my explanation, I lay out the proposition that psychologists
have put an immense effort into the project of making it possible for
one who can earn a degree in one of the varied applied disciplines to
become a secular version of an M. D. a "junior psychiatrist," so to
speak. I could write an extended chronicle to support that
proposition, but I will try to be brief.
The most telling aspect of the ways in which psychologists in
psychology departments reveal their aspirations is to be seen in the
ways in which courses in "abnormal" psychology have been taught.
The textbooks used, the course outlines, and so forth reveal fully that
the official line in the discipline has prompted the perspective that an
illness metaphor -- a diagnostic narrative, a medical tale -- usefully
contextualizes unwanted behavior. Professors are hired, prompted to
become affiliated with those who promulgate the diagnostic narrative,
and are promoted on the basis of their skill in having done so. That
is, a prospective professor is evaluated in terms of how well his/her
doings are accepted by the standard diagnostic metaphor makers [NIMH,
mental health clinics, publications, etc.]. Tenure, promotions, etc.,
are awarded on the basis of how well one fits into the social surround
that supports the diagnostic narrative.
Students admitted into Ph D programs are selected in terms of how well
they have shown their allegiances to the diagnostic narrative. Thus, the
supply of supplicants to the illness metaphor is foreordained.

All of this would be no great problem, because an open scholarly
process can eventually kill off useless paradigms.

The major failing of this process is the loss of the kind of academic
freedom that encourages the production of alternative, potentially more
useful metaphors. The cohort of persons who will seek out other
narratives to contextualize unwanted behaviors is constantly reduced.
The persons who adhere to the diagnostic metaphor struggle to uphold
their metaphors. They gain control of the outlets of publications
["Gatekeepers of our Science"], so that prospectuses for alternative
publications are correctly [from a marketing standpoint] rejected by
publishers. Rejections may be phrased as follows: "This textbook would
not be adopted by clinical psysychologists who teach abnormal psychology
courses. It is not written from the perspective of a clinical
psychologist. It is written from the perspective of a philosophically
oriented personality theorist, using concepts borrowed from cognitive
psychology [Horror of horrors!!!].

And so, I find myself very amused by the failure of an effort to tie
psychology more and more closely with the diagnostic metaphor!!! It is
particularly amusing, to me, to see the failure take place within an
effort to claim that psychologists can "treat" DISORDERS with authority
equal to that of the big boys. P u h l e e z e -- the big boys have
that corner fully occupied. Why should they allow the little boys to
move in? The psychologists have done a tremendous job of passing the
diagnostic perspective on the the general public. They have very
loyally and effectively served the promoters of the diagnostic
narrative. To the big boys, that is the function of the professors in
the psychology departments. The medical people are in control so long
as they are accorded the task of mastering the genes, the chemicals,
etc., that can be taken as the cause and as the corrective of unwanted
behaviors.

I will take this opportunity to advocate an approach that I would
recommend as an alternative to serving as the promoters of the
diagnostic narrative.
Let us stop teaching from the perspective of the diagnostic metaphor.
Psychological explanation is our territory.
Let's honor efforts to teach about unwanted behavior from the
perspective of a "philosophically oriented personality theorist who uses
constructions from cognitive psychology."
Let us relinquish to biology departments the use of the diagnostic
metaphor to frame unwanted behaviors. [Will biology departments take
over that task??? I hope that they refuse, on scientific grounds, to do
so.]

Any other suggestions?

--
James C. Mancuso        Dept. of Psychology
15 Oakwood Place        University at Albany
Delmar, NY 12054        1400 Washington Ave.
Tel: (518)439-4416      Albany, NY 12222
        Mailto:mancusoj@capital.net
  http://www.crisny.org/not-for-profit/soi
A website related to Italian-American Affairs

THE MATERIAL BELOW THE MARKERS WAS THE CONTENTS OF THE MESSAGE I SENT OUT LAST EVENING. ++++++++++++++++++++++++++++++++++

The material below made it way to my e-mail box. For a number of reasons, I found the contents to be very amusing -- and I do mean, amusing. Would Michael Jordon allow me to play basketball with me, acting as if he regards me as a colleague? Would Luciano Pavarotti sing a duet with me taking the baritone part? Would Umberto Eco allow me to coauthor his next novel?

By the way, if you want to look at the electronic journal, you need to type this address into your browser [the address in the message is given incorrectly]: http://www.apa.org/journals

Have fun:

======================================= Message lifted out of my e-mail, copied here in order to clean up the formatting. =======================================

Subject: [Fwd: slightly updated final draft] Date: Sun, 08 Feb 1998 13:39:56 -0500 From: David Herman <daherman@suffolk.lib.ny.us To: mancusoj@capital.net

Subject: slightly updated final draft Date: Sun, 8 Feb 1998 10:34:54 -0500 (EST) From: seligman@cattell.psych.upenn.edu (Martin E. P. Seligman) To: daherman@suffolk.lib.ny.us

Tell me if you think Tom is still appropriate? You might ask him directly.

marty

Treatment and Prevention

Martin E.P. Seligman

Donald Klein, M.D., and I had a dream. It started as a public argument between us on the internet about whether drugs or psychotherapy was the treatment of choice for panic disorder. Out of this argument arose our dream: that the American Psychological Association and the American Psychiatric Association would collaborate on a electronic journal that would become the medium of such dialogue between psychiatrists and psychologists. After two years of work--both political and intellectual--this became a reality, and the stegosaur and the tyrannosaur agreed to mate. Both organizations formally agreed to co-publish an electronic journal. The journal would publish breakthrough articles in psychotherapy and pharmacotherapy along with peer commentary. We published our first article and commentary in September 1997. You can read it on the web at http:\\www.journals.apa.org (RHEA: please fact check address)

The dream is ended. In December 1997 the American Psychiatric Association's Board of Trustees, acting in a closed-door meeting, withdrew from the collaboration. They cited the need for a "broad review of the costs and benefits of electronic publishing projects." This, of course, was not the whole story.

In August I began getting messages from their leadership that their board, led by the California trustees, might end their participation. In September, they put their co-operation on hold, citing the "state of the relationship between the two associations." I was informed that the American Psychological Association's policy of seeking prescription privileges for psychologists was the central problem. What

publishing this scholarly journal had to do with that issue was not clear, but we crafted a disclaimer that reading TREATMENT did not qualify one to prescribe. It was clear, however, that their final decision to end the collaboration was political. Many of their trustees were worried that any collaboration with the American Psychological Association would legitimize the efforts of psychologists to obtain prescription privileges.

The American Psychiatric Association's decision to end their participation in the journal TREATMENT is shameful. Collaboration among scientists, the rapid dissemination of knowledge of immediate benefit to patients, and the open exchange of ideas among scientists and practitioners--be they psychiatrists or psychologists--are high ideals.

This is how progress in the treatment of mental illness can best occur.

These ideals should not be sacrificed to political ambition or to squabbles between guilds about the scope of practice. The act of their Trustees nullifies two years of dedicated work by the authors, publishing boards, and editors from both organizations. It is a giant step backwards from the improving relationship between the two largest mental health associations in America crafted under the leadership of Dorothy Cantor,

Psy.D., and Harold Eist, M.D.

TREATMENT will continue. If our Publications and Communication Board approves, it will become the flagship electronic journal of the American Psychological Association. Its new title will be TREATMENT AND PREVENTION. It will continue to publish breakthrough articles in the areas of psychotherapy and medications. It will publish articles about prevention and about personality, is as far as these are relevant to treatment. It will underscore the theme that interventions not only repair damage, but also build human strength. It will fill the gap created for clinical science by the narrow coverage of, Science, Nature, and The New England Journal of Medicine. It will also publish, with peer commentary, an electronic reprint of "The Article of the Week," selected by all APA editors, as the current article to be brought to the attention of the membership and the media. TREATMENT AND PREVENTION will be free to all members of the American Psychological Association, and you can subscribe at http:\\ www.journals.apa.org. (RHEA: Please fact check)

What of the future relations between the two organizations? I believe that while the actions of the American Psychiatric Association regarding TREATMENT are (I can find no gentler word) dishonorable, there are many

issues on which we remain on the same sides of the barricades. Managed care, funding for science, and patient welfare are three examples. We must stand ready to be allies over these issues, and we must continue to hope that the American Psychiatric Association will, in future, come once again to stand with us for the open exchange of ideas in the promotion of science and patient welfare.

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