Doubt in therapy

Chilean philosopher and biologist Humberto Maturana writes about how you can fall for the "Temptation of Certainty" - the belief that you know something for sure. This is very obvious in the context of the wave of evidence that washed over the world of psychologists in the early 1990s with the cognitive method. "This is how therapy should be done; otherwise you're doing it wrong". It was and is a fierce challenge to a century of practice where psychologists have felt, thought and related to their own and older psychologists' experiences with clients' problems.Now you had to deal with scientific studies that were based on natural science and its methods. Randomized, double-blinded, manualized became words you should and must relate to. Evidence-based practice became the big mantra. Yes, was the answer, but what about Practice-Based Evidence? If something in therapy actually works, what then? This led to Scott Miller and his FIT - Feedback Informed Therapy. They have some exciting ideas and contributions to psychological practice.

The cognitive ones developed their methods with a Metacognitive perspective, which they have skillfully researched methodically, you have to give them that. It came in the 1990s and is still marketed as the great revelation that can solve many mental health problems. It's also a really exciting perspective that you have to look at and relate to the way/form of thinking rather than the specific content. It was and is being launched as a new concept, although it is overlooked that Freud already used the word Metapsychological. Narrative psychologists have worked metapsychologicallysince Michael White and his Narrative Method from the 1980s. He was the first person I ever met to go meta/"over" people's problems, to thematize them. Named them, examined what they did and created. Talked to people about their handling of the problem. Externalized it so you could do something about it.

When it comes to doubt in therapeutic work, I welcome doubt. Previously, I could relate to it based on treatment manuals and see what I/we should do. Today, I'm more patient if something doesn't work. Then I think there's something I haven't quite understood yet, inspired by Miller & Rollnick, Prochaska and diClemente.

I see it as a psychological task to be able to "be in doubt"; between A and B together with the client. To be able to explore the different perspectives and then choose the angle that the client likes best. You can't always know in advance what is the right thing for the client to do. Doctors, for example, understandably need to decide and be trained on whether something is A or B? It can mean life. Psychologists can also work with life and death, like when I sat with actively suicidal patients in psychiatry. If they cut a little deeper, they would die. Here it wasnice to have well-researched methods that could point the way. Still, doubts could arise; a Not-Knowing that Checchin and the systemic school have been good at considering. Here, the patient emerged as an actively choosing subject and could choose to do something different. To live more rather than seek death. These are my thoughts so far on doubt in therapy. Thanks for reading this far 🙂