The scientific imbroglio of psychotherapy: A way out

Abstract

The notion of the imbroglio is introduced as a critical instrument. If on the one hand it serves to identify a confused state of affairs, on the other it invites its clarification and exit. Two imbroglios are identified in psychotherapy. The first is the puzzle of how different psychotherapies, surprisingly, have similar efficacy. This is clarified according to three levels of analysis: ontological (distinguishing natural versus interactive entities), anthropological (common factors of psychotherapies), and psychological (certain healing effects inherent in all healing practices). The second imbroglio is the problem of the demarcation between science and pseudoscience. While important, the problem of demarcation conceals other even more important problems that have to do with the current conception of science. This is because the demarcation is subsidiary to a positivist conception of science, itself problematic when applied in the clinic. These other problems have been identified as bad science, scientism, and integrationism. Even when these imbroglios have been clarified, the way out is to pose the basic ontological question about what is a psychological disorder, without assuming the standard conception as a «failure» in internal mechanisms. An idea of the disorder is raised that is based on life’s problems.