A graduate student in clinical psychology recently asked to interview me for a study he’s doing. Below are his questions and my answers, published here with his permission.
Many readers have written in with these questions themselves, so I thought the entire interview would be of interest.
Q: How does contemporary research influence your clinical practice?
A: I keep up on the research of interest to me. Most of it reinforces what I know, or is based on assumptions I don’t share.
For example, I read that further research has shown that cognitive-behavioral psychotherapy is the single best way to help people with emotional or behavioral problems. I knew that, although it’s valuable to see it reinforced.
Or, for example, I read that brain chemistry causes people to be fat. Wait a minute, I think. What about the mind? What about cognitions, beliefs, ideas, premises and emotions? What about free will? Are they of no relevance? Does the brain or do genes determine everything? If the research takes for granted that this is so, then I stop reading. I’m not interested.
I already know for a fact, not merely belief, that we are mind and body at the same time. I want research which studies the brain, and some of that research is highly relevant to a psychotherapist. But it has to be meaningful research based on at least remotely correct assumptions.
So I keep up with research, although critically and objectively so.
Q: How did you arrive at your clinical orientation? (that is, what perspective do you bring to therapy and how did you arrive at that perspective)
A: Details are in my book, ‘Bad Therapy, Good Therapy: And How to Tell the Difference.’
The short answer is: My clinical (i.e. theoretical) orientation is cognitive-behavioral. In plain English this means the assumption that our emotions are determined primarily (if not exclusively) by our thoughts, ideas, underlying assumptions and our most fundamental premises.
I make reference to philosophy in my orientation to psychology, although I do not usually discuss philosophy with clients. By ‘philosophy’ I’m referring primarily to epistemology (theory of knowledge) and ethics (what a decent person does). The great majority of problems and issues people bring to me boil down to either, ‘How do I know what’s true or correct?’ or, ‘What should I do, what’s right?’
People are very, very concerned about being right and accurate, and being moral and decent. My philosophical perspective informs my psychological recommendations. I don’t tell people what to do, but I rely on the principle (from philosophy) that knowledge is objective and we can therefore figure out what’s true based on available and known facts, and abstract/conceptual (ultimately sensory-based) reasoning about those facts.
The purpose in therapy is to help people figure out, ‘What’s true and what facts/reasoning tell us this?’ rather than, ‘Here’s what you should do because I say so.’ People in distress sometimes long for the latter (‘Please, please Doctor, tell me what to do!!’), but I stubbornly resist giving it to them. They must figure out what’s reasonable and true using their own minds, and my job is to help them develop skills and confidence for doing so.
It’s similar with morality and ethics. People are told that they should be selfless and only live for others. Every religious leader and every authority from the President on down tell us that on a daily basis. It’s relentless insanity, if you ask me, but it’s everywhere.
I think exactly the opposite, and I don’t shy from telling therapy clients so. But my job is not to preach or lecture to them about my view of ethics. My job is to tell them, ‘Look. Here’s an ethical perspective that I think will work better. Let’s apply it to your situation and see what happens. Are you willing to try something different? If so, let’s do it.’
Q: Do you enjoy research or practice more?
A: I don’t do formal research. I haven’t done that since my doctoral dissertation (completed in 1991). I think I would enjoy research as a career, but don’t have time for everything.
However, I write extensively online every single day, usually about psychology and always about underlying philosophical issues which affect psychology, daily life, culture, government and everything else. If you categorize this as research (and research is sometimes involved in those articles), then I do both and I enjoy each equally.
I can’t have one without the other. I cannot exist by having theory without practice, or practice without theory. Most therapists are practical and generally well-meaning people, but have little or no interest in theory or research. To me, that’s horribly boring, and I think my clients are much better off that I do so much research and am almost constantly thinking about a whole host of issues.
Q: What area of research would you like to see get more attention?
A: Cognition. The mind. We are living in the era of biological determinism. The brain is everything. Which gene makes me fat? Which brain chemical makes one person kill, and another be peaceful? What neurotransmitters cause one person to be a Democrat, the other a Republican? Isolate the cause in the brain and you will determine all that makes a person human. B.S., I say!
I have read that ideas move man, and man moves the world. That’s what psychology should be studying: Human ideas and their impact on the psyche.
Don’t get me wrong. We can and must study the brain. I want to know everything possible about the brain. But that’s the discipline of neurology. Psychology must get back to what is supposed to define that field: Cognition, including psychotherapy. What do we think, why do we think it, what habits of thought have become automatic and how or why must those habits of thought be changed?
Also, psychiatry and psychology are almost exclusively focused on ‘disorder.’ This begs for an answer to the question: What is ‘order’? What is a standard of psychological health? I have begun to write about serenity (a state of inner peace) as the standard of mental health, although that must be carefully and objectively defined (and I don’t use the term in a supernatural sense, either). I’d love to see psychology not only return to cognition, but develop an actual standard of health.
Q: Do you have a favorite psychological researcher or clinician? If so, why is he your favorite?
A: In psychotherapy, I like cognitive therapists and theorists the best. The one I probably respect the most is Aaron Beck, M.D. He is likely my favorite because he has illustrated the principles of cognitive psychology—the notion that ideas cause emotions—and demonstrated this both through research and practice. This is a man who can write a theoretical book on psychology which an intelligent and motivated layperson can understand, while also writing a great self-help book (‘Love is Never Enough’) on how to communicate properly in a marital/romantic relationship. He’s an abstract and scientific thinker, but he can keep us firmly planted in reality.
I also owe a great debt to philosophy. As I said, psychology and therapy rely greatly on ethics (for ‘What should I do?’) and theory of knowledge (‘How do I know that?’) I’ve always loved Aristotle, and Ayn Rand is my favorite philosopher. (She’s not yet widely recognized as a serious philosopher for ‘the ages,’ but I have no doubt she will be.) Also, professional philosophers in her ‘orbit’ include Leonard Peikoff Ph.D. and Andrew Bernstein Ph.D. They and others have been of great help to me, indirectly, in psychology.
Q: If you could do anything different in your career as a clinician, what would it be?
A: I’m honestly doing everything I want. I always have, and never would have it any other way. Is there more to do? Yes. Somewhere there is in me another book begging to come to the surface, a project on the psychology of love. I am thinking lately a lot about visibility in relationships (romance most of all, close friendship too), and the role of self-disclosure with respect to closeness and intimacy. But I’m seeking to provide or articulate something different on that subject of love (broadly defined, even beyond romance/sex), and am not there yet.
Q: What do you enjoy most about being a therapist?
A: No two days—no two hours—are ever exactly the same. I was promised that once by someone in the field, and it’s absolutely true. Theory and practice merge into one, and (for me) there’s no better place to be than that.
Be sure to “friend” Dr. Hurd on Facebook. Search under “Michael Hurd” (Rehoboth Beach DE). Get up-to-the-minute postings, recommended articles and links, and engage in back-and-forth discussion with Dr. Hurd on topics of interest.