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Behold the Paradigm Shift!

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Behold the Paradigm Shift!
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    Human Nature Review 3 (2003) 196-209 The Human Nature Review ISSN 1476-1084 URL of this documenthttp://human-nature.com/nibbs/03/paris.html   Essay ReviewBehold the Paradigm Shift!ByLeif Edward Ottesen Kennair A review of   Myths of Childhood  by Joel Paris. New York: Brunner-Routledge, 2000.  Nullius addictus iurare in verba magistri(I am not bound to believe in the word of any master) -- Horace (First Century BC)These words set the stage for Joel Paris’ book   Myths of Childhood  , dedicated in part tohis teachers, who he claims to have spent a life-time trying to prove wrong. In science thatwould not be so bad – in science that is thename of the game. Within the authoritarian, al-most totalitarian, field of psychiatry this is mostirregular. There are even theories that may de-scribe this as pathological. These theories are,of course, based on misunderstanding or mis-reading, not on science (Scalise Sugiyama,2001).In my recent review of La Cerra and Bing-ham’s (2002) Origin of Minds (see Kennair,2003), the major obstacle to finding their theory both new and convincing was not that theywere critical of mainstream Evolutionary Psy-chology. Rather it was the fundamental lack of novelty and too obvious foundation on old,mythical psychology – the old paradigm of  psychology. This old paradigm has only re-cently become visible. The new empirical re-search, with at least a part of its base in biologi-cal disciplines – such as behavioural geneticsand evolutionary psychology, but also other disciplines such as cognitive neuroscience and psychopharmacology – is revolutionising our understanding of human nature, brain-mind processes and mental disorder.Steven Pinker (2002; see Kennair, 2002b for a review) provides the synthesis of the old para-digm by showing how powerful the traditionalideas of romanticism, empiricism and dualismare within psychology and all areas of researchthat attempt to describe or understand humannature. This view is paralleled in Paris’  Mythsof Childhood  and in Kennair et al. (2002)within psychiatry and clinical psychology. Theold truths of human nature – like the claim that Human Nature Review, Volume 3, 2003, 196    Human Nature Review 3 (2003) 196-209 the normal development of normal personalityusually is dependent on what normal parents do(Psst! It isn’t, you know…) – are coming under serious attacks from sciences like behaviouralgenetics, evolutionary psychology, cognitiveneuroscience and psychopharmacology.I teach the behavioural genetics of normal personality at the Norwegian University of Sci-ence and Technology. When I get to address thestudents they have already waded through thetypical approaches – theories based on psycho-dynamics, humanistic psychology and learning psychology. All of these have a major focus on parents, not peers nor adults outside the family.Consequently, what I come along and claim isthat all they have been taught to believe in the previous lectures is wrong, and contrary to theother theories “claiming” to be true and beingeasy to believe (as they are congruent with thecurrent cultural myths of mind), behaviouralgenetics is based on empirical research. And – most importantly empirical research that tests both the genetic and environmental influence!But, it is not  easy to believe…For years we have focused on different“schools” of psychology – and been taught howthese differ. Well, actually they did not differ on some very crucial ideas… ideas that have proven to be false. I believe it is quite fair totalk about nothing less surprising than a classi-cal Kuhnian shift of paradigm within current psychology (Kuhn, 1996). Some very importantand never-before challenged ideas are beingtoppled by new research and improved meth-ods, which are making human nature ever moreaccessible to natural scientific study. A cluster of such ideas are the ‘myths of childhood’. What is the Myth of Childhood? It is not news – everyone knows it: give methe child before age 7 or age 5 and I will giveyou the man, the pathology or the believer. Butis it true? Of course it is true – it is both com-mon sense and scientific fact! Wrong. It may becommon belief, but it is not scientific fact. Allthe same this idea forms the basis of most pro-fessional advice on parenting and creates the basis of most clinical psychological or psycho-therapeutic work. And it is merely a myth. Now, as Paris states, most academics thatare placed in a situation where one of their pil-lars of their understanding of human nature – and their own life narrative, no less – is chal-lenged, are quick to point out that: “Absence of evidence is not evidence of absence”! Probablymany of you have already come to that conclu-sion. Well, that is true, of course. But, thatwould only be relevant if the research had not been done. Scientific inquiry has been made – the results are negative, so far. Indeed, arguingfrom the void is not an unusual tactic, but it isan increasingly ingenious and tedious approachto lack of evidence for what most professionalsfound their careers and practice on.The myth of childhood includes the idea thatchildhood adversity is the cause of adult mentaldisorder or distress. It includes the idea of psy-chological determinism and the idea of primacy – that the earlier the trauma or adversity thegraver the adult disorder. It is also closely tiedto beliefs that the quality and style of parentingdetermines both psychological disorder as wellas normal personality development. Most psy-chologists, psychiatrists, social workers, nurses,doctors, professors of literature or academics ingeneral believe that these ideas are both correct,and based on so much science and commonsense that suggesting they are incorrect is closeto ridiculous. Everybody in our culture believesin this, surely it is true! No. The world is round,not flat. Empirical research, not cultural con-sensus teaches us what is true. In this caseDickens was closer to the truth than Freud or Watson.The myth of childhood is a part of westernculture, pop-psychology and academic psy-chology. It is the idea that the experiences achild has, especially the earliest experiences,are more important than later experiences – andthrough the idea of psychological determinism,these experiences create the personality of theadult. Further, if these experiences are trau-matic or in some specific way not good, they Human Nature Review, Volume 3, 2003, 197    Human Nature Review 3 (2003) 196-209 are the cause of any psychological disorder or distress. Finally, the experiences that may becalled “parenting” are the most important of these experiences.Paris (2000, pp. xi-xii) lists the followingthree main factors of the myth: Myth 1:    Personality is formed by earlychildhood experience.   Myth 2:    Mental disorders are caused byearly childhood experiences.   Myth 3:    Effective psychotherapy depends onthe reconstruction of childhood experiences.  Don’t believe the hype! These are myths. Pariscalls them cultural  shibboleths –  they are takenfor granted, not questioned. But they ought to be! They are not supported by science. Scien-tific inquiry has been performed. The results arenegative. Yet they are believed. And by thosewho believe them, those who practice them, arerevered and provided with authority and power.This is psychiatry and clinical psychology’s“dark secret”. The Myths Exposed Joel Paris reviews the literature on childhoodexperience and adult personality and mentaldisorder. His findings are not surprising, tothose who are familiar with the literature ondevelopmental psychopathology, behaviouralgenetics and the general lack of science inclinical practice.Let’s cut to the chase: 1. Primacy According to Paris (2000, p. 17) the belief in  primacy is the belief that:1. The earlier in childhood adverse experi-ences occur, the stronger will be their long-termsequelae.2. Early childhood experiences, particu-larly socialization and attachment in the family,shape normal and abnormal personality, so thata secure and happy childhood is the strongest predictor of good adult functioning.3. Conversely, adverse and negative ex- periences during childhood can seriously distort personality structure and are strongly impli-cated as risks for psychopathology in adult-hood.There is no evidence that any of the above istrue. There is no evidence that early adversity ismore important than later adversity. Tempera-mental and other genetic predispositions causeinteractions with environments, such as parentsand parenting style. These factors also providethe basis of continuity in personality. Further they may predict better than experiences, whattype of disorder one may suffer from as anadult. Remember – experiences, or learning,may only influence the expression of genes – one cannot learn something one has not got thegenetic potential to express.Primacy is not the cause of normal personal-ity. Neither is parenting (see also Harris, 1995,1999). Experiences may be important – mosttheories of which experiences influence normal personality have been falsified. Currently thereare no specific experiences that there is consen-sus for actually form personality is a specificmanner, and which there is scientific evidencefor. Harris’ group socialisation theory is an in-teresting hypothesis, as is Pinker’s (2002) moretongue in cheek suggestion that random expres-sion of genes may be important.Adversity in early years does not predictmental disorder. As clinicians we see those whohave mental disorders. These are, as all behav-ioural and mental traits (Plomin et al., 2000;Pinker 2002; Turkheimer, 2000) influenced bygenetics – thus problems in the family may re-flect common disorders and heritability rather than cause via primacy effects. Also, those nottreated for mental disorder report much thesame type of childhoods that those in treatmentdo. Thus if someone reports early childhoodadversity, and now present with symptoms of mental disorder, we often become victims of afaulty theory that prejudices our formation of narrative, sloppy logic and a distorted sample.We just cannot conclude that the adverse ex-  Human Nature Review, Volume 3, 2003, 198    Human Nature Review 3 (2003) 196-209  perience caused the pathology! Most peoplewith that experience do not develop pathology.If the experience, which is picked at random asspecific pathogen experiences are not known,was important it must have been in interactionwith genetic predisposition. But we neither know this. Mere speculation is not helpful…mostly because the idea of primacy is false, anddocumented effective therapy is not dependenton reconstructing the past. 2. Adversity and outcome Parenting does not influence normal person-ality. I repeat this. There is little evidence thatnegative parenting, apart from upsetting chil-dren and affecting them at the time, has anylong term consequences. This makes for diffi-cult assessments for e.g. child care services – what do we do when we do not know? For theclinician with an adult patient, the problem is asdescribed above – it is impossible to claim thatthe described parent behaviours caused the pa-tient’s mental disorder. Also, the patient’s dis-order will predict the report of experiences bet-ter than the opposite.Much of the results showing increased fre-quency of mental disorder in groups who haveexperienced abuse fail to show more than a cer-tain increase – also there are methodological problems when attempting to establish cause.Even the most extreme abuse will in most casesnot cause disorder. Also genetic factors must becontrolled for.Paris (2002, p. 36) concludes as follows:The outcome of adversity in childhood ishighly variable. If possible, it is better for children to avoid trauma, family discord,family breakdown, or serious poverty.Each of these difficulties may increasethe risk for psychiatric disorder, at leastin some children and in  some adults. Themore adversities that are present, themore likely pathology is to develop.Yet even when exposed to multiple ad-versities, most children manage to escapeany form of mental disorder.Thus it is true that extreme abuse, neglect or negative life events may statistically jeopardisethe development of children. But it may be a passing effect – at least in groups studied longi-tudinally the amount of disorder declines withtime – and in any case resilience is more typi-cal. It is not typical that studies of children or grownups in extreme situations show that mostwill develop mental disorder (such as posttrau-matic stress disorder) – rather the great majoritydoes not. 3. Concluding the Exposure These findings are quite surprising to most.Many are even infuriated and feel affronted bythese results. The more rational reaction would be curiosity, a change of what beliefs one takesfor granted and revision of personal profes-sional practice – and what kind of practice oneaccepts from professionals for one’s own men-tal disorders or that of one’s loved ones. Alas,this rational response is very rare. All the moreimportant to repeat what we know, and repeatwhat we do not know !Also, resilience is more typical than not.Most people who experience extreme traumasurvive without sequelae – i.e., mental disorder,unhappy memories may of course be trouble-some and painful, but most survive these too.Parenting only has to be good enough, as bothScarr and Winnicott have pronounced. Justimagine the childhoods of Socrates, SnorreSturlason and Shakespeare – they seem to havesurvived childrearing practices that we proba- bly would have considered atrocious today.Evolutionary analysis simply informs us thatour species had to be able to develop normallyand survive emotionally even if there were noculturally trained child rearing experts around.  Nota bene this does not mean that parentsmay abuse or neglect their children – that is aridiculous interpretation. Neither does it meanthat parents do not matter – parents are there to protect, feed, love and take care of their chil-dren. Those who come to such horrendous con-  Human Nature Review, Volume 3, 2003, 199    Human Nature Review 3 (2003) 196-209 clusions after reading Paris’ book, or moretypically Harris’ (1995, 1999) work, ought to be ashamed of themselves – if the only reasonto love children is to be allowed to influenceevery aspect of their mental health and person-ality then one ought to buy a dog, not have achild. Why do Mental Health Professionals Believein Unsubstantiated Claims? Robyn Dawes (1994, 2001) has written sev-eral books attempting to teach his clinical col-leagues how their own psychology worksagainst them and makes them believe unsub-stantiated claims or misunderstand causal or statistical patterns. Alas, even if they infuriatedmany clinical readers, his books never becameas influential as some of us hoped. Dawes(2001) analysis of stories and belief is most im- portant though.I have several times been impressed at howmuch my colleagues know about researchmethods and critical thinking about statisticalanalysis when presented with findings based onlarge numbers. On the other hand, being overlycritical to such work is hardly balanced by theequally impressive ability to be swayed by awell told yarn, an illustrative anecdote or per-sonal experience. N=1 is for most mental health professionals more persuasive than N=20, or  N=1000 for that matter.Paris is also interested in the problem of whyhis colleagues believe what has not been provento be true as if it were scientific fact. More par-ticularly he wonders why clinicians still believein the general psychoanalytic model, rooted inthe theory of primacy. He suggests three expla-nations: belief in narrative, toleration of cogni-tive dissonance, and the need to account for failure. A fundamental part of Paris’ analysis isthe belief that therapy works – no matter whatmethod one uses. We will address this belief later. At the same time he is aware that the rea-son is probably not to be discovered throughfollowing the heuristic of primacy, and that thistherefore is not a necessary ingredient. Withthese starting points in place Paris provides areasonable explanation.Everyone in our culture believes in primacy,in their personal mythologies or life narratives,no less those who have themselves beenthrough an analysis. Paris compares giving upsuch “deeply rooted beliefs” as “almost equiva-lent to losing one’s personal identity” (p. 157).Indeed in a narrative tradition that is absolutelyso. Further, the ability to accept cognitive dis-sonance is typical for humans. Paris suspectsthat the best clinicians are far from purists, andthat the most successful therapists performtherapies that maximise the effect of generaleffects, although they might later explain it intheoretically loyal terms. I will later show thatgeneral effects are overvalued by Paris, but asfar as achieving what general effects may, I be-lieve his analysis is correct here too. The lastexplanation, accounting for failure, is some-thing I see time and again. Psychodynamicallyoriented therapists attribute success or failuremore to the individual therapist than cognitivetherapists – instead of attempting to follow themanual closer (external locus) they believe thefault is in their own ability (internal locus).That also means that if a cognitive therapist presents a successful case, it will be consideredgloating – even if the therapist presenting thecase believes the method was what was effec-tive. Paris’ conclusion is that some patientshave a limited ability to change, due to their temperament or genetic makeup or type of dis-order (more precisely, all three). Yet again, thisis probably true. The problem with the size andcomplexity of the basic psychoanalytical or  psychodynamic theory – which is the basic ideaof how the mind works adopted more or less bymost therapists (Kennair, 2000) – is that almosteverything may be explained within it, and thusrevision is rarely the first alternative. Thus itsurvives in the minds of psychotherapists, andin our culture – although there is almost no sci-entific reason for believing in it.This is a most interesting problem. Psycho-analytic theory itself is one of our centuriesmost used framework for attempting to discover  Human Nature Review, Volume 3, 2003, 200  
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