|"In an environment increasingly demanding evidence for the effectiveness of therapy, might there be other ways to justify our work than the elusive evidence base researchers desire to construct?" |
Andy Rogers’ article ‘The art of therapy’ (Therapy Today, December 2008) came as a relief to me in the midst of the debates about regulation and the NHS. I have long thought that the sort of therapy I lean towards has far more to do with art than science.
Wisdom can’t be measured
Andy Rogers’ article ‘The art of therapy’ (Therapy Today, December 2008) came as a relief to me in the midst of the debates about regulation and the NHS. I have long thought that the sort of therapy I lean towards has far more to do with art than science. On the other hand, I also think that so-called ‘scientific’ research is usually itself an example of very poor science masquerading as something else, and the language used by those who cite it supports that view.
The word ‘evidence’ is used as though it meant ‘proof’, with the inference that proof itself means some sort of absolute truth. Parallel with this runs the use of the word ‘scientific’ – which carries almost sacred importance, but which is bandied about with considerable ignorance as to its real meaning.
If I complain to BACP that my counsellor hit me, then my complaint is evidence. Without corroboration it is not very strong evidence. My broken nose at least supports the idea that somebody hit me, and when my counsellor comes to the hearing with her knuckles in plaster, then these pieces of evidence can be tested against one another – which is what ‘prove’ means.
This is the sort of proof ‘beyond reasonable doubt’ which is required by a court of law. Even law courts never claim to have found a truth which is absolute. Still less do scientists – not the good ones anyway. The greatest achievement of scientific research is to reveal how little we actually know. Indeed, as Douglas Adams might have put it, in an infinite universe we know precisely nothing.
This, joking aside, is real science: highlighting the unknown through the shadow of the known. There are two problems with much of the current socalled scientific research into counselling outcomes. Real science is unselective; all evidence is valid for consideration, not merely evidence chosen because it is acceptable or somehow ‘approved’. The other problem is that science (the study of the unknown) has become confused with technology (the study of the known). If something cannot be measured, goes the argument, then it does not exist; and 19th century surgeons demonstrated this axiom by wiping their scalpels on the soles of their boots in order to show their disdain for the concept of germs.
Science – or rather, technology – has not really come that far since then. Take, for instance, ‘scientific’ attitudes towards astrology.
Astrological predictions are not the result of guesswork or flights of fancy, but the detailed observation of evidence over millennia. What astrologers have observed is that human beings born under certain configurations of stars and planets appear to be subject to repeating patterns.
To say there is no evidence is nonsense; there is any amount of evidence. Simply to dismiss it is to behave like 19th century surgeons. This does not mean that astrological predictions are therefore absolutely true; only that they have been tested many times over, and appear to hold true in enough cases for the findings to deserve serious consideration.
If technology cannot detect the forces that astrology maintains exist, then it is as likely that the technology is insufficient as that the forces themselves do not exist.
So-called ‘evidence-based’ practice is really only based around what can be measured.As I have tried here to demonstrate, what can be measured is only the tiniest part of what actually exists. To ignore the evidence of our intuition and experiences is patently absurd. Anecdotal evidence may not submit to the measurement of machines; this does not diminish its importance as evidence. And anecdotal evidence is what we, as counsellors, deal with all the time – the stories our clients tell us. And the other cornerstone of our work is not knowing; assuming that we never see the ‘truth’, only a sense of there being more; the more coloured by the limited knowledge that we believe we have gained through our own experiences and the experiences of others.
Mystery coloured by knowledge, experience and an understanding of our own blindness, might be termed wisdom – and there is no way that wisdom can ever be measured.