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Have We Rejected Psychodynamic Therapy Too Quickly?

The dangers of motivated reasoning in science.

Scientifically sound evidence allows consumers to distinguish fact from fiction. In theory, this is true. In reality, it is extremely hard to view the world as it is.

There are certain beliefs that we wish for, work towards, and even hold a financial interest in protecting. We construct a version of reality by carefully deciding where we search for evidence, how we evaluate the quality of evidence, and whether we are willing to entertain evidence that contradicts our beliefs—much less use them to revise our beliefs.

Take a seemingly benign example from the world of psychology. Pick up almost any self-help book on how to treat anxiety, depression, anger, or eating disorders and you will find a statement close to the following:

Cognitive-behavioral therapy is the gold standard of psychotherapy.

When an article is published showing the superiority of cognitive-behavioral therapy to physical exercise or mindfulness smartphone apps, few questions arise. Nobody rips through the research methodology and statistics in search of flaws.

Compare the gentle approach to research on cognitive-behavioral therapies with reactions to psychodynamic research. Famous for their founder Dr. Sigmund Freud and his wacky “Oedipus complex” hypothesis: boys want to sleep with their mothers but they can’t, feel contempt and want to kill their dads, and from suppressing homicidal urges, mental health issues arise. Other, less wacky psychodynamic ideas stand the test of time because of their legitimacy, such as Freud’s argument that:

Stable personality patterns begin in childhood and that childhood experiences with caretakers play a crucial role in shaping personality (especially in shaping later ways of becoming attached to and intimate with others).

This argument is the cornerstone of attachment theory. Some people show a strong sense of security in their adult relationships—a sense of security that manifests as viewing other people as trustworthy and reliable, actively seeking out support when adversity arises, and feeling sufficiently safe to then take risks and explore the world. Whether we form a stable, positive self-concept and beliefs that other people are dependable is largely influenced by how secure we felt around early caregivers. These are mainstream ideas that originated with psychodynamic therapies.

Other psychodynamic arguments persist, such as an awareness that our evaluative statements about other people are heavily influenced by unconscious and not just conscious experiences (in my view, one of the best reviews of this work is the book Biased: Uncovering the Hidden Prejudice That Shapes What We See, Think, and Do).

In 2003, a few researchers summarized the results from 23 studies showing that long-term psychodynamic psychotherapy is relatively effective. In return, they received a brutal rejoinder. And here’s the thing: the criticisms levied against psychodynamic therapy—such as we don’t know how it works, there is a lot of variability in how many sessions a client attends, and nobody is clear on what therapists truly think about the therapy—are equally relevant when discussing trials of cognitive-behavioral therapy.

I’m not claiming psychodynamic therapy is the new gold standard of psychotherapy (although curiosity is warranted, especially in light of a 2017 review of head-to-head comparisons). What I am saying is that we search for, accept, and reject information differently depending on our preconceived preferences. Scientists are no different from the rest of humanity. When we do not like the message or the source, our skepticism increases. Skepticism also amplifies in the presence of a conflict of interest. You might make a living on book sales and consulting opportunities that hinge on particular results. You might have publicly criticized a person or viewpoint, and will stick to an antiquated, biased evaluation rather than risk the label of hypocritical flip-flopper.

These concerns are the province of myside bias. When we hunt for flaws and expect to find them, it should come as no surprise that we find something that bothers us—and lash on with vigorous pleasure. There is no place for this in the courts of justice, the classroom, or scientific disciplines. This is not the behavior of a truth seeker. This is the behavior of a zealot seeking validation and confirmation.

We are all hypocrites. But we can all reduce how often this happens, and how receptive we are to new, high-quality information. In a society that values persuasion and influence, let's remember that sometimes the greater virtue is persuasibility.

Read more in The Art of Insubordination: How to Dissent and Defy Effectively (Avery/Penguin).

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