The problems of academia and therapy integration

By Ian Rory Owen PhD

People outside of academia might assume that academics have sagacity and a wide scope of understanding of the whole breadth of their own and adjacent areas of study: But nothing could be further from the truth as a general rule of thumb. Most academics have only a small area of expertise. Perhaps this is to some degree inevitable because no one could be expected to have a supreme grasp of all the literature on any topic of study. However, for the non-academic community, there is the warning that some academics who have no knowledge of opposing views in their chosen area still feel free to rubbish systems of thought and practice about which they know nothing. This problem becomes worse when whole groups of the same type of academic get together with their false knowledge to propagate social practices of publication and ‘academic standards’ that keep out more accurate opposing views and maintain their own false knowledge. When these self-serving systems last for decades, then whole generations of students are trained in falsehood. The outcome is the propagation of unfairness towards the texts in question. So instead of the breadth and depth of scholarship, there is an excessively narrow scope of knowledge, and a failure to accept the strengths of other schools of thought and practice.

These problems are particularly evident in phenomenology, philosophy, psychology, psychotherapy and psychiatry. Mentioning no one by name, the following warnings need to be made. Firstly, anyone who tries to cover over the substantial differences in reading Husserl and phenomenology is doing violence to the evident phenomena. Specifically, phenomenology is not science and empiricism (because it began to correct the problem of psychologism, of an excessive focus on experimentalism). Neither is phenomenology merely about the objects towards which perception in the five senses is turned.

In short, phenomenology is not...

... empiricism or practice of any kind without a detailed connection to original texts.

... without a self-reflexive understanding of its own heritage and a clear statement of how it links with that heritage.

... not seen through the lens of the false readings set forth by persons who have not spent time in adequate scholarship.

Psychotherapy approaches that stand back from dogmatism are integrative. Integration is an answer because therapy is continually evolving and can accommodate its disparate branches. Integrative therapy is an approach which is flexible. It is not about providing the same type of therapeutic relating or interventions that are assumed to work for all clients, or with any combination of problems, in any one type circumstance. Nor is it a grand ideal of a super-therapy, a source of pride and competitiveness. Currently there exist systems that explore the integration of two or more models of the full range of therapies. However, the ideal of an integrative approach is to provide a cohesive and consistent theoretical model that draws on evidence about core therapeutic processes that are present across the spectrum of human experience. What is being urged is not a random eclecticism. Therapeutic possibilities should be carefully considered within a detailed biopsychosocial view of the whole. No account is given concerning what should become of the more peripheral and less popular styles which will not be integrated into the intentionality model. Rather, it is hoped that once readers understand the ubiquity of intentionality that they will use the idea to further their own development.

However, there is cause for hesitancy. Circling around the question of the degree to which therapy is capable of being integrated into a cohesive whole, reflects the difficulties involved in capturing the whole of the ways in which people can be distressed - and the degree to which any one person can provide help. The intentionality model seeks to begin discussions about the future of the profession in regard to the potential limits of its diversity and promote clarity of thought about the aims of its practitioners. There is also the strong possibility that therapy cannot and should not be a single conformity. Practitioners should be allowed to do as they please, as long as they work within the code of ethics of their professional body and attend to the relevant bodies of evidence for justification of what they do and say.

Finally, integration in therapy is about existing between the various ways of justifying practice. Current empirical research needs tempering with client choices and idiosyncrasies. Psychopathology needs to be understood experientially and developmentally, "from the inside" of the other person. Many people have the co-occurrence of personality disorders, lifelong problems, and multiple psychological disorders. Formulations need to be accountable to colleagues and easily capable of explanation to clients. There is no consensus in the field of therapy as a whole. There are degrees of consensus within the same brand names but not even that sometimes. Nor is there any means of enforcing standardisation across the brand names. Final measures of truth are not being sought by the intentionality model or phenomenology and such conclusions could never be delivered through hermeneutics.