Psychotherapy, Neuroscience, & Consilience


A couple of months back I published a blog article titled, Game Plan, that laid out various areas of interests and research that I want to pursue going forward on this blog. I proffered those areas of thought with the hope that they would become a guiding framework for future discussions and explorations. I believe each area addresses important concerns, not only within the field of counseling, but also in dealing with human nature and the human condition. This month’s blog article concludes five years of monthly blogs since I constructed this website. Next month’s blog will kickoff a sixth year of blogging. Going forward in accordance with my game plan I will inaugurate some detailed pursuits of the major changes occurring in the field of counseling, as well as discussions revolving around the Arts and Sciences – all within a wide framework of mind, meaning, thought/action, finitude/humility, and worldview. Within the next couple of years, I do believe that major changes for our professional field of counseling are heading our way. As I stated in a previous blog, the fields of endeavor that will produce the most impact on the way we see our work will be the those of cognitive science and neuroscience. In 1998 E. O. Wilson wrote Consilience, addressing a confluence of knowledge among the sciences and social sciences, as well as the humanities. These themes have been furthered explored by cognitive scientists, such as Steven Pinker and Daniel Dennett. Are we seeing the inroads of such a confluence when we consider the fields of cognitive science, neuroscience, and counseling?

Unity of Knowledge

The areas of cognitive science and neuroscience will introduce some earth-shattering changes, not only in the way we conceptualize within the profession of counseling, but also in the manner in which we do our work. The new technologies emerging in these fields are introducing information about the brain that we could have never imagined just a decade or so ago. The fields of cognitive science, neuroscience, and neurology will most likely shatter the way we have thought about counseling theories in the history of our field. We will have to take on revolutionary ways of thinking about human nature. For some time now, holistic theories in counseling have been gathering momentum that challenges past thinking about how we work as counselors. These holistic approaches for several years now have criticized the headiness of counseling and have sought to reintroduce the mind-body connection back into our understanding of human nature.

Although the pursuit of understanding the mind-body connection has always fallen in the domains of philosophy and psychology, the fields of cognitive science and neuroscience have open the door to empirical evidence of what occurs in the brain in real time. Technologies that have been developed within these fields provide correlative and palpable snap shots of brain activity while we think, act, and emote. We can actually look into the brains of people who are depressed and compare them to those who are not depressed. We can get a picture of an individual’s brain as its changes overtime as a person experiences therapy, engages exercise routines, makes dietary changes, etc. These technologies provide practitioners of various fields such as counseling with information we couldn’t touch or even get to until recently. We need to heed the warning that if counselors discount and negate these technological innovations, they do so at their peril. Fields evolve. Fields also overlap and interact in ways that are helpful. Shared information among the sciences and other fields is leading to partnerships that can now be made stronger due to the technological advances that not only inform research in the medical sciences, but also inform innovative research methods in the fields of psychology and psychotherapy.

It’s not that the field of counseling has never drawn from what are considered the hard sciences to help better understand human nature. It’s just that now, such interaction with other fields of endeavor are becoming easier. More importantly, such interactions are becoming vital if we want to better serve our clients. I think this is particularly true in clinical contexts where counselors are working with such populations as those who are severely depressed, experiencing crippling anxiety, dealing with past trauma, navigating life disturbing mania, and having to live day-to-day medicated for psychotic disorders. The information and technology from the fields of cognitive science and neuroscience can and will lead to a confluence of understanding and knowledge within the fields of the sciences, social sciences, and humanities. I think we are seeing the flow of knowledge merging like several streams coming together in ways that E. O. Wilson discussed nearly a decade ago in his work Consilience. Such unity of knowledge will bring about some amazing transformations in our understanding of human nature, and the ways that we work with human beings.

The Art and Science of Counseling

Of course such overlapping and integration of many fields of endeavor can also create problems. Turf battles for funding always come to mind. But what are some of the concerns that counselors may have regarding the fields of cognitive science and neuroscience?

Medicalizing the Field of Counseling

For some time within the field of counseling there has existed what is similar to C. P. Snow’s description from several decades ago in 1959 known as The Two Cultures. According to Snow these two cultures divided along the lines of the sciences and humanities, not only in problem solving about the world’s concerns, but also in embracing two completely different worldviews as he saw it. Though Snow has been severely criticized over the years, one can recognize the animosity that has no doubt existed between the two cultures. For example, in what might be called Romantic movements, one can detect an attitude of anti-science and anti-technology. Likewise, many believe that the fields that are deemed the hard sciences have sought to become the new priesthood of the day. Across the history of the field of counseling, this animosity has played out particularly in the debates between the behaviorists, psychoanalysts, and the humanists. The debate usually falls along the lines of who and what defines the framework for the field of psychotherapy. The cognitive behaviorists attacked psychodynamic approaches as being unscientific, promulgating concepts that could be neither observed nor measured. Others in the field shot back that counseling is not a science, but an art in human interaction, communication, and relating. Other debates followed along these lines involving such historical philosophical questions as free will versus determinism. Still others in the field of counseling were uneasy with what they considered an overuse of diagnostic labels and medication, leading to what they called the medicalization of the field of therapy. Hence there began for a number of decades the development of various conceptual camps resulting in what have been called the theories wars.

Yet the challenge stood: How can professional counselors inform public consumers that what they’re buying actually works? To say that this question is unimportant is naïve? To say it can be easily answered offhand is equally naïve. Research protocols began to be developed within each theoretical camp, the main emphasis being to prove the benefits of a particular theoretical conceptualization. Such divisiveness haunted the field in certain ways, especially in academia and the fallout among faculty who held different theoretical positions. It was not unheard of that some individuals were refused academic tenure due to the theoretical position they held.

I truly believe that the consilience E. O. Wilson proffers can quail and put at ease much of this theoretical bickering. For many counselors, however, there is still the fear that the field is becoming medicalized. With the onslaught of cognitive science and neuroscience challenging views of human nature, for some counselors their fear has intensified. A particular concern for many counselors regarding these innovative fields is the notion that they will lead to another form of reductionism. I see no reason for such fears.

Helpful Research Protocols

On a positive note, the debates among the conflicting perspectives in the field led to some worthwhile research. Perhaps in any field of endeavor its development requires such debates, infighting, and bickering in order for the field to evolve. Researchers developed a host of protocols for particular diagnostic groups, such as depression, anxiety, eating disorders, etc. Likewise, other researchers developed ways of possibly measuring the impact of such variables as client strengths when they begin therapy, client engagement of therapy, and the therapeutic relationship. Hence, the two cultures were finding ways to solidify their various interests and conceptualizations.

More importantly, however, the description of what the field of counseling is all about had to be expanded. I personally find it useful to distinguish between clinical concerns for clients versus general concerns that clients bring to counseling. There will always be clients who enter counseling, not because they are experiencing some diagnosis, but because they have general concerns about their direction in life, particular problems they need to solve, and life decisions they need to navigate. Many of these clients simply do not fit diagnostic criteria. They simply need to work some things out, and in doing so, they may find it helpful to talk to a professional counselor.

We have to recognize these two populations within counseling without falling into the hard lines of the two cultures. Not only that, we also have to recognized that the concerns clients face might very well overlap. Those who work through clinical difficulties will still need to possibly address general concerns when they no longer meet particular diagnostic criteria. Dialectical Behavior Therapy (DBT) recognizes such distinctions in the way they conceptualize various levels of therapy. Likewise, we need to be aware of the extremes whereby some therapists view medication as a panacea, while other practitioners oppose diagnostics and medication all together. In other words, we need a radical change in the way we view the field of psychotherapy, but a change that reconciles the concerns of the two cultures. The fields of cognitive science and neuroscience have ushered in that need – to the excitement of some and the fear of others. One of the more immediate ways that cognitive science and neuroscience will impact our fields is in the area of theoretical conceptualization. Although this is another blog article for another time, we may be looking at a radical change in terms of how we talk about theory in counseling. The old theoretical textbooks just might have seen their day or will soon enough.

Conclusion: Consilience

We have moved a long way in the field of counseling where we recognize that we possibly dissected the human being in terms of mind and body. For some time now, various approaches have sought to put Humpty Dumpty back together again. Whether people like it or not, there appears to be a confluence in the streams of knowledge that help us understand human nature and the human condition. Moreover such consilience can lead to a proper and civil working relationship among scientists, social scientists, and the humanities. Obviously, there will always be disagreements, even sharp disagreements regarding our conceptualizations and understanding of the human predicament. Why should we expect these different perspectives and worldviews not to lead to some sharp and intense debates? Such debates further the growth of the field.

I strongly believe that counseling professionals should welcome the influences from the findings of cognitive science and neuroscience. We should also be aware that when we adapt such knowledge for our practice as counselors that we are rightly and accurately utilizing the knowledge from these scientific endeavors. Avoiding misinterpreted and misapplied pop neuroscience is as important as avoiding reckless pop psychology.

We are in an age where what E. O. Wilson designated as Consilience is coming to fruition. Hopefully the animosity produced by the existence of the two cultures will abate. It behooves all of those who have existed in the two cultures to find ways to make peace, while at the same time rightly adapting to new, innovative, and cutting edge knowledge and technology so as to enhance how we work. There exists no need for counselors to fear that cognitive science and neuroscience will put an end to the need of how they serve their clients. That need will always remain, but it will also evolve. If counselors, however, choose not to embrace new knowledge and technologies that can benefit their understanding of human nature, then it might be that it’s the counselors themselves who will put an end to their field.

John V. Jones, Jr., Ph.D., LPC-S/July 14th, 2018