Clinicians and Neuroscientists Must Work Together to Understand and Improve Psychological Treatments

In this interesting commentary article from the journal Nature, the authors argue that we need to create a mental health science that draws from both the neuroscientific literature as well as the clinical research and practice side. These two camps rarely communicate with each other and there has been very little interdisciplinary work so far. Let's hope that changes.


Full Citation:
Emily A. Holmes, E.A., Craske, M.G. & Graybiel, A.M. (2014, Jul 17). Psychological treatments: A call for mental-health science. Nature; 511:287–289. doi:10.1038/511287a

Psychological treatments: A call for mental-health science

Emily A. Holmes, Michelle G. Craske & Ann M. Graybiel
16 July 2014

Clinicians and neuroscientists must work together to understand and improve psychological treatments, urge Emily A. Holmes, Michelle G. Craske and Ann M. Graybiel.

Illustration by David Parkins

How does one human talking to another, as occurs in psychological therapy, bring about changes in brain activity and cure or ease mental disorders? We don't really know. We need to.

Mental-health conditions, such as post-traumatic stress disorder (PTSD), obsessive–compulsive disorder (OCD), eating disorders, schizophrenia and depression, affect one in four people worldwide. Depression is the third leading contributor to the global burden of disease, according to the World Health Organization. Psychological treatments have been subjected to hundreds of randomized clinical trials and hold the strongest evidence base for addressing many such conditions. These activities, techniques or strategies target behavioural, cognitive, social, emotional or environmental factors to improve mental or physical health or related functioning. Despite the time and effort involved, they are the treatment of choice for most people (see ‘Treating trauma with talk therapy’).

For example, eating disorders were previously considered intractable within our life time. They can now be addressed with a specific form of cognitive behavioural therapy (CBT) [1] that targets attitudes to body shape and disturbances in eating habits. For depression, CBT can be as effective as antidepressant medication and provide benefits that are longer lasting [2]. There is also evidence that interpersonal psychotherapy (IPT) is effective for treating depression.

Treating trauma with talk therapy

Ian was filling his car with petrol and was caught in the cross-fire of an armed robbery. His daughter was severely injured. For the following decade Ian suffered nightmares, intrusive memories, flashbacks of the trauma and was reluctant to drive — symptoms of post-traumatic stress disorder (PTSD).

Ian had twelve 90-minute sessions of trauma-focused cognitive behavioural therapy, the treatment with the strongest evidence-base for PTSD, which brings about improvement in about 75% of cases. As part of his therapy, Ian was asked to replay the traumatic memory vividly in his mind's eye. Ian also learned that by avoiding reminders of the trauma his memories remained easily triggered, creating a vicious cycle. Treatment focused on breaking this cycle by bringing back to his mind perceptual, emotional and cognitive details of the trauma memory.

After three months of treatment, Ian could remember the event without being overwhelmed with fear and guilt. The memory no longer flashed back involuntarily and his nightmares stopped. He began to drive again.  

A house divided

But evidence-based psychological treatments need improvement. Although the majority of patients benefit, only about half experience a clinically meaningful reduction in symptoms or full remission, at least for the most common conditions. For example, although response rates vary across studies, about 60% of individuals show significant improvement after CBT for OCD, but nearly 30% of those who begin therapy do not complete it [3]. And on average, more than 10% of those who have improved later relapse [4]. For some conditions, such as bipolar disorder, psychological treatments are not effective or are in their infancy.

Moreover, despite progress, we do not yet fully understand how psychological therapies work — or when they don't. Neuroscience is shedding light on how to modulate emotion and memory, habit and fear learning. But psychological understanding and treatments have, as yet, profited much too little from such developments.

It is time to use science to advance the psychological, not just the pharmaceutical, treatment of those with mental-health problems. Great strides can and must be made by focusing on concerns that are common to fields from psychology, psychiatry and pharmacology to genetics and molecular biology, neurology, neuroscience, cognitive and social sciences, computer science, and mathematics. Molecular and theoretical scientists need to engage with the challenges that face the clinical scientists who develop and deliver psychological treatments, and who evaluate their outcomes. And clinicians need to get involved in experimental science. Patients, mental-health-care providers and researchers of all stripes stand to benefit.

Interdisciplinary communication is a problem. Neuroscientists and clinical scientists meet infrequently, rarely work together, read different journals, and know relatively little of each other's needs and discoveries. This culture gap in the field of mental health has widened as brain science has exploded. Researchers in different disciplines no longer work in the same building, let alone the same department, eroding communication. Separate career paths in neuroscience, clinical psychology and psychiatry put the fields in competition for scarce funding.

Part of the problem is that for many people, psychological treatments still conjure up notions of couches and quasi-mystical experiences. That evidence-based psychological treatments target processes of learning, emotion regulation and habit formation is not clear to some neuroscientists and cell biologists. In our experience, many even challenge the idea of clinical psychology as a science and many are unaware of its evidence base. Equally, laboratory science can seem abstract and remote to clinicians working with patients with extreme emotional distress and behavioural dysfunction.

Changing attitudes

Research on psychological treatments is, in the words of this journal, “scandalously under-supported” (see Nature 489, 473–474; 2012). Mental-health disorders account for more than 15% of the disease burden in developed countries, more than all forms of cancer. Yet it has been estimated that the proportion of research funds spent on mental health is as low as 7% in North America and 2% in the European Union.

Within those slender mental-health budgets, psychological treatments receive a small slice — in the United Kingdom less than 15% of the government and charity funding for mental-health research, and in the United States the share of National Institute of Mental Health funding is estimated to be similar. Further research on psychological treatments has no funding stream analogous to investment in the pharmaceutical industry.

This Cinderella status contributes to the fact that evidence-based psychological treatments, such as CBT, IPT, behaviour therapy and family therapy, have not yet fully benefitted from the range of dramatic advances in the neuroscience related to emotion, behaviour and cognition. Meanwhile, much of neuroscience is unaware of the potential of psychological treatments. Fixing this will require at least three steps.

Three steps

Uncover the mechanisms of existing psychological treatments. There is a very effective behavioural technique, for example, for phobias and anxiety disorders called exposure therapy. This protocol originated in the 1960s from the science of fear-extinction learning and involves designed experiences with feared stimuli. So an individual who fears that doorknobs are contaminated might be guided to handle doorknobs without performing their compulsive cleansing rituals. They learn that the feared stimulus (the doorknob) is not as harmful as anticipated; their fears are extinguished by the repeated presence of the conditional stimulus (the doorknobs) without safety behaviours (washing the doorknobs, for example) and without the unconditional stimulus (fatal illness, for example) that was previously signalled by touching the doorknob.

But in OCD, for instance, nearly half of the people who undergo exposure therapy do not benefit, and a significant minority relapse. One reason could be that extinction learning is fragile — vulnerable to factors such as failure to consolidate or generalize to new contexts. Increasingly, fear extinction is viewed [5] as involving inhibitory pathways from a part of the brain called the ventromedial prefrontal cortex to the amygdala, regions of the brain involved in decision-making, suggesting molecular targets for extinction learning. For example, a team led by one of us (M.G.C.), a biobehavioural clinical scientist at the University of California, Los Angeles, is investigating the drug scopolamine (usually used for motion sickness and Parkinson's disease) to augment the generalization of extinction learning in exposure therapy across contexts. Others are trialling D-cycloserine (originally used as an antibiotic to treat tuberculosis) to enhance the response to exposure therapy [6].

Another example illustrates the power of interdisciplinary research to explore cognitive mechanisms. CBT asserts that many clinical symptoms are produced and maintained by dysfunctional biases in how emotional information is selectively attended to, interpreted and then represented in memory. People who become so fearful and anxious about speaking to other people that they avoid eye contact and are unable to attend their children's school play or a job interview might notice only those people who seem to be looking at them strangely (negative attention bias), fuelling their anxiety about contact with others. A CBT therapist might ask a patient to practice attending to positive and benign faces, rather than negative ones.

In the past 15 years, researchers have discovered that computerized training can also modify cognitive biases [7]. For example, asking a patient (or a control participant) to repeatedly select the one smiling face from a crowd of frowning faces can induce a more positive attention bias. This approach enables researchers to do several things: test the degree to which a given cognitive bias produces clinical symptoms; focus on how treatments change biases; and explore ways to boost therapeutic effects.

One of us (E.A.H.) has shown with colleagues that computerized cognitive bias modification alters activity in the lateral prefrontal cortex [8], part of the brain system that controls attention. Stimulating neural activity in this region electrically augments the computer training. Such game-type tools offer the possibility of scalable, 'therapist-free' therapy.

Optimize psychological treatments and generate new ones. Neuroscience is providing unprecedented information about processes that can result in, or relieve, dysfunctional behaviour. Such work is probing the flexibility of memory storage, the degree to which emotions and memories can be dissociated, and the selective neural pathways that seem to be crucial for highly specialized aspects of the emotional landscape and can be switched on and off experimentally. These advances can be translated to the clinical sphere.

For example, neuroscientists (including A.M.G.) have now used optogenetics to block [9] and produce [10] compulsive behaviour such as excessive grooming by targeting different parts of the orbitofrontal cortex. The work was inspired by clinical observations that OCD symptoms, in part, reflect an over-reaction to conditioned stimuli in the environment (the doorknobs in the earlier example). These experiments suggest that a compulsion, such as excessive grooming, can be made or broken in seconds through targeted manipulation of brain activity. Such experiments, and related work turning on and off 'normal' habits with light that manipulates individual cells (optogenetics), raise the tantalizing possibility of optimizing behavioural techniques to activate the brain circuitry in question.

Forge links between clinical and laboratory researchers. We propose an umbrella discipline of mental-health science that joins behavioural and neuroscience approaches to problems including improving psychological treatments. Many efforts are already being made, but we need to galvanize the next generation of clinical scientists and neuroscientists to interact by creating career opportunities that enable them to experience advanced methods in both.

New funding from charities, the US National Institutes of Health and the European framework Horizon 2020 should strive to maximize links between fields. A positive step was the announcement in February by the US National Institute of Mental Health that it will fund only the psychotherapy trials that seek to identify mechanisms.

Neuroscientists and clinical scientists could benefit enormously from national and international meetings. The psychological treatments conference convened by the mental-health charity MQ in London in December 2013 showed us that bringing these groups together can catalyse new ideas and opportunities for collaboration. (The editor-in-chief of this journal, Philip Campbell, is on the board of MQ.) Journals should welcome interdisciplinary efforts — their publication will make it easier for hiring committees, funders and philanthropists to appreciate the importance of such work.
What next

By the end of 2015, representatives of the leading clinical and neuroscience bodies should meet to hammer out the ten most pressing research questions for psychological treatments. This list should be disseminated to granting agencies, scientists, clinicians and the public internationally.

Mental-health charities can help by urging national funding bodies to reconsider the proportion of their investments in mental health relative to other diseases. The amount spent on research into psychological treatments needs to be commensurate with their impact. There is enormous promise here. Psychological treatments are a lifeline to so many — and could be to so many more.

References

1. Fairburn, C. G. et al. Am. J. Psychiatry 166, 311–319 (2009).
2. Hollon, S. D. et al. Arch. Gen. Psychiatry 62, 417–422 (2005).
3. Foa, E. B. et al. Am. J. Psychiatry 162, 151–161 (2005).
4. Simpson, H. B. et al. Depress. Anxiety 19, 225–233 (2004).
5. Vervliet, B., Craske, M. G. & Hermans, D. Annu. Rev. Clin. Psychol. 9, 215–248 (2013).
6. Otto, M. W. et al. Biol. Psychiatry 67, 365–370 (2010).
7. MacLeod, C. & Mathews, A. Annu. Rev. Clin. Psychol. 8, 189–217 (2012).
8. Browning, M., Holmes, E. A., Murphy, S. E., Goodwin, G. M. & Harmer, C. J. Biol. Psychiatry 67, 919–925 (2010).
9. Burguière, E., Monteiro, P., Feng, G. & Graybiel, A. M. Science 340, 1243–1246 (2013).
10. Ahmari, S. E. et al. Science 340, 1234–1239 (2013).

Affiliations

Emily A. Holmes is at the Medical Research Council Cognition & Brain Sciences Unit, Cambridge, UK, and in the Department for Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.

Michelle G. Craske is in the Department of Psychology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.

Ann M. Graybiel is in the Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.

 

This article comes from a Special Issue of Behavioral Sciences: Analytical Psychology: Theory and Practice. This is the first article I have seen that examines the efficacy of Jungian psychodynamic psychotherapy, which Jung had named Analytical Psychotherapy.

Just for clarification, these are some of the characteristics of Psychodynamic therapy models, which can be quite diverse, although all of them believe to some extent in early attachment issues as a foundation for later mental health issues. To be clear, I disagree with some of the items in the list below, which comes from Wikipedia:

Although psychodynamic psychotherapy can take many forms, commonalities include:^[3]

• An emphasis on the centrality of intrapsychic and unconscious conflicts, and their relation to development. [The conflict model has fallen out of favor since Kohut developed his Self Psychology model in the 1970s, which looks more toward the interpersonal or relational dysfunctions as the source of psychological issues.]
• Seeing defenses as developing in internal psychic structures in order to avoid unpleasant consequences of conflict. [Defense mechanisms are now seen more as coping strategies to navigate psychologically painful traumas.]
• A belief that psychopathology develops especially from early childhood experiences.
• A view that internal representations of experiences are organized around interpersonal relations.
• A conviction that life issues and dynamics will re-emerge in the context of the client-therapist relationship as transference and counter-transference.
• Use of free association as a major method for exploration of internal conflicts and problems. [This is more a part of the psychoanalytic tradition.]
• Focusing on interpretations of transference, defense mechanisms, and current symptoms and the working through of these present problems.
• Trust in insight as critically important for success in therapy.

Typically when one sees the term "empirically-based therapy" or "evidence-based practice," what is being referred to is some form of cognitive therapy, often Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT). However, as Jonathan Shedler demonstrated in his 2010 article, The Efficacy of Psychodynamic Therapy, psychodynamic therapies are as effective as CBT in the short term and more effective than CBT in the long-term.

Here is the abstract to the Shedler article, originally published in Scientific American Mind:

Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings.

Si it's good to see another model of psychodynamic therapy has proven itself to be "evidence-based" and beneficial for clients.

Full Citation:
Roesler, C. (2013, Oct 24). Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies. Behavioral Sciences; 3(4): 562-575. doi:10.3390/bs3040562

Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies

Christian Roesler 1,2

1. Clinical Psychology, Catholic University of Applied Sciences, Karlsstraße 63, 79104 Freiburg, Germany 

2. Faculty of Psychology, University Basel, Switzerland

Abstract

Since the 1990s several research projects and empirical studies (process and outcome) on Jungian Psychotherapy have been conducted mainly in Germany and Switzerland. Prospective, naturalistic outcome studies and retrospective studies using standardized instruments and health insurance data as well as several qualitative studies of aspects of the psychotherapeutic process will be summarized. The studies are diligently designed and the results are well applicable to the conditions of outpatient practice. All the studies show significant improvements not only on the level of symptoms and interpersonal problems, but also on the level of personality structure and in every day life conduct. These improvements remain stable after completion of therapy over a period of up to six years. Several studies show further improvements after the end of therapy, an effect which psychoanalysis has always claimed. Health insurance data show that, after Jungian therapy, patients reduce health care utilization to a level even below the average of the total population. Results of several studies show that Jungian treatment moves patients from a level of severe symptoms to a level where one can speak of psychological health. These significant changes are reached by Jungian therapy with an average of 90 sessions, which makes Jungian psychotherapy an effective and cost-effective method. Process studies support Jungian theories on psychodynamics and elements of change in the therapeutic process. So finally, Jungian psychotherapy has reached the point where it can be called an empirically proven, effective method.

Download PDF Full-Text [230 KB, uploaded 24 October 2013]

Jonathan Shedler, PhD - Where is the Evidence for Evidence Based Therapies?

Jonathan Shedler, PhD, is somewhat of a hero of mine. He has offered the best meta-analysis and most convincing evidence available that not only is cognitive behavioral therapy (CBT) not very effective, in general (and that few CBT therapists actually practice manualized CBT), but that psychodynamic is considerably more effective in nearly every measure (see The Efficacy of Psychodynamic Psychotherapy, 2010).

He also authored That Was Then, This Is Now: Psychoanalytic Psychotherapy for the Rest of Us (2006/2010), a work-in-progress on the current state of psychoanalytic psychotherapy. For anyone who thinks psychoanalytic therapy is still about laying on a couch with the therapist acting as a "blank slate" and offering little in the way of interaction, aside from abstract interpretations, this article will get you up to speed.

If you would like a little more, see his Scientific American article, Getting to Know Me: Psychodynamic therapy has been caricatured as navel-gazing, but studies show powerful benefits (2010). This is a shorter, more accessible version of "The Efficacy of Psychodynamic Psychotherapy."

In the post below, Dr. Shedler has started what may be a multi-part series (we know there will be at least two parts) looking at the lack of evidence for the so-called evidence-based therapies, such as CBT, REBT, and so on.

Where is the Evidence for Evidence Based Therapies? 

A study from a prestigious psychology journal recently crossed my desk. It found that clinicians who provide Cognitive Behavior Therapy—including the most experienced clinicians—routinely depart from CBT techniques described in treatment manuals. “Only half of the clinicians claiming to use CBT use an approach that even approximates to CBT,” the authors wrote.

The finding is not surprising, since there is no evidence that manualized therapy leads to better outcomes, and therapists in the real world naturally adapt their approaches to the needs of individual patients. Their practice methods also evolve over time as they learn through hard-won experience what is helpful to patients and what isn’t.

In fact, studies show that when CBT is effective, it is at least in part because the more skilled practitioners incorporate methods that are fundamentally psychodynamic. These include open-ended, unstructured sessions (versus following an agenda from a manual), working with defenses, discussing the therapy relationship, and drawing connections between the therapy relationship and other relationships.

So the research finding was no surprise. Something would be seriously amiss if experienced clinicians practiced like beginners, following an instruction manual like a consumer trying to assemble a new appliance. What caught my eye was the authors’ conclusion that clinicians should be trained to adhere to CBT interventions “to give patients the best chance of recovery.”

The study did not evaluate treatment outcome, so the authors had no way of knowing which clinicians were effective or which patients got better. They just presumed, a priori, that departure from treatment manuals means poorer therapy. And this presumption—which flies in the face of actual scientific evidence—slipped right past the “evidence oriented” reviewers and editors of a top-tier research journal. They probably never gave it a second thought.

The Big Lie

Academic researchers have usurped and appropriated the term “evidence based” to refer to a group of therapies conducted according to step-by-step instruction manuals (manualized therapies). The other things these therapies have in common are that they are typically brief, highly structured, and almost exclusively identified with CBT. The term “evidence based therapy” is also, de facto, a code word for “not psychodynamic.” It seems not seem to matter that scientific evidence shows that psychodynamic therapy is at least as effective as CBT. Proponents of “evidence based therapies” tend to denigrate psychodynamic approaches (or more correctly, their stereotypes and caricatures of psychodynamic approaches). When they use the term “evidence based,” it is often with an implicit wink and a nod and the unspoken message: “Manualized treatments are Science. Psychodynamic treatment is superstition.”

Some explanation is in order, since this is not how things are usually portrayed in textbooks or psychology classes. In past decades, most therapists practiced psychodynamic therapy or were strongly influenced by psychodynamic thought. Psychodynamic therapy aims at enhancing self-knowledge in the context of a deeply personal relationship between therapist and patient.

Psychodynamic or psychoanalytic clinicians in the old days were not especially supportive of empirical outcome research. Many believed that therapy required a level of privacy that precluded independent observation. Many also believed that research instruments could not measure important treatment benefits like self-awareness, freedom from inner constraints, or more intimate relationships. In contrast, academic researchers routinely conducted controlled trials comparing manualized CBT to control groups. These manualized forms of CBT were therefore described as “empirically validated” (the preferred term later morphed into “empirically supported” and later, “evidence based”).

Research findings never suggested that manualized CBT was more effective than psychodynamic therapy. It was just more often studied in controlled trials. There is obviously a world of difference between saying that a treatment has not been extensively researched and saying it has been empirically invalidated. But academic researchers routinely blurred this distinction. A culture developed in academic psychology that promoted a myth that research had proven manualized CBT superior to psychodynamic therapy. Some academics and researchers (those with little regard for actual scientific evidence) went so far as to assert that it was unethical to practice psychodynamic therapy since research had shown CBT to be more effective. The only problem is that research showed nothing of the sort.

This may shed some light on why the authors of the study I described above could so cavalierly assert that clinicians should adhere to CBT treatment manuals to give patients the best chance of recovery—and how such an empirically false assertion could sail right through the editorial review process of a prestigious research journal.

Where is the Evidence for Evidence-based Therapies, Part 2

Stay tuned. In the next installment, I will discuss whether “evidence based therapies” help people. The answer may surprise you.

Robert D. Stolorow, Ph.D. - Scientism in Psychotherapy

Dr. Stolorow is one of the founders of the intersubjective school of psychoanalysis - which makes him very cool in my world - but he is also a leader in the philosophy of psychotherapy. He has some , serious doubts about the usefulness of evidence-based practice in psychotherapy, and rightfully so.

The evidence-based models all ignore or deny the importance and the uniqueness of each therapeutic dyad - it's the relational aspects of therapy where healing occurs, the rest is just building skills and changing behaviors.

Scientism in Psychotherapy

Show Me the Evidence! 

Published on June 22, 2012 by Robert D. Stolorow, Ph.D. in Feeling, Relating, Existing

These days, in this Insurance-Company-Driven Age of the Quick Fix, there is much talk in psychotherapy circles of “Evidence-Based Practice.” The application of this slogan has been remarkably devoid of philosophical questioning of the nature of psychotherapeutic practice or of the proper evidence for guiding the therapeutic approach to a suffering human soul.

My collaborators and I (Working Intersubjectively: Contextualism in Psychoanalytic Practice (Psychoanalytic Inquiry Book Series) - with Donna Orange and George Atwood) have applied the Aristotelian distinction between techne and phronesis to the practice of psychoanalytic therapy. Techne or technical rationality is the kind of method and knowledge required for the uniform production of things. It is exemplified in the traditional, standardized rules of psychoanalytic technique, especially as these are claimed to apply for all patients, all analysts, all analytic couples, and all relational situations. We argue “that the whole conception of psychoanalysis as technique is wrongheaded … and needs to be rethought” (p. 21). We further suggest that what is needed to ground psychoanalytic practice is not techne but phronesis or practical wisdom. Unlike techne, phronesis is a form of practical understanding that is always oriented to the particular, to the uniqueness of the individual and his or her relational situation.

Traditional psychotherapy research tends to reduce human beings and human relationships to “variables” that can be measured, calculated, and correlated.  Such procedures partake of what Heidegger calls the technological way of being or technological form of intelligibility. According to Heidegger, entities as a whole, including human beings, are intelligible in our technological era as meaningless resources to be calculated, stored, and optimized in the quest to conquer the earth. In my view, the technological way of being is also associated with the philosophical stance of scientism—the presupposition, exemplified in the scientific positivism characteristic of much research on change in psychotherapy, that the chief form of valid knowledge is that attained through experimental and quantitative methodology.

Such considerations point to the potential importance of qualitative, rather than quantitative, research. They also bring me back to a tradition in academic personality psychology—the tradition in which I was trained as a clinical psychology doctoral student at Harvard during the mid- and late 1960s—known as personology. This tradition, founded by Henry Murray at the Harvard Psychological Clinic in the 1930s, held as its basic premise the claim that knowledge of human personality can be advanced only by the systematic, in-depth study of the individual person. This emphasis on “idiographic,” rather than “nomothetic,” research was a radical departure from the philosophy of science that then dominated, and has continued to dominate, academic psychology in the United States.

I suggest that grasping the practice of psychotherapy as a form of phronesis rather than techne justifies a return to idiographic methods in studies of the psychotherapeutic relationship—methods that can investigate the unique emotional worlds of patient and psychotherapist and the specific intersubjective systems constituted by the interplay between them. It is only such idiographic research, I contend, that can illuminate the rich, complex, living relational nexus in which the psychotherapeutic process takes form.

Michael Dowd - The New Theism: Shedding Beliefs, Celebrating Knowledge

Metanexus is one of the really interesting online magazines - for lack of a better word, they seem to be approaching and highlighting a more integral approach to understanding the world, through a variety of lenses. They believe that Big Questions and Big Problems require a perspective from Big History.

They offer the following description of their project: "Metanexus fosters a growing international network of individuals and groups exploring the dynamic interface between cosmos, nature and culture. Membership is open to all. Join Now!"

This article examines the emergence of a new form of theism that requires evidence, which means science, for making meaning in the world, to "grow in right relationship to reality" as a spiritual path.

The New Theism: Shedding Beliefs, Celebrating Knowledge

May 30, 2012

By Michael Dowd

Since April 2002, my science-writer wife Connie Barlow and I have traveled North America virtually nonstop. We have addressed more than 1,600 secular and religious groups of all kinds. Our goal is to communicate the inspiring and empowering side of science to as many people as possible.

Whether addressing evangelicals, atheists, UUs, or gurus, our message is always the same: We show how a deeply meaningful and fully evidence-based view of big history, human nature, and death can inspire people of all backgrounds and beliefs to live in integrity and cooperate in service of a just and thriving future for all.

Over the course of the last decade, in addition to talking with folks after our programs, Connie and I have lived with hundreds of people in their homes. We’ve thus been privileged to have intellectually rich and heartful conversations with countless kindred spirits—those, like us, whose passion lies at the intersection of science, inspiration, and sustainability.

The manifesto below reflects the thinking and work of many individuals, all of whom agree that traditional labels are no longer adequate. Please consider the following but a rough first draft. Feedback is welcome. Please email me your questions, comments, criticisms, and especially your suggestions for improvement at Michael@ThankGodforEvolution.com.

A Manifesto for the New Theism
A new breed of theist is emerging in nearly every denomination and religion across the globe, and many of us are grateful to the New Atheists for calling us out of the closet.

New Theists are not believers; we’re evidentialists. We value scientific, historic, and cross-cultural evidence over ancient texts, religious dogma, or ecclesiastical authority. We also value how an evidential worldview enriches and deepens our communion with God (Reality/Ultimate Wholeness/The Great Mystery).

New Theists are not supernaturalists; we’re naturalists. We are inspired and motivated more by this world and this life than by promises of a future otherworld or afterlife. This does not, however, mean that we diss uplifting or transcendent experiences, or disvalue mystery. We don’t. But neither do we see the mystical as divorced from the natural.

As secular Jews differ from fundamentalist Jews, New Theists differ from traditional theists. While most of us value traditional religious language and rituals, and we certainly value community, we no longer interpret literally any of the otherworldly or supernatural-sounding language in our scriptures, creeds, and doctrines. Indeed, we interpret all mythic “night language” as one would interpret a dream: metaphorically, symbolically.

New Theists practice what might be called a “practical spirituality.” Indeed, spirituality for us mostly means the mindset, heart-space, and tools that assist us in growing in right relationship to reality and supporting others in doing the same.

New Theists are legion; we are diverse. Many of us continue to call ourselves Christian, Jew, Muslim, or Hindu. We may also self-identify as emergentist, evidentialist, freethinker, neo-humanist, pantheist, panentheist, or some other label.

New Theists don’t believe in God. We know that throughout human history, the word “God” has always and everywhere been a meaning-filled interpretation, a mythic and inspiring personification of forces and realities incomprehensible in a prescientific age. We also know that interpretations and personifications don’t exist or fail to exist. Rather, they are more or less helpful, more or less meaningful, more or less inspiring.

New Theists view religion and religious language through an empirical, evidential, evolutionary lens, rather than through a theological or philosophical one. Indeed, an ability to distinguish subjective and objective reality—practical truth (that which reliably produces personal wholeness and social coherence) from factual truth (that which is measurably real)—is one of the defining characteristics of New Theists.

New Theists do not have a creed (we’re not that organized). But if we did, it might simply be this:

Reality is our God, evidence is our scripture, integrity is our religion, and ensuring a healthy future for the entire body of life is our mission.

By “reality is our God” we mean that honoring and working with what is real, as evidentially and collectively discerned, and creatively imagining what could be in light of this, is our ultimate concern and commitment.

By “evidence is our scripture” we mean that scientific, historic, and cross-cultural evidence provide a better understanding and a more authoritative map of how things are and which things matter (or what’s real and what’s important) than do ancient mythic writings or handed-down wisdom.

By “integrity is our religion” we mean that living in right relationship to reality and helping others and our species do the same is our great responsibility and joy.

By “ensuring a healthy future for the entire body of life is our mission” we mean that working with people of all backgrounds and beliefs in service of a vibrant future for planet Earth and all its gloriously diverse species (including us) is our divine calling and privilege.

Why call ourselves “theists” at all if we’re not supernatural, otherworldly believers? Simply this:

All theological “isms” (e.g., theism, deism, pantheism, atheism) came into being long before we had an evolutionary understanding of emergence. Therefore, all such concepts are outdated, misleading, and unnecessarily divisive if they are not redefined and reinterpreted in an evolutionary context. Other terms that have been offered in addition to “New Theist” include “evolutionary theist,” “evolutionary humanist,” “post-theist,” “mytheist,” and “creatheist” (pronounced variously, and humorously, as “crea-theist” or “cree-atheist”).

Labels are far less important to us than celebrating the fact that we are naturalists who wish to be counted among the religious of the world—no less than all others who are devoted to something sacred and larger than themselves.

Whatever our differences, we are evidentialists, committed to living upstanding moral lives in service of a just and thriving future for humanity and the larger body of life.

We see this as Religion 2.0.

Originally published on The Advent of Evolutionary Christianity: Conversations at the Leading Edge of Faith.

Victoria Lemle Beckner - Science of the Mind: How the Brain Works to Regulate Mood, Emotions, and Stress

This talk comes from the Osher Center for Integrative Medicine at the University of California, San Francisco. Dr. Beckner talks here on what we call evidence-based psychotherapy (which generally means one of the generic, manualized therapies like CBT or REBT or Solution-Focused Brief Therapy) - in fact, she is part of a group practice called The San Francisco Group for Evidence-Based Psychotherapy.

She is lead author on Conquering Post-Traumatic Stress Disorder: The Newest Techniques for Overcoming Symptoms, Regaining Hope, and Getting Your Life Back.

The Science and Art of Psychotherapy: Insider's Guide

Victoria Lemle Beckner, Assistant Clinical Professor in the UCSF Department of Psychiatry, discusses the different approaches to psychotherapy and how research informs clinical practice to help patients achieve lasting improvement. Series: "UCSF Osher Mini Medical School for the Public" [5/2012]

IONS - "Evidence-Based Spirituality" with Charles Tart

This podcast with Charles Tart is a year old, but it's worth listening to - Dr. Tart is one of the founders of a scientific investigation of spirituality and spiritual states of consciousness. This comes from the Institute of Noetic Sciences library.

"Evidence-Based Spirituality" with Charles Tart

Visionary: Charles T. Tart, PhD

Given that it's reasonable to be both scientific and spiritual in approaching life, just exactly  what does this mean?  How do we apply the best of science and the best of spirituality to each other to work toward what Tart likes to call "evidence-based spirituality for the 21st century," a practical  spirituality that works in life and is compatible with science?  Could research in the right spirit, e.g., tell us that if we have cancer it would be better to have, say, Baptists praying for us rather than Buddhists, but perhaps the opposite for Parkinson's?  Or can we expand the evidence for reincarnation enough to deal with the question of how much karma affects next lives, such that we will live really believing that we reap what we sow, even if the harvest is delayed for a lifetime or more?

The idea of evidence-based or at least evidence-enriched spirituality is audacious, preposterous, inspiring --- and absolutely needed!  Better answers need to be discovered, they aren't in, and there is real resistance to even thinking about this, but if we don't get some answers that are effective, there may not be much life left to mankind after the 21st century, we may have destroyed our planet by greed and stupidity if we don't get a practical spirituality that makes us really care about each other and the world.  Professor Tart shares some ideas to get us started thinking about this direction of evolution, and then draw us out to give us even more possibilities….

Related Sets: "Shifting Paradigms" Teleseminar Series

---

Download as mp3

Publication Date: 2011-01-12

Length: 00:58:16