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Perspectives

Nominations for the Registry of Insidious Big Ideas

June 15, 2020

The idea of positive psychology must go, even though there is much to recommend in it. What started as an alternative to a focus on abnormal psychology has evolved into the apotheosis of self-improvement. There are apparently people who think they need only improve upon their strong foundation, and they turn to an exclusive section of the therapeutic catalogue for their renovation.

The big mistake is fostering a belief that some people have psychopathology, with all its nasty emotions and conflicts, and others have some mistaken ideas about themselves that just need straightening out. Some people need to spend time behind closed doors with a therapist, while others can find fulfillment with a few lessons of skill building, now conveniently available online.

Positive psychology is surely seductive. It is one way our field can be successful, especially in a society looking for easy, straightforward answers. My years in the behavioral healthcare field have failed to discover any of these people needing only a positive tune up. I found people with varying degrees of success and happiness, but never a person lacking childhood pain or messy personal conflicts.

Why does this matter? Apart from calling a spade a spade, I am always on the alert for insidious big ideas in our field. These concepts are enticing and yet ultimately harmful. They are frequently ideas that develop attention gradually and become established before their negative qualities are apparent. This is my view of positive psychology, the study of strengths and other qualities that help people thrive.

Positive psychology is not yet a popular label with the public, but many people like what it is selling. We now offer a psychology of hope for those seeking to build on their strengths and another for those coping with helplessness and despair. This was not exactly the intention of innovators like Martin Seligman who constructed this framework, but intentions are not the issue.

There is little cause for alarm that a dangerous ideology of positive psychology is on the rise. The more realistic problem is that we inadvertently promote a misleading picture of real lives. For example, thoughts may generate feelings, as shown by cognitive research, but people are not that simple. Theoretical constructs impose order on complex realities. Let us not lose the complexity.

What are the complexities to which I refer? The reality of trauma in psychological development is one such reality. Everyone does not experience trauma, but it is commonplace and formative for many people. I worry that we move this into the shadows with the uplifting notions of positive psychology. Might this be the genesis for parallel systems of care? Big ideas have consequences.

The word that best describes my concern about positive psychology is “palatable.” No one is offended by the genre. In fact, it might attract people to give psychology a try. This is one reason for the reliance on cognitive-behavioral skills in online programs. They fit an educational framework well and are not off-putting. Palatable is not a bad thing, until it crowds out what is uncomfortable and important.

The Registry of Insidious Big Ideas starts here

Our field offers abundant evidence that we should be cautious about the theoretical constructs that guide us. They acquire significance and meaning over time. Society attaches extrinsic value and importance. Ideas assume a reality beyond the concepts themselves. Take science as an idea. Science is a practical undertaking, but it is also a conceptual model of immense social importance.

Consider the science of addiction. A new disease concept of alcoholism was adopted in the 1950s. Yet this disease concept was embraced in advance of any real evidence for it. Our greatest clinical advances since then, like techniques focused on motivation and relapse, or medication-assisted treatment, did not emerge from the disease concept. The idea of a disease is still bigger than the science behind it.

Does this matter? Many more people can tell you addiction is a disease than can identify the tools we successfully use today. Both the public and healthcare professionals share this limited knowledge. The disease concept has assumed an ideological function. The social reality of the concept exists apart from medical knowledge of addiction. Belief in this concept is discussed. Research quietly proceeds.

In fact, the medical model has become one of those insidious big ideas. The idea often takes us well beyond the evidence. It entices us to believe in miracles. I write this as the 2020 pandemic still rages, and people await a cure or vaccine. People find it easier to believe in miracles than in the complexity of science. Visit your doctor to get whatever ails you fixed. Evidence contradicts this, but hope endures.

Science is a messy process that rarely produces miracle cures. Like psychological work described earlier, it confronts some simple problems, like twisted ideas that need some tweaking, and complex problems like trauma. Science in a pandemic may recommend distancing, masks and handwashing, but people await the cure. Failure to cure past infections does not dim our hopes. Our hope is older than science.

This leads to the final question: Has our field moved beyond conceptual battles today with the widespread endorsement of empirically supported treatments? Doesn’t our field now speak the language of science? We seem to be rejecting big ideas and just listening to the evidence. I would argue that our current situation is more reminiscent of the spirit of “American Idol” than the spirit of research.

We embrace the results of research like the latest round of voting for a winner of the contest. A casual student of our field would surely conclude that cognitive behavior therapy has won the battle as the most empirically supported treatment. I am puzzled that the actual result – that all the major approaches to therapy are validated – is not more exciting and more widely reported.

This is the insidious nature of empirical validation today. It is not just a scientific concept. We attach baggage. We celebrate the winning remedies. We want stars, not just solutions. A social function of some sort is being served. The emergence of a palatable psychology, miraculous science, prize-winning therapy – society seems to need these constructs. Social needs are fulfilled more than personal needs.

These comments should not be taken as containing indignation or disapproval. The development and promotion of insidious big ideas will persist. It is how we think and dream as people. It might best be seen as a source of fascination, as many distortions of reality can be. Our job is to dispassionately evaluate how ideas get used and abused. I personally like both positive and negative psychology.

Ed Jones, PhD, is senior vice president for the Institute for Health and Productivity Management.

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