Saturday, November 27, 2004

The Reading Cure

(Note: Since I don’t have a professional-level education in psychology, I’m probably about to overstep my bounds here. Oh well. I’m claiming blogger’s license. But I did take a little Psych in college, and have read a few books and articles on the subject, so I don’t think I’m completely uninformed.)

Psychology is in the midst of a fragmented, long overdue civil war. Battle lines have been drawn in efforts to define the very nature of the field.

In one camp, there are established professionals versed in the traditional talking cures descended from Freud, the behavioral therapies inspired by Skinner, and the innumerable variations espoused by others who continue to create esoteric models to explain how the mind works.

In another camp, a mostly younger breed of scientifically minded therapists are trying to incorporate standards of scientific evidence in an effort to implement whatever actually works; Credible studies have suggested that receiving traditional talk therapy from a professional psychologist is no more effective than talking with a sympathetic listener.

A related and overlapping camp of secessionists questions the very relevance of talk therapy in the age of antidepressants and other provably effective drugs that work directly on the brain, and in light of advanced brain scanning increasingly offering the chance of actually spotting and surgically correcting the physical abnormalities behind some of the rarer but more serious psychiatric problems.

Ultmately, in the coming age of nanotechnology and artificial intelligence, I think the human brain will be so well understood that there will be little need for “black box” hypotheses that only occasionally result in effective treatments—treatments for which the causal mechanism is often unknown. But until that time, I submit that an alternative, memetic approach lending itself to scientific comparison may be the sanest way to treat many of the softer issues addressed by counseling and therapy.

I define “soft” issues as those that don’t justify or lend themselves to today’s drugs, and only warrant therapy because the patient believes that they do. A person who considers himself to be intolerably shy, for example, may seek counseling, even if those around him think he’s just a little withdrawn. Someone deeply disaffected with a marriage, yet equally determined to fix it, may seek counseling as well, even if divorce would be a socially acceptable solution. In such cases, the patient is considered successfully treated when the patient declares that it is so. There is really no alternative to this subjective victory condition in soft therapy, except in cases where close associates of the patient deserve to be polled as well (A family with an abusive parent is not served by a patient who considers himself cured because the therapist has convinced him that abuse is an appropriate expression of frustration.)

I think it’s fair to say that no two therapeutic conversations are exactly alike. The therapist, patient, and context will always vary from one occasion to the next. This makes it hard to scientifically study the effectiveness of a counseling approach. About the best we can hope for is a rough comparison between obviously different counseling philosophies and loose “control groups” that are “treated” by any sympathetic listener. Any increase in uniformity among therapy sessions allowing for cleaner studies would therefore be potentially be worth the loss of customization; effective session content would quickly reveal itself as such, creating opportunity for developing still more effective, testable techniques.

It turns out that we already have a ready supply of uniform therapy sessions. They are called books. Not necessarily non-fiction self help books, either. I think every reader of fiction has encountered a story that noticeably changed their outlook or behavior. Soft psychology problems—the ones we’re not yet trying to identify and treat physically—are memetic in nature (composed of ideas and concepts); at least, we are only concerning ourselves with the memetic component if we’re calling it a soft problem. As dense memetic delivery systems, books can alter or overthrow patterns of ideas and values in the mind of a reading patient, literally changing their lives.

The pharmaceutical industry provides a ready model for the techniques of identifying and marketing effective treatments. Drug companies typically spend only a slice of their efforts creating new compounds; The low-hanging fruit is in testing existing compounds found in nature or in drugs used for other purposes, to see if they provide a net benefit in the treatment of a particular condition. Similarly, a memetic drug company would have ample low-hanging fruit in the form of existing literature; there would be little need to develop stories or self-help books from scratch. If anecdotal evidence suggested that “Gone With the Wind” was effective for people who feel hopelessly codependent, the memetic drug company would sponsor studies and trials in an effort to compare it to other potential alternatives. When proven safe and effective (perhaps by the inevitable memetic arm of the FDA), the book could be marketed as a memetic drug.

We will probably never see scientifically minded, federally regulated meme-drug companies like this, however, because of the easily reproducible nature of media. It would be tough for a company to make enough profit to cover the cost of the studies when anyone can check the cure out of a library or download a copy off the internet. But perhaps the combinations of copyright, buzz, and medical authority would offer enough profit potential, in the form of boosted sales for forgotten or declining titles. If not, government money and philanthropy already headed into scientific psychology (I don’t know how much of this there might be) could be directed to such an effort.

But perhaps the only way we’ll ever see anything like this will be if people take it upon themselves to create it, in the form of internet communities where people can rank books they’ve read according to their value in treating their various psychological discontents.

The reading cure would not be for everyone. Not everyone can read at the level necessary to receive the impact of a given book. (Movies and recordings might be effective substitutes.) And some people will always feel most comfortable when talking to someone professionally trained to listen. But, many seek traditional therapy only because they know of no alternative, and needlessly waste their money on whatever marginal treatment their therapist happens to use. The reading cure could be an inexpensive and effective alternative to traditional psychology.


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