psychology’s got a hammer
commentary • 07.03.04
You see the term “borderline” used in psychology when describing certain conditions. I wonder about that.
The early analysts, chief among them Freud, were concerned with people who had serious psychological problems, people who crossed a definable line in that they could be considered ill. The practitioners found that by employing therapeutic disciplines some of their patients could be brought back over that line to normality and have their quality of life restored. On the basis of empirical experience they formed theories around mental conditions and argued for their scientific validity. So was born psychology.
In the intervening century there has been an extrapolation of the early theories of Freud and his followers. But as well as these theories being applied to people with serious conditions they are also used to analyse those with ordinary existential issues. Those kinds of problems, though not entirely healthy, hardly qualify for being called illnesses. The idea that many commonplace issues are minor variants of more serious conditions is spurious. The assumption that they can be understood and improved by employing the same practices as with the major cases might be a mistake leading to faulty diagnoses.
One of the problems of psychology is that it is thought not to be a proper science, sometimes referred to as a pseudo-science. This is because it rests on theories that are not very amenable to testing. This in turn is due to the fact that psychology isn’t dealing entirely with physical entities. Yes the brain is a physical thing but the mind is not. The thoughts and feelings that arise from it can’t be studied in a lab. That you can help or cure a patient employing a certain theory of the mind doesn’t confirm that theory as scientifically valid. This is not an unusual phenomenon in medicine generally. Cures are possible where causes aren’t known and causes are known but cures can’t be found. The non-physical nature of mental problems makes this kind of knowledge deficit even sketchier. You may be able to ease a troubled mind employing a certain kind of thinking without really knowing for sure if that thinking is sound.
This has been a problem for psychologists and sometimes undermines their validity. If their theories are so wide open to interpretation then practitioners may be pursuing lines of diagnosis that are dubious. They can proffer insights no amount of evidence will confirm or contradict - e.g. the theory that your errant behaviour as an adult is due to being abused as a child might be plausible in your circumstance but it is not provable. The fact that your condition is helped by believing it doesn’t strengthen the case either. It’s more a matter of faith. Believing that God shows mercy might do the same job.
Given that medicine is considered a hard science, relegating psychology to a brand of faith healing is not going to be easily conceded by its practitioners. Jung went to great lengths to point out his empirical and scientific credentials. This is understandable. Psychology has always been vulnerable to attack from hardline empiricists.
So the conclusion to this preamble is that psychology operates on shaky ground. It is given slack because it can get results not because the theories underpinning it are sound. The effect on a patient is what’s primarily important. Validity of the theory is secondary.
Where does the use of “borderline” fit in to this? Well, the term is used to describe a condition that isn’t quite the condition but close to it. Borderline personality disorder isn’t the disorder but something that looks a little like it. Now, if psychological diagnoses of conditions are in general provisional then behaviours that only look a bit like those conditions are even more so. This methodology can venture close to analysing many commonplace behaviours as deviant. Branding them such lends them to being treated as if they were a species of the full blown thing. By doing this it seeks to understand something that is not an illness as if it is.
It is not long before the propositions used can become absurd. Someone who seeks to excel might be said to have a perfectionist complex. Those with a tendency to leadership are control freaks. A person cautious of commitment has intimacy issues. At the worst extreme is the likes of “repressed memory syndrome” where patients are encouraged to recall encounters of abuse which they have “repressed”. There are cases where these memories have been shown to be fallacious. From here it could get to the stage where any mental state and its associated behaviour which falls outside a particularly conformity could be interpreted as problematic and deviant. Psychology’s got a hammer so there’s a tendency for it to see every issue like it’s a nail.
The philosophical sceptic would classify psychology as a theory of false consciousness: you’re feeling what you’re feeling not for the reasons you think but for other reasons hidden from you. The doctor will enlighten you as to what they are. He will do this based on a particular school of thought. Despite its obvious usefulness psychology’s practices are open to distortion and abuse. The notion of “borderline” cases exemplifies this. It is suggestive and capable of bending reality to suit theory. It should be treated with caution.