Psychotherapy and Science

At the outset of this book, Robert Langs argues convincingly that psychotherapy is unlikely to survive as a distinct discipline without the “development of formal science of its own.” He tells us that to turn away from the rigors of theory-building and the testing of assumptions that guide practice is worse than an indulgence. From here he then sets out to describe to us the quest he has undertaken over the course of his long and fruitful career to bring science to bear on psychotherapy. The style of the book is an engaging mixture of personal narratives about his triumphs and disappointments and more formal academic writing about Langs' theories and his understanding of the key questions science has yet to address. The tone is impassioned and the work as a whole seems to be an effort to awaken a field that the author perceives as slumbering.

To both describe his own adventures and discuss the issues of the field, Langs has divided this book into four parts. In the first he introduces basic issues and talks about why our field is ambivalent about scientific inquiry. Here Langs perceives an emotional rather than an abstract issue. In a manner that rings true, he writes: “the universal dread.…of a confrontation with the most awful aspects of one's relationships, self, life experience, inner impulses and particularly, inevitable demise carries over to a dread of science.”

In the second section, Langs presents a model of the aspects of the mind that are addressed by psychotherapy, those aspects or systems that make meaning of emotionally charged information. His presentation is dense and detailed. He offers lists of numbered postulates. He describes the division of the emotional processing mind into conscious and unconscious domains and uses names such as the “perception-analyzing receiving system” and “output control center” to distinguish individual components of these domains.

In the third and most engaging section, Langs takes us into his confidence and describes his personal tribulations as a little more than a decade ago he attempted to code a series of psychotherapy transcripts and then subject the data to mathematical modeling. For example, Langs tells us how he found in one series of studies that the amount of time clients spent narrating versus intellectualizing increased as the therapist was quiet but actively lending energy to the interaction. Here Langs explains that he believes he was measuring mental energy, and he evolves a number of laws about human communication. While I suggest that there are many alternative explanations of this finding, including ones that draw from a less synthetic and mechanistic view of the mind,^1,2 these findings and Langs' thoughts are nonetheless exciting and provocative. They draw the reader into arguing both with Langs and with themselves about the basic processes that go on between therapists and clients. Thus here more strongly than in any other section of the book, the case is made in vivo for how science can revitalize our thinking about psychotherapy.

In the last section, Langs speculates about how the forces of evolution may have shaped the human mind into the structures he has observed. Here he grapples with the issue of why people act in so many absurdly self-destructive ways. Why do we have important knowledge that is so difficult to access (knowledge Langs calls unconscious)? Then, at the close, Langs returns briefly to try to put psychotherapy into the context of the mind as evolving entity.

This book is ultimately a collection of closely related assertions about the nature of human consciousness and psychotherapy. The directness of Langs' assertions is both the strength and the weakness of the work. His points are clearly made. There is no guessing about his postulates or conclusions. Some of his points, though, seem unlikely to stand the test of time. For example, he asserts that “the human brain is a Darwin machine” and that there is an unwavering biological basis of the denial of death. This may be unconvincing to many readers familiar with literature on the social construction of narrative.³ Some of his thoughts about the philosophy of science are also perhaps limited by their reliance on the early 20th century positivist view. Nevertheless, this is how science moves forward. Langs is courageous enough to tell us what he thinks, and we can consequently accept or reject what he purports, thereby advancing our field. Langs writes: “It is my fervent hope that this book has aroused a restless interest and need for science.” For myself, it was the case that Langs' work helped to revitalize and spur on just such a process.