The art and science of clinical psychology: A response

Arabella Kurtz responds to Ryan Nah’s post

I think it’s absolutely right what you say, that the practice of clinical psychology is as much an art as a science. I came to clinical psychology and psychotherapy through the study of English Literature (the turning point was being introduced to Freud as part of my English degree); and I have always seen a natural synergy between psychology and literature, which is after all devoted to the expression in written language of human nature, subjectivity and, particularly in the novel, the development of character. Quite a few of my clinical colleagues are avid novel readers. After all, there is lots of psychology to be found in most fictional narratives. It is so interesting to be invited, through a novel or film, a song or poem, to look at things we are familiar with in our work, but from a radically different perspective: that of the artist, whose job it is not to promote change, but simply to represent experience. It can be very freeing. But it is important too, in that, in my view, it can open up new areas of thinking in our work.

An engagement with the arts is also useful from a technical point of view. As clinical psychologists our main tool is language, and we use words to try to develop a shared understanding with clients of their difficulties, and to find a way of representing their experience. As I see it we’re often working at the edge of language, trying to find a way of saying what has previously seemed unsayable. We and our clients are all in a sense artists, forging new forms through which to express experience – or adapting old ones. It follows from this that poets and writers have a lot to teach us about how we can use language to do our job better.

It was in this interdisciplinary spirit that we organised the ‘Novelists in Conversation with Psychologists’ conference at the University of Leicester in 2003. Three novelists (Pat Barker, Nick Hornby and AS Byatt) took to the stage to converse with three psychologists (Caroline Garland, Simon and Stephen Frosh) about areas of mutual interest. The result was by turns absorbing, moving and dramatic. And this year, I co-authored a book about psychotherapeutic process (and the nature of the therapeutic relationship in particular) with the novelist JM Coetzee. It’s called ‘The Good Story: Exchanges on Truth, Fiction and Psychotherapy’. The book is a dialogue in written form, in which Coetzee asks me questions about therapy and how it works from the point of view of the sympathetic outsider. The hope was that this would allow a relatively jargon-free account of psychoanalytic psychotherapy to emerge.

I would like to invite members of our community to recommend a book, a film, or a piece of music that has shed light on a psychological matter. Your post doesn’t have to be long at all: you might just want to make a recommendation and say something brief about the psychological issue it elucidates or expands or alters. Alternatively you might want to tell us a bit more about your recommendation. But the hope is that we might begin to build up a resource in teaching the art, as well as the science, of clinical psychology.

Arabella Kurtz, August 2015

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2 thoughts on “The art and science of clinical psychology: A response

  1. Here’s an example from TV that made me re-evaluate my attitude to the situation of doctors deciding whether or not to operate on a child against the parents’ wishes.

    In the Babylon 5 episode ‘Belivers’ ‘An alien couple comes to Dr. Franklin with their fatally ill son. The child could be cured by a simple operation, but the parents’ religion specifically forbids it.’ (quote from http://www.TV.com). Feeling that the station’s Doctor would act without their consent after his consultation with them, the couple try to get any of the four alien ambassadors on Babylon 5 to represent them – as their own race doesn’t have an ambassador on board. None of the ambassadors present will involve themselves, not wanting to be dragged into a difficult moral situation, as the religious and psychological stance of the parents is effectively signing their son’s impending death. Commander Sinclair, the station’s top officer, decides to decline the Doctor’s request to operate on the alien boy. Doctor Franklin, along with a nurse, operate anyway without consent and save the alien boy – but the alien parents, realising what has happened, now consider that their boy’s soul has gone as he has been opened up (i.e. operated on) and replaced by an imposter soul. At the climax of the episode Doctor Franklin sobs as he discovers that upon the family leaving the hospital wing, the parents have killed their son (sent him on ‘The Great Journey’).

    The episode was well written and acted. Beforehand, I would have been on Dr Franklin’s side – but the story made me consider that you cannot just override the religious and cultural wishes of the parents in similar situations (e.g. where blood transfusions would save lives). In this case, I do not agree with what the alien parents did – but it is them who would ultimately have to take responsibility for their actions if subjected to any intergalactic law.

  2. I would heartily recommend a film called Lars and The Real Girl (Starring Ryan Gosling). One of my favourite films and one that very sensitively addresses the subject of delusional beliefs and how people can help someone who’s ideas and experiences are somewhat different from those around them. I won’t give the storyline away but it’s certainly unconventional. Check it out.

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