Did 911 Reveal the Limitations of Psychology?
A New York Times article recently declared, "September 11 Revealed Psychology's Limits, Review finds" (July 29th, 2011 page A-18). As the tenth anniversary of 911 approaches, it is a good time to pause and reflect about this horrific, historical event and to comment upon what we have learned in the 10 years since. When examined closely and considered in the proper context, it would be more accurate to say, "September 11 Demonstrates the Value of Psychology."
The NYT article was commenting upon a special issue of American Psychologist (August 8th, 2011). This special issue was devoted to reviewing the body of scientific research concerned with studying the effects of terroristic attacks, conducted over the past 10 years. This body of research has greatly advanced our understanding of the individual and collective trauma that results from acts of terrorism;of human behavior and human resilience in the face of a mass disaster predicated by terrorism;and of effective forms of disaster relief and disaster response. Simply stated, research provides us with critical knowledge and useful information by systematically evaluating, "What happens to X, when Y occurs?" In this case, "What happens to people when a mass disaster occurs?" Fortunately, mass disasters do not occur very frequently, but this infrequency makes it a difficult topic to research. Therefore, prior to 2001 the research about mass disasters,and the proper response to these disasters, was very limited. Furthermore, the research that did exist was primarily based upon natural disasters, not disasters of a terroristic nature.
In the 10 years since September 11, 2001 an enormous amount of research has been conducted that has tremendously advanced our understanding of these types of events. In so doing, we learned that people are more resilient than we might have expected, that some types of responses are more effective than others, and that some people may be traumatized by indirectly viewing disasters of this nature (for instance, viewing media coverage of the event). The psychological profession responsibly evaluated its response to these events, and publicly reported its findings. Rather than "revealing limitations" of the profession, I find it demonstrated the significant value and effectiveness of the psychological profession. As a result of this research, we are now much better prepared to respond to any future disasters, of similar nature, with greater effectiveness.
So why does Benedict Carey, the author of the New York Times article, conclude that the events of 911 demonstrated the weaknesses of psychology, while I conclude those same events demonstrated the effectiveness of psychology? Like most opposing viewpoints, there is a kernel of truth in each assertion. But in order to reconcile these two opposing viewpoints, we must first review how research guides applied scientific disciplines such as medicine and psychology.
Many people think the word "psychologist" is synonymous with the word "therapist" but this is not the case. First and foremost, psychologists are trained as scientific researchers. Some psychologists also apply this science to help people solve problems of a behavioral or relational nature in much the same way as an engineer applies physical science to help solve problems in the physical, non-human realm. When psychologists apply behavioral science to provide practical help and assistance to people, we commonly call this "therapy" or "psychotherapy." As practitioners of an applied science,psychologists strive to have science guide their work using "evidence-based practices" meaning there is a sufficient body of research that supports the effectiveness of a particular practice, method, or therapeutic approach. However, in some cases the research base is inadequate and real-world practitioners have to make an informed and educated estimate of the best practice, method, or therapeutic approach, given the present state of research. This was certainly the situation facing psychologists attempting to intervene in the aftermath of the 911 attacks. The fact that it is sometimes necessary for psychologists to estimate the best therapeutic approach, given the lack of relevant research, in no way demonstrates the "limitations" of the profession, but simply demonstrates the "limited" research relevant to that situation. Imagine what would happen if someone was in desperate need of help but a psychologist just stood by and said, "Sorry buddy, can't help you, there is no scientific research that tells me how to help you in this circumstance."
Quite naturally, prior to the events of 911, there were few opportunities to study events of this nature, so psychologist-practitioners of that era, had to rely on their best estimate of what would be helpful, given the limitations of the research at that time. As a result, some techniques were applied that were later demonstrated, through psychological study, to be ineffective. One such technique was a type of group intervention, often referred to as "traumatic debriefing." This was a therapeutic intervention that involved assembling a group of people immediately after exposure to a trauma, and guiding them to explore the facts of the event, discussing thoughts and feelings about the event, and introducing some strategies for coping with intrusive thoughts or overwhelming feelings. Because of psychology's research efforts since 911, we have since learned this is not a particularly good approach. But psychological research has also taught us what would be more effective, such as providing, practical help and resources (e.g., creating safety; providing food, water, shelter; facilitating immediate access to healthcare; centralizing the distribution of information so that victims can locate family members and needed resources, etc.).
Other criticisms were that psychologists and other mental help workers rushed in to provide help in order to make themselves feel better, without regard to whether their assistance was needed, wanted, helpful, or effective. Well yes, it certainly would have been better if we had some advance knowledge of these attacks so that we could have arranged to study our effectiveness; but those darn terrorists, they failed to mention what they were planning and in the chaos that followed, we failed to prioritize researching the effectiveness of our efforts. I liken psychologists' efforts to provide unbidden help to a normal, natural (and quite lovely) human response, not necessarily motivated by a selfish desire to make oneself feel better, but motivated by a sense of helplessness. For instance, recently in my community a family's house burned down, and they lost several family members in the fire, along with all their possessions. People from all over the community began to bring them food and bags of clothing. Their church held a fund raiser and raised $500. Clearly $500, a few bags of clothing, and mountains of covered dishes did not alleviate this family's suffering, and I'm sure no one thought it did. But were the people who provided these things just selfishly trying to make themselves feel better? Did they foolishly believe this would fix anything? Or did they simply feel helpless at bearing witness to such a devastating event in their own community, and felt a compelling need to do something, anything, and therefore provided whatever they could with the best intentions? Although psychologists study human behavior, we are also human, and are prone to behave in the same manner that most humans do.
As with all applied sciences, each profession is "limited" by its research base. At one time, physicians applied leeches to people in an effort to draw out infection. We do not look back on this practice and declare, "Holy smokes, those physicians are a bunch of idiots. They have no idea what they are doing!" Instead, we place it into a historical context and appreciate that medical science has advanced beyond leeches and now offers highly effective means of eliminating most infections. Why do we now have these effective means of treating infections? Because physicians learned that leeches did not work very well and then researched and developed more effective treatments (thankfully!)
In the same manner, we should be able to appreciate that behavioral science functioned exactly as it should: An unprecedented event occurred for which no research existed. Despite the lack of research, we applied our best efforts to address a unique circumstance, based on the limited information available at that time. We subsequently seized this opportunity to study our efforts. This research revealed that some things we did were not effective. We publicly announced these failings. We utilized this information to develop effective strategies that do work. As a result, we have advanced our understanding of mass disasters of a terroristic nature, and are in a much better position today to respond with effective techniques and methods. I surely hope that we will never need to utilize this new knowledge and information but I sadly acknowledge this is rather unlikely. Therefore, I have concluded, "September 11 has demonstrated the value of psychology." As a psychologist, I am committed to practicing according to scientific research. If I am ever called upon to serve during another disaster, I am grateful to my profession and our dedicated researchers. Each citizen is benefited by this research. In the future, our response to similar circumstances will no longer be "limited" by the lack of research; and that demonstrates the value of psychology.