The Zen of Science

Field theory

By MARC RINGEL, MD

I made it all the way up to a final interview for admission to Harvard Medical School, where I performed one last time the application song-and-dance that I'd polished over the course of the long application season. I said I wanted to be a doctor so I could become a psychiatrist and continue studying the mind-body problem that had so fascinated me as an undergraduate philosophy major.

"So," my interviewer—the head of the pathology department of a large metropolitan hospital—asked, "if you want to be a psychiatrist, why didn't you major in psychology, not philosophy?"

I told him that I didn't care for the psychology department at my university. "It is too behaviorist," I explained. "Even Skinnerian."

"Yes, B.F. Skinner," responded the doctor. "A brilliant man. He excelled at everything he tried. He was my roommate at Harvard." The next fall I enrolled at the University of Illinois School of Medicine.

When I attended college, behaviorism, whose most visible spokesperson was B.F. Skinner, dominated American psychological thought. Behaviorists observed organisms—rats and pigeons and humans and lots of other creatures down to single-celled ones—from a reductionist scientific vantage point. The only things that counted, behaviorists espoused, were the things about the organism that could be viewed directly—which, for psychologists, were behaviors, ergo the name of their school.

To study objectively a person's inner reality, a behaviorist would say, is like trying to draw a graph that conveys an individual's experience of the taste of truffles. Behaviorists treat the interior of the individual as a "black box," irrelevant because it is forever unobservable and unknowable. (I cannot resist repeating an old joke here. What does one behaviorist say to another after sex? "I can see it was good for you. But was it good for me?")

Behaviorists are great at manipulating behavior on the basis of punishments and rewards. They can train animals to do amazing things, like run mazes in a flash or peck a lever attached to a food source at the firing rate of a machine gun. There are some applications to human psychotherapy too. A behavioral approach is useful for treating bedwetting and phobias, for example. As you might imagine, though, a psychology that denies the relevancy of all internal experience has relatively narrow uses when it comes to dealing with conscious human beings.

Perceptual psychology is at the opposite end from behaviorism on the spectrum of psychological systems. The main tenet of perceptual psychology is that to predict an individual's behavior, you must look inside that black box to understand her view of the world (called the perceptual or phenomenal field). For example, if I know how you perceive dogs, I can predict if you'll coo and stroke my enthusiastic, friendly, overgrown puppy when he greets you with his front paws up against your chest or if you'll holler and back away from him as fast as you can.

My interest in perceptual psychology (also called field theory or humanistic psychology) comes directly from a great friend and mentor, Art Combs, who retired in Greeley and lived around the corner from me. I believe our meeting was fated.

Art was the first graduate student of Carl Rogers, who is credited with founding humanistic psychology. Many of Art's pioneering contributions to the body of psychology theory and practice have to do with applying the principles of humanistic psychology to education.

Early in our relationship, I read the copy that Art gave me of his 1976 textbook, Perceptual Psychology, which outlines the science that fleshes out his theory. It is a fascinating work. Some of the most interesting studies cited in the text examined the effectiveness of elementary school teachers. Colleagues were questioned and student records were evaluated to determine who were the best and the worst teachers. Then Art and colleagues measured a number of parameters: teacher education, teacher IQ, variety of teaching techniques, class size, etc., none of which correlated with teacher effectiveness. The one factor that consistently predicted how well a teacher did was how strongly she believed that children could learn and that her teaching could make a real difference in their lives.

The phenomenal field has a huge influence on the effectiveness of teachers and, subsequent studies have shown, on the effectiveness of other helping professionals. Understanding people's hearts and minds is what really counts. Changing their hearts and minds is the best way to change their behavior.

Art's work blew me away. In it I saw compassion, a spiritual value, operationalized into a testable scientific theory. Perceptual psychology has changed my career as a physician, having provided an important bridge between science and spirit.

The hallmark of perceptual psychology is to treat individuals as people, not as things. What you learn from me if I attempt to mold your behavior by punishment or reward is not likely to stick for long, once my scolding or praise is withdrawn. What you learn from me because I have come to understand what really motivates you is more liable to last. So, as a perceptual psychology kinda guy, I spend way more of my day listening to patients, trying to understand what makes them tick, than I spend telling them what to do.

There are plenty of scientific studies which show that health professionals who learn what motivates their patients are much more successful in getting them to take their medication as prescribed or to modify their health habits. It's even a scientifically proven fact that a real relationship with her patients is the best protection a doctor can have from being sued for malpractice.

Why then are so many doctors stuck in a behaviorist mode? Because the so-called scientific worldview that has been with us since Descartes and Newton, that people are merely very complex machines, is still the dominant metaphor in our culture. (These 17th century philosophers did posit the existence of a soul, but they never figured out how an immaterial soul could interact with the stuff of a body-machine.) I say "so-called scientific" because, as Art Combs and his collaborators showed in numerous repeatable, scientifically sound studies, a broader view of human nature is much closer to the truth than is a black box machine, limited to receiving stimulus inputs and outputting behaviors.

Art Combs practiced what he preached. Up until the day he died, in his 88th year, he listened closely to and learned from those around him. He was a simple guy who held, unshakably, a profound spiritual and intellectual belief in the value of each person and of each person's experience. That's how he trained teachers. That's how he did psychotherapy. That's how he treated friends, colleagues, acquaintances, and even enemies. Art's beliefs made him strong, flexible, resilient and, most of the time, even happy.

Buddhists sometimes describe their core practices of compassion and meditation as scientific, rather than as spiritual or religious. "Test them," they insist. "See if these ways work, if they make your life better and make you feel happier."

Art had learned transcendental meditation in the early 1970s, during the wave of popularity of Maharishi Mahesh Yogi, and, for the rest of his life, began each day with 20 minutes of silently chanting his mantra. Art's meditation practice no doubt contributed to the happiness and productivity of his life.

It would appear that there are parts of our being that we can understand better by scientific means and others better by spiritual means. For me, perceptual psychology has greatly blurred that distinction. Both as a practicing physician and as a plain old perceiving being, I prefer things to be a bit messy, rich, and ambiguous, because that's how I believe we humans really are. And, ultimately, isn't that what psychological and spiritual practice is supposed to do, to help us know who we really are?

Marc Ringel, MD, is a family practitioner and writer based in Greeley, Colorado.