Developmental psychopathology as a meta-paradigm: From zero-sum science to epistemological pluralism in theory and research

In a thoughtful commentary in this journal a decade ago, Michael Rutter reviewed 25 years of progress in the field before concluding that developmental psychopathology (DP) initiated a paradigm shift in clinical science. This deduction requires that DP itself be a paradigm. According to Thomas Kuhn, canonical paradigms in the physical sciences serve unifying functions by consolidating scientists' thinking and scholarship around single, closed sets of discipline-defining epistemological assumptions and methods. Paradigm shifts replace these assumptions and methods with a new field-defining framework. In contrast, the social sciences are multiparadigmatic, with thinking and scholarship unified locally around open sets of epistemological assumptions and methods with varying degrees of inter-, intra-, and subdisciplinary reach. DP challenges few if any of these local paradigms. Instead, DP serves an essential pluralizing function, and is therefore better construed as a metaparadigm. Seen in this way, DP holds tremendous untapped potential to move the field from zero-sum thinking and scholarship to positive-sum science and epistemological pluralism. This integrative vision, which furthers Dante Cicchetti's legacy of interdisciplinarity, requires broad commitment among scientists to reject zero-sum scholarship in which portending theories, useful principles, and effective interventions are jettisoned based on confirmation bias, errors in logic, and ideology.

Regaining Autonomy in a Holding Environment: Patients' Perspectives on the Existential Communication with Physicians When Suffering from a Severe, Chronic Illness: A Qualitative Nordic Study

Patients experience existential themes as pivotal in their lives, in order to be able to live with a severe, chronic illness; however, physicians report a hesitative approach to existential communication. The current study investigated Nordic patients' experiences of existential communication with their physicians related to the treatment of multiple sclerosis or chronic pain. Semi-structured interviews with 23 patients were analyzed following Interpretative Phenomenological Analysis. Physicians focusing on medical aspects at the expense of psychological and existential aspects of being ill was experienced by patients as challenging their treatment and well-being. For making a shared decision with the physician on their treatment, patients needed a transition from being dependent to being autonomous. A holding environment and existential communication about transitional objects such as relationships with something bigger than themselves, as nature or religion, supported this autonomy. The analysis showed that existential communication not only supported patients in developing and regaining autonomy but also functioned as a moderator for illness-related distress, as a prevention of withdrawal from treatment, and as significant for patients in relation to living with chronic illness. Further education in existential communication is desirable, to support physicians integrating existential dimensions in consultations and shared decision-making with patients suffering from a severe, chronic illness.

Addressing Religion in Secular Healthcare: Existential Communication and the Post-Secular Negotiation

This article aims to understand why religion has proven difficult to address in secular healthcare, although existential communication is important for patients’ health and wellbeing. Two qualitative data samples exploring existential communication in secular healthcare were analyzed following Interpretative Phenomenological Analysis, leading to the development of the analytical constructs of ‘the secular’ and ‘the non-secular’. The differentiation of the secular and the non-secular as different spheres for the individual to be situated in offers a nuanced understanding of the physician–patient meeting, with implications for existential communication. We conceptualize the post-secular negotiation as the attempt to address the non-secular through secular activities in healthcare. Employment of the post-secular negotiation enables an approach to existential communication where the non-secular, including religion, can be addressed as part of the patients’ life without compromising the professional grounding in secular healthcare. The post-secular negotiation presents potential for further research, clinical practice, and for the benefit of patients.

The Epistemic Imperialism of Science. Reinvigorating Early Critiques of Scientism

Positivism has had a tremendous impact on the development of the social sciences over the past two centuries. It has deeply influenced method and theory, and has seeped deeply into our broader understandings of the nature of the social sciences. Postmodernism has attempted to loosen the grip of positivism on our thinking, and while it has not been without its successes, postmodernism has worked more to deconstruct positivism than to construct something new in its place. Psychologists today perennially wrestle to find and retain their intellectual balance within the methodological, theoretical, and epistemological struggles between positivism and postmodernism. In the process, pre-postmodern criticisms of positivism have been largely forgotten. Although they remain deeply buried at the core of psychology, these early alternatives to positivism are rarely given explicit hearing today. The current piece explores some of the early critiques of positivism, particularly of its scientism, as well as early suggestions to tip the scales (back) in favor of sapientia (“wisdom”). This third option, largely overlooked within mainstream psychology, is of tremendous value today as it is both deconstructive and constructive relative to the shortcomings of positivism. It avoids the overly reductionistic “trivial order” of positivism, as well as the deeply unsatisfying and disorienting “barbaric vagueness” of postmodernism, while simultaneously embracing important core elements of both currents of thought.

Psychology’s epistemic projects

What are the epistemic projects of psychology? What insights does psychology seek to produce, and what kinds of knowledge are adequate for the psychological challenges of contemporary worlds? These are the fundamental questions we address in this special issue. Dating back more than a century, psychology emerged as a discipline in a specific context with specific challenges and tasks. Since then, societies, humans, and the world have changed, and the pace itself at which changes take place has accelerated considerably over the past couple of decades. It is time to pause and revise psychology’s epistemic projects. More than finding solutions to particular shortcomings, the discipline needs to reflect on how psychology comes to define particular phenomena as areas of scientific concern, what kinds of phenomena are relevant and for whom, and how the disciplinary shaping of psychological concerns has a bearing on what can and will be researched.