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Why politicians should have backgrounds in clinical psychology

Alex Lickerman, MD
Physician
May 14, 2013
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Of all the different criteria people use when deciding for whom to vote in presidential elections, I’ve never heard anyone talk about the importance of a background in clinical psychology—but it’s always struck me as important for a president to have as for a clinical psychologist. Certainly, foreign policy experience, a firm grasp of the principles of economics, a bold and confident leadership style, and the ability to get people to work together are all critically important—but a moment of reflection is all it takes to realize that all of these abilities spring from an understanding of and ability to leverage the principles of human psychology.

Our scientific understanding of these principles has finally advanced far enough—and in many cases has been found to be counterintuitive enough—that, as wise as any one of us may be in our personal lives, compared to trained clinical and research psychologists, we’re all a bunch of amateurs. As a result of our politicians’ distinct lack of psychological expertise, we’ve experienced—and will continue to experience—a number of significant policy failures. Why? Because at its core, public policy achieves societal improvements by changing the behavior of its citizens. How can a policy be expected to achieve its purpose if it’s not then grounded in a correct understanding of human psychology?

Consider, for example, the war on drugs. It’s hard to imagine anyone thinking today that this policy has achieved its objective: data suggests that the percentage of people addicted to drugs now is just about the same, if not slightly more, than when Nixon declared war on drug use in the 1970s. My point here isn’t that the goal is a worthy one (though I think it is). My point is that the strategy—the policy—designed to reduce drug use has failed because it wasn’t grounded in science. Certainly in the 1970s the science wasn’t yet known and it was generally accepted that addicts were addicts because they were weak-willed, lazy, and hedonistic. But now we know just how ineffective willpower is in helping people resist temptation, especially people whose brain chemistry has been altered by chronic substance abuse. We don’t generally blame people for contracting Parkinson’s disease. Yet perhaps because all addictions begin with the willful choice to experiment even now we continue to blame addicts for their inability to free themselves from their addictions, and policy makers continue to believe if we only make the punishments for using drugs more and more severe most people will stop trying drugs and most addicts will stop using them.

Consider as a second example the use of torture. Though most of us find our country’s use of torture morally barbaric, little research has actually been done on whether it actually works. (For obvious reasons we wouldn’t conduct a randomized, prospective trial to answer this question. But as people have been tortured and continue to be tortured around the world, we can ask the question “Does torture work?” in a scientific way even as we provide succor to its victims.) Though it may strike some as immoral even to be interested in studying this question, to do so might end the debate once and for all: for what if science proves that torture doesn’t work? (In fact, here is an example of a study that suggests just that). Then the debate is over before it’s begun.

What about the debate raging in New York about banning the sale of over-sized sugary drinks? Science suggests that the consumption of these drinks contributes to the rates of obesity and other illness. So getting consumers to drink fewer of them would seem like a good idea. But again our politicians may be putting policy before science, for here is an example of a study that suggests such a ban would actually increase consumption of sugary drinks.

One problem, of course, is that scientific understanding proceeds slowly. It can take many years, if not decades, to confirm findings. And politicians are notoriously impatient to take action in general for obvious reasons. But if our politicians only had a rudimentary understanding of how science works, perhaps the most important question about any policy up for consideration would not only have a better chance of being asked (before ever needing to entertain the questions of ethics, morals, politics, or constitutionality), but also of being answered correctly: will it work?

Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World.  He is the author of The Undefeated Mind: On the Science of Constructing an Indestructible Self.

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