Evidence-based?
In the world of psychology, there's a powerful and often-praised concept: evidence-based practice. At its heart, the idea is simple and logical—use methods that have been proven to work. On the surface, who could argue with that? We want therapy to be effective, and we want to know it is.
But what if this approach, in its rigid application, has become less of a guide and more of a cage? What if, in the pursuit of what can be measured, we've started to dismiss what truly heals?
The Problem with a Narrow View
The reality of therapy is complex. It's not just about applying a formula and getting a predictable result. It's about sitting with another human being and grappling with their unique lived experiences—the pain, the mystery of their suffering, and the symbolic life of their psyche. These profound, often messy, aspects of human experience don't fit neatly into the checkboxes of a randomized trial.
This is where the trouble begins. When certain therapeutic approaches, like those focused on the symbolic or deeply personal narratives, can't be neatly quantified, they risk being dismissed as "unscientific." The work isn't seen as valuable because it fails to fit the bureaucracy of funding streams and insurance criteria, not because it fails the person seeking help.
The danger is that we begin to prioritize what's easily measured over what's actually meaningful.
Evidence Should Serve, Not Police
Evidence is a tool that should serve the purpose of helping people. It should inform and guide practitioners, not dictate every move they make. When the focus shifts to a rigid hierarchy of what "counts," based solely on randomized trials, we risk losing sight of the core of what therapy is: a dynamic, human-centered process.
When we stop listening to the subtle, powerful truths that emerge in the therapeutic room and listen only to what can be quantified, we betray both the people who trust us with their well-being and the very spirit of the profession itself. The goal of therapy is healing, not control.
The question isn't whether we should value evidence. It's whether we've allowed the politics of evidence to strangle the very soul of the work.
