Centre For Theoretical Research In Psychiatry and Clinical Psychology
Bringing Light to the Dark
The lack of balance between theoretical and empirical approaches in psychiatry limits progress and impedes the success of research in achieving true outcomes. Novel well-developed ideas are needed to achieve balance; fresh perspectives should be encouraged and not discouraged. Framing a theoretical paper as a review article makes it easier for open-minded editors and reviewers to accept it, and a good theoretical publication typically includes a solid review of the relevant literature. Fortunately, psychotherapy journals tend to be more open to theory than psychiatry journals and often constitute the best option, but of course the topic must be psychotherapy relevant and framed in this way. An important component of theoretical research is learning to work with reasoned feedback from reviewers, and to persevere through reviews by those clearly biased against theory.
Conscientiousness is one of the "Big 5" dimensions of temperament/personality, and like openness to experience greatly assists in producing robust theoretical research. Good theory requires a high degree of conscientiousness pertaining to research, concept generation, fitting of concepts to research data and clinical experience, revising and refining ideas, applying a devil's advocate approach, writing, editing, and responding to reviewers' feedback. Developing solid routines and habits assists in generating a momentum and even "flow" experience. For those low in conscientiousness the challenge is much greater, but solid adherence to the guidelines provided can compensate.
Believe in what you are doing by appreciating the value of theory for good science. Understand that various perspectives pertaining to a complex topic can each have merit, meaning that there might not be a single right answer. Realize that the current status quo of psychiatry and medicine is highly oriented to short-range product generation. Although theory does not align with market objectives in the short-term, fresh ideas and novel approaches are likely to hugely benefit long-term product generation; in business innovation equates with growth. The "right thing" for psychiatry is a balance of theoretical and empirical approaches, requiring a major ramping up of the former.
Ask the Right Question
Frequently we ask the same questions expecting unique answers. A critical component of theoretical research is asking the right question. The nature of a question guides responses, with novel questions leading to novel solutions. Try asking a different question such as "Might hypomania be a treatment for depression?" instead of "How should we treat hypomania?" A quick consideration of these two questions suggests that a novel theory is more likely to come from the first one. Asking different questions is an excellent way to break fixated points of view aligning with the status quo, and shift to creative options.
Research, Research, Research!
Good theoretical research does not occur in a knowledge vacuum. Any time spent thinking about a concept will at least be matched by time seeking out, acquiring, reading, and assimilating relevant articles and books. Research reveals the current state of knowledge and existing theoretical propositions for a given topic. Access to academic search engines such as Medline, Embase, and PsycInfo is crucial, as is developing skill in selecting search terms that yield the most information. Non-academic search engines such as Google also yield relevant information often not obtainable from academic searches.
Think, Think, Think!
Theoretical research is a 24/7 way of life. Isaac Newton when asked how he came up with his concepts replied, "By thinking about these things for a long time." New insights can occur at any time, and need to be well thought through or jotted down for later consideration. Play with ideas using creativity, free association, and concept linkage. Allow yourself to mentally travel down various paths, many leading to dead ends. Appreciate the value of short and longer term breaks for overcoming fixations—Novel insights often follow a refreshing break from thinking, and particularly so when trapped in a fixated train of thought. Research and idea generation must exist in balance, and balance in life facilitates success in theory development. Physical activity, even consisting of long walks, is one aspect of balance that can be particularly effective in enhancing and maintaining the capacity for insightful thinking.
Apply a Cross-Discipline Approach
The truth does not respect what are typically artificial man-made boundaries separating one discipline from another. A robust theory will usually consider and incorporate diverse perspectives. The resulting theoretical product will be more comprehensive, less likely to represent a fixated and rigid point of view, and will have considered many potential objections. The sub and sub-sub specialty focus of academic medicine ironically works against good theory generation! Apply knowledge from disciplines including psychiatry, psychology, biology, neuroscience, sociology, anthropology, evolution, and even physics. To acquire this knowledge cross-discipline research and reading is essential.
Best of Fit
There are three ways to test a theory: Fit with existing research data, fit with experiential data, and empirical testing. Theory generation in psychiatry and clinical psychology utilizes best of fit with both existing research data and clinical experience. To evaluate best of fit with the former extensive research and reading is essential. To assess best of fit with clinical experience exposure to a wide range of patients is a major asset. In select instances small-scale empirical data can be generated to test ideas during the process of theory development. Large-scale empirical testing is important but some theoretical propositions do not readily lend themselves to this form of evaluation. Some scientists hold the belief that unless a theory can be empirically tested at the present time it should not be generated. If so many concepts in science such as string theory in physics would not be proposed, and a growing notion is that theories can be generated before the means to empirically test them have been developed. Even when feasible empirical testing can be highly subjective and biased due to statistical, reporting, and conflict of interest influences.
Be Flexible with your Ideas
If your theory does not represent a best of fit with existing research data and clinical experience revise or scrap it—Avoid forcing a square peg into a round hole! However, be wary of isolated results that are most likely non-reproducible. Be careful not to rigidly adhere to earlier viewpoints because theory generation usually involves an evolution of ideas. Modify your theory to incorporate new evidence and insights. Going back to the so-called drawing board is far better than producing a weak theory and finding yourself in the position of trying to defend the indefensible. Be sure to apply a flexible approach throughout the process, and not just with idea generation.
Simplify Your Theory
A theory that cannot be explained to a child is probably not of much use according to Einstein. Robust theories adhere to the law of parsimony—The simplest theory is usually the most accurate because ultimately the truth is simple! The fewer words to explain a theory the more robust it is likely to be. A good theory also provides a story that often resonates with people.
Discuss Your Theory
Theory creation qualifies as a lonely art. On the positive side, isolated research assists in detaching from the status quo, thereby helping foster novel perspectives. On the negative side the isolation can produce distorted perspectives that do not fit with research data or clinical experience. Discuss your theory with a trusted colleague/s willing to play devil's advocate. Adopt this role and apply it to your own theories—You should be your toughest critic!
Learn How to Write
Publication of your theory in a peer-reviewed journal or book is an important goal requiring writing ability. Clear and economical writing challenges and sharpens the precision of your theories; ideally the thesis can be presented in a few sentences as in an abstract. Write in a fashion that can be followed by a diverse audience to facilitate cross-discipline communication. If you have trouble writing the best way to learn is simply to write, even journaling ideas. Manage "writer's block" by understanding the relationship between performance and motivation—Performance for other than simple rote tasks is optimal with moderate motivation and falls off when motivation is either very low or high. Writer's block typically involves excessive motivation. If you experience "writer's block" reduce excess motivation via relaxation strategies. Learning how to present material to an audience verbally and visually is an add-on to the writing guideline because it helps promote your theory.
Select the Right Journal
There is too much emphasis on high impact factor journals, with researchers focusing on these journals to advance careers and conducting the type of research that sells. Select a journal that fits with your topic particularly if the journal has published similar or relevant articles, thereby demonstrating editorial interest in it. At times the same basic theory can be published in different journals with divergent foci and audiences, so long as the theory is oriented accordingly. Pay attention to the submission requirements of the journal you select, such as maximum word count for the abstract and article.
The Dark Side!
Unfortunately, there is substantial resistance to theory present in psychiatry, and certainly compared to neuroscience and physics. Editors of journals are those who have succeeded in a system opposed to theory, and hence are often not open to theory. Many seem to serve as guardians of the status quo, and theory by its very nature challenges the status quo. Most psychiatry journals do not publish theoretical articles, or only do so via "invited" or "solicited" articles aligning with the editors' views. Editorial bias is a major problem in academic publishing and one that typically does not favor theory.
Following these guidelines greatly enhances the quality of
A Spirit of Open-Mindedness and Curiosity
Openness to experience is one of the "Big 5" dimensions of temperament/personality. Simply observing clinical states in an open-minded fashion is often a starting point for novel ideas. Appreciate how embedded we are in the status quo, and how detaching from it fosters fresh perspectives. Realize that in time the current status quo will likely not be considered valid. An inquisitive, curious, and creative nature assists in theoretical research; research as a way of life, and not a means to an ends!