Q METHODOLOGY AS PROCESS AND CONTEXT IN INTERPRETIVISM, COMMUNICATION, AND PSYCHOANALYTIC PSYCHOTHERAPY RESEARCH.
This study will examine the assertions of Q methodology (Brown 1980; Stephenson, 1953) in terms of its critique of dualism/objectivism, its relationship to the linguistic and interpretive turns, and its relationship to contemporary psychoanalytic theory and research. One can indeed characterize the human sciences in general and psychology in particular as being in a state of extraordinary transformation (see for example, Gergen, 1985; Gergen, 1994, Sampson, 1978; Stephenson, 1977). Broad metatheoretical debates (Fiske & Shweder, 1986) are challenging traditional frameworks of thought, language, truth, and knowledge.
Stephenson (1953) the originator of Q methodology attempted to cultivate a science of subjectivity where self-reference became a locus for understanding the human condition. By blending interpretive methods with statistical-mathematical operations he articulated an alternative framework in the human sciences (Goldman, 1995). Of necessity, Stephenson scrutinized and critiqued the anomalous substructure of hypotheticodeductivism along with its ideologies of determinacy and objectivity (Stephenson, 1961). Q privileges the Peircian notion of abductory inference which valorizes indeterminacy, interpretation, and discovery. The frameworks for understanding human expressivity will therefore be interrogated in this project from the vantage points of Q methodology's central tenets such as factor theory and quantum theory (Stephenson, 1982), concourse theory (Stephenson, 1978) and abductory inference (Stephenson, 1961).
Building on Stephenson's earlier work in psychoanalytic theory and research this project will also contextualize contemporary neo-psychoanalytic frameworks and their relationship to Q methodology. Psychoanalytic theory is in the midst of a paradigm shift and hence is drawing on poststructural theories of language (Schafer, 1992), self-psychology (Kohut, 1971), quantum theory (Kohut, 1977; Scharov, 1992), and other interpretive perspectives. A psychoanalytic psychotherapy Q study will elucidate the abductive princples of Q methodology and illustrate how psychoanalytic practices such as self-representation, transference, and countertransference can be analyzed and understood.
Consciousness, Subjectivity, Self-, and Concourse Theory
Subjectivity according to Stephenson (1975) is essentially "the condition of viewing things exclusively through the medium of one's mind" (p. 100) as opposed to consciousness of one's perceived states (Stephenson, 1968). The modernist notion of "consciousness" can be traced to the Cartesian philosophy of mind, which instituted a subject/object cleavage that has become embedded in Western thought. Descartes conceived of the mind and body as separate but interacting entities. His theory located the body in space and time making it identical to all other bodies that are governed by mechanical laws. Minds, in contrast, were immaterial, private, immune from mechanical laws and governed by innate ideas, such as "unity," "infinity," and "perfection." This outlook with only minor objections became the "official theory" (Ryle, 1949) of mind in Western thought from the Renaissance onward.
Within this Cartesian framework, minds dwell in a world that differs from the physical world, and therefore they require a set of methodological tools through which their contents can be made known, analogous to the ways in which the contents of the physical world are extricated. This "methodology" espouses the notion that minds have a two-fold "privileged access" to their labors by way of consciousness and introspection. Ryle (1949) makes the following observation:
On the view for which I am arguing consciousness and introspection cannot be what they are officially described as being, since their supposed objects are myths; but champions of the dogma of the ghost in the machine tend to argue that the imputed objects of consciousness and introspection tend not to be myths, since we are conscious of them and can introspectively observe them. (p. 155)
Consciousness was defined as a state or a stream that can be made known by introspection or non-sensuous inner perception.
Thought was thus placed "inside" a person's mind, and with it consciousness and its contemporary usage as when one is "conscious" of something. Prior to Descartes there was really no notion of consciousness as in its current usage. The Latin root of consciousness comes from conscio, which means "I know with (someone) .... or, I share (with someone) the knowledge that" (Stephenson, 1980, p. 23). The ancient meaning of mind was communicational, cultural, and public, and not internal and private.
The objections to this framework of privacy theories and theories of the "ghost in the machine" were realized in the early work of Husserl and the later Wittgenstein (1958). This critique also found its way into contemporary metatheoretical discourses including Q methodology (Stephenson, 1953), philosophy (Rorty, 1979), neo-psychoanalytic theories (Kohut, 1977; Schafer, 1976), anthropology (Geertz, 1973) and more. All of these discourses fundamentally challenged the notion that consciousness and mind exist in any substantive sense. As Stephenson (1975) puts it, "Consciousness is rejected because what is involved is little more than a conversational matter. The human being, for us, is most profoundly a communicable creature, and communicability, not consciousness is what mediates . . ." (p. 100). That is, although there is agreement that thought is ideational, subjectivity does not exist in one's head. Subjectivity is a form of shared knowledge, an enacted document if you will, and is therefore public, cultur al, discursive, and communicable.
Hence, conversational possibilities as public discursivities for any subjective idea, fantasy, thought, or dream are empirical (material) and represented in Q methodology by what Stephenson (1975) has termed concourses. Concourse theory begins with actors' subjectivity and frames of meaning such as thoughts, feelings, dreams, beliefs, fantasies, and so on. These empirically grounded statements are embedded in the discursive codes of interpretive communities (Fish, 1980). Concourses and the subjectivity that they display about events, objects, thoughts, feelings, and so on are thus infinite and constitute the building blocks of Q studies.
Concourse theory is in principle semiotic theory of culture and communication. Concourses are structured in feelings and not facts; they are the cultural knowledges and social constructions that each of us can access both implicitly and explicitly. As Stephenson (1978) argues:
This is because concourses are not compilations of facts or information such as we learn systematically, but because `presentations' are feelings which are lived through on an everyday basis. Formal learning deals with fact and logic, with algebra, physics, grammar, etc. Presentations fend for themselves in ostensible learning and imagination, subject to fortuitous experiences, in common conversation, singing songs, viewing television, reading for fun, etc., in countless situations and musings, lived at random. (p. 13)
From this perspective, concourses are not self-contained systems of meaning that are cut off from the rest of the world as in the semiology and structural linguistics of Saussure (1966). Rather, concourses are representational of the common stock of knowledges, the "social recipes" (Schutz, 1967) in and through which we make the social world intelligible. They are dialogic (Volosinov, 1973) and defy an "individualistic subjectivism" in that they are suffused with social meanings from the outset.
Q technique begins with samples that are drawn from concourses and this allows for the representation of all forms of communication by statistical quantities of statements about any concept event, idea, or object. Individuals are then invited to rank order these items in relationship to some condition of instruction in terms of what they "most agree" with (+5) to what they would most disagree with (-5). The items so constituted are called a Q sort. Q sorts obtained by several individual or by one individual Q sorting under several conditions of instruction are duly correlated and factor analyzed by preferably the centroid method (due to its indeterminacy). Factor scores or factor "structures" suggest that clusters of persons have grouped the statements in fundamentally the same way. Interpretations of factors is advanced in terms of commonly held frameworks of meaning. The guiding principle here is that new ideas are formed in relation to concourses, not by logic, but by way of feelings and self-reference. M eanings arise out of the configuration of statements that are structured in feelings.
Our social worlds are created in and through clusters of mundane and ordinary conversations. Bakhtin (1986) typifies these sublanguages with his concept of the heteroglossia. For him the heteroglossia represents a multivocality of voices that resist unitary meanings. Bakhtin differentiated this notion from a monoglot text that conveys singularity of thought and discourse. The heteroglossia, much like concourses, situates society within a matrix of contradictory and diverse voices and conversations. Although Stephenson does not develop concourse theory within a framework of power, as Bakhtin did, concourses do reflect the discourses of linguistic communities. The Q sort and the formative nature of the factor structures allow for the statements in the concourse to display order, form, and pattern in relation to feelings. As containers of symbolic action, concourses contain cultural understandings and factors create structures of significations, and places them into an intelligible framework. Factors are create d from the vantage point of the self and hence Q methodology also includes a theory of self.
The notion of self as set out in Q methodology is not a reified transcendental concept. Instead, it can be thought of as a perceptual structure closely aligned to the ideas expressed in Gestalt psychology. Thus the notion of an essential self as argued in the essentialist tradition, and likewise the nominalist view which privileges the researchers' conceptions or inferences of what constitutes a person's self, are not applicable ontologies. Self is not a categorical construct in Q, rather it is thoroughly contextual, discursive, and social. It is formative, emergent, and contingent, an empirical abstraction prone to elaboration and understanding rather than reduction. Self, therefore, is not a categorical cover-all for subjectivity: it is flux-like in process, thoroughly empirical in its ramification...Without a doubt, the self is not the subjectivity of all experience called subjective (as that to which the person alone has access); but neither is it merely reflexive, as Mead believed, 'a cognitive rather t han emotional phenomenon.' Focalizing attention is reflexive. The structure it provides by way of our statistical theory, is an abstraction. (Stephenson, 1978, p. 34)
The self as so conceived is not a reactive or an observed agency, but is rather an active agent, that is, an assembly of self-representations that are articulated during the Q sort procedure.
The Linguistic "Turn"
Traditional theories of psychology are increasingly giving way to approaches that examine the everyday world of "ordinary" language, narratives, conversations, and accounts that create and constitute the world as we know it. This framework valorizes local knowledge claims and contests totalizing discourses and abstract universals (Geertz, 1983).
The linguistic "turn" in philosophy presents some pivotal challenges to epistemology in general and social science in particular. The later Wittgenstein (1958) proposed that the meaning of a language is derived from its social rules and use, and that various cultural formations as "forms of life" are constituted in sets of "language-games." He replaced his earlier "picture theory" of language with a position that suspended belief in the "cognitive transparency" of language. Wittgenstein (1958) claimed that philosophical problems arise when we "predicate of the thing what lies in the method of representing it" (#104). He explained: "A picture held us captive. And we could not get outside it, for it lay in our language and language seemed to repeat it to us inexorably" (#115). For Wittgenstein, our ways of representing and engaging the world are structured in our language, as opposed to empirical "realities." Hence, we constantly need to be wary of linguistic entanglements and bewitchments and attend to descri ptions of "the actual use of language" leaving the world "as it is" (#124).
The linguistic turn originates from the premise that language does not constitute an undistorted mirror of nature (Rorty, 1979). Roughly, the argument is that there are no genuine philosophical problems outside of language, and that philosophy and all cultural forms for that matter are constituted in language and language usage. As Rorty (1967) explains, these problems "may be solved (or dissolved) either by reforming language, or by understanding more about the language we use" (p. 3).
The linguistic turn is surely contentious; some of its critics have referred to it as an "eclipse of reason" or "as a culture that has lost its way." Nevertheless, contemporary linguistic philosophy and related theories of subjectivity raise a number of epistemological questions that need to be addressed, given that the linguistic foundations of all symbolic forms and knowledge-making have now become subject to critical interrogation.
Stephenson does not view language unreflexively as a transparent medium of communication. Concourse theory explicitly argues that languages are bound by local realities and interpretive communities. The indeterminacy of factor theory can grasp actors' frames of meanings or definitions of situations.
Q Methodology, Interpretivism, and Scientific Understanding
It is well known that Watsonian behaviorism replaced introspection, but neglected to take into account actors' meanings. The behaviorist project, as evident in Clark Hull's (1943) preference for the hypothetic-deductive method and causation, centered on the production of covering laws that aimed at confirming what had been reached deductively beforehand. The emphasis was on prediction and explanation of human action, but this disregarded the actor's frame of reference. The interpretive turn in part responded to the anomalies of the dominant paradigm by granting reasons and causes to actors' frames and meanings.
The methodological initiatives of Q methodology one could argue would be consistent with the interpretivist critique of essentialist/ foundationalist epistemologies. Western science has been dominated and guided by the notion that knowledge was about objects external to the observer and embedded in foundational actualities. This form of thought positioned a sharp separation between the observer and the object of observation. Throughout much of the twentieth century, foundationalism has been challenged in many of the major disciplines. One readily thinks of Kurt Godel in mathematics; physicists Niels Bohr and Werner Heisenberg; philosophers such as Ludwig Wittgenstein and Jacques Derrida; philosopher of science Thomas Kuhn; psychologists William James and William Stephenson and there are more. The common core in all of their theorizing was the notion that foundational "realities" were discovered to be illusive, moreover, this illusiveness was found to be disturbingly necessary (Pearce, 1989).
Epistemologically, Q methodology ruptures the boundaries between the scientific and interpretive frameworks. The anti-essentialist position in Q is expressed in its theory of self but also in relation to factor theory. Human expressivity has infinite moments and is fundamentally indeterminate and contingent. The multiplicity of self-referent possibilities in Q studies are never absolute and foundational but always contingent upon broad abductory potentialities that may be discovered through the indeterminacy of the centroid method of factor analysis (given that its equations can be solved in an infinite number of ways).
Q methodology, as we know, takes the actor's worldview and understanding as central to its investigative procedures. The end result of any Q study is the understanding of meaning and its explication. Q involves synthesis, advances subjective knowledges, and opens the possibility for finding truth-value in subjectivity. This process has roots in American pragmatism particularly in the scientific epistemology of Charles Sanders Peirce and his notion of abductory inference. Stephenson (1975) makes the following observation:
There are two uses of abduction in Peirce and both find themselves at ease in Q. One concerns pragmatic rules (a loose body of aphorisms, for example to try extreme conditions first) upon which experimental design and factor rotation are based. The other is the principle that "Abduction must cover all the operations by which theories are engendered" (Peirce, 1934, p. 414), but which cannot be deduced. (p. 56)
Abductory inference with its roots in understanding and discovery rather than the causal, covering law model of the hypothetico-deductive framework and positivism is central to Q methodology. As Stephenson (1975) states:
In this connection, therefore we do not accept the position of philosophers who hold that reality is known only to the senses (positivism)... We are satisfied with the premise of communicability per se...its immediate advantage is that it makes science possible for subjectivity, the mode of communicability that members of Vienna Circle and Wittgenstein ignored. (p. 102)
In a later manuscript on mind and factor theory Stephenson (1980) adds:
From this we have the foundation stones of positivism, that there need be nothing in a statement that requires interpretation as understanding. Its literal meaning is all that is has...but it is the first principle of our work, the distinction between statements of fact and statements of communicability, the former positivist, without self-reference or feeling--cold reason--and the latter the reverse, intrinsically self-referent and subject to belief and affectability. (p. 56)
Stephenson's critique of positivism is aimed at objectivism and hypothetico-deductivism and not naturalistic scientific procedures.
The human sciences, Giddens argues, are now in a crisis mode due in part to the collapse of the dominant paradigm or "orthodox consensus." This has resulted in the emergence of a multitude of interpretive and methodological frameworks in social (e.g., ethnomethodology, neo-Marxism, phenomenology) and psychological (e.g., social constructionism, narrativity) theories. Positivism, Giddens (1989) points out, has become an "empty word" in recent discourse. "No one exists now who would recognize himself or herself as a positivist. This has become a sort of scare term" (p. 53).
There is a growing consensus according to Giddens that the natural science model that traditional social science emulates is philosophically flawed. Conventional proponents of this framework believed that the highest aspiration was to develop a value-free deductive system of laws. In post-Kuhnian philosophy of science a hermeneutic or interpretive view of natural science has emerged whereby the actions of scientists themselves, as a linguistic community, had to be taken into account. Laws are fundamental to natural science, but they can only be meaningful when their interpretations are contextualized within theoretical frameworks. Natural science, "therefore, involves interpretive systems of meaning and the nature of science is involved in the creation of theory frames" (Giddens, 1989, p. 56).
Q lends credence to post-Kuhnian philosophy of science both theoretically and methodologically. Laws in Q are not conceived of as merely regularities or as statements of universal truths such as Newton's laws of motions or as in Hull's behavioral project. Generalizations, laws, or abstractions from theory serve pragmatic aims, as conditions of instruction in Q studies are guides to help the "scientist' conduct the inquiry. The idea here is not to subsume observations under a covering law, but rather to put clusters of signifiers within an intelligible framework. Instances of the generalization or law may or may not be observed. Abductive inference following Peirce (see Stephenson, 1975), rather than deductive inference, is at issue here in that laws are only indicative that something may be, but neither is nor must be. This conceptualization of scientific inference is consistent with post-Kuhnian philosophies of science that stress the contingent and formative nature of research. As noted, Stephenson's epist emology is interpretivist and it is also firmly positioned within the naturalist paradigm of quantum physics (Stephenson, 1982).
Although there are certainly areas of intellectual engagement and agreement between Q methodology and interpretivist methodologies, there are also sharp divisions. Q methodology considers understanding, meaning, and self-representation as fundamental to human inquiry, but also includes a mathematical-statistical empiricism steeped in quantum theory. Its route as a subjective science rests in its paradigmatic synthesis of the human and natural sciences models of inquiry.
Subjectivity and Quantum Theory
Historically, the extraordinary revolutions in scientific methodology in the mid 1920s, particularly quantum mechanics in physics, influenced Stephenson's epistemological outlook. Causality and immutability of laws were being challenged by notions such as uncertainty and relativity. Indeterminacy in the observations of the most elemental components in nature, paralleled by experiments concerning the properties of light, contested the fundamental underlying relationship between the observer and the observed. Neils Bohr in 1927 in what has since then become known as the Copenhagen interpretation of quantum mechanics emphasized the need to shift our customary ways of thinking about reality (Sucharov, 1992). In the sphere of microphysics, one now had to concede that knowledge-making was contingent and conjoint since interactions between measuring instruments and the observed were constitutive of the phenomena. Wave particle dualities, indivisibility of quanta, and the uncertainty principle are contradictory to c lassical physics, which is dependent on determinism, certainty, continuity, and sharp delineation between the knower and known.
Stephenson's theories of subjectivity are strongly aligned with quantum theoretical approaches. Central to this position is the notion that factor theory in psychology and quantum theory in physics have parallel mathematical-statistical foundations (Stephenson, 1982). The purpose of the former is to unfold the nature of mind; the aim of the latter to probe the substructure of nature. The classical Newtonian model of physics and the objective paradigm concerns itself with predicting events while quantum mechanics and the framework for a subjective science concerns itself with the clustering of systems of states. Newtonian physics is based on sense perception and observables as in R methodology, whereas quantum theory is based on the behavior of subatomic particles involving complex structures, mass phenomena, and systems of states not amenable to direct observation.
Although factor analysis in general is a method for classifying variables, along R methodology lines the variables are tests or traits. In Q methodology the variables are the Q sorts themselves. The interest therefore is in determining how individuals have classified themselves rather than being subject to the operational definitions of the researcher. At issue in any Q study is to design compelling experiments to elicit factor structure that are inherent in the phenomena rather than mere artifacts of the instrumentation. Stephenson incorporates the language of quantum theory and argues that unlike R, which involves itself with observables such as intelligence scores and attitudes or traits, experimentation in Q concerns itself with feelings and centrality of self. The statements of the Q sample are therefore measured in terms of saliency of feelings as systems of states.
The language of Q and quantum physics intersect both philosophically as well as at the statistical-mathematical level. The observer and observed are inseparable in Q, given that only the individual can measure his or her own subjectivity. Standardized instrumentation is therefore made inconsequential as one is primarily concerned with states or clusters of feeling rather than the intrusion of instrumental effects.
Self-psychologically informed psychoanalysts have been attuned to the quantum theoretical perspective (Kohut, 1977; Sucharov, 1992). Epistemologically, quantum physics has been employed by self psychologists as a corrective to the Newtonian psychoanalytic framework. The Freudian mechanistic view of unconscious interaction between analyst (measuring instrument) and patient (as observed data) assumes a separation between the observer and the object of observation. Freud theorized the notions of transference (observed data) and countertransference (distorted measurements of the analyst) as separate manifestations. Drawing on quantum physics Kohut (1977) recognized that observer-object interactions are indivisible and constitutive of phenomenon. The introspective empathic stance that Kohut subsequently theorized involves complementary modes of description that recognizes subjectivity, uncertainty, and contradiction. While the self-psychological perspective provides an alternative to the mechanistic view its meth odology of free association as a research tool can be cumbersome and lengthy. Q, as will be shown in the single case study, can provide an operational basis for the self-psychological framework.
Subjectivity and Psychoanalytic Theory
Within psychoanalysis and psychology for that matter (see for example, Gergen, 1991; Sampson, 1991) obsolete Cartesian-motivated theories of mind are contested by viewpoints that stress self, self as agent, and subjective experience. Psychoanalysis has certainly not been immune from the paradigm dialogues within contemporary philosophy, psychology, and social theory. Classical psychoanalysis has primarily been interested in intrapsychic processes and drives, so that even when communication with external environmental objects became apparent it was considered secondary as in the concept of secondary gain. The Freudian mechanistic language and model of mind as mental apparatus has subsequently been contested and theorized within self-psychological (Kohut, 1984), interpretive (Levy, 1980), and linguistic perspectives (Shafer, 1992). Self-psychological and narrative (Schafer, 1976; Spence, 1982) psychoanalytic theorists have been embracing a plurality of interpretivist and interactionist traditions.
Kohutian self-psychology ushered in a paradigm shift in both the theory and practice of psychoanalysis. Kohut's early papers on empathy (1959) and major books (Kohut, 1971, 1977, 1984) have been the building blocks for an increasing proliferation of publications and theoretical discourses. The psychoanalytic intersubjectivists (Atwood & Stolorow, 1984) have relied extensively on phenomenology to extend Kohut's ideas, arguing that psychoanalysis is fundamentally a hermeneutic science. Goldberg (1990) and his colleagues, however, have argued that phenomenological analysis can be embellished with data from the neurosciences and infant development.
As a cultural psychology, psychoanalysis has been increasingly situating itself within an action orientation that draws much of its inspiration from philosophies embedded in the linguistic and interpretive turns (Levy, 1980; Schafer, 1992). The notion of self from Kohut's (1977) perspective as force, much like an instinctual drive akin to or as a replacement for Freud's pleasure principle, is being replaced by a view of self as agent or author of experience. Levy sees dialogue as most central to psychoanalytic interpretation. Drawing on Geertz (1973), he likens psychoanalytic theory and interpretation to an ethnography whereby structures of meaning and significations are explicated through "thick descriptions." The analytic dialogue is much like a text that the analyst constructs a reading of it by examining its import and interpreting the already fashioned interpretations produced by the person.
The narrative framework argues for a socially constructed sense of self hood, whereby experience is crafted by the actor and recognizable in actions and ordinary language. Schafer (1992) explains it this way:
With reference to self...for the individual subject, the self is always a narrative construction, always open to flux, and so never totally settled once and for all...Thus, unlike other current and popular positions, my position on the self is anti-essentialist; I do not regard the self as an entity found in nature and available for detached study by nonparticipant observers. Selves are told through dialogue, in words images and enactments and they are retold by observers whose narrative preferences and strategies express specific aims, values and competencies. (p. xvi)
Spence (1982) tends to focus less on the formal narrative structure in psychotherapy. From his perspective, the analyst attempts to discover the appropriate linguistic forms for expressing the unconscious material of the client. Spence terms this "narrative truth," which unlike "historical truth" is not an accurate representation of the past but rather a creative way of placing the clients unrecognizable experiences into a manageable framework. Change occurs by new "truths" that the analyst facilitates during the therapeutic encounter, rather than on the basis of historical precision.
These discourses contest the Newtonian outlook and challenge the classical psychoanalytical paradigm in matters such as historical truth, subjectivity, and empathy. However, their methodology, which relies primarily on free association, can create distortions in their research practices.
In theory and method, Q recognizes communication, self-reference, and subjectivity as fundamental to psychoanalysis (Goldman, 1991). Q also subverts psychoanalytic essentialism and turns its attention to ordinary language and action. The existence of substantive psychical processes such as consciousness, unconsciousness, mind, and so forth, are challenged and replaced by a framework that examines discernable actions performed by actors. Q technique can provide concrete readings of the subjectivity that is expressed in the psychoanalytic dialogue, including such issues as transference and countertransference as the case study discussed below will illustrate.
The concern of a self-psychologically informed psychoanalytic theory in light of Q methodology is therefore primarily concerned with communication and not with consciousness or intrapsychic processes. Stephenson (1954/1979) states it this way:
Thus, I take a forthright stand by including all of man's (sic) so-called subjectivity within the rubric of behavior. This includes what is ordinarily called mental, conscious, or unconscious states. It includes man's dreaming, thinking, musing, feeling and the like, all of which are examples of everyday behavior, every bit as much as is walking to post a letter or running to catch a train. All so-called subjectivity is just behavior. It is open to our objective regard.... (p. 3)
The unconscious can therefore be thought of as an enacted document, a form of communication that is prone to experimentation and understandings within concrete behaviorial segments. Although unconscious sets of actions are outside the realm of an actor's immediate experience, they are nevertheless intelligible frames of meaning that can be illuminated by the Q sorter and the factor structure that he or she creates. As structures of subjectivity the unconscious can be reconstituted and symbolized through Q technique.
There have indeed been applications of Q to psychotherapy research. An extensive research program in client-centered psychotherapy initiated by Rogers and Dymond (1954) at the University of Chicago utilized Q technique. More recent studies in psychoanalytic psychotherapy (Jones & Windholz, 1990), comparative psychotherapy research (Ablon & Jones, 1997), and assessment of therapeutic outcomes (Westen, Shedler, & Harnden, 1997) have applied the Q sort procedure. Although these studies make use of Q sorts their applications have been within the R framework (objective) where the focus is on measuring individual differences, thereby negating the fundamental principles of Q methodology (Goldman, 1997; Rohrbaugh, 1997).
Q studies begin by defining a concrete situation, in this case, a patient undergoing psychoanalysis. The statements that are collected in conversations between the analyst and patient constitute the concourse of communication. Embedded in these languages or texts are the meanings and understandings of the analytic dialogue. Both analyst and patient interactions are contingent and integral to the phenomena, akin to Kohut's introspective empathic stance. The study becomes operational when samples are drawn from the concourse. Both patient and analyst are asked to represent each of their points of view by Q sorts under different conditions of instruction that are designed to emit the subjectivity inherent in the situation. Factor analysis illuminates the subjectivity and frames of meaning that both analyst and patient are subsuming. Interpretation by the investigator and/or patient and analyst brings the study to its conclusion.
The method of free association in psychoanalysis as a research procedure can be protracted, laborious, and unrewarding. As a corrective to this process, probes using Q technique can clarify and facilitate change in the treatment situation.
An issue that can be worrisome in the psychotherapeutic process is when the patient and analyst have misunderstandings of each other. That is, elements of transference and countertransference tend to confound (and if properly worked through resolve) the analytic process. Sullivan (1940), for example, presents the case of a woman who after 300 sessions falsely describes him as white-haired, old, and fat. Stephenson (1954/1979) reports similar difficulties between clients and graduate students in the clinical psychology program at the University of Chicago, during the early 1950s when he was associated with Carl Rogers. Misconceptions between clients and therapists are also reported by Parloff, Stephenson, and Perlin (1963) in the 'Case of Myra' and by Scandrett (1979) in group psychotherapy. Of interest in the 'Case of Myra' is the observation that change in Myra's condition occurred not in relation to the psychologist's conception of her within the treatment regime but rather in the direction of her own unde rstandings of herself. It seems that it would therefore be useful for the analyst to have some knowledge of the client's perceptions of her/himself prior to therapy and indeed in part to develop a treatment of plan on the basis of these understandings. Change it would seem occurs in relationship to self-relating conceptions.
A case already discussed in the literature (Stephenson, 1954/79) will be utilized to illustrate the issues discussed. The case involves an analyst and a patient undergoing analysis. Both analyst and patient performed three and four Q sorts respectively for a total of seven Q sorts with 96 statements for the following conditions of instruction:
1. Analyst describes his own best self, "What you are like at your best."
2. Analyst describes what the patient is like now.
3. Analyst describes what he himself is like now.
4. Patient describes himself as he remembers himself to have been before analysis began.
5. Patient describes what he thinks his analyst is like.
6. Patient describes him as he is now.
7. Patient describes what he is at his best.
The seven Q sorts were correlated, factored by the centroid method and rotated to 'simple structure' providing the data given in Table 1.
Conditions of Factors Instruction A B C 1. An best self 80 00 18 2. An: What patient is like 39 42 -09 3. An now (present self) 67 01 05 4. Pt remembered -07 61 -09 5. Pt: What An is like 10 00 51 6. Pt now (present self) 33 41 05 7. Pt's best self 13 -01 67 (Decimal points are omitted; loadings above .35 are statistically significant)
The factor structure reveals that Factor A involves only the analyst; Factor C only the patient, and Factor B includes both analyst and patient.
Factor A includes the analyst's self, best or ideal self, and what he thinks the patient is like now (Conditions 1, 2, & 3). The factor shows an adjustment between self and ideals but is also cross-loaded with Factor B which includes the patient's self now as well as the analyst's view of the patient. Rather interestingly the analyst is identifying with the patient and appears to be in a countertransference situation.
Factor B appears to be inflected with truth-value. It includes the patient's self, which is unadjusted in the Rogerian sense due to the lack of congruence between self and ideals, the analyst's perception of the patient, as well as the patient's memories of himself prior to entering treatment.
The structure in Factor C is surprising and appears as a projection of the patient's ideal self onto what he perceives the analyst is like, It's as if the patient's transference was upon his own ideal of himself. This would not be an unlikely scenario in light of the enigmatical analytic stance of the therapist. What else would the patient have to transfer upon other than his or her idealization of him or herself?
Clearly, this data is indicative of substantial misunderstanding between patient and analyst. Moreover, from a Rogerian perspective one would expect improvements to be in relation to the self-references of the patient (Factor C) rather than the conceptions of the analyst (Factor A). As this illustrates, Q provides valuable understanding of meanings that both analyst and patient bring to the psychotherapeutic process.
The study illuminates the human expressivity and self-representation that is fundamental to Q methodology. Issues pertaining to language and self as expressed by Schafer (1992), Levy's textuality (1980), and Kohut's (1977) self-psychology can find methodological companionship in Q.
Q methodologists find themselves in the midst of paradigmatic shifts. Indeed, as a framework for the study of subjectivity as both process and context, Q sets out a project that offers an alternative to existing interpretive perspectives. Too, while Q sorts are widely used, its methodological and epistemological world view tends to get obscured. This project was therefore an attempt to discuss the fundamentals of Q in light of the transformations in the human sciences in general and psychoanalytic theory and research in particular.
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