Science is Process

Here's a fun revelation from my second term in Marriage and Family Therapy: we're all a little "disordered," and that's perfectly okay.

As a teenager, I saw interviews with women saying they were happier after 30 because they accepted themselves and their bodies more. I didn't believe it then. But now that I am over 30, I do. I attribute it to maturity, but it might be something else (please comment if you have a take on this). I find myself turning toward others with curiosity, wondering what life is like for them. And even though I've heard it countless times before, I finally accept that perfection does not exist—in others or ourselves. So, we are better equipped to make peace with everyone, starting with ourselves. Cognitive Behavioral Therapy (CBT) reminds us that we are often our worst enemies and that reframing is healing. Age, I would argue, is a fantastic tool in this reframing and healing process. I guess I am also more open to seeing how "disordered" I am.

I've been diving deep into the DSM (that's the Diagnostic and Statistical Manual of Mental Disorders, for the uninitiated). It's essentially the encyclopedia of mental health diagnoses that professionals use to identify and categorize psychological conditions. The more I study it, the more I realize I'm on the spectrum for... well, almost everything. And guess what? You probably are too.

The DSM: What It Is (and Isn't)

Let's be clear: the DSM isn't a book about why people develop certain conditions—it's a guide to recognizing them. Like a birdwatcher's guide, it won't dive into the evolutionary history of why the bird developed those traits—it'll just help you identify which bird you're looking at and where you might find it.

Here's something fascinating: the DSM keeps changing based on what actually works in therapy, not just on new theories. Take psychosis, for example. We used to think there were five distinct types of psychosis, each needing its own approach. However, therapists and researchers kept noticing that their patients didn't fit neatly into these boxes. More importantly, they saw that flexible treatment approaches working across different types of psychosis often got better results. So what did the DSM-5 do? It turned these categories into 'specifiers' – more like different flavors of the same experience that can shift over time. This wasn't because someone discovered the 'true cause' of psychosis. It changed because therapists in the field said, "Hey, this other way of looking at it helps us help people better."

This focus on what works in practice rather than perfect categorization makes an interesting gap stand out: family systems. While the DSM has evolved to be more flexible with individual diagnoses (like discontinuing its multiaxial diagnostic system), it's still surprisingly quiet about family dynamics. You won't find 'dysfunctional family patterns' as a diagnosis, even though we know family relationships can be at the heart of both problems and solutions. It's like the DSM acknowledges that individual symptoms exist on a spectrum, but hasn't quite figured out how to capture the spectrum of family dynamics that often drive these symptoms. This is where practitioners like Gottman come in...

Gottman: When Science Meets Practice

One thing that strikes me about the DSM is how little it explicitly addresses family systems. Yet in real-world therapy, we know that relationships and systems play a crucial role in both problems and solutions, especially when issues are central to family life. This is what makes psychology fascinating to me—it's a constant dialogue between research and reality, between what we believe and what we observe. Clinical practice and research need to reinforce each other, and in many ways, psychology has done an excellent job of integrating both. It's not just about applying formulaic solutions; it's about understanding each unique situation and adapting our approach accordingly.

John Gottman exemplifies this balance between research and practice. He started by identifying patterns, like how he could predict divorce with over 90% accuracy based on certain behaviors. For instance, he found that stable couples respond to each other's bids for attention 86% of the time, compared to just 33% for couples who later divorced. He also identified the infamous "Four Horsemen" of relationship apocalypse: criticism, defensiveness, contempt, and stonewalling. But here's what's really fascinating: he observed that couples could experience all four horsemen and still have a healthy marriage—if they were good at repair attempts. A well-timed joke or a sincere apology could make all the difference in keeping a relationship on track. It wasn't about avoiding conflict entirely; it was about how couples recovered from it.

Together with his wife Julie, a clinical psychotherapist, Gottman transformed these research insights into practical interventions. Their collaboration bridged the gap between understanding relationships and actually helping couples. Studies show that couples who complete Gottman Method Therapy report a 75% improvement in relationship satisfaction.

What Economics Could Learn from Psychology

A science that, in my view, struggles to integrate practice and research is economics. Instead of endless debates about causation, we could focus more on developing practical interventions. And to do that, we need practitioners from the fields that are being researched.

No effective intervention in education can emerge without involving teachers. The same applies to health, sustainability, and all other subjects economics tries to study using randomized controlled trials (RCTs) or complex econometric models, often without real-world expertise. To create meaningful interventions, one must understand the nuances of the field—not just analyze it from a theoretical distance.

I don't say this to offend anyone—it's not my intention. I'm no PhD, but I completed a rigorous undergraduate degree in economics. I know economists are incredibly smart, and it breaks my heart to see so much human potential going into getting grants and mastering sophisticated models that often don't translate into real-world impact. There's almost a market failure problem here: an overproduction of theoretical knowledge with limited application. I would love to see all this brainpower redirected toward creating effective interventions.

Economics has long been dominated by abstract modeling, but solutions are not created in abstraction except for theoretical sciences like mathematics or philosophy. If economics wants to be truly effective, it must embrace a more applied, hands-on approach grounded in real-world expertise.

The Bottom Line

Science is a process—not an endpoint. We will never have an absolute truth. Instead, we must refine our understanding through constant testing, iteration, and adaptation. Karl Popper taught us that a hypothesis can only be falsified, never verified. If we will never know what is ultimately true, then science should at least aim to create useful hypotheses that improve our lives. And, most importantly, actionable solutions. The world desperately needs that.

Instead of fixating on uncovering root causes, we should focus on discovering effective treatments. The most important question is not "Why does this happen?" but rather "What can we do about it?" We might still want to discuss chicken or egg dilemmas, but only if they will interfere with treatment. Whether in psychology, economics, or any other field, the goal should be to create interventions that make life better—not just theories that explain why things go wrong.

References:

1. American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
2. Gottman, J. M., & Silver, N. (2015). The Seven Principles for Making Marriage Work: A Practical Guide from the Country's Foremost Relationship Expert. Harmony.
3. Popper, K. R. (1959). The Logic of Scientific Discovery. Routledge.
4. Metcalf, L. (2019). Marriage and Family Therapy: A Practice-Oriented Approach (p. 80). Springer Publishing Company.