by Thelma B. Freedman, M.A.
Shortly before closing this issue of the Journal, I asked Thelma to share with our readership her thoughts and wisdom on this vital topic. The need to encourage research looms so importantly in my own thinking, that it also became the topic of the Editor’s Page. (Did you take the time to read it?) In a manner so typical of her, Thelma drew from her knowledge and experience, and penned the following. I am not sure whether it is most appropriately called an article, an encouraging lesson, a set of instructions, or an admonishment. Perhaps all four. First and foremost, it presents the reader with thoughtfully prepared and practical advice. Her style is simple and direct, the true sign of a teacher-mentor. The message is clear for those who read it – and, after all, is not the mark of a wise person the ability to recognize and heed good advice?
– Russel C. Davis
Our Editor has, in his opening statement in this issue, compared research to the typically American gathering known as the “potluck.” At a potluck, everyone brings something, whatever they can, be it a simple basket of apples or a complicated and risky new main dish. I attended a potluck dinner recently where a footloose bachelor arrived with the paper plates and cups, and these too are vital to the success of any potluck! Whatever the contribution, all are necessary and all are freely given and shared.
Russ has chosen an apt metaphor. It fits research at its best, and in a field as new and strange to others as ours, it is the approach we must take.
Where is our field, research-wise? What have we got, so far? It would be easy to reply “not much,” but that would not be true. Actually, we have established a bedrock and we are starting to build some recognizable structures of research upon that bedrock. Consider Wambach’s famous study (1978), Wambach and Snow’s survey of therapists (1986), Cladder’s work with phobics (1986), Lucas’ Mind-Mirror project (1989), Baldwin’s study in this issue of the Journal. These are inventive studies that enlarge our knowledge. All are controversial; that is probably unavoidable in our field. But all are also honest attempts to discover the dimensions of our field, and that is what good research should always be.
So, yes, we do have some research, and it is very useful. But mostly, we have case studies. All those case studies! Together they have become our bedrock. Although published case studies of reported past lives date from the 1860’s, it was in 1956 that Bernstein’s Bridey Murphy sparked our modern interest and led to their use in therapy. Continue through the years since then, through all the books, all the case studies published in the Journal, all the workshop reports. (I’m not going to name any because I would be sure to miss some and all are important). Over the years we have shared hundreds, a case study potluck, if you like.
Older, more established fields may claim that case studies are not really research. In the formal sense, of course, they’re not. But case studies are essential for a new field. They show us where our more formal research efforts should be focused. For example, one case study reporting one successful cure of migraine headaches by means of past-life therapy is interesting. Ten case studies by ten different writers reporting the same thing are electrifying. Here is an obvious lead for a formal research project testing the effectiveness of past-life therapy with migraine sufferers.
Continuing with this example, do you, as a therapist, work a lot with migraine sufferers? If so, you are probably familiar with the case studies in that area, and you probably agree or disagree with some points made. You may be ready to carry out a pilot project and then a formal study, testing your ideas, and to do these well.
You may have learned in school that research is research and therapy is therapy and never the twain shall meet. Forget this moth-eaten lesson. In our field, therapists are what we’ve got, for the most part. How many of you have access to large clinical populations, or to university psychology laboratories, funding sources, computerized statistical analyses, and classrooms of captive students? If you do, great; you can do a Really Big Project. But if you don’t, if you are a therapist who works alone, you can still do good research.
There are two traditional objections to therapist research, but you can do a lot to overcome them both. I’ll start with the first objection and discuss the second one later in this paper.
The First Objection
The first objection is that if a therapist is truly isolated from peers, working in a one-therapist office, and the research comes from this isolation, there is no way to be sure that the results are accurately reported. The concern here is that the therapist has a vested interest in being “right” and may skew results in the “right” direction. This can come close to accusing therapists of fraud, especially in a field as controversial as ours, and you want to do all you can to prevent such charges. It is a good idea to discuss your ideas and plan of action with a hard nosed friend who will not hesitate to criticize. That way, you will design your study from the start to meet those criticisms. Of course, the most basic thing is pretty obvious: be absolutely truthful in reporting what you did and what results you got, whether they support your ideas or not, and tape everything to prove what you say. Assuming honesty, there are several good ways to carry out good research as a therapist. I’ll discuss four that are actually do-able, starting small and working up to some more ambitious projects; and that’s a sound plan for us all! The first two do not avoid the isolated therapist’s problems entirely, but the third and fourth can do so if you plan your study right. I’ll continue with the migraine example throughout.
- The simplest kind of study, but one that can yield valuable information, is very feasible for therapists who have practiced past-life therapy for many years and who have kept good records (and release forms)! Suppose you have, over those years, worked with many migraine sufferers. If you have kept good records, perusing them might prove productive. Do your own cases support the published case studies? Do you find common factors? Are there things about your successful treatments that set them apart from the failures? If so, you have found something important and worthy of sharing at the research potluck. Of course, this kind of study requires that you have kept careful records. Hunches and general impressions are interesting, but they are not research.
You can expand this model by finding another past-life therapist who also works with migraine sufferers and also keeps good records. Do you both find the same things? What are your common factors and what are your differences? A retrospective study like this has some obvious weaknesses, but it also has one special strength: It’s based on actual clients, not specially gathered subjects. As hinted above, however, you’ll need release forms from those clients before you can discuss their cases in any detail, even retrospectively. If you don’t have them, you can still peruse your records and the case studies and design a survey of therapists (such as Wambach and Snow) to see if other therapists share your findings.
The above model uses clients as subjects, of course, even if retrospectively; that is inherent in the model. The next three do not, and this in itself makes them stronger. For isolated therapists, it’s probably best to advertise for your subjects. Taking a narrow, almost ridiculous, view, it’s even easiest to do so, because you will get them all at once and not have to wait until a suitable person walks through your office door. There are other, more serious, reasons for this method of gathering subjects, discussed below.
- This research model is a stronger approach, although it does not counter the isolated therapist objection. Your study does not have to be large. A study of, say, ten or fifteen subjects is very manageable for one person, and is especially useful if you are looking for common factors. It is also useful if you have some specific question about therapy. For example, how many of the migraine sufferers who improved did so after one session and how many needed more? How many did not improve at all? Fortunately for you, past-life therapy for problems like migraines is usually rapid, so you won’t have endless months of sessions to cope with and you can keep your therapy methods focused. Tape everything, and include follow-up in your report. Small studies like these are usually exploratory in nature and you won’t need the dreaded control group; they are really expanded pilot studies that may lead you into larger projects. Well done, they bridge the gap between one-case studies and formal research.
- The next two models are more ambitious and make an attempt to avoid the problems of the isolated therapist. The first is to come to an APRT Convention or place a notice in the Newsletter and find a geographically distant therapist pal or two with interests similar to yours. The two of you work out your plan of action (and, as Research Chairperson of APRT, I am ready to help with that if you want). Then you each go home to your isolation and carry out the plan, pilot study first with just a few subjects, then some phone calls to finalize your methods, then the bigger project. You both use the same methods throughout the study, you don’t communicate with each other about results during the study itself, and you tape everything. All along you send results, sealed, to a willing neutral person, who will do the counting. At this stage of research in our field, we have no need for complicated statistical analyses and the isolated therapist should avoid designs that require them. Follow-up is important, and should ideally be written or taped. The neutral person should analyze the follow-ups, too. Then you’re ready to write the paper that will put your research into the potluck, and this you do together.
This model is especially useful because you can get large numbers of subjects and you can actually set up a control group if your project calls for one. Realistically speaking, you yourself might not find it easy to get and work with 45 migraine sufferers for a one-researcher project, but if you and two distant colleagues can find 15 each, you’ve got 45 and can map out a really good study, control group and all.
- The best way to avoid the problems of isolation is to get a colleague who is neutral (or even hostile) to your ideas to work with you directly, thus eliminating the isolation factor entirely. I say “neutral or hostile” because two therapists working closely together who are committed to an outcome are no better than one such. Your neutral/hostile colleague will not only criticize your plan or count your numbers, as suggested above; he/she could actually work with you to plan the study, carry it out, and write the paper. This kind of collaboration requires great honesty and commitment to finding the truth on both people’s parts, but it can result in excellent research.
Such a colleague may not be easy to find. He or she could be a therapist in another field or, if you are lucky enough to know one, a researcher in a mental health field. Either way, this person, being neutral/hostile, will find the flaws in the plan and curb any excessive enthusiasm that might distort your judgment. Having such a person as co-researcher will eliminate criticisms of a one-therapist model at the outset. Again, everything should be taped, and follow-up is, as always, important. Since you and your colleague are in the same geographical location, you may not be able to find as many appropriate subjects as in the method above, but with two people working on the project, you should have a fair number and be able to set up a control group as well if your project calls for one.
The four approaches discussed above are only suggestions of ways in which good research can be done by isolated therapists. All are flawed in one way or another, but then, no research in any field is ever perfect. You may have better ideas, and you will certainly have to adjust whatever you do to suit your research questions. But the main point is that it is possible for isolated therapists to carry out research and to do it well. There is, however, another traditional objection to therapist research, isolated or not.
The Second Objection
This objection is that when therapists do research, their subjects become as clients, no matter how they are gathered, and the ethical therapist must consider the client/subject first, project last. This is absolutely true: in all research with human beings, the needs of the client/subject must come first. As I have already suggested, one way to ease the situation is by not using your clients at all, gathering your subjects through ads instead, because people answering an ad expect to be part of a study from the start. They do not expect the same relationship with you they would have as a client. This is yet another reason for the advertisement method, recommended above. But even when this is done, as a therapist doing research on a form of therapy, you have special obligations toward your subjects.
Certain safeguards for ethical treatment must be built into the study from the start. Indeed, without them, the Journal will not publish your study. The place to find those safeguards is in the American Psychological Association’s Ethical Principles of Psychologists (revised), 1981. This statement can be ordered from the APA Order Department, 1400 North Uhle Street, Arlington, VA 22201. The Principles are essential, and will help you design a solid, ethical study.
There are ten Principles discussed: responsibility, competence, moral/legal standards, public statements, confidentiality, welfare of the consumer, professional relationships, assessment techniques, research with human participants, and the care and use of animals. Obviously, all but the last of these are relevant to research in our field.
Briefly, subjects in research should be considered co-participants, should be told as much as possible about the purpose and methods of the project so they can give truly informed consent, should be debriefed after the project and told the results, and should be treated for any negative aftereffects. Confidentiality should, of course, be guaranteed, and needless to say, they should not be charged for sessions. In studies using a control group, subjects assigned to the control group should be told after the study that they were so assigned, and if the past-life therapy was effective for the actual subjects, control group people should be offered similar treatment gratis. The above covers the basics pretty well, but you should send for the statement itself before designing your study.
The APA’s Principles are the standard for the industry, so to speak, and building them into your study will strengthen it. For example, rather than some vague and rambling initial interview, after which you as researcher/therapist decide that this person would be good for the study, the initial interview can cover very specific things: explaining as much as possible what the study is about and how it will be done, guaranteeing confidentiality, securing informed consent, and gathering demographic material. This is easiest with people who have come in response to a specific advertisement, who already expect to be part of a study.
By adhering to the APA Principles and having the papers and tapes to prove it, you ensure that you have met the best standards in Psychology in your treatment of your subjects.
After your project is done, you write the paper that will carry your findings to the potluck. Many people have no problem with this aspect of research. Writing comes easily to them and once the research is done, they put it on paper smoothly. But others seem to think that writing research papers is too complicated, too specialized, positively arcane. Not so. In fact, writing a report of a well designed study is one of the easiest forms of writing because it is so straightforward and organized.
Before you start your paper, which I hope you will intend for this journal, familiarize yourself with the Journal Guidelines, found in every issue on the inside back cover or available separately from the Editor. Then you get to the writing part.
The first great rule is, write it clearly, simply, directly. Remember that you are writing to your fellow therapists and researchers, and we are all eager for your findings. So, in a general sense, and briefly, here’s how the paper can be organized. (Notice I said “can” be organized. You are free to adjust).
- Abstract: Write this last. For the Journal, it should be between 75 and 150 words, and is really a re-write of the Summary section of the paper. Use third person for the Abstract, although you may use first person in the paper itself if that’s appropriate.
- Introduction: You tell us why you decided to do the study, and who went before you, whose case studies intrigued you enough or what experiences from your practice made you ask your research question. In the introduction, you tell us the Question. For large studies that compare two different therapy methods or groups of people, it is best to shape your question as an hypothesis, but this should have been designed into the study from the start. For the isolated therapist, as I said above, small studies that are exploratory in nature are best and the Question is just that, a question.
- Method: You tell us what you did. How did you get your subjects, how did you screen them, separate them into groups, brief them, and so forth. How many were there, male/female, age, whatever demographic data you have gathered. (It is good to keep track of this data because it may turn out to be relevant for this or some future study). Did you use a pre-test/post-test design? (A “0 – 10” scale on which the client ranks the severity or frequency of his or her symptoms before and after is fine and puts things into numbers, always satisfying to other researchers and editors of journals. However, your scale should have exact descriptions of what each number means). When you have told us all this, it is time for the next section and the one we are waiting for: Results.
- Results: Here you tell us how it all came out. Did your subjects improve? How much, along the “0 – 10” scale? Did one group (women? over-40 men?) improve faster than another? With a small study, you cannot fine tune these findings too much because you do not have enough people in any one group to draw conclusions. But in your Results section you should note these things anyway. Once you have presented your Results, you go on to the Discussion (sometimes called Conclusions).
- Discussion: You tell us what your findings tell you about your research question. This section should address four areas, at least. First, the positive findings: where your treatment worked and what that may mean. Second, where it did not work, and what that might mean. Third, what strange things happened? Why did the over-40 men improve fastest? You do not know the answer, but you raise the question and suggest further research to answer it. (Notice that you have just moved into your next research project). Fourth, what would you do to change the study if you did it again? What flaws or problems did you find as you went along? There may be other things you want to discuss in this section that are relevant to your study, and you are free to do so.
- Summary: Some papers do not include this section, but it is a good idea. Here you recap the question addressed, the basic method used, the results, the conclusions you have reached, and any new or lingering questions, such as the mystery of the over-40 men.
- References: The Journal follows the latest edition of the APA Publications Manual, Revised, available at most university bookstores or by mail from the APA Order Department address above. However, the quick way is to follow the papers in the Journal itself; use them as models for your format.
As a last word on the paper writing part of your project, the Editors of the Journal are ready and willing to help you whip it all into shape. If it is a good study, the Journal wants it. If you need help with the paper, say so and you’ll get it. We will not write it for you, but we will try to suggest ways to help you make it professional and sound.
I began by talking about all the case studies we have amassed over the years since the infant Bridey scratched at the paint of her crib and, in so doing, scratched at the door of our astonishing field. That door is fully open now. The many case studies since Bridey have mysteriously overlapped and bonded together into the bedrock of our research. We all love case studies, especially case studies of previously unreported past-life phenomena. We still need them to bring new ideas into our field.
But we also need to build on the bedrock they have given us. We cannot stay at the case study level and build our field into a truly professional discipline. With case studies alone, and in a field as controversial as ours, we will not be taken seriously and should not take ourselves too seriously, either. Some research has been done, but we need much more. So we must look at the case studies, find the common factors, find the researchable questions inherent in those common factors, and structure research on whatever level we can personally handle well to answer those questions.
By “we” I mean you and me. Each of us. All of us. We are our field, we are the past-life therapists and must be the researchers, too. There is no one else but us. We are the ones who must make and bring the dishes, new and strange to the rest of the world, to our potluck feast of past-life research.
So that is where we are now: Moving beyond the case studies, using their precious hints and directions to build the research projects that will shape our field.
Baldwin, W. Report of a study. The Journal of Regression Therapy, 6, 1. 1992
Bernstein, M. The Search for Bridey Murphy. New York: Pocket Books, 1978 (1956).