A PERSONAL STATEMENT BY A BOARD CERTIFIED CLINICAL PSYCHOLOGIST
James Carpenter, PhD, FAACP
Psychologists tend to be an excellent lot. This should be affirmed, and I believe that board
certification is an important way to emphasize and affirm our excellence, individually
and collectively. Our profession intrinsically embodies a commitment to excellence,
and it is important that we personally to reaffirm that ourselves by board certification.
Board certification is the designation now being used for those who have passed the
American Board of Professional Psychology (ABPP) examination in clinical psychology,
or one of several other psychological specialties. Previously these psychologists have
been referred to as "diplomates." Just as medicine uses board certification to signify
a high degree of competence in some medical specialty, the ABPP diploma has been
created by psychologists for the same purpose. I think we can discriminate two related
aspects to the meaning of certification: it recognizes proficiency in a psychological
specialty, and affirms our commitment to professional excellence. Both proficiency
and excellence are important, but it is the latter aspect I wish to emphasize here.
I have seen at least three facets to this excellence of psychologists. First, many unusually
able people elect to join our profession. When I was teaching at UNC Chapel Hill, I did a
little arithmetic one year during the admissions process to the Clinical Training Program.
With their distributions of test scores and GPAs, our many hundreds of applicants would
have stood a ten-times better chance being admitted to our medical school than to our
program, and a fifteen-times better chance with the other programs offering a graduate
degree that would equip one to be a psychotherapist. Yet these groups of gifted young
people chose year after year to compete for the chance to become psychologists.
Secondly, in my experience psychologists frequently demonstrate excellence. I have
worked in several mental health centers and two state hospitals, and at each place I
noticed that the psychologists quietly rose to the status of an unofficial elite. Other staff
looked up to them because they simply had proven themselves to be unusually helpful.
Their patients became more highly functioning, their patients' families became more
humane and less pathogenic. The other staff with whom they worked were helped to
be more communicative and cooperative and inventive. When psychologists assumed
administrative duties, their staffs tended to become elite themselves, investing new
energy into treatment and creating new alternatives for care. Of course, not all
psychologists had this touch, but many did, and the proportion of them having such
competence and energy and humanity always seemed to be the highest among the
various professional disciplines.
Finally, it seems that most are drawn to this profession by what we might call, in an
old-fashioned way, some sort of "higher calling": motives with their own intrinsic
pull toward excellence. My own motivation, I think, was primarily an urge to explore.
I remember in high school telling friends that I figured I would either become an astronaut
or a psychologist - that I would explore either outer or inner space. Being a military pilot
was about the only path to astronautics available in those days, and that was out for me.
So inner space it was. Different motives have drawn others, but whatever the reasons,
it tends not to be simple status or wealth or the wish to change the world to fit
some moralistic prescription, because other disciplines offer more direct routes to those
ends. We tend to value understanding as well as change, problem solving as much as cure,
and scientific clarity as much as healing. We tend to value our clients and deeply identify
with them as human beings. We are committed to hard scientific work with which to
shed new light on human nature and problems and remediation. We are open-minded
toward outcasts, and optimistic about the human beast.
I do not wish to boast, but it is good to remember our excellence. Our sense of it has
been somewhat battered in recent years. Managed care has created an environment
in which excellence would not seem to matter. Even more demoralizing than managed
care for psychologists, in my opinion, is the trend in our popular culture toward biological
reductionism (the presumption that the more physical an account we can make of
something, the more "real" our understanding is). Judging from what the media tell us,
we are all essentially nothing more than incidental repositories of genes, pathologies and
imbalanced chemicals. Psychologists are natural holists, and we sense that while drugs
may be useful, a world-view based on drugs is tragically short-sighted. In a recent
newspaper I ran across two articles separated by a couple of pages. One seemed a
thinly disguised press release from some drug company reporting the effectiveness of
some compound in curing depression which, we are reminded, is now known to be a
purely physical disease. The second article reported that psychiatrists with the World
Health Organization had determined that almost all the women in Afghanistan are now
clinically depressed. Are all of these women mysteriously Zoloft-deficient? Or does it have
to do with living in a savagely oppressive, dangerous environment which individuals feel
helpless to change? There is certainly a chemical substrate to the depression of these women,
as there would be to happiness or to anything else human. But to seek a complete
understanding of the phenomenon at that level of analysis is foolish, even though newspapers
and physicians seem often to forget that fact. Psychologists can help keep things like this
in perspective. We seek to understand minds and bodies, experience and behavior, all in
the context of whole human lives in interpersonal environments.
Why board certification? Because ABPP is the machinery we psychologists have devised
to define and declare our own highest standards. It is a time of extraordinary challenge
and opportunity for the profession. Our numbers have exploded, and at the same time
economic forces threaten to destroy our livelihoods. It is well and good to spend time
thinking about "retooling," or coping with managed care, or avoiding lawsuits; but I believe
it is more important to remember the reasons we became psychologists, and reaffirm our
own personal striving for excellence. We stand for psychological knowledge and psychological
change. The world needs us.
James Carpenter, Ph.D., FAACP
(formerly) Board of Directors
American Academy of Clinical Psychology