Science Beyond the Lab
How working in a mental health facility changes my understanding of science
As a graduate student, I never felt impostor syndrome. My peers described it. “You don’t think you’re good enough” or “you don’t feel like you belong.” It was a common response to intellectual insecurity. People with impostor syndrome didn’t believe that they could make a real contribution to scientific knowledge. But I felt like a seminar room superstar. Give me four articles to read for a class and an hour to discuss them and I’d be invigorated, inspired, and able to see exactly what was missing in the current research program. I knew I could pull apart the logic of psychological science and find what was real, what was questionable, and what still needed to be understood. Now, I’ve left that world behind. And I feel impostor syndrome all the time.
After years of research experience at multiple universities and in collaborations with huge organizations like Lockheed Martin and the U.S. Army, I landed a role as a researcher and statistician at a large, nationally recognized mental health facility. I collect and analyze outcomes statistics for our facility. This can be used to help plan out treatment, and I’ve had to create custom report templates to share with both patients and care providers. It can also be used to evaluate our success as a facility. I’ve built a reporting pipeline that creates periodic treatment outcomes summaries. And it can be used for custom business purposes, like providing evidence to insurance companies that our care improves lives when negotiating to go “in network.” All of this technical data manipulation stuff feels good to me. It’s the kind of work I understand, and I’m pretty good at it.
What gives me impostor syndrome is the gap between the questions that patients have about their mental health and the answers that I can give from the research. When I was doing research on, for example, how social interactions influence economic decision-making, I felt like a new twist or perspective on the topic was a real contribution. If we didn’t fully understand the phenomenon—and there were always loose ends that where “more research is required”—it was fine. That’s what our long, glorious scientific careers were for!
But now, the need for answers feels urgent. I might be giving data to a patient, their therapist, and their psychiatrist that they expect to use to understand if they might have PTSD or depression or ADHD. And while there are certainly expert clinicians making any final decisions, there is a new urgency to getting my part right. I don’t just want to have an interesting perspective, or to complicate a simplistic picture with nuance. I want to be able to give people a reliable sense of what’s going on with their mental health, and how they are progressing. Getting it right matters—not just to me, but to the people receiving my information. I don’t just have “participants in studies” anymore. I have real people, looking for real answers, with real problems. And I’ll probably see them in the hallway while I go get coffee and they head to an intense and emotionally draining therapy group.
In grad school, a student in my program who was a few years above me told me about the job application letter that ultimately got her a faculty job at a research intensive university. It basically said “I study this topic, and I know how to publish scientific research in elite journals, as evidenced by these three A-level psychology journal publications. Hire me.” And they did. I always thought that’s essentially what being a scientist was—or at least what it was going to be for me. I would learn the rules and the game of doing interesting studies, writing for important psychology journals, and pushing articles through the arduous revision process to acceptance. And then I would do it again and again, until I had enough A-level psychology publications to be named a Prince of Psychology and receive my reward of tenure in a small town in a state I had never previously considered visiting.
For a while, I was delivering psycho-education lectures to groups of patients. I remember giving one on the idea of psychological networks as a new way of looking at mental health. This was a very cool new idea when I was in graduate school, one that really countered a lot of the conventional wisdom about what a mental health diagnosis was. Instead of depression as coming from some underlying single thing—something like a depression brain deficit, or a depression gene—you could think about mental illness as being defined by a series of self-reinforcing feedback loops that together define the problem. For example, depression might really be just a name for a pattern of sadness and low motivation, which then caused someone to be less active, which then disrupted their sleep, which then led them back into sadness and low motivation. There is no magic brain deficit or gene, no single cause that you can zap back to health with a pill or the exact right therapeutic protocol. It’s a pretty deep, cool idea, right?
Except, when I was explaining this to a group of patients, I hardly got 15 minutes in before I heard the question “so what?” What does it mean, for a specific person with a serious depression, who hasn’t had good luck with antidepressants, that depression is a network? Why should they care?
This is, embarrassingly, exactly the type of question I never asked in graduate school. I have sometimes heard physicists say that they have a sense of which ideas are right because those ideas are beautiful. Theories that are true just have a certain attractive logic to them that makes thinking about them feel right. It was like that for me in psychology. Certain ideas just felt right. They felt exciting to contemplate, to play with, to apply to new areas. I was lost in the happiness I felt at being an intellectual—without focusing back on what real problems I was trying to solve. Seeing someone struggling, and then struggling to answer their most basic and immediate question, is humbling. It also reorients my perspective on science.
The kinds of questions I wanted psychological science to answer in grad school were big and philosophical. What are the functions of emotions? How can we really know what scientific results are valid, and which are flukes? How has evolution shaped the human mind?
The kinds of questions I want to see answered now are much more practical and immediate, and, in a sense, they’re not really my questions anymore. They’re the questions I have been asked, and that I think we psychologists should be able to answer. They are not part of “what about?” or “isn’t it surprising that?” research projects, but “here’s how it roughly works” or “here’s what would happen if you did this” types of research projects. They exist to solve problems, more than create them (even though, done well, science does always create new questions).
These are the kinds of questions that, as a society, I think we need to see answered more from science. There is a declining trust in science in modern U.S. society. Science itself—as embodied by scientific establishments like the National Institutes of Health, scientific journals, and professional organizations like the APA—is being driven into an ever-expanding political propaganda war. People see this “Big S” Science—science as embodied in its institutions—as elitist and disconnected from everyday concerns. Part of this is due to irresponsible messaging backed by specific agendas, be they political or corporate profit-protecting. Countering this messaging is important. But so, too, is reshaping science so that it answers the questions that people broadly still want—and need—answered.
I’m writing about my journey from academia to industry to reintroduce this space, and present its newer focus. I’m a different person that I was when I started writing about psychology research methods for Psychology Today in 2018. Life, as it does, has changed my perspective. What I’d like to present here is a perspective on how psychological science can help people survive, thrive, cope, and regrow, in the practical, measured register of a scientist working in a clinic.